It's 2:18 AM and I Still Have Attention Deficit Disorder

You'd like to think this sort of thing goes away. Now that I know about it, the ADD should just stand up and with a humble bow, doff its hat and say, "It's been a great run, but I must be going now."

It didn't exactly play out like that. I have Adult ADD and by finding out in my thirties, not in the third grade, means I have to deal with the huge gaps in my education and the consequences of lapses in confidence that led to poor career choices and a lifetime of wasted potential.

I've always known of my talents but never used them. I've always believed I could be making more money, but had no idea why I wasn't.

I don't like having ADD. It doesn't make me feel special -- like the sense of being different and special that I get from playing a musical instrument or being a lefty -- but rather slow, incompetent, and incomplete. I feel this way especially because the medication the doctor prescribed didn't work past the first four and a half days. Instead, it made me crabby, sad, and depressed.

The depression was intense, though I've felt that way before. Just not for a long while. In fact, I have worked very hard to combat depression. I felt as if the medication completely knocked me off the foundation I had created and put me back to where I had once been.

So the doctor took me off the stimulants and prescribed Wellbutrin, a mild anti-depressant that is commonly used to help smokers kick the habit. The Wellbutrin requires several weeks before any therapeutic benefit can be felt. I haven't gotten there yet and still feel the twinges of depression and defeatism that always lurked just below the surface of my life.

Although I am blessed in many ways, and can easily rattle off dozens of reasons why I should be the happiest man alive, I am in danger at any moment of falling into a depressed state.

I've long suspected I had a chemical imbalance of sorts -- how else could I justify times where I would spend a few hours in a restaurant with close friends, and find myself with nothing to say? Or to experience a mild setback at work and spend days consumed with anxiety and anger?

For a long time, I knew these feelings were involuntary and that something had to be wrong. But I couldn't bear to address the problem with a professional and label myself clinically depressed. I just didn't want to deal with it. The thought of going on anti-depressants was also terrifying. There are many side effects ranging from sexual problems to seizures and suicidal thoughts. It was a road I just didn't want to travel.

But my curiosity about possibly having ADD, on the suggestion of a friend, led me to speak to a psychiatrist about my experiences.

When I first met my doctor, he questioned me for nearly an hour before telling me I had a classic case of ADHD. I was confused because I'm hardly hyperactive; probably much the opposite. He told me that ADHD is the term used for all attention deficits, with hyperactivity or not. The technical subgroup is ADD-Inattentive and that is the term I use to describe my diagnosis.

He prescribed 18 milligrams of Concerta, an extended release form of Ritalin, to be increased after several days to 36 milligrams. The first few days on 18 mg were beyond description. I felt as if someone had switched on the ON button in my brain. For the first time, things seemed clearer, slower, and easier to process.

After a two days, before switching to the 36, I realized that I was getting very irritable and nasty at around 4 p.m. You can say many things about me, but "nasty" is not one of them. It was definitely a warning sign.

I called the doctor and he told me to take another 18 milligrams at noon. At this point, I was taking 36 milligrams in the morning and an additional 18 at noon.

Despite the increase, the benefits I first felt were diminishing. And I was feeling very depressed, frustrated, sad, and angry. I started oversleeping in the morning, a reliable symptom of depression. I was also getting very overwhelmed and angry with my work.

The sense of being scatterbrained and sluggish while working was more pronounced and the sense that learning that I have ADD had ruined my carefully ordered life began consuming me.

By the time I went back to the doctor, only two weeks after I had been first diagnosed, the term "basket case" was the easiest way to describe what I was becoming. The doctor asked how I was feeling when I arrived -- late -- for my appointment. The words, "Like crap," just tumbled from my mouth.

For the next 20 minutes we discussed what I was experiencing and he advised I stop taking the Concerta, and instead begin taking the Wellbutrin -- an anti-depressant. His reasoning was that I have latent issues with depression, which were triggered by the Concerta, and I needed to address the depression before I would be able to manage the ADD.

He told me that people with ADD tend to view the efficacy of solutions, advancement, and achievements as "All or Nothing" He means that people with ADD often feel that if something isn't solved, improved, or accomplished fully and perfectly, it's as if nothing has happened. He believes that my "all or nothing-ism" will hamstring any efforts I make in overcoming ADD. Therefore, to improve my chances of getting to where I want to be professionally, I needed to get my depressive tendencies in check.

While it sounds reasonable, I was horrified. "What the hell is happening?" I thought in panic. "Two weeks ago I was fine, now I'm ADD, not responding to stimulants and going on anti-depressants."

I decided that I would take the prescription from him and not take the meds. I would give all this up and just live my life, with ADD, and forget I had ever heard those three letters in the context of my miserable professional life.

It was only after speaking with my wife, who sounded relieved that someone had finally given me a way to manage my brooding, predictable cycles of depression, that I decided to give it a shot.

It's been about 2 weeks and then some. I still don't feel the anti-depressants (not that I feel particularly depressed, I just don't feel any different) and the ADD is still the culprit behind the pile of work on my desk and the foreboding I feel about the approaching Monday morning.

My next doctor appointment is on Thursday. I still have ADD and I don't know what is next.