Still Here...

It's a whole new post.

The first since '08.

Still on Adderall.

Still on Lamictal.

Still in a crappy job.

Still making very little money.

Still easily distracted.

Still hoping for a corner to turn.

But studying for the LSAT.

Wish me luck.

Happy ADDiversary

June 5, 2006 was the day of my appointment. I won't rehash. It's all in the blog. But what's happened since? You decide.

A diagnosis is a blessing. But it's one of those blessings that doesn't always make in time for the good stuff. I learned I have ADD. I learned there is an explanation for the frustrations and inconsistencies of my life prior to June 5, 2006. But it hasn't explained ...

Goddammit. I can't be philosophical or reflective. I can barely write anymore. And I'm a fucking writer for god sakes. I just feel it slipping away since my ADD diagnosis in 2006. Soon after the ADD, i was given another diagnosis, Cyclothymia, which is a mood disorder within the Bipolar spectrum.

I learned that 1) Bipolar isn't all madness and psych wards. 2) And that I have Bipolar disorder.

Fortunately, there's a nice, fuzzy type of bipolar disorder called Bipolar II. And, golly, it doesn't make you a mental patient. It just makes you an irritating, unpredictable asshole who can't get anything done with any degree of competence or consistency.

And I take meds. I take 300 mg of Lamictal every morning, followed with 60 (30 2x a day).

Don't misunderstand. As I said in the first sentence, a diagnosis is a blessing. I'm lucky. You couldn;t count how many people spend their lives meeting doctor after doctor to learn they have depression, anxiety, anger, schizophrenia, ADD, ADHD, OCD, ODD, and from the non-believers, a incurable case of being an asshole.

As the road of misdiagnosis progresses, disorders building up like bumper stickers on a Volkswagen bus, breathing life into ponderous regimens of prescription medication.

So I'm lucky. I'm lucky because I'm medicated and no longer spend life feeling like a skateboarder trying to hold onto the icy back fender of a bus, that any moment i'll lose my grip and spiral into the low-grade blackness keeping the rot colored glasses welded to my face.

But I cant write. I can't out my thoughts into words anymore. It's become hard. I procrastinate, ruminate, obfuscate, and masturbate. The Lamictal robs me of words, so my verbal and written expression sounds dull, feels slanted, and takes forever to finish.

i've been working on this too long. I have to get something else done. I started it at 4 p.m. I promised it would be done yesterday. I'm doing as a favor for a friend and not getting paid, there is PAID work from PAYING waiting for work. I won;t get paid until it;s done. And I'm falling asleep.

Happy ADDIVERSARY to me.

It's just a mood (disorder)

The therapist has convinced me I have a mood disorder. It's slight, the therapist says, but it's real. What's mood disorder? It is something that falls between BiPolar II (less manic than Bipolar I, but with the cycling between moods), and more serious than occasional depression. Mind you I first heard about this one week ago and went loony at the thought. What began as ADD is now a diagnosis for a mood disorder. It makes sense. My whole life I have suspected that I had some kind of chemical imbalance. It just seemed odd that I could be in a room of people I liked and who were having fun, and just feel this dead, lifeless, boring, non-stimulated feeling. I felt it at weddings, on simchas torah, and at times when everything was just super. I'm not sure if it's related but I could cry after seeing a touching McDonald's commercial of the cheesy end to a feel good movie that went straight to video, but cannot cry on hearing of terrible tragedies or sad events. I did cry when my grandparents died so I know I'm capable of the emotion. But I digress. Wherever I have gone my entire life, I have experienced this disconnect to the current mood. I have a hard time feeling happy, though I have felt many, many moments of extreme happiness, joy, optimism, and confidence. Yet, these are always counterbalanced with moments when none of those feelings apply. So it's a mood disorder, aggravated by ADD, and exacerbated by what the therapist says are genuine areas of genius. I never heard that one before, but I've shown the therapist some of my writing and the therapist feels the genius is definitely there. Not that you can tell, by the way, from this meandering drivel. What's the answer? The therapist and my psychiatrist have a conversation and they decide a mood stabilizer is the answer. I'm already taking Welbutrin, an anti-depressant, but the consensus is, it isn't working. Mood stabilizers come in all types and flavors. The point is to allow ME to control my moods and emotions, not the arbitrary levels of brain chemistry at any given time. With the mood stabilizer in my system, I don't have to worry that my response will be to a particular event or situation. Although I didn’t have the vocabulary or insight at the time to understand, I was worried on the way to my wedding that I wouldn't smile enough or feel happy. Fortunately, everything was fine, which put my marriage off to a happy and thankfully continuing start. so the answer is a mood stabilizer. The drug of choice is Lamictal. Supposedly this is a wonder drug. Reading some of the online commentary supports this claim. Benign and effective, Lamictal is usually used for people with seizure disorders. It's also one powerful mother f-er drug. Supposedly, if I am to be staying in this drug for a prolonged period of time, I would need to carry some type of ID letting medical personnel that I am taking Lamictal in the event that something happens to me and renders me unconscious. Pretty scary. Also, a very serious side-effect is a type of rash that can be life-threatening and cause physical debilitation if left untreated. Fortunately, I've been on the drug a few days, and although I feel nothing yet, it hasn't given me the feared rash. I'm still taking the Wellbutrin, though I'm being eased off of it. The Lamictal is supposed to cause nasal congestion, which i have, nausea, blurred vision and motor coordination problems , which I do not have. On the message board, a few people mentioned that it could impede verbal acuity and articulation, two side effects that to me would be completely devastating. The dr. told me he/she has heard no such thing. Relived at hearing that, I've been taking it the past few days. It's too early to know what if any effect there will be. Another side effect I heard about is vivid dreams. This is a typical side effect of SSRIs, and evidently is common with Lamictal. I have been having weird dreams the past few days, though I'm hesitant at this time to blame it on the drugs. I frequently have weird dreams. I hope this is all going somewhere constructive.

Good times. Bad times.

A few good weeks...then a really bad one. See for yourself:

Dear Dr. XXXXXX,

Shavua Tov. I really do want to speak with you, though I haven't had the time to return your call. It may just be more efficient to write down what I'm feeling.

Forgive me because I do tend to go on, but cutting to the chase, I'm rapidly cycling between depression and relative calm, I am feeling absolutely incensed that I am going through all this, when I feel it was all pretty much in check as XXXX, the day of my first appointment with Dr. YYYYYYYY. I am furious at Dr. YYYYYYY who I feel is completely detached and seemingly unable to see a therapeutic approach that goes beyond the way I'm feeling at the particular moment I'm in his office, I am feeling as if the Wellbutrin is doing nothing and I'm considering going off of it, because....well, why the hell am I taking pills?, and last, I am absolutely furious over my complete inability to respond to the typical, albeit very, frustrating things that happen to everyone else on this planet without becoming completely unhinged and falling into depression.

I'm frustrated, I am very behind on my work, I feel as if all this is going nowhere, and on top of it all, I can't believe that I'm going through this when I was doing so well until the day I met Dr. YYYYYYYYYY and started taking pills.

If you want to know, and if you can stand to read through it, allow me to present this introductory narrative of the events, which bring me to writing this email. I'll ultimately get to the point I've just made above:

This morning, I came home from shul approximately 7:15 a.m. and went down to my home office and noticed along one of the basement walls, water was streaming down from the ceiling. Long story short, I find the source of the leak, realize I need to call a roofer, and do what it takes to catch the water at the source so it doesn't destroy my house and office. In the midst of my frustration and strong irritation over the damage, thinking what it would cost, blah, blah, blah, I yell at my 8-year old son.

He chose the wrong moment to mouth off to me.

My son is very (very) smart, very independent minded, and extremely volatile. He's sensitive, serious, and very detail-fixated. Evidently, me screaming at him set him off. A short while later, after waiting for 15 minutes at a bus stop with my oldest son for a bus that never came, I return home to learn that my 8-year-old is having a meltdown for several reasons, among which he wanted a water bottle that was A) unopened, and B) cold, when we were only able to offer him one or the other.

So I'm attempting to calmly negotiate a settlement with him, at 8:20 a.m., he's supposed to be at school already, I had just stood on a rainy bus stop with my other son for 15 minutes for no reason, my wife is on edge because she is not eating due to a medial appointment later that day, and our Spanish speaking cleaning lady is in my kitchen yammering into a cell phone because my wife had been unable to communicate to her the schedule for the day and needed a translator. Meanwhile, I desperately needed to start working, and on top of everything, still upset about the roof and rain in the house.

Mind you, I'm not actually thinking about any of these things at the moment, but my son takes it one step too far and I absolutely lose it. I throw a water bottle across the kitchen, which explodes and soaks the counter.

This is the big no-no in my life. I have a long history of absolutely losing it. I embarrass my wife and she gets extremely upset when this happens. Although I have almost completely ceased such outbursts since last XXXXXX, all has resumed since early XXXX when I began the treatments for ADD. In fact, my wife brought this up to me the other day in the context of: “I think about how wonderful you've been all year and I think, 'That was nice.'"

In the throes of my fury, my wife extricates me from the situation by inviting me to go downstairs. I quietly apologize to her and then stomp down to my office in an attempt to begin my day.

From there, my day is uneventful, even relatively pleasant, until much later. A 1/2 hour before Shabbos, I had just bailed gallons of water from the bottom of a clogged shower so I can unclog it with Draino, on the recommendation of the hardware store guy (only later, after reading the label, did I discover the bailing was entirely unnecessary and the guy was wrong), and I go down to the kitchen to overhear my wife mention to one of my daughters that there are no potatoes in the cholent because she ran out.

In that split second I think: I've been home all day, you could have told me to go and buy some potatoes...cholent without potatoes tastes like industrial sludge. I stupidly stand there with a look of amazement and say out loud, "Why didn’t you tell me. I can't believe it. That's a total waste." My wife hears this after, unbeknownst to me, the children had just harangued her dozens of trivial complaints after a long, difficult day for most of which she hadn't eaten, along with dealing with a number of other things. She starts to cry and storms upstairs.

This is the worst possible thing that can happen. I try as hard as I can to never piss off or insult my wife and would go to any length to avoid making her feel bad. Making her cry is the absolute last thing I ever, ever want to do and have a fantastic track record. But now I've made her cry and there's nothing I can do about it except run after her apologizing. She wants to be alone and goes to take a shower.

Here's where my point begins:

I get angry. I'm pissed. It gets bigger and bigger. Soon I'm running around the house yelling and screaming for the kids to pick up all their things. I go back to my room and I just feel incredibly furious. Essentially at this point, I'm slowly becoming non-functional.

This is what happens to me: I feel this fog, almost a weight descend into my head. I feel burning mad and can barely bring myself to talk to anyone. I slow down. I can't get ready or dressed at any semblance of a normal pace. It's painful. It just feels like intense emotional pain inside accompanied by a numbness in my senses that doesn't go away.

Even though my wife is out of the shower and already over it, I'm not. I’m not talking because I can't. I can't think coherently and everything to me is just terrible. My thoughts center on, "You're a loser, you can’t do anything, your business is a disaster, your professional life is pathetic, you're pathetic, everything sucks, etc."

My wife is talking to me and I grunt or reply in monosyllabics. Ultimately, I get dressed, very long after Shabbos began, and my two youngest kids essentially drag me to shul. Even then, they're talking and I can barely process what they're saying let alone respond.

This continues until I get to shul. To my surprise, I discover that I’m not as late as I had imagined and actually get to daven ma’ariv with the minyan. I feel much better, so much so, that when I get home, I ask my wife if she's my friend and she cryptically answers, "Am I YOUR friend??" I have no idea what she means, we have company for dinner, and the meal goes off just fine.

I go to shul the next morning, with a sort of neutral feeling: not happy, not depressed, Daven the whole davening and do all the things I'm supposed to do. My wife and kids are in shul, there's a Kiddush and my wife asks me if i want to go. I really don't. I'm not feeling social and defer to her. She says she doesn't care so and I say, “Fine, let's go home.”

While we’re walking, she says to me, "What was going on last night?" I have no idea what she is talking about.

To avoid having to write the entire dialogue, my wife tells me that I'm always pissed, she tries as hard as she can to anticipate what is going to set me off, and that I just seemed all angry last night and she had no idea what she had done.

.....OK. Tachlis. I can't be this person. I'm have not always been this way. Yes, my life has been rife with these mood episodes and I'll concede I may have a slight mood disorder. But this is getting bad. It has been this way, excluding the months of XXXXXX to XXXXXXX, since the fall of XXXXX.

The cycling back and forth, the depression, the wheel spinning. I can stand this anymore.

Though at this moment I’m sort of OK, I do not feel as if I am not in control of my moods and emotions ever since I started this whole stupid ADD thing. I feel as if no forward momentum is happening, while I just fall deeper and deeper into dysfunctional behavior.

It is not good. I am not doing well. And I am at an absolute loss. But it is getting bad.

I’m afraid things are falling apart and my life was far from falling apart four months ago.

Please let me know what to do.

Thank you,
addingyears

You're putting me on what!!

...Zoloft. The concerta made me batty. i went to the doctor on Monday and my telling him how loopy i was feeling -- angry, sad, depressed, irritable, moody, schmucky, etc. -- he decided that a) I shouldn't be on stimulants, and 2) I should move up tp a an SSRI. Now SSRI's are scary. The list of side-effects is longer than my arm and the descriptions get scarier as you move down the list. I'm not going to take it. I haven't filled the prescription and I'm waiting for the Dr. to return my call about my decison. It occurred to me, when I went to a meeting immediately after seeing the Dr. that i'm not out of control, i can function, and suprise -- when I'm in a meeting, I'm fine. i'm better than fine. i'm the myself that i like to be when I'm not depressed. This happened to me all shabbos. I interacted wonderfully with guests, with people i met later that day. No doubt, that morning in shul i was losing it and picked up and left the moemnt I could. But then I swallowed a bunch of concertas on Friday. I'm positive the concerta is what sets me off. There is no question that i have issues with depression. But I believe the Wellbutrin has at least been keeping me even. Going to Zoloft will not end well. And it isn't necessary. I suspect the doctor is being "Mr. Fix-it" and chagning strategy depending on the way I feel when I'm in his office. I don't understand why he doesn't see the clear connection between the concerta and my heightened state of depression. I'm not feeling depressed today, but i started the day on a high note and it just went downhill as the hours passed with the same projects sitting on my desk going uncompleted. now it's 5:25 and the two things I promised two different clients are still no complete. The phone call i promised to make yesterday still hasn't been made and the bills that need to be paid by tomorrow are still sitting here. what did i do today? Who knows. But ask me how many times I checked my email....how long I was websurfing....how long I was talking to irritating clients on the phone...how many papers I shuffled around my desk. The answer is: enough to waste the entire day. i'm not as depressed the last two days. The meeting broke my fund and it's been smooth sailing since then. The quesiton of course is when will be back. More on that next post. But trust me, I do not plan to be on Zoloft by then.

BTW, I'd love toknow what people's experiences with Zoloft have been. Either leave a comment or email me at addingyears@gmail.com Thanks!!

This isn't going well...

I’m concerned that I've unleashed some type of monster. I've always had difficulty with work, I’ve always cycled through depression and I’ve always felt that I wasn't doing everything I could be doing. But I'm on the Wellbutrin, which form what I've read is supposed to be the happy it's all good pill, and I'm definitely not feeling happy or it's all good. I have a scowl on my face and i feel like I'm in some type of involuntary emotional pain. I sat in shul yesterday in this pissed of mood and just left as soon as it was socially acceptable to slip out. I'm upset because work is really getting to me. My job is shitty. I am a writer, I own my own company. My work allows me to operate on the hours i set at the pace I choose. My clients come from all over and they just come. i don't make a lot of money, but I don't have to lift a finger to get projects. Thank god. But the approach I take to my work is completely haphazard. I have no rhyme or reason and I'm only marginally organized. I work from a dingy basement in my house but spend hours upon hours sitting in the same chair. I am a chronic procrastinator so it will take hours, sometimes days before I will attack a project. Then it could take forever to finish. The amount of tie I spend ruminating over my work is starting to truly affect my life. I haven't gone to shul in over week, not counting shacharis on shabbos. I have no desire to ever daven again, as far as I'm concerned at this moment The way I feel this moment, is that religion is a trap and I feel trapped by it. i want to be free and not have to do all the things that are expected of me just because that's where I live and that's what my kids need to see. The feelings I’m having are just dread, sadness, anger, and complete dejection. It took me 5 hours to write a 400-word article this morning and then another three to write a small feature of 300 words. The work is nice when I get into it. But when I step back and digest how pointless my professional life has become, I want to gag. Piles of work, brochures, letters, advertisements, the list goes on and on. My sense is that I could spend literally forever in my office and not finish my work. But here's the kicker.....i don’t have so much work, i just takes goddamn forever to get anything done. In the context of this blog, it should seem pretty clear why I'm having trouble. Because I have ADD, right. But I don’t think so, and this is where the monster has been released. i went on welbutirn to take care of the depression. It worked for a while, I guess, because I wasn't particularly depressed. But then i went back on the concerta and it didn't really work. so i stopped taking it. The other day I thought let me try it, but on a larger dose. I took a larger dose. Barely an effect. Then I took another dose in the middle of the day. By the evening I was just so depressed. I was so focused on how little work I had accomplished that week. I did spend most of the week just jerking around on the internet and wasting time, bullshitting clients, and pretending to get work done. i just couldn't get myself to work. It all began earlier this week. On Monday I went to see my psychologist (I can't fucking believe that I'm seeing two mental health professionals and taking anti depressant and stimulants, what the fuck happened to my life!!!!!!!). It was a pretty heavy session, not content wise, but for the conclusions she arrived at. She seems to feel that i have some type of mood disorder. I think that all this crap with me going for therapy for ADD and taking all these drugs and telling myself that I have this diagnosis is making me crazy. I literally spent an entire year with almost zero depression. i find out I have add, take some meds, and now I'm a fucking basket case. There has to be some connection, either from my personal feelings about all this, or its the drugs. All I know is that I'm exactly where I was last year and quite a bit set back from where I was this current year. I’m going to see the psychiatrist tomorrow. I wonder if he's giving up. I spoke to him today and he said, I don’t want to put you on any other stimulant because I don’t really understand why you're feeling this way. This is fine. The thing I'm worried about is the way I've been feeling. I can't go on with these insane cycles of feeling ok and feeling like shit. It's an insane existence that I blame on my inability to be organized, lack of structure, and oh I don't know. I'm just not in a very good place today. By the way, it took about 9 minutes to write this 900 word screed. Why the fuck does it take me 5 hours to write an article?

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.