September 22, 2010

The Racing Thoughts of Adult ADHD

For all of my adulthood, I have gone to bed very late. Now that I am getting some perspective on ADHD, and learning about the symptoms, and of the neuropsychological underpinnings of the disorder, I understand why. I never wanted to lay down in a quiet bed and listen to my brain revving, so I would exhaust myself until I passed out. Or in the past I would have a few (or more) drinks. That would dull the cavalcade of mental imagery.

Imagine you've got a nice vintage Mustang car. You've got it in your driveway. Your friend drops by and asks if he can sit in the driver's seat and turn on the ignition to hear the classic engine. You answer "yes, go ahead". He smiles, turns the ignition over and then jams his foot down on the pedal and the engine races out of control, your eyes bug out and you feel out of control. That's what it can be like with ADHD.

I think fast. I talk fast. I read fast. People have always commented on the fact that I can read a page of text about 10 times faster than Superman. But this isn't like bipolar disorder where there can be an unceasing pressure to spit words out, and often the utterances end in nonsense. Where the thoughts are inchoate, indecipherable jumbles of ecstatic confusion. No, this is simply because my brain runs very fast, and I either talk quickly or think quickly.

If I can match my thinking and actions with my environment, then I feel in sync and I feel okay - assuming I am filling my environment with activity and excitement (TV channel surfing, internet surfing, multi-tasking, talking, reading several books at once, engaging in several hobbies, bungie-jumping, sky-diving - you name it). But turn down the tempo on my environment and then I become uncomfortably conscious of the tempo of my thoughts, the racing, the sensation that I cannot control the speed of my thoughts.

So I don't go to bed until I'm worn out. I can be by myself for hours, but I have to be reading or doing something. I can go backcountry solo camping, but there I'm always exploring the woods, or collecting firewood, or cooking, or taking photographs. Alone with my thoughts, yes, but always matching the tempo of my internal world with the tempo of my external world so as not to get overwhelmed.

I described the train of thoughts in my head to the psychiatrist in my assessment back in April/May like that of a a lumberjack who is racing to remain upright on rotating logs in a river. You have to keep running lest you tumble into the water and get crushed by the massive logs. It is beyond your control and it feels threatening.

As I was falling asleep (or at least trying to) a couple of weeks ago, I came up with a new metaphor. I imagine that my mind is like a large boiling pot of soup with chunks of vegetables and chicken and such in it. Each item that boils to the top is a thought, quickly to be replaced by another totally different one - over and over and over. And it takes ages for it to slow down so that I can sleep.

I am now able to describe accurately a mental experience I've had for years: I'll be thinking (either as I'm laying in bed, or just generally during the day), and have an intriguing, or useful thought, and then all of a sudden it will be displaced by another thought - and I'm only left with the sense that I had something interesting to think about - and can't remember the damned thing! Quite frustrating! Sure this happens to everyone. But constantly? I think not.

But something interesting has been taking place recently. And I suspect it is due to the effects of the Strattera, and to a lesser degree, my own learning about the disorder, and new coping strategies that I am putting into place in my life. The racing thoughts I experience as I lay down at night, or simply during the day when I am in a quiet environment - the racing thoughts aren't there as much. At times there is almost a calm silence. A sensation of openness. Of alert calmness. Hard to describe, but it is a wonderful nascent sense. I am wondering if my dopaminergic and nor-adrenergic pathways are beginning to balance out, somehow becoming tuned and working smoothly. Maybe that's what is happening as this selective norepinephrine reuptake inhibitor (Atomoxetine - Strattera) takes effect in my brain.

Strange to reflect on it - but now that I've had several experiences lately of this calm alertness, this alert tranquility, I realize now that all of my life has been spent fighting against the rushing of thoughts and of both mental hyperactivity and impulsivity. What a drag that has been. What a darned drag (I am trying to remain family friendly, but substitute any adjective you'd like). Sad in a way, I feel bad for that guy who was me, all that time, never knowing that it wasn't normal to be fighting this. I always put it down to just being a nervous or insecure guy.

Anyway, I'm feeling good about this. Now I am trying to put into place more scheduled and early bedtimes for me. I need my beauty sleep of course. I need my brain sleep.

Cheers,

Mungo

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24 comments:

  1. Mungo, this is SUCH A GOOD POST. Even within the ranks of adults with ADHD it is sometimes hard to find others whose experiences are quite similar to ones own. (Even my husband's experience of ADHD is very different from my own most of the time.) Your description of how your mind and thoughts move is SO vivid, and so alike how I feel my mind moves. It's this rapid motion that makes it hard to follow what others are saying (like log-rolling!), and indeed, it took me until just last year, to figure out that other people's brains really didn't do this, and that it didn't need to be a struggle 100% of the time. I knew it...but I didn't KNOW it until I tried medication and saw the difference and...holy moly, what a difference.

    I only wish Strattera had given me this sense of calm you speak of. It mostly made me want to puke...I was calm, but absolutely on the edge of puke, way too much of the time. Concerta does give me a glimpse of calm and I enjoy it. Peace should not be so elusive. Being able to listen during a conversation or sit still in any situation...it feels SO GOOD. Relief.

    ReplyDelete
  2. Hi Mungo, found your blog this morning searching for Strattera and working memory an kept reading it througout this lazy sunday.

    I'm a 44 yr Dutch guy diagnosed with ADHD some ten years ago after a severe burnout. Back then started with Ritalin that didn't work, some anti-depressant that made me aggresive and later on Clonidine that did wonders to keep my mind shut up when going to bed. For daytime, medication didn't get me where I wanted to go so I focussed there on coping techniques and electronic reminder systems. All in all, that worked fine for me because as a freelance ICT-journalist my deadlines and clients kept me sane.

    Last year I almost went bankrupt (only partly due to ADHD symptoms) and unemployed. The lack of external deadlines made me more aware of the negative sides of ADD which in my case is mostly the inabillity to set only a couple of goals and stick to them. I always knew about my pour working memory but saw that mainly as an irritating side-effect of ADD.

    A few months ago I started to see a psychiatrist again to look into medication once more and I tried Concerta and dexamfetmines. They brought me some kind of hyperfocus but didn't work on the neccesary goals. So in my next appointment, it's probably Strattera that I'm going to try.

    I'm slowly learning that my working memory might be to blame for a lot of my troubles. The lack of it is legendary in my surroundings where not only I forget stuff, make a mess of work and living space but in conversations I suddenly can't remember names, places or other specifics. I don't have to tell you much about it. I hope the Strattera works for me as you describe.

    I keep following your blog in my feeds.

    ReplyDelete
  3. Mungo,

    Reading this was like finding my own journal! Since I don't actually keep one, I've used yours to help my very nonADHD husband get a glimpse into my & my daughter's heads. He oscillates between finding my frenetic hobby & experience dabbling invigorating and downright scary. (he's had nightmares of me insisting rickety bridges are safe instead if taking the long way around b/c the view is so spectacular... Then watching me plunge into some jagged ravine to emerge with only a twisted ankle!)

    My dad (who'd never believe he has ADHD) described his need to interrupt others as like watching telephone poles while doing 60mph. If he didn't share the thought as it arrived itvwould already be gone & replaced by an endless stream of others. I think your log rolling metaphor is very similar.
    Thanks for finding me on Twitter. Your posts have become a new coping tool in my ever changing arsenal.

    ReplyDelete
  4. This is a great post. One of my favorite things about my ADD medication (I take Concerta) is the *quiet* in my head. It isn't a lack of thought that makes it quiet; I still think all the time. It's the calm environment in my head that I love, and the ability to follow a thought without, as you said, having it quickly displaced by another one. I can put thoughts "on the shelf" and feel comfortable that I can come back to them later, when I finish what I'm working on.

    I've been working hard on my sleeping schedule, too, and I feel so much better when I get a solid night's sleep and keep regularity in my sleeping and waking times.

    ReplyDelete
  5. Yes! Me too. I go to bed way too late and then play sudoku on my phone or read until my eyes are shutting. Those seem to focus me enough to quiet my thoughts. Or I play the radio just barely loud enough to hear for the same reason.

    ReplyDelete
  6. Ahhhh, what a wonderful job you've done in putting this to words, Mungo.

    I wonder....you say you even feel sorry for the guy who never experienced these moments of calm and openness. Do you think that guy ever feels sorry for you now?

    It is so hard to explain the desirability of that peaceful feeling to some people with ADHD who have never experienced it and, moreover, don't trust the mere idea of it. They might say they love the constant rush. Do you think you'd have been one of those people had you never tried the medication?

    Just curious.

    g

    ReplyDelete
  7. Mungo
    Its great to have come across your story. I have recently been diagnosed with Adult ADHD, which for so long had been treated as clinical depression. Reading the story of others is helping me understand better the road ahead.
    Thanks.
    Rob

    ReplyDelete
  8. Awesome description of the ADHD thought processes. I wish I could get my husband to read this. I've tried multiple times to explain to him, but he just doesn't get it (might be the way I try to describe it). Or I think he just doesn't take me seriously.......

    ReplyDelete
  9. Hi there. I am living in NZ. I am 50. I have tried concerta, and rubifen. Disastrous! Made me feel like I was a stunned mullet... Then, I tried Strattera. This has been wonderful for me. I am on 100mg, the max, I am also on 20mg of Citalopram. I feel like a new man!

    I was impulsive verbally, like walking along and go F...F...F... for no reason at all. Anything would come out of my mouth anytime. I would get into loud verbal arguments with myself. Like for example , my wife and I having an imaginary argument. I would start to yell and scream and rant and rave. I had a hard time with change during the day, my mind would stick on one thing. I was accident prone, impulsive and rushed jobs and all that.

    Now, I am better, it seems. Calmer, less anxious, not so depressed and more even emotionally. I have less trouble paying attention. I would wander off...

    ReplyDelete
  10. Hi there. I am living in NZ. I am 50. I have tried concerta, and rubifen. Disastrous! Made me feel like I was a stunned mullet... Then, I tried Strattera. This has been wonderful for me. I am on 100mg, the max, I am also on 20mg of Citalopram. I feel like a new man!

    I was impulsive verbally, like walking along and go F...F...F... for no reason at all. Anything would come out of my mouth anytime. I would get into loud verbal arguments with myself. Like for example , my wife and I having an imaginary argument. I would start to yell and scream and rant and rave. I had a hard time with change during the day, my mind would stick on one thing. I was accident prone, impulsive and rushed jobs and all that.

    Now, I am better, it seems. Calmer, less anxious, not so depressed and more even emotionally. I have less trouble paying attention. I would wander off...

    ReplyDelete
  11. Hi Mungo, found your blog this morning searching for Strattera and working memory an kept reading it througout this lazy sunday.

    I'm a 44 yr Dutch guy diagnosed with ADHD some ten years ago after a severe burnout. Back then started with Ritalin that didn't work, some anti-depressant that made me aggresive and later on Clonidine that did wonders to keep my mind shut up when going to bed. For daytime, medication didn't get me where I wanted to go so I focussed there on coping techniques and electronic reminder systems. All in all, that worked fine for me because as a freelance ICT-journalist my deadlines and clients kept me sane.

    Last year I almost went bankrupt (only partly due to ADHD symptoms) and unemployed. The lack of external deadlines made me more aware of the negative sides of ADD which in my case is mostly the inabillity to set only a couple of goals and stick to them. I always knew about my pour working memory but saw that mainly as an irritating side-effect of ADD.

    A few months ago I started to see a psychiatrist again to look into medication once more and I tried Concerta and dexamfetmines. They brought me some kind of hyperfocus but didn't work on the neccesary goals. So in my next appointment, it's probably Strattera that I'm going to try.

    I'm slowly learning that my working memory might be to blame for a lot of my troubles. The lack of it is legendary in my surroundings where not only I forget stuff, make a mess of work and living space but in conversations I suddenly can't remember names, places or other specifics. I don't have to tell you much about it. I hope the Strattera works for me as you describe.

    I keep following your blog in my feeds.

    ReplyDelete
  12. This is a great post. One of my favorite things about my ADD medication (I take Concerta) is the *quiet* in my head. It isn't a lack of thought that makes it quiet; I still think all the time. It's the calm environment in my head that I love, and the ability to follow a thought without, as you said, having it quickly displaced by another one. I can put thoughts "on the shelf" and feel comfortable that I can come back to them later, when I finish what I'm working on.

    I've been working hard on my sleeping schedule, too, and I feel so much better when I get a solid night's sleep and keep regularity in my sleeping and waking times.

    ReplyDelete
  13. Wow, it's nice to read that others experience what I do. My mind thinks a mile a minute. Sometimes it hurts! I just want it to rest...... maybe it's time to try medication.

    ReplyDelete
  14. I was diagnosed as ADHD at 46. I know that a lot of folks with ADHD will read an article like this and think to themselves, WOW, that's just like me. I have a little bit different story to relate to it. I have been a runner for most of my adult life. When I was 40, I ran in the local marathon. A few weeks after the race, I developed a soreness in one of my ankles that forced me to stop running for a while. My wife bought me a bicycle so that I could at least continue some sort of training. The bicycle was a disaster. I was constantly hitting curbs and doing "endos". I finally realized what the problem was. I had always used my running not only for fitness, but for stress relief as well. When I was running, my mind was racing pretty much full speed...going over all of the various issues in my life...ideas for new products/inventions, etc. I'm not sure if my brain, over time and many years of running had just adjusted to that speed, or if the bicycle was just inherently too fast for my brain to keep up. Hence the wrecks.

    ReplyDelete
  15. This is exactly how I feel! I read, write, speak and think really quickly. I sometimes skip words letters or even entire phrases because my mind moves really quickly. I have to exhaust myself by staying up late in order to fall asleep and when the environment around me slows down, I often feel uncomfortable. I too am OK being alone but I have to be doing something. I tend to fidget when I am sitting still and unless I consciously try to pay attention. It is so good to know that there are other people who are going through the same things.

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  16. This piece of text, it is just as if I had written it myself. Wow!

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  17. Awesome! Great minds think alike? :-)

    ReplyDelete
  18. I've always had racing thoughts but I never thought anything of it until recently. After a year in Law School I was dropped because I was below the minimum GPA. My first semester I was put on academic probation. I know that I am smart if not smarter than any of the other students in my class, except that it takes me longer to study, read, and do assignments because my mind races so much. In undergrad you have more freedom in class times and whether or not you want to go to class, however in Law School I had to get go to school Monday through Friday and you cannot miss class. It was very hard to pay attention and I found my self shaking my leg and moving around in class. I could not be still. People would notice my odd mannerisms in class and instead of asking me if I was ok or whats wrong they would laugh at me or gossip about me. It was as if when I met people they would already know who I am because they had heard negative things about me. I am a nice, friendly person who goes out of my way for people but people would not take the chance to get to know me. No one ever invited me out. I also would struggle at my internship. I could not remember peoples names, I would have to write down everything the attorney told me so I could remember, and I did my work slower than every one else because I would get side tracked with my racing thoughts. I've been doing some research on what could be wrong with me and I feel like I have ADHD. I just got dropped from lawschool and I am hoping to either go back or find a job hopefully with health insurance so I can afford to go to a doctor and get properly diagnosed.

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  20. Thanks for this; it was a very helpful read! I don't know why rapid-fire thoughts aren't more commonly associated with ADHD, especially for those who are more academically inclined. I'm a college student, and I've even been misdiagnosed as bipolar because I described racing thoughts in the past. There are definitely upsides and downsides, like you noticed. I find it's really easy to synthesize multiple ideas and create arguments quickly, which is good because I can't complete long readings to save my life. But then there are days when you decide to write a book, change your career path, apply to study abroad, convert to a new religion, practice handstands, etc.... and then just get overwhelmed. The mind hurting from too much thinking/not being able to relax is so true...medications usually make me want to meditate. I find the overstimulated thinking is how laundry doesn't get done for weeks, keys get lost, and people get angry at you for not listening in conversations. It feels more like attention modulation disorder than deficit.

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  22. Very helpful read... I can really relate your words to my personal life. I've newly found that I have ADHD, which sheds light on my chaotic past and thought process. I have done my research, but I was hoping I could ask you some questions pertaining to ADHD if you would be open to exchanging e-mails. If so, it would be greatly appreciated.

    Thank-you.

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  23. You bet. Thanks for leaving a comment. My email address is on the Contact Me page at the bottom. Look forward to hearing from you.
    Take care,
    Simon

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  24. Thank you for writing this, I like others feel that this can be written by myself. I am 34 and have recently been diagnosed with adult Adhd I am 3 weeks into my course of strattera. Thank you again, Lucy uk

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