Whoops, Forgot My Medication Today...

For the first time in nearly 10 months since I've been taking Strattera, I forgot to take my tablets this morning. I was in such a rush because I wanted to get to work nice and early. I got to work at 7:20 am. Grabbed a coffee. Wrote my daily work priority list. Reviewed e-mails. Reviewed my schedule.

Then realized I'd forgotten my Strattera.

I wonder if I will notice any significant effects, i.e. worsening of attention or increased impulsivity or hyperactivity? I wonder.

Let's see how the day goes. Pleased that I'm doing my daily priority list and getting in early to get a productive start on the day, though. That's gotta count for something!

Mungo

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Benefit in the Long Term by Delaying Impulses in Adult ADHD

I bought Dr. Russell Barkley's "Taking Charge of Adult A.D.H.D." recently, and I want to recommend it. It is a terrific read - I'm finding it to be extremely practical and helpful. He writes how fundamentally there is a diminished ability to control impulses with ADHD. He presents several principles and practical methods to address ADHD symptoms. One principle is to "Stop the Action". Here, ADHDers should put some delay or obstacle between an impulse and subsequent action or comment, thus allowing the executive region of the brain to fire up and contribute to the thought process, thereby enabling verbal and non-verbal working memory to kick in and help find a socially acceptable way to moderate impulses.

The trouble with ADHD is that planning and reflective thinking ('executive thought processes' which take place in the orbitofrontal cortex) is often bypassed, leading to impulsive actions, as opposed to preplanned, consciously moderated actions. This may be due to neurological structural differences in the orbitofrontal cortex of ADHD brains.

So one method of putting a delay or obstacle between an impulse and subsequent action or comment is to gently bite my tongue or place a finger over my mouth (while looking thoughtful). I reason that it is better for me to be seen as a bit of an odd duck constantly biting my tongue or placing a finger over my mouth during a conversation or meeting, than to be viewed as someone who says something impulsive - albeit possibly true and incisive - but ends up distancing or alienating the person who I am addressing, thereby negatively affecting my relationships.

Another method to help insert executive thought moderation into the 'impulsive path' - which an ADHD brain is highly geared towards - is to quietly talk through the task in which you are currently engaged (like writing a blog post, or planning an appointment or meeting), visualize next steps, and recall previous similar circumstances either earlier performed by oneself, or seen performed by someone else. If you are shy about talking out loud, you could stick one of those blue-tooth headsets on your ear and make it seem like you're on a phone call... or just quietly mutter to yourself. Again, better to be seen as someone who talks to themselves (everyone does it!), than to be regarded as an impulsive, rude or awkward person.

This method of stopping to think and to verbalize your recall and planning not only helps you to establish a repertoire of working memories (in which you are likely deficient, as an ADHD Adult) which will help you in the future to delay impulses, it also helps you to gain access to memories in the moment that will help you perform in a way that will benefit you in the long term.

By using this method, you improve your chances of gaining long term benefits and diminishing the effects of disruption, discomfort, and interpersonal troubles which result from acting upon your impulses.

Cheers,

Mungo

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Poem: Dream of a White Coat

I wrote a poem a few years ago. I was struggling a lot then. I think it is about trying to find a common thread through all of my different interests and periods of life.

Freud wrote in The Interpretation of Dreams that dreams are usually overdetermined, "in that they are caused by multiple factors in the life of the dreamer, from the 'residue of the day' (superficial memories of recent life) to deeply repressed traumas and unconscious wishes, these being 'potent thoughts'".

In that same way, I believe that poems are overdetermined. In fact, I think adults with ADHD are particularly sensitive to the fact that even everyday conversations are often overdetermined, which I think can account for some of the distraction we all feel during talks with friends, family & colleagues. We read subtle interpersonal cues that reveal much more about the speaker than words would suppose.

But I digress.

Dream of a White Coat

this dream never really died
it just transmuted into the unrecognized
carried in me like a body on a stretcher
and laid out for visitation
on a foggy Irish night
in a cottage
with whiskey and bread

it wore a white coat when I was young
a paramedic

it wore a white coat when i was in high school
late night studies of chromosomes and lysosomes

it wore a white coat when I became a butcher
and it wore a white coat finding dreams in the library stacks

it wore a cheap suit in an office where it cried
and none would argue it tried to appear
but I don't know where it went
maybe up north on a site by a tent

Thanks for reading,

Mungo

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Job Searching, ADHD Style

It has been 10 weeks since I posted last - I took a bit of a break from writing to focus on work issues. I left my job working at a broadcast company, and am lucky enough to have received a package which will help me through for a while, while I looked for another job. The holidays were nice, and I got to spend a lot of time with my wife and our little boy, who turned 2 last week.

Recently, I somewhat presciently wrote about Adult ADHD jobs and workplace issues. There I wrote about how impulsivity, distractibility and hyperactivity can be difficult traits to have at work, and how these symptoms can have a negative impact on you.

The feedback I got on that post was heartening, and many people added comments about their own experiences. This is what I love about writing this blog - it is a place to connect with people who share similar experiences. Hearing about this makes my journey a less lonely one.

I'll say this: Looking for a job is a full-time job! I used various job search web sites, used LinkedIn.com a whole lot (feel free to connect with me there and note that Mungo is my nom de plume), and followed a colleague's advice to network, network, and network some more on LinkedIn. In the end, this is what got me connected to an agency which found me a contract position. I am starting Monday.

A job gives me daily structure. So does having a little boy who wakes up before 6 quite often, and has to get to daycare, and have his dinner and bath and bed time at a regular time. External structure is critical to me, so I have learned and viscerally learned and relearned over the past year. So having a regular 9 to 5 job is important.

When looking for a job, it is important to maintain a sense of schedule. Try to keep your days scheduled. You may need to have a few pajama-days, and take-it-easy days - because often it is hard to leave the job search when the 5 o'clock whistle blows... but try to have breaks. Go easy on yourself. Expect a roller coaster of emotions. Expect disappointment and strong emotions to arise and fade away as you attend interviews, get rejection notices, don't hear back, and heal from wounds from your previous job experience.

Connect with friends and family. Try to be open about your feelings about the job search. Accept advice and help.

Sometimes you will be called for job interviews for a job you know at a gut level isn't right for you. Attend it anyway, if you can. Interview experience is important. You often will learn something from each interview. It might be a question you didn't anticipate, and end up thinking about afterward. It may be your gut reaction to an interviewer or the location - you'll learn better to trust your instincts about whether you want to work for this person and company or not. You'll learn better how to dress for an interview. And so much more.

I found organizing my interviews and scheduling follow up calls and e-mails difficult. I used my Google Calendar to post reminders and the second I got an interview or a pre-screening call scheduled, I would add it to my calendar. If I didn't, I might end up writing it on a scrap of paper and then forgetting as I tend to get quickly distracted and leave my thoughts behind as I move on to the next thing...

Read books on ADHD to help you keep coping mechanisms in mind. The book I'm reading currently is Taking Charge of Adult ADHD by Dr. Russell Barkley. This is probably my favourite book so far on Adult ADHD (I own and have read about a dozen books in the past year since my diagnosis). I can't recommend this book enough - every adult with ADHD should read this great source.

Try to take some time for yourself. Go for walks or go and see a movie. Be kind to yourself.

I am really relieved to be starting my job on Monday. It will be an exciting role. I incorporated myself as part of the process to work on contract through an agency - it pays better that way, and I can write off certain expenses. That was a process which my lovely wife helped me with - she is really good at organizing and at paperwork. She helped me enormously through the past couple of months, and I thank her very much.

Take care everyone and be well.

Cheers,

Mungo

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I'm Back, Baby, I'm Back...

Folks, it has been too long. A lot has happened since I last posted in October, but I'm back and ready to start writing again.

Hope all is well with you. More very soon. :-)

Cheers,

Mungo

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Memory & Sleep & Something Else But Can't Remember

So this is a quick post, coming after having had a poor sleep for nearly a week. Our little boy got sick with a virus, and had a rash and joint swelling. Poor little guy couldn't walk with the pain, and he hardly slept. Lots of crying (him, not us...). He is feeling better, and my wife is staying home today and tomorrow to be with him. Poor little guy.

I've been sick myself. Another accursed headache this morning - I've popped some Tylenol.

Like a lot of experiential knowledge, you just don't know until you know, but this I feel exquisitely this morning: lack of sleep exacerbates memory problems. And all the more so if you have ADHD, i.e. where you have a pre-existing memory condition. I write about working memory deficits elsewhere in this blog.

"[...]adults with ADHD are thought to have deficits of working memory as exemplified by less ability to attend to, encode, and manipulate information. Such deficits in working memory may decrease the ability to filter out distractions, which contribute to further symptoms of inattention in adults with ADHD."

I forgot to put the recycling out this morning. I haven't forgotten in a LONG while. I forgot a bunch of things and have been procrastinating getting things done. Admittedly, it is hard to do work, and cross off to-do list items when you're taking care of a little one, so I'm not being too hard on myself there... but the memory thing is quite tangible today. I am going to keep my notebook with me at all times today (my personal 5" by 7" paper notebook in which I record to-do items and notes).

I will return to writing shortly - hope all is well in your world,

Cheers,

Mungo

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Adult ADHD and Workplace / Jobs & Employment Issues

I went to a seminar at the Ontario Science Center earlier this year to hear psychiatrist Umesh Jain, and ADHD advocate, writer, and comedian Rick Green talk about Adult ADHD. The topic being discussed at that point was employment difficulties for adults with ADHD. The person who sat beside me leaned over and told me that she'd had over 35 jobs and that she was 35 years old. I was stunned - I think I was at 17 at that point, at age 39 (more below). It was not such an uncommon story amongst other audience members.

Sitting there in the audience, I was stunned to see over a hundred other adults who had been diagnosed with ADHD in their adult years. They all looked normal - no prehensile tails, no little horns... and at the same time, I felt like I was with a group of people who understood everything about my struggles. Because they'd gone through them too. It was uncanny, it was almost surreal. I had not yet been diagnosed, and had been recommended by a therapist to look into an assessment.

But back to jobs.

The typical diagnostic triangle for Adult ADHD is impulsivity, distractibility and (generally mental) hyperactivity. This does not bode well for an employee at a conventional office workplace.

Impulsive comments and behaviours can flag you as erratic, unusual, weird, and lead to you being excluded from the group to which you belong. Being in management as I am, this can be disastrous, because trust, conformity and communication is key to management relations (perhaps more so than in non-management roles).

Being distractible will help ensure that you never quite get priority items done on time, because you're off on a tangent and never sticking with that documentation or presentation you needed to get completed. Not delivering on deadline can be a career-limiting habit. Plus you'll miss essential discussion points during meetings and probably be perceived to be annoying as you keep looking at your BlackBerry, or out the window, or start twirling your pen in circles around and around and around and around and around. You will not be perceived as being 'present'. People may regard that as disrespectful behaviour, even though it has nothing to do with disrespect, and everything to do with attentional inconsistency.

Hyperactivity - which in adults becomes internalized as opposed to the stereotypical whirling dervish child, racing from place to place, screaming out loud - becomes internalized as the adult develops coping strategies over the years. Hyperactivity presents in the Adult ADHD individual as fast thoughts and speech. You may talk so much and so intensely that no-one gets a chance to add their own perspective and opinions, and you'll have a difficult time getting to hear and learn about other people. Getting to know other people is important at the workplace, and if you don't develop relationships based on mutual understanding and respect, you may be shunned from the group. It is quite annoying to be on the receiving end of someone's fast-paced talking. And because they're thinking so fast, they'll be jumping ahead in topics faster than the pace of the average person, and be perceived as being erratic and disjointed in thought - even though they actually are simply naturally progressing through the topic as you would - if your brain was sped up.

These symptoms have affected me negatively at all of my jobs.

Since I left university (where I studied cognitive psychology), I have worked as the following:

1. Butcher
2. Support Worker for developmentally handicapped adults
3. Counselor at a custody facility
4. Developer / Programmer
5. Lead Developer
6. Project Manager
7. Production Manager
8. Project Manager (contract)
9. Business Analyst / Information Architect (contract)
10. Project Manager (contract)
11. Operations Manager
12. Project Manager (contract)
13. Development Manager
14. Program / Project Manager (contract)
15. Project Manager
16. Project Manager
17. Applications & Systems Manager

17 jobs in the last 15 years. The first 15 jobs took place over the first 11 years. The last 2 roles have been at my present company and have lasted nearly 4 years. This is a good trend, I'd say.

And now, since I have been diagnosed and taking treatment and medication for Adult ADHD, I see my successes at work increasing, and my satisfaction improving. Work can be hard and trying for all, and for those with Adult ADHD all the more so. I may even have more jobs to add to this list in time, but I now know that my experiences will improve and my struggles will lessen. This gives me great hope.

I would love to hear comments from other folks about any ADHD related employment stories - do share!

Cheers,
Mungo