I've been taking a minimal dose of the ADHD medication Medikinet for three weeks now.
My life has changed significantly in that period, and in nearly every sense for the better.
I met up with my psychiatrist two days ago to assess my dosage, and to talk about how things were going. We're going to stick to the 5mg three times a day - the minimum dosage. I'm suffering very few side effects, but the changes in my life have been quite rapid, so I'm happy to stick with what we've been doing. There's little understanding of exactly how the methylphenidate works, but plenty of anecdotal and experimental data to suggest that dosage does not relate to body mass, and that varying the dosage can have little or no effect for many people who use it.
I want to stress here, as this is a public blog about ADHD, that methylphenidate is a balancing medication. For people who have significant symptoms of ADHD it can help return to the user normalised functions of 'willpower', concentration and focus. For people who have few, or no symptoms, it can be a problematic, and addictive drug, causing anxiety and stress. Also, Medikinet just happens to be the brand I have been given by my pharmacy here in the UK - there are many variations which are identical, including the well known drug Ritalin.
So what has changed?
As this blog attests, I've had times when I didn't think anything was happening, but the longer view has given me a better and more positive picture.
The big thing, is that I am able to stick at things, organise myself better, and get some enjoyment from the tasks that I need to get done.
I'm a single parent of an eight year old daughter, and through everything I've managed to look after her well in the seven out of every fourteen days that she's with me at home. It has been a struggle though, and I'm very pleased to have more energy for her now.
For over 18 months, from late 2009/early 2010 I have suffered severe depression, following my relationship separation - something which I found so stressful that it induced a manic-depressive episode the likes of which I hope never to repeat. The depression phase is something that was slowly lifting naturally, and before starting the ADHD medication I felt that I was nearing the end of that. It's a very, very slow process, but the medication seems to have accelerated my recovery.
I'm able now to sense more meaning in being alive, which is a relief I can not overstate. I still have many 'butterfly brain' moments during the day - even some socially awkward ones where I will forget what I'm thinking about in the middle of a sentence, or have anxiety about forgetting important upcoming events. This of course, is not restricted to ADHD sufferers, but mental health conditions are not discrete illnesses - they are an extension or variation of processes that naturally occur in all people. This is key to understanding where anyone is on the spectrum of mental health.
There are many people who live with mental health conditions which are actually very positive (such as involuntary hyper-organisation, or a gift with numbers that veers towards autism).
The only requirement of a condition to need care and diagnosis is if it's impairing normal functioning (in any sense) or causing a loss of enjoyment of life.
The people who come into contact with the health services are often people in the midst of a full blown crisis, but that leaves millions of people around the world with difficulties that may never be addressed because they haven't reached the very high threshold required to receive care.
In serious illness, on the NHS, it usually takes the disclosure of suicidal thoughts, or intent to harm someone else, to trigger proper care. This leaves many people suffering needlessly - both the people who are below this very high threshold, and anyone, who quite reasonably would not want to disclose such feelings.
I've become much more social in the last three week. I still have low level anxiety, almost constantly, but I can put it out of my mind enough to hold a decent conversation. Eye contact seems much easier as well.
My relationship with food has changed significantly too. It's no longer a 'filling in' activity, or an 'emotional response' activity, and as such my body weight has started decreasing. I've lived in a somewhat overweight state for a long time, and given that I used to run, and complete half marathons, this is an anti-depressant all of it's own.
This is also slightly disorientating, as I can see now that food, particularly high carbohydrate food, was something I counted as a reliable 'fix' amidst an unreliable emotional rollercoaster ride.
My mood is still prone to go in cycles - the bipolar element is still there, and even yesterday I had a couple of dips which left me close to tears. It's hard to say whether these are caused by a thought or an external event but my gut feeling is that, like everything with mental health, it's both.
A way to understand this is to look at brain function as covering two overlapping spheres - emotional response and rational reasoning. There is an interplay there, meaning a strong emotion may prejudice my reasoning, and likewise the result of reasoning may induce a weak, or a strong emotional response.
The cyclical nature of bipolar represents the interface between those two areas becoming weaker or stronger during the cycle of a day, week, month, or even over years.
The view I've arrived at is that this varying of the interface is a normal part of brain function that everyone experiences - lots of people have low days, grumpy days, or unusually happy and productive days. I'd go so far as to say that the menstrual cycle in women includes monthly variation in this interface, where suddenly a slight event can bring tears or even anger.
It's not very well understood, but there is plenty of anecdotal evidence to suggest that men have similar cycles.
I only found out recently that my parents had become quite worried about my moods when I was a teenager, so much so that they began to mark the low points on a calendar. I have wondered how much different my life may have been, had some kind of action had resulted from that observation but there wasn't any. Where I grew up, in New Zealand in the 1970s and 80s, it's very questionable whether I would have received any useful care from the medical system of the era.
Even today in modern countries, ADHD, and bipolar are still regarded with suspicion by many people, and in fact by many doctors. Personal bias about what causes behavioural problems plays a large part in determining whether sufferers get the help they need.
This relates to a fundamental problem with those labels and 'modern' psychiatry - those terms are not a diagnosis in the same sense as known physical-based illnesses. They come from the DSM - the , the 'bible' of modern psychiatry, and a small amount of research reveals that these labels do not relate to a known physical mechanism - they are simply the groupings of behavioural statistics that originally came from soldiers in the American army, from a document written in 1943 by William C. Menninger called 'Medical 203'.
Indeed I've purposely used that term 'physical' illness in an incorrect sense - but this is also the commonly accepted sense. It's a whole other topic, but seeing bipolar or ADHD as something other than a physical illness is one of the biggest and most damaging misconceptions that we have inherited from Dualism. The concept of Dualism - or a separated mind and body - was coined by Descartes, a 16th century philosopher. But it has it's origins much further back in religious practices, where the idea of a soul, separate from the body has been conceptualised for thousands of years.
I don't have a fixed belief that the 'soul' or 'mind' concept is wrong, but from my experience, I gained an insight about how that the dominance of post-religious moralism, and the separated 'mind' concept are overstated and flawed in many respects.
I think this is the cause of much human suffering - not just for me, but for a vast number of people alive on the planet today. This encompasses many, many things - from the reasons why the events in Norway, Whitehaven, and Columbine have occurred and how to prevcnt them, the daily struggle so many people face with mental health stigma, the ongoing problems with the cycle poverty, right through to challenging the accepted premise of the existence of prisons, and our punitively-based justice systems.
I'm starting a project called 'This is the Way Home' - the purpose of which is to state this case, provide evidence, and back it up with easily understood information and analogies. I'd like to not just help myself, but help as many other people as well, to understand how their brain works - and how this can be the key to alleviate suffering, increase feelings of meaningfulness to life, and to greatly enhance personal happiness, within ourselves, and in relation to other people.
More later...
My life has changed significantly in that period, and in nearly every sense for the better.
I met up with my psychiatrist two days ago to assess my dosage, and to talk about how things were going. We're going to stick to the 5mg three times a day - the minimum dosage. I'm suffering very few side effects, but the changes in my life have been quite rapid, so I'm happy to stick with what we've been doing. There's little understanding of exactly how the methylphenidate works, but plenty of anecdotal and experimental data to suggest that dosage does not relate to body mass, and that varying the dosage can have little or no effect for many people who use it.
I want to stress here, as this is a public blog about ADHD, that methylphenidate is a balancing medication. For people who have significant symptoms of ADHD it can help return to the user normalised functions of 'willpower', concentration and focus. For people who have few, or no symptoms, it can be a problematic, and addictive drug, causing anxiety and stress. Also, Medikinet just happens to be the brand I have been given by my pharmacy here in the UK - there are many variations which are identical, including the well known drug Ritalin.
So what has changed?
As this blog attests, I've had times when I didn't think anything was happening, but the longer view has given me a better and more positive picture.
The big thing, is that I am able to stick at things, organise myself better, and get some enjoyment from the tasks that I need to get done.
I'm a single parent of an eight year old daughter, and through everything I've managed to look after her well in the seven out of every fourteen days that she's with me at home. It has been a struggle though, and I'm very pleased to have more energy for her now.
For over 18 months, from late 2009/early 2010 I have suffered severe depression, following my relationship separation - something which I found so stressful that it induced a manic-depressive episode the likes of which I hope never to repeat. The depression phase is something that was slowly lifting naturally, and before starting the ADHD medication I felt that I was nearing the end of that. It's a very, very slow process, but the medication seems to have accelerated my recovery.
I'm able now to sense more meaning in being alive, which is a relief I can not overstate. I still have many 'butterfly brain' moments during the day - even some socially awkward ones where I will forget what I'm thinking about in the middle of a sentence, or have anxiety about forgetting important upcoming events. This of course, is not restricted to ADHD sufferers, but mental health conditions are not discrete illnesses - they are an extension or variation of processes that naturally occur in all people. This is key to understanding where anyone is on the spectrum of mental health.
There are many people who live with mental health conditions which are actually very positive (such as involuntary hyper-organisation, or a gift with numbers that veers towards autism).
The only requirement of a condition to need care and diagnosis is if it's impairing normal functioning (in any sense) or causing a loss of enjoyment of life.
The people who come into contact with the health services are often people in the midst of a full blown crisis, but that leaves millions of people around the world with difficulties that may never be addressed because they haven't reached the very high threshold required to receive care.
In serious illness, on the NHS, it usually takes the disclosure of suicidal thoughts, or intent to harm someone else, to trigger proper care. This leaves many people suffering needlessly - both the people who are below this very high threshold, and anyone, who quite reasonably would not want to disclose such feelings.
I've become much more social in the last three week. I still have low level anxiety, almost constantly, but I can put it out of my mind enough to hold a decent conversation. Eye contact seems much easier as well.
My relationship with food has changed significantly too. It's no longer a 'filling in' activity, or an 'emotional response' activity, and as such my body weight has started decreasing. I've lived in a somewhat overweight state for a long time, and given that I used to run, and complete half marathons, this is an anti-depressant all of it's own.
This is also slightly disorientating, as I can see now that food, particularly high carbohydrate food, was something I counted as a reliable 'fix' amidst an unreliable emotional rollercoaster ride.
My mood is still prone to go in cycles - the bipolar element is still there, and even yesterday I had a couple of dips which left me close to tears. It's hard to say whether these are caused by a thought or an external event but my gut feeling is that, like everything with mental health, it's both.
A way to understand this is to look at brain function as covering two overlapping spheres - emotional response and rational reasoning. There is an interplay there, meaning a strong emotion may prejudice my reasoning, and likewise the result of reasoning may induce a weak, or a strong emotional response.
The cyclical nature of bipolar represents the interface between those two areas becoming weaker or stronger during the cycle of a day, week, month, or even over years.
The view I've arrived at is that this varying of the interface is a normal part of brain function that everyone experiences - lots of people have low days, grumpy days, or unusually happy and productive days. I'd go so far as to say that the menstrual cycle in women includes monthly variation in this interface, where suddenly a slight event can bring tears or even anger.
It's not very well understood, but there is plenty of anecdotal evidence to suggest that men have similar cycles.
I only found out recently that my parents had become quite worried about my moods when I was a teenager, so much so that they began to mark the low points on a calendar. I have wondered how much different my life may have been, had some kind of action had resulted from that observation but there wasn't any. Where I grew up, in New Zealand in the 1970s and 80s, it's very questionable whether I would have received any useful care from the medical system of the era.
Even today in modern countries, ADHD, and bipolar are still regarded with suspicion by many people, and in fact by many doctors. Personal bias about what causes behavioural problems plays a large part in determining whether sufferers get the help they need.
This relates to a fundamental problem with those labels and 'modern' psychiatry - those terms are not a diagnosis in the same sense as known physical-based illnesses. They come from the DSM - the , the 'bible' of modern psychiatry, and a small amount of research reveals that these labels do not relate to a known physical mechanism - they are simply the groupings of behavioural statistics that originally came from soldiers in the American army, from a document written in 1943 by William C. Menninger called 'Medical 203'.
Indeed I've purposely used that term 'physical' illness in an incorrect sense - but this is also the commonly accepted sense. It's a whole other topic, but seeing bipolar or ADHD as something other than a physical illness is one of the biggest and most damaging misconceptions that we have inherited from Dualism. The concept of Dualism - or a separated mind and body - was coined by Descartes, a 16th century philosopher. But it has it's origins much further back in religious practices, where the idea of a soul, separate from the body has been conceptualised for thousands of years.
I don't have a fixed belief that the 'soul' or 'mind' concept is wrong, but from my experience, I gained an insight about how that the dominance of post-religious moralism, and the separated 'mind' concept are overstated and flawed in many respects.
I think this is the cause of much human suffering - not just for me, but for a vast number of people alive on the planet today. This encompasses many, many things - from the reasons why the events in Norway, Whitehaven, and Columbine have occurred and how to prevcnt them, the daily struggle so many people face with mental health stigma, the ongoing problems with the cycle poverty, right through to challenging the accepted premise of the existence of prisons, and our punitively-based justice systems.
I'm starting a project called 'This is the Way Home' - the purpose of which is to state this case, provide evidence, and back it up with easily understood information and analogies. I'd like to not just help myself, but help as many other people as well, to understand how their brain works - and how this can be the key to alleviate suffering, increase feelings of meaningfulness to life, and to greatly enhance personal happiness, within ourselves, and in relation to other people.
More later...
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