Friday, October 5, 2012

A Walk in the Shadows

Wednesday was interesting.  No, we're not at a decision point yet. Yes, I've had a referral, which led to an interview, which led to an appointment, which now leads to another appointment, which leads to...??? Yes, this is normal. What am I talking about? I'm talking about the evaluation of my Adult ADHD and how to ultimately determine what we will do about it.

The first step was my talking with my primary physician and getting him to agree with me to start the process of evaluation (that was no problem at all, actually; he was happy to help and get the ball rolling). The second part was to have a nurse practitioner call me and set up a phone interview and discuss a number of the basic areas that would have them determine, in the roughest sense, if I was someone that actually should come in. That was also a pretty easy hurdle to overcome, as I was able to answer pretty handily any of the aspects they would normally look for (and I think I added a few of my own that made them sure it made sense to have me come in for a proper evaluation).

On Wednesday, I went in for a longer form discussion with a Social Worker. This is the process that Kaiser uses to make sure to weed out any potential "fakes"; Ritalin and their class of medications are central nervous system agonists; I'm sure that a number of people try to go in and get the legal equivalent of cocaine/methamphetamine under false pretenses, so this was a chance for a trained individual to have an extended conversation with me, to talk out the details, and to propose questions and treatment ideas other than drugs.

I came away with some interesting thoughts from this, and one that I'd never really considered before. How's this for a re framing of an old problem... I fought against taking Ritalin and such drugs because I didn't like the way it altered my personality. At least, that's what I'd always said. This really piqued the social worker's interest because, for most people, that's a very unusual reaction. The large majority of people do not have such a reaction to it, or any other drugs in its class. Ritalin is not a psych-therapy drug in the classic sense; it doesn't alter brain chemistry or act to change mood the way drugs like Xanax or Zoloft do. So why would I have that kind of reaction? Again, the tester in me decided to play "what if..." and talk it out, and here's what I came up with.

As a kid, I really resented having to be treated for this. Why was I being singled out? Why were my other friends, who seemed just as happy and energetic as me, not being treated this way? It felt to me like my parents and others just wanted me to shut up, sit down, and not bother anyone. Fine, that's how we're going to play this? Then that's how I'll be. In short, was there a personality change... or did I at an early age decide to be passive aggressive about it and say "fine, you want me to be quiet? Try this on for size!" I honestly don't know, but suffice it to say, there was enough going on in my youth that that would have been a very legitimate explanation.

Also, one of the factors that encouraged me to stop taking medication was simple. I was having some success as a musical performer, in an environment that rewarded my creativity, my spontaneity, my wildness, and my over-the-top demeanor. It wasn't that the medication wasn't "effective"; it could have been that I wasn't willing then to overcome the resentment of having to take it, and then, later, finding a niche where my "defect" was seen as a "feature", and having the platform to exploit it for all it was worth.

With the end of this meeting, I have now been scheduled to see an actual psychiatrist, and then we shall see if and what treatments make sense. I mentioned that I was open to all options. If it meant medication, OK, I was willing to give it an honest shake, unlike my youth where I resented that kind of intrusion. There's also a behavioral element that is a possibility, including individual and group consultation, potential classes and the ability to interact with others dealing with the same issues. I expressed I was open to participating in those activities. It's good to know that there are options that exist now that didn't when I was younger, and the opportunity to interact with others who may share many of the challenges I do. It's possible I may have some answers that might help them!. The most telling, and for me, encouraging aspect of this, was when I talked about all this with my kids. My son was very quick to offer suggestions, including some of the avenues that have worked for many of his friends. I think we've reached  point where, at least for my son's generation, ADHD isn't seen as the same stigma it was when I was a kid. It's not seen as a black mark on your character or on your soul. It's just a part of life some people have to deal with.

One aspect of TESTHEAD that I have tried to keep as part of its mission is the human side of testing, and the things that I have learned along the way. That means that this site goes well beyond just talking about software testing in isolation. In many ways, my testing is informed by the very mind that makes me ask questions. I talk... a lot! Sometimes in circles. Often needing to be reminded of what's important and what's not. What tangents are potentially fruitless, and which ones might yield really good information. In short, understanding testing means understanding the mind(s) that process the information they receive, and the ways they go about receiving it. Thus, to me, exploring Adult ADHD fits well into the overall scheme of software testing. In this case, I'm exploring a very different software program... only this time, I don't have a developer to turn to and discuss how to fix the bugs... I AM THE DEVELOPER, and more to the point, I have some interesting constraints (or potential features) to work with.

Often, I seem to come back to the Talking Heads "Once in a Lifetime". For some reason, these verses resonate with me today...

You may ask yourself, what is that beautiful house?
You may ask yourself, where does that highway lead to?
You may ask yourself, am I right, am I wrong?
You may say to yourself, my god, what have I done?

Unlike the song, though, I've decided that "Same As It Ever Was" need not be the answer. Stay tuned for further developments :).


Geordie Keitt said...

Hi Michael - My daughter struggles with ADHD and I have found these posts illuminating. Thank you. I also find the ADHD questions and boars on Quora to be full of very useful info by smart people such as yourself. If you aren't on Quora I recommend it as a resource.

Michael Larsen said...

Hi Geordie, thanks very much for the comment. I've recently started looking at Quora for some topics, but Adult ADHD wasn't one of them... until now :).