Adding ADHD to my character sheet

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This year has been a big one for my mental health. Early in 2018 I was diagnosed with Bipolar II. The treatment helped, although I still found myself struggling with motivation and concentration. While I could barely look at my taxes for more than a minute without needing to get up and make yet another cup of tea, somehow my brain was fine at learning how to transpile C# code at 2am.

After many jokes about how it was funny that bipolar came with so many of the aspects of ADHD, I came to realise that maybe it wasn’t just bipolar that was responsible for these peculiarities with my brain.

A visit to my psychiatrist confirmed my suspicions. I had signs of ADHD in childhood, with my kindergarten wanting to keep me back because I didn’t seem to pay attention to the teachers. There was a probable genetic link, with my late mother always losing track of time and forgetting to turn off lights, yet being incredibly focused on the things that she was interested in. The fact that I have systems for everything fills the gaps my brain has for keeping track of things naturally. And of course when we did a diagnostic questionnaire, my psychiatrist said that he didn’t even need to score it to see the result.

So ADHD is now firmly on my character sheet, in addition to Bipolar II. Apparently having both is not unusual, but it presents a difficulty when it comes to treatment. The most common ADHD treatments in Australia (methylphenidate and dextroamphetamine) are stimulants, and can risk of triggering a manic episode. I knew there’d be concerns about treatment options.

At this point I have to reveal just how incredibly fortunate I feel about my psychiatrist, and how I feel both considered and involved with my own treatment. He agreed that while there were risks involved, well-managed treatment for ADHD can be life-changing. Between my own self-monitoring, and my weekly therapy sessions, he felt that it was definitely worth seeing how I’d go with treatment.

I was prescribed methylphenidate (Ritalin), and it’s been amazing. It feels like I have my cognition back!

I’m not sure I can properly express how big a deal this is for me. Being able to think and reason has always been pivotal to my life, and the fact that my brain would sometimes refuse to cooperate has been something I’ve had to constantly manage. Everything is harder when I can’t concentrate, but especially emotions, self-reflection, and clear communication.

One of the possible side-effects of methylphenidate is increased anxiety, and I’m pleased to say that it’s had the complete opposite effect on me. I deal with anxiety by analysing the situation: what am I anxious about, what risks exist, how can I mitigate them, and so on. My medications helping me think clearer has made me much less anxious, more resilient, and of course much more productive as well.

I’m also learning that mornings can exist without being hellish. I was used to my brain feeling incredibly foggy for hours after I’d wake up, and the Ritalin has dramatically reduced this. While I’m still not a morning person by any stretch of the imagination, mornings are now quite tolerable.

Reading other people’s experiences with ADHD has been tremendously interesting; I’ve always struggled with feeling a sense of accomplishment when completing tasks, and reading Erynn Brook’s tweet that this can be from ADHD was both eye-opening and profoundly relieving. All of Erynn’s content on ADHD has been fascinating, and is well worth a read.

Of course, any new diagnosis also means revisiting old ones. While ADHD can sometimes be misdiagnosed as bipolar, my history still very much shows signs of both. I’m really pleased that during my Ritalin trial the one time when I showed warning signs of hypomania (racing thoughts, irritability, reduced need for sleep), I very much did not want to take Ritalin, and an extra dose of mood stabilisers did an excellent job. Both myself and my psychiatrist are very pleased with this.

I really feel like I now have both an excellent toolkit and professional partners in managing my brain chemistry, and for that I’m extremely grateful.

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