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Bill Mehlman

Spinning My Wheels: Treating Adult ADHD With Humor - and Meds

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Polishing Up that Golden Rule

posted: Tuesday May 13th - 8:38am

How 'Please', 'Thank you', and 'Yes, ma'am' can build confidence in your ADHD child. Some call it manners; I call it beautiful, predictable structure.

Every now and then I take pleasure in slipping into my curmudgeon outfit (itchy, three-piece wool suit, starchy shirt with collar stays that are too long, a narrow tie in a single Windsor and shoes with laces) and rail about today's youth. C'mon, now, I deserve an easy target sometimes, no? And what could be easier than the death of etiquette?

I'm not talking about prissy, Mrs. Grumblebottom's Guide to Behaviour for Young Men and Women of Quality. We're never going back there. No one has the time, no one cares. And how many of you own, let along know how to use, a fish fork, or know the difference between spoons for clear soups and thick soups? Basically, that Victorian bushwah can be condensed into a few simple concepts: watch your hostess and do what she does, use your silverware in the order it's been laid in, from the inside out, don't eat with your butter knife, and, no matter what you do at home, no icecubes in the Haut-Brion, you yahoo.

The rules of etiquette that concerns me are the guidelines that grease the interactions between people. Again, I don't mean removing your hat in the elevator when a woman enters, although that's not a bad idea. It's stuff like holding the door—not just for a woman or an older man, but for anyone who might happen to be walking behind you. It's helping your neighbor when he's overloaded with packages. And most of all, it's "Please," "Thank you," "You're welcome" and "Excuse me."

Try to instill this mindset in your kids. All your kids, but especially those who are ADHDans. Why? All goes back to what I'm always harping on: try to remove from their daily lives as much doubt, confusion, ambivalence — anything that distracts them — as you can. They shouldn't have to worry, when they're introduced to their best friends' mothers, what to say or do. No rocket science, no Lord Fauntleroy folderol. How about, "OK, so when you go to Bobbie's house, and you meet his mother, offer to shake hands, and say, "It's nice to meet you, Mrs. Cramden." And if the adult who reacts scornfully or incredulously to this — and trust me, those clowns are out there—your kid probably shouldn't be hanging out in that house anyway.

Security and self-confidence are excellent antidotes to anxiety and doubt. Keep it simple, keep it meaningful. I'm trying not to mention the Golden Rule here, but in the long run isn't that what it's all about?

Can you see a downside to any of this? I can't.

Thank you very much. It's been a pleasure to talk to you.

Black-Belt Therapy

posted: Friday May 9th - 8:39am

The search for composure and concentration in tai chi can provide concrete, and frequently elusive, focus to ADHDans.

I tend to be contrarian, but not dogmatically so. For example, I'm totally in accord with the notion that appropropriately vigorous exercise is an unmitigated positive for everyone. Furthermore I think that it's essential for ADHDans.

Name your game: cycling, swimming, soccer, jogging, anything that gets you to break a sweat and burn off some of those heebie-jeebies. (As much as I love a good game of nine-ball, time spent in the pool hall doesn't count.) I think that martial arts fulfill this requirement, and bring an additional, specific set of benefits to us.

The martial arts I'm going to talk about in this and future posts are the "soft" or "internal" disciplines. Those of you devoted to shotokan karate, taekwando or capoeira or any of the other more aggressive forms, knock yourselves out, so to speak. All aspiring writers are taught to write what they know, and my experience in this area is limited to tai chi chuan and aikido.

"Soft" should not be construed as "wimpy" or "ineffective." Advanced — and I use that adjective deliberately — students of tai chi frequently win competitions open to all martial artists. Friends of mine, undercover cops, who find themselves in distinctly non-dojo situations, advocate aikido as the most practical, efficient form of self-defense in the street. Aikido students may not be able to break cement blocks. Wrist and legs, yes, but not cement blocks; personally, I've never been threatened by a cement block.

Tai chi comes in many flavors. For those who are resolutely non-violent, there are forms, such as Taoist tai chi, that eschew any and all combative activity, concentrating on the spiritual and health benefits of the art. At the other end of the spectrum, you can find instruction in weapons forms and tai chi boxing, which will definitely satisfy your aggressive instincts. And, while aikido claims to have no, none, zilch, offensive moves, the defensive moves will deter pretty much any aggressor, unless he likes being bounced off the sidewalk, very hard.

Both of these forms emphasize balance, both physical and emotional, and some notion that developing one's inner strength is more critical than any bodybuilding routine. This search for composure and concentration can provide concrete, and frequently elusive, focus to those of us in the ADHD community.

So we’ll get to both of these in short order. Meanwhile, I hear a plaintive chorus sighing, “What about yoga?” What about it? I’m sure, as the punchline to the old joke goes, it couldn’t hurt. But I know nothing about it, never did it, and you’ll have to look elsewhere in ADDitude to find information thereupon.

A Life Less Boring

posted: Thursday May 8th - 8:49am

The meandering path of a ADHD brain on (and off) the job.

At first glance, copyediting might seem like an excellent vocation for an ADHDan. You sit in a quiet room, all by your lonesome. There are no (non-spousal) distractions. You don't have to worry about interacting with other people. You work until you're tired, or your eyes ache, and then you take a nice break. What could be bad?

Are you mad? It's the worst possible situation. Copyeditors sit in quiet rooms, surrounded by reference material, joined at the hip to their computers. Time passes. You started to check whether Henry II was a Plantagenet. When you come to your senses a half-hour later you've investigated Henry II, Henry IV, Henry Ford, Ford Madox Ford, Elliot Maddox, T.S. Eliot, Thelonious Sphere Monk, checked for the next new episode of Monk (we're suckers for shows about other people's disorders), OCD, OCM, opm (and speaking of other people's money, when is your brother-in-law gonna pay you back?), "Mother-in-Law" by Ernie K. Doe, Ernie Kovacs, Tennessee Ernie Ford, Edsel Ford, Henry Ford II, Henry II... Yup! The author was right, he was a Plantagenet.

And you've just blown forty-five minutes of your work day looking up stuff that's of no possible use to you. Stuff you really don't actually have any interest in. And if you go off on a random walk like this a couple of times a day, you'll find that your deadline for this project hasn't made a corresponding retreat, and you're facing a very long night. Better TiVo that episode of Monk, brother.

Is there a point to all this? I think so. You've got a problem. Your brain dances to a slightly different drummer than the majority of brains. Maybe, even if your parents have always wanted you to be a lawyer so that you can join the Fine Old Firm that your great-grandfather founded, you should find something less... boring. Are you actually going to be able to read an entire book on contract law? Or would you be much happier, regardless of what Mom and Dad want, being a landscaper or an auto mechanic? It's your life, and you should find something to do with it that makes you happy, and that you can do well.

PS: So how do I get through my days of copyediting? Simple. Rent. Food. Insurance. Tuition. Not the highest and best of motivations, I assure you. Not having a choice is not the same as making a choice.

Blog... Interrupted

posted: Wednesday May 7th - 8:31am

We all wish to leave footprints in the sands of time, but often much simpler feats prove far more challenging.

Lives of great men all remind us
We can make our lives sublime,
And, departing, leave behind us
Footprints on the sands of time.
"A Psalm of Life"
Longfellow

I'd be willing to bet that if we were to poll 10,000 Americans under the age of forty, fewer than 500 could identify Henry Wadsworth Longfellow, and fewer than 100 could honestly claim to have read any of his works.

Having been exposed to what seemed, at least in eighth grade, to be the stifling, irrelevant and interminable bathos of Evangeline, I can't see this as a major cultural tragedy. Nonetheless, like so many of the poets who wrote [here I get lost for three-hours, while I wander, lonely as a cloud, through various discussions of poetic theory, culminating in a lengthy, albeit fruitless, consideration of negative capability]... narrative verse, Longfellow does speak to the dilemma of the common man.

Anyway: it's widely understood that man is driven, in significant measure, to create some monument to his existence, some ontological...

A typical ADHDan tragedy: I started to write this yesterday. Got a phone call. Forgot to write even the briefest of notes so that I'd be able to pick up the path again. And here you see the result: a half-done, useless, depressing (I was really into something, honest) mess. Once again, metaphysical considerations are trumped by the failure to use a Post-it. If the thread of this comes back to me while I'm out fishing this afternoon, I'll finish it; otherwise...

We Interrupt This Program...

posted: Tuesday May 6th - 1:23am

How to tackle that impervious to-do list without falling prey to monster distractions: save the worst for first.

Most ADHDans would probably put prioritization near the top of their lists of problematic areas. (Yes, that's one of those lists we make and never look at again, but that's another story.)

I'm sure this rings a bell. You've got about a dozen or so things on your calendar. The peril is that you'll start thinking about which one to do first. Odds are you'll bat them around for a couple of hours and then it's lunchtime and then its... What you need, my friend, unless you can find Trapper John and Hawkeye to triage your to-do list, is a simple, foolproof algorithm for deciding what to do next. By the veriest coincidence, I just happen to have one that I'm willing to share.

Take the to-do list. Find the item on the list that will probably be the most fun to do, like "Revamp the Yankee's pitching rotation." Put that at the bottom. Then find the item that you think is most critical. Maybe something like this: "Save Earth from rogue comet." Put that just above the most-fun-to-do task. Keep going like this, arranging the tasks in order of their appeal, until you find the task that you really, truly, viscerally hate to do. Some examples: doing your estimated taxes; making an appointment with the periodontist; sending out that condolence card. Find the most hateful, boring, potentially embarrassing item on the list: THAT'S the one to do first.

Here's my thinking. If you don't get that horrid task finished, you'll never get anything else done well. Even while you're trying to figure out if Mussina should start before Pettitte, part of your mind is gnawing away at you because you haven't filled out the tax forms. So you can't concentrate on correcting Joe Girardi's mistakes. And what do we call this kind of situation? Nice and loud, class: DISTRACTION!

So get the ugly stuff off your list first thing every day. Not only will you enjoy the more frivolous items, but you'll do a better job with the critical ones. And you'll feel like such a mensch.

PS. I think Pettitte definitely gets the nod.

Pinballing Particles in My ADHD Brain

posted: Wednesday April 30th - 7:59am

Strangely, the complex scientific theory of Brownian motion does a damn fine job of simply, elegantly explaining my ricocheting ADHD brain

Many years ago, before the Executive Committee of the university from which I eventually graduated suggested that (a) I take a year's sabbatical and (b) should I wish to return, I forget about a Civil Engineering major, I took a physics course in which we discussed Brownian motion. It made sense, in a vague, non-mathematical fashion, but it wasn't until I was faced with the ADHD situation that it made sense in a metaphorical way.

Briefly — very briefly, unless you want me to copy some insights into Riemannian manifolds and Laplace-Betrami, whatever they are — Brownian Motion is an eminently intuitive notion: that particles suspended in a fluid collide in such a way as to create totally random motion. It's a "stochastic process," a series of sequential movements in which the direction and size of each move is randomly determined.

If you are, or have meaningful experience with, an ADHDan, a light bulb should be going off about now. You know why. Because this is the way your mind tends to work, at least in its worst-case scenario. Your focus, which you'd like to stay in one place so you can get some work done, gets bumped by some random thought. Then another one, totally unrelated. And it just keeps going, until, if you were able to draw a picture of your mind's peregrinations, it would look something like this...

On a really bad day, you can start out saying to yourself, "I'd better get started on that project now or I'll have to work on it all weekend." So you fire up your computer and open the spreadsheet you need to complete; as you're typing you notice that you have a hangnail; looking for the nail file, you find the spare set of car keys you misplaced last week, the ones you can't get duplicated because there's a computer chip in them and so it's gonna run you about $200 to copy them; you're happy about that, until you remember that you haven't paid a parking ticket and it's about to go into collection; then you remember that you didn't move the car last night, and you're probably going to get another one. You run downstairs, just in time to see a smirking meter maid putting a parking ticket under your wiper blade. Cursing, you stomp over to the car and see that you didn't get a ticket.

You got two tickets. Why? Because you forgot to get your car inspected.

Now you're furious. So you decide to . . . no, you don't want to start drinking at 10 am. Or even if you do, you recognize that you shouldn't. So you head for Dunkin' Donuts, and get a large coffee and a dozen doughnut holes. You get back home and set down your coffee and sugar bombs, only to notice that the sticky you'd put on your monitor to remind you to call your mom and wish her a happy birthday, it already being too late to send a card. Now it's too late to call. You slam your fist on the desk, causing your nice, sweet coffee to fall over. The top pops off and your keyboard gets a caffeine bath. As do all the notes for your project.

What project? The one you set out to finish, five miserable hours ago.

Random, and in this case, disastrous, movements, leading nowhere. Or, as they said in that physics class...

Hearing But Not Understanding

posted: Tuesday April 29th - 8:39am

Could Auditory Processing Disorder be to blame for your child's ADHD-ish symptoms?

When I went to Mt. Sinai Hospital a few years ago to see if they could find any evidence that I had ADHD, the first thing they did, after the intake interview, was to give me an extensive hearing test. Makes total sense, actually. How can you expect someone to "pay attention" when she doesn't receive all the aural data that's sent her way, or, worse, isn't even aware that she's being spoken to. The hearing test is quick, painless, unintrusive and, unless presumably, unambiguous. Considering the protean nature of ADHD, it certain makes sense to rule out any purely physical deficits that might contribute to impaired attention.

Then there's a less familiar syndrome, APD — Auditory Processing Disorder. This isn't hearing loss, in the sense that a deaf person has hearing loss. A child with APD (also known as CAPD) can hear what's being said, but to one degree or another doesn't understand what's being said. In other words, this is neither deafness nor illiteracy nor a function of intelligence. Sadly, as with so many of the learning/behavioral dysfunctions, the causes and modalities are largely unclear. It may be — may have some connection to equally chimerical syndromes such as dyslexia, attention deficit disorder and autism.

APD mimics some of the symptoms of ADHD. If your child is being treated for attention deficit, and doesn't seem to be making what you consider acceptable progress, by all means extend your search for answers to having him examined for APD. This is an extremely informative site which presents numerous treatment options.

The next time your frustration level hits the danger level, and you feel that you're about to say, perhaps not in a kindly voice, "Did you hear what I just said?" you might take a deep breath. Consider that even if the answer you get is "yes" it might, in a very real sense, be "no."

Welcome to ADHDville, USA

posted: Monday April 28th - 10:00am

I wish to propose a linguistic alteration.

I'm already tired of writing "children who suffer from ADHD" and "adults who exhibit symptoms of attention deficit disorder." So, unless my editors get all OED about "ADHD", I'm going to start referring to the subjects of these posts as "ADHDans." The "-an" suffix frequently indicates a resident of the place whose name precedes it, and as far as I'm concerned Attention Deficit Hyperactivity Disorder is definitely a state of its own.

So, if you're reading this, it means my editors believe in descriptive, rather than prescriptive grammar. In other words, they're cutting me some slack. And cutting ADHDans like me some slack is what the rest of the world should do. We're not freaks, we're not sociopaths, we're not the Typhoid Marys of learning disorders. We just process things a littttttle bit differently than the majority of you folks.

And now, I'm off to watch the big game: ADHD State vs. Dyslexia Tech.

Unless that was yesterday.

Nice Genes

posted: Friday April 25th - 11:54am

Genes are, to some extent, suggestions. Opportunities. Possibilities. Not mandates.

It's entirely possible to have one child who can be distracted by a feather dropping to the ground in the next county, whose full sibling could, if she wanted, read Wittgenstein in a steel mill while texting seven or eight of her closest buddies and memorizing every stitch of Mary J's wardrobe.

What's the point? It's not your fault if your kid has ADHD, even if you can trace it back in the family to great-uncle Hiram. Especially since, as far as I know, no meaningful genetic testing for the syndrome exists (although I'd love to hear about it if I'm wrong). The only things you can blame yourself for are denial ("It's just a phase, he'll grow out of it." Right. My phase has lasted since the Eisenhower administration.), willful ignorance, laziness and shame.

You think your child has ADHD? Fine. At least your eyes are open. Now get off your duff and DO something. Unlike me, you don't live in a Major Metropolitan Area? Do some research. You'll find a competent specialist. If you have to travel a couple of hundred miles once a month, so what? You'd do that, gladly, to get to the Rhododendron Festival, or the opening day of trout season, right? This is your kid's future we're talking about. His health. Her life, for heaven's sake.

Start taking some notes, not in front of the child, of course. When you do find someone to help, the more accurate anecdotal information you can provide the better things will go. Start reading. I have no axe to grind, but when I got interested in this subject the first book I read was Driven to Distraction and by Edward M. Hallowell and John J. Ratey. For me it was a good starting point.

I'll be writing soon about exercise and diet. In the meantime: a big bowl of Sugar-coated, Honey-drenched, Maple-glopped Chocolate Snakkies isn't a wholesome breakfast for anyone. For a kid with attention-deficit problems, it's a disaster. Are you really too busy to make a couple of scrambled eggs and some whole-wheat toast? Get up ten minutes earlier. We're talking about your child here.

I Heart REM

posted: Thursday April 24th - 11:44am

I've been holding out on you. There's a secret treatment for ADHD...

...Not a cure, but something that will help you stay focused, keep calm, remember where you left the little key that opens the thermostat cover and, generally, be more productive and better balanced.

It's free. It's verrrry enjoyable. All qualified medical practitioners agree it's necessary.

Sleep.

Before I got into wordsmithing fulltime, I spent about 25 years working as a cook and chef. I owned several businesses (losers, all. You need a big tax deduction, write to me directly.) Working 12-hour days was a vacation. Hundred-hour weeks were the usual routine. Tired? Beyond tired. Numb. Borderline hallucinatory.

Listen: fatigue can be a DRUG. It can feel good. You know how sometimes you actually LIKE being a little sick? Nothing serious, nothing overly painful, just something worth staying home from work for and spending the day watching The Thin Man or Now, Voyager. Or being a little hung-over, so everything's a little fuzzy? Fatigue is like that. It gives you an excuse for forgetting to pick up the kids. Moreover, it provides what part of your brain is always in search of — a filter. If you see life through a lens wiped with Vaseline, only the big images appear.

I've watched myself carefully. I usually try for at least six hours a night. Two or three nights in a row with only five hours? I can't even type, let alone write.

The head doctors can explain what happens. No REM sleep, no dreams, whatever. All I know is that if I can grab even eight hours every third day, I'm a different man. (You, in the mauve velour top, stop cheering).

Good ways to sleep better: exercise; take a nice warm shower about an hour before bedtime; turn your back on that leftover burrito in the fridge. No heavy food after, say 8:30. Watch a little TV, talk to your spouse (remember HIM, at least?). Spend a few quiet moments going over your notebook and calendar, planning tomorrow's assault on distraction. Oh, yes, spending some intimate, friendly, non-verbal time with your s/o (for cryin' out loud, do I have to spell it out? This is a family blog, sister.) is an excellent way to lead into a good sleep. Assuming everything goes as planned. I don't write about that stuff. As the Romans said, absit omen.

So if you find that you're absolutely DRIVEN to watch the end of CSI: Omaha, don't be surprised if you walk out tomorrow morning leaving your cell phone in the charger. Your brain wants its quiet time. Keep it up near the red line all day, all night, and you'll pay with those familiar fogs and static all day. Get your sleep.

As a matter of fact, it's 12:30 am and I'm . . .

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