Attention-deficit disorder in adults

Circadian two-step

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Early to bed and early to rise… makes a neurodivergent irritable as hell!

On Sunday (January 5) I was presented with a unique opportunity. A heavy winter storm was approaching the area, so to be safe, my workplace announced it would be closed on Monday (January 6). But in order to make sure everyone gets their forty hours of work this week, everyone would be working ten hour days for Tuesday through Friday. I wasn’t very happy about this, but there wasn’t much I could do beyond complain. And that wasn’t likely to get any useful results, so I didn’t bother.

However, since I had absolutely no schedule for Monday, I decided to do an experiment and let my body go to bed when it was ready to, and get up when it was ready. My mind seems to be most productive, and most focused, between the hours of 4pm and 9pm. And I have often joked that if left to my own devices I would stay up until the wee hours of the morning, sleep until around noon, and work my job from mid-afternoon until mid to late evening.

I ended up turning out the light around 3:00am last night, and got up around 11:30am today. It would seem that my circadian rhythm is that of a night owl, which didn’t surprise me in the least. I became a night owl in college, and have largely remained one ever since.

A quick internet search pulled up a number of studies that connect ADHD (and other neurodivergent conditions) with circadian rhythms that don’t neatly align with the rise and fall of the sun. Many of them correlate to chemical patterns in the brain and nervous systems that effect sleep patterns. People with ADHD, for example, often stay up later than most, often because it’s difficult for their minds to quiet down until the body is completely exhausted. Some more severe conditions can lead to insomnia, or at the other extreme, narcolepsy. Lisa and I sometimes joke that we have trouble falling asleep because “our brain won’t shut up.” Chemistry in action!

But does this correlation between late-leaning circadian rhythms and neurodivergency suggest a causation? That’s an interesting question, and is a subject of ongoing research. I tried to come up with an explanation, but none of my ideas held together. Conventional wisdom says that one can train their circadian rhythms to conform to one schedule or another by strictly adhering to a specific time schedule for a prolonged period of time. Many people have been able to achieve this, especially those who work at night. But this has not been my personal experience. I generally get up at 5:30am to be at work for 7:00am, and most of the time I have little difficulty. But when the weekend arrives, and I am temporarily free of the timetable, I instantly revert to staying up very late (on Friday and Saturday) and sleeping late (on Saturday and Sunday). One would think that after several months of this strict weekday schedule, my body would remain on that schedule all the time. Instead, if given the opportunity, my body instantly snaps back to the “night owl” schedule I had back in college. I am therefore inclined to think that neurodivergency does have a causation effect on the circadian cycle, but I suspect it would be difficult to demonstrate.

I’m going to leave that to the psychiatrists, neurophysicists, and other experts on the workings of the brain.

Because of my night owl tendencies, I have considered moving to the second shift at my workplace. It would be more in line with my apparent circadian rhythms, and one day I may make such a switch. However, such a change would cause schedule conflicts with almost every other aspect of my life, and of society in general. One problem that I have noticed is that contemporary society, especially in the United States, is designed around “morning people.” This is the result of historical patterns based on agricultural schedules. Getting up early is imperative when you work on a farm, and for a long time that was the overwhelming majority of the nation’s population. That’s not the case anymore, but the pattern remains. When I try to schedule an appointment or official visit, the first suggested times are invariably early in the day. For someone who is naturally a night person, this is annoying. I often have to push for a later time, and sometimes I meet resistance. It’s not something that makes me overly angry or upset, but I do find it irritating. Like a mosquito bite.

This upcoming work week is likely to be difficult for me. I’ll have to be at work at 5:00am, and work until 3:30pm. Getting into work that early, and then putting in a ten hour day, is going to be a challenge. I suspect my whole metabolism, and not just my circadian rhythms, will be very unhappy by Friday afternoon.

What do you readers think about this? If you are part of the neurodivergent crowd, are you a night owl? Or an afternoon cruiser? Have you been able to train your circadian rhythms to follow something different than their natural inclination?

Image from Shutterstock.

Crashing in slow-motion

For me, 2016 will be remembered as a “bad year.” When it started, I was making plans for a year of accomplishment and success. Instead, it was the year where I watched my career decline, falter, and collapse.

I was diagnosed with ADHD in early March. When I first talked about this last June, I believed that I had survived the worst of it, and that things would start calming down. I was about as far from the mark as a person could be. Things were only in a lull when I wrote that article. They soon got uglier with each passing week.

I may as well set the stage and state that this doesn’t end well. Today, March 6, 2017, is my final day as an employee of the Library of Congress. After more than fourteen years with the agency, the complications brought on by ADHD have forced me to leave.

Now I’ll tell you how and why this happened.

First off, understand that removal from federal service – that’s really what they call it – is not a simple process. It takes a long time, requires meticulous planning, and a lot of documentation. That’s one of the reasons it doesn’t happen very often, and when it is done it isn’t done lightly.

In all likelihood, the Library made this decision as much as two years ago. Given how long this process can take, they would have had to start that far back for this to end here and today. The worst part is that for much of that time I wasn’t aware of what was going on.

And yet, the clues were there. In hindsight, I think the Library had been trying to compel me to leave on my own for quite a while. My job became increasingly intolerable, in one way or another. No matter what I did to change things, or to improve my work situation, nothing seemed to work. I was never good enough, I was never efficient enough, I was never thorough enough, or something. I was always falling short in some way. Improvement in one area never mattered as much as deficiencies in another.

You may be asking why I put up with such a toxic situation if it was so bad. That’s easy: my fear of the unknown, namely being without a job and of being unable to provide for my family, was greater than whatever fear I had of the administration at the Library.

I should have been more observant, and definitely more shrewd.

The process really got moving in the summer of 2015. By then, the Library most likely concluded that I was not going to leave unless I was forced to (and that is actually true). It was then that the performance related disciplinary process began, though at first I didn’t recognize it as such. It wasn’t until February of 2016, when I was given a written warning that I was in danger of receiving an unsatisfactory performance rating, that the true nature of my situation started to become clear.

It was also shortly after this that I was diagnosed with ADHD. That changed the whole situation, and put many things in a different light. Prior to that, I had been asking myself why I was having so much trouble, and why I always felt frantic and rushed. Now I had an answer, and with the root problem identified and addressed, I was confident that I could overcome it.

I was in constant contact with my professional guild (AFSCME 2910) about possible accommodations and help with legal issues. I changed my methods of therapy, and was put on a new set of medications. I implemented some workplace accommodations to help deal with the physical issues of ADHD. I frequently put in extra hours at work, in the hope of finding a pattern than would work for me. I was determined to sufficiently improve my work performance. By the summer things had quieted down. I thought I had found the right working pattern, and that things would start to improve.

The summer lull had given me in a false sense of security. In August I was given an assignment that proved to be exceedingly difficult, and I was given a very short time in which to prove myself. The task was indeed very complex, and had several facets to it. But it was not beyond the requirements of someone with my job title. Sadly, I was unable to adequately do the assignment. I thought I had, but I did not. Knowing what I do now, I don’t think there was any way I could have succeeded with that assignment, and the Library never seriously expected me to. The only possible outcomes were varying levels of failure.

I didn’t think my situation could get worse than this, because now I was quite sure that I would be receiving an unsatisfactory performance rating. But, in mid-September I was informed that I was not performing my job at the level expected of me, and that further disciplinary action would soon follow in addition to a likely unsatisfactory performance rating. I kept trying to improve, and working with my guild to find options

Nothing worked. In October I was informed that an adverse action was going to be filed against me, and that it would probably call for my removal. Even so, I kept trying to save the situation, if only because I had nothing left to lose. In November I received my long-overdue evaluation, which rated my job performance as unsatisfactory. I still kept trying. At this point I was hoping for a re-assignment or demotion, because I knew my current position was lost.

Finally, in early December, I was informed that I was going to be removed from my current position. Also, in the opinion of my superiors, given the severity of my unsatisfactory work, I was not being considered for re-assignment or demotion. I called on my guild one last time. I spent an entire day speaking with my representative, explaining everything I could in as much detail as I could manage. I also described, at length, exactly how my work is done, and how ADHD has created so many problems for me. My representative became crestfallen.

There is a fine line between being a quitter, and realizing that it is time to quit. On that day, I crossed that line.

I never allowed myself to seriously consider leaving the Library, because when I looked at the various issues in life that I need to juggle every day, the prospect of being without my federal job – or more accurately, the salary and benefits it provided – was too horrible to contemplate. But the facts were clear. The Library had exhaustive paperwork showing how that for the past three years my work performance had been steadily deteriorating. And for every argument my guild had for keeping me on board, my superiors were able to produce at least two additional arguments for why they shouldn’t. They didn’t know there was a medical condition involved until late in the game, but it wouldn’t have mattered if they had. Poor work, no matter what causes it, is still poor work.

A few nights later, in a fit of crushing despair, I finally accepted what ADHD had done to my mind: I was no longer capable of doing my job.

I considered ending my life. I’ve suffered from depression for most of my adult life, but I hadn’t been in a place that dark in over twenty years. But here I was, thinking about clocking out. I didn’t, obviously, but I still felt lost. The only career I have ever seriously pursued, or have any solid experience in, could now be closed off. I was faced with the very real possibility that I no longer had a career. I may have to go back to entry level work, or do wage based labor, to survive. For a man who is approaching fifty, has a medical rap sheet, a stay-at-home wife, and two young children to care for, this is a terrifying position to be in!

I still had one option. My guild recommended that I take involuntary retirement, based on a medical disability. It took some negotiating, but eventually a settlement was reached where I would be allowed to retire from the Library of Congress under those guidelines.

I was six weeks shy of my fiftieth birthday, so this was a very surreal experience. Most men my age are in the coasting phase of their career, and are getting ready to gather resources for retirement. Very few are actually entering it. Fewer still are entering it unprepared and against choice. But here I was, preparing to retire almost fifteen years earlier than I had ever expected.

I have applied to retire through the Federal Employee Retirement System (known as FERS). I have to be approved before I can start receiving annuity, and even if I quality, not all of my problems will be solved. More needs to be done.

So what am I doing?

Lisa and I are restructuring our family’s finances into something that can last long term. I’m trying to help Lisa find a job so that get her re-established in the work force. She is helping me look for a new career, or at least find a job that will help keep us afloat. We’ve both been looking over our various skill sets to see what, if anything, we can refresh or update by taking a class or online tutorial. We’re setting ourselves up with temporary employment agencies that may help get us through the upcoming drought. I’ve been contacting old colleagues from earlier chapters of my life to see what the professional landscape has become and where it might be going. I’m exploring some work paths that I had never seriously considered before, like home-based computer work, and freelance writing.

I’m trying to determine what I can or should do with the rest of my life.

I’m doing what anyone else in my position would do.

I’m doing what I have to do.

Winter of my discontent

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icydogwood

I can safely say this this calendar year started out well. I began to feel ambitious again. I wanted to do new things. I wanted to achieve things. I even made a list of resolutions for the year, and I was seriously going to try and meet them. In all, things were looking up.

But at the end of February, everything fell apart. That is the primary reason this blog has been quiet for several months. I’ve been a bit… preoccupied.

It began with a warning of unsatisfactory job performance at work. I don’t think I need to explain what that can result in. It wasn’t long before the cause was identified. I apparently have Attention Defect and Hyperactivity Disorder, commonly known as ADHD. The signs have been present for quite some time, but for whatever reason I never made the connection. Nor did anyone else in my life, apparently. My wife knew something was wrong, but like me and everyone else, she though it was that damn clinical depression I’ve been struggling with since who knows when.

I’ve been having trouble at my job for quite a while. There are a lot of things to remember and keep track of, and quite often I was overwhelmed. I also have never felt confident in my job, nor do I feel accepted by my colleagues. I’m not afraid to say that I have some colleagues who have openly questioned my competence and why I am even there. What’s worse, for a long time I genuinely believed that they were right, that I was not cut out to do my job, that no matter how hard I tried that wasn’t going to change, and it was only a matter of time before I was shown the door. It wasn’t until January, ironically, that I began to feel differently on this matter. I’m not sure why, but I started taking a different stance of a lot of things. By that point it was too late to prevent the performance warning.

At my agency, an unsatisfactory performance rating often results in a demotion or dismissal, which they euphemistically call “separation.” I had 90 days to improve. I did take steps to change my life and improve my job performance. But at the end of the 90 days I needed more time. Fortunately, thanks to the help of my doctors and my professional guild, I was able to get an additional 60 days. At this writing, my extended re-evaluation period will end in late July.

But that’s only part of the story. I wasn’t only having problems at work. I’ve been having problems at home as well. I’m almost always tired and short tempered. When I get home in the evening all I ever want to do is sleep. My brain simply doesn’t want any more stimulation, nor does it want anything asked of it. When all of this came to a head I asked my wife to make a list of personality changes she has noticed in me in the last few months. I won’t list them here, but some of them really hit hard.

I later shared this with one of my doctors, and his immediate response was advanced depression. That was no surprise, but it acquired a new wrinkle. One fear we had was that I had suffered a micro-stroke, but some blood tests pretty much ruled that out. (I don’t know how blood samples can determine something like that, but I’ll assume my doctor knows what he is talking about.) Another possible culprit was my hyperactive blood sugar, but he thinks that is a result and not the cause. He thinks the root problem is that I have been under so much stress for so long that my metabolism became unbalanced.

(There is a correlation between excessive stress and haywire blood sugar, actually.)

Over the last few years, I have been under constant, relentless stress from multiple angles. I’ve been dealing with the clinical depression, problems at work, problems at home, Michael’s medical history, some of Caitlin’s problems, diabetes, my mother’s death, Lisa’s car accident last August, and my weight problem. I’m sure there are other things as well.

Some of these issues have resolved themselves and faded. But the problem is the “damage” they did while they were happening. I was overloaded with stress and worry, and apparently it was more than my mind could handle. This caused the ADD to manifest itself. So even though some of the issues are no longer a concern, the residual effect of the stress has remained.

One thing I need to stress is that ADD and ADHD are not “acquired” conditions. They are genetically based (which also suggests they can be hereditary), and can manifest in different ways. My doctor figures that I simply hadn’t been diagnosed. A lot of people with ADD and ADHD are never diagnosed, because the condition is not problematic so long as the patient can compensate. And generally people compensate without actively thinking about it. Like anyone else, they find courses of action that work best for them, and proceed. They may not realize they have ADHD, and so long as they can continue to compensate, the condition will go unnoticed, and may never be a problem.

It’s when the patient loses the ability to compensate, and can no longer find effective courses of action, that the condition becomes apparent. My doctor suspects that up until 2-3 years ago, I was able to compensate, at least sufficiently, to keep ADHD at bay. But then I was hit with too many things in too short a time, and it became more than my depression and ADHD riddled mind could handle. Even so, I tried to compensate and roll as best I could. Along the way my brain chemistry was changing, as it tried to continue compensating. Sadly, the changes didn’t work. Unfortunately this how it often happens, my doctor said. Once the ability to compensate is lost or becomes insufficient, and ADD fully manifests itself, it’s as good as permanent.

I described my situation as “overclocking” my brain, like one can do with a computer. By means of overclocking, it is possible to make a computer go faster and therefore do more things. But the system board is operating at a hertz rate that exceeds design specifications, and it will eventually overheat. When that starts to happen, it’s not long before the chips are fried and the computer is as good as toast. The doctor liked that metaphor.

One he likes to use is to compare it to managing fires. There is a limit to how many “fires” one person can manage at a given time. For someone with ADHD, that number is lower than most. In my case, some of the fires went out of control, because I couldn’t divert the necessary attention to fight them. I simply had to let them burn.

There was an episode of the animated show Gravity Falls, called Dreamscapers, where one of the characters used virtual-reality technology to look into another character’s brain. The place looked like a very convoluted wooden house. If someone were to do that with me, parts of my brain would look like the aftermath of a forest fire.

After her car accident, Lisa was found to have a serious vision problem, which had not been apparent until that time. The eye doctor called it a “reveal,” where a condition the body had been compensating for, and hiding, suddenly becomes apparent and the body can no longer compensate. I had a reveal of my own. Near as I can tell, up until around 2013, I had been doing an elaborate balancing act to keep ADHD hidden. But once that balance was upset, the ADHD did a reveal.

This also reminded of my father’s condition. He died of an angina rupture, which is genetic in origin. There are symptoms, but it’s hard to make the connection unless you know exactly what to look for. My father was generally OK. He had blood pressure problems, and was badly overweight, but he managed to keep both of those conditions more or less under control. At the very least he was able to prevent them from getting worse. But in May of 1993, the right set of circumstances occurred, causing the genetic time bomb that had been with him since he was born to detonate, and his life ended.

Apparently I had a genetic time bomb of my own, and somewhere within the last three years it went off. But mine didn’t go off with a loud, catastrophic bang. It was a slow moving incendiary device, that gradually chipped away at my mind’s ability to work. I had been too long overclocked, and my circuit boards suffered heat damage. Too many fires had burned out of control.

And my life has changed forever.

Currently I am in the process of changing to a new medication plan. My brain stabilizer of choice is Adderall; so far I need a small but consistent dose. I will admit that I’m not comfortable taking an amphetamine, even one that is very mild and tightly regulated. I have heard horror stories about what those things can do under the wrong circumstances. But it was either that or watch everything that matters to me fall away. So, bottoms up!

I’m also looking for an additional counselor to help me with some specific issues. I’m also putting together a plan for controlling my weight. These are all part of a larger gestalt of treatment plans. How well it works remains to be seen.

My reactions to this whole affair have covered a huge range: anger, sadness, confusion, and even vindication. And this ride is still ongoing. In fact, this may only be the beginning. This isn’t something I can fight. I can only manage it.

Time to adjust course and move on.