The Stigma of Addiction and other Mental Issues

The topic of stigma and mental problems has been coming up a lot for me lately, especially (of course) in relation to addiction.  So it was rather fortuitous to discover another great blog this morning and this post...

Sometimes I find it easy to forget about, because I have a lot of supportive, loving people in my life who just don't go in for stigma.  Couple that with having even less of a social life than usual this summer and I found myself in that comfortable place - the place where I just don't have to think about the destructive force of words - words that perpetuate shame.  It is that shame that really gets me fucking angry as hell.  I get enraged at the notion that a whole lot of people - some of whom I know - are so terribly ashamed of their own fucking brain.

To me, it is so obvious now...Feeling ashamed of the way one's brain works, is a lot like feeling ashamed of having brown eyes instead of blue, or red hair instead of blond.  It's obvious enough to me, that I forget sometimes that it is not so obvious to others.  It's obvious enough to me now, that I even forget sometimes that it wasn't always so obvious to me.  And even as obvious as it is, it is still easy enough to feel shame about who I have been and how I have behaved - because it is impossible to sort out where my neurochemical issues end and just plain old bad decision making begins.  It is especially hard, because everything I have done, all the bad decisions that I have made - all of it was at least influenced by the way my brain works.

How then, does one separate what one should be ashamed of, from what they should just accept as part of having neurological issues?

My short answer; one can't.  Trying to do so requires sorting through every factor that influences our decision making.  As a thought exercise, I would ask you to think for a moment, about the last book you read (or article).  I want you to consider everything that went into the decision to read it - don't just scratch the surface - dig deep into your motivations.  Follow the chain that brought you to the point where you wanted to read that book or article.  Where did your interest in the subject of that piece come from?  Where did the interest in whatever influenced you to get into that subject arise?  What else did you read, that indicated you might like to read this piece?  What influenced you to read that?  In short, try to untangle the skein of influences and motivations that brought you to the simple decision to read that book.  If it was a friend who recommended it, why do you trust their judgment?

If you just did as I asked, you probably got stuck rather close to the decision you made to read whatever it is you recently read.  Unless you took quite a bit of time and really went at it, you barely touched on a small fraction of everything that went into that very basic decision.  And even if you did take the time and focused, you quite likely still only scratched the surface - just a little deeper than some people would scratch.  Now think about this - we're just talking about the decision to read something.  How then does one sort out the decision to wander the country, sleeping outside as often as not?  How does one sort out the decisions to use virtually every mind altering substance set in front of them?  How does one sort out the decisions to have sex with virtually every woman and some men, who were willing and willing to use protection?  How does one sort the decisions that leaves one virtually homeless for more than five fucking years?  How does one sort the decisions to sell drugs, so one has drugs and sometimes a little money (and sometimes a lot of money)?  How does one sort the decisions to buy dope, instead of buying shoes that aren't literally falling apart at the seems?  How does one sort all the decisions that led to losing the roof over not only one's own head, but that of their family?

How does one sort the decisions that paint a picture of a reprehensible excuse for a human being?  How can such a person not be brutally ashamed of their own fucking brain - regardless of what actually influenced those decisions and how?

I wish there were a simple answer.  I really, really do, because it is hard being that person - hard not to be ashamed to the point of incapacitation.  It's hard not to extrapolate thirty some years of bad decisions into an inherent failure.  It is hard not to take those stigmas that are attatched to being mentally ill and accepting them as absolute truth.  But there is an excellent place to start - a place that not only helps the person who has made these decisions, but helps others as well.

Fighting these vile fucking stigmas is a very important place to start.  Being loud and proud of who and what one is, because as reprehensible as many of my decisions have been, I am also a good person on a great many levels.  And what makes me a good person, what fosters the positive - these factors are just as influenced by the way my brain works.  Just as the bad - the things that can foster shame - are influenced by the way my brain works, so are the positives.  The same chemistry that has seen me getting high on all manner of stupidity, has also seen me fostering my children's native intellect - communicating, reading and providing them with the absolute security of my absolute love for them.  The same chemistry that has seen me sleeping under bridges and in all manner of flops, has also seen me work feats of extreme beauty and grace in multi-million dollar homes.  The same chemistry that sees me lashing out in extremely harsh words, has also seen me develop a love for a wonderful women that transcends anything I ever thought anyone could feel in that context, let alone me.

Stigma is a trap.  Stigma is a prison of invisible bars that hold some people far more firmly than steel and concrete could ever manage.  Stigma does nothing but destroy and break further, people who are already broken and in need of healing.  Not broken because our brains are atypical, but because we haven't the tools to integrate our neurochemistry with the society in which we exist.  We are broken, because our society doesn't have a place for us - though that is slowly changing.  But regardless of what makes us broken, stigmas just exacerbate the problem - the brokeness - the shame.

Because I love you all, I wanted to mention...

...that I am becoming increasingly busy, as the end of the summer semester approaches. I have a shitton of work to get finished and a week from today, I am picking up my boys from TN. I will still have two finals to take after they are here and lots of important, fun things to do with my kids - whom I only get for a very short, less than two week stretch. Then I will have a few days to take care of non-school type business (Like the job I have managed to somehow basically take over), before the absolute greatest women ever is coming to see me, for about a week.

So blogging is going to be lite - or should be. If it's not, please feel free to naggingly ask me if I have gotten ahead of the mountain of shit I have left to do. Not that I expect you to, it is after all my responsibility to put my work ahead of my infesting conversations with my big blue meanieness (really, really, mean and nasty, big blue meanieness)...But if you have the urge and notice I am being a little more obsessed with a argument than someone who has too many other things should be, feel free to point out my stupidity in being so obsessed right now....

See you all on the other side...

In Which DuWayne Discusses HisTherapy

This last Friday, was my last session with the therapist I have been seeing. Her internship is up and I am probably going to be out of therapy until June.

I am very grateful for the experience that I had in eleven sessions with Theresa and can state categorically, that she is one hell of a therapist who will serve her clients well. I was rather reticent in the beginning and she admitted yesterday, that she was as well - for some of the same reasons. For my part, I was concerned about her lack of experience and the fact that she's a women. She was concerned because she believes that I am more intelligent than her and that I would find therapy more effective with a male therapist.

I have been trying to figure out how to explain the methods used in my therapy with Theresa and keep running into something of a wall with it. The reason is that the therapy was by needs, rather unconventional - utilizing a great many tools that are not generally used together. The diversity of the problems that I need to deal with make any singular approach simply impossible.

The first thing we did was to define the issues I am dealing with and my goals. This was excruciating, to put it mildly. We discussed a great many, very difficult issues in a very short time and explored issues that I was mostly unaware of. The biggest issues were figuring out where the cognitive problems end and the neurochemical issues begin and helping me recognize my emotions. The former is not something that can be accomplished with absolute accuracy. What we were really trying to do is help define broadly, the parameters of my neurochemical issues. The latter was and is, far more of a problem. When I first walked in the door, I knew that I needed to learn to deal with my emotions more effectively - instead of just shoving them away, into the recesses of my mind. What I understand now, is that I have very little grasp of my emotions.

On top of all this, we were also dealing with the nuts and bolts of managing the situation with my family and my reaction to it. This was in part, the hardest aspect of therapy to deal with - mainly because it really was what caused the realization that I have very little grasp of my emotions. It was also the hardest, because the situation with my family has been so absolutely insane.

In working out the parameters of my neurological issues and their interface with my cognitive issues, Theresa really probed my understanding of managing cognitive issues. Not necessarily in direct context to my own experience, but in a more generalized context. She then probed for how I've been dealing with a lot of my problems - what has helped and what has not. Finally, we delved into my experience as a child - not so much what was happening around me (though that was explored some as well) but what was happening in my head. Through this we were able to make some reasonable assumptions about where this therapy should be focused and also where my discussion with my doctor should be focused.

Exploring my problems with emotion was considerably more complicated. This is also where Theresa's ability as a therapist really shined. It's not that I was purposefully skirting the issue, it was just very hard to bring me to the place that I could actually see what's been going on. She had to ask a lot of questions, sometimes pretty much the same question - restated after we had managed to work out another point. She had a very good grasp of what was going on, but due to a need for me to figure it out myself, we had to get there the hard way.

Like any effective therapy, it was entirely based on asking the right questions and through that leading me to figure out what the hell is going on. When the problems being discussed are as diverse as my own, a baseline difficult task becomes huge issue. And to make it far more difficult for Theresa, I came into therapy with a few beliefs about who and what I am, that turned out to be entirely wrong. I truly believed that I had a pretty solid grasp on my emotions - I just didn't think that I was really capable of many of the emotional responses to various situations, that I saw in most of the people around me. While it the context in which it was said is important, alexithymia came up and I wasn't the one who mentioned it. She was clear that she didn't think this was a perfect descriptive, only that based on our discussions, she saw some alexithymic tendencies in me and the way that I manage my emotions.

One of the very few times she actually pointed something out to me directly, was when I came in and told her that the short-form assessment I had taken at the doctor's office had claimed that I suffer depression. This was certainly news to me and my surprise at this was pretty obvious. She then pointed out that when I was very young, I had desperately wanted to die - that when I got over wanting to die, I then moved to simply not caring if I died. Then she asked me how I felt about dying now, to which I responded that I don't want to. It finally sunk in when she asked me why I no longer wanted to die, which I explained was because of the boys...Not because I had somewhere developed a desire to live, but because I have children who need a dad. Just to make sure, she was clear that most people, even people who aren't really afraid to die, want to live and would really rather put off death - excepting those who get particularly old, or who suffer some debilitating disease or injury.

No, I'm really not a moron. This does however segue well into another important focus of my therapy - my own little world, the world that I built for myself when I was really young and wanted to die so badly. The world that I built as a form of self-medicating. The world that I thought was no longer a factor, after an early version of it shattered when I was thrown out of my church so many years ago. The world that has continued to be a huge aspect of my life since I was nine or ten, though it has seen a great deal of remodeling over the years.

A great deal of my life is spent inside my head. There is a rich and diverse universe to experience there, where I will never run out of ideas to explore, sculptures of words and music to explore and occasionally attempt to express on the outside and completely abstract mindscapes to ride, like a helicopter ride over the most beautiful landscapes this planet of ours has to offer. I have always been pretty capable of occupying myself for extended periods of time, with minimal external stimuli (I basically did just that when I spent a little more than a month in the woods once, completely isolated from human contact).

A side effect of spending this time in my head, has been my presumption of self-awareness and my ability to compartmentalize. Combined with my ability to feel at all, I firmly believed that I really understood my emotions and what I was capable of. I just believed that I wasn't really suited to feeling the way a lot of other people seem to manage.

I am not setting a course to vacate my head though. It is an important aspect of who and what I am. I am working on spending less time there and deconstructing some of the more prohibitive aspects of my own little world. Mostly, I am trying to learn who and what I really am - learn how to feel what I am really feeling and embrace it in all it's glory, horror, pain and ecstasy. I am trying to learn what DuWayne is actually capable of feeling. Thankfully, outside the parameters of therapy, I have found the most remarkable help with that.

One of the earliest discussions that came up, one that's pretty relevant, was about my belief that I am incapable of feeling romantic love, the same way most people do. I believed that I am incapable of loving a women the way women should be loved. I explained that the reason I had been so keen on my children's mom, is because I thought she was pretty much the same. I have since discovered I am very, very wrong. And while there are issues to iron out, Juniper is all about working it out together and loving me, in spite of my rather fucked problems with feeling, which she is aware of.

My therapist was excited when I initially told her about Juniper and was positively thrilled when I told her that I had told Juniper I love her. And while there are definite logistical issues that complicate our relationship, it has it's advantages for a person who is as broken as I am - offering a chance to explore feeling and understanding it, without the pressure of my lover being with me most of the time. At the same time, we both get the support that can only come from someone who loves you so much that it hurts - and both of us need that support.

I am far from done with therapy. I doubt that I will ever not be in therapy, though the focus and needs will change with time and context. I am a firm believer in those who work as psychotherapists should always be seeing a therapist for their own sake. And I am going through a hell of a run with school that is only going to be more challenging - not to mention the situation with my kids is not going to get easier any time soon. I need the help maintaining, above and beyond learning how to be not broken. But I am definitely in a much better place than I was when I first walked through the door and sat down with Theresa to talk.

And I have a supporter and teacher who provides me with something that no amount of therapy could begin to challenge. A remarkable, brilliant woman who accepts my love and beyond reason loves me as desperately as I do her.

Post Wizard and Doctor Update...

It was a very interesting and stressful day yesterday. Therapy was pretty intense for me, as usual and the visit to the doctor was pretty intense too - though I really think that the two on the same day is rather helpful. It helps to deal with both on the same day, because both are hard to deal with and getting them done together is much easier than trying to go through this shit on two different days. And it also puts everything firmly to the forefront, so I can really provide the doctor with solid perspective.

Last night I didn't take the Seroquel. I'm still a little off, but feel better than I have since I started taking it - and that even though I started my new meds right away. Before I talk about those though, I really want to be clear about something. Just because Seroquel didn't work for me, doesn't mean it's not a good drug. It just means it wasn't a good fit for me.

I recently reconnected with an old friend. Back when she was part of the group of friends I spent a lot of time with, nine years ago or so, she was pretty extreme in many of her behaviors. And she was also pretty obsessive. When I ran into her about a week ago, she was really stable - a huge difference. As soon as I mentioned this difference she said that changing the influences in her life and therapy had helped, but that the biggest help was from her meds. When I asked her what she's taking, she said Seroquel.

And that's the thing about psych meds (or most meds really), what works for one person, may not work so well for another.

So now I am continuing on the Ritalin and occasional Xanax, while replacing the Seroquel with Welbutrin and Clonidine - we shall see how it goes...

Off to see the Wizard and other thoughts...

So I am getting set to see my therapist shortly. I do have a post in the works, hopefully for this afternoon - one that rather steps away from most of my recent posts. I am working on a post about Meaning post Faith. I intend to write several posts over the next few months, detailing some of the issues that helped hold me back from shedding my Faith, we'll see how it goes.

I am definitely thinking that Seroquel is not going to work out real well. I know a couple of my wonderful blog friends are into neurology and/or pharmacology. I have discussed this with one of my pharmacology friends who recommended that I discuss the possibility of switching off Seroquel in favor of Clonidine and Welbutrin. If others have any thoughts on that, I would love to hear them. I have a week before I see the doctor next and would like to have some solid ideas to discuss with him.

The lowdown on my problems with SSRI's is that I had sex drive problems - on steroids. The lack of sex drive really isn't a problem for me - indeed at the moment it would be kind of nice. But mine went beyond mere lack of desire, I actually experienced discomfort in the genital region. A sort of dullness that was accentuated by a prickly feeling. I have been told that I probably wouldn't have the same problems with Welbutrin, but that it is a possibility. It may seem a silly concern, mainly because I just can't really know until I try, but I would prefer to avoid trying anything that is extremely likely to be a problem - I am paying out of pocket for my scripts and on student loans this is not a small concern.

Back to the wizard.

I am going to be discussing the meds of course, but also will be delving into the problem of feeling. I really wanted to write another post on how DuWayne got to where he is, continuing my series from last Thursday, but the damned Seroquel was not making that easy. I am going to try to get on that in the next few days, because it really seems to be useful for me. We'll just have to see.

The big issue that we have been running up against, is my issues with really delving into my feelings. I had this inane notion that I was pretty solidly in touch with my feelings and emotions, but have been realizing that this is not entirely accurate. Rather I have been very keen on dancing around my feelings and focusing an awful lot on others, to the detriment of my own personal connections to me. We'll just have to see how it goes, I'm definitely going to try.

I would also like to apologize to those who have been writing me this week and not gotten a response. I am not ignoring you, I just have not had it in me to write much. Also, I would really appreciate it if folks wouldn't IM me. I really hate to message like that, with very few exceptions. Please feel free to email and I promise I will get to you eventually. Messaging is just a little too much for me.

Seroquel: Day 2 Night 3 on my new meds

Sorry, there is some cursing going on here and I am not really feeling up to mucking about with the HTML to put it under the fold.

So on Friday, I went not only to my normal Friday therapy appointment, I also went to my doctor. I can not begin to explain how wonderful it is to be seeing the doctor I grew up with (or a doctor at all for that matter). I am not able to see him for general health concerns, because the visits are out of pocket. But to be able to deal with him for my psych meds is just so much easier, than dealing with the sliding scale clinic would be. Dr. T has known me since I was a relatively small child and knows a lot of my proclivities. He is also aware of my substance abuse issues and takes that into consideration.

Above all, it is really great to be dealing with a doctor who exemplifies everything great about family GPs. And who is also a licensed clinical psychotherapist and psychiatrist.

We spent about half an hour discussing my concerns and fears about going on a mood stabilizer. He was very clear that whatever we end up with, I am going to have to accept that some of what I am afraid of losing, is going to be lost. Ultimately, some of what I am afraid of losing is part of what is holding me back. I understand this, but it is not easy to accept - but then there are those beautiful little boys in the last post and it's a little easier to accept. So I am now taking Seroquel.

That said, I almost didn't take my new meds again last night. I don't like this, feeling like this and not feeling like I usually do. I am fucking angry and frustrated and really don't like it. Yesterday was fucking awful. Four or five times I just broke down and cried. I couldn't think straight to save my life. Today was a little better and tomorrow should be even better - we'll see. But I am also supposed to increase my dosage here soon, not as quickly as a lot of people do, but still. I really don't want to have another day like yesterday.

I am coming to understand it, but it boggles my mind that I got through thirty-two fucking years without really accepting or understanding what the hell is happening in my head. I chalked it up to the ADHD and honestly never really bought into the bipolar diagnosis. I mean I accepted that I may well be bipolar, but I never really grasped the actual impact it has had on me. I brought this up to Dr. T, because while there has been a several year hole, he's known me for almost twenty-five years.

He suggested the very thing that I brought up in my first of a series on Thursday, I have been dealing with this since I was born. I have had my entire life to learn ways to compensate. I didn't have a sudden onset as a teen or tweener, I got a leg up on them by working through my childhood on being less atypical. And I had the ADHD to blame for what I couldn't manage.

Fuck! I just took my pill for the evening ten minutes or so ago. And I am just fucking drifting now. I can focus, but I am not able to focus - it's really hard to explain. The bitter irony, there was a time when I would have been thrilled to have this shit. It's a fucking high to be sure. But I don't control it. I would love nothing more than to flush this crap down the fucking toilet and get a bag of weed. It may not be as effective, but at least I have control of my high. And the first half hour to an hour with weed doesn't make me keep getting weepy. Though I have to admit that that too is not as bad tonight, as it was the first night, or even last night, which wasn't as bad as the first.

I am going to give it the week at least, probably more. Even if it doesn't work out, we need to know exactly what kind of problems I am having with it, so we can move on to the next with a higher likelihood of success. And the few nights I've taken it are just not a reasonable assessment period. But this really fucking sucks.

I am, by the way, going to continue writing that series I started on Thursday. But it is going to be in my own time. It's not all that easy for me, though it is extremely valuable to me. And I would also really like to write about the issue of these "conscientious" objecting pharmacists, who don't want to fill scripts for meds that they think are wrong, but honestly, it just makes me so fucking angry that I have a hard time writing about it rationally. I already blew up big time at Abel's TerraSig and started to really lose it at Pal's White Coat Underground. Sorry guys. But I would really appreciate it if you would take a look at their posts and after, take a look at this clearinghouse for proposed and passed state legislation about conscience clauses for pharmacists and other health care pros. I would like to say that I will get around to posting about it, but it's highly unlikely - I have way too much on my plate. Two midterms on Tuesday and homework I haven't touched since Friday, because of these fucking meds. Not to mention home repair projects for a couple of very supportive friends, that are piling up.

In Which DuWayne Explains His Rage, Anger and Fear...Part One

I really don't have the time to do this now, but the way things are going, I never will. And I need to. The following series of posts (interspersed with other posts) will probably include a great deal of profanity, it will certainly include a great deal of information that will likely make some readers uncomfortable. I am going to talk about what many would perceive as rather dark aspects of human sexuality and even darker aspects of the human brain - namely my own. I am a very dark and lonely place

I want to be very clear to those who choose to read the following, that I make no apologies and carry no shame for who and what I have been. I am who and what I am, who I have been got me here. Quite honestly, given the opportunity to do it over, I am not certain that I would do a damned thing different. I have always done my best with the tools I have, though all too often those tools have failed me or my ability to use said tools has failed me. More...
Here I am, fucking naked again. More naked than before.

Of my first twenty-four hours out of my mother's womb, I slept just under ten. Before my eyes could even focus enough to see anything more inches from my face clearly, I needed to see it all. My mom hated it when I actually took a nap, because that would inevitably mean I was going to sleep even less that night. And when I woke up, I was always absolutely awake and ready to see more shit. My brother Jack taught me to read when I was two, at which point I began to incessantly devour books like they were food and water in a time of famine. I read Paddington Bear when I was four and was onto philosophy and theology by the time I was nine.

When I was nine, I learned about people. I learned how to read the people around me, not just what they expressed to me - I learned to read the truth of them. I had ideas. Always hammering me relentlessly, on top of each other, around each other and in and out of each other - it never fucking stopped, not even for a moment - but it slowed a little when I was explaining some bit or another. It made it better for that little while. When I was nine, I learned that when I was bouncing ideas off of the people around me, they didn't have the smallest clue what the fuck I was talking about.

When I was nine, I begged my god to take me home. I just wanted to die, rather than to go on without even the tiny abeyance that came when I was explaining it to someone else. But my god just wouldn't do it. So I retreated into a special world that I created for myself. A quiet place that was filled with the people I came to love so very much, the characters in my books. The times, places and realities that were not my own, but that I could borrow for a time. As a little boy I slipped away from this place and into a place of wonder, where I wasn't so very stupid and slow.

When I was ten, I took ownership of a very special sort of freedom. I no longer wanted to die, but nor was I afraid to die. This body wasn't the whole of me but I don't think that mattered even then. Had there been nothing more than this, the this I had had to that point would have been enough. But at the time I knew it wasn't. Not fearing death and being the singularly arrogant person that even then I was, I felt no real fear of any temporal authority. To be sure, I felt beholden to my own moral framework and the dogma of my Faith. But I was beholden to these, to the exclusion of all other authority.

I loved my god with every bit of my being. There's a very good reason for that, two really. For all of my study into the bible and theology, I created my god in the image of my idealism. And for all of my awe and wonder at the world around me, the world that my god had created, my observation of reality was also shaped to fit the reality of my god. Even though I dearly loved the people around me, everybody around me, People were an abstraction to me. Later, when I became more fully aware that People were people too, my god creation changed - But I digress. At that point in my life, the reality I perceived and inhabited was entirely my own creation.

The reason that the betrayal of my church (see a much earlier post) was such a traumatizing event for me was not so much the betrayal itself, it was the shattering of my own, perfect little reality. It became unglued, untenable - while I was desperate to hold on and keep it together. But I couldn't keep it together and everything was hammering me again. Because in the act of creating and maintaining, I burned enough of my energy, used enough of my brain to stem the tide of thoughts and ideas to a peacefully babbling brook - contrasting the non-stop flash flood that opened up on me, even as my reality collapsed.

Then I discovered cannabis and alcohol. And before long, sex.

I will continue this in another post, for the moment I just need to stop. But I would like to take this moment to explain something. In a previous post I mentioned balancing the sensory overload of music and drugs, with the additional sensory overload of sex. Someone very special to me, who I am coming to adore and care for very much, mentioned the contradiction of that, when I sent her the post before I actually put it up. She later wrote me and asked why I hadn't changed that (I told her I would). I couldn't answer at the time, because I really didn't grasp entirely why I didn't feel right changing that.

I think I understand it now. I meant exactly what I said, even though I really didn't consciously understand why. My life has generally been various states of sensory overload in a rather delicate balance, with one thing playing off another. Through this process, I have slowly learned to ride the balance of the tide, as it rushes through my head. The conscious and unconscious largely interchangeable. And after decades of running from it, I have finally come to embrace the rush. With the last vestiges of my creations falling to dust around me, I am finally riding the reality of me.

At thirty-two, I am both a very old man and a swaddling infant - but I am free. I am, finally, me. This is why I am afraid of going on more meds. Ultimately, I am just finally getting the opportunity to know me, with my filters stripped bare.

I know that it will be ok and I know that I need to do it. No matter how many ideas and sculptures of words flow through me, I am unable to do a fucking thing with them as it stands. And I fucking have things to do.

Reading What isn't there - Figuratively and Literally

I should mention that I actually got the material I was looking for, thanks Becca.....

Before I go very far, I am hoping for some help. I really need an article out of a journal that is not part of the databases I have access to. Because I am uncertain I will actually want to use it, I don't want to buy it. So if you have access to the journal Psychology of Men and Masculinity I would really appreciate it if you would email me. If I actually end up using the article I am looking for, I don't mind buying it. But if I'm not, I'd rather not spend the money.

So I stuck foot in mouth a bit yesterday. Being in a strange state of focus lately, I rather read an awful lot into some comments at Greg Laden's blog. What annoys me about this is not the embarrassment of having to admit to my mistake and apologize. Being rather egotistical, I appreciate having the opportunity to be humbled. I am annoyed, because I just don't do this - reading in things that are not actually there. I get really irritated when people do it to me, being one who tends to mean very specifically what I actually say.

I much prefer to have to admit I was wrong about something, because someone else convinces me that my reasoning was flawed or my evidence is wrong. I really hate admitting I was wrong, because I jumped to conclusions by inference. The fact that most of the time the conclusions are correct, does not make it any less obnoxious or sloppy.

Having been somewhat focused on this line of thinking, I realized that I have been guilty of this a lot lately. While this is the first time it's really come to bite me, I am doing a lot of reflecting on how I have developed this habit. Stress is at least a part of it, but I tend to think that there is something more going on that I need to delve into. This is not the only "not DuWayne" issue that has arisen in the last few months.

The problem with this is there are so many factors involved, that it's really hard to differentiate and sort through it all. And it is really important that I sort through a lot of it, because I am finally trying to really deal with the negative aspects of my neurological make-up. It is critically important to me that I maintain the best balance possible between functionality and retaining who I am. But at the same time it has become increasingly apparent that my neurochemistry needs more help than Ritalin and the occasional Xanax are providing now.

Going much beyond the minimal constrictions of my current regimen really scares me. It hurts like hell to be me, quite a lot of the time. It's hard sometimes to sort through the constant barrage of ideas, words and music that inundate my mind. It's frustrating to get sent on tangents that distract from what I am trying to accomplish at a given moment. But it's me. It's who I am, what I am. I don't know how to be not me.

But I also don't know how to be me and succeed in the ways that I must.

Listen to Your Doctor.....

I finally got through the hell of trying to get into a doctor and went to the one I grew up with yesterday. I am now on regular old methylphenidate (Ritalin), which will allow me to exert a great deal of control over my dosing. So on days when I need to go to class, I can take two 10MG in the morning, one at lunch and generally call it good. On days when I need more time to study, I can take two in the morning, one at lunch and one mid-late afternoon, while on weekends I can minimize, unless I am studying.

Though I have to admit that I really would love to try Vyvanse. Unfortunately, at ten dollars a dose, it's just not feasible, as it's a total out of pocket cost. Basically, Vyvanse is a prodrug equivalent for Adderall. It is theoretically superior to Adderall and Ritalin, because instead of being an extended release because the pill is made a particular way, it's release is extended through metabolizing. This apparently reduces many of the side effects found especially in Ritalin, but which are also occasionally found in Adderall.

We also discussed the possibility of a close generic equivalent to Adderall, dextroamphetimine which is the actual generic for Dexedrine. The thought was that this might decrease or eliminate the headaches I often get when I take methylphenidate. The problem with that being that the script is twenty some dollars to fill, as apposed to six for methylphenidate. Unfortunately, cost is a significant factor, so for the time being, I am taking methylphenidate.

I was also prescribed Alprazolam, which is the generic for Xanax. I am not going to take it often, as I really only need it for certain, specific cycles. I am starting out with the ability to get a refill before I see the doctor next, because he felt that it might help me getting used to the methylphenidate. Mostly I am keen on having it to help me nip off the cycles that got me diagnosed with bipolar. Though it was nice to see my old family doctor again, as he agreed with my assessment that it is more likely that the symptoms are a result of a lifetime with far less sleep than most people should get. The other reason I was interested in Alprazolam, is to help me through therapy. Last Friday's session was really intense and left me pretty shell-shocked.

So now we get to listening to the doctor.....

I have a really tough time remembering to take my meds, when I am on meds. Even worse, is if I have to take more than one, at different times. It is much easier if I can just take them all at once. So my doc explained that I should probably not take the Alprazolam, until I am getting towards lunch time, or unless I really felt the need for it before then. But he wanted me to take my first dose of methylphenidate without it, figuring that if I really was going to have trouble, it would be with the second dose of the day. He also warned me that I probably would do better to offset the mythylphenidate and the Alprazolam by at least forty minutes to an hour. I asked him if taking them at the same time was dangerous, which he said it really isn't, it just causes a lot of people to get a little buzzed.

So what do I do? Screw that, I say to myself. I'm going to forget the Ritalin if I don't take them together. Then came my remedial algebra (yes, I am math inept - failed pre-algebra in high school, twice). I had no trouble focusing on class. I was able to pick up the concepts we were learning today. I could not however, ask either of the questions I had, to save my life. I was actually afraid if I tried to talk that gibberish would come out. Thank the gods for email and a instructor who is happy to answer them.

Amusingly, when I was out having a smoke after class, I mentioned it to the smoking clan. One of them explained that he had experienced the exact same thing. He said that the offset in taking them really makes a difference. Of course he also mentioned his fondness for taking them together on weekends. I have to admit, that while not at all conducive to full functionality in class, it did feel pretty good. Thankfully, I have years of memories of getting high and don't feel the least urge to abuse the drugs that are here to help me function. I did seem to have an easier time in humanities, which follows the math.

No problems contributing to the discussion - though that may be because we were talking about the Roman Empire, a topic that really gets me excited. Though I should admit that I did have to leave class early, but that was because we were watching a documentary I've seen twice and really hated. There's a twit who makes the assertion that the Romans built Hadrien's wall and never went north, because they felt it was a wasteland. That was just their excuse. The reality is that the naked blue warriors had the invulnerable Roman Legions pissing themselves in terror. So by building Hadrien's wall, the Romans saved face and the Picts were left alone again. Watching the video might have worked anyways, but the sound was kind of warped in my head and was making me very uncomfortable.

Harm Reduction Part 1: Addiction, Substance Abuse and Therapy

If you haven't already, I would like to strongly recommend that you listen to this podcast, or read through some of the transcript here. It will provide a very solid introduction to the Harm Reduction approach to addiction treatment. And please, do not take anything said in this post as an excuse for addictive patterns that lend themselves to self-abuse. This is something ideally discussed with a therapist. Short of that, discerning what any individual is really dealing with in their substance use requires a great deal of honest self assessment.

I am having some trouble with pushing on through this discussion. I want to warn you that one, I am using some strong language in this post and two, I am going to take a while to tie it all together. I expect to put two more posts into this discussion. I really am going somewhere with this and am arrogant enough to say that it's a point worth getting to. I really hope you will understand that while I am not afraid to discuss whats going into this, what I am talking about is rather painful - pain that I am dealing with right now. Bear with me, I like to think it will be worth it.

More...I am really glad that I decided to relax last night, instead of pushing through and finishing the post I was working on. Not only do I feel better now, I have a somewhat altered perspective to talk about. I had a rather busy morning and really have a fair amount to get done this evening and into tomorrow. But I think I need to take the time for this right now.

I just had a very intense session with my therapist. On top of my general neurological proclivities, on top of being in school for the first time in sixteen years, I am trying to muddle through the very worse experience of my life. And it's been fucking brutal. Not one to deal with stress and anxiety very well in the best of times, it takes a lot for me to simply stave off meltdown. Add to that, that I have been abstaining from cannabis, traditionally my warm comfort in times of extreme anxiety. For the first time in years, I'm really having the urge to drink and get trashed (as apposed to simply wanting a beer or good bourbon, because I enjoy them).

To make things worse, I have been trying to get in to see the doctor so I can get on meds. I set an appointment for the 20th, back in early December - only to have them call and cancel because they made a mistake. So I tried to reset, twice they've set then canceled, again, due to mistakes. This has not helped with my anxiety issues. All together it's everything I can do not to curl up in a corner and descend into fucking hysterics. The upshot, is that I have an appointment Monday, to see the doctor I grew up with. It will cost money I really don't have, but it will also help me succeed in school and make it easier to avoid losing it.

What the hell does any if this have to do with addiction you ask?

I am an addict, an abuser of substances. By most measures I'm an alcoholic, in spite of being capable of the occasional drink without falling into a binge. It wouldn't be inaccurate to call me a marijuana addict. No question I'm thoroughly addicted to cigarettes. I could go on, but I think you get the picture. I'm an addict, an addict who has a fairly high degree of success at manging his addictions - excepting the cigarettes. But according to the dominant addiction paradigm, I am an abysmal failure.

My measure of success is not that of the dominant addiction paradigm. I am not abstinent. Even though I am not drinking, it's because I know that if I have a drink right now, I could well lose it and fall into self-abusive behaviors. A year from now, hell maybe in a few months, it will probably be perfectly safe for me to have a drink. I like good beer and I love good bourbon, but my fondness is limited to a single drink, two at the most. Beyond that I don't like to drink.

My reasons for abstaining from the weed are a little different and will probably be a very long-term, if not permanent decision. It was no longer performing the function I wanted it to and in some cases was actually increasing my anxiety instead of reducing it, as it traditionally has. Beyond that I have other motivations for quitting that far outweigh the desire to get stoned.

How did I get here?

Several years ago, I had a fortuitous encounter with a cognitive psychology professor who busted me, sitting in on one of his lectures. We ended up spending more than an hour talking in his office and one of the topics that came up was my ADHD and a theory that's been floating around for a long time about it. He explained that it seems likely that ADHD is in part a dopamine deficit. This was ultimately pretty earth shattering for me, because it ended up having a profound effect on how I looked at my use of psychoactive drugs and even some of the things I love to do, like writing and playing music.

Over the course of the weeks, months and years after that conversation, I began to formulate a whole new personal drug use paradigm. The initial concept was simple and not necessarily well affected - it's ok to get high, the problem is getting wasted all the time. As time passed, I began to take increasing ownership of my drug use. Never having heard the term, I had stumbled upon the harm reduction approach to substance abuse, or as Dr. Denning puts it, substance use issues. I am far from unique in this. I don't have some special knowledge or brilliant fucking insight that no one else can have. I figured this out because with a bit of introspection it just makes sense.

I will continue this discussion a little later, maybe tomorrow. It was a productive day and a very good session in therapy, but it has also been a fucking brutal day in many regards.

Here I am, I am just a man
this is my life, starting all over again
nearing the end my last life was broken.....

ADHD, Bipolar and other neurological issues: A Quick Note

To be clear before I go further, the information available to me about those hitting this site is very limited. But one of the things that my site meter tells me about, is the referring URL, i.e. where you clicked in. And when a google search brings someone here, while I don't know who that person is, I do know what the search string was.

I have noticed that I get fairly regular hits from searches on ADHD, bipolar and neurological disorders. Often included are methylphenidate, ampehtamine, adderall, ritalin, substance abuse, etc.

Please, let me make you welcome. If you are hitting this post, feel free to peruse the rest of the blog, but more importantly, please let me know what you are looking for. While I am painfully busy right now, I would very much like to provide links in the sidebar to help facilitate your search and the searches of others who come after you. I do have several links that I intend on posting, but school and, well, ADHD behaviors have kept me from getting to it. Meanwhile, there are links to some forums that may be of use. Discussing our problems with people who have similar issues can be a major help in itself. And some of the forums provide links to other information - and you can always post a request for links.....

More than just a place to foster interesting discussions, I want this blog to also be a place where information on topics that affect me and those I love can be found. I have rather severe ADHD and not so intense bipolar issues. I have many years of experience with substance abuse issues and am studying psychology with the intent of going into addiction research and clinical work.

If you happen to be looking for substance abuse links, please take a look to the right of this, you may have to scroll down. There are some links now and that list will be growing as I have time to get to it.

So please, if you don't see what you're looking for, let me know. You can post anonymous links or email me (just write confidential in the subject line). While I am not a therapist and cannot provide mental health care, I can point you in different directions and am often happy to talk. While there is no legal compunction for me to do so, I am very discreet and will never post or talk about you. If you give me permission, I may discuss things you share with me, but would make sure to keep your identity private.

Eugenics, Yes, I said Eugenics; Is there a problem?

Please check out and even contribute to the comments section. We have a decent discussion going and would love to hear from you too.

At this point if you're reading this, it is quite likely you've only recently discovered my blog. Mainly because I quite recently posted for the first time in a very long time. I'm really glad that I did, because someone managed to go back and hit on a post I wrote over a year ago (granted there weren't many posts between here and there). I'm glad, because I really think this is an important discussion to have - one that becomes more important by the day. And the comment left by Juniper Shoemaker is worth addressing. And to make it really fun, Juniper is a geneticist in training. (Juniper is also the bittering agent in the last beer I had, an awesome brew by my friend Mac back in Portland.)

For those who might not want to read the original post, I am basically making the argument that we need to get past the hysterics that almost inevitably ensue when the word eugenics is brought up. I would like to be clear that I am not advocating for or against eugenics, though there are certainly ideas involving eugenics that I am strongly against. All that I am advocating for is a rational discussion of eugenics, much like Richard Dawkins did a couple years ago.

The reason this is important right now, is that a lot of controversial things are happening that should be fostering important conversations. But those conversations aren't really happening and I suspect that the reason they aren't happening is because the term eugenics is so very loaded. So before I get into addressing Juniper's comment, I would like to point you to a very illustrative post that discusses eugenics. (without ever actually using the word)

Turns out that a couple had been searching for awhile to find an egg donor who looked like the mother and possessed certain attributes that clinics do not approve of as legitimate donor criteria.

Yup, that there is a shining example of eugenics in action. It's not abortion. It's not killing a flawed infant. It's not sterilization and it's not genocide. It's simply a couple who needs a little help having a child, a couple who wanted to exert a little control over the genes of their child to be. Not really very controversial, it's not much different than the decisions people make when choosing a mate they might reproduce with naturally. But on to Juniper's comment....

The problem with eugenicists is that they ignore the fact that the desirability of ANY trait is dependent on its environment. The environment always changes. Traits you cannot possibly conceive of as "desirable" today could prove desirable tomorrow for a myriad of reasons. For all we know, these traits could include hypertension, bipolar disorder, Down's syndrome and autism. Reality is bizarre and unpredictable.

I have no problem with that. I'm bipolar and also have very severe ADHD. And guess what? My son has been diagnosed with severe ADHD and probably has either some of my other neurological issues or those of his mom. I have very little doubt that my youngest will also exhibit something of our neurological issues too. I can even accept that there may well be some value in the propensity for DS as well.

I will also go as far as saying that the idea of aborting a fetus that has tested positive for DS is not a black and white decision or an absolute net positive. This, in spite of the fact that if our incredible one year old had tested positive as a fetus, he would not be with us today. No question, no discussion necessary. Had that test come back different, we would have terminated the pregnancy. Because while the idea is far from black and white, our ability to deal with it is absolutely clear. We already have a child who needs a lot of special attention. Under ideal circumstances, the sibling of a child with that level of disability is going to lose out. In the case of a sibling who has special needs of his own, it's a recipe for disaster.

But this statement of Juniper's is really the crux of the matter. She is presenting one of the best examples of why we really need to have this discussion. Because right now, it is possible to test for a variety of traits, invitro and make decisions to abort based on those tests.

Call me a hypocrite, because I will freely admit that in a sense I am one. I am fully aware that any child I produce is likely to carry certain traits of mine, that aren't all sunshine and roses. Having the neurological issues that I have is not an easy burden to bear. But I have reproduced and more than once. And I think that the value that comes from having neurochemiustry such as mine, is ultimately worth the hardship it entails. Honestly, if it becomes possible to test for ADHD invitro, I would have serious issues with the notion of trying to eliminate that trait.

Yet without question, I would have no problem with terminating the pregnancy of a fetus that has tested positively for DS. I'd like to say that this is only because of the child I already have. But being perfectly honest, I don't think my reaction would be much different if I was childless. Dealing with a child with that level of need is not something I think I am suited for.

And then we have a somewhat gray area for me (but not for a lot of people), autism. I suspect most people out there who would terminate a pregnancy for DS, would also terminate a pregnancy if there were a significant risk of autism. I'm not one of them, but that is because I have a fair number of autistic friends. At the same time, having the older child I do, I am not sure given the option, I could, in good conscience bring a fetus to term that carried a significant risk of severe autism.

These are not black and white questions, but they are well on there way to being a fact of life and are indicative of why we need to be talking about eugenics.

However, it irritates me when eugenicists assume that the only reason why people get pissed off with them is the "controversial" nature of the subject. That implies that people have to choose between a ringing endorsement of a loaded practice or a sheep-like unthinking aversion to the practice.

Honestly, I think that this is why we need to separate Eugenicists, from ownership of eugenics. Because I really don't think it's reasonable at all to allow anyone lay claim to a concept that is as broad as eugenics. Eugenicists, as Juniper is describing tend to fall into a fairly narrow range of beliefs. And those beliefs are not based on actual science, any more than the beliefs of the so called intelligent design movement, or evolutionary psychology.

I get pissed off because people who like the idea of eugenics usually have a shitty understanding of evolutionary theory.

I would take that one step further and say that eugenics only has a peripheral relationship to evolution at all. Because eugenics is really contra-evolution. Not that being contra-evolution makes eugenics inherently bad. But the claims made by Eugenicists are worse than ignorant, I believe that for the most part they are flat dishonest.

No matter how dishonest, no matter how ignorant their theories, I think it is long past time to take the concept of eugenics away from the Eugenics movement. It is also way past time to take the concept of eugenics away from the specter of the Nazis. Because like it or not, eugenics is a reality and the hysteria surrounding it is preventing us from having some very important discussions with very profound social implications.

DrugMonkey Asks; Decriminalization: What would happen? Part 2

Or Why I am studying to become an Addiction Researcher......

So now I am going to talk about the drug users, both current and potential. But I am probably not going to get to the decriminalization/legalization aspect of the discussion until we get a ways into this. First I would like to discuss addiction, overt dependence and what I see as the failure of our current addiction paradigm.

I think it is important to make the distinction between addiction and overt dependence. I think a very good way of expressing this is to identify two different types of heroin junkies. You have most heroin junkies, who even after they detox from opiates, still have a driving need to use more heroin. Then you have a much rarer type of heroin junkie, the junkie who after detox, will have absolutely no desire to even look at heroin again, much less still want to use it.

Overt dependence (OD) is the specific chemical mechanism that is very different from substance to substance. It is what makes heroin detox very different from detoxing from crack, or meth from alcohol. Using a particular drug will cause specific changes in one's neurochemistry. While some of these mechanisms might be somewhat similar, they each have their own unique patterns, that are nonetheless going to be common to other people who have OD on the same substance.

Addiction on the other hand, has some common characteristics, no matter what the addiction in question. These are characteristics that you will find with heroin addiction, alcohol addiction and shopping addiction or sex addiction. It would be way oversimplifying and completely inaccurate to claim that this is the whole story, but there are factors that are common to all addictions, something you just won't find with OD.

The known neurological common denominator in addiction is one that I am personally very familiar with, dopamine. This is why substance abuse is so very common with people who have ADHD. We are always on the lookout for better ways of getting our dopamine fix, as one aspect of ADHD is a dopamine deficit. At the same time, I suspect that this very trait is what provides most people with ADHD, some immunity to OD.

I suspect that there are more common neurological threads, that wind their way through addiction, which is why I am going in the educational direction I am. Not to say that I am limiting myself to neuropsych. I am going to work my way through clinical psychology on the road to my goal, because I think that there is a great deal of value to be had by approaching this from multiple directions. But ultimately, I want to study the common elements of addiction and the human brain. At the same time, I also want to find some of the uncommon neurological elements. Because I suspect that in the quest for both, lies a better answer, or a better paradigm for treating addiction.

So what do I mean by uncommon elements? Let me use my own addiction to tobacco as an example. Nicotine dependency is but a tiny aspect of my addiction to cigarettes. As is my dopamine fix (though that is by no means negligible, as I suspect that the OD on nicotine really is). What is far more important to my driving need to smoke cigarettes, is what smoking means to me.

When I was fairly young, I left home and then left the state to wander the U.S. and even some outside the U.S. I hitchhiked nearly every state. During those years, I slept outside far more often than I slept in. I lost absolutely everything I had on multiple occasions, starting completely over - mind you all I had at any given point was what I could carry on my back. The only consistency I had in my life, was cigarettes and coffee. The only things that were absolutes in my life. Next to that, I almost always had marijuana and a copy of Huxley's Brave New World.

Of the things I've listed, the only elements that are still critical components of my life are cigarettes and trying to hang onto a copy of Brave New World. I usually drink the coffee, but at times I feel the need to detox. And I have for a few reasons, found it necessary to quit smoking or otherwise use marijuana. So smoking is a huge issue for me, because it is one of the very last threads that tie in important aspects of my life.

On top of that, I have made smoking more than just a fix. I really enjoy smoking. I enjoy trying new tobaccos and blends. I like how it tastes and because of the quality of tobacco I smoke, I actually like the way that it smells. So defeating my addiction to cigarettes, is going to take a lot of effort on my part.

I did warn you that it would take us a minute to get to my hypotheses to answer DM's question, didn't I? If you're still with me, take heart, because we're there baby! Kind of, sort of....

Here's the problem. I honestly doubt that with our current addiction paradigm, as addiction pertains to drug users, our society would look much different than it does now. This is accepting that many of the changes I detailed in part 1 would make some rather significant changes to society. But as far as drug users go, things don't really look a whole lot different.

The exception to that, is that I do believe that we would see a temporary spike in drug use and with it, a spike in addiction rates - also temporary. This is not to say that the addictions accrued during this time would be any more temporary than addictions are now, just that as use dropped back down, so would the rates of new addicts.

I suspect though, that in the long term, overall use of most drugs would ultimately drop below the levels we have now. Because I believe rather strongly that legalization would foster an environment that encourages us to explore new addiction paradigms and that it would also foster new approaches to prevention/education.

I am honestly not that sure about what a new addiction paradigm should encompass. But I certainly have some ideas. First and foremost, I would love to see our society gain a much better picture of what addiction really is and accept that while addiction can be and all too often is a very ugly existence, addiction can not only be benign, but can even be an unmitigated positive. That it is ok to tell a drug addict that they are always likely to be an addict, with the caveat that they need not always manifest their addiction in the use of harmful substances or destructive behaviors.

I have mentioned that I have ADHD. Not only do I have ADHD, I have very severe ADHD. I have also been diagnosed with bipolar disorder and have been an insomniac since birth (seriously, I slept less than ten of my first twenty-four hours outside the womb - it was downhill from there). I know about dopamine deficiencies and have spent a rather large percentage of my life trying to compensate. When I was younger, that led me to using a lot of different substances for such compensation, but it also led me in other, unexpected directions.

I love to write and perform music. Performance in itself isn't the key though, what really gets the dopamine squirting, is when I am effectively influencing the emotions of my audience, making them feel what I feel or want them to feel. The stronger the effect I have on someones emotional state, the more intense the experience is for me. Given my Christian upbringing, this made the next step in my musical addiction a natural; writing worship music and leading worship. Because this brought the emotional intensity to a whole new level, making the effect could garner so much more intense.

I am not going to go into the interchange that brought me to that place right now, though I may address it another time. Suffice to say that in this process, I managed to do what a lot of addicts do. I lied to myself to make me believe this was ok, and by extension lied to others. That in itself isn't the worse, my addiction led me to stick with it after I had realized the lies I had told myself. To be sure, I was encouraged by some folks in the church who knew where I was at, for a variety of reasons, but when it came down to it, I stuck with it because of what it did for me. Because of my addiction.

The thing is, it could have been and has become an honest, benign addiction again. I stick to writing music that I believe in and while I'm not performing now, I know that when I am able to share my music with others, it will affect them. No lying and no harming anyone - least of all myself. Yet addiction it most certainly remains. The act of creating beauty with one of my favorite mediums, words, gets the dopamine moving. Even sitting here right now, putting these words on this page is making it happen. It's an addiction, but quite arguably a very positive one. After all, I believe what I am saying. I believe it strongly enough, that I want to direct my education so that I can either prove it, or discover that I am wrong - either of which is fine with me, because either result will still be a step in the right direction. That direction being furthering our understanding of the world, specifically addiction.

And if I can convince others that I might well be right, that may encourage them in a positive way. Or this may encourage people to challenge me and maybe even make a cohesive argument that encourages me to change my position. Or their challenge may encourage me to think more and develop a more cohesive position of my own. Hell, their challenge may be so ridiculous that it fills me with righteous indignation. Any and all of these possible results, will produce yet more dopamine spikes and feed my addiction even more. All without me resorting to the use of destructive chemicals or other destructive behaviors.

There is a lot more I could say and maybe I will. But I think I have provided about as much a overview as I can for now. I realize that much of this seems quite tangential to the issue of what decriminalization or legalization might look like, but it's all interconnected - or should be. I think that it is quite reasonable to say that both the prohibition and war on drugs have been abysmal failures. But that is not the only failure. Our entire drug paradigm is an absolute, categorical failure. Our entire addiction paradigm is an absolute, categorical failure.

Therefore, I think it is rather unreasonable to attempt to discuss any of these in a vacuum.

Lots going on...

Wow, it's been a while. Sorry about that. I am still waiting on a connection at home and dealing with a lot of things at once.

We are having a baby in a matter of weeks now. Not really prepared enough but working on it. Unfortunately, I am going to have a break from working that I really need not to have. I will probably come up with something, but it's very stressful timing with Christmas and a baby coming quickly.

On top of it all, my five year old is really having issues at school. We have bent over backwards and jumped through hoops to make it work, to create continuity between school and home. His counselor has also gone the rounds to help us create a workable solution. Part of the problem is the school, part of it is his ADHD. So we are pulling him out at the semester turnaround. As much as we hoped to avoid it, we will be teaching him at home.

To a certain degree, this is kind of exciting. There will be many advantages to home schooling. Ultimately, I think it is probably the best way to educate someone with severe ADHD. One on one teaching would have done a lot for me. But it is also very intimidating. It will all be in our hands and on our heads.

It also means that we are going to have to make some serious changes to the way our household operates. This in itself would not be such a problem, but it comes at a time when we are already going through serious changes, what with the baby and all. It also means that there is little possibility of momma going back into the workforce (not that this was likely to happen in the near future anyways).

On the upside, it is motivation to write more about education. I have been wanting to get a forum going to discuss parental supplementing and home schooling. We are actually getting a new internet connection soon, which will get me back to doing more blogging. We will also probably both be getting into writing about our experiences, both good and bad, with educating our son. I am also interested in hearing from others who are either home schooling or actively supplementing their child's education. I am also keen on hearing from parents who are done (or mostly done) with that sort of thing. Educators are also of interest, as are those who just have an opinion about it all.

I will probably be starting a new blog for this endeavor. Expect it after the holidays. I don't intend to blog less here, indeed with a home connection, it should go on the upswing again. But I will probably do more on the new one, as I hope my partner will too.

Again, I am sorry that it has been so sparse lately. But as you can see, I've been busy.

STOP!! Vote for Shelley Batts

The amazing, remarkable Shelley Batts (ok, a little thick, but Ed's threatening painful death, so it could be worse) who wrote the great piece on the neuroscience of ADHD, that I loved so much, is in the running for a scholarship to help with her PHD. So click here, even if you don't actually take the time to go to her blog, click the dot next to the name Shelley Batts and click on vote. Seriously, she's a poor grad student with a hungry parrot to feed. If you're even questioning whether or not to even care, please, click over to her blog. Look at that sweet, hungry parrot (probably not actually hungry, I imagine if given the choice between her and the bird, the bird would eat, but still, Shelley rocks)

Sorry for the creative tags. The more searches the better. If you got here through a search, Vote For Shelley, it's worth it. Then come back and read some of the pieces, they're worth it too, some of them anyways.

What's happening. . .

I would like to apologize for the dearth of posts lately, especially those pertaining to human rights. Things have just been very chaotic for me lately. Actually, they usually are, it's just been worse than usual lately, what with almost ending up homeless. On top of that, the youth minister at my church recently fell off a ladder and broke his back. It wasn't a bad break and it will heal with minimal permanent damage, but it does mean that he is unable to finish getting his house ready for painting and the paint on. I have been helping him build his house over the last year and a half. As such, I know better than anyone, exactly what needs to be done, so I am coordinating the final steps to make sure it's painted before winter. As I am unable to climb ladders, this is a rather complicated, inefficient process.

I would also like to thank those who emailed and commented on my situation. I would especially like to thank those who offered to help us keep a roof over our heads. It was really appreciated. I meant to move the post about it below the denialism posts, but accidentally backdated it by several months instead of several days.

I am almost finished with my own posts on ADHD and neurological disorder denialism. I am still hoping to get more posts up by others and will undoubtedly have more of my own thoughts on the subject, but after I get the last two parts of my story up, I will definitely be taking a break from writing on this topic.

I am also almost done with my reading list for the post on morality, torture and the neurology of violence. It will probably take a bit for me to finish writing that post though, I may even split it up into multiple posts. There is a lot of information that I want to get out there. I would like to take this opportunity, to direct you to a short post at Nuerophilosophy, about torture. Actually, Mo's got several really cool posts up that are worth checking out.

Having gotten through a lot of the reading, my opinion about morality has not really changed. I am realizing though, that this is very much a semantic discussion, more than anything else. This is not to imply that framing it thus makes it any less important, language in many ways defines social interaction. However, I think it's important to realize most people have very different ideas about what defines morality. Indeed, many people use more than one definition of morality, depending on the context or axioms being discussed.

At first, I was trepidatious about getting into the discussion of morality. I didn't really think it was particularly relevant to the discussion of human rights. But after receiving a couple emails admonishing me to consider it's relevance more, I realized that not only is it topical to the discussion of human rights, it's fundamental. A large part of my desire to start this blog (aside from whim) was to explore the foundations of human rights, to get to the fundamentals. So not only do I feel more comfortable with bringing morality onto the table, it is my intention to focus on morality quite a bit in the near future.

This brought me to consider the relevance of my recent foray into neurological disorder denialism, and neurological disorders in general. On several different levels, this is also relevant to the discussion of human rights.

First, I think it's important to recognize that neurodiversity is a very good thing. For every negative aspect of most neurological disorders, there are positives that need protection and fostering. The main reason I am so excited about all the advances we are achieving in neuroscience, is that I believe this will lead to a greater understanding of how to preserve the richness of neurodiversity, while compensating for the negatives that accompany it. The status quo is focused on elimination of the symptoms, rather than compensating for them. The problem with that is that we lose something on the process, something of immeasurable value. The goal should be finding ways for us to fit into the structure of society. The goal should most assuredly not be to turn us all into neurotypicals.

Second, this touches on a discussion that was discussed very briefly here. That is, the rights of children, versus the rights of their parents. There are very few contexts for this discussion more important and more ambiguous than the context of mental health. Having suffered as a direct result of my parent's denial of my neurological disorders, this is a topic that hits close to home, obviously.

Finally, this touches on the very real problem of persons with neurological disorders that seriously compromise their ability to reasonably function in the framework of society. Where is the line drawn, where should it be drawn? What restrictions are appropriate and where are they appropriate?

As always, I welcome cross-posts and guest posts. If you have something to add to the discussion, I would be happy to check it out and probably put it up. Even, maybe especially, if you disagree with me on something. I would appreciate dissenting points of view. I would also welcome some relief from the pressure of trying to keep posts flowing. In any case, thank you very much for stopping by. I hope to hear from you, as I really appreciate feedback.

The Neuroscience of ADHD - Dopamine Abnormality in ADHD

I can't begin to describe my appreciation for both Shelley Batts, of Retrospectale and now, Joseph, of The Corpus Callosum. Indeed, I should also express my appreciation to the denialists that I tangled with in comments, attached to Shelley's post about The Neuroscience of ADHD, for motivating me to do this. I would ask that you please follow the link and read Shelley's post, it is fairly quick reading and well worthwhile. As she doesn't offer explicit permission to repost her writing, I will not do so here.

Joseph, on the other hand, offers a similar license to the one on my blog, so I will reproduce his post on Dopamine Abnormality in ADHD, here, with comments. To be clear, he has not offered specific permission for me to reproduce it and probably does not know that I have. He is however, kind enough to license his writing under a CC license, the details of which can be found here.

From Joseph's site;
Corpus Callosum is written by a psychiatrist at a small community hospital somewhere in midwestern USA.

A while back, Shelly wrote a nice introduction to ADHD at Retrospectacle: The Neuroscience of ADHD. Read that first, for background, then consider this to be a minor addendum. There are still people who believe that ADHD is not real. This is a good example of the scientific findings to the contrary. It is an open-access article (there is one every month) at Archives of General Psychiatry.

Depressed Dopamine Activity in Caudate and Preliminary Evidence of Limbic Involvement in Adults With Attention-Deficit/Hyperactivity Disorder

Nora D. Volkow, MD; Gene-Jack Wang, MD; Jeffrey Newcorn, MD; Frank Telang, MD; Mary V. Solanto, PhD; Joanna S. Fowler, PhD; Jean Logan, PhD; Yeming Ma, PhD; Kurt Schulz, PhD; Kith Pradhan, MS; Christopher Wong, MS; James M. Swanson, PhD
Arch Gen Psychiatry. 2007;64:932-940.

Context Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder of childhood. There is considerable evidence that brain dopamine is involved in ADHD, but it is unclear whether dopamine activity is enhanced or depressed.

Objective To test the hypotheses that striatal dopamine activity is depressed in ADHD and that this contributes to symptoms of inattention.

Design Clinical (ADHD adult) and comparison (healthy control) subjects were scanned with positron emission tomography and raclopride labeled with carbon 11 (D2/D3 receptor radioligand sensitive to competition with endogenous dopamine) after placebo and after intravenous methylphenidate hydrochloride (stimulant that increases extracellular dopamine by blocking dopamine transporters). The difference in [11C]raclopride's specific binding between placebo and methylphenidate was used as marker of dopamine release. Symptoms were quantified using the Conners Adult ADHD Rating Scales.

Setting Outpatient setting.

Participants Nineteen adults with ADHD who had never received medication and 24 healthy controls.

Results With the placebo, D2/D3 receptor availability in left caudate was lower (P < .05) in subjects with ADHD than in controls. Methylphenidate induced smaller decrements in [11C]raclopride binding in left and right caudate (blunted DA increases) (P < .05) and higher scores on self-reports of "drug liking" in ADHD than in control subjects. The blunted response to methylphenidate in caudate was associated with symptoms of inattention (P < .05) and with higher self-reports of drug liking (P < .01). Exploratory analysis using statistical parametric mapping revealed that methylphenidate also decreased [11C]raclopride binding in hippocampus and amygdala and that these decrements were smaller in subjects with ADHD (P < .001). Conclusions This study reveals depressed dopamine activity in caudate and preliminary evidence in limbic regions in adults with ADHD that was associated with inattention and with enhanced reinforcing responses to intravenous methylphenidate. This suggests that dopamine dysfunction is involved with symptoms of inattention but may also contribute to substance abuse comorbidity in ADHD.

One of the key points in this study is that they did the brain scans on ADHD patients who had not been treated with drugs. One of the problems in studies like this is sometimes that it is hard to know if the abnormality was caused by the treatment, or by the condition. In order to get around that, you have to find patients who have not been treated. Then, you run the chance of biasing the results by selecting a nonrandom sample, but there is no easy way to avoid both problems simultaneously.

The study indicates that persons with ADHD have lower levels of dopamine in the emotional center of the brain (the limbic system).

I notice the last sentence in the abstract: "This suggests that dopamine dysfunction is involved with symptoms of inattention but may also contribute to substance abuse comorbidity in ADHD." I am not sure why the reference to substance abuse belongs there. It is true that there is an association between substance abuse and ADHD, but that is not the point of the study.

So there really isn't much for a laymen to add. While having ADHD certainly offers a decent perspective on the discussion, I am not a neuroscientist, nor am I anything more than a reasonably educated laymen, when it comes to psychology.

That said, Joseph's comment about the appropriateness of the comment correlating dopamine dysfunction and substance abuse, really jumped out at me. This seems like a no brainer to me, but then, I'm not a scientist. It may just be, that as this was not the stated intent of the study, it seemed an odd thing to comment on.

The thing is, that I don't think the dopamine hypothesis is a new idea. Nor is the notion that the tendency for persons with ADHD towards substance abuse being due to lower levels of dopamine very new. I mean it makes sense. The stimulant medications for ADD/ADHD stimulate the production of dopamine. Studies also seem to indicate that persons with ADHD who are medicated for it as a child, have far less a tendency for the substance abuse problems that plague many, if not most people with ADHD.

Still, it is very exciting to see more research and more studies that bring us closer and closer to understanding the physiological aspects of neurological disorders. As I have mentioned before, I see my neurological disorders as much more blessing than curse. The more we understand where they come from, how they work, the better we'll be able to deal with the harshest aspects of them, while maintaining the most positive aspects of neurodiversity.

Welcome to My World - Living With ADHD Part II; School

School

Kindergarten

While I had a lot of behavioral issues, the first experience that comes to mind, when I think about how ADHD effected my education, is from kindergarten. Indeed, this is about the only thing that I remember about kindergarten. My class was supposed to be writing out the alphabet. I knew the alphabet, quite well at this point. One of my brothers managed to teach me to read, when I was only two years old and taught me to write, when I was three. I had even written the alphabet out, several times the night before, to get practice making my letters as perfect as I could, in anticipation of doing it the following day. But when the time came to actually do it in class, I simply couldn't do it. It was a rather hot day and all that I could think about, was getting out of school to climb the tree in my back yard. It didn't help that at the time, we lived right in front of the school, the windows in my classroom looked right out on my back yard, right out on the tree that I so desperately wanted to climb. Too, many of the kids got finished very quickly and were playing just a few feet away, so I was thinking how nice it would be to join them, how nice it would be to climb the tree. Then I got to thinking how much fun it would be to take the book I was reading up into the tree with me and laze around in the shade, with the book about Duncan, the alpine rescue dog - perfect antidote to the hot weather. Did I mention that I was also getting hungry? By the time lunch rolled around, I wasn't even to L yet. The teacher told me, through my tears, that I would not be joining my class for lunch, until I finished the alphabet. I got into a world of trouble, when I decided to put it away, half finished, to join my class for lunch. Twenty-six years have gone by and I can still remember that experience with a clarity that I have trouble focusing on my memories of last week.

Ritalin

When I was seven, I was put on ritalin. This was when I was first diagnosed with a form of ADD, which would later be labeled ADHD. Unfortunately, it was a multi-dose pill. On occasion, a dose would be missed. When this happened I would get severe migraines, very shaky and feel quite nauseous. When it happened at school, I would have to go home for the day. Even when I was on my regular doses, I would often times focus on the wrong things. I don't really remember much of this time, except as a feeling of general dreariness and discomfort. After a few months, it became quite apparent that ritalin, in that particular form, was not appropriate for me. There are two reasons why the ritalin experience was an important aspect of my life. First, it made me very skeptical of medicating children. I am still very reticent to use medication to deal with ADHD. To me, it can only be an absolute last resort. The other reason had a very profound impact on the rest of my education. I believe that this was when my dad really became something of an ADHD denier, at least as it related to me. He was firmly convinced that it would be possible to punish the problems away. It is easy to see why. Not to be arrogant, but I am a very bright person. This was shown when I learned to read at two and in the prolific testing that was done over the years. I had unbelievable potential but consistently failed to measure up. While I was in elementary school, this was mostly expressed through behavioral problems, rather than academic failures.

Math

When I got into middle school, I was tested by the school and they suggested that I might respond well to special education classes. Not for everything, indeed while I was in middle school, it consisted only of taking a study hall that provided special helps, where I was having trouble at any given moment - which was pretty much with everything. The thing that really stands out in middle school, was the introduction of the Math & Science Center, advanced classes for kids who were especially talented in those areas. To make this understood, I was an abysmal failure at math. Not because I couldn't do math - I could. I could even do rather complex problems in my head, which I still can. The failure was in my inability to do math problems the way that the teachers wanted me to. I could do the problems, get the answers right, I could even write down the steps I took to get the answer. The problem was, that they weren't even close to the steps I was supposed to be using. So I failed at pre-algebra, never made it past. When I asked if I could take the test, to get into the MSC, my math teacher actually got annoyed with me, thinking I was just trying to get out of class. I found out later, based in some assessment tests I took as a part of the special ed program, I would likely have passed it. At the same time, it is also probable, that without medication, it would have been impossible for me to handle the curriculum.

Homework

I was entirely incapable of doing homework. The biggest problem was, that it was infinitely easy for me to get distracted. Trying to do the banal, pointless worksheets, always led to getting distracted by something in the work and going off on a tangent. I.e. reading up on the answers, might send me off on a reading frenzy, starting with the topic I was looking up and ending God knows where. It was very easy for me to spend several hours on one question - and never actually get the question answered, because by the time I was winding down the tangent, I was so far off I had forgotten where I started. This was made much more difficult by the fact that I had very little problem with quiz's and tests. I knew the material after reading the text (usually within a few weeks of the beginning of the semester) and half heartedly listening in class.

Writing papers was even worse in some ways. Worse, because I actually wrote decent papers, I just rarely managed to keep them on the topic I was assigned. My best example of this, was an assignment to write a three page paper on Thomas Jefferson. In the process of researching it, I went off on a Ben Franklin tangent and ended up turning in a fifteen page paper about him. I actually would have gotten a reasonable grade, had I talked to the teacher about changing the topic and had kept it close to the page limit. Because I did neither of those things, I got a C-. He didn't want to fail me, because it was a decent paper.

There is so much that could be said about school, I may add more another time. However this is getting fairly long for a blog post and I still have adulthood to cover.