kaigou: this is what I do, darling (2 what I do)
[personal profile] kaigou
I should've said this before: this is LONG, and when I say something is LONG, you can expect it to be about six times as long as the longest long you've seen. I know I go on, but the length here is in direct proportion to the height of my temper. Just so you're warned.

RE: This Is Your Brain On Drugs . . .

NOTE: consider the above link as having a trigger-warning if you have a disability, know someone who does, or are sensitive to sudden spikes in blood pressure when in the vicinity of someone with a big megaphone busy talking out of her ass.

Ms. Lindholm's blog topic on May 20th of this year puts her in the Tom Cruise Denouncing Postpartum Depression category: someone rattling on quite definitively with little to no comprehension of the facts, in a way that essentially amounts to what you are experiencing is not only all in your head, it's a personal problem and shame on you for thinking you should, or even deserve, to seek a resolution.

First, to make this perfectly clear, the issue at hand is ADD (Attention Deficit Disorder) and its counterpart, ADHD (Attention Deficit Hyperactivity Disorder). The two are cousin-conditions that we could generally define as "a state of excessive mental activity, sometimes accompanied by excessive physical activity (the hyperactivity element)".

ADD and ADHD are not mental "illnesses". ADD and ADHD are disabilities.

More precisely, they are cognitive disabilities, along with other cognitive disabilities such as dyslexia, dyscalculia, dysgraphia, and dyspraxia. ADD/ADHD shade into the class of physical -- because 'chemical' in the brain is still, fundamentally, a physical attribute -- disabilities, while the cognitive side is what impairs or affects thought processes like learning new skills, accessing short-term memory or transferring new information into long-term memory, capturing and comprehending incoming information, and so on.

So, to repeat: ADD/ADHD is not an 'illness'[1]. It is not something that you catch; it is not something you can cure. It is, like so many other disabilities (including learning disabilities), something you live with. You find a way to get through, and if you're really lucky, you find things that will help you deal with the disability, and the stress it causes in your life each time you ask someone around you to put up with, help cope with, or even just feel compassion for, the result of having that disability.

But because this is an alien concept for you, Ms Lindholm, let me make it perfectly clear for you, as well as any readers following along at home. Allow me to begin with a concrete representation of the situation at hand.



I'm sorry, Ms Lindholm, but by your standards, those glasses really must go.

Your eyes are disabled -- through no fault of your own, certainly! -- but you simply can't imagine it's acceptable to attempt to compensate in any way for this. You should learn to live with your disability, embrace it, even! Think of all the creativity you're refusing to allow yourself to express every time you avoid walking into walls, or keep from tripping over obstacles at your feet, or even recognize a friend at a distance.

Really. As you so wisely put it: "Do you [wear glasses] all through college? Do you [wear glasses] during your career years, when you are training on that new software, or reading up on a new client? Where does it stop? Do you ever get to be your [semi-blind unseeing] self again? Or must you forever be slightly modified to suceed [sic]?"

Let's consider what your life would be like, without those glasses.

You can't drive, for starters. You'll need to have friends drive you, or you can take the bus when running errands. Of course, if you do take the bus, you'll be waiting anxiously as each one pulls up, squinting at the signage, and halting the boarding procession each time because you have to confirm what you can see but -- and this is very important -- that you can't be certain you see. Is the correct bus, or is that Q actually a G?

If the wrong bus, you'll have to back up, annoying the line of everyone who'd known already what bus it is. You will apologize: to the driver, to the people in line who move, to the people who won't move, to the people who mutter at you for holding everything up. And if you aren't already ashamed of yourself for imposing on them with your inability to see clearly, their attitudes will make it clear that you should be.

So let's say it's the right bus. Even then, you'll have to slow down and confirm you've got the right bus-pass (and not your library card), the correct bills (since American money isn't sized by currency), and the entire time, you'll be aware of the bristling of passengers stuck waiting behind you, because obviously you're not blind -- no cane, no dark glasses, no dog -- thus, to them, you must be stupid. That's why you'll try to be last in line, so as not to hold them all up; otherwise you risk one of those irate passengers shoving past you to put their money in. And since you can't see all that well, an at-a-glance doesn't work for you. What do you grab to keep from falling? Air? Now you're not only stupid, you're clumsy, too.

Once you do manage to get on the bus, now you have another issue to deal with: knowing when your stop is coming. Everything outside the windows is a blur, and if the building signs are big enough, you might get a fuzzy impression of blue in a round shape, or red in a square shape. You will probably spend a lot of time either calling for your stop too soon, calling for it too late, and apologizing profusely to everyone you've inconvenienced because you couldn't see far enough ahead to react in time.

You'll be spending a lot of time apologizing, period.

You'll have to explain to friends, repeatedly, that you didn't not wave because you honestly didn't see them, even when they were five feet away. Like driving in heavy fog, you'll be navigating the world at a slow pace, unable to foresee and avoid obstacles like curbs, steps, and parking meters if you're going too fast. You can't catch a baseball, kick a soccer ball, or even catch car keys tossed your way. These things require eye-hand coordination, and you can't coordinate what you can't see.

But other people won't realize that. They'll see you don't register what's around you until you're right on top of it, that you're clumsy and uncoordinated, that you stare for a long time before reacting. Yes, you're attempting to cope for your lack of distance-vision, hoping to trick your eyes into giving you details that the rest of the world takes for granted. That doesn't matter to them. They've already decided you're stupid.

Meanwhile, despite your best attempts otherwise, you'll probably end up continually apologizing for other people's reactions to you. The alternate -- expecting them to recognize, or even respect, that you have a disability -- is untenable, or impossible, or unforgivable. At least, that is, so long as you're convinced that a disability should not be addressed, but is a personal problem, and that the only acceptable option is to live with it, to embrace it, even.

So, no glasses. No contacts, either! That's putting something in your eyes. If glasses are a band-aid over the disability, contacts are even more obtrusive, and don't even consider Lasik surgery. That's practically cutting open -- no, wait, that is cutting open -- your body in order to fix a disability that, after all, is just your personal problem. By your own measure, Ms Lindholm, if you were truly a worthwhile and creative soul, you'd embrace living life as a fuzzy blur.

For shame, to see the eye doctor annually, to demand to wear glasses. That's not a disability, that's simply the way you're made! Oh, it's true the way you're made means your life is going to have a lot more hardship than the average person, what with constant stress, tension, and difficulties as you try in vain to cope with the disability or its after-image negative impact: on your ability to hold down a job, your ability to sustain long-term relationships, your ability to make it through a single day with any dignity.

It's much better to accept this as your lot in life and to find a silver lining, isn't it? Even if you bloody well can't see any linings farther than three inches from your nose.



If it's not bad enough that you must take a personal decision -- to live with one perceived condition -- and make it universal, it's made worse by your ignorance on conflating this condition with another. You just pile more on top when you also reveal your ignorance of what that other condition really is, how it operates, what solutions exist, how those solutions work.

For instance, your gossipy repetition of the drawbacks of Ritalin. Oh, how I've heard this before. It's like the Anti-Vaccine Idiocy of Learning Disabilities. You repeat it, I've heard it, and almost always from a well-meaning soul (like you, Ms Lindholm) wishing to just, y'know, "enlighten me" as to the "truth" (scare quotes intentional) of that possible medication.

I dislike repeating such, but just so there's no doubt how flat wrong you are, Ms Lindholm, I quote you:
Over the years, I’ve heard several funny* stories about Ritalin and its effects. One young friend told about being in charge of a younger sibling’s bath. He got the tub running and kid undressed and went for a towel. But as he passed through the living room, a Discovery channel program caught his eye. ...there he stood, captured by it, even though he knew that the water was now overflowing and the younger sib was yelling for him to come fix it. He literally could not tear himself away. Pure focus.

That, there, is not Ritalin when it's working. That's Ritalin when it's failing.

*Also: that kind of story is 'funny' in the same way that stories about a blind person walking into walls is quote-unquote funny -- ya gotta be sighted to think there's humor in what is really a very frustrating and humiliating experience.

That 'pure focus' behavior is a facet of ADD/ADHD, and it's one those of us who deal it with learn to use as a power for good (if we can). It also baffles many around us, when it's not frustrating them in turn. It's also a lot easier to explain using images, rather than words.



Whatever you're doing -- reading this post, talking on the phone, washing the dog, doing your bills -- gets the majority of your attention. But it's not all of your attention; you're aware that you have to leave for an appointment in fifteen minutes, that on your way home you need to pick up cat food, that your partner's birthday is next week. Those secondary tasks don't intrude on your ability to read, or talk, or wash, or pay bills; they exist alongside. Your attention is mostly focused, with minimal diffusion -- and that secondary diffusion, for the most part, you can choose to filter out, and having done so, you do not forget it's there; you can choose to have it filter back in again.

It is true that the first two letters of ADD/ADHD are 'attention deficit', but this is an inaccurate term that really needs to be retired already. A better version of the same is to call it 'Attention Diffusion'.

ADD/ADHD is not a state in which one cannot focus, or an diagnosis that means one lacks the ability to 'pay attention'. It took researchers well into the 90s before they realized that ADD/ADHD people are in fact perfectly capable of paying attention; the key is that ADD/ADHD attention is spread out amongst a range of stimuli that's anywhere from nine to ninety times the stimuli usually in play in an unaffected brain.

That is, the usual person may be aware of ten things jostling for center stage, and actively relegates nine things to the sidelines to pay the lion's share of attention (but not all) to center stage. For someone with ADD/ADHD, center stage -- and the sidelines -- are filled not with nine items but nine hundred, all demanding attention at precisely the same volume. There is no jostling or juggling or moving attention-foci about. The ADD/ADHD brain doesn't have that ability, and therein lies the dis-ability. Maintaining the focus on one thing or another -- and disregarding or suppressing or reducing attention paid to that which is secondary -- is beyond one's control.

ADD/ADHD is, to simplify utterly, the inability to willfully and selectively focus concentration.



It's often repeated that people with ADD/ADHD are statistically smarter than the average population. From what I've seen, I'm inclined to disagree. If the average, unaffected brain can juggle three things, without pause or hesitation, for an hour, the ADD/ADHD brain can juggle thirty things for five minutes before losing hold. Unfortunately, when the study only last two minutes... certainly the ADD/ADHD brain looks like a positive Einstein. It's only in the long-term that you see the insidious effects of this disability.

If we have solid and educated support from family, friends, and coworkers, and if we're lucky enough to have a boss aware of ADD/ADHD (or intuitive enough to catch on and react, even unknowing) -- and we're lucky enough to be in an industry that rewards ADD/ADHD attention-diffusion styles -- then we just might come out okay, or at least a lot less worse off than we could've. Unfortunately, most of the time, we're not going to be that lucky.

ADD/ADHD brains, when given a good opportunity to flex in the right ways, are phenomenal at juggling massive streams of incoming information that bowl over the average, unaffected brain. To the ADD/ADHD person, the overwhelming incoming information isn't much more than what we deal with, every day, when unmedicated. That also makes ADD/ADHD folks, with a bit of self-training, almost unparalled at being able to compile, analyze, and synthesize seemingly random and contradictory pieces of information, plucked from a streaming chaotic mass that to anyone else is, well, just a streaming chaotic mass. We already spend every minute, basically, working to single out disparate discreet items from among the ninety jostling for attention on center stage.

Putting us in a situation, like certain types of multi-informational, high-stress, fast-deadline jobs, where we can use those innate coping mechanisms and processing styles to our advantage is, to the ADD/ADHD brain, a chance to use the fact of our disability to achieve some pretty amazing (if, to us, rather mundane) results. The irony must be noted, however: when you do have a brain that can run on eighty cylinders at once, the mere fact of this being so different from unaffected-brain learning processing means that the ADD/ADHD person often down-plays, or just stays somewhat insecure about, those ADD/ADHD-caused skills.

Others will want to know how, or why, the ADD/ADHD brain can "do that", or they'll wonder why the ADD/ADHD person is so good at the multi-information streams but can never remember a meeting on time. These are simple things, coworkers (and family, and friends, and lovers) will say: how can you not manage this? The thing is, those are not simple things, to the ADD/ADHD brain; those require directed/concentrated attention with the remainder of stimuli suppressed or temporarily disregarded. For the ADD/ADHD brain, that so-called 'simple' thing is the most difficult, if not outright impossible.

So what most ADD/ADHD brains learn to do, very early on, is exactly what that kid was doing watching the Discovery Channel while the bathtub filled. I say "early on" but it's more precisely that it's learned automatically -- it's the flipside of the second circle-image, really -- and becomes more of an active tool as one enters adulthood (if you're not lucky enough to have childhood-ADD/ADHD that resolves itself in the onset of puberty).



That single sliver of yellow is not really just one thing -- the bathtub filling -- it's everything else that was in the second circle-image, squeezed into an incredibly compressed state. And, like a blackhole, when it reaches a point of ultimate compression, it will inevitably spring back, shattering the hyperfocus and sending everything into chaos on center stage while all the disparate stimuli run around at top speed. Until then, though, the hyperfocus can be almost complete, and in some cases truly complete, to where the filling bathtub no longer even exists.

And that's not something the unaffected brain can do, either. For the non-ADD/ADHD brain, there is always a chunk of long-term memory, a kind of mental operating cost, that quietly but continuously maintains all the other stimuli, bringing forth what's needed as needed, and settling down those that might jostle in the background. You could say the unaffected brain has a capable stage manager, while the ADD/ADHD brain does not. To give decent focus to one player on the stage, the ADD/ADHD brain can't get the others to pipe down, so instead it banishes them completely from the theater. Until they bust the door down to get back in, they are truly out of sight, out of mind.

That is the ADD/ADHD brain, when unmedicated.

Ritalin, when it works, makes the brain look and feel and operate just like an unaffected brain.

Here, I must also add: Ritalin is a medication. I take huge exception to the fact that Ms Lindholm, following in the fine tradition of ignorant fools everywhere, prefaces her anti-disability-medication position by starting off talking about how she's never done illegal drugs, or at least never inhaled. Perhaps the readers at home will see it for the manipulative false-analogy it is, to rephrase it this way: I've never done crack cocaine ... so I wouldn't take insulin for diabetes, either.



On top of all else, Ms Lindholm, you say: "You have to be who you genetically are."

I'm sure Mr Hines, and all other diabetics I know, would be happy to be genetically who they are -- except then they'd also be dead. [2]

I'm sure people with hypertrophic cardiomyopathy would love to be genetically who they are, and be able to live without a daily dose of Verapamil (among other things). But then, they'd be dead, and my father along with them.

It may be true genetically that I have a pretty good chance of getting two decades more on this planet, maybe two and a half if I'm lucky and very careful. I have twelve great-uncles and great-aunts and two grandparents (on both sides of the family), five uncles, and three aunts who have all died of massive heart failure between their fifty-eighth and sixty-fourth birthdays.

Genetically, that means my life is more than half over.

Genetically, that's who I am.

Genetically, I fucking refuse to accept that this is all I fucking get, and I sure as hell refuse to let some ignorant fool with a megaphone shame me into ever believing otherwise.

I am not solely the sum of my genetic parts. I am not going to live my life blindly stumbling into walls. I am not going gently into that self-delusion that I'm a better person by refusing any possible treatments.

I have a disability. A treatment exists. I have the right to use that treatment. And above all, I have the right to live without being shamed or ostracized for my disability -- or my wish to treat it -- by people like you, Ms Lindholm.

[ continued in part 2 ... yeah, had to break it in two. sorry. ]



To clarify a few things that might've gotten buried:

[1] Many mental illnesses are also disabilities. I'm only focused on ADD/ADHD here, but a lot of what I say here could be extended easily to autism, bipolar, OCD, and others. What I dislike is the hidden connotations in that term: mental = "all in your head" and illness = "something curable". As though it's acceptable to dismiss the illness and/or expect one to get better! The truth is that any long-term condition, even those manageable with various tools/treatments, are (to me) not 'mental illnesses' but '[mental] disabilities'; they infringe on our ability to live as full a life as we'd have without them, and thus on a practical level are all disabilities to some degree.

[2] I am not saying that diabetes/heart-disease/ADD is a simplistic direct correlation, that because diabetes has clear-cut medication requirements, so does ADD/ADHD. Technically, the analogy fails already at 'heart disease', since that disease's medications are a cocktail to be carefully navigated to fit the particular patient, just like any medications for ADD/ADHD. But in terms of those who carry social prejudice against medication for mental/cognitive disabilities, the diabetes/heart-disease analogy does work, or I wouldn't freaking use it. Like all analogies, it breaks down when you go too deep, but for my purposes it holds up: medication is a valid tool.

As someone who, ironically, has responded to very few medications for ADD/ADHD, I will never tell you that my life is intact due to medication. In fact, I'm still here in spite of modern psychiatry, yet I continue to believe medication is a valid and crucial corner of the triangle of treatment. It may not work for every disease and every person, but it should not be discounted as an option, out-of-hand, either. The patient-and-doctor in question, ultimately, should make the decision -- not social prejudices about the mentally ill.

[3] If you are, or know, or think you may know, someone with ADD/ADHD, the best book I've found for concrete behavioral coping mechanisms -- with info for supportive family/friends, too -- is ADD-Friendly Ways to Organize Your Life by Judith Kolberg and Kathleen Nadeau. Just FYI, if you wanted more concrete info on how to help yourself, or a friend or family member.

[4] A much-shorter follow-up on what's going on in the brain (roughly, very unscientifically) when it comes to ADD/ADHD medication, cobbled out of the explanations of a whole lotta doctors & neurologists.
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kaigou: this is what I do, darling (Default)
锴 angry fishtrap 狗

to remember

"When you make the finding yourself— even if you're the last person on Earth to see the light— you'll never forget it." —Carl Sagan

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