confluence of depression and ADHD
I am 43 years old, and recently found out I have undiagnosed ADHD, something I have very plausibly had since I was a child.
It will take me more than one post to write about this, and many contemporaneous tweet threads, as the situation employs both facts and feelings that are ongoing. Thoughts that are in fact extremely tangled in my brain - something I now know is par for the course of an ADHD brain. Which means I don't even know where to start in my attempt to write coherently about this. Also, it is an ADHD trait to often start something without finishing it. So I am not going to pressurise myself to write a long post with a logical completion if my unmedicated brain does not want to cooperate.
I am currently at a confluence where two rapid-flow tributaries meet. We know my depression is chronic. But at times, due to certain stressors, there are acute episodes, like how rainfall affects river flow and volume. The same is true for ADHD, as far as I know (although it is a river that has never been mapped before, maybe because it has been an underground river, but I am digressing with yet another analogy). Being at this confluence feels like two huge forces have collided, feeding off each other, eddying and swirling, becoming more forceful with each impact upon collision, until something catastrophic eventually happens as the stressor of extraordinary rainfall continues unabated: a landslide, a flood, a dam bursting. Unless there is drastic intervention carried out in time to stop this incoming disaster. In this timeline, I am now at that point before that disaster.
For the past few months, way worse than usual, I have been struggling with executive dysfunction: I could not get myself to work on my goals. Right around May or June, I had started to ease myself back to work, even though my house is still in disarray and not completely organised. But then suddenly I just couldn't get my self to do anything, be it self-care, home organisation, or work. It was like a motor stopped, I lost motivation, had no psychic energy within me anymore. I could hardly do basic adulting.
According to Understood, people struggling with executive skills may:
- Have trouble starting and/or completing tasks
- Have difficulty prioritizing tasks
- Forget what they just heard or read
- Have trouble following directions or a sequence of steps
- Panic when rules or routines change
- Have trouble switching focus from one task to another
- Get overly emotional and fixated on things
- Have trouble organizing their thoughts
- Have trouble keeping track of their belongings
- Have trouble managing their time
I had to do something to get back on track. Going back to work was critical. It is still an unpaid job upon my return, but I had plans to bring LKP to a level where we could finally employ staff, including myself, and eventually a bigger brick-and-mortar space where I could also live in, to provide round the clock care for the shelter cats when volunteers are not around.
I also need to complete setting up my home, from which I could work, and take better care of myself again, something that fell by the wayside ever since my separation from J. It was a simple plan in essence: take care of myself, take care of my home, go back to work. This was always the path, ever since I left J and moved into my own place with Sayang.
When I suddenly became unable to do more than simply feeding myself properly every day, I reflected introspectively at the problem so I could get out of this executive dysfunction slump. I realised this was triggered by my financial situation: I have been spending my parents' money the past year, as well as part of my income from the sale of my old flat on setting up a new home and for my monthly medical and living expenses. I say 'part' of my share of the flat sale, because there is a large remaining sum still with J. I was counting on this for my survival until I had another means of income. But J then said he lost money on investments or scams or both, and started to only return me small trifling bits of this money, at irregular intervals. Eventually, the dwindling sum of money in my bank gave me huge worries because it is now at a very unsafe amount for me and my parents. When all this happened, my depression symptoms worsened, and my executive function went down the drain.
Although my mood was not in dangerously low levels, I became unable to do basic activities of daily living, experienced a loss of motivation in things I normally enjoy doing, such as my work, and low energy levels. I am finding it even harder to take care of myself than it already was on an everyday basis. I ended up turning to means of escape from daily life by burying myself in books, shows and gaming. This understanding that my depression worsened came before I realised I have ADHD. It is still true. This is tributary one, as mentioned in the river analogy above. Eventually I also stopped gaming and being social, and withdrew into myself, as if my body was trying to consolidate and regroup.
I did look into executive function even before there was any hint that I might have problems with it due to having ADHD. Because that was what was happening to me, the loss of executive function; finding basic adult things hard to do. I only stumbled onto tributary two from something rather unrelated.
I was texting on Discord with a friend from Twitter, P, for advice on dealing with sensory and information overload that so often triggers an immediate stress response. I asked P because they are autistic and a special education teacher. While I don't have a diagnosis of autism, I did have this symptom that mirrors it - overload of sensory stimuli or information input that triggers that fight-flight-freeze response. I wanted to know how to cope with a situation where I am presented with information at work and my brain just starts overclocking and working high-speed that leads to stress. The problem wasn't just about the information I would be presented with; it was with what floods my brain when I process this information. I start thinking of what-why-when-who-where-how, seeing the big picture and seeing the details, seeing words and visualising diagrams being superimposed on those words, recognising what the end goal is and what the immediate step is, seeing patterns almost immediately and applying it to another pattern that would help contextualise the information and/or my response. All of these thoughts in words and diagrams are what make me good at my job of being the head of an organisation, but it comes in way too much too fast, and I wanted to learn how to control the rate of it entering my brain so I wouldn't meltdown but instead learn to organise and utilise my thoughts into something stress-less and actionable.
This discussion led to P saying to me, "I think you need to get assessed for ADHD." P also has ADHD, which is one of the comorbidities with autism, and is taking medication for it precisely so that the overloading can slow down. ADHD isn't always actual physical hyperactivity, said P. It can be thought hyperactvity. Which was what I was likely experiencing. Without being on medication for ADHD, the coping techniques prescribed for this very issue would be very hard to utilise successfully. Here are some online resources P shared with me right there and then.
Just this infographic alone illuminated so much. I have the combined-ADHD symptoms the most:
And then, this YouTube channel, which spoke even more volumes for me:
When I first knew that I had clinical depression, it was through watching a documentary on TV twenty years ago, and I was internally going, "That's me! Right there!" This YouTube channel did the same for me, especially in this video:
Thus, tributary two has been identified and mapped. I needed to get formally diagnosed, medicated, and incorporate coping techniques into my therapeutic plans. I asked for an earlier appointment with my psychiatrist right away. So far I also talked about it with my other psychiatrist with whom I have psychodynamic therapy. He didn't discredit me, even though he could not be the one who formally diagnoses me of anything, and I talked to him about some of the emotions I felt when I found out about this. Feelings of, why didn't I see this sooner, or why didn't anyone see this sooner, and grief for how things could have been so much less painful or more successful in my life had I just been diagnosed and treated early on from childhood. I also spoke to my GP about it - they have known me for almost two decades - and they believed me too. I am going to see my psychiatrist in a week or two. I have to hold on till then.
Till then - I try to just get through the day and take care of myself successfully, as far as that is possible. The stress of the separation, living on my own, not being able to get my money back from J so I could survive in the short term - it just triggered acute episodes in both my depression from chronic PTSD and what we now know is ADHD.
And it isn't my fault that my brain's wiring is fucked up, something I know intellectually, and am still trying to know emotionally. I don't think J would understand this, but ADHD also explains why I couldn't do certain things up to his ableist expectations besides the fact that I have depression and fibromyalgia. Everything doesn't have to be this hard. And it has felt hard for four decades of my life, and it is even harder now than usual to do simple ADLs as well as going back to work after this financial stress trigger from J occurred. Something How to ADHD explains thusly:
I will probably report more about my ADHD here soon, because there is more to process, and hopefully I will stop regressing and start progressing when this missed diagnosis is set right, finally. I am done grieving over the person I could have been if one of the innumerable doctors I have consulted with over my lifetime had just noticed. What is done, is done.
Labels: arts, me, state, status, therapy