It’s been a month now since I started taking Wellbutrin. The effects on my ADD are subtle, or at least they seem that way to me. But I’m happier, in general, and somewhat more able to focus for long periods of time. Becky has observed that I’m not only taking more initiative to start tasks around the house, but actually almost finishing most of them. I met up with my pshrink again yesterday, and — following the time-tested physicians’ maxim “some good, more better” — we’ve upped my daily dose by 50 percent.
I’m actually pretty glad the effects have been subtle. It’s reassuring. Still, it makes it hard to sort out pharmaceutics from placebo, and in this instance there’s a mental factor that potentially makes the placebo effect pretty damned strong.
To wit: the diagnosis of ADD undermines the worst things I have believed about myself.
From as early as I can remember other people have informed me of the reasons I don’t finish things or pay attention. I lack discipline. I am stupid. I am incapable of understanding complex concepts. I lack motivation. I am obviously not cut out to take part in the intellectual work required for me to succeed in the elite school for which my father shells out his hard earned money to pay my tuition. I am emotionally disturbed. I am lazy.
I plead no contest to the last two accusations. I am embarrassed to admit how much stock I placed in the others.
At age thirteen I was a senior in high school. I enrolled in a calculus class. Math was never a strong point for me unless the teacher avoided rote learning and concentrated on theory. Tell me how the numbers interacted one with the other, and I was rapt. Rely on rote and I was lost. Unless I had a private tutor, calculus — relying as it does on a nested series of abstract arguments — would even now be next to impossible for me to learn unless my life depended on it, which would provide the necessary measure of interest.
When I started bringing home the inevitable failing grades from calculus class, my parents — upset that their 13-year-old would disappoint them in such a fashion — scolded me for a day and a half and then sent me to a counselor. He was a nice guy, and he helped me come to terms with a couple of things bright 13-year-olds often have trouble with — isolation from peers and such. It wasn’t a waste of time. But the only ways in which he could have helped me pass my calculus class would have been either to tutor me, or to diagnose my ADD and propose a course of treatment, which was unlikely in 1973.
One evening he asked me to draw a picture of my family. I decided to provoke a reaction. I drew stick figures, Mom, Dad, Carrie, Coral, and Craig, and then — next to them — I made the tiniest possible mark on the paper, and labeled it ‘Me.” Time was up, and he asked for the sheet of paper, and his eyebrows went up a little. “Don’t worry,” I said. “I was joking.”
“That’s an interesting joke to choose,” he replied.
I spent the rest of the session losing track of what he was saying.
Early on in my school career, I gave up on taking notes. In order to pass classes, I had to battle distraction. Taking notes was a distraction. My memory was good enough that if I could force myself to pay attention in class, I could remember what was said. Despite the fact that it turned out to be a survival skill, I always felt like my not taking notes was a failing. Some years after I left school, I found an old notebook that contained a semester’s worth of notes from an American Literature class. Below is the sum total of notes I took in that class:
“EMERSON”
I still don’t take notes in meetings unless I’m responsible for minutes, in which case I only write down the results of decisions, and I shush people while I write so that I don’t miss anything.
I have to be fair to my parents: ADD was not a familiar concept in the 1970s. I imagine they were at a loss for how to help me. But I have to be fair to myself as well. At age seven I was wondering whether I might have this problem, trying to put a handle on the intellectual frustrations I felt. The kid my age next door told me about being diagnosed as “hyperactive,” which, he explained, meant that he had trouble paying attention in class, that he’d find himself spacing out, though that was almost certainly not the phrase he used. I thought about that for a while. The next weekend, my father was working in the yard behind our little yellow brick ranch house. I decided to ask an authority. “Dad, am I hyperactive?” “You’re hyPO-active!” he replied.
(Later that summer, when — after skimming our copy of Dr. Spock’s Baby and Child Care — I asked my father when I could expect to start menstruating, he replied with almost precisely the same mixture of sarcasm and impatience.)
My father was right about my lack of hyperactivity, and, for that matter, my lack of a uterus. One of the things that has masked this ailment all these years is my notable lack of interest in fidgeting. Given a comfortable place to sit and a compelling book, I can become absolutely torpid — more so in those days before caffeine. But had he taken my question seriously enough to give it more thought, who knows what might have happened? My neighbor was being medicated for his “hyperactivity,” probably with Ritalin, possibly, in those days, with Dexedrine. I can say at the risk of understatement that I am not a good candidate for any course of treatment involving long-term amphetamine use. But had Dad decided I was onto something, I nonetheless likely wouldn’t have been medicated at all. ADD as a syndrome distinct from hyperactivity wasn’t recognized by pshrinkologists until 1980, and for years afterward most professionals thought it was a disease found only in girls.
Short version of the above blathering: I have lived for 46 years with a disability I thought was a severe character flaw, and god damn it, I can’t blame anyone for not figuring it out.
I am especially intrigued by the apparent undercurrent in psychological thinking that holds that behavioral modification approaches to ADD — the to-do lists, the making sure the keys go in the same place every night, the post-it notes proliferating on the monitor, the syncing of PDA with computer with online database to make sure you have your meeting schedule no matter how flaky you were when you left the house — I am intrigued, as I said, to hear that some experts think such Behavior Mod stuff cannot work by itself.
“Such Behavior Mod stuff cannot work by itself.” You want an example of a simple concept that shakes a man’s self-image to its foundations? There you have it.
It’s not that I want to pathologize my leaving around of dirty socks and thus abandon any hope of reformation. I want to find a way of solving the problem. And 46 years of having the best intentions did not work. Forty-six years of flunking class after class, of parental shrieking and girlfriends leaving and employers cutting off the paychecks. Forty-six years of me telling myself the only problem was laziness. I want to say that no one would accuse a paraplegic schoolkid of malingering, but that glass is half-empty. I know there are teachers out there, and parents, who would tell a kid with cerebral palsy not to flail like that, who would tell a kid with Down Syndrome to “stop being so stupid.” I spent the first eighteen years of my life hearing people telling me, in effect, to just stop having ADD. I have spent the last three decades telling myself the same thing.
I want to call the last 46 years, struggling with this problem, this sieve of distraction clamped around my mind that has only just now begun to dissolve — I want to call it a waste. That would be silly. I’ve accomplished a hell of a lot, especially in the last fifteen years, and those accomplishments look all the rosier now that I know I scaled those hills with a hidden bag of cement in my pack. Besides, if the ADD were the worst thing to have happened in my life I’d have been a lot luckier than, in fact, I was. And now I’m doing something about it. Some people never figure this out. And even if the Wellbutrin doesn’t help long-term, at least I know now. That’s something. And ADD takes with one hand, and gives with the other: it’s linked to creativity in expression and thought. And and and.
But I’m sorrowful that it took so long. And I’m angry — searingly angry — to think of that eight-year-old’s enthusiasm as it succumbed to frustration and repeated insult, and to think of the twelve-year-old he became, certain that he was the worst waste of skin in the world.
Posted by: Chris Clarke
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