Tuesday, January 22, 2019

The Impossible Task



ADHD Part two: The impossible task.

In part one, A Thousand Problems, I present an abbreviated history of my life with ADHD.
The scope of the condition's effect on my life can not be understated. The difficulties have been
compounded by its failure to be diagnosed. My ADHD was missed by educators and myself.
It might have stayed hidden except for my current underemployment.


I'm in my longest period of full time employment. This is a long term period of stability, a massive relief after unemployment, and precarious employment. The job that took me out of precarious employment is a straight forward manufacturing job. In some ways I'm a pair of robot hands for turning wrenches. The job offers, steady hours, decent benefits and survivable pay. It was exactly what I needed at the time, though that is less and less the case now.

After two years of temp work I was nearly burned out. When I took the contract that would become my current job I was deeply exhausted. It would take months to climb out that fatigue. I was tired enough that early on sweeping the floor at the end of week was confusing. Become a full time employee removed many stresses, but I still feared that I would be marked expendable at any moment. The worry that carried forward shaped my work for a while. I knew poor sleep, and stress were making things harder. This stressed mindset diminished over the first year. Eventually stress dropped to a normal background level.

Life was feeling normal, a sense of security started to develop. Without the uncertainty and associated
stresses, I expected a overall improvement in performance. Mostly I did. Still I made errors frustrated
me and my supervisors. There is nothing sufficiently difficult about my work. It should have been easy for me to learn. After making some avoidable error, or missing an error done by someone else a
supervisor rhetorically asked, "what was wrong with you?" Internally I started to work on answering that question.

Repetitive work and an uninteresting pop radio station left my brain plenty of spare cycles to ponder this. I started the examination with the anxiety stemming from the uncertainty baked into me from temping too long. While it did provide explanation for some bad days, it did not cover enough. Depression followed a similar path, I could account for moods well enough to know, neither anxiety or depression were the main drivers for bad days. Another explanation was needed.

Other? What is my brain doing differently. Why are simple things hard. A slight historical aside. For a brief but significant period I was attempting to have a career. I had worked in exploration geology, a job that needs the backing of a Earth Sciences education. I have a bachelors of Science in Earth and
Environmental Science. That this career was doomed when I failed to pursue my professional association registration is beside the point. It was work that demanded some specialty knowledge and
some skills. It falls under my list of hard things. Also on my list of hard things, going to university and BCIT, and working as Geographic information Systems tech.

The tautology that hard things are hard may have delayed my asking, how hard should they be. ADHD limited the context I could observe. I could see that hard things were hard for me, I was not seeing that they were easier for others. Only in my current job did I have the opportunity to ask, why are the easy things hard too.

Multiple times I had to receive instruction on how bend a set of wires so they make a nice shape on the workpiece. Intellectually I knew I should be able to retain this information. Why did that information fall out of my head? I could watch the demo and two minutes later do work that looked like a drunk toddler did it. Every so often I would get it right, but I couldn't reconstruct how. This should have been simple. Questioning why a simple task in a job that requires no formal training was impossible was an important moment. Asking why easy things were hard too was an important part of the path to diagnosis and treatment. It would not be enough on its own it would take an Impossible Task to push me to that.

My right knee has an old injury. Its 90% managed by healthy amounts activity and keeping my weight down. In the winter of 2008 I got my boot suck in a pallet. I managed to pivot around on my knee, don’t do that. In the summer of 2017 I was doing too much. I was trail running, biking and a bunch of other things. Over the space of a couple weeks, I ignored pain signals that said slow down. I did one too many things. My knee got to the size of a small mellon.

The doctor told me largely what I expected, no new injury. Don't do it again, and you should get physio. X-rays confirmed it was an activation of the old injury. I agreed that physiotherapy was logical. Physio should have been easy to arrange. There's a clinic a block away from my apartment complex. Its hours can support after work sessions. The benefits package ways to offset the cost. Work would likely have been accommodating if I needed some time for it. All the pieces were available and obvious, I could not act on them. Somehow the simple three step process, book physio, do paper work to reduce costs,  and do physio was impossible.

The impossibility of a healthy logical, accessable, affordable, and beneficial service was what pushed
me to call my GP. I knew people all around me were fitting in after work activities, I should have been able to fit in an activity that could hasten my return to full mobility. I could not reconcile why I could not connect the parts and get the help I needed. So called my doctor to book an appointment.

My knee was injured in late July of 2017. I called my Doctor's office in the middle of October.
I would not see the specialist until late April 2018. Those 8 or so months, are now worthy of their own post.

Story continues, in part three the Long wait.









Tuesday, January 15, 2019

A Thousand Problems.

Its been a long time since I started a blog post. Longer still since I finished one.
This is part one of a series to explore for myself and anyone who may read me, the changes in the last year or so.  Since I have moved to Vancouver various friends have shared their struggles with mental health.  This openness has helped me ponder my own.  A job that provides too much mental idle time helped provide the rest.  In October of 2017 I started on a path forward to address my own long standing mental health issue, ADHD.  This post is about the time before that.  It is important that I explore, how it was missed, the cost of the ignorance, and the frustration.

So by now the fact that I have Attention Deficit Hyperactivity Disorder ADHD is well known to friends. It's a terrible name, it fails do describe how it shapes lives. This diagnosis comes after a life time of frustrated under performing, and periodic encounters educational difficulties and special resources. 

First I would repeat kindergarten, I was told later that it was due to social development issues. I still feel like I'm playing catch up.The difference was softened by joying a younger cohort. I started a different version of this where I started listing a great many ways in which my ADHD was missed, and the times it might have been caught. In summary that, I would say that I present more inattentive than hyperactive. A consistent presentation of intelligence contributed to my condition to be missed. The truth is ADHD is well understood by the medical and scientific community that studies. Unfortunately ADHD and deeply misunderstood by pretty much everyone else. The biggest red flag that makes me with people were look for more connections was my delay in functional literacy. 

Reading came late because eye tracking was under developed.  We were lucky that a public health nurse knew a person who had an occupational therapy program that could improve my motor control.  The fine motor control on the extra ocular muscles had do be developed from near zero. It was a slow tiring process. My father, drove me to all the appointments all of which were several hours out of town and worked me through the exercises. Its hard to thank him enough for that, it was perhaps the significant contribution to my education he contributed. 

It was hard. Working underdeveloped muscles burns when you start, its the same for small ones as big ones. Like lifting a too heavy weight. Only the the weight is you eye ball. To read I had to be taught how to move my eyes in the succades that are needed to track text across a line and follow the shape of words.  The knowledge of the alphabet, and many words was already there, but to follow blocks of text was mechanically difficult.  In this narrative of how my adhd was missed. I look at this and think,gaining functional literacy for a time, eclipsed any possibly worries about my adhd. Literacy was the most pressing matter to my education at the time. It still manifests, my reading speed can be slow. My visual is uptake slow. It was treated on its own, and no one was looking for connected issues.  Reading about the motor issues now leaves me speculating about dyspraxia as a co-morbid disorder. My elementary years saw off and on academic support and special lessons, of questionable utility.  School over all was not fun socially.

Bullying shaped a lot of the school yard dynamics, it would follow me into high school. A growth spurt and change in social dynamics shifted me away from the very bottom of the social space.  At the core of the hazing were two key behaviours that provided entertainment to jerks. Language processing, and startle response.  Slang and alternative meanings of words and the reading between the lines that unpacking those uses of language were and remain difficult for me.  On the school yard this was used against me,  embarrassing or cruel things were buried in questions loaded with slang and hidden meanings. Missing the subtext would used against me, or just cause jerks to laugh. Startle response was similarly exploited for its entertainment value.  Being naturally inattentive made it easy for people to sneak up on me, I have a strong startle response. This is naturally entertaining to far too many.  Where startle response failed, misreading threats worked.  Aggressive posturing, implied possibility of threat, and misreading body language combined to lead bullies to find was to make me flinch or escalate.  I trained myself to a freeze response over time, it was almost a healthy coping mechanism.  Harassments based on startlement and implied threat have largely vanished from my life since public school.  Unfortunately the language side of things has followed me around. I know I'm missing somethings, I don't know what things I'm missing, people still find ways to get entertainment at my expense from that.

Looking back I see a pattern that followed most schoolwork.  Deep engagement on topics of interest, especially when the content was novel.  An almost pathological avoidance of topics that failed to engage.  Deadlines snuck up on me, work was done on a last minute basis. Second drafts were about as far as my editing process went. Extra curricular actives were few and rare. Writing from researched materials remains exceptionally hard.  Cumulatively days of my life have been spent sitting in front of a keyboard knowing the content, knowing how I wanted to present it, failing to type. 

In parallel to all this, a pile of unfinished or upstarted projects.  Projects that got conceived, but dropped when the steps between idea and end became too many.  Life lived wanting to do cool things, but not knowing how to fill in the steps from start to end.  Shame filled in the cracks, I would be ashamed that I didn't know the middle steps. Ideas died as I lost track of them, floundered because lack of money, or simply not being able to do them all at once.  Employment suffered.  Ask me to write at cover letter and I'll flounder,spending hours failing to type. 

These things did not get easier over time.  Some coping mechanisms must have developed,they didn't go far enough. University and later social media, gave me a deeper view of how much other people were doing, and the relative ease with which it was done. My peers were flying a head of my with apparent ease. My time line was the farthest out paper, or the end of term exams.  Classmates were already thinking about careers while I could barely see two weeks ahead.  I said nothing, saw myself a failure. Thought I wasn't trying hard enough.  A bitter anger, nameless and shapeless grew from all this. 

There is a gap between the intelligence that so many agree I have and what I accomplish. That gap shaped a bitterness which flourished at times of unemployment, and underemployment. During the last really rough patch I described it as an impotent rage. A consuming frustration, turned to anger, yet with no direction, no strength.  There was nowhere to aim that anger, nothing concrete to attract. No matter which way I pointed my attention something else would pop up and be disproportionately difficult.  Turning inward to withdraw and depression happened then, you can't fail if  you don't try. You are failing at everything at that point, but logic is not the driver here. 

This is not an exhaustive list of struggles across all areas of my life.  It serves to illustrate the scope of the difficulties. They all have two things in common.  One, for most of my life I thought they had nothing in common.  I simply had a thousand different problems, I was bad at a thousand different things.  The second thing is they almost all have one thing in common, adhd.  They are the emergent properties of undiagonsed untreated Attention Deficit Hyperactivity Disorder.  The relief, and control I felt when I confirmed I had adhd was immense. As I learn more about ADHD my life makes more sense. It's only been about 9 months since then, I've barely begun bring that under control.

Ultimately I forgive the people who missed my diagnosis.  None were experts, they tried and they cared. I don't forgive the system for failing to have a tool set for connecting the dots.  I'm left with the feeling there should have been enough information to lead people to asking better questions but there were no tools for that.

In part two, The Impossible task, I will tell how I stumbled on the the path that lead to diagnosis and treatment.