September 22, 2010

The Racing Thoughts of Adult ADHD

For all of my adulthood, I have gone to bed very late. Now that I am getting some perspective on ADHD, and learning about the symptoms, and the neuropsychological underpinnings of the disorder, I can understand why. I never wanted to lay down in a quiet bed and listen to my brain revving, so I would exhaust myself until I literally passed out. Or in the past I would have a few (or more) drinks. That would dull the cavalcade of mental imagery.

Imagine you've got a nice vintage Mustang car. You've got it in your driveway. Your friend drops by and asks if he can sit in the driver's seat and turn on the ignition to hear the classic engine. You answer "yes, go ahead". He smiles, turns the ignition over and then jams his foot down on the pedal and the engine races out of control, your eyes bug out and you feel out of control. That's what it can be like with ADHD.

I think fast. I talk fast. I read fast. People have always commented on the fact that I can read a page of text about 10 times faster than Superman. But this isn't like bipolar disorder where there can be an unceasing pressure to spit words out, and often the utterances end in nonsense. Where the thoughts are inchoate, indecipherable jumbles of ecstatic confusion. No, this is simply because my brain runs very fast, and I either talk quickly or think quickly. If I can match my thinking and actions with my environment, then I feel in sync and I feel okay - assuming I am populating my environment with activity and excitement (TV channel surfing, internet surfing, multi-tasking, talking, reading several books at once, engaging in several hobbies - you name it). But turn down the tempo on my environment and then I become uncomfortably conscious of the tempo of my thoughts, the racing, the sensation that I cannot control the speed of my thoughts.

So I don't go to bed until I'm worn out. I can sit by myself for hours, but I have to be reading or doing something. I going solo camping, but I'm always exploring the woods, or collecting firewood, or cooking, or arranging. Alone with my thoughts, yes, but always matching the tempo of my internal world with the tempo of my external world.

I described the train of thoughts in my head to the psychiatrist in my assessment back in April/May like that of a a lumberjack who is racing on rotating logs in a river. You have to keep running lest you tumble into the water and get crushed by the massive logs. It is beyond your control.

As I was falling asleep (or at least trying to) a couple of weeks ago, I came up with a new metaphor. I imagined a large boiling pot of soup with chunks of vegetables and chicken and such in it. Each item that boiled to the top was a thought, quickly to be replaced by another totally different one - over and over and over. I am now able to describe accurately a mental experience I've had for years: I'll be thinking (either as I'm laying in bed, or just generally during the day), and have an intriguing, or useful thought, and then all of a sudden it will be displaced by another train of thought - and I'm only left with the sense that I had something interesting to think about - and can't remember the damned thing! Quite frustrating! Sure this happens to everyone. But constantly? The only way to avoid this is for me to hyperfocus (or engage in perseverative hyper-concentration).

But something interesting has been taking place recently. And I suspect it is due to the effects of the Strattera, and to a lesser degree, my own learning about the disorder, and new coping strategies that I am putting into place in my life. The racing thoughts I experience as I lay down at night, or simply during the day when I am in a quiet environment - the racing thoughts aren't there as much. At times there is almost a calm silence. A sensation of openness. Of alert calm. Hard to describe, but it is a wonderful sense. I am wondering if my dopaminergic and nor-adrenergic pathways are beginning to balance out, or somehow become tuned and working smoothly. Maybe that's what is happening as this selective norepinephrine reuptake inhibitor (Atomoxetine - Strattera) takes effect in my brain.

Strange to reflect on it - but now that I've had several experiences lately of this calm alertness, this alert tranquility, I realize now that all of my life has been spent fighting against the rushing of thoughts and of both mental hyperactivity and impulsivity. What a drag that has been. What a darned drag (I am trying to remain family friendly, but substitute any adjective you'd like). Sad in a way, I feel bad for that guy who was me, all that time, never knowing that it wasn't normal to be fighting this. I always put it down to just being a nervous or insecure guy.

Anyway, I'm feeling good about this. Now I am trying to put into place more scheduled and early bedtimes for me. I need my beauty sleep of course. I need my brain sleep.





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