Slightly less hilarious brain-stuff

One of the few less-cool things I think I have in common with the autistics in the house is sporadic executive dysfunction. I've actually known I had this pretty much as long as I can remember, and I got a name for it sometime in college, but previously I'd only been aware that it was linked to physical damage to the frontal lobes and attention deficit hyperactivity disorder. I'm quite sure I don't have any history of getting whonked repeatedly in the head, and previously when life got so insane I ceased to function, I would generally drive myself even crazier by looking up stuff on ADHD just in case I'd magically developed any of the other symptoms this time.

I do not have ADHD. I know this perfectly well. I know people with ADHD. I know people whose faces are probably next to the clinical diagnostic criteria for ADHD in the DSM. The all-time winner in this regard is probably the friend who once had to be frog-marched down to the local pharmacy to explain that he couldn't find his ADHD medication, because he hadn't taken any of his ADHD medication, because he couldn't find his ADHD medication, and so on and so forth in an infinite loop that the pharmacist finally broke by calling up the unfortunate doctor involved and getting an authorization faxed. This is extra special fun when you live in a country founded by a combination of 16th c. venture capitalists and religious zealots who lived their entire lives terrified by the thought that someone, somewhere, might somehow be enjoying themselves, and you're trying to get an extra refill on instant-release dextroamphetamine.

The slightly-less ADHD friend in that story is someone of whom I've often said that he is the only person who would make somewhat more sense if he were still holding conversations with people in his home dimension. He and yet another ADHD friend -- don't look at me, Moggie collects these people -- used to be co-resident advisors in the same wing of one of the university's freshman dormitories. They paired up the RAs to do the building walkthroughs, on the theory that even if they each only brought half a brain to the job they could still manage to get something useful done. The only problem with pairing these guys up was they each brought the same half of the brain, which resulted in a lot of incidents where they walked right past some 18-year-old's door conveniently held open with a case of illegal beer. D'oh.

I worked with ADHD The Third up there one summer in a dorm that was being rented out like a hotel for local conferences. We were living there when the housing association delivered new mini-fridges for all the rooms. He went upstairs to get something off of his desk, dicked around with his computer for a few minutes, came all the way back down to the lobby and resumed our conversation, and only then realized that there had been a surprise refrigerator in the middle of his floor.

The point is, a deficit of attention is not my actual problem -- just the ability to unscramble tasks into a workable order, and only sometimes. It's particularly nasty right after I've woken up. I'll lie there in bed, after having slapped around to locate whatever I gizmo set the alarm on and oh god turn it OFF, and think, "Okay. I need to get up, get dressed, feed myself, feed rats, pack some stuff David forgot, do dishes." And this is not a huge to-do list by any means, but for some reason alarm clocks tend to drop a brick on the clutch pedal of my brain, and it comes out more like this:

"I need to get up. Up, out of bed. Pants. Go get food and I need pants. Multivitamins. Bathroom first. Must pants for bathroom, I should take the rat bowl out to the kitchen with me on the way to the bathroom, no wait what pants do I need, David's stuff might make a mess, shouldn't be any of my nice work pants. I also need to shoes before taking out the trash, but bathroom first, and vitamins! and food for rat and PANTS so food for me and dishes while the food cooks do any of the dishes go to David? Maybe dishes first NO BATHROOM FIRST make some eggs and take my multivitamin, feed eggshells to rats, and porridge? leftover bread? rice? what do I have? must remember to get the rat bowl on my way back to, no on the way out to the kitchen BUT FIRST PANTS, BUT FIRSTER BATHROOM..."

It's like trying to move a double armload of loose socks. I can get most of it, but as soon as I get a decent grip on one aspect, something else important hits the floor. I do eventually somehow manage to get out of bed without falling over flat on my face and get myself sort of dressed, if only in non-scandalous pajamas, and stagger around kind of randomly turning on taps and rearranging foodstuffs until, mostly by luck, I've managed to get a bowl of cold porridge into the rat cage and some scrambled eggs into me.

This makes me officially Not A Morning Person. I'm hideously grouchy when I've just gotten out of bed, because I don't like not working. It's worst when I wake up, but I also go stupid between about 5 and 9am even when I'm not unconscious. I leave standing orders that when I get up no one is to talk to me until I've spoken to them first, because if I can manage three whole words in answer to anything, a minimum of 33% of them will be profane.

I woke up for work once to find a friend of ours had come to visit; I was on graveyard shift at that point and he and my flatmates were all preparing to sit down for dinner when my alarm sounded. The friend -- one of the sweetest people I have ever had the good fortune to meet -- was so very happy to see me that he immediately turned to me, the shambling horror in sleep pants, hugged me, and started saying cheerful, friendly, bubbly, happy things to me. I have no idea what any of them were, because all I could process was the tone. A couple of sentences later when the relays finally kicked in, I took this darling, kind boy by the arms, leaned forward as if to deliver an important message, and said with with great effort and as much sincerity as I could muster: "Stop. Talking."

Then I shuffled back to the bathroom to dunk my head in cold water. I presume my roommates explained the situation to him. They knew better than to try to talk to me.

Like many people with undiagnosed brain weird, I self-medicate like a motherfucker. I tell people I don't work without caffeine. For some reason they think I'm funny when I say that. Even after they happen to see the mute shambling horror that is me before I've finished booting up all the way, they think I'm being hyperbolic. (Or just lazy and full of excuses, one of the two.) I have no idea why. I've been caffeinating myself into having a life since I was in high school. Not literally when I was in school, mind; my school started classes at 7:20 in the morning, which goes a long way towards explaining why my attendance rate was hovering around 50% my senior year. Nothing helps that early; I just drank a ridiculous amount of soda in an effort to stay awake around midday.

Once I was in college and doing my own damn grocery shopping, I gave up and just graduated to NoDoz, or equivalent generic. I don't know if I have a ridiculous tolerance just from chronic use or if there's some kind of functional threshold that I need to hit before the "extra" caffeine starts making me jumpy, but I have to get up to ~800mg before I start getting that rubbery odor of scorched neuron hanging around in the back of my nose. I don't normally take that many, of course, but I do take one of them every morning with the aforementioned multivitamin, so that I can actually get up and do things with my day.

When I was having the horrible anxiety problems that ultimately drove me out of Arizona, the ER attending suggested I eliminate caffeine and see if that helped me sleep. Since she was the one who handed me a 90ct bottle of Xanax for unsupervised home use and then apologized for being unable to convince the dispensary to give it to me for free, I would have given anything she said a shot even if it involved a lovesick wildebeest and a unicycle. It was a disaster -- I actually slept worse even after the headaches subsided, because I was spending all of my awake time flailing around randomly, unable to remember anything at all I had to do more often than once, and less often than once a week.

I don't find it fun under normal circumstances, but it gets pathologically worse when I'm depressed. I have not had good luck getting any of this across to psych professionals. I tell them that I can't do things when I'm depressed. I think they think this is some sort of alexithymic metaphorical expression of the nihilistic futility of life or my own self-loathing getting in the way of feeling like I "deserve" to eat dinner or something, but I just mean I can't. I lose my ability to can, as the kids on tumblr say. It can get absolutely ridiculous at times. One of the most thoroughly idiotic instances I recall was many years ago when I was a miserable undergrad, when I walked out of my apartment in the morning and came to the realization that it was slightly colder than I expected, and I was going to need a coat. I ended up standing outside and having the following dialogue with myself--

Me: It's colder than I thought.
Also Me: Yes. I should get a coat.
Me: I'm going to be chilly on the walk to class.
Also Me: Yes, a coat would fix that.
Me: It's windy.
Also Me: A coat will help with that too.
Me: So I should go back inside and get a coat.
Also Me: Yes. Get a coat.

--for twenty minutes. With my hand on the knob of the unlocked door, both parts of the internal debate in perfect agreement about the fact that I needed a coat, and I still couldn't get anything to happen.

It makes you feel intensely stupid, which at the very least does not help a depressive fugue. One of the reasons I credit Moggie with not letting me die is that I have been known to stop functioning to the point where I will just fork over all kinds of important personal information and tell her to just call someone up and pretend to be me, because I cannot make myself make some truly necessary appointment. It doesn't happen often, but it happens right when I need it to not happen the most, which can make life annoyingly difficult.

Comments

  1. Thought about posting this link earlier this week as the whole atypical brain diagnosis thing seemed to fit your interests. Since you've mentioned ADHD, I couldn't resist.

    https://theconversation.edu.au/moving-the-diagnostic-goalposts-medicalising-adhd-8675

    Autism diagnosis seems a bit further ahead. They've at least identified some related genetic markers.
    http://www.news-medical.net/news/20120913/Melbourne-researchers-develop-genetic-test-to-predict-risk-of-autism-spectrum-disorder.aspx

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  2. Oh god, that is almost exactly one of the ways my depression manifests. I will seriously have mental conversations with myself that are basically:
    "man, I have to pee."
    "Yeah, I should get up and go to the bathroom."
    "Yeah, but I have to pee and I need to get up to do so."
    "...which is why I should get up. I just said that."
    "Right, but I have to pee and also the bathroom is far away, but I should get up anyway."
    "Oh my god it is across the fucking living room what is wrong with you??"
    "I have to pee :("
    "GET UP. JESUS."

    and so on and so forth.

    ReplyDelete
  3. I forgot how to leave my room once. It was an intensely unpleasant experience. And yes. Losing the ability to can. Good way of phrasing it.

    And "related genetic markers" for autism isn't diagnosis, it's pre-natal screening.And a screening measure with 70% accuracy would only be slightly better than completely useless.
    Here’s why.
    Say you had 1000 kids and you ran the genetic test to see which ones would become autistic.
    If we assume that the rate of autism in the population is around 1% then we’d expect 10 of the 1000 kids to be autistic. Given 70% accuracy, we’d expect 7 to show up on the genetic test as autistic.
    The problem is the other 990 who aren’t autistic. 70% accuracy means that 30% would be incorrectly diagnosed as autistic. 30% of 990 is 297.
    Putting those together, our genetic test thinks that 304 of the 1000 children are autistic. Of those, only 7 really are autistic, the other 297 have been mis-diagnosed.

    In other words, if your child took the test and the test came out positive, there would still be a 98% chance that your child was not autistic.
    So fuck that. It's not diagnostic.

    ReplyDelete
    Replies
    1. It would be nice if other people understood statistics, wouldn't it? But they don't.

      I've no idea if I've got any related genetic whatzits. I have two weird genius parents, which you find a lot when you look at the already-diagnosed kids, but which you probably also find a lot when you look at allistic kids, too. If I were to bother getting any expensive unnecessary genetic tests it would likely be for CYP2D6 metabolic function -- a lot of medication affects me in truly bizarre ways, and the only common factor I can find is that they're all metabolized via that pathway. The ones that are broken down by CYP2D6 whack me like a truck, and the ones that require the enzyme to be metabolized into the working compound (primarily synthetic opioids) do fuck-all. It would be nice to have a thing to point at so doctors stopped looking at me like I'm mad when I tell them this.

      Delete

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