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ADHD

Yesterday, while catching up on medical concerns with a patient before we started her Osteopathic session, I said “oh, yes, I tried that too” to convey understanding about what she was telling me regarding her experience with ADHD. She had been wondering whether to try a new treatment, and she stopped short. She was so surprised, and asked me, “Wait, you have this?” And I said, well, not the hyperactivity symptoms, but yes, I’ve been dealing with it since I was a teenager. It seemed to help her trust what I had to say about effective treatments and medication options, so I thought maybe it would be helpful to write about too.

Typical of many girls with mild attention-deficit symptoms, my main issues growing up were becoming bored and fidgety or even combative after only a few minutes of something I wasn’t extremely interested in, forgetting to do things like homework while doing adequately in school (so as to not raise any red flags learning-wise), getting in trouble over and over in class for falling out of my chair or daydreaming or talking, having major depressive symptoms with serious irritability and quickly becoming frustrated, and being able to ‘hyper-focus’ for hours on end on something I was truly interested in (in my case it was usually books or video games).

It wasn’t until around age 12 that I realized one day playing my game-boy, that my body was hurting all over laying cramped on the couch playing, and I didn’t want to eat dinner because I’d just ‘won’ and the game had automatically started over at a harder level… I was willing to be in pain and not sleep or eat in order to keep playing. I felt so angry about everything (mostly at my mother insisting that I pause the game- which turned off automatically after 10 minutes on pause so I rushed through eating), especially at any attempt to get my attention- I was so intent that didn’t hear anyone unless they were touching my shoulder at which point I would jump and yell at them- that a lightbulb went off: I didn’t like myself like that. I decided to put the games above my tallest bookshelf and not play them again.

Somehow I got through college (with an unimpressive GPA from taking so many classes and not being able to complete the entire curriculum for any one of them), but afterwards I was lost. I didn’t know how to do anything but be in school, even at the sliding-through level I generally took, and I was dealing with emotional trauma I hadn’t had help processing yet, so my mother paid for me to go to therapy while I looked into going to grad school. I took Effexor (venlafaxine), which is a combination SNRI (serotonin and norepinephrine) receptor blocker. In those three months, my mother and I didn’t fight once. (A miracle, honestly, given our violent and frightening history.) I studied for the MCAT, albeit cursorily, by skimming the entire Kaplan book in 3 days, seated at my desk, without music or food as with my previous study habits. And then, at the end of the summer, the relationship I was in went through a rough patch, and I stopped my medication cold turkey. (NEVER do that, by the way. Withdrawals are absolutely horrific.) Fighting with my mother commenced shortly afterwards, and I was told to either pay rent or leave, so I left the next morning, and decided that I’d try to find ways to deal with my sensitivities and attention issues without medication if I could.

The next chapter of my life really began after a year of working in a restaurant, using alcohol to calm myself down in order to be social, and playing video games until 3am most nights, when I somehow was accepted into medical school. I went through two video games there, one each year I lived in Kansas City, until realizing after one 8 hour bout wherein I ate an entire box of Better Cheddar crackers and drank only 20oz of Mountain Dew that day, that again, this was not the way I wished to live. My ban on video games resumed. I finally learned to study, even though it was with enormous amounts of caffeine, and also tried a few other anti-depressants and stimulant medications, but every one either gave me untenable gastrointestinal side effects or caused such nausea and anorexia that I would stop after 2-3 days. Personally, with no medical evidence for this, I blame the withdrawal-induced traumatic brain pathway I gave myself, and assume my gut-brain connection just decided it had had enough of me messing with it.

Now, I never had the major issues or severe symptoms that some of my patients have experienced, but it was enough of a problem that when I was semi-officially diagnosed (I didn’t want it on my medical record, so my psychiatrist at the time just spoke with me about it at length), it was actually a relief to know I wasn’t simply ‘lazy’ or ‘lacking motivation’ as I’d been told when I was younger. As for the sometimes frightening hypersensitivity to sound and busy environments I had experienced since I was about 6 years old, my psychiatrist attributed those issues to the same group of symptoms, and gave me a ‘good’ reason to leave environments that were difficult for me to handle and to take time to myself when I was overwhelmed.

Fast forward through residency, where the stress of losing my mother, 100-hour work weeks, and the fear of causing harm to patients seemed stimulating enough to force me to learn what I needed to become a good physician… then to today, and my current way of living. I’ll share the things I’ve learned, many of them in the last 5 years, that help me accomplish necessary tasks, and allow me to be creative and passionate without letting me forget about responsibilities I’ve taken on. I don’t do every one of these perfectly, but these are definitely the most helpful non-medical ADHD symptom modifiers I’ve found.

* I meditate every day. As my ‘Insight Timer’ on my phone records, I’ve missed 3 days in the last 400. And I felt it when I did! Nothing has given me more insight or helped me more in my own life, and nothing has allowed more healing. I recommend developing a personal regular practice of some kind very highly, no matter what your experience level or belief system.
* I take on only as much as I truly can handle- Some days that isn’t much, and as an introvert, I need a lot of time to recharge between activities. If I don’t take the time I need, or if I stack my schedule too high, I get sick, depressed, frustrated, and am ineffective at work.
* I haven’t had a TV since I was 19, and only watch with my housemates when I truly have no responsibilities and can waste a few hours, and really enjoy what is available. Otherwise I keep a Netflix queue and only watch when I can truly take time off.
* I am not allowed to play video games, and if I try one that makes me think about it after I put it down, or if it causes me to miss something someone around me said, it’s over.
* I go to bed at 10pm and get up as early as I can- my favorite time is 5:55am. I need a lot of sleep to recharge, to allow my overstimulated brain to ‘file’ important things and get rid of things I don’t need, and to make sure I am well-rested and alert so when I need to focus during the day I am able to without medications or caffeine.
*  As much as possible, I eat whole foods without chemical additives and avoid refined sugars (including agave, hfcs, brown rice syrup, coconut sugar, and crystalline fructose… there are probably more…). Some people may benefit from avoiding flour also, and some may benefit from avoiding dairy. Personally I love home made sourdough bread and grass-fed whole milk for the omega 3s, but that’s my personal preference.
* I don’t try to multi-task anymore. It’s not possible anyway, and it’s not worth the frustration and disappointment when I fail.
* I write everything down in pen, keep an online office schedule also so I have to cross-reference and don’t forget something, and I make lots of hand-written lists, but re-write them when many things are crossed off or too many new things have been messily added. I do not use my phone calendar or reminders (I am on the internet too much anyway, and writing with my hand allows me to remember photographically much better than typing), and when I leave myself a voice note or need to write a note in my phone, I transfer it to a word document as soon as I can or put it in my written paper calendar, or I act on it right away.
* Most of all, I am as understanding and realistic as I can be about myself. I keep what matters to me in the forefront of my mind, and stop to reevaluate as needed. I am comfortable being wrong, and work daily on being flexible while sticking to what is important to me.

I hope that was a little helpful, and if nothing else, sometimes it helps to know that doctors are regular humans too. The people I look up to most are those that have had to work with something that was not easy and found ways on their journey to be even more bright, loving, and compassionate. In my case, I hope to use my experiences to help others if possible, and at the very least, to learn to be more peaceful and kind to myself.

4 Comments

  1. Wow. Thank you so much not just for the personal history but also the detailed information on how you deal with your situation today. I think this will definitely help me with my own similar issues and help me to understand my sister, who was diagnosed with ADHD at a young age. Thanks again, and keep up your wonderful work!

  2. Dr. Andrea SeifferttApril 30, 2014 at 9:32 pm · Reply

    Thanks! I’m so lucky I have relatively easily manageable issues– for people who really need medication and serious life-help, I’m hoping at least knowing they can do basic things like this to support themselves may be helpful :)

  3. Hi Andrea,
    Great post. It’s so refreshing to read health care providers being real about their own lives. I also struggle with ADD, and have come to many of the same conclusions. We should catch up soon…
    Didi

    • Dr. Andrea SeifferttMay 14, 2014 at 12:07 am · Reply

      Thanks Didi! :) Yes, we should catch up soon- I’m leaving my practice and traveling to write for a while, maybe I will get to see you in person someday soon!

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