The ADDled Brain and Anxiety

I never thought of myself as an anxious person. Maybe I wasn’t when I was younger. Truth be told, though, I suspect I’ve had anxiety issues most of my life and was never treated for it.

It’s common for people with ADHD also to have issues with anxiety and depression. I mean, who wouldn’t be depressed when our brain differences aren’t recognized or accepted in a world that is becoming increasingly hyperactive and overwhelming?

According to the Anxiety and Depression Association of America, about 4 percent of American adults (or about 8 million people) have ADHD, half of whom also have an anxiety disorder.

I had a 50-50 shot at NOT having anxiety — my luck, I guess. And speaking of luck …

A 2017 study of 423 adults selected on the basis of gambling habits or impulsivity (impulse-control being one of the issues associated with ADHD — see my post about puzzle obsession) found that 20 percent had symptoms of ADHD. However, only 7.3 percent had received a formal diagnosis and, ostensibly, treatment for it.

“ADHD symptoms were associated with significantly lower quality of life, lower self-esteem, higher emotional dysregulation, higher impulsivity-compulsivity questionnaire scores, more problematic internet use, greater occurrence of psychiatric disorders, and impaired stop-signal reaction times,” the study’s authors wrote.

So it’s not surprising anxiety plays a role in my life. Now that I’m older, I’m learning how to handle it better. I mean, my anxiety isn’t severe — I hadn’t even considered I had it, for goodness sakes. But now I realize, it does get in the way — particularly with sleep, decision-making and impulsivity (read: puzzles).

My curiosity was piqued a few weeks ago when I heard a story on NPR about a study that found specific brain cells in mice that seem to control anxiety levels. Although Mazen Kheirbek, assistant professor at University of California, San Francisco and lead author of the study, says the research is preliminary, it could lead to better treatment for anxiety.

Avoidance is a typical and healthy response to threat, the authors write in the introduction to the study published in the journal Neuron. But people with anxiety can overestimate threat leading to excessive avoidance behavior.

Can you say procrastination?

The hippocampus region of the brain is thought to be involved in mood and anxiety disorders. But little is known about how or why some people’s brains cause them to worry excessively.
scared mouse

Using highly technical methods I won’t go into, researchers discovered a specific neural pathway in the hippocampus of mice that appears to generate avoidance behavior in stressful situations.

Of course, and Kheirbek was clear about this when speaking with NPR, research conducted on lab animals doesn’t always translate to humans.

Still, it gives me hope.

My ADDled Brain’s ADDiction

“There are no extra pieces in the universe. Everyone is here because he or she has a place to fill, and every piece must fit itself into the big jigsaw puzzle.”

                –Deepak Chopra

I admit it. I have an addiction.

I also have mild depression and anxiety — conditions not uncommon to people with ADD or women going through perimenopause, of which I have both.

Yay for me!

Though it’s not destined to destroy my physical health like alcohol or drug addiction, mine does feel self-destructive. It affects my ability to pursue my career and creative goals.

My addiction? Puzzles.

When I’m feeling stressed, anxious or overwhelmed and want to avoid work, I turn to online jigsaw puzzles, word games, crossword puzzles and Sudoku.

Side note: Nearly 1 in 5 American adults are affected by an anxiety disorder each year, according to the National Institutes of Health.

Now substance addiction is a different animal than say, gambling or puzzle playing, I don’t deny that. Using alcohol, drugs or even tobacco has true physiological effects. But in terms of brain chemistry, I wonder how different those addictions and mine really are.

For me, I think doing puzzles calms my overwhelmed and sometimes anxious brain, much like a heroin addict who soothes his anxiety or pain by shooting up. OK, I admit, that’s probably a stretch given the physical ramifications of not taking a highly addictive substance, as in withdrawal, which is a serious health concern in and of itself. But either way, both addictions result from a lack of impulse control (as embarrassing as that is for me to admit about myself).

Self-proclaimed Puzzlecrossword addict Dean Olsher is ambivalent about crossword puzzles. In a 2009 interview with Melissa Block on NPR, Dean Olsher spoke about his book, “From Square One: A Meditation, With Digressions, On Crosswords.”

Olsher confirms my thinking about puzzle addiction. Reading from his book on NPR,  he says, “Entering a crossword is like stepping into the clean, white cube of an art gallery or into a church or a Japanese rock garden. There are days when solving puzzles feels like a practice — the next best thing to seated meditation … It is more honest, though, to think of crosswords as a habit, like smoking. It’s just something to do every day because it’s there.”

Soothing, right?

However, Olsher also asserts that puzzles “have an addictive, immersive quality that keeps people coming back for more.” Part Zen and part addiction, he likens them to their own form of mental illness.

Yiiiiiiiiikes!!!

According to an October article by National Institutes of Health, researchers found that “addiction’s power lies in its ability to hijack and even destroy key brain regions that are meant to help us survive.”

Healthy brains reward healthy behaviors, it says. Exercising and eating healthy foods switches on brain circuits that makes us feel good, so we’re motivated to repeat those behaviors.

When a healthy brain senses danger, it elicits a chemical release that prompts the body to react quickly — the so-called fight-or-flight response. According to a  Harvard Medical School article on depression, “Every real or perceived threat to your body triggers a cascade of stress hormones that produces physiological changes. We all know the sensations: your heart pounds, muscles tense, breathing quickens, and beads of sweat appear.”

But drugs and alcohol mask those chemical responses by hijacking the brain’s pleasure/reward circuits, the NIH says. Addiction sets danger-sensing circuits of the brain into overdrive, making an addict anxious and stressed when not under the influence, leading them to want more and more.

For substance abusers, it becomes a vicious cycle that has them using drugs or alcohol to avoid feeling bad rather than to feel good.

And those stress hormones? They are produced as a result of increased activity in the frontal cortex of the brain — lo and behold, one of the areas of the brain affected by ADD and depression!

If you’re tempted by something questionable—like eating candy instead of a healthy dinner or buying things you can’t afford—the frontal regions of your brain can help you decide if the consequences are worth the actions. But if your frontal cortex isn’t totally functional, as is the case with addiction, ADD and depression, you may not have the ability to rationally stop yourself from doing something you know won’t be good for you. I feel that. It becomes an intense struggle to control impulses. And, like any addiction, it gets in the way of living life.

But I can report now that I have cut down on my puzzle-playing over the last few months during which time, this post sat in my draft folder. Maybe I felt the need for some good news before I came clean to you.

I’m far from cured. I still take an occasional trip to my favorite online puzzles. But I’ve deleted games from my phone and I often stop myself when I feel the urge, so I’m getting there. So does PA exist — a support group for puzzle addicts?

What us wheel-running gerbils can learn from chefs

“It’s like a very … Zen-like thing. All my knives are clean. Clean cutting board. Clear space to work. Clear mind.”

– Greg Barr, sous-chef at New York City’s Esca

One of the tenets of living successfully with ADHD is staying organized.

I use various tools and practices which I previously wrote about (see “Where is … uh, what was I looking for again?“). But this morning as I was on my way to join some friends for an open-water swim (in an effort to exe(o)cise the distraction devil), I heard a story on National Public Radio that was quite interesting.

Though the story didn’t mention a thing about attention deficit, apparently, we all, not just us distractible types, could learn something from highly trained chefs who use a system known as mise-en-place (French for put-in-place). It’s a technique taught and practiced in just about every culinary arts school and high-end kitchen. It is a way to marshal the culinary troops, so to speak.

The practice, as described by several chefs for the NPR story, involves gathering all the tools and ingredients necessary (and ONLY those things) for a certain job and place them at your work station in such a fashion to enable a chef to conserve movement, energy and time.

Culinary Institute of America instructor Dwayne Lipuma told NPR that a chef’s every minute and every motion is accounted for:

“Every component of one single dish is in one single corner so [a student’s] hand literally moves inches,” he explains. “Once [students] set up their station I should be able to blindfold them and tell them … and they should know that their tongs are always here, their oil is always right here, their salt and pepper is always right here. “

Same should apply for wily writers who should be working on other things rather than writing a blog post (ahem). When I prepare to sit down to work, whether I choose my couch, the kitchen counter or my deck as office of the day, I usually spend about 10 to 20 minutes setting it up — pen, paper, documents and phone on my right, computer on my lap, coffee and/or a glass of water nearby … you get the idea.

One could surely argue that I’d be more productive if my workspace wasn’t so mobile. But I have a good excuse besides the lack of a desk or comfy chair in my home office.

Writing is hard and the right environment is critical to my getting anything accomplished. Some days outside with the birds chirping and a view of the mountains is what my creative soul needs. Others it’s the austerity and coolness (it is summer after all) of the living room. But wherever I end up, my office rarely moves until I pack it in for the day.

Getting back to the chefs, they also say it is important to clean as you go. It keeps your workspace organized and makes clean up at the end of the day, so much easier.

Same goes for us average ADD folk who have a tendency to lose and/or forget things. Clean-as-you-go is a parallel notion to OHIO (which I also previously wrote about). OHIO is an acronym for “only handle it once.” If you take something out, use it, clean it and put it away. Mail: toss all the junk into the recycling bin on the way into the house, pay bills immediately or place them in the same spot every time so they aren’t lost when it is time to pay them.

You can, of course, reduce your paper inflow by receiving and paying most, if not all, your bills online. But that takes a certain amount of disciplined order on your computer (which is another discussion).

But in essence, the OHIO principle simply suggests you take that extra step or two to put things away immediately rather than placing them at the top of the stairs so you’ll take them next time you go down — that typically leads to a pile of stuff at the top of the stairs which gets forgotten, ignored and grows! Not terribly efficient or attractive.

According to the NPR story, other principles of mise-en-place include becoming “one with your list,” being punctual and time-aware and, somewhat ironically, slowing down enough to get things right the first time.

Now if I could only figure out how to stop procrastinating …

 

 

Productive Procrastinator

“The best time to plant a tree is 20 years ago. The second best time is now.”

– Chinese Proverb

I’ve always wondered how people got stuff done. I mean, really.

If you have a full-time job, how is one supposed to get to the bank, pick up groceries, pay bills, go to the dentist, tend the garden, clean the house, cook meals and return that overdue library book — not to mention having time left over to get some exercise and have a social life?

This is NOT my office ... just sayin'.

This is NOT my office … just sayin’.

And for me, that’s WITHOUT kids. Single parents who work AND attend school simultaneously, well, I just can’t fathom it.

Since learning I have this “disorder” called ADD, I realize that most people are more efficient than me, don’t lose track of time and have the ability to stay organized and focused. These are all things I’ve lacked my entire life.

Now I’m in sort of brain-training mode and consider myself a productive procrastinator.

There are myriad ways to overcome ADD without drugs. Tools like alarms, reminders, calendars, task lists are all available apps that can be synced between computer and mobile devices (see more about learning to live with Adult ADD in a previous post: Where is … uh, what was I looking for again?).

It’s true, I’m becoming more productive, less distracted, more organized and overall I’m happier.

I’m even watching football as I write this. I must admit, however, if someone asked me what just happened in the game — unless it was something spectacular — I wouldn’t be able to tell them. I guess I’m just half-watching.

Anyway, here’s a list of some of what I’ve accomplished in the last few days:

  • Finished a 700-word magazine story.
  • Applied for a job.
  • Paid some bills.
  • Researched wetsuits (have I mentioned that I’m addicted to triathlons?).
  • Went grocery shopping (several times — I know, not exactly efficient).
  • Cooked several dinners.
  • Tended the gardens — multiple, yes.
  • Went on a 25+ mile bike ride (woo hoo).
  • Went to the farmers market and ordered iris rhizomes.
  • Cycled into town from the farmers market, attended a local arts festival, drank beer with friends (way fun day).
  • Picked about a pound of sour cherries.
  • Wrote a couple of blog posts.
  • Invoiced a consulting client.
  • Sent a birthday gift to my sister-in-law.
  • Baked a cheesecake.
  • Cleaned the bathroom.
  • Made a mess of the kitchen several times and cleaned it up again.

All of this in just three days. Maybe this isn’t a lot, I don’t know.

So I’m curious what you think?

Exercising the Distraction Devil

I’m just back from a lovely 25+ mile bike ride and it’s clear how exercise helps with ADD. I feel energized and happy and ready to get to work.

Experts say (and I know from experience) that ADDers required to sit in one place for long periods of time can get quite fidgety and distracted. Any sort of exercise, even getting up and taking a short walk, can help redirect an unfocused mind.

“Think of exercise as medication,” Dr. John Ratey told ADDitude magazine.

Associate clinical professor of psychiatry at Harvard Medical School and co-author of “Driven to Distraction” (which I highly recommend, by the way), Ratey continued:

“For a very small handful of people with attention deficit hyperactivity disorder (ADHD ADD), it may actually be a replacement for stimulants, but, for most, it’s complementary — something they should absolutely do, along with taking meds, to help increase attention and improve mood.”

I know for me, the task of sitting still to write anything longer than a tweet can be excruciating.

This week, I was working on a short magazine story. After conducting four interviews, I was ready to sit down at my computer and punch out about 700 words.

Unfortunately, I just couldn’t stay focused on the story for more than an hour or so at a time. I washed dishes then wrote a little. Poured more coffee, wrote some more. Ate lunch, read the newspaper and played a computer game before typing up a few more paragraphs. Then I watered the garden.

At least the gardens weren’t dry, the kitchen was clean and my stomach was full.

People with ADD, myself included, are not only apt to daydream or lose concentration, but they can also become hyperfocused. When I’m in hyperfocus mode, it’s generally a good thing because it means I’m being productive. There are downsides, however.

When I’m in the zone, I tend to lose track of time.

Yesterday, for example, I had about an hour to pay a few bills online before taking the orange monster cat to the vet at 10 a.m. Before I knew it, it was 10 minutes to 10 and the feline was still out roaming! Fortunately we were able to wrangle him up, get him packed in his crate and I was only a few minutes late for his appointment.

When hyperfocused I also tend to shut out the world. Someone can speak to me and I hear his voice, but the meaning of his words don’t register. This infuriates my significant other. And I can’t say I blame him. But I’m working on it … really I am.

For now, I guess I can be content that the story has been submitted and I can get back to blogging since I started this post around noon. And now it’s past time for bed.

Um, what was I writing about again?