Well, in another installment of “I wish they’d told me that a long time ago”, it turns out that SSRI’s can contribute to hyponatremia, a potentially dangerous condition in which your body doesn’t have enough sodium to regulate the water in your cells.

It is believed that SSRI’s might contribute to at least mild hyponatremia in [...]]]>

Well, in another installment of “I wish they’d told me that a long time ago”, it turns out that SSRI’s can contribute to hyponatremia, a potentially dangerous condition in which your body doesn’t have enough sodium to regulate the water in your cells.

It is believed that SSRI’s might contribute to at least mild hyponatremia in up to 30% of patients taking these medications.   Symptoms of hyponatremia are nausea and vomiting, headache, confusion, lethargy, fatigue, appetite loss, restlessness and irritability, muscle weakness, spasms or cramps, seizures, and decreased consciousness or coma.  SSRI-related hyponatremia is more common in women and the elderly than in the general population.

Now I’m not unconscious or throwing up, but I have been having some unusual issues with my muscles lately.  I’ve been incredibly tight, and no amount of stretching seems to help.  In fact, I pulled my hamstring last weekend while gently easing into a yoga pose that is usually pretty easy for me.  Coincidentally, just last week, my doctor doubled the dosage on the SSRIs that I take.

To make a long story short, other than serious organic illness, my “lifestyle” embodies many potential causes of hyponatremia:

• I take SSRI’s, which in addition to being potentially diuretic, also make me thirsty, so I drink a lot of water.
• I’m on ADHD meds, which also cause dehydration.
• I’ve been taking a lot of asthma and decongestant medication to deal with a bad allergy season
• My diet low in sodium, because I’m a vegetarian who eats no processed foods.
• Since I’m thirsty, I consume a lot of water while exercising.
• I drink alcohol.

As for that last one, you’re supposed to be careful with booze when you’re on the meds I’m on.  I know that.  I’ve known it for years.  I’ve been naughty.  But it’s been a rough summer, and I’ve been self-medicating.  I clearly need to stop doing that.

Since hyponatremia (if that is what I have) can indicate a serious organic illness, I’m going to the doctor on Monday to make sure it all checks out.  In the meantime, I’ve spent the last couple hours drinking miso soup and coconut juice to try and restore my electrolytes.  I already feel better.  And if you’re on SSRI’s, be aware that hyponatremia is a possibility, and discuss any symptoms with your doctor.

Getting those filled was no picnic, I assure [...]]]> About six months ago I wrote here and at Well-Ordered about a very nasty shock I received at the dentist: a whopping SEVEN $#%^&@ING CAVITIES.  Twice as many cavities as I’d had in my adult life thus far.  All of them between my teeth.

Getting those filled was no picnic, I assure you.

The culprit, it turned out, was my Vyvanse.  ADHD drugs, like many anti-depressants, and many allergy meds, and many athsma medications, can dry out your mouth something serious. Without saliva, your mouth isn’t able to defend itself from teeth-eating bacteria.  Teeth-eating bacteria cause cavities.

My dentist assured me that he’d seen this kind of thing before, due to all types of medication, and if I followed his instructions — floss EVERY night, use a prescription-strength high-fluoride toothpaste, and chew high-strength xylitol gum and mints — my teeth would be fine.

And they are!  YAY!

If you’ve recently started a new medication, a trip to the dentist is in order.  Tell him or her that dry mouth is a side effect of your new med (whether or not you’re consciously aware of feeling dry mouth).  They can set you up so you won’t have to go through what I did.

Partly, it’s because I’ve just been too depressed.  I feel like if I write about [...]]]> I haven’t been posting a lot lately.  Partly this is because of the amount of time I’ve had to spend reading job listings, filling out applications, tweaking resumes, and trying to write cover letters that aren’t don’t sound like total BS.

Partly, it’s because I’ve just been too depressed.  I feel like if I write about what my life has bee like lately, I’d just be whining, and I should be trying to be chipper and cheerful and all that crap.

But then I realized, this is a blog about adult learning disabilities.  Life with adult LD sucks sometimes.  And seldom does it suck more than in the area of employment.

So here goes.

Back in March, when my husband was offered his exciting start-up opportunity that involves a significant pay cut, my plan was simple: I’d go back to my previous job, which wasn’t that exciting, but was a decent place to work, and I’d put in a bunch of hours there while looking for something that paid better and was more in line with what I’d actually like to do with my life.

It seemed like a good plan, because every time I’d been into the store where I used to work, my former boss had said that he’d love to put me back on the schedule.  It sounded like a done deal.

So I applied there.

And then I waited.  And waited.

And then I called them about my application, and it turned out that there had been some changes in the management staff, but I landed an interview.  I was told that my previous employee evaluations looked good, and that they could probably use me, but I should call back in a week to follow up.

So I did.

And I was told that they hadn’t made their decision yet, and I should call back in a week.

So I did, and I was told that they hadn’t made their decision yet, and I should call back in a week …

And it went on like that for about six weeks, at which point they decided to go with someone else.

Which is fine, I guess, but did they really have to string me along for six weeks?  And actually, it’s not fine.  It’s a bit of an ego blow to get turned down for an incredibly boring, menial job that I worked for five years; a job that I can do in my sleep; a job for which the company would not even need to train me.  I had pretty good evaluations at that place — and if they won’t hire me, why the hell would anybody else want to?

A few weeks after that, one of my applications actually got a nibble, and I was asked in to interview.  It was a tough interview, what I later found out was a “behavioral interview“, that began with the interviewer pressuring me to disclose “things I didn’t like” about my previous management.  I was caught off-guard, and since I was totally unprepared for that kind of interview anyway, I totally bombed it.  I know I bombed it because I received an email form letter less than 24 hours later telling me they’d decided that “another applicant was a better match for their needs” — this after they’d told me the day before that they were still interviewing a lot of people, and wouldn’t be making a decision until mid-June.  They didn’t know who they liked, but they knew it wasn’t me.  Ouch.

And all of this is on top of my ongoing problems with employment — the fact that I was never able to land an entry-level professional job, because the skill sets for all of those jobs are in the exact areas in which I am learning disabled.  Administrative assistants have to be organized and able to prioritize.  They need to keep track of other people’s schedules and contact information.  They need to know where everything is, and often they’re called upon to do light book-keeping.  Try doing that when you have dyscalculia, dysgraphia, and ADD.

Lest you assume that my problems are simply psychological, that I’m psyching myself out, let me state that my problem is not that I haven’t tried doing this sort of work.  I have.  I have tried, and I have failed, and I have gotten fired.

What kills me is that when I describe this situation to friends, they often tell me, “Yeah … you really need to be at a high enough level so that someone else is doing that work for you!”

Great!  That helps so much!  But I can’t be at a high professional level, because I can’t get my frakking foot in the door.

So I have been stuck doing retail and customer service, and all kinds of informal teaching in the arts, and at a time like this that just isn’t good enough.  My work history is all over the place, and I’m competing for jobs with people who have been focused and successful.  I hate the kind of work I’ve been doing, but I don’t know how to dig myself out.  I’m smart, I’m competent, and I learn quickly; I’m a good problem solver, I’m analytical, and I write well; and I turn 35 this month, and I still don’t know how to work around my learning disabilities.

Seriously.  I’m an American.  Who doesn’t eat enough fat. Obviously I am a commie pinko traitor who hates all that we stand for in this country.

I learned this after complaining to my physical therapist/trainer today that I’m gaining weight.   I was frustrated, because [...]]]> I have been informed that my diet does not contain enough fat.

Seriously.  I’m an American.  Who doesn’t eat enough fat. Obviously I am a commie pinko traitor who hates all that we stand for in this country.

I learned this after complaining to my physical therapist/trainer today that I’m gaining weight.   I was frustrated, because I had recently added an extra half-hour of cardio onto my workouts.  The extra cardio made me exhausted later in the day unless I ate more, but it seemed like no matter how much I ate, I was always ravenous.

My trainer asked me to describe my diet.  Protein, carbs, some fat, and ideally some greens at breakfast.  Protein shake and a banana after working out.  Low-fat protein, carbs, greens at lunch.  A bit of trail mix for a snack.  Bean-based vegetable stew for dinner, with a slice of bread, and more greens.  Except sometimes I just couldn’t stop eating the damn trail mix.

“That sounds really good,” he said.  “But you should try to work  a bit more fat in there, especially at lunch.  A few slices of avocado should do it.”

It seems my problem was a fairly common one.  The extra cardio made extra metabolic demands, and triggered my body into starvation mode.  Body thinks it’s starving, sends hunger signals to the brain, yada yada yada, you’re hungry all the time, and your body tells you to take a nap to conserve calories, so you lay down fat instead of the muscle you’re need in order to do that extra cardio.

The stupid thing is, that for much of the winter I had been having a some guacamole with my lunch.  I loved it.  I get the avocados at my local farmers’ market, so they’re super fresh, and my lunches were incredibly tasty — but I felt slightly guilty, thinking that I didn’t really need that extra fat.  Then, several weeks ago, I heard a program about research into food addiction and nutrition on the local NPR station.  Fats and sugars, apparently, trigger dopamine in much the same way as addictive drugs like opiates.  This means that when you start eating them, it’s hard to stop.  Of course, your body needs carbohydrates and fats in order to function.  “But,” said one of the guests on the program, “if you live in America today there’s very little chance you aren’t getting enough fat.”

“Wow,” I thought, “he has a really good point.  I really don’t need those extra fat calories from those avocados.  Besides, the dopamine system is the one that goes haywire in ADD, which is probably why that guacamole tastes so incredibly good.  I’ll stop eating it.”  And I did, and I felt virtuous.

If I’d stopped to think about what he said, I would have realized that I was committing a logical fallacy.  I inferred from the fact that I live in America, and the standard American diet is high in fat, that my diet was therefore high in fat (it’s the fallacy of division, kids! Yay!) .  The problem here is that I do not eat the standard American diet.  I’m a vegetarian, and that simple fact alone means that my diet is not “standard”.  It does not necessarily follow that any vegetarian diet is low in fat, but mine is — because I take scrupulous pains to make sure it’s healthy and balanced, because if I don’t, I experience brain fail.

Of course, if I’d stopped to think at all, I would have realized that it’s stupid to change a diet that’s working for you based on a throwaway line from a radio show, even if the person speaking it happens to be a neuroscientist who studies the effects of addiction and nutrition on the brain.  Yeah, fat triggers dopamine, and yeah, that means it can be addictive — but, as the neuroscientist would have been happy to tell me, sometimes dopamine is triggered for very good reasons.  Those guacamole soy-chicken wraps tasted probably tasted wonderful because they contained what my body needed.

Obviously, I didn’t stop to think.  My decision to deprive myself of that tasty, tasty guacamole was based on an almost unconscious equation of  “deprivation” with “virtue”, and the assumption that what I saw as morally “good” was going to be “good” for me (another logical fallacy, btw).

There’s probably a whole essay here about the Obesity Epidemic(tm) and the media.  Why was I so quick to assume that there was something wrong with how I eat?  Why did I take that off-hand statement to heart, when my weight is Normal(tm) and I’m in excellent health?  How many other people out there take statements like that to heart, and inadvertently sabotage their own health and fitness in the process?  And how can we have a much-needed national conversation about health, exercise, and nutrition when it’s all so damned complicated?

That’s an essay for another day.  In the mean time, I’ve learned a lot from the aftermath of that fateful decision to forgo those few ounces of guacamole:

1. Nutrition, while basically simple, is very sensitive to individual situations.

2.  Self-deprivation for its own sake is super lame.

3.  My body can tell me what it needs, and I should damn well listen to it.

4.  In spite of my Liberal Arts Education(tm), which trained me in the rigors of Critical Thinking(tm), I am just as vulnerable as anyone else to making irrational, emotionally-driven choices.

and

5.  Did I mention my body is smarter than I am?

For now, I’ve reinstated that guacamole, and after only one day I already feel much better.  I didn’t get ravenous in the afternoon, I didn’t fall asleep, my mood was stable, and I could even focus mentally.  Virtue can go to hell.

A few weeks back, a feature recently ran in the Shelby Star in which a reader wrote in asking about whether the Feingold Diet might work for her son’s ADHD.  The columnist, John Rosemond, replied that while many mental health professionals believe that the diet is ineffective because of, you know, insufficient evidence.  But, [...]]]>

A few weeks back, a feature recently ran in the Shelby Star in which a reader wrote in asking about whether the Feingold Diet might work for her son’s ADHD.  The columnist, John Rosemond, replied that while many mental health professionals believe that the diet is ineffective because of, you know, insufficient evidence.  But, he says, that’s only “true as far as it goes” — because studies address averages, and even if the participants didn’t improve “on average”, the study might not report that some of the participants did improve.

Well, actually, studies usually do contain that information.  In order to be worth anything, a scientific study must publish all of its data — this is so that readers of that study can evaluate it properly, and so that the study can be replicated by other researchers.  This is a core underpinning of the scientific method.  Any reputable study of the efficacy of the Feingold diet for ADHD treatment would need to indicate how many subjects participated, how many of those participants were diagnosed with ADHD, and how that diagnosis was reached.  The participants with ADHD would be divided into two groups, one using the diet, and one not (to be even more rigorous, the study might then compare these two groups to non-ADHD control groups both on and off the diet).  Finally, the published results would need to indicate exactly how many of the ADHD participants — both on the diet and off — experienced alleviation of their symptoms, and how many did not.

But even more concerning is that the columnist asserts that “perhaps the most convincing evidence” for the efficacy of the Feingold Diet is the testimony of parents.  Sure, the “ADHD Establishment” likes to “dismiss these claims as unscientific”, but “the issue boils down to one fundamental question: Why would these parents say their kids’ behavior improved if it didn’t?”

Mr Rosemond, meet the placebo effect.

For whatever reason, the human brain is subject to “expectancy”, which basically means that it’s prone to producing the results it expects.  In other words, if someone gives you a sugar pill for a head cold, and tells you it will make you feel better, there’s a decent chance your sniffles will clear up.  This person has set you up to expect that you will feel better, and you do.

In fact, human beings are so sensitive to expectancy that if the person giving you the sugar pill believes it will make you feel better, there’s a good chance that you will pick up on this intuitively, in fact you may feel better because of what someone else expects.

This is why clinical trials are required to be double-blind.  A certain number of patients are on the real medication, and a certain number are on the placebo.  The clinicians administering the pills have no idea who is getting what medication.  The only people who know are the researchers, who at the end of the study compare the efficacy of the medication to the efficacy of the placebo.

In the case of the Feingold parents, there are a couple of why the parents in question might report improved behavior.  The first is that they are expecting to see improved behavior, and they interpret their child’s behavior as improving whether it actually is or not.  The second is that the children themselves have been told that this new diet will improve their behavior.  The expectancy has been set up — and their behavior really does improve.

I’m not saying any of this to bash the Feingold diet.  There may not be a lot of scientific validity to back it up, but that could in part be due to the complications of studying something like diet and psychological symptoms.  I certainly support anyone who wants to eliminate synthetic additives from their food.  Furthermore, there’s along and proud history of physicians using the placebo effect to help their patients — in the days before modern pharmacology, it was often the only thing that could.  The Feingold Diet won’t hurt you, or your child, and if it genuinely makes your family’s life better, scientific validity might not be your top concern.

However, before you try Feingold, you may want to make sure that it doesn’t lead to behaviors that do cause harm.  Check out Stephen Barrett’s article on the potential pitfalls.

This is huge news.  If the results of this study hold up to scientific scrutiny, this will mark the first time that direct evidence has been found for a neurological difference in those with ADHD.  Until [...]]]> A new study out of UC Davis has provided physical evidence for a “faulty brain connection” in children with ADHD.

This is huge news.  If the results of this study hold up to scientific scrutiny, this will mark the first time that direct evidence has been found for a neurological difference in those with ADHD.  Until now, ADHD has only been defined, and therefore diagnosed, by behavior.  This is necessarily a subjective approach, and has led to wide-spread myths about attention deficit disorder being a hoax, or “only” a cultural phenomenon, or just an excuse for bad behavior.

The study compared the levels of alpha-waves in kids with ADHD and controls when both were given a task that required either visual or auditory attention.  It was shown that the control group’s alpha waves dropped when they performed the task, which is consistent with current models of attention.  The ADHD group’s alpha waves remained the same.

It is believed that when a normal brain pays attention to a task, the frontal cortex alerts other parts of the brain (in this case the visual or the auditory areas) to prepare to receive information, and this is reflected by the drop in alpha waves.  In the ADHD brains in this study, there is no drop in alpha waves, indicating that this process is disrupted.

This study was done on children, so it’s not clear what it means for adult attention deficit disorder.  It’s also very, very new research, so it will be some time before we can expect this test to lead to anything of practical diagnostic use.  But it is nonetheless enormous news with far-reaching implications for ADHD research and treatment.

The study appears in the current issue of Biological Psychology.  An article about the study can be found at PsychCentral.com.

An article in Science News reports that Adderall XR is very dangerous to cats.  While most cats, most of the time, are pretty good at not poisoning themselves, there’s something about Adderall XR that they [...]]]> I also wrote about this at Well-Ordered Chaos, but it’s REALLY REALLY IMPORTANT so I want to post it here too.

An article in Science News reports that Adderall XR is very dangerous to cats.  While most cats, most of the time, are pretty good at not poisoning themselves, there’s something about Adderall XR that they just love.  And while CNS stimulants aren’t toxic to cats in small enough doses, a dose that’s adequate for a full-grown human — or even a human child — can kill an animal that’s 7-15 lbs.

If you take Adderall XR, keep it away from your kitties.  This should go for any human medication, but again, Adderall XR is attractive to them for whatever reason.

If you know that your cat ingested a simulant medication, get to the vet immediately.

Symptoms of stimulant poisoning include distressed vocalization (also known as “lots of weird meowing” ), agitation and nervousness, and hypersensitivity.  If your cat shows these symptoms, get to the vet immediately.

For more information, read the full article here.

Now comes the difficult part.

After two virtually structureless weeks, weeks in which I could go wherever my whimsy took me, weeks in which someone else cleaned my room [...]]]>
Well, I’m back from France. It was awesome for all kinds of reasons. The food, the art, the food, the history, the architecture, the food …

Now comes the difficult part.

After two virtually structureless weeks, weeks in which I could go wherever my whimsy took me, weeks in which someone else cleaned my room and cooked my food, I have to return to my normal routine. But before I even do that, I have to recover from jetlag. At the moment my body has no idea what day or what time it is, and my mind has no clue about where it should be directing itself. I haven’t felt truly hydrated since getting off the plane Saturday night.

Overseas travel is a challenge to anyone, but for adults with attention deficit disorder, it presents unique challenges. We’re more sensitive than others to disruptions in our normal routine (as much as we may struggle against the very idea of routine). This is particularly true when the disruptions are physical. Changes to our diet, our sleep, our intake of water, alcohol, or caffeine — all of these can wreak havoc on our ADHD symptoms. And all of these are an inevitable part of travel.

I’m trying to give myself some slack as I recover from this trip. Of course, I feel like I should be hitting the ground running; but this isn’t fair. I’ve been trying to think in French for two weeks. I’ve been eating a lot more fat and carbs than usual. I’ve had more caffeine and more wine than I normally do (because you just can’t have pain au chocolat without coffee, dammit, even if it is decaf!). And my body clock has had to abruptly re-set itself by nine hours twice in the last two weeks.

Yesterday I gave my brain the day off, and spent the whole day watching tv. Today I worked out, which has already helped, and made sure to drink an electrolyte beverage afterward. That seems to be helping with the hydration issue. And I’m working in my studio, with all its daylight spectrum lighting, and letting the light work its magic.

“Attention” [...]]]> I’ve blogged before about the seasonal aspects of my ADD.  Unsurprisingly, things have been even worse since the return to Standard Time (ptui!) and the loss of another hour of light in the afternoon.  I’ve been more tried, more hungry, more spacey … and paradoxically, less able to get to sleep at a reasonable hour.

“Attention” is a neurological state that’s heavily dependent on dopamine, the brain’s reward chemical.  Dopamine, in turn, is heavily dependent on a number of factors, including sunlight.  Most people are aware of seasonal and weather impacts on their mood and habits, but for some people, these effects can be extreme.  I obviously fall into the second camp.

My doc and I decided to up my Vyvanse from 50 to 60 mgs.  My hope is that this will improve my concentration, attention, and ability to take initiative.  He also advised me to spend time in my art studio from 4 pm until 7 pm ever day.  If you’ve read my previous post, you’ll know that my art studio is equipped with a full-spectrum daylight bulbs.  My doc says it takes 5 or 6 “average” 150-watt bulbs to produce a therapeutic amount of light.  I already had four, and I knew my two overhead lights would put me into therapeutic territory; this was a major impetus for getting off my ass and hanging the lights.

Finally, he advised me to start taking melatonin before bed.

Today is the first day I’ve managed to be in my studio right at 4 pm.  I’ve got to admit it feels pretty good. I am noticing, however, just how hard it is for me to stay in one place for more than an hour.  My inclination is to jump up and go do something, and come back, and jump up and do something else, and come back … it’s so annoying when you have to fight ADD tendencies in order to treat ADD.

In general I’ve been sleeping better, but it does seem harder to get up in the morning.  Whether this is the melatonin or the increasing dimness of my bedroom I’m not sure.  Tomorrow will be my seventh day on the new regime.  Maybe things will settle in and get better.