When I was 15, my parents took me in to be tested for ADHD. They had noticed several distracted and compulsive behaviours, and thought I may have attentional difficulties. The results of the tests confirmed their suspicions, but revealed more pressing issues. The observed severity of my depression made my attentional problems look insignificant in comparison, and the doctors were concerned about my anxiety levels.
“[Paddy] is very overcontrolled of his feelings and does not have adequate confidence in himself.”
The doctors recommended that I be, at the very least, put in therapy and on medication immediately. They suggested privately that my parents may wish to consider pulling me from public school and considering other options to finish my high school career.
My test scores reveal pretty accurate information about the way my brain works: I have trouble memorising and recognising faces, I think primarily in “verbal” modes (symbols like words and numbers) and have trouble with spatial reasoning.
I’ve had unfortunate experiences with medication. My doctors tried to treat a lot of my conditions and symptoms all at once, so I would be given a new cocktail of pills once a month or so. I would try them, have problems with the medication—vomiting, headaches, loss of appetite—and the doctors would tell me to stick with it for a few weeks, to make sure the side-effects weren’t just temporary as my body adjusted to the new pills. They never were, so I would go back to the doctors a few weeks later, and they’d give me a new cocktail to try. Which inevitably had new side-effects.
I think the worst part was that doctors never seemed to appreciate the gravity of what they were doing. They would prescribe me medications designed to permanently alter the functioning of my brain, but their prescriptions of the pills generally sounded something like “We’re going to try you on X, Y, and Z, and see what happens.” Medication for mental health issues is far from an exact science, but hearing that doctors were just taking guesses wasn’t the most reassuring thing in the world.
“Medication for mental health issues is far from an exact science, but hearing that doctors were just taking guesses wasn’t the most reassuring thing in the world.”
Finally, we settled on the medication that had the fewest, least-disruptive negative side-effects. Which, again, is not the ideal criterion for selecting medication you’re supposed to take on a daily basis. But sometimes the enemy you know, right? They kept me on a prescription for 10 MG of dextroamp-amphetamine (the generic Adderall XR) for my attentional difficulties and 15 MG of Mirtazapine (the generic Remeron) for my depression. After a couple of years on this prescription, my doctors gave me permission to phase the pills out to an as-needed basis.
The main way my mental health issues manifest is through my sleep schedule (or lack thereof). I have extreme difficulty holding to any sort of routine or schedule, and that includes sleeping. The times I fall asleep and the times I wake up vary wildly; it’s possible for me to fall asleep at midnight and wake up at eight a.m. one day, then fall asleep at six a.m. and wake up at 2 p.m. the next day. It’s also possible for me to sleep for 14–24+ hours solid, or to only sleep for 3 hours. There’s no rhyme or reason to my body’s decisions about how much sleep it needs or when it needs it. I’ve tried altering my diet, getting in bed at the same time, altering the amount of exercise I get in a day, when I exercise, the amount of natural light I get, when I get natural light, etc. I’ve been given sleep pills, had bloodwork done, and consulted countless doctors about it. So far, I have nothing to show for my efforts.
This inability to get on the same schedule as others cripples me more than I would’ve thought. Most employers, for example, require employees to be in the office during “core hours”, at the very least. Without a set schedule, that doesn’t really work out so great for me. My favourite part of any job interview is watching the interviewer’s face slip from excitement over having found me into despair over all my red flags. Fortunately, some employers permit remote working across timezones, and don’t have core hours.
“My favourite part of any job interview is watching the interviewer’s face slip from excitement over having found me into despair over all my red flags.”
Another problem I run into frequently is that I have little control over my engagement in things. I am either consumed entirely by a project, or I’m not interested in it at all. And if I’m not interested in it at all, getting me to work on it is like pulling teeth. I’ve literally sat in front of a computer, after turning off my internet, just staring at a code editor for hours, trying to force myself to focus on the task at hand. Once I’m engaged in a project, though, once I feel like I have some agency and that the project is worth doing on its own merits… I do great work. And that discrepancy leads to a lot of disappointment for people, which I hate.
The insecurity and need for support and reinforcement are still there, but I’ve found ways to deal with those, and have largely neutralised their ability to impact my life. I still can get depressive bouts, where I despair for the world ever improving, but these tend to last only until I sleep, and I’ve found ways to do damage control when I recognise them rearing their heads.
The most effective strategy I’ve found, personally, is openness. Jenny the Bloggess writes and vlogs that depression lies, and that’s the best representation of the issue I can think of. A lot of my anxiety comes from things I know better than to be anxious over. I’ll know, cognitively, that the fear and anxiety are unwarranted, and yet they’ll persist. They’re the little lies my brain whispers, because my brain is a douchebag. The best way I’ve found to fight lies is with the truth. When my brain starts poking or prodding, insinuating I’m a fraud or a failure or not good enough, I start a mental recitation of the people I respect who also respect me. The people who take time out of their lives to talk to me and support me. Because if they think highly of me, I should, too. But this only works if I let those people see me. The whole me. Uncensored, nothing held back, totally open. Otherwise, my brain will find that crack in my proof, that lie that if those people just knew that I act like a six year old, or knew that I’m petrified of needles, or saw my code, they wouldn’t think so highly of me. I need to publish and hold aloft all the things about me I find undesirable, to get the reassurance that people will love me anyways.
While I was in college, I found a brainhack that allowed me to focus sometimes. I was a theatre kid in high school, so I had a lot of stage make-up just sitting around, going unused. When I was really procrastinating on a paper, I’d take a dextroamp-amphetamine pill to get my focus back, then apply eyeliner as I waited for the pill to take effect. Eyeliner was something I could play with in five minutes, something I could let my mind wander while doing, so it didn’t feel like a context switch. And I liked the idea of changing the representation of yourself by putting on make-up. What I didn’t realise is that I was creating a habit cue; my mind started associating putting on eyeliner with “time to focus”, even without the pill. After college, I started just applying the eyeliner and not taking the pill, and found it worked about the same without the side-effects. My boyfriend and I started joking that it was my “warpaint”, and the metaphor stuck with me. It’s how I gear up to do battle with the world.
“The hardest but biggest win I’ve achieved is finding people I love and respect, and keeping them close.”
To get around my sleep problems, I tell my employers about them before I even get the job offer. The thought process is that if they know about the issue and want to hire me anyways, they’re going to be willing to help me work through it. And if they don’t want to hire me after hearing about some of my issues, they’re probably not going to be an overly-supportive environment for me, anyways, and it’s probably best that I don’t work with them. When I have important things to do that are one-off events—speaking at a conference, sitting in a meeting, and other things I need to be synchronously present for, but which aren’t regularly scheduled events—I tend to manage just fine. I’ll set alarms all over my apartment, including alarms that make me solve math problems before they’ll shut off. I have family, friends, and loved ones call me in the morning. If it’s really important or I’m really worried, I just won’t sleep beforehand.
The hardest but biggest win I’ve achieved is finding people I love and respect, and keeping them close. It’s hard to find people that I respect or love without reservation, and when I find them, it’s hard to keep them close. Unlike Twitter, these people can say I’m not good enough, and I’ll actually notice. If someone on Twitter unfollows me or thinks I’m an idiot, I don’t even notice. Your closest friend, though… you tend to notice that. I hate settling down in any specific location, so it’s hard to remain close to people. How do you stay close to someone when you move every few years? But if I can find and keep these people, they provide a great safety net for when I eventually break.