Apr
01
2010

  ADD Depression

I had my first neurofeedback session today, and it left me depressed. I don't think it had anything to do with the procedure, it was more from reading about the different types of ADD. The therapist gave me some books to read, and I made through the first few chapters of one of them. The case studies presented as examples of patients with different types of ADD were depressing. They made me think about all the difficulties I had to endure when I was younger.

Just thinking about the past exhausts me, which is why I generally avoid it. It's much more fun to think about the future. I've got to re-read the literature more closely, but it could be that all the energy my brain is expending to avoid thinking about the past is reducing the brain power available to think about the present. On the one hand, it's a problem because I need more brain power available to get through my life a little more easily. But on the other hand, my brain is doing this for a reason-- when I am depressed I really don't get anything done. So my brain has made the choice to get through the day on a reduced-capacity basis rather than to relax the brain and allow it to function more fully, but spend the day incapacitated by depression.

There is another point in the book I'm reading that I find interesting-- there is a type of ADD that manifests as depression. But it's not really depression, since "classic" depression is cyclical. And I've never really had that. I was diagnosed with disthymia, which is chronic low-grade depression. Which is exactly the effect of "limbic" type ADD. So treating the ADD will cure the "depression" since it's not really depression anyway.

I'm glad I'm done with my prescribing psychiatrist. He was wrong about my sleeping problems, and in retrospect I suspect he's wrong about the depression. I suffered the side-effects from trazadone for years, because I believed him that depression causes sleeping problems that are fixed by trazadone. But it turns out that my sleeping problems were caused by APNEA, not depression, and I feel amazingly better using my sleep machine than I ever did taking the pills.

And while the Wellbutrin/Ritalin combo does keep my ADD manageable, it's not really fixing the problem, it's just helping me to cope. Like the trazodone overrode my sleeplessness for a few years, but eventually the underlying problem got worse and worse until I needed a sleep machine. And when I first went on the meds, I really needed them to cope, so I'm not upset that I went that route. But now I think I'm ready to try solving the underlying problem once and for all.

I asked my therapist how the neurofeedback changes people. There are aspects to having ADD that I've come to enjoy, and I'm hesitant to do anything that will eliminate them. I've also developed various coping mechanisms to make up for the non-functioning logical-thinking part of the brain, and I'm not sure I want to have to abandon them. Most concerning is the fact that back in 2007 I made the conscious decision to use my intuition for just about everything, and stop trying to "figure things out". I came to accept that because of the ADD I was no good at figuring things out logically, and I would make bad choices when I tried, but my first instinct was usually right, even though I couldn't come up with a good reason to justify my instinct. So I decided to abandon trying to justify my choices, and just did what my intuition directed. I've made much better choices since then.

This actually showed up in the initial baseline analysis we did in my first appointment. The brain scan clearly showed that I had very little activity in my pre-frontal lobes, and that I was using the deep unconscious recesses of my brain to solve every problem. Which seems weird, given that the tasks were things like repeating strings of unrelated numbers, reading aloud, reading silently, and doing multi-step math problems in my head. But that's how I do it. I kind of just get myself into a little zone when I'm reading and try NOT to think to much, and just "absorb" it. Then trust that my brain will give me the information back when I need it.

It's the same with remembering things. I've always relied a bit on photographic memory when I was in school. When I was taking a test, I would just close my eyes and picture the page the answer was on, and I'd remember it. Formulas and all. It always seemed to me a very convenient skill, and it meant that I tested very well. When people would comment about how "smart" I was, I'd generally demur that I just tested very well. I didn't have to learn how things worked so much as I just had to read the material and then I'd magically remember it verbatim.

Over the years I've taken this to the next level, particularly since I decided to give up on thinking and rely solely on intuition. You know those memory games? Where the boxes are all covered and you click on tiles to match them? Terry is amazed at how well I do them. But I don't have a "strategy" per se. I just get into my "zone" where I purposefully try to NOT think, and start clicking. I usually start in one corner and work my way left to right. When I see a tile I saw previously, I go back and click on it. I don't try to memorize positions (well, I do try a bit, but I do better if I can suppress that instinct), the best I can describe it is kind of a jedi thing, I just use "the force", which I interpret as my subconscious.

So when the therapist was testing me by reading lists of numbers, at first I tried to come up with associations to help me remember them. But she never repeated the same sequences, so I quickly realized that it would take me waay too much time to figure out associations for each list in real time (although associations can be worthwhile for games like Simon where the pattern repeats over and over and just builds on itself). So I just relaxed and listened to the numbers, and just parroted them back. After a few I finally hit on the strategy of "listening" to her saying the list in my head, like it was playing back on a cassette tape. Very similar to the photographic memory, but for oral instructions. Curiously, I'd never thought of that before. Would that be phonographic memory? I guess I've just never had much occasion where I had to remember random facts presented orally.

Back to the issue of whether neurofeedback will destroy my intuition. Answer: Probably not. The therapist said this is a common concern among her patients, it must be fairly common coping mechanism for adults with ADD. She said she has dealt with a few people who rely on their intuition so much that they're borderline ESP the way they pick up on subliminal things. And they've had nothing but glowing reviews of the neurofeedback process. The goal of this brain-conditioning is to pretty much keep everything we already have, but add some choice to the mix.

The example the therapist gave was something like this: if my brain was a car, I'd do all my driving in 5th gear, or in reverse. I've got two choices, completely opposite of each other, yet even with those limited options I can get everything done. I can drive forward, I can drive backward. And I'm probably better driving in 5th gear and reverse than a lot of people, since I've had relatively more experience doing it, since I never use 1st, 2nd, 3rd, 4th gear, or park. So neurofeedback isn't going to take away my 5th gear and reverse, and I won't necessarily lose the skills I've developed there, but ideally it will teach me how to use the other gears.

She didn't go into much more detail than that, but I can imagine that if my to-do list was in the car, many pages would go flying out the window as I raced along in 5th, and I'd get a crick in my neck and a headache from looking over my shoulder going backwards anytime I needed to drive slow. If learning how to use the transition "gears" of my brain mimics the effects of the meds, I can imagine that my life will be SO MUCH EASIER. And if the sleep thing is predictive, then this physical cure will be even more satisfying than the meds.

The therapist did warn me that progress isn't usually smooth. It tends to be a "feels worse before it feels better" sort of thing. Because if the training works and my brain changes, I won't be used to feeling and thinking in this new way, and I will immediately interpret this new feeling as bad. It's the nature of it. It takes some getting used to. Interestingly, this was the same thing the neurologist told me about the sleep machine, and it was true. I felt that I slept WORSE the first several weeks I was using the thing, I hated it. But he told me to persevere, and lo and behold, by the end of the first month I was sleeping better than I had in years. So the guidelines for this neurofeedback is to give it 20 sessions to see if it's working. Then at least another 20 to make the necessary changes "stick".

I've had one session already (I did two 2-minute sets watching the monitor and listening to bells, it was somewhat interesting), and I've got six more scheduled over the next two weeks. The first sessions will be short until we discover how my brain will react, then we'll work up to longer sessions.

Combining this treatment with my weight-loss plan will make me a new woman by the end of the summer. I'm looking forward to it. It will be so nice to not have to rely on taking meds multiple times a day every day just to feel "normal".