Josh is not doing well at all with this school thing. He has missed more classes than he's attended.
HE is very disappointed.....and yet.....he wants to make excuses.
Everytime I have tried to talk to him about this his attitude is that *I* don't understand. Every discussion ends with him leaving the room in anger, only to return fifteen minutes later to repeat the entire exercise.
No matter how gently I try to couch my comments, they offend him.
He feels overwhelmed and I point out that HE keeps backing himself into a corner. I point out that all along I have been encouraging him to GET ON A NORMAL SLEEP SCHEDULE and be militant about maintaining it.
"Yea, but last night I had all that homework to do so I had to stay up and then I slept through my alarm."
"OK, but Josh, you left campus on Thursday knowing what homework you had to have done for Tuesday. You knew you had to work all day Saturday, which means you had all day Sunday and Monday to get it done. But you slept all day Sunday and Monday. This is a time management/sleep schedule problem and the 'answer' to it is really very simple and totally up to you. Sleep everyday from Midnight to 9AM and do your homework in your next available time slot. You act like you're being asked to climb Mt. Everest. Honey, there are lots of people who take 5 or 6 classes and work full or part time. You are taking THREE classes and working about 15 hours a week."
"It isn't just that though Mom. I sat up all night TRYING to do my homework, but basically just spinning my wheels."
"Yes, and you don't want to hear this, you get mad when I even approach the subject, but I think ALL of this is Bipolar related."
"How? How is this Bipolar related?!"
"Josh, if you were sliding toward the manic end of the pole, none of this would be a problem. You'd be buzzing around, busy as a bee and creative as hell. You still wouldn't be sleeping worth a damn, but you'd be productive. You are sliding toward the depressive end and in THAT mode, nothing is easy. It isn't easy to motivate yourself or stay on task. You sleep too much, and everything seems overwhelming. I hate to point this out to you honey, but one year ago TODAY? You were right in this same spot, functioning the same way. I BEGGED you to address this over the summer BEFORE school started and you promised me Josh, you PROMISED me that if you went off your medication and you began to struggle, you would get to the doctor and begin the process of finding the right medication for you. You are about one month away from sitting in the bathtub again with razor blades honey and you are deep in denial."
"Well, I told you I think I need to get back on Adderall."
"Yes, and I told you to try that....I encouraged you to get to the doctor and get a prescription for it, because if that's ALL you need, you'll know it really quickly. And if it makes no improvement, than I would think you'd have to consider Bipolar medication."
"Well, you never made the appointment!"
"You are NOT a child Josh, I asked you several times to call and make the appointment, so don't blame me. Pick up the phone and do it."
So he has an appointment Tuesday afternoon, but I'm pretty sure Adderall isn't the answer.
"Josh, a year ago I told you that it wasn't too late to salvage the semester, and I'll say the same to you today, BUT, you have GOT to act. Get the adderall, give it a couple of days, that's all it will take to see if it helps, and if it doesn't, you need to get back to the doctor and get on something for Bipolar."
"God Mom, remember what that medicine DID to me? I'll definitely fail if something like that happens again."
"I know honey, and maybe if the Adderall doesn't work, you need to consider biting the bullet and dropping out. Yes, you'll have to repay your grant, but that isn't the end of the world. Maybe you need to drop out and address medication and get stable on it and give yourself a year of just working full time, you can live here as long as you're working full time and doing the things you need to do. Pay off the grant and a year from now reapply for school and try again. This isn't a matter of you failing because you're stupid, you are failing because you're not functioning well. And you never know, the first Bipolar medicine you try, could be the right one."
Josh had to go to work, and he has to work till 2 am on inventory and he has to work tomorrow night, which means he really will not have the time required to get his assignments done. So yes, he has created a terrible set of circumstances for himself AGAIN. And he seems to want me to produce some magical answer to solve all his problems.
And I think I HAVE the magical answer, he just doesn't want to hear it.
This is a post I wrote on my private blog October 15, 2009...almost exactly a year ago.....
I am very concerned about Josh....about this depression which manifests itself as sadness, inability to sleep at night, inability to get up as necessary in the morning for class and basically not functioning well with his responsibilities.
I've cried a small river (does that mean I cried a creek?) of tears this afternoon. I talked with his brother, my sister and various friends in the blogosphere about this situation.
We all agree that medication is called for, but Josh is an adult and after meeting with his doctor several months ago, he refused the medication that the doctor suggested.
At 3:oo, before I left to go to the gym, I woke Josh up (well, he was awake, but still laying in bed buried under the covers). I was crying, and I told him that I'm very concerned about him, about the fact that he missed class again; that he isn't functioning well. I told him that I'm sure that he is as upset as I am that he overslept again. He agreed. I told him that I would be home by 4:15 and that I wanted him here when I returned so that we could talk.
And this is basically what I said to him:
First of all, I want you to know that I'm not mad at you; I'm concerned about you. I know that when you wake up, long after class is over, you are upset with yourself. I can see it in your eyes and your demeanor. And that's the whole point Josh...I know you WANT to do better, your intention is not to blow off your classes, but you are unable to DO better. (this is where he started crying)
I love you and I care about you....I want you to be successful, so we need to find a solution to this problem. You have all the symptoms of true clinical depression Josh (which I listed for him) and when you saw Dr P and discussed this with him, he felt that medication could help you.
I know you're opposed to medication, you don't want to be a "zombie", unable to "feel anything". But I have to tell you that your perceptions of what this type of medication does to a person is not really valid. I'm not a doctor, I can't begin to explain to you how it works or why it works or even what it might make you "feel like", but I can tell you that the people I know who take medication for depression swear that it changed their lives. There are people out there who suffered, as you are, for years, and I hear them say that their only regret is that they didn't take medication sooner.
This is what I know for sure. Dr. P is the first human being to ever touch you, and he has been your doctor ever since. He has always shown such caring and concern for the three of us. I trust him....literally....with our lives and I always have.
I trust him in this too. If he feels medication is called for, I trust that he is making that recommendation out of a desire to help you.
Add in to all that, the fact that *I* care about you. I know you better than any other person on this Earth, and *I* think that medication could be the answer to what you are struggling through. Let's face it, you have knuckled down over the last couple of weeks, determined to do better....but you're not. Doesn't that illustrate to you that possibly this is out of your control? If you don't trust Dr. P as much as I do, don't you at least trust me?
If you don't want to consider medication, than let's talk about other possible solutions together because, bottom line, I can't stand to sit by and watch your future go up in smoke.
He and I then talked about medication a bit more and I ended the discussion by saying that perhaps he shouldn't make a decision about the medication right now, but should agree to go talk to Dr P about it again...express his concerns about medication, have Dr. P explain how the medicine works, why it works, what he might experience were he to take it.
In the end he agreed to do that...to go see Dr. P again and discuss the options. He does not want me to go with him.
He left to go see his brother, and as he was leaving, I walked to the door with him and gave him a huge, gigantic hug and told him that I love him.
"I love you too, Mom."
And he was gone.
I'm still crying...I can't seem to stop.
The difference between last year and this year is that I'm not sitting here crying. I'm upset, but not consumed with worry. Because one thing has changed during the last year. I've realized that nothing is going to get better or easier for Josh until he gets a clue. My role in this is limited. I can talk. I can point out this and that. I can encourage. But I can't really own the problem.
I've made some progress since last year. Let's hope that Josh will do some growing too.
6 comments:
I did not see much mention of his history one way or the other with ADHD, but his symptoms sound like ADHD, Primarily Inattentive, with co-morbid depression or bi-polar disorder to me. The best treatment could be stimulant such as Adderall along with bipolar medication/ antidepressants. Those can dampen the anxiety side effects of adderall.
ADD/ADHD frequently causes depression. They call it co-morbid. Drug use is also considered a co-morbid of it. ADD also causes problems sleeping at normal times, despite not being well documented in that reguard. I have been diagnosed as ADHD primarily inattentive without depression. I would discribe my symptoms as feeling too tired to do things I am not interested it. Delayed sleep phase syndrome, acondition where you sleep and wake up later than normal is common with certian sleepy ADHD inattentive types.
http://http://en.wikipedia.org/wiki/Delayed_sleep_phase_syndrome
Depression is a common complication of add/ADHD. I don't have depression. I am analytical and seldom think in terms of feelings. I have them but often i am not aware of them. I don't feel motivated until the last minute, exciting and interesting tasks can fuel me like aderall does, especially exploring outdoors or fixing an iPod or computer the first time. Adderall can cause anxiety or panic attacks in normal or anxious people, but inattentive sct types need the jolt. I have come across people on Add forums the have add and depression or bipolar, that take adderall with antidepressants etc. I am combining a light welbutrin does with Adderall, for a stimulating effect like strattera provides. It strangely seems to regulate my sleep. Welbutrin itself has similarities to antidepressants and stimulants. Mild narcolepsy is also suspected in my case and is a neurotransmitter disorder like ADHD, also treated with Adderall.
Two days is not enough for Adderall. You have to titrate and increase dosage after two days and again after two weeks.
Many are pushing for a new category for these sluggish types called Slugish Cognitive Tempo.
http://en.wikipedia.org/wiki/Sluggish_cognitive_tempo
I am not a mental health professional, just a 40 year old inattentive type that can spend hours "researching" /surfing the net in insatiable curiosity as a distraction to other things I should be doing like sleeping, putting the kids to bed, or straightening up.
I personally think ADHD people are a human personality adaptation, a specialized person in the hunter gatherer tribe that explored for new hunting grounds and invented things. One whose brain is "geared" for life and death situations such as descending a cliff or dealing with the stress of being lost and having to reason thier best way back by possessing lower levels of neurotransmitters. "Normal" people would be too stressed out or impatient to do this. Humans were hunter gatherers for hundreds of thousands of years, civilized for 7,000 years, and only have had electric lights and television as distractions to dusk til dawn sleep for decades. This unatural light itself is a contributining factor.
The old adage about finding your passion in life and perusing it as a career, so that makes work not seem like work, would well serve one of this type.
If psychology is his passion, he will still have to struggle through the core boring classes, but hopefully the courses in his major will not be a struggle.
ADHD does not always go away with age, often it is masked by ones ability do deal with it as you get older, then suddenly with age you realize you have had it all along, like in my case.
Another thing to consider is that Adderall abuse could have contributed to the episodes in the spring, as well as future episodes. By abuse I mean taking additional doses or snorting crushed tablets to experience a rush similar to cocaine. General Adderall use without antidepressants could cause such episodes as well, but I would think abuse would make it much more likely.
I wish I could tell him to be patient with the meds. There are several out there for bipolar, and if one doesn't work another one might. It takes TIME, sometimes a couple of months, to get over the hump of feeling strange from the med, but normalcy settles in eventually, it just has to take time and you have to be patient. If you're looking for a magic bullet, it ain't out there. I've tried seroquel, lithium and trileptal. Seroquel didn't work at all, lithium worked for the mood swings but I gained weight and slept alot, and the trileptal (i'm on it now) has been flamin' AMAZING, however you absolutely cannot miss a dose.
In my opinion, Josh needs to grow the hell UP, take responsibility for his situation.
Great responses from Ryan and Rootietootietoot. (Sorry, couldn't resist; your name makes me smile...and it's a free bit of joy...so I'm gonna indulge myself every time. LOL)
Have you printed out that bit from last year and shown it to him?
Funny; I just had this article sent to me. Not trying to be inflammatory in any way...as HTTS can vouch for me having been about as concerned about any of this as anyone...just thought it was a fascinating confluence, especially as my mom's doctor had an intriguing conversation with her today about going on Crestor.
Ryan - VERY interesting information you've provided here. I've printed the Wiki links for Josh to read and we'll be taking them to his Doctor appt on Tuesday.
Thanks SO much!
Rootie - I agree that Josh needs to grow the hell up and take responsibility for this stuff. This is one of those situations where it's hard to tell how much is Josh not being willing to step up to the plate and Josh not being 'able' to step up to the plate. But either way, HE has to take charge of all this.
Schmadrian - I didn't print it out, but I told him about it....comparing THEN to NOW and how sadly identical the situations are AND reminding him where he wound up a year ago because of his refusal to 'handle' the situation.
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