I know you may mean well by making people aware that it’s okay to be a bit different. We don’t all need our own versions of normal to have a label put on them. But there are people who are greatly impaired by mental disorder and illness from anxiety and depression to schizophrenia to autism to personality disorders.
I’m really failing to grasp how some people can think every human brain will always be functioning in a perfectly balanced way. The cerebral cortex is made up of between 15-30 billion neurons with synapses that connect to several thousands of other neurons each releasing a chemical messenger. If one or more of those neurotransmitters is not firing enough or too much or absorbing too quickly or not absorbing fast enough then this can lead to a person having symptoms covering a wide range of mental health and neurological issues, including ADHD, schizophrenia, anxiety, depression and possibly even autism. For the more deeply biologically ingrained mental health issues there may be physical differences in how areas of the brain developed, and even long term mental illness can change the size or functioning of some brain areas. In depression it’s found that the hippocampus begins to shrink and in bipolar the longer someone goes without treatment the more their frontal lobes shrink, which means they are less able to plan and reason and have the basic executive function issues. Executive functioning is basically what we rely on to carry out tasks and it helps us plan for the future, transitioning from one task to another comfortably and navigate through complex social demands. Basically put, it helps us have healthy relationships with people. Other parts of the brain help in all these things too but in a more specialised and regulated way, in contrast the frontal lobe is the organising committee.
It’s even been found that people with smaller amygdalas, which helps regulate how we react emotionally to situations, are more likely to develop PTSD. Scientists have found many changes in the brains of people with mental health issues and neurological disorders, even the condition that gets the most denial, ADHD. The research is all out there on the internet. Go look it up for yourself.
Now that I’ve brought up ADHD let me talk about it more. A lot of the time the people who question someone’s diagnosis of ADHD and doubt the condition even exists is just meaning well and more wants to free this person from identifying themselves with a label and encouraging them to be content with being a different creative and free-spirit but the problem here is that for those with ADHD symptoms, whether it’s actual ADHD or some other disorder, is that not only do they have to face these severe impairments in executive functioning and poor limbic system regulation (controls emotions which may show as hyperactivity) making them incredibly hard on themselves but they also compare themselves to the average public. The fact is they can’t just ignore how everyone else copes better than them when they have to go through such a difficult time.
Some common issues for an adult with ADHD include a lack of motivation and usually a hyper focus on tasks they enjoy but aren’t exactly needing immediate attention, so they will struggle to pull away from this highly stimulating task and they also have a poor time transitioning from one task to another and if they can’t pull themselves away or just keep finding more interesting things to stimulate themselves with, they will feel like a failure.
That’s just one symptom. Symptom two is the most common one: poor ability to focus. It’s like having a switch in their brain that randomly decides when they can focus and it won’t tell them. If you can pick up any book and begin reading it and processing it and remembering what you read it’s not likely you have ADHD. If at times you can read it but other times you can’t then you may have ADHD but it could also be something else.
I don’t want to talk too much about ADHD symptoms because ADHD isn’t a mental illness so it gets all a bit confusing but it is the highest stigmatised brain disorder. But the symptoms also lead to problems socialising; either the person is too impulsive and blurts out a lot of offensive things, they can be too forward or hyperactive, or they can be quiet and withdrawn and not able to say very much. The focus and memory issues still exist in social setting too and it’s difficult for them to even pay attention to what people are saying without feeling bored, distracted and they may have to put a lot of conscious effort into following what people say. They may do ok one on one but may fall apart in a group conversation.
This doesn’t apply to all with ADHD too. It might be more applicable to people with both ADHD and Asperger’s syndrome too.
The most stressful of all ADHD symptoms are the racing thoughts. These can be random neutral thoughts or over focusing on rumination. A person with ADHD is capable of thinking several different or ‘branched off’ thoughts at once, and can feel physical pain over them. Co-morbids such as OCD and bipolar come into play here too. The most common co-morbids are caused by the social issues associated with ADHD. They are anxiety in the more hyper-impulsive type and depression in the Inattentive subtype, the group with very little hyperactivity. Both types can have either or both mental illnesses too. There’s also a combined type of ADHD consisting of symptoms from both types.
Everything I mentioned above and more contribute to people with ADHD feeling like failures and comparing themselves to other people’s successes in the most basic tasks who don’t have ADHD or mental health issues at all. I’ll just mention here that very mild symptoms can exist in the general population but not cause severe impairments. The difference between having ADHD and not having it is the disabling nature of the symptoms. Some people try to ignore those feelings or adopt a completely positive outlook but others will constantly have to challenge these notions of themselves.
Let’s return to real mental illnesses now. Bipolar disorder to me encompasses all mental illness into one disorder. You even have schizoaffective disorder which is a bipolar schizophrenia duality. I think it’s the best disorder to look at to understand how serious and real mental illness is. I can use myself as an example because I’ve only had completely developed bipolar 2, or what really seems like it, for about a year. In that time nothing changed about my diet and exercise regime, but I did suffer a trauma leading to PTSD and had to increase my dosage of Ritalin. What had worked well for many years at keeping me focused on a task now made me too impulsive and having extreme grandiose delusions. I’ve been off it nine months bar that one New Year’s Day night and my cyclic mood swings that switch between extremes of euphoria and dysphoria into severe lows and often suicidal ideation, with a few hours of a normal mood, have not balanced themselves out. So, I don’t take medication for my ADHD anymore and have reintroduced words such as stupid, lazy and selfish into my lexicon of ways to describe my behaviour despite knowing the differences in my brain often leads to that behaviour. Just without the medication helping me better manage those symptoms and regulate my emotions I’m under more stress from my symptoms, and I can be one of those people who beat themselves up and feel like a failure over their symptoms. I also do go through many severe depressive episodes a month. Lately it had been half a day manic, half a day depressed. Now I’m into day two or three of mania.
I basically feel like a walking chemical imbalance. It’s confusing to me that people don’t even believe they exist. So you can’t see evidence of them in a blood test but if you take a psychoactive drug or any illicit drug you can create a chemical imbalance and experience good and bad highs, hallucinations and have the withdrawal effect of depression and anxiety. People with mental illnesses often get the withdrawal affects severely from drugs like ecstasy. I get paranoid delusions after drinking a cup of coffee so I know to stay away from harder drugs. I don’t need drugs to get high or hallucinate too. I pretty much feel like my brain is on drugs by default. Drugs could probably give a more stronger experience but I don’t want that. I don’t want to spend the next couple of days severely paranoid and depressed.
I know that’s a fairly simplistic explanation behind chemical imbalances but it should make you think. Scientists always prove my theories of black holes were pretty spot on too so I could be onto something here.
I know that not identifying yourself with a label when you a bit quirky or eccentric is a good thing when there is no mental illness or disorder, but for those who struggle each day with them a label can be a relief for them. I hide behind the label of autism to decrease social anxiety. I used to act like an arrogant snob who felt superior to everyone. Now I just remind myself why I struggle so much and accept people’s help when I they offer it and I feel I need it. I remind myself that I’m not really stupid or lazy but have ADHD and it will just take me more time to get organised. On medication I would spend a week on writing a blog post like this but now I just want to get it up as soon as possible. Even working on this the next day is making me feel anxious.
Before I make any decision or even type something in a comment box I think about people’s reactions and ask what is my real motivation for writing something like that. To me when people try and tell me ADHD doesn’t exist and other mental illnesses too I don’t see them as being very concerned for me but wanting to prove that I’m wrong. I think people care more about how someone reacts rather than to get an important message across, and yes I’m guilty of that too. I can just write something in a comment box for ‘likes.’ It’s like a drug. Then there may be people out there who think they can change someone for altruistic reasons but they go about this is all wrong. They don’t empathise with the person they are trying to change and they don’t elaborate, i.e they say ‘ADHD is just to excuse bad behaviour and for the school system for having subservient youth.’ It would be better to say this, ‘I know ADHD can be a real disability to those who actually have it, however I think many people are misdiagnosed and doctors are not thorough enough in their assessments and may prescribe a drug to a child who may not have the disorder in a single 1 hour session, sometimes within just 10 minutes. Medication should also not be the first choice and the dangers of taking the drug should be clearly laid out.’ That tells me they acknowledge ADHD as something that is real but may be labelled to people who may not have the disorder. And there’s little room left for misinterpretation.
If you really want to help people with mental illness and disorder listen to them. Don’t just jump immediately to saying ‘you don’t have this’ because that to them is instant denial that they have any problems at all. Don’t just say you can be fixed up by changing your diet and changing your environment, because that makes you assume you know something about the person’s lifestyle you don’t actually know and you are blaming the cause squarely on the diet. Mental illness can have many causes, most often being a reaction to extremely stressful circumstances or trauma. Medication is the quickest method to recovery of symptoms and is not always done alone. Therapy is done alongside taking the medication. I’m very critical to people with mild symptoms taking medication before therapy. I have severe mental health issues and even a seizure disorder which I won’t medicate because of a past of some of the most horrific and long lasting side effects from medication I have taken, including seizures.
To me people who deny mental illness is a real and serious brain condition are just dismissing it so they don’t have to care or they can’t open themselves up to see that someone’s brain can work in a different way to theirs. In autistic circles we call that a lack of theory of mind and apparently people without autism should have an average theory of mind.
Lastly, don’t think you can change a person without taking into account the severity of their symptoms. You need to step into their mind and experience the world and react to every situation just how they do.