Sunday, June 26, 2011

Missing the Boat- Aging, AD/HD, Societal Overload? Life is too short to cheat ourselves of the good things we do!

“I missed the boat so many times….there were so many crossroads where I made the wrong turn.” Regrets of aging, of AD/HD, of denying the value of what we have done – Thoughts on my father and on life….

I spent some time with my 86 year old father today. I see him often, but most often there are other people around, my mother, my children, siblings, friends. I talk to him almost every day and he regularly says “Let’s make a date. I would love to have some time just with you.”
Today we did. He is 86. He has Parkinsons, some form, perhaps Parkinson’s dementia, perhaps some Alzheimers’s thrown in, perhaps just a mind that gets confused and has trouble remembering things both present and past….

My son was diagnosed with AD/HD when he was 3…..an AD/HD emergency, the neurologist called it. I was diagnosed with AD/HD about eight years ago, but was aware I had it long before that. And my dad was diagnosed about 5 or 6 years ago, before his Parkinson’s was in full swing. It is hard to know now what is Parkinson’s, what is AD/HD, what is being old for him.

Recently, Nor and I read a book together by Ned Hallowell that drew a parallel between the experience of people with AD/HD and the experience of everyone. The point was that our society is overwhelming now, filled with distractions, excessive demands and pressures, information overload. This creates a societal Attention Deficit disorder that mimics many of the symptoms of AD/HD for those that actually have it. True enough. Imagine what is like for those of us that have AD/HD and have societal overload as well. Imagine what it like for my dad, as he struggles to establish where he is, what point in time, what part of his life. As he comes and goes from considerable lucidity and awareness to being in the ball park, but not quite, to being totally frustrated by his difficulty recalling a thought or a needed word, to being totally disoriented and disconnected.

Whatever the other factors, I am convinced he did have AD/HD. Through out his adult life, despite amazing accomplishments, he struggled with many things, time, completion of projects, keeping track of details….and we certainly saw incredible signs of it when we helped my parents move from their house – letters piled in old bags, uncashed checks, files replicating other files, things hidden away all over and countless systems of organization – each well designed, but none consistently implemented.

As I was growing up, my dad constantly communicated a message that I was very talented, but could do even better, should try harder, could do more. Saving the world was pretty good, but all in a day’s work. But he was an even harder critic of his own work. He developed and constantly revised elaborate formulas for calculating what he had accomplished. How many patients had he seen? How many students had he taught? How many patients had the students he taught helped? And on and on. Never enough. The numbers an attempt at comfort and satisfaction, but actually an impossible trap – what ever the numbers were, they were never enough.

So we talked today….or mostly I listened and occasionally asked questions and tried to cut through the haze of his confusion. He kept saying he “had missed the boat, made too many wrong turns….” He wasn’t sure if he would have been here or there, but wasn’t sure where here and there were, but was sure that the choice was whatever the path he hadn’t taken.

I talked about how hard it is to be confused and overwhelmed by choices, information, expectations, and that we can only do what we are able – and he couldn’t allow himself to hear that. He wasn’t confused, he just……and then he would lose what he was saying. Then he started telling me a story about a cat and a small man, a story that he said his father told him repeatedly. Both the cat and the small man had many virtues, but their virtues conflicted with each other and they couldn’t seem to acknowledge each others virtues or find a way for each to work with the other. It was one or the other, but never both. It took a while to tell the story, and it was unclear if he was reporting the story his father told or sharing his own story or talking to me in the present. I asked him if this was a metaphor for his life and his marriage and he laughed but didn’t respond, perhaps couldn’t respond. He wasn’t sure who was telling the story or to whom it applied. He said there was so much he hadn’t done, had not accomplished. I described the Cohen condition – always expecting too much, accomplishing much, but focusing on what we haven’t done, not on what we have done. I talked about the number games he had played trying to prove to himself that he had accomplished a lot but always seemed dissatisfied. I shared that we were all our own worst critics and needed to be able to give ourselves credit for what we had done (and he had done an incredible amount), but he kept coming back to bad choices, wrong turns, things undone. A societal condition? A personality characteristic? A genetic predisposition (it seems to run in our family!) A part of his AD/HD? I am sure it is all of the above. But I think the story of AD/HD makes this particularly hard, and the experience of aging can make it very hard. But AD/HD does create confusion, persistent doubt. We constantly generate new ideas, new projects, new possibilities. Many get done. Many don’t. But there are so many in our head, so many things always spinning in our minds, that it is impossible to feel that we are ever finished. It is hard to feel we have ever done enough. It is hard to feel that we have accomplished what we could or what we should, because more is always there, both because of the many things in our head that never make it in to the world and because the many things in the world that demand our attention and make it harder to focus on the things that we are doing or need to do. As I sat with my dad, I was crying inside, in part because of the pain of watching him struggle just to say what he wanted to say, but also because whatever confusion he felt, there was no question that he saw his life in many ways as a failure and was unable to see or value the great things that he was able to do.

Growing old is hard. Each person experiences it differently. And having AD/HD is also hard and we each experience it differently. But a common element, for all of us, is to value what we do, to treasure what we have experienced, and to enjoy the people in our life and what we can give to them and they give to us. It isn’t healthy to ignore our problems or to minimize mistakes we make. We need to deal with them and learn from them. But we need to be able to value the things we have and that we accomplish. And we should be able to recognize that it is a very difficult and confusing world, one that we can’t totally control and that often overwhelms. Sometimes, just keeping going is a big accomplishment by itself. I love my dad, love what he has done, and love our moments, even as he struggles to hold on to them. We all need to hold on to them. Old, AD/HD or just facing an out of control world, we should value that we keep doing what we can to make things better.