Ebola Hysteria and Panic. An ADHDer's Perspective

People tell me I need better hobbies.  These people are probably correct.  While "normal" folks might read novels or watch zombie movies, I read epidemiology and virology as well as neurobiology and mental health issues.  I consider this "casual reading".

If you were to examine my library, you would find a section on costuming and jewelry and a section on ADHD, Autism, Neurobiology, Mental Health... and disease- virus based disease.

Smallpox?  I own several histories on Smallpox and it's eradication- and WHY it could be eradicated.  Influenza?  Have a few histories of the pandemic of 1918 and projections of possible future epidemics and potential pandemics.

Exotics?  I have books that cover Dengue, Malaria, Hantavirus, General Arenavirus', HIV/AIDS and Botulism.

I also own books- several- written by the people who fought the demons up close- Piot, McCormack, Peters, and more- I own the work of the investigators.

Then there is the section on Filovirus.  Ebola and Marburg.

I have read every book in my library and have searched for additional information on each one.

Filovirus is a batsh*t scary kinda thing.  It makes no sense whatsoever.  It doesn't look like anything else so it almost has no classification, there doesn't SEEM like there is a natural host- although there are species implicated- it isn't possible to clearly define a host.

Emergence of both Marburg and Ebola has been frightening and- very oddly- reassuring... although that reassurance is becoming more and more removed.

So- like an ADHDer, I look for facts.  I manage in the big picture and strongly believe that if you can do this, you can solve for the smaller picture.

Ebola emerged...again.  Not the first time, not the last.  In general and in the past outbreaks, it emerged, burned out, and went back to hide.  This time it hit large population centers and hit hard.  In addition, spread occurred- possibly because of a lack of awareness of what Ebola is and what it tends to look like in countries where it is likely to occur.

It looks like Malaria in the early stages.  Very likely, the "index" or first patient, appeared to local medical workers as yet another patient with Malaria.  That patient was likely treated with anti-malarial medications and sent home.

Burial customs in that part of the world require that the deceased be evacuated of bodily waste among other things.  Mourners come in very close contact with the deceased in the process of mourning- hugging, kissing, and touching.  Soon, the attendants of the burial of that first patient are now infected- and spreading disease.

We live in a massively connected world.  Ebola can certainly fly out of its country of origin  and to a variety of places.  It has done.

I hear screaming to shut down air travel to the affected areas.  I hear the CDC retaliating that they have stringent policies in place.  The US is terrified and screams out it's terror while a government that is mostly distrusted is trying to manage the nearly impossible.

From this ADHDer's perspective, what do you do?

Bleach is the filovirus' worst enemy.  Antibacterial hand wash won't cut it.  A cheap spray bottle filled with an 80/20 mix of Clorox works.  If you think you are in contact with things that are potentially contaminated, use it.

I heard a woman state on O'Reilly"s show that we don't know which strain of Ebola this is.  *sigh*  The strain was proven long ago- thus proving that O'Reilly's guest had no clue what she was talking about.  The strain is Zaire.  Her belief that it was Reston is massively idiotic.  Reston does not infect humans.  The Reston Strain infected imports of monkeys during quarantine prior to release to testing labs.  Through the magnificent work of USAMRIID coupled with CDC and an alert veterinarian, that presence of Ebola- human negative- was managed.  Thanks to Drs. C.J. Peters, Nancy Jaxx, Jerry Jaxx, Peter Jharling, Joe McCormack, and so many others.

Oh wait- her claim was that Ebola Reston communicates to dogs.  Umm... not by science.  Maybe by panic.


So what can science confirm?  Well, we know that the "prodrome" or the entire length of time between exposure and evidence of disease is 21 days.  We also know that normal incubation is nine days or less.  That said, the prodrome is 21 days.

The family of Thomas Eric Duncan are planning to sue due to "racial bias".  I truthfully believe that they will come out of quarantine on 19 October with no ill effect.  As an American, I wonder how they would feel about being sued by the American people.  Thomas Eric Duncan brought Ebola to our shores.  He lied to escape his country of origin.  His unwise act has now imperiled an American who only sought to help.


How do we deal with this?  I ain't God.  What I am is someone who has studied this virus because I find it endlessly fascinating.  I'm also someone who believes that some things are true.

Do you work with a constantly changing population from Africa?  Give up your antibac hand cleaner and go for a bleach solution.

Screaming for an end of travel from affected countries?  It won't work and can serve to spread disease.  If travel is stopped from the affected countries, people will go to places that travel is NOT stopped.  Those places may not be equipped to manage Ebola or to recognize it.  Those places might then become new sources of Ebola.  This brings new problems.  Stopping travel isn't as easy as it may sound.

You may or may not trust the gov.  That's valid.  What you CAN trust is that a bleach solution will kill Ebola if you believe that you have been exposed.


We can choose to see panic while it builds around you- and ignore it with knowledge gleaned from science.  We can also chose to reject panic in favor of what can be scientifically proven.

Not ADHD, But Kinda

Something that is an odd but persistent artifact of ADHD is the ability to become wrapped up in a subject or set of subjects that are endlessly fascinating.  This is one of the reasons that many don't believe the idea of "inattention".  When we find the focus of our attention, it has ALL our attention.

I'm guilty.

I enjoy antiques, beadwork, sewing, jewelry making, painting, depression glass, quilting, porcelain dolls, and a few other oddities.  I'm obsessed by forensics, epidemiology, and virology.  Specifically, I am obsessed with filoviruses- Ebola, Marburg, and Lassa Fever.

Why?  Dunno.

I discovered virology in the 70's and proceeded to read every word available- and have continued to do so.  I met Ebola in the early 80's through meager published papers and added Marburg to my list, shortly followed by Lassa Fever.  I read every word I could find.

In 2014, I have continued to read every word I can find.  In the world of the Internet, I read everything online resources could provide, I bought every book i thought might be relevant- and even when I found myself reading epidemiological garbage, I scoured those pages for real science.  Sometimes I even found some.

Dr. William Close is my hero.  Just sayin'.  The world lost a real medical hero when he died.  

Today, I am finding that my odd "hobby" has a place.  This is nothing I ever expected.

So if you read my blog and find that you are confused by the screaming reports that seem to be fielded by everyone with an agenda that has nothing to do with Ebola and everything to do with scaring you, I might be able to help.

Can Ebola spread through air?  No.  For some years there was a theory that a nurse named Mayinga might have gotten the disease as she cared for a Belgian nursing Sister in Ngaliema.  The thepry was that young Mayinga had observed the requirements of barrier nursing.  The fact was that barrier nursing procedures were not in place at the time that Mayinga  cared for the Belgian Sister.  Dr. Margarethe Issacson- one of the first to respond to the outbreak, insured that barrier nursing would be in place.  

A novel by Tom Clancy theorized a "Mayinga Strain" of Ebola.  There was never any such thing.  A brilliant novel does not fact make.  PERIOD.

That guy in Texas infected EVERYBODY!!!  No.  As I write this, the family members- those who were closest to the acknowledged patient- have had no symptoms.  While we have to wait out the prodrome, Ebola moves faster, generally.

Surveillance is just that.  A group that we consider.  We watch and consider.  People who came in contact with that guy in Texas.  

Ebola has morphed and can spread through the air!!!  Umm.  No.  Near as I can tell that thinking is based in Richard Preston's telling of Reston Ebola outbreak in a monkey quarantine location in Reston.  While that virus was deadly to monkeys, it never spread to a single human.

Ebola is going to kill us all!!!  Not according to my Magic 8-Ball.  What CAN kill is a lack of information combined with a lack of trust.  

This is hard.  There are NO easy answers.  Many don't believe that the Government is giving us good info and really we want to know that we won't die bleeding from every orifice.  

Ebola is a "stuffy" virus.  It wants everything to be what it wants in order to invade a new host.

People tell me that docs and nurses who KNOW barrier nursing would NEVER allow a break.  Not true.  The most casual break can be the portal for a sub-microscopic virus. 

Crossing a barrier is too easy.  Touching oneself is a way of grounding- a way to "feel" centered.  Unfortunately, that can also mean that the barrier is broken.

Finally, ADHD does NOT cause Ebola.  But an ADHDer might help you understand it.

Letting Go and Going On

On August 31 I will celebrate my fourth Wedding Anniversary.  On September 4 I will acknowledge that my husband has been gone four years.

If you do the math, I was married roughly four days to a living man.  If you see it through my eyes, I have been married nearly four years.  Legally.  My husband and I were together for nearly six years.  We were engaged for most of that time.  To both of us, the engagement WAS the marriage- with jewelry.  We had been married long before the diamond showed up.

I realize that there are those who would suggest that my loss is somehow less valid because my husband and I were not given the luxury of more years.  There are those who would suggest that I should somehow "be over" the loss because he has been gone so long.  I would suggest to those that they shut the F up.

Today I gave several things that belonged to my husband to a friend of ours who will manage them responsibly.  That friend drove over 2,000 miles to take possession of these things and told me how he will manage transporting and handling them.  There is no question in my mind that these things will be handled responsibly and with respect.

And yet...

My step-son and mother-in-law both demanded that they be given the things that my husband had that they wanted within the first month of his death.  I complied with those demands.

What is left are things that my step-son would like to sell- because they mean nothing to him.  While those things have a financial value, that value is insignificant in view of other- and more important - points.  And all these things mean something to me.

Today has been difficult and ugly in many ways.  I let go of things that my husband loved.  It was like losing him all over again.  Right now, I hate everything.  I'm second-guessing myself, I worry that I didn't get every possible "buy-in" from people who don't live here.  I worry about the fact that I don't care about them.

There are more things that I will need to deal with and deal with reasonably soon.  I have been managing pneumonia lately and find that I have lost some ability to breathe and function as a result.  This tells me that I need to understand what it will mean to go on.

I need to get rid of "stuff".  I need to live more simply.  I know this.  But doing the thing I know leaves me anxious and bereft.

There are no easy answers.

There Are Elephants in this Room

To my mind, it is time to declare a moratorium on elephants in rooms and let them into fields to be free. On the downside, this means that we have to get honest- and perhaps brutally so.  We will have to talk about difficult subjects at a level deeper than the lip-service that has become popular.  Additionally, we also have to forgo the ever-so-popular civil disobedience.

In short, we have to decide that the issue is important enough to take a stand in a very unpopular way.  We need to responsibly speak up- and then stand our ground.  We have to decide that stigma can no longer be tolerated and that people who live with mental health issues be allowed a safe place to discuss them.

Lovely pipe dream.  *sigh*

My ADHD life includes some lovely side effects.  While ADHD itself is a neuro-biological differentiation. it usually brings "friends" along with it.  Those "friends" are called co-morbids and they live in the Mental Health spectrum.

ADHD  carries along "the three D's".  They are Dyslexia, Dyscalculia, and Dysgraphia.  I have Dyscalculia and, to an extent, Dysgraphia.  In short, I am wicked ugly with numbers and I can only write because I can draw.

Dyscalculia is number confusion.  Math leaves me in a cold sweat and I transpose and substitute numbers routinely.  I can't balance as much as a checkbook because I am bewildered by numbers of any kind.

Dyslexia is letter confusion.  Letters flip about and become incomprehensible.  Written communication becomes a horrific mine field and reading can be nearly impossible.  Some report that even pictographs are confusing.  

Dysgraphia is a challenge of writing and fine motor skills.  I was taught to "draw" rather than to try to "write".  I was blessed with people who taught me to see the task differently as a way to master it.

With the "three D's" more complex issues exist and thrive.  Among others, they include depression, anxiety, Obsessive Compulsive Disorder, substance abuse (frequently as self medication) and more.

Just to keep everything fun, ADHD is often considered to be nothing much and people who live with it to be "drug seekers"because the medications that are generally most helpful are also stimulants.  

So a person with ADHD doesn't just have to try to deal with their non-existent social skills, whatever co-morbids are tagging along, and often crippling impulsivity, they are told that their only problem is that they don't try hard enough and they need to "get over it" because ADHD isn't real (it is), is over diagnosed (it isn't) and EVERYONE has issues (they do- but that doesn't negate mine).

What I'm saying is that we can't have serious discussions about mental health without recognizing that there is some mental illness that we don't want to discuss.  We have to understand that real people have real experience and that some of it makes some folks uncomfortable- but those people need to have a safe space to relate their experience too.

Mental health doesn't pick and choose.  It doesn't target only the thin, beautiful, talented, or socially accepted.  It gets some of those, but it gets a bunch of us "regular folks" as well.

In order to have any credible discussion of mental health, we have to become willing to challenge preconceptions and stop the disbelief.  The experience of the individual has to be considered and valued.  The stigma must end.

In the perfect world, stigma around mental illness would end and the elephants in the room be allowed to roam free.

ADHD Isn't REAL

EVERYONE has problems remembering.
EVERYONE has problems managing time.
EVERYONE is socially awkward.
EVERYONE gets distracted.
EVERYONE has problems staying on task.

YOU ARE NO DIFFERENT.

*sigh*

Isn't this kind of like telling the autistic to "suck it up?"

The history of ADHD suffers by a myriad of definitions and the scholars that use these definitions.  In 1967 I was diagnosed with "Minimal Brain Dysfunction".  The theory was that it would "go away" at age 12 or so.  Didn't happen.

Later it was Attention Deficit Disorder.  That didn't work either.  It didn't take onto account issues of hyperactivity or impulsivity that were a part of the lives of the people who live with the disorder.

Still later it was Attention Deficit, Hyperactivity Disorder.  That brought on complaints as well.  For many, hyperactivity had been tempered by age.  Impulsivity hadn't gone anywhere and the hyperactivity had been refined by time and social modeling.  Many believed that "ADHD" didn't define their experience.

To this day we see people who define themselves as "Primarily Inattentive".  The DSM has a rather narrow band of descriptors that clarify impulsivity and most who fight with impulsivity would prefer to downplay that part of their reality.

Okay.

I have ADHD- Combined Type.  At the age of 52 (well, nearly) I am still hyperactive.  I fight daily with impulsivity.  My attention is seldom.

Is that all there is?

Nope.

The average ADHDer lives with the equivalent of 100 television sets in their head.  Those sets are ON 24/7 and they are all on a different channel.

Can you think functionally in that cacophony?  Didn't think so.

We ADHDers MUST.

Yeah, yeah, yeah.  "That can't be possible!!!"

Want to live in MY brain for awhile?

Unless a disability is visible, it is ignorable.  I know this to be a truth.

My friend Mike has been a quadriplegic since his teens.  He is in his 50s today.  He lives in a large motorized wheelchair.  You would think that people would be willing to accept both his strengths and his limitations.

Not so much.

I've watched people trip over him and then get pissed because he didn't move out of their able-bodied way.  I know he gets left out of social situations because of the way others perceive his limitations.  In my perspective, he is limited by others- based on their beliefs about him.

My disability is in my brain and it affects how I am perceived.  I personally know of two people who took my husband aside to advise him to get rid of me early-ish in our relationship.  One did this on my birthday- when I would have liked my husband to be with me- my mother had died two months earlier.  Hubby took the meeting because he thought the person could be helpful from a career perspective.  What he got was a pissed off me- after hearing that an irrelevant someone else spent that time to tell him to get rid of me.  That person was useless from a career perspective.

I'm open about my ADHD.  That gives others permission to either disregard me entirely or assume I am functionally retarded.

That's special.

You don't have to believe that ADHD is real.  You don't have to believe that gravity is real either.  At the end of the day, your belief is meaningless.

I Am Responsible

I hear this routinely.  "You think that ADHD means that you don't have to take responsibility!"  "It's just an excuse!"

Well, no.  ADHD might help to explain what is going on.  The ADHDer is still responsible.   According to my mother, there is no such thing as a good excuse.

So what is responsibility?  Let's look at it.

A friend of mine complained that her ADHD hubby couldn't load the dishwasher properly.  She was frustrated because she had told him repeatedly how to do it.  One day the light went on for her and she took a picture of the dishwasher properly loaded.  Problem solved.

So who owned the problem and who owned the responsibility?

She owned the problem.  He was trying to do the right thing but, because of ADHD, couldn't be successful.  She solved the problem by giving him a "map" for success.  He took that additional information- that he was able to use- and followed through.  Net result?  She owned her responsibility and gave him a path to success.  He owned his responsibility by continuing to try, and ultimately being successful.

Here's a tougher one, taken from the pages of Tom Brokaw's "The Greatest Generation"  One of the people he profiled stuck his head up a bit too far in his foxhole.  He was shot cleanly through the brain, resulting in the loss of his sight.

On his return to the States, he worked at what he COULD- accepting that there were professions that he couldn't participate in because of his blindness.  Nevertheless, he found a profession that he could be very successful in.

In his interview with Mr. Brokaw, he attributed his blindness not to the misfortunes of war or Hitler or the German who fired on him.  Instead, he said that he was sitting too high in his foxhole and should have been lower.

He was responsible.  He accepted that.

ADHDers live with responsibility.  They also live with failure.  This leads, frequently, to the anxiety that we have discussed in another blog.

I was taught from way young that failure to appear on time was me telling others that they are unimportant.  I have no real sense of time but developed incredible anxiety around time.  If I can't be on time for something, I frequently won't go at all.  I rarely accept invitations that have a time attached because I know what I'm not good at.  To me, this is taking responsibility.

I am being responsible because I am not making a commitment to being wherever "on time".  I don't trust that I can meet the requirement so I simply don't make the commitment.

Downside?  I only commit to things I believe I can manage.  The list is short and gets shorter by the day.

I'm an ADHDer.  I know what I CAN and what I CAN'T do.  I am responsible for knowing the difference, I am responsible for managing and communicating what I know.  When I do this successfully, I can manage my anxiety.

ADHD is never a free pass.  It MAY be an explanation.  It is NOT an excuse.

Anxiety And You!

As I get older I find that I have to deal with anxiety more and more.  The "why" of it is a point of discussion.  ADHD may CAUSE anxiety due to repeated failure.  The anxiety is a result of ADHD.  Anxiety may also be a common co-morbid of ADHD- General Anxiety Disorder may also be an element of ADHD.  Which is correct?  Dunno.  Don't know that I care as long as we recognize the beast for what it is and figure out what the right way to deal with it is.

I personally am incredibly sensitive to anything that manages anxiety.  The common pharmaceuticals are benzodiazipenes like Valium and Atavan.  These interventions often increase my anxiety.  I don't use them.  Keep in mind that these are reasonable and viable interventions and every person is different.

What I am left with is trying desperately to manage my anxiety that can go out of control for what may seem like no reason.  Well, no reason if you don't live in my brain.

As a side note, let's look at what anxiety is.

Dictionary.com tells us that it is a feeling of unease.  In another tense, it may be a compulsion to do something in an effort to complete a job correctly.  While close, neither of these come close to the anxiety I'm thinking of.

When I am dealing with anxiety, it is soul-killing, destructive, and immobilizing.  Fighting it off and doing the thing that is the cause of the anxiety doesn't result in empowerment, it results in more anxiety.

An example...

I want to visit my husband's grave.  I know that this will require a two hour drive.  I know that, right now, this means that I will have to drive through some ugly road construction in order to get to the cemetery.  I know that I need to keep the things I can as familiar as possible.

So I've done everything I can to make the trip as functional as possible.  I've packed the truck, checked the weather reports, have a clear sense of what I am going to do and how.  I finally open the garage door, ready to back out and go- and stop.  The fears that keep me from getting into the truck are multitudinous.  It takes me an easy ten minutes to get into the truck.

I need to stop and get cash and top off the tank.  At any point, I will turn around and go home.  I get what I need and move on.

Within ten miles of home I wanted to turn around.  So I made a deal with myself- I would keep going if I could set my cruise control and not have to change it.

I made it to Duluth.  I was able to get to the cemetery.  I was able to spend as much time there as I wanted.

Coming home I had to fight off visions of dead cats and a burned out home.  That was fun.

So I'm obviously writing this post.  My cats are sleeping- Callie in her kitty bed, Minou on the sofa beside me.  Am I less anxious?

The sad answer is, "No".

ADHDers have to deal with anxiety every single day.  It can be a massive de-motivator and it can also keep us from doing any and every thing.

The only way I know of it to test the things that make us anxious.  AND to be aware of things that can't be tested.

When I couldn't manage to change my license plates- required by law every seven years in Minnesota- I was ready to sell the truck and hide in my house.  While this might look like an easy solve to most, I COULDN'T solve it without help.  Thankfully for me, my friends Sandy and Bob were willing to help.

I was given a ton of advice from friends.  Mostly, it consisted of drive illegally until you get to someone who can fix this.  What no one understood was that I could not do this.  The anxiety would not let me out of the driveway.  Truthfully, even letting the truck out of the garage was nearly impossible.

ADHD comes with anxiety.  Think of it as a package deal.  Managing it isn't easy.