Conquering the Chaos
December 27, 2023
"I was a very chaotic child, just because I had been through a lot that most people at four haven't been through," Ricki starts. After all, when she was just three years old, her caretakers hid her from the government and she ate chicken bones off a dark basement floor to fend off starvation. At least, that is what she has been told. Her brain has forgotten this trauma, but these experiences have shaped her life in a variety of ways. Through treatment, self-awareness, and perseverance through struggles, Ricki has learned to manage her anxiety, ADHD, and complex PTSD.
Before being adopted by a family in the US, Ricki experienced "forcible separation from multiple families," resulting in anxiety and trauma about losing loved ones. Ricki explains, "for example, we'd go shopping at Walmart, and I would see something I was really excited about, and then I would lose my mom and start crying and panicking. 'Where's my mom? Is she going to leave the store without me?' I have a lot of trauma around separation." Ricki would often "try to sneak into Mom and Dad's bed to sleep with them even into my early double digits, because I would get nightmares a lot and my nightmares would be pretty vivid, like watching my parents get beheaded or stabbed… very gruesome nightmares."
In the early years of elementary school, Ricki could not focus and performed poorly in school, especially since she was still learning a different language. In frustration, she banged her head on desks and walls and bit people (including herself). Ricki adds "Having all of these behavioral issues and not knowing why you are the way you are: there's a lot of judgment from other kids and people, like 'Oh, she's kind of crazy… I don't want to hang out with her' and, you know, as a kid, that's very damaging to growing up and development."
Fortunately, Ricki was able to get support early on because both of her parents understood the importance of mental health. Ricki was diagnosed with attention deficit hyperactivity disorder (ADHD), a disorder whose key symptoms often include impulsivity, hyperactivity, an inability to focus, and a struggle with attention and motivation. As serious as the diagnosis was, it was "a game changer in being able to articulate and understand myself and how I interact with the world." The diagnosis gave her the vocabulary to understand and articulate her abnormal behavior and helped others understand how they could get along. However, putting a name to the condition also invited stereotypes: "Then there came the jokes, but they weren't funny. I would be talking really fast about something I was really excited about and I'd be super hyper, and then my family would say, 'There goes Ricki again, did you take your meds?' If I showed any excitement or energy at all, it would be like, 'Oh, you're ADHD – you're too much for me.' And then that contributed to a lifetime feeling of – to this day – worrying about being a burden to people or irritating people because I was told I was a burden and annoying for like two decades of my life."
Nevertheless, with an official diagnosis in hand, Ricki was able to receive prescription medication. Figuring out the most suitable medication for Ricki took some trial and error: "In general, when I've taken ADHD or antidepressants or antianxiety medication, it usually takes about a month to figure out consistently, what are the side effects that are good and bad. That's why usually psychiatrists will check in with you at the beginning and then again at the end of the first month." At one point later in life, the psychiatrist had Ricki try out Adderall, which she found out made her "the most moodiest person and also the most irritated person on Earth." Ricki "got in a huge fight with my favorite teacher" and asked to be put back on the old medication. When asked about how the right medication affected her ADHD, Ricki explains that "I have a lot of energy in my brain, and it's constantly buzzing. Like if you were to think about energy as being palpable, it's like chaotic energy everywhere… Having medication allowed me to have the same level of energy, but direct it better. So now it's like, 'Oh, I want to focus on this class because the test is next week.' I'm actually able to focus versus before, no matter how much I wanted to, I just couldn't – my brain didn't work that way."
The psychiatrist also treated Ricki by helping with behavioral management: "my regular check ups involved a lot of talk therapy, where my psychiatrist would ask 'What are the behaviors? How is school going?' He would then dive into things I'm doing and ask me about why I do them, and we would talk through it. Therapy can help you change by reframing the way you think about something or helping you understand why you do something and developing self-awareness."
The combined treatment regimen was successful, and Ricki went from being in special education one year to being an honors student the next, because she could now properly manage her attention, motivation, and energy.
In Ricki's junior and senior years of high school, she joined Running Start, a program in which high schoolers would take community college courses to accelerate their college careers, in addition to taking regular classes at high school. Ricki became extremely busy, attending high school, college, and joining multiple time-consuming extracurriculars such as band and tennis. The schedule would have been overwhelming even for people without ADHD and the challenge prompted Ricki to develop new organizational strategies to cope. Ricki has kept those habits, resulting in her saying "I will probably be one of the most organized people you've ever met in your life. I color-code everything, I make bulleted lists out of everything, and people say my calendar is impressive." Ricki explains, "People who were diagnosed with ADHD as children and then discontinued medication are often in a better place than adults who have never had their ADHD managed because the medication and therapy helped them harness and focus that energy so good habits were built."
Around this time, Ricki's psychiatrist felt that Ricki was outgrowing ADHD and placed her on the minimum dose of medication. The psychiatrist offered to discontinue the medication entirely, but Ricki knew that she wanted to attend graduate school and did not want to risk her undergraduate GPA. With her psychiatrist's encouragement that she had indeed outgrown ADHD, she stopped taking ADHD medication after she graduated from college.
Later on in life, Ricki observed some of the ADHD symptoms – such as the inability to focus – creeping back into her life, especially when she felt burnt out. Initially, she would deny that she was experiencing a relapse of ADHD, thinking "No, I outgrew ADHD. I should be able to handle this. I should be better than this." However, after reviewing more current research and talking with some therapists, Ricki learned that "you actually don't outgrow ADHD. You always have it, and you're neurodivergent your whole life." "Neurodivergence will always be a part of you," she added, "medication is one way to manage, but cognitive and behavioral changes help you understand your symptoms and develop the right coping mechanisms."
Adding to the challenges of managing her ADHD, Ricki started dating someone. Over the course of three years – including the time that she started college and lived with him and his family – she came to regard the relationship as toxic, even though "he is a great guy" – Ricki added that "we're still friends." However, "he was just very naive in a lot of things, and I just couldn't handle it because I'm very sensitive and I'm very aware of these things." Unfortunately, the breakup triggered Ricki's traumatic memories of separation from early childhood. She explains that "breakups are very much a separation and you have to go through the process of grieving them." Ricki fell into a massive depression such that, while she was not suicidal, she felt that "it's so painful, I just don't want to be here anymore." Ever a problem-solver, Ricki decided to go see a therapist, thinking "this is why therapists exist."
Ricki describes the first therapist that she saw as an adult as "a really cool guy – he was very chill." However, that laid-back demeanor ended up not being a good fit for her. She explains, "I am an anxious, full-of-chaotic-energy person" and "so much of what he wanted me to do was slow down, meditate and breathe." She did not disagree with him ("I never doubted that he was right because I'm probably one of the people where meditation would help the most"), but "I wasn't in a mental capacity where I was willing to learn a new skill like that. I wanted somebody to help me walk through the way I was thinking about things and listen to me and validate me." After a couple of months, Ricki decided that she wanted to switch therapists, but she has "a very hard time rejecting people." She remembers apprehensively approaching the front-desk receptionist, asking "Is it okay to switch therapists?" The receptionist assured her that doing so was normal and that it is really important to have a good fit with one's therapist. Relieved, Ricki told the receptionist what she was looking for, and the receptionist recommended a different therapist.
The next therapist was a much better fit, because she was both understanding and transparent. She helped Ricki work on problems with self-criticism. As a result, Ricki "learned a lot around being kind to myself and not being as hard on myself," a struggle that came with Ricki's naturally ambitious character. Still, the therapist was "not afraid to call me out when I was saying stuff that was contradictory." For example, the therapist once pointed out that "You're having a hard time living because you're not experiencing things. But you also told me that you don't get out of bed… So what do you want?" Ricki appreciated that candor, helping her recognize the choice before her. Ricki responded "I do want to go and experience things" and the therapist responded "So this week, let's think about one thing you can do to get out of the house and experience." Ricki really appreciated that type of guidance – clear and direct, yet respecting her autonomy. Around half a year later, that therapist retired ("I was devastated"), so Ricki switched again.
The third therapist had yet a different style. He covered a lot of psychological theory with Ricki, giving her "packets of information" to read, causing her to feel like she was studying. Through these sessions, the therapist gave Ricki very useful tools to help with rumination, a symptom of anxiety where those who are affected dwell on persistent negative thoughts. The previous therapist had explained that anxiety can be like a snowball, starting out small, but as the anxiety persists and grows, it can grow much, much larger and become unbearable. One tool to prevent the snowball from growing is called the Five Senses method, in which people learn to divert their brains from the source of their anxieties by keenly observing the world around them and focusing on their senses. Another tool is called the Forrest Gump method, in which practitioners slow down and narrate their lives, grounding them to reality rather than letting their imaginations run away with what might happen. Unfortunately, Ricki felt that this therapist's style was too authoritarian. He would say things like, "Well, you should do this because I'm telling you, this is the right thing to do" and Ricki did not respond well to that style. Instead, she prefers having conversations about improving her mental health and for her to ultimately make the final decisions on which course of action to embark upon ("This is my mental health. I decide what I do in my life."). However, Ricki did not want to criticize his style, because she knew that some people preferred it; she just realized that his style was not for her.
Around this time, Ricki decided to try a seven-week session of group therapy. At first, she was reluctant to attend, but "when they suggested it a couple of times, I'm like, 'You know what? Whatever. I'm at a place where I'm about to jump in front of the light rail train… I should go to this group therapy class.'" For the most part, Ricki did not find the sessions very helpful "because I'm very private. I don't like to share in a group. So that was very hard." At the same time, "I think the most powerful part of it was the validation that a random stranger can feel the difficulties and pain that you're feeling." She felt that it was life-changing to realize that anyone could be in a similar place as her mentally without appearing like it. Ricki felt validated in her mental health struggles: "Somebody would say, 'I have this anxiety. Sometimes I feel crazy. I can't sleep at night.' and I'm like, 'Wow, someone gets it!'" The group therapy sessions also came with homework: worksheets for participants to ponder different aspects of their lives during the week. During the sessions, participants would share these thoughts. Despite her reservations about group therapy, Ricki would still recommend it for some people because of how validating it can be to not feel alone.
After this first round of therapy, Ricki felt that she was in a good enough place to use the tools she had been given. Ricki graduated from college, majoring in psychology. She worked for a few years, including a stint as a research assistant at a university's department of psychiatry and behavioral sciences. She then completed a master's program in human-centered design and engineering and accepted a user experience researcher role at a large technology company. While Ricki got along extremely well with her immediate manager, she felt that the general leadership of her department cultivated a toxic environment. One of the challenges was the complete disregard of her input by a manager who then acted on the same input said by a male colleague, and even more problematic, the subsequent refusal by leadership to acknowledge the issue.
Compounding the stress at work, Ricki was diagnosed with a tumor. It was a low malignant borderline tumor that had grown to the size of a basketball. She got surgery for the tumor and entered the most mentally and physically painful time of her life. Ricki describes the pain as "so bad that for the first time in my life, I understood why people would want to do euthanasia to end the chronic pain because I was like, 'I get it. I have never been in this much pain in my life, and it was every day for almost two months… This was the first time in my life that I really, genuinely didn't want to live and that was a period of two years where I would think, 'I don't want to be here. Every day that I wake up, I hope that I don't.' It was really bad."
Ricki decided to see a therapist and found one off of Ginger, a platform for remote therapy. As an aside, Ricki adds "For the record, I've been really impressed with the quality of therapists on Ginger. They're just great." While these therapy sessions were Ricki's first virtual ones, she says "The therapist that I got matched with was great. She helped me so much." Over the course of these sessions, Ricki also started processing the sexual assault that happened to her a few years earlier, perpetrated by a longtime family friend. That betrayal permanently damaged her ability to trust people because, as she describes it, "When you have somebody that you thought would never hurt you, really hurt you, then anything is possible. Your best friend can betray you. Your partner can break you." Even worse, when she told her family about it, her sister said that it was partially Ricki's own fault. Ricki silently carried the shame from being sexually assaulted and the difficulty with trusting people for a long time, suppressing the memory in a dark corner of her mind. In processing everything else that was going on in her life, this memory resurfaced.
Ricki says that the therapist "really helped me reframe a lot of the ways that I was thinking and helped me process the things that were happening so that I could accept them." Ricki was diagnosed with major depression and generalized anxiety disorder, and she wondered if she was just broken. The therapist told Ricki that she was not damaged or broken, but that people just often need extra support when going through unexpected and revolutionary changes in life. She also helped Ricki realize how miserable she was working at her job, leading Ricki to find a new job at a different company. Furthermore, the therapist helped Ricki see that the sexual assault was not her fault, and Ricki remembers feeling a huge weight being lifted. Ricki's favorite message from this therapist is, "We can't help the bad things that happen to us, but we can shape how they affect us in the future."
Towards the end of their sessions together, this therapist also diagnosed Ricki with complex PTSD. Suddenly, Ricki's nightmares, flashbacks, trauma-level issues with the concept of death, separation anxiety, trust issues, and other struggles all made sense. Looking back on her early childhood, Ricki says "I think I've learned a lot of compassion and empathy for little Ricki now and everything she had to go through, from all the therapy I've been doing."
Thoughts on Therapy
Ricki has pretty much always had a great relationship with her parents. "My parents are probably the most important people in my life... I have always been both a Mommy's girl and a Daddy's girl. I'm very attached to my parents." Ricki feels very fortunate about how supportive her parents are: "Even when my parents and I disagree, for the most part, they always find a way to support me. I'm really lucky that way." She is especially grateful for their care of her mental health: "I'm really thankful that my parents took the time to help me understand ADHD, get support for that, get therapy for the crazy trauma that I had to go through as a baby and all those things because I think I would have ended up an entirely different person if I hadn't gotten that as early as I did."
In addition to helping Ricki process her trauma, therapy has also helped Ricki grow in her communication skills. Growing up, she was often able to mediate conflict between family members, in part due to her experience with therapy and psychology. Ricki explains "Most people – if you're not aware of mental health – will automatically speak in invalidating ways without realizing how invalidating they are, which causes people to put up barriers and not actually be vulnerable." Therapy has also given Ricki the tools to be more introspective, leading to important conversations and deeper communication with others.
Ricki encourages others to talk to someone educated in mental health, if something feels off. She believes that being able to articulate and understand yourself can be a game changer. "Going to therapy or getting a diagnosis can be scary," Ricki admits. "But ultimately it empowers you to be yourself… It enables you to understand and interact with the world in a way that lets you be authentic and happy as you are."