Living with ADHD

“Okay, for this next test, the computer is going to flash letters on the screen.”

The neuropsychologist looked me in the eye to make sure I was following. I nodded understanding.

“Every time you see a letter, hit the space bar. Unless it’s the letter ‘X’. Then, you don’t hit the space bar.”

“Got it,” I said. Sounds easy enough.

He walked into the other room and I got to it.

G. Tap. B. Tap. R. Tap.

Z. Tap. X. Tap—shit.

A. Tap. Y. Tap. X. Tap—dammit!

This was going to be harder than I thought.

By the end of the test, I had hit the space bar for every single letter, including all the ‘X’s.

That can’t be good, I thought.

…

A couple weeks earlier, shortly after my thirty-sixth birthday, I had gone to the doctor for a routine checkup and he asked me if I had any concerns.

“Well, I’ve been having trouble sleeping, and I seem to be really forgetful.” I’d wake in the middle of the night and be unable to go back to sleep. When I was able to go back to sleep, it was restless. It happened in phases, and it was getting worse as I got older.

The follow-up questions he asked seemed unrelated to sleep, but several of them hit a nerve: Did I feel anxious in social situations? Did I ever feel overstimulated? How much alcohol did I drink?

All the time. Regularly. Too much.

“I think your memory problems might just be from the lack of sleep,” he said, “but we should get a full neuropsychological evaluation to make sure there isn’t something more sinister going on.”

Sinister? What does that mean? Like a brain tumor?

…

It was five weeks after my neuropsychology appointment when I received my official diagnosis: ADHD, inattentive type. As the neuropsychologist put it, “you checked all the boxes.”

Not a brain tumor, then.

But there was another type of relief, too. Relief that there was a reason behind the struggles. Maybe it wasn’t my fault that I was always so disorganized. Or that I got bored easily and had trouble completing projects. Or that I became anxious and tongue-tied around other people—so much so that I struggled to make friends or even to talk to the few I had collected over the years.

My past suddenly had a different perspective.

Elementary school, when the teacher would call on me out of the blue and I would stammer and vow to pay better attention, but I would always end up spaced out like the last time.

Middle school, when my parents and I met with teachers to discuss my missing assignments. We opened my backpack to find it stuffed with all manner of half-completed papers. I felt exposed and judged.

High school, when I grew so bored and frustrated and anxious that I couldn’t stand one more class, so I walked around the park and ruminated on all my shortcomings instead. And when I stayed there during lunch, because I was sure my friends didn’t like me anyways. This happened a couple of times a week.

College, when I left every assignment until the night before, even the two 25-page papers that were due on the same day.

The class discussions that moved along quicker than I could shape my thoughts into a coherent argument. The interviews I crashed and burned. The impulsive decisions that I came to regret. The girls who I wanted to meet—how many of them thought I was dull-witted or boring or lacking confidence because I just couldn’t focus a thought long enough to express it?

And it was true, my confidence was pretty low. Not because I had little to offer, but because I had learned that my conversation was almost always clunky and awkward.

I always thought it was a moral shortcoming, a character flaw, but now I could see it was a difference in biology.

Now that I knew better, what to do about it?

…

Attention Deficit Hyperactive Disorder, or ADHD, is best known for the hyperactive type. Children with hyperactive type ADHD are easily identified in school, because they’re the ones who can’t sit still and jump quickly from one topic to another, often with bizarre and funny results. Teachers and parents struggle to get them to behave, and it becomes clear that something about them is different. They tend to get quick referrals to be tested.

Inattentive type, as the neuropsychologist explained to me, is the quiet younger sibling in the ADHD family. It is the form of ADHD most likely to be diagnosed in adulthood, often because it slips by undetected for years. Kids and adults with inattentive type ADHD are often described as spacey, shy, or quiet. They don’t tend to cause problems in the classroom, and as a result they often don’t get the support they need.

The specific disability is a deficiency in the executive function systems of the brain, which are responsible for planning, organization, and impulse control. Such as the inability to stop oneself from hitting the spacebar when the letter ‘X’ appears on the screen.

I had noticed all of the symptoms long before I was diagnosed with ADHD, but had never realized how they were related.

• Impulsiveness
• Forgetting names and dates
• Missing deadlines and leaving projects unfinished
• Extreme emotionality and rejection sensitivity
• Becoming easily distracted and disorganized
• Suffering generalized anxiety disorder and depression
• Low frustration tolerance
• Trouble multitasking
• Excessive activity or restlessness

(source: Additude: inside the ADHD mind)

When I looked at this list, it was like a walk down memory lane, accompanied by a heavy dose of shame. There was also a list of secondary symptoms. I recognized that one, too, and it was even more unpleasant:

• Outsider syndrome
• feeling that you are the cause of discord of those around you
• seclusion
• fatigue
• overstimulation
• impaired social relationships
• addictions (alcohol, drugs, gambling, internet, etc.)

They were awful, but they described the reality I was already living. What was new was the realization that my problems weren’t simply the result of poor choices. At the same time, I had to contend with the fact that these symptoms were, on a fundamental level, the results of who I was.

…

When I tell people I’m ADHD, they’re often surprised. “You don’t seem ADHD,” they say, “You’re so focused,” or “You’re so quiet.” They may only know about the hyperactive type. When I look at those lists, though, I can “check every box.”

“But those things describe everybody,” some people say. Yes, that’s true. The executive function of even a normal brain gets fatigued, and everybody deals with some of these symptoms some of the time. The difference in an ADHD brain is that we struggle with these things much more of the time. It’s much like climate change: any given weather pattern could be the result of random chance, but the general trend is irrefutable (it’s also like climate change in that some people will deny its existence regardless of the preponderance of evidence).

The benefit of a diagnosis is that it points the way to possible solutions. If others had successfully dealt with their symptoms, perhaps their strategies could work for me.

…

My doctor prescribed me Vyvanse, one of the newer medications. “You might want to start taking it on a weekend, just to get used to it,” he said.

I took it on a Saturday morning, early. I started to do a little work to prepare for my music history class, and I couldn’t believe how much I was getting done. At 1pm, my wife asked me if I wanted to take a break for lunch. That’s when I realized I hadn’t eaten breakfast.

On Sunday I woke with a splitting headache, but it disappeared shortly after I took my pill.

On Monday I surprised myself when I shouted across the parking lot to say hi to the superintendent. I was friendlier than I had ever been before. Instead of my usual anxiety about talking to people, I was eager to chat. All day long I greeted people by name, conversed easily, and easily closed conversations without awkwardness. I felt like a different person. More confident. Nicer. I’m pretty sure my posture improved.

Then after a few weeks, my sleep got worse.

The headaches started back up. Horrible, unbearable headaches that felt like my hair was standing on end, coursing with electricity.

I’d get sudden adrenaline surges in the middle of teaching and my heart would start racing uncontrollably.

I felt like I wasn’t me anymore.

My students were learning more than ever before, but I was so focused on results that I forgot about the relationships. The joy had disappeared from my classroom.

I talked to my doctor. We tried a lower dose, but the effects were the same. I finally decided I had to stop.

That’s when I began to notice all the details I had been missing: trees blowing in the wind, the feel of sunlight on my skin, the taste of water. I used to revel in subtleties. In my hyperfocused state, I hadn’t even noticed they were gone. For every ability and freedom I had gained, I had lost something more precious.

Now I felt like I had myself back, and I never wanted to lose that again.

…

Five years later, my ADHD is still a struggle, and I’m sure it will always be. I still make careless mistakes and impulsive decisions.

I will go to call someone for their birthday, pull out my phone, and a notification will distract me and I’ll forget what I was doing.

I will automatically respond to my wife when I am reading a book, and I won’t even realize that she has said something to me, or that I responded.

I will burn the bagels in the toaster, as I did again this morning.

But in the end, I’ve learned to value the way that I think. It comes with negative impacts, but it also allows me to experience the world differently and make connections that others don’t see or appreciate.

ADHD is helpful as a diagnosis, but by itself it doesn’t define me. We’re all individuals, and each of us has to design our own systems and approaches that work for us.

I’ve learned to find creative work-arounds for many of my symptoms. Where other people can depend on the power of their memory and focus, I am forced to offload much of my decision-making and memory into automated systems and routines that ultimately free me up to be more creative and effective.

For example, I’ve learned that coffee helps my executive function for about two days, and then I pay the price in restless sleep and poor decisions. I’m more likely to drink alcohol, react impulsively, become forgetful, and make exceptions to my routines. So I generally drink coffee only two days a week. (I could give it up altogether, but I’m not aiming for perfection here, and coffee tastes good.) That system works for me (most weeks), but many people with ADHD use coffee daily as medication, and it works for them.

And sometimes I just have to forgive myself for screwing up and recognize that some problems are out of my control.

My ADHD diagnosis helps me understand myself, but ultimately my life and my relationships are still my responsibility. It’s not about making excuses, it’s about recognizing my limitations and finding realistic solutions. I will continue to make mistakes and struggle, but I can also learn from my mistakes and continue to improve.

As it turns out, it’s really not that different from being a normal human, whatever that is.