Embracing ADHD

I've often wondered if I had ADHD as I seem to experience many of the common behavioral markers, namely (but not exhaustively):

Inattention

• Forgetfulness

• Easily Distracted

• Avoidance of Prolonged Tasks

• Difficulty Organizing

• Attention to Detail

Hyperactivity and Impulsivity

• Unable to Stay Seated

• Talkativeness

• Impatient

• Answering Before Question is Completed

• Difficulty Keeping Thoughts Inside

In addition to many of these, I've always battled what I can best describe as an unidentifiable yet persistent sense of anxiety and fear, also common for people with ADHD.

And yet, I've also been a skeptic, especially about the idea of medicating oneself. I wondered if it was a real thing. "Everyone has trouble focusing and gets anxious," I thought. "I just need to try harder to control it." But what I quickly learned is that claiming ADHD isn't real because everyone sometimes faces distractions is akin to dismissing depression because everyone feels sad now and then. Both views oversimplify and misunderstand the depth and severity of these conditions, and I started to recognize that while traits associated with these conditions can be found in everyone to some degree, the intensity, frequency, and impact on daily life are what set clinical cases apart. And I was showing a lot of signs of a clinical case. Most importantly, I didn't like these signs and I needed help changing.

So with that education, thoughtful conversations/diagnoses with trusted psychiatrists, and a lot of curiosity, I decided to try a pill. I figured the worst that could happen is that either 1) I don't like it or 2) I like it too much (i.e. it feels like a party drug). And I was prepared in both cases to walk away and not think about it anymore. The possibility that it actually helped me and improved my life seemed high enough that it was worth a shot. But I simply had no idea how profoundly my life would improve in meaningful ways.

Pills

I started by testing small doses of three similar but different medications to see which one made me feel the most 'normal': Adderall (most common), Ritalin (next most common), and Focalin (this is the one I like most). All basically do the same thing in different ways - increasing the amount of dopamine and norepinephrine in the synapses (spaces between neurons). Although these are considered stimulants, if you have ADHD they actually help you to be calm and focus.

I know people have strong opinions about big pharma, pharma in general, homeopathic medicine, Western or Eastern treatments, Freudian psychology, Jungian psychology, and just about everything else. Everyone's experiences and opinions are valid to them and all I can offer are mine, which are that I've found incredible success with both Freudian and Jungian methods and with both Western and Eastern medicine, so I'm all about trying stuff and seeing how it goes.

Observations

Put simply, my decision to try ADHD medication has been one of the better decisions for my mental health to date. I’ve never been happier and I’m often overcome with gratitude at how effortless it now is to be what feels like my 'true self' and live every day without the constant road blocks that have been keeping me from being as happy as I could be. To be clear, I wouldn't have ever said that I was 'unhappy', but I simply didn't realize how much happier I could be. Everyone has different reactions, and two people with ADHD could have two very different sets of symptoms and outcomes, so all I can report is what has happened to me. Here are two observations from my experience:

• Anger/Rage/Frustration: I’ve had a rage issue as long as I can remember where I boil over with uncontrollable frustration, usually physically needing to release energy. I typically hit something, slam the table or, in extreme cases, punch and break things. I punched and broke a windshield as a teenager, have punched walls, poles, floors, computer monitors, broken headphones, keyboards, drawers, appliances. Mostly with my fist, to the point that the knuckles on my right hand are permanently larger than the left from scar tissue. Few know this and anyone in my life would be shocked to hear this since 99% of the time I am chill and easy-going. An example trigger would be when I have a responsibility and something out of my control is keeping me from fulfilling said responsibility. So work frustrations, traffic, or technology not working (this one has led to famous outbursts in front of friends and colleagues where I smash said technology, much to their delight). It can also be as simple as loud, unexpected noises, such as my children screaming or fighting. It's hard to express the amount of shame that I’ve carried around my whole life, wondering why I can't control myself as well as everyone else. I've asked myself "What's wrong with me?" silently and aloud, about a million times. Questions like, "Why can't I do this? Why can't I focus? Why can't I control my temper?" of course lead to "I can do this! I can be better! I can try harder! I can focus! I can be calm! I can not explode in front of my kids!" This enthusiasm and motivation works a little, until it doesn't, and I again fall into deeper shame having failed at my goal. This has gotten worse in recent years, since loud children are a daily trigger and the shame is also more severe when I freak out in front of my kids. My son started saying things like, "I don't like when you get mad." My smaller girls, unable to express this, will freeze and look to me for my reaction when something happens that they've learned will trigger me. And yet, knowing all of this, I still can't seem to control it. It's like my body overrides my brain for a split second, and before I know it, I've thrown/hit/smashed/yelled something that I immediately regret, a toned-down version of Jekyll and Hyde.

• Anxiety: I never realized until I tried medication that I’ve had a cloud of unidentified anxiety and fear hovering over me my whole life, causing noise that makes everything worse. Like a swarm of bees constantly buzzing, I've learned to ignore them and focus on the task at hand, be it a work project, a conversation, a moment with the family. But they're always there, and I didn't even know that they were, since as long as I can remember, they've been there, a part of me. Not being able to focus for more than 30 minutes at a time at work was just "how I am" and I've learned to work around that, with surprising success. Not being fully present with my family and friends is the status quo, leading me to try meditation and read books on mindfulness, again with some success. Not being able to relax with my wife and just chill was just a fact that I assumed wasn't in the cards for me. A slightly stressful day of work or parenting would turn into downward mental spirals often leading to existential crises - who I am supposed to be - why I’m not good enough - I'm in the wrong place or doing the wrong thing - people don't like me - things aren't working out for me. This also spread further than feelings about myself and into my spouse, my friends, my colleagues. I would be judgmental about them in my mind, wishing that they would be different so that I could be happier. If only they would... then... This kind of victim mentality isn't uncommon, blaming behavior of others for our problems. But again this typically small and infrequent judgement would be frequent and severe, leading again to downward mental spirals of what others should be doing, despite the fact that I simultaneously understood this feeling to be a lie. Then there's the standard, constant, subtle feeling that I'm always supposed to be somewhere else or doing something else. This swarm of bees is likely the cause of the rage, since everyone else starts the day with their patience bucket at a 0 and they don’t explode until a 100. I start at a 90 and explode easily since I use so much energy and effort to constantly push the cloud of bees away. Again, I had no idea that it was there until it was gone. 

Calm

Since starting medication, I’ve had a total of one single moment of intense anger/rage (compared to an almost daily occurrence) and it was on the day that I forgot my pills at home. Like magic, I can handle even the most severe previously triggering situations with a calm demeanor. My wife is emotional with joy seeing me gently handle screaming kids with love and patience and thoughtfulness. Not only can I handle my own emotions calmly, but in those meltdown moments I’m now able to help my kids work through their big emotions instead of running away from them out of fear of my own meltdown. I have never felt more present with them, to the point that I’ve cried several times at how beautiful the moment is and how long I’ve been missing out on them. I've seen in the past how they can tell when I'm physically present and visibly excited, yet not able to fully commit to them since my brain is processing all of the other amorphous things that I'm 'supposed to be doing'. I recognize the contrast now because now they can really feel that I'm fully invested in them in that moment, and there's nothing in the world that could matter more to me. I can tell that they love it and it means the world to them, because they open up more, smile more, and are more excited about our time together.

True Self

Work is wonderful, which has not been the case, and even on boring days I leave feeling positive and listening to music enthusiastically on my way home with a smile and plenty of energy to give the kids. Before I would leave depleted with existential dread that I’m in the wrong place and wondering what I am doing with my life. Often I would get home and just lay down with nothing left to give. At best I would will some enthusiasm into existence, pushing myself to be the fun dad chasing my kids around or the loving husband ready to spend time with my wife. Now I can bring real energy, savoring these moments with my family. I was worried that ‘medicating myself’ would keep me from being my true self in order to conform to my environment. What I’ve learned is that I actually feel more like my true self now, and that this part of me was actually getting in the way of me being myself, taking over whenever it felt like it. My creativity, curiosity, optimism, and other positive attributes that I love about myself are still there, but are more frequently and easily present. To this point, I wrote a poem:

______________________________

Dexmethylphenidate

Where am I

Next to the highway

Frontage road, potholes, road blocks

They seem so effortless up there

Where am I

Struggling to tread water

While everyone else floats

These chains around my ankles are heavy

Where am I

Fighting off the swarm of bees

That hover around my head

Never stinging, always buzzing

Where am I

Quick to snap, lose control

Is my bucket of patience smaller than yours

Or is there a hole in the bottom

Suddenly

Highway on-ramp

Chains loosen and slip away

Bees return home

Bucket is patched

There I am

_________________________________

Determinism

If all of this isn’t enough, seeing first hand how weak my willpower is compared to my biology has reinforced my perspective as a (soft) determinist, realizing that no matter how hard I tried to control these behaviors, I was only capable of moving the needle so much on my own. I've gained so much more empathy, compassion, and unconditional love for others, knowing that the things that they don't like about themselves (or that I don't like about them) aren’t really their fault, and not really their choice. Our illusion of control leads us to feel shame about what we can't do, and that shame only makes it worse. This perspective has led to (among others) conversations and experiences with my wife that have launched us into another higher realm of maturity and love, connecting in a way that I can only describe as truly seeing her for the first time and loving that person for exactly who she really is, deep down below all of the conditional layers that I subtly pile on her without even knowing it. I'm not being overly critical of myself - I think we all do this to each other constantly.

Renewal

In short, I’m overcome with joy and gratitude for the miracle that is modern medicine and I can’t believe that I could be so lucky as to have the chance at what I am experiencing as a renewed life without shackles. I feel like I’ve been treading water with a weight on my ankles my whole life, and yet still staying above water out of sheer will and force. And now that the weight is gone, it’s opening up so many possibilities that I can explore in order to live a more full life that I never imagined would be possible with my brain. Realizing that a little dopamine and norepinephrine was the answer all along to many of the core, complicated, often distressing problems in my life continues to be mind blowing and hard to process.

Dependence

I was worried about trying medication since I didn’t want to become dependent on it. I think that that concern was both right and wrong. I do take it every day now and I don’t want to go back to the life where I was my regular self a lot of the time and an anxious, angry mess the other part. Somehow I feel like I was supposed to be this way all along, and that I’m finally settling into how I was supposed to live life. So am I dependent on this pill? Kind of. But unlike a dependence that would make my life worse (e.g. heroin), this dependency makes my life objectively better. So is being addicted to happiness a problem? Or peace, calm, etc.? If it felt unnaturally so, I might be able to see some point there. But it feels very normal. I still have highs and lows, good days and bad, moments of happiness and sadness, anger and peace. But the extremes that don't feel like 'me' are gone, and my baseline is calm instead of anxious. If a surgery would permanently change this for me, I'd do it, and I think many like me would, much like if my leg were broken or I had a tumor. But taking a pill every day has a more judgmental connotation, and I shared this judgement and hesitancy. But what I'm learning is that I was wrong, at least for me.

Now this is philosophically tricky, since there are strong theories that ADHD brains had evolutionary utility - basically we were constantly anxious and fearful of a lion attacking the tribe, so we survived while the relaxed, calm person either got eaten or they were safely protected in the tribe while we ADHD-ers killed the lions. In that sense you could say that my ‘true self’ is indeed anxious and fearful and I don’t have a ‘disorder’ but that's just who I am. On the other hand, I am objectively happier and better when I’m not behaving that way. Where I land on this so far is (as is often the case) somewhere in the middle. I believe that our ADHD (or whatever anyone wants to call it) had evolutionary utility for that time in human history, but isn’t part of our ‘true self' which I won’t attempt to define, but is something more like what makes us feel alive and what our heart desires and less like what helps us survive a lion attack. We’re not on the savannah anymore, so that attribute is no longer useful. There is no lion. So my 'true self' can live an elevated life of higher meaning than simply surviving, if only it could get rid of that pesky part of its brain that produces too little dopamine and norepinephrine. If only there were a way to fix that...

Touch Green Grass

I’ve come so far in my life over the past seven-ish years of mid-life exploring by moving forward with faith, trying new things and talking to new people, saying 'yes' to things that might make my life better or closer to my true self and 'no' to things that don't. And every time I’ve been better for it, even when it isn’t what I thought it was going to be. I didn’t know what I didn’t know and I still don’t know what I don’t know, which leaves me wide open to the likelihood that I will continue to learn something new and profound about myself as I continue to look inward at how my brain and body work.

Luckily, I learned early on that pursuing a better life, more happiness, more of anything, must be done delicately. If done with expectations (i.e if I get/do this, then I'll be happier/better), it is of course a disaster. Looking longingly at the grass that looks greener is indeed a fool’s errand, a la Tanha of the four noble truths. But, importantly, what I’ve learned is that sometimes the grass is actually, in fact, greener, and better. And the only way to know is to go and check it out. So one way to summarize what at this point I would consider a wildly successful mid-life journey, is that instead of longing for the greener grass on the other side of the fence, I decided to just hop the fence and investigate myself.