Mental Health: ADHD

I was going to originally title this post The Stigmata of Mental Health as a play on words, but funnily enough, I didn’t realize that stigmata was the plural of stigma. I always thought of it in the religious context: the physical marks that are the result of a relived traumatic experience. It still fits.

This is a bit off topic from my usual posts, but I think it’s something worth sharing. I’m pretty down with being open about topics that make people feel vulnerable, so mental health is right up my alley. I like to talk about things so other people don’t feel so alone. This is going to be a two part series covering ADHD and anxiety.

Today, I’m going to tell you about my experiences with ADHD. It’s a lot of personal info, but whatever, I’m down. Let’s do this. I’m only talking about my own experiences, and everyone is different, so if you experience something different, that’s OK!

Most people focus on the bad stuff that happens when you’ve got ADHD. I want to talk about both sides: what I gained and what I lost when I went on medication. To do that, I’m going to have to give you some background.

I like to explain ADHD as being a derpy form of computer threads.

People are multi-threaded. We can do a lot of stuff simultaneously under a single process. People with ADHD have a fuckton more threads to deal with than most. We’re processing a lot more data, but that doesn’t mean we’re necessarily always effective. We reach a limit. One of the biggest problems is figuring out how to context switch or prioritize the correct thread, like, say, someone that’s talking directly to us while we’re thinking about pokemon and obama and the conversation happening behind us and an email we need to send and what we’re making for dinner tonight and aren’t we supposed to be hanging out with someone tonight and some code we’re working on and the list goes on and on. Sometimes we can’t grasp any single thread, but just sort of bounce between all of them. Sometimes a thread just gets forgotten entirely, like where we put our phone. Oh, it’s in the refrigerator? Well, that makes sense.

Yes, I know that comparison falls apart in a few places, but it’s mostly pretty apt.

There are three different types of ADHD. ADHD-PI (inattentive) is more prevalent in adults, and ADHD-PH (hyperactive/impulsive) is seen more in children. Personally, I’ve got ADHD-C (combined), which means I’ve got all the fun of both.

I’ve always had ADHD, before anyone even knew it was a thing. Back in school, I was always acknowledged as being “freakishly smart,” but my grades didn’t really reflect this. I started having problems in 3rd grade. I’d still ace all my tests, but my grades weren’t that fantastic once homework started factoring into final grades. I’d still get put into AP classes when they were available, but my school had no idea what to do with me.

It’s not that I didn’t want to do things their way, I just couldn’t. I would promise myself that I would try, and that I would do better, but I’d sit down and stare at my homework and get distracted by a pencil, not be able to sit still, or even completely zone out. I couldn’t focus at all, and believe me, it wasn’t a matter of willpower. If I didn’t do my homework, I would get in trouble, and my father would hit me, so I had no lack of motivation. I spent most of my childhood hiding from him, because I couldn’t figure out how to “be a good kid.”

Don’t ever think that kids with ADHD just need to try harder. Believe me, they are trying as hard as they can to live in a world that isn’t equipped to deal with them.

By my sophomore year in high school, I had stopped attending hardly any of my classes, except for major tests and midterms, which I would ace, fucking up the grading curve and making most of my classmates pretty angry. Fortunately, I rarely saw them, because at that point I was spending all my time on the computer and in the public library, where I could define my own expectations, create my own goals, and have enough mental stimulation to define my own education. This might be why I didn’t realize until today that stigmata is the plural for stigma. There are definitely gaps in my education. I do not recommend my path for others, but in the end, it worked out pretty well for me.

Part of the fun back then was that my teachers were incredibly frustrated with trying to determine how I was getting good scores on my tests without being present for any lectures or doing any homework. They were convinced that I was cheating. I didn’t understand what the problem was, because I assumed what I was doing was something anyone could easily do. I had a trick. It didn’t always work, but it was reliable enough then to get me through tests.

Let me state this up front: I don’t have a photographic memory. It’s not like that. My memory is just fucking weird. I can remember random things that I’ve read once and just start rattling them off, word for word. Not always, and it has to be in the right situation. But when it came time to take a test, I was able to close my eyes, picture where I was when I was reading the material in question, what the book looked like, how I was sitting — a bunch of stuff that’s really hard to describe. I would quickly glance at the class material before a test (I read very, very fast), and most of the time, I could mentally picture parts of what was on the page, word for word.

I’m now aware that it sounds weird. I know that this isn’t normal. I can’t do this as much anymore. It’s probably partially because I’m much older now, but it’s also because I started medication to treat ADHD.

Because of ADHD and having a weird memory, I’m amazing at pattern recognition. If I was having problems getting to sleep because my thoughts were all over the place, I’d look at a sudoku puzzle, lie down, close my eyes, and solve it in my head. I really miss being able to do that. I’m still good at most pattern recognition, especially when looking at large amounts of data, but the ability to recall and visualize is missing.

I still have the ability to recall things like that sometimes, but it’s completely unreliable and unintentional. A few weeks ago, I was playing Overwatch and chatting with someone about that buff oil slick Olympics dude, and I started reciting a paragraph of an article about him that I’d read 2 days before, word for word. There was an awkward silence, and I realized what I’d done. Oops. Maybe I’m just a rain man for hot dude bods, but that’s the first time that’s happened in a while.

My mom still has my final report card right before I dropped out of high school: every grade was an F except for an A+ in romantic lit. I fixed the teacher’s email for him, and he was engaging and encouraged class participation on a level that kept me interested. (Come to think of it, that teacher also had a hot dude bod. Maybe I just remember things better when there’s hot guys involved? Requires further testing.)

I still go off my medication sometimes to try to keep my dosage down. I’ve got this genetic thing going on that makes me very resistant to medication. I have to take an obscenely high dosage, or I immediately fall asleep. If I take less than 40mg of Adderall (most people take a much lower dosage), I can’t keep my eyes open. Stimulants and I have a difficult relationship, and this looks like it has some very close ties to my memorization abilities. A very small percentage of people have the same problem. Fortunately, there are tests for that kind of thing. If you’re interested in brain chemistry, memory, and ADHD, read those links. They are fascinating.

Recently, I went off medication for a while and tried playing Overwatch, and I started to notice something that I hadn’t picked up on before.

I play video games a lot. Shooters have never been my thing because I’m way too tense. I can’t even play games like Left 4 Dead or Fallout without jumping out of my chair and getting really unhappy. However, I’ve been able to play Overwatch without that happening. Maybe it’s just too cute? It’s the first FPS I’ve ever been able to play for more than 10 minutes, and while I sucked a lot at first, I’ve been getting much better. I’m always hyper-competitive, so I play close attention to my stats: eliminations, deaths, damage done, and accuracy.

When I’m taking Adderall, my stats are garbage. I have no map awareness (when you are able to keep track of where everyone on the map is — your teammates and the enemy team). I hyper focus on one target. I can’t aim as well. My reaction time drops just enough that I can’t play a twitch or precision character (one that requires a fast reaction time & accurate aim).

It’s easy to realize these things in a video game because you’ve got numbers that back you up. It’s not so easy to recognize it in real life. The thing no one ever says is that ADHD is actually kind of awesome in some ways because we can process so many more inputs all at once, but the world isn’t built in a way that allows us to use it.

I know I’m going to be told by a bajillion people “Hey, you should try <medication> because it totally works for me!” — no. Please, don’t do this. Medication is different for everyone, and I’m working with a doctor now that I’ve got a more clear picture of how ADHD medication affects me.

Two days ago, I switched to Vyvanse. I’ve been on Adderall for well over 10 years. My dosage was just getting way too high, and something needed to be done, so I asked my doctor if we could try something else. It’s $300/month vs Adderall’s $20/month so I am figuratively dying inside, but it looks like it might be worth it.

Until now, Adderall has been the only medication that didn’t make me feel like hot garbage. Most take Adderall XR (extended release). This is largely because they just want to take one pill, and Adderall IR (instant release) tends to be abused and sold on the streets, so doctors are hesitant to give it out. I have to take Adderall IR. Because I don’t process it correctly, the half-life of Adderall is about half of what it is for most other people, and I end up taking a lot of pills throughout the day. With IR, I’m able to only take it when I really need it to be functional, so I can keep my dosage as low as possible.

Vyvanse is only available in extended release, so I was worried at first. The jury’s still out, but hot damn. My stats in Overwatch have never been better, and I haven’t woken up with a case of keyboard face from sleeping at my desk. I don’t really know why, because technically the genetic thing I’ve got going on should affect both medications the same way. I’m already at the highest available dose of Vyvanse, so if my tolerance grows, I’ll probably end up switching between Vyvanse and Adderall or taking a combination of both. Who knows? Brain chemistry is weird.

Final words for those of you that have ADHD: if you’re struggling at finding a medication that works well for you, don’t give up. Even though most of them are stimulant based, they all work differently. It’s trial and error. I’ve still got hope that someday I will be able to be good at work and video games and have a freakishly good memory about things related to hot dude bods.

If you’re medicated but still having problems with impulse control (yo, call out to my people that also had to disable amazon 1-click) or living in a messy chaos, that’s totally normal. Once you’re medicated, it takes a long time to unlearn that behavior, but really, you never completely get over it. You learn coping mechanisms. It’s a constant struggle to explain to a family member, partner, or roommate the little things about ADHD, like no, your keys must stay in a bowl on a table right next to the door, because that is where your keys live, and you need them to be there because otherwise they will somehow end up inside a box of cereal. Yes, that has happened to me.

Being diagnosed with ADHD doesn’t mean you are broken.

Being diagnosed with ADHD doesn’t mean you are bad at adulting.

You can make it through this.

You aren’t alone.