Me and ADHD

I didn't get diagnosed until my late 20s, so I feel like I can articulate some of the differences. One of the things that contributed to that is that I am incredibly lucky in that math, statistics, and computer science are the things that most capture my interest. It never really manifested itself in my school work until now, graduate school, where things become a lot more open-ended and self-driven. I need incremental goals or I start to flounder.

I went to the doctor for depression, but she said that it seemed a lot like diagnosed ADHD (which often manifests itself as depression because of dissatisfaction with many aspects of your behavior). Before I start that I'd like to say something that the psychologist that evaluated me told me. The key aspect to ADHD is the dysfunction it causes. I'm not a psychologist or a doctor, but basically the thing that clearly signifies ADHD is the severity of the negative impacts in different aspects of your life.

For me some things that I always hated about myself and frustrated the hell out of other people:

She would ask me to do things and I'd completely forget about them after she left for the day. She'd call on her way home and it would immediately trigger my list of things I was supposed to do. I'd stress out and rush to do them before she got home. It wasn't that I didn't want to do them, or that I didn't care enough to do them. It was that they literally never entered my mind without an external trigger. I tried writing todo lists, and I would just not look at the todo list.

On the opposite end of the spectrum, if something is interesting, I can literally sit in my chair for 20 hours without eating or drinking. If someone tries to talk to me, I literally do not hear them. I don't ignore them, I just don't hear it. This was a lot worse when I lived by myself. I would regularly sit down in the morning to do something and find that I'd completely forgotten to go to class, eat, drink anything, and that it was now 7 in the evening. If I was lucky, then the original task would be complete or almost complete. If I wasn't then I'd spent the last 10 hours weighing the pros and cons of various ways to properly install python on a fresh computer (venv, virtualenv with or without virtualenvwrapper, etc.). For my uses, it literally does not matter, but I've still done this multiple times. I've spent way too much time responding, in excruciating detail, to Reddit/HN comments when all I'm going to get out of it is, "Cool. Thanks."

I know this can sound like standard procrastination, but I absolutely don't want to do these things. I have been in so many arguments about forgotten obligations or accusations of ignoring someone. It's so frustrating. You start to see yourself as someone that's unreliable and incorporate being forgetful and flighty into your own self image.

I and my wife were pretty skeptical at first, but, after my first month on medication, I took care of so many important things that I just hadn't done for years (like applying for the master's degree that I earned as part of my PhD) and got more done on my dissertation than I had in the last four. It's still not easy, but it makes it easier for me. I can actually remember to look at all the lists I make now, and I can stop myself after 10 minutes of an obsessive rabbit hole now instead of after 10 hours when my bladder is bursting.

It's not about cheerfully being able to do things we don't want to do. It's about actually remembering to do them. ADHD isn't about not being able to pay attention to anything. It's about not being able to regulate the things you pay attention to. It's about being able to even out the deeply obsessive blessing/curse attention black hole that is your natural state.

I have ADHD, and I've been treating it with meds for over 15 years now.

> dosage should not make you feel "high" -- if anything it's almost the opposite

Even when I was young and fit, many years before I started taking any meds, my blood pressure and pulse rate were consistently on the high side. I've always had what could be called somewhat of a 'jittery' or 'high strung' personality.

In my 30s, I started taking a low dose of Ritalin, and it made a hell of a difference. For the first time in my life, I was actually, fundamentally calm. I gathered some pretty detailed data over a pretty long period of time, and there was an iron-clad correlation: when the Ritalin was in my blood stream, my blood pressure and heart rate were lower.

> most ADHD people develop tolerance to medication over long periods of time

From the beginning, in order to defend against this possibility, I always took the meds sparingly, only on work days, and not all of them. For a number of years, I organized my schedule around taking the meds three days a week. On those three days, I did most of my deeper, focused software development. On the other work days, I'd focus more on meetings, digging into operational issues, troubleshooting, basically everything except deep focused software development.

Prior to starting the meds, I had many successful years in technology at various organizations. That continued after the meds, but with one big difference: while I was able to sit down and focus before the meds, it took an enormous amount of effort and energy. I'd come home from work and immediately nap for an hour before waking up with enough mental energy to go about the rest of my evening.

On the meds, my total ability to focus was roughly the same, but it didn't take nearly as much energy. A 9 hour day at work would not leave me drained.

I've always had the fortune of having the prescribing docs break up my maximum daily meds into many small dosed tablets, which gave me a lot of flexibility.

Thankfully, after all this time, the meds still work very well for me.

> Are there really people out there who can cheerfully do things they don't want to do?

It isn't about cheerfully doing it, it is about most menial tasks being impossible to do without days or even weeks of mental preparation and/or lifestyle changes. Imagine filling out a paper form causing as much anxiety as proposing to the love of your life and you understand better what ADHD feels like. You can learn to live with that, but if you have it you are pretty sure not everyone feels like that all the time.

I have undiagnosed ADD. I know partially because I observe my own behavior, but also because once at a party I took adderall and while everyone else frantically danced themselves into a heavy sweat, I was compelled to go into the kitchen and do all the dishes and reorganize my closet.

I don’t like how stimulants make me feel, even though I know they might make it easier to fit into society. It is probably hard to describe how they make me feel to someone who does not have the underlying condition, like trying to describe how it feels to get a prosthetic arm to someone who has never lost their arm to begin with.

Compared with other people, my internal experience/world seems frantic. If I sit for more than 30 seconds alone without my phone I will have wild daydreams—-my mind works kind of like the old website StumbleUpon. Or like being in a crowded restaurant and trying to follow everyone’s conversations. My favorite quote regarding ADHD: “my brain never takes the same route twice”.

But I don’t think that stimulants make me have a “normal” experience like “normal” people do. Yes, on one hand the increased dopamine means that I am actually able to maintain a mental checklist for more than 5 minutes. I’m sure I would be the best employee ever, and the yessiest of yes-men. There is an element of taking stimulants that feels just like putting on noise-cancelling headphones and produces the same focusing effect.

But there is also a dark side. I can’t relax. I feel absolutely driven to accomplish things. The outside world impinges so much more heavily on my mind. My access to my intuition and creativity are diminished. My jaw is clenched. Instead of forgetting to eat like normal I am just not hungry, my stomach is churning. It makes me feel like a golem. There is a chance that minus the physical side effects normal people do feel this way mentally, but it is so much more sterile. It’s like trading the lush forest of imagination for a cubicle farm of execution.

My personal theory is that ADHD is just at the far end of the normal distribution of personality and that it is a trait that is very useful for raising children. In a real way there is a childish wonder that I have never lost, even as I see those around me “grow up” (i.e., become rigid). I have heard other theories regarding it being adaptive for hunting. Either way, I enjoy my existence as a space cadet. My whole life is shining with such a rich and imaginative inner experience and I don’t think I owe it to anyone to dim that brightness just so I can fit into their terribly boring, rigid, and repetitive world more easily.

I would down an energy drink when needing to do long drives and would have a calm, almost euphoric, feeling. Definitely not stimulating.

Similar to the feeling (although much weaker) hydrocodone gave me after I had oral surgery.