The medication removed the issues I had with focus in 6-hour intervals, but it didn't suddenly make me a better person.
I still feel like a person whose character is underdeveloped. My life in the present is a blank slate. Not many ideas come to my mind, and I feel as if I've closed myself off to everything.
The fact is, when you read things like books on developing self-esteem, the issues make no mention of ADHD specifically in the context of the larger issue. ADHD can be a single detrimental component in a life that is, on the whole, dead and unfulfilling. It might have been part of the reason for that unfulfillment, but you still have to put in effort to go outside and meet people, or choose which books to read, or decide what's interesting to you. The medication at most gives me the opportunity to make that choice, a choice which I can then deliberately refuse.
It's damn near impossible for me to stay positive or see the value in accomplishing things. For example, I can't seem to decide if the fact that I lose interest in video games after a day, on medication or off, is because of a lack of executive function or the fact that I've spent my whole life beating myself up over losing, and still remember even the smallest losses years later in excruciating detail. Or maybe it's something else entirely. The loss of interest could be explained by multiple factors, and maybe all I've done at this point is break through the first barrier. It's my responsibility to decide what narrative makes the most sense, and act accordingly.
I think the diagnosis has given me a license to stop taking responsibility for a lot of things. I can deliberately stop taking the medication and point to me stopping as the reason I didn't do X today. Why didn't I do X? "Because I'm not the kind of person that is able to just do X." That's the default mindset I carry, one that has persisted for well over a decade before I was diagnosed with anything. And now that I have a diagnosis I supposedly have concrete evidence that I can point to so I can claim that mindset has been justified the whole time. And it's easier for me to keep confirming that attitude by sabotaging myself than changing it.
My problems extend far beyond the limitations imposed on me by something like ADHD. The diagnosis did not flip a switch that let me proceed on to a productive, fulfilling life. It gave me crucial knowledge about some of my behaviors that has materially benefited me, and it also gave me ammunition which I can use to absolve myself of responsibility in unproductive ways and delay my self-improvement further and further.
Honestly, I'm most inclined to believing the people that respond to my grief with things like, "well, in the end, living life as an adult is hard. Take responsibility." Those people include my current therapist, and I don't think she's incorrect in saying that. I can't count how many times I've wished someone would essentially come along and help me, by drawing over my blank slate with new ideas that I can pursue and new modes of thinking to believe in. No such person is supposed to appear. I still don't have someone I can always feel at ease communicating with, as equals.