Inside the adult ADHD brain
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newsoffice.mit.edu
— The first day on Ritalin, you feel like you have superpowers. You are cold, calm, Spock-like, having laser-like focus. Unfortunately, brain adapt to this new state quickly.
— Later, you return to your baseline, but something changed. You can now actually learn things that you read in these countless self-help books while trying to understand what's wrong with you. Meditation? It works now! (Before treatment, I couldn't sit still for 2 minutes). GTD? Sure! It doesn't come naturally, you have to work to learn hundreds of things that were obvious for non-ADD kids, but now you can.
— You'll keep your insatiable curiosity and desire for new things. Otherwise, I wouldn't agree to the treatment.
If you have any more questions, I'll happily answer them.
When I started Ritalin (in my 30's, I think) I also become somewhat "Spock-like." This was a problem when talking with my girlfriend about some sensitive matters, as I was kind of detached and lacked empathy.
I also noticed that I no longer had a soundtrack running through my head. Usually I would have assorted self-invented tunes and riffs playing in my brain. That stopped and it really bothered me.
Before too long I became more adapted to the drug. The empathy and soundtrack returned. I eventually stopped taking it, though, because it didn't seem to make much of real difference as I became more acclimated. Even taking "drug vacations" didn't seem to make a difference.
I took Adderall some years latter and the positive effects lasted maybe a week. Very disappointing. Immune to speed; what a let-down.
At this point I just accept it as a fact of life that I have to work at managing attention and motivation and not get too depressed when I have a million unfinished things.
Life is too short, and I have a dance-party in my head.
Honestly, I would rather go without meds than have to take Ritalin every day. That stuff is plain awful. The long-acting meds are where it is at.
When I was first treated they started me on regular ritalin, and I didn't have any negative side effects, but it wasn't very helpful simply because it only lasted about two hours. Switching to Concerta worked much better for me because it lasts steadily throughout an entire day.
As far as the mechanism of action and side effects, I have the impression from talking with psychiatrists and my own reading that Adderall tends to be a bit stronger in effect than Ritalin. Ritalin is a dopamine reuptake inhibitor, which means that dopamine remains in the synaptic cleft and continues to stimulate dopamine receptors. On the other hand, Adderall (amphetamine) is both a reuptake inhibitor and a releasing agent for dopamine, so it stimulates the release of dopamine into the synaptic cleft and blocks the reuptake of dopamine, which causes dopamine to remain in the synaptic cleft for a longer period of time as with Ritalin. The wikipedia links on the mechanism of action for each drug are helpful: https://en.wikipedia.org/wiki/Methylphenidate#Pharmacodynami... https://en.wikipedia.org/wiki/Adderall#Mechanism_of_action
Some knowledge of how synapses work may also be helpful: https://en.wikipedia.org/wiki/Synaptic_cleft#Structure Basically, neurons secrete specific chemicals to transmit specific messages to other neurons, and other neurons have specific receptors that bind to those specific chemicals. Increasing the release of messaging chemicals like dopamine will increase the strength of the "message", and preventing the chemicals from being reabsorbed back into the neuron that originally sent the signal allows them to bind repeatedly to the receptors on the neuron that receives the message, which also effectively strengthens the message. Dopamine itself plays a number of roles in cognition, which makes me suspicious that ADHD medications that operate on dopamine release and reuptake are probably a little more of a "shotgun" approach to dealing with ADHD symptoms than would be ideal, but their effectiveness in dealing with the symptoms is very well established. https://en.wikipedia.org/wiki/Dopamine#Attention_deficit_hyp...
This is a really simplistic way to describe the mechanisms, but the impression that I've had is that Adderall tends to be a stronger drug because it acts on more than one mechanism (both stimulating dopamine release and blocking its reuptake). For me the extended release methylphenidate has been extremely helpful, so I haven't been concerned about trying any other ADHD medications.
Disclaimers: YMMV, consult a psychiatrist for actual medical advice and explanations of the mechanisms of these medications, etc...
- I started to constantly feel nauseous
- I started to feel vary anxious about everything
- I had a hard time eating or wanting to eat anything
- I started to feel overloaded by my environment
Got off of it and lost some of my super powers, but gained my sanity. Which was worth it. Converted over to understanding my strength and weaknesses, eating better and getting out.
I'm taking the dose determined after some experiments (27 mg/day) for the last 6 months, and I don't feel particularly insane. Anyway, like I said, it works differently for different people.
It can be useful to pay attention to when a drug is triggering anxiety; just in case you go on to try other meds in the future.
What you write really gives me hope, for now my neurologist put me on Wellbutrin mainly to treat my depression but he said he really wants me to try Ritalin soon.
I'm one of those people who rather meditates and works out regularly than to take any drugs - I don't like to mess with my brain - but I'm so fed up with my ADHD and the Wellbutrin alone already helps not only with overcoming my fail(ed-potential) derived neurosis but also a little with focus.
Do you feel as if Ritalin might help with getting to where the ADHD recovery group managed to get themselves even when not on Ritalin? "Plasticity of the brain" yadda yadda...
> I'm one of those people who rather meditates and
> works out regularly than to take any drugs - I
> don't like to mess with my brain
Meditation, exercise, diet, getting lots of sleep... these help me more than Adderall. BUT, the Adderall does help too. So I think you are a very good candidate. It sounds like you are thinking of the big picture and not just relying on Ritalin to be a "magic pill."
Probably the best thing about trying Ritalin/Adderall is that you can always stop them if they're not helping you. Just reduce your dose slowly over the course of 3-4 days.
Good luck!!
So regular exercise and meditation? Check. Discipline with my diet? Check. Proper sleep hygiene? Check. Still fed up? Check.
Thanks for your always-uplifting comments, they are very much appreciated.
Exercise feels like it helps my ADHD in indirect (but important) ways.
Exercise boosts my energy level, and reduces my stress level in general a bit. I also sleep much better at night if I get exercise during the day. The sleep, of course, helps with everything else as well.
I salute you for having discipline with your diet! That's the hardest for me!
I've been on a vegetarian diet for about 10 years and it helps me with attaining more of an "inner calm" / reducing my constant inner agitation but that wasn't the reason why I picked it up originally - it's just a very welcome side effect for me. I could definitely improve on the health side especially when I get the blues, like I've been having for the last couple of months - I tend to binge excessively on sweets (which for me is worse than being on too much coffee in terms of ADHD symptoms) and processed junk food. I feel really great on low GI foods, so usually I eat lots of beans, fruits and vegetables. I also try to take my vitamin b12 supplements as well as my ground flax seeds regularly (omega 3) and have some organic eggs or cheese now and then. I've been on half-year long, strictly vegan diets twice over the years but ran into health issues (iron, vitamin b12 deficiencies -> anemic) each time probably because my discipline and knowledge were limited then.
I feel there is so much chance involved with picking up the right habits - e.g. if it weren't for Vibram's Five Fingers (I know they are not as healthy as they were advertised but I simply love the feeling of running "barefoot") and all the quantified self apps on smartphones I probably wouldn't be running today. It's all the little things that keep me motivated.
I'm one of those people who rather meditates and works out regularly than to take any drugs - I don't like to mess with my brain
Something to consider is that your brain is already messed with, so the use of drugs might be needed to un-mess it. But it's kind of a black art. You need to try things and see what works for you.
I had been on assorted antidepressants and stimulants for a number of years and it really helped to a) read up on neuropharmacology and b) have doctors who would listen to my suggestions about what drugs to try and why I wanted to try them. For example, it's handy to know if you respond better to drugs that focus more on dopamine than, say, serotonin.
(The reality is that no mind-altering drug is so cut-and-dry and completely understood, so you end up being a lab rat in your own life experiment.)
Absolutely. I came to this conclusion after a few months of therapy and reading several books about ADHD (Driven to Distraction was the first of a rather deep rabbit hole). I was terrified that I'd lose that creative spark I always held unique, because that's what previous psychiatric medicine had done to me.
Bupropion (Wellbutrin) isn't just a dopamine reuptake inhibitor: it's also a norepinephrine reuptake inhibitor and a nicotinic acetylcholine receptor antagonist (which is why it's also prescribed for smoking cessation). It didn't work with me. I was calmer, less hyperactive: but I had a flat affect. I could concentrate on busywork, but I couldn't think. It also wasn't prescribed for ADHD: it was the second attempt to treat a (non-existent) bipolar disorder when I was 15. I'm pretty sure (at this point) my neurochemistry is such that my reuptake rate is fine, but my release/synthesis rate is much too low. Which is why a reuptake inhibitor seemed to only work part way.
The first tried, however was Depakote. In extreme cases it's prescribed to stabilize mood and impulse control with ADHD. It's usually prescribed to quell manic episodes and control seizures. I only dully remember my time on it. I do remember being in a constant fog, a miasma - while I couldn't really think straight beforehand, I could barely think /at all/ on that medication. I was on 900mg/day. Given my bodyweight at the time, my plasma concentrations were probably well above the typical controlled therapy concentrations of 100mg/L. It was probably closer to 200mg/L, which explains the stupor and slight tremors I had.
Given its pharmacology, I can't see how it is, in good conscience, prescribed to those with ADHD unless a manic skewed bipolar disorder is also present.
But the story of why they were absolutely convinced I was manic/bipolar is another thing entirely.
Both Ritalin and Adderall are dopamine reuptake inhibitors. I believe that Adderall also stimulates the production of dopamine, in addition to the reuptake inhibition.
Methylphendiate (Ritalin) is a dopamine reuptake inhibitor, to be certain: it binds to and blocks both dopamine and norepinephrine reputake inhibitors. It's thought to increase neuron firing rate, but that mechanism of action is unknown.
Adderal, however, is a mixture of dextroamphetamine and levoamphetamine salts. They stop reuptake of the two monoamines not by blocking the transports, but by reversing their action. Instead of taking up dopamine and norepinephrine, they pump it out. It also stimulates the release of the monoamines from the synaptic vesicles into the intracellular membrane.
Ritalin causes dopamine and norepinephrine to stick around longer, making their action last longer. It's like closing a drain half way with the faucet on medium: the water level rises more than typical, but no higher.
Adderal causes them to flood the intracellular fluid. It's like turning the faucet on while flood waters are coming up the drain pipe.
Yes, it's truly interesting to read up on all the "wetware" aspects while trying to introspect on how the medication affects you accordingly.
The whole thing feels like finding hacks to make your mind work properly.
I briefly tried Wellbutrin as an alternative to Ritalin a couple of decades ago and I did not find it helpful then. On the other hand I find Ritalin really does work for me and in ways that meditation and exercise simply do not.
I'm not saying that meditation and exercise aren't helpful. They're important parts of my life (/ coping strategy). It just that Ritalin is also part of that strategy. In fact, at this point in my life I view using Ritalin much in the same way as wearing my glasses and hearing-aids.
That feels like an apt analogy, I'm looking forward to see how Ritalin works for me.
ADHD is a recognized neurological condition, and I believe it's better to remedy it with drugs than try to live with unadjusted brain. It's not our fault.
Caffeine effects are somewhat different — Ritalin gives me the ability to think clearly and plan more long-term, caffeine just makes me more alert (a good thing, too).
I am far from being cured, though.
- I experience an extremely severe crash in the evenings (attention issues worse than my baseline, depression, anxiety, and lethargy to the point that it's difficult to start any non-trivial task) which I manage with anti-depressants and beta blockers.
- I become physically dependant on the drug after about 5 days of constant use. After discontinuing use, it takes approximately 4 - 6 weeks for the withdrawal symptoms to go away and to return to baseline.
- Excessive dosages (can be caused by not taking my medication for a few days then restarting) cause symptoms similar to mania, aggression, anxiety, social withdrawal, sweating, and racing heart.
My medication helps me live a normal life as a software developer, but I respect it for what it is - a powerful, physically addictive narcotic with potentially severe side effects. I know that it's become in vogue for professionals and students to take prescription stimulants as performance boosters, but it's important for these people to know that these medications can be very dangerous if abused, and are certainly no where near the safety and side effect profile of caffeine.
And unlike coffee, with a little determination it's physically easy to ingest enough Adderall to do serious harm. (Although that's pretty much true for any medication in pill form.)
Were it not too late to edit my post I'd amend it to say that.
I definitely believe your experiences! However, from all of my reading and anecdotal reports from friends, I believe your experiences are not the norm.
> I've taken Adderall XR for several years... I experience
> an extremely severe crash in the evenings
I didn't crash as severely in the evenings as you report, but the XR seems formulated to give about 8 hours of efficacy and that wasn't nearly enough for me. I now take 7-8mg of Adderall (non-XR) three times a day: morning, noon, and late afternoon. Sometimes more if I need intense focus... less on the weekends.
> After discontinuing use, it takes approximately 4 - 6 weeks
> for the withdrawal symptoms to go away and to return to baseline.
With the non-XR Adderall, I have much more control over my doses and can gradually reduce my dosage day by day.
The coffee worked well. Entering highschool I couldn't stand coffee and didn't do anything to address the ADD symptoms. In college I powered through on other caffeinated beverages. I now enjoy the occasional cup of coffee (1-2 cups a week) and can definitely tell the difference in my ability to focus when I've been drinking coffee and when I haven't.
35.
That seems like a surprisingly low number from which to draw broad conclusions of brain activity for adults diagnosed with ADHD when they were children.
Hypothetically, if this study was undertaken in small-town Wisconsin, and genetic factors could even remotely be involved, the samples wouldn't be representative in the slightest for most genes in the world.
It's good that you question it, it should always be one of the first questions asked when looking at these sorts of statistics.
I was just pointing out that the number 35, by itself, is plenty to justify a conclusion, and because perfect uniformity is not completely possible, more tends to be better. If the conclusion is faulty, it isn't typically due to the sample size of 35 being too low.
"Historically, the very first demonstration of the t-test (in "Student"'s 1908 paper) was in an application to sample sizes of size four. Indeed, obtaining improved results for small samples is the test's claim to fame"
It's quite possible that a number of these "cured" people were just misdiagnosed in the first place.
35 isn't all that terrible, either. An estimated 10 million adults have ADHD (although that sounds bogus to me), and plugging that into a calculator with a 95% confidence, that gives a confidence interval of 16.5. Not sufficient for definitive proof of anything, but still meaningful.
(I was only diagnosed with ADD at 40)
The thing is, ADHD seems to be a catch-all diagnosis for people having attention problems, and yet there might be multiple conditions that give rise to symptoms similar to classic ADHD. Consider SCT[0] for example. I know that Russell A. Barkley, who is a leading ADHD researcher tends to believe that "real" ADHD is the one that begins with hyperactivity symptoms in childhood (children diagnosed with the hyperactive-impulsive subtype), and those that don't have those symptoms (diagnosed with the primarily-inattentive subtype) have a condition called SCT, which is separate from ADHD.
The second part of your question is complex. I will say that brain chemistry changes throughout ones development and neuroscience has a much better understanding of how that works. Though, we are far from a succinct explanation of how it all fits together.
Also, all sorts of activities, meditation and neurofeedback, have been shown to alleviate some of the symptoms and problems of ADHD, even without medication. That means there should be a solid chance for someone with ADHD training their attention capabilities more or less "accidentally" over the years.
But still, treatment, even medication, is a much better proposition than waiting 10-20 years for a cure that might or might not come.
I don't think you really "cure" a particular brain configuration. You work with it and around it.
Japanese Goju Ryu Karate practitioners train under freezing waterfalls to hone their focus. I did very similar training and went into a meditative state. It is very extreme and you can go into shock if you're not careful, but it allows you to reach ultimate concentration when done properly.
I'm still super ADD, but use it as a strength and not a weakness. Why? Because I can multitask better than just about any of my coworkers as I am forced to.
In the meantime, most children with ADD will develop depressions, suffer social problems, beat up on their peers and achieve much lower, academically, than necessary...
We'd expect the brain scan of someone who had never played piano to look different from a later scan after they learned to play piano.
So, a problem I have with this kind of article is that by concentrating on words like "disorder" and "remission", they kind of imply a passive response.
Learning to control yourself is an active process, and once you're at the level of the median person, do you have a disorder, at all?
Turn off the idiot boxes(TV, Internet, video games) and go do something tangible that requires action instead of passive observation. It's amazing what can be achieved when you're not dulled by sensory input overload. Be warned, this is not the path of least resistance, it will take EFFORT!
edit:stuff
it will take EFFORT
In some ways, that's like telling a person suffering from a growth problem to just make the effort to be taller rather than taking growth hormones. Maybe someone with a spinal injury should just make an effort to heal. Maybe someone with Parkinson's should make more of an effort not to stutter and twitch.
The reality is that many of the behaviors you'd like to believe are strictly efforts of will are composed of complex chemical interactions in the brain that can be hampered or helped with the addition of other chemicals.
Some things can be altered through effort, but completely dismissing the proven medical condition some people suffer from is inappropriate when discussing matters of the brain.
FTFY
As for chemical imbalances, yup, many suffer from extreme divergence and undoubtedly need therapy and meds. There are, however, a lot of 1st World hypochondriacs and lazy folk, as well. People who sit sedentary for large blocks of their daily life consuming input that requires little effort and yet gives them a sensation of drama/humor/fear/lust is absolutely consequential to how their brains develop over time. I'm yet to meet an ADHD person who cannot muster the will power to never miss their "shows" or spend countless hours with a game controller in their hand...
That's a lot like telling someone who is learning to walk again after an injury that they don't need those fancy "crutches" or "slings" that pansies use - people with real gumption just hop out of bed. If they break their noses a few times along the way, they just need to remember that they aren't taking the path of least resistance, and that it's a sign that they aren't weak people.
I'll probably be starting medication management in about a month, after 31 years worth of trying to make it work for myself. It was manageable previously because I had lots of structure provided to me to lean on - from school, from bosses, whatever. Now that I'm the one providing structure for myself and others, I've found that I simply can't function. I've tried for three years to self structure with all the self-help you can think of. I don't want to be medicated forever, but I really need something to help me focus just a little bit so that I can develop good habits.
An important factor is that differences are objective, but disorders are to an extent subjective and socially relative.
I.e. 20 years ago I was a guy with ADHD who was having trouble concentrating on school. Now I'm a successful creative with hit products on the market. Yes, I've definitely developed new skills and damped down bad habits, but part of my success has been to choose a playing field where I have the advantage.
Finally, I should say that there's no silver bullet (not even turning off the "idiot box", etc.). For me, it's been a slow accumulation of skills, weeding out of bad habits, picking my battles, and fixing sleep problems.
An ADHD diagnosis can be helpful initially in that it connects you with a body of things to try out. I think it's important to move beyond that label, eventually, but it's a gradual process.
The study does seem to correlate with the existing diagnostic criteria.
What if it were normal to have diagnostics like tumor detection at a very early stage made possible by your bed = MRI machine in disguise.
Something like that would be phenomenal - daily diagnostics and now and then introspection plus treatment for things like the mentioned executive function impairment.
Additionally you need a very homogenious magnetic field. This is accomplished by rotating the field very fast by rotating the reels (part of why the machines are so loud). If we find another way to fix this or find a way to deal with it (possibly a supercomputer with supersoftware) cost and size might go down. But this was the best solution available which indicates the size of the problem.
[1] http://en.wikipedia.org/wiki/Magnetic_resonance_imaging#How_...
It's been a long road to medication for me.
I was sexually assaulted as a child. My parents divorced when I was a fourteen. I spent three weeks over christmas in a mental hospital with an incorrect bipolar diagnosis when I was fifteen. I basically ran away from home seven years later when I moved to where I am now.
Things were tough the first year. They got better after that, but over time my addictions took their toll. I struggled with alcohol abuse, tobacco addiction and constant marijuana use -- and a pervasive question of, "where did all my money go?"
My professional life suffered for years. The first few months on a job I would do extraordinarily well. But things would slide. I'd end up reading HN, reddit, digg, tumblr instead of working.
I'm lucky at my current position: I've been here for over four years now; I've made it through two buyouts of the company and one CEO resignation.
It's the longest time I've ever spent at a single job.
A year and six months ago I moved in with a person who I'd always thought was my best friend. I didn't know that I'd end up co-dependently (financial, emotional, et cetera) supporting their own addictions. They couldn't remember entire conversations we had only a day later. I took a long look in the mirror and started to see the negative aspects addiction in my own life. My room was never clean. I had clean clothes maybe four times a year when I got off my ass to bring them to the laundry room (in the basement of the apartment building -- a quick elevator ride away). I wasn't brushing my teeth regularly. I could barely get to work on time, and I spent all my free time drunk, stoned or both -- and binging on netflix and hulu and porn. I had dozens of empty beer bottles lining my desk, the floor... and I constantly complained that I didn't have the time to work on the things I spent all my time dreaming about.
I started seeing a therapist. I moved out soon after, into my own place with my own lease.
Four months after moving out, I was still binging occasionally but not eight bottles of beer a day. Not smoking (either tobacco or marijuana, but holding onto my e-cig like a safety blanket). But my place was a mess. There were boxes from the move that I hadn't unpacked yet. There were other boxes that were flattened but not taken out. Recycling was everywhere. Dishes were piled in the sink. My clothes hadn't been laundered in two months. I spent my free time distracted by TV, distracted by books, distracted by computer games, distracted by anything I could get myself distracted by -- if only to escape from the shithole I called my apartment (in fact, it's quite a nice place). My therapist was concerned because I seemed to lack an 'inner parent.' I just passively was, instead of actively be.
Even when I was watching TV, or reading, or listlessly listening to music, I wasn't actively involved - my mind was elsewhere. I had a thousand trains of thought in my head, and nobody minding the switch. It was as if my brain was a room lined with televisions, each of them changing channels at random with the volume turned to 11.
I made an appointment with a psychiatrist, and was quickly diagnosed ADHD and put on Adderal. I was rather surprised, considering its potential for abuse and my history with alcohol and other drug abuse.
Over two weeks my dose was increased from 5mg a day to 25mg a day (15 in the morning, 10 in the afternoon). More than that and I felt too jittery.
All of a sudden it was like I had control over the remote control for that wall of televisions. I could choose to turn them all off and focus in on one, and even modulate its volume.
I could notice when I was getting distracted, and refocus myself. I was able to introspect without falling into a spiral of self doubt, self pity, and self loathing.
I don't binge anymore. I now realize that alcohol binging was self-medication - it was a way to dull my mind enough that it wasn't buzzing with overactivity. The last time I tried marijuana, I realized what it actually did was the precise opposite of what my Adderal did. Now that I know what it's like to actually be able to concentrate on something, I have no desire to use a drug that absolutely obliterates my ability to concentrate.
I still struggle with the urge to drink heavily, but am actually able to have only one or two beers with a nice dinner out on Saturdays. Booze on weeknights is a big no-no. I have a very strict schedule I stick to after work, because if I stray from it I have an extraordinarily difficult time sleeping. I miss my drinking buddies, but I also feel the desire for friendships that are more than planting your ass on a stool and getting shitfaced together. My nicotine intake is down from 72mg/day to 36mg/day. By new years, I will be nicotine free. Marijuana use is nil.
I was diagnosed ADHD at age 29.5. I have years of therapy ahead of me. I struggle with disappointment with my family for not seeing it and helping me. I struggle with disappointment in myself for not being stronger.
It may be overdiagnosed in some children, but it can also be underdiagnosed. And the impact of not knowing what the hell is wrong with you is more devastating than anything I can think of.
I am constantly tapping my toes or fingers, biting my nails, clicking my teeth to the beat of a song stuck in my head, etc. My knees even get sore from tapping my foot/shaking my leg while driving in the car. I've been wondering for some time if I suffered from ADHD but didn't want to self-diagnose, and I was too lazy to look for a doctor. Finally set the appointment two months ago and I am ecstatic about finally speaking to someone about it.
One thing that really struck a chord with me was your description of alcohol consumption. Some of the the best stretches of productivity in my life have been when I was holding a buzz after two beers, or the week I was taking Vicodin for a wrist injury. It's like they calm my brain down enough to let me get things done.
I also feel like many people just shirk it off as me being lazy about doing things. Want to study for that certification you've been talking about? Just sit down and do it; turn off the distractions and get to work! It isn't that easy, yet I feel guilty when people think of it that way, even though I know there's more to it.
Thank you for sharing your experiences, it has given me some hope that I might be able to get some help with this.
Please keep in mind that if you are diagnosed ADHD: medication, if directed, is only one part of living with it! A comprehensive treatment plan is absolutely necessary. You can't just pill it away. A lot of my treatment so far has been forming healthier organization habits, especially around time use. I had the plan before I started the medication, but I felt like my transmission was stuck in neutral. For me, at least, the medication a facilitator for the cure, not the cure in and of itself.
I do agree with medicating ADHD, though. When I first started treatment (~7 years ago), I felt like I was finally on an equal playing field with my peers -- I could use my brain normally/efficiently.
I was just prescribed Ritalin yesterday, and you've made me hope that this will be the one that actually works thanks.
For me, I was diagnosed when I was in 4th grade, but my mother didn't want to medicate. I was able to more or less cope a little bit while school and such gave me structure - I was able to cope as long as school provided me with strong structure. But as soon as all that structure started to dissolve I began to struggle quite a bit, and three years ago any structure provided by others all but dissipated.
Thanks for sharing.
It took about a month from diagnosis to beginning medication- my psychiatrist wanted to look into my previous hospital stay, have conversations with my therapist: there was definitely an unspoken worry about my past alcohol abuse.
This.
I skipped three grades in elementary school and was used to thinking of myself as a prodigy, but when it came time to study things that weren't immediately interesting in University -- I kept feeling like I was fighting some "other". Hmm. I like compilers, and I've got an exam tomorrow, and I know I should study, but let's just play one more round of Unreal Tournament (and I know I'm BSing myself that it's just one more round, but F-it).
When I first started ADHD meds (Dexedrine + Wellbutrin) it was like that experience where you suddenly realize that the room has gone quiet, but you don't recall precisely when. Normally, I'd have a ghostly music video running in my head just below the level of consciousness. Thoughts darting, snippets of music, visuals. All that was just gone and I was just there. Kind of like a flow state when playing sports. It was very interesting.
I eventually developed side effects to the meds, and stopped taking them. In the decade since, I've been diagnosed with severe sleep apnea. I'm treating that with a CPAP machine, and the results have been incredible. I can still go down research rabbit-holes, but generally have much more control over my executive functions, and I don't fall asleep at my desk every afternoon. Note that at the time of the ADHD diagnosis, I had borderline sleep apnea, not severe.
So, now I don't really consider myself to have ADHD. Aside from any possibly incorrect diagnosis due to sleep apnea, I feel that it's important to go beyond labels.
Identifying with a label is the first stage. Ok, now you've got an explanation, and a body of knowledge to help. But, I feel the eventual goal should be to move beyond that label. This is where the ADHD as broken leg analogy breaks down. We can't (AFAIK) heal a broken leg only with our minds, but I think we can develop enough skills and life experience to turn "you've got ADHD" into "you're creative and slightly impulsive".
EDIT> One strange attentional trait that I've still got is that I hear everything. Like, I thought I had super-human hearing for a while. It's not, but it makes open-concept offices extremely annoying. Co-workers are constantly surprised that I can hear their conversations from 40 feet away.
I know what you mean. I've used the analogy of having a plethora televisions on in my brain, all tuned to different cacophonous channels with the volume to 11 and no clicker. The medication gives me a clicker, so I can turn all the ones I don't want to pay attention to off. It doesn't get rid of my distractions: it gives me agency over them.
>This is where the ADHD as broken leg analogy breaks down.
I don't like that analogy one bit -- it implies that something is broken in me, and once it's fixed I'll be okay after maybe some physical therapy. Something isn't /broken/, my executive functions are /impaired/. Fixing that negative brings a host of positives with it: my brain makes creative connections all the time; my problem solving abilities are fantastic (even more so now that I have agency over those abilities instead of just letting them 'percolate' while I distract myself); yes, I'm a little impulsive -- but that just keeps things interesting ;)
Managed ADHD is a boon. Unmanaged, untreated, undiagnosed ADHD is crippling.
I understand what you mean about hearing everything! It's odd, because often I have to ask people to repeat themselves, but it's not because I have a hard time hearing. My 5th grade teacher even had me tested for hearing difficulties. The truth is I hear too well (even after years of death metal concerts attended sans ear protection) ... and I can't necessarily tune other stuff out (or my own thoughts) well enough to actually pay attention to what someone has said.
I think it's telling that I can still hear the refresh rate on most CRTs at nearly 30 :)
I neglected to mention that for a good five years or so I experimented with just about anything I could get my hands on: research hallucinogens (2CI, 2CH, 2CB, 5MEO-DMT in addition to LSD and mushrooms), cocaine, dextromethorphan hydrobromide, various opioids...
Alcohol, nicotine and my distractions were my addictions.