How it feels to be properly treated for ADHD
Look, I don’t think I’m exaggerating when I say that today has been a revelation. I’ve cried. I’ve sat still in endless awe. Today is my first day trialling medication for ADHD, and thus, my first day of understanding exactly how needlessly difficult everything has been for me my whole life.
This is that story. I had to write it down somewhere, and for once, I have the focus I need to do it.
—> What the heck is ADHD?
ADHD stands for Attention-Deficit Hyperactivity Disorder. It can be a hard thing to understand if you haven’t experienced it yourself, or if you haven’t watched anyone else struggle with it, because most official descriptions only mention observable hyperactive and impulsive behaviour, with very little mention of what it’s like inside the person’s brain. Most people think it’s a disorder that can only affect children, because most people think all ADHD means is that you have trouble sitting still for long periods of time.
Fun fact: ADHD is so much more than that, and if it goes completely undiagnosed in a child, which happens more often than you would think — especially in female-presenting children — then surprise! It doesn’t magically disappear. It just adapts, and presents differently. So-called ‘adult’ ADHD is an area of burgeoning research, both in people who were diagnosed as children, and — most importantly for me — in people who had absolutely no idea they had ADHD until they were adults.
Which was me! I only got diagnosed today. (Yesterday, depending on your timezone.)
—> So what’s it like living inside an ADHD brain?
ADHD is, at its core, a failure of executive function.
Executive functions include decision-making, planning, and prioritising tasks, which are all derived from foundational functions including awareness of time and self-regulation. In a neurotypical person — which here means a person without ADHD or other mental health difficulties — when a decision needs to be made, you make it, whether it’s as big as ‘should I go skydiving with my friends tomorrow’, or as small as ‘do I want beef or pork for dinner’. If something small or easy needs to be done, you do it without thinking too much about it. If chores aren’t getting done, it’s likely because you’ve consciously decided you don’t want to do them. You have an idea in your mind of how long tasks take, and you’re able to prioritise accordingly, whether by writing out to-do lists or simply getting started. If you want to make a plan, you can do it relatively easily (even if following through on the plan is sometimes a challenge).
In someone with ADHD, the executive functions are gummed up. Here’s what that looks like:
Difficulty making decisions. Someone with ADHD can stall badly on tasks that require a decision, even if that decision is stupidly small. I would often find myself putting off meals for hours because I hadn’t decided what to eat, or losing hours to a game because I hadn’t decided what to do when I put the game down. People with ADHD often report knowing they need to do something, screaming at themselves inside their own heads to do the thing, and yet do not move.
Difficulty planning and an inability to prioritise. A neurotypical person can prioritise tasks fairly automatically in their own head. In someone with ADHD, however, all tasks are assigned equal importance, whether it’s ‘clear off the kitchen counter’ or ‘finish this essay for class’. As a result, people with ADHD often feel overwhelmed, paralysed, and unable to start any task, because a day that feels like ‘just have to finish this essay!’ to most people becomes "‘okay, I need to shower, and then I need to eat, and then I need to do the dishes, and then I need to feed the cat, and then I need to organise my workspace, and then…’ to someone with ADHD. It’s not a single-task day — it’s a 10,000-task day. A last-minute change neurotypical people can easily take in stride might completely derail the plans of someone with ADHD — it’s the straw that breaks the camel’s back, so to speak.
Object semi-impermanence. In babies, a developmental milestone is object permanence — the stage when they realise objects don’t stop existing simply because those objects are out of view. In a person with ADHD, however, there’s an unconscious tendency to forget the existence of anything out of view or unimportant. Messes? Don’t see them. Sticky notes in the same place as always? Don’t exist. As an extension of that, people with ADHD have a limited concept of time. They can’t always tell how long a task will take, and will frequently lose hours to an easy task without realising, because time doesn’t exist in an ADHD brain. My friends and family used to make fun of me for talking about events that happened last year like they happened last week (‘just the other day’ was basically my godsdamn catchphrase).
Chronic disorganisation, unproductivity, and difficulty focusing. You can probably start to see why this is a thing, right? If it takes concerted mental effort to make decisions, plan, prioritise, or do basically any of the brain functions most people take for granted, of course you’re going to be mentally and physically disorganised. Of course you’re going to have trouble finishing tasks, switching brain tracks, or focusing on basically anything.
—> Wait, so then why is ADHD all about inattention and hyperactivity?
The subjective, biased answer: because ADHD is described by how it inconveniences everyone else, and not by how it inconvencies the person suffering from it.
The longer and more professional answer: self-regulation is an executive function gummed up by ADHD. To make a complicated neurological story short, the process by which a brain rewards itself normally is damaged in an ADHD brain, so people with ADHD are constantly seeking stimulation. This can be external, resulting in impulsive and hyperactive behaviour; or it can be internal, resulting in inattention and daydreaming. People with ADHD will often tune out of conversations without meaning to, or ignore unstimulating events (like lectures, class activities, etc.) in favour of much more stimulating daydreaming.
As a fun side note, the inattention/daydreaming side of the equation is much more prevalent in female-presenting children and in adults, which is why ADHD is so often underdiagnosed in those groups.
—> How did you go so long not knowing you had ADHD?
For the same reason most people do: I thought my difficulties were things everyone found difficult.
I wasn’t physically hyperactive or impulsive. I didn’t disrupt classes at school. I kept unobtrusively to myself. My brain was always going 1000 miles an hour, but I thought that was normal, and didn’t have any frame of reference to understand that it wasn’t.
I thought I was just lazy whenever I couldn’t finish things, no matter what reward systems I tried. I thought everyone had trouble telling how much time passed. Why wouldn’t I, when there was so much emphasis placed on learning effective time management in school? Never mind that time management lessons consistently failed to help me; obviously I was just being stubborn. I thought everyone forgot important things all the time. In retrospect, I think I just unconsciously assumed everyone else had discovered some sort of secret that I was too stupid to find.
When I nearly flunked two classes in 8th grade after years of straight As, I didn’t know why. Neither did my teachers. I remember them telling my mother I was obviously intelligent, so maybe I just wasn’t applying myself.
When I did flunk out of my first attempt at university — the first time I didn’t have an external structure to help me keep track of deadlines — I found dozens of other reasons for it. Laziness. Depression. Maybe I just wasn’t as smart as I thought I was. Maybe I’d always been wrong, and I’d never amount to anything after all.
When, during the course of my psychology degree, we studied ADHD, it was always in terms of observable behaviour. Obviously, that didn’t fit me.
When I had to stop working as a psychologist, and came to the realisation that practicing psychology was not a good fit for me, there were about a dozen other reasons I could cite. None of them included my difficulty in meeting deadlines and remembering important details from reports.
I self-published my first book by dragging my brain, kicking and screaming, into the habits I knew would get me there. For a while, I was doing great; self-publishing was shiny and new, and that was enough to keep me engaged and invested. But then the book was out there, and I was facing the prospect of doing everything again for my next book, and it didn’t take very long for me to fall off the habit wagon. I remember spending days in tears, furious with myself, convinced that if I couldn’t achieve self-discipline with the one thing that has always, always, been my one driving passion…. then I couldn’t be worth very much.
—> How did you find out you had ADHD?
A couple of months ago, I was scrolling through social media, and I came across a post from someone with ADHD where they talked about their difficulty with recognising time passing. I remember seeing it, thinking ‘…. huh, that’s weird, I have the same thing’… and then moving on.
Not long after that, I saw another, similar post collating homework tips for people with ADHD. So much of it resonated with me… and then I ignored it and moved on.
I remember seeing dozens of comics after that, drawn by artists with ADHD describing what ADHD felt like, and feeling more and more uncertain with every single one.
The one thing that finally clicked, though, was when someone with ADHD posted about how they were having trouble processing the death of a loved one, because it didn’t feel like they were dead. It felt, this person said, like their loved one was perfectly fine at home, just waiting for someone to come and find them. Death didn’t feel real, this person said. Even the funeral service didn’t help the feeling go away. The loved one was out of sight, and therefore, out of mind, inhabiting the same ‘somewhere over there’ brain space they’d always inhabited before. (Object semi-impermanence, you might remember.) It reminded me so perfectly of my own feelings surrounding my dad’s death that I couldn’t ignore the coincidences anymore.
In other words: I finally worked out I had ADHD by listening to the lived experiences of other people with ADHD.
I did more research. I tentatively brought up the idea I might have ADHD with my friends, then my family. Then I talked to my GP about it, and got referred to a psychiatrist who specialised in adult ADHD. I was a bundle of miserable nerves on the morning of the appointment, convinced I’d exaggerated my difficulties or just imagined them all, that I was completely and shamefully wrong. And after an hour, the psychiatrist told me I was right.
Today is my first day on medication for ADHD. I was prescribed dexamphetamine sulfate — 3 tablets a day, each at 5mg. Each tablet lasts about 3 hours. My doctor told me that, unlike antidepressants which can take weeks to start working, the effect of this medication would be instant. I did not realise he meant that I would, within 30 minutes of taking the first tablet, feel an abrupt and sudden mental shift, and finally understand exactly how much I’ve been nerfed compared to the entire rest of the world.
—> So how does it feel, being treated for ADHD?
Like waking up for the first time.
Physically, it feels like I’m more settled, like I fit inside my own body better. Like gravity has a little bit more of a hold on me, in a comfortable weighted-blanket sort of way. I noticed this immediately during the mental shift, and I still can’t quite find the right words for it. I’m more aware of my body, my breathing, and my experience inside my own body. Even small movements, like turning my head, feel slower and more purposeful. Walking around my own apartment was amazing.
Mentally, my brain quieted right the fuck down. My understanding of that fact came in waves. The first thing I noticed was that the song that had been stuck in my head so very badly for the last 18 hours had vanished. Then I noticed that my thoughts were coming slower, with more weight. I lost the incessant need to multitask; I didn’t need a background TV show anymore, because I found that I wanted to pay full attention to it, so having it on while I was doing other things became distracting. Sitting in silence became an engaging activity in and of itself. I honestly spent like twenty minutes just sitting on my couch revelling in the brain silence.
Emotionally, it turns out I had no idea how much I was fighting with myself before I could do literally anything. My sister texted me, for example, and I didn’t know how much any text irritated me until I realised this one hadn’t irritated me at all. No small flash of annoyance came with its chime. I just checked the text, right away, easily. And smiled, and replied. Right away. Easily. No irritation. No fighting myself. My brain no longer branded fast and easy tasks with an ‘URGENT’ label, so there was no longer any reason to be irritated at an unexpected change to my mental plate. Before this, I had no idea my inability to text consistently was because of ADHD.
I can prioritise. I didn’t realise this right away; I was too busy marvelling at everything else I could feel. Eventually, I began idly considering the things I wanted to do to today, and they felt possible. It did not feel, as it always has before, like a looming dark shape of obligation rising from the depths. It felt like discrete items instead, things I wanted to do, things that didn’t overwhelm or paralyse me to inaction. One of the items I realised could easily wait until tomorrow, so I mentally filed it away, and then — then I realised what I was doing. I realised I was prioritising. Prioritising. Without needing to write shit down. It was just happening naturally. The feeling of realising this was so overwhelming that I burst into tears right then and there. It’s probably laughably simple for most people, but it’s never simple to someone experiencing it for the first time.
I feel like doing fun things, for fun’s own sake. Before, fun things, especially fun social things, would paralyse me the same as any other high-priority task; I could do it, but I had to fight with myself nearly every step of the way. Requests from friends to do fun social things always spiked my anxiety immediately, even if I could play the game in question completely by myself. And while I always had fun, there was also always a twinge of attached responsibility that my brain resented. I ended up never trying new things, even things I knew I would objectively enjoy, because I was too scared of losing my entire day to it by accident, or developing a hyperfixation that would swallow up my entire brain and its broken reward system for weeks, if not months. Today, fun ideas occurred to me without any attached feelings of obligation or resignation. And I followed through on them. And I had good, honest, genuine fun, the kind of fun you only get from consciously engaging with a thing instead of passively observing it. I’d forgotten what that felt like. Part of me is sure I’ve never felt it before.
Timesucks stopped being appealing. Before this, I had a puzzle game on my phone that I enjoyed playing for quick, regular bursts of mental reward. Before this, I had a need to play it every single day, usually with a TV show on in the background for multitasking purposes, and I would easily lose 4-5 hours to it if I wasn’t careful. Today, I contemplated playing it, but the idea just… wasn’t appealing. Why would I play it, when are so many more interesting things I could be doing?
Seriously guys, I never realised how much effort I was exerting just to engage with things that should have been fun! I had fun today, with zero effort, and that fact made me start crying again.
Time goes by so much more slowly. In a good way, not a boring way. In a way where I feel like I have time, like I won’t lose time completely by accident. I finished a fun thing earlier today and then sat down to write this article. No effort. No fighting with myself. I had time. It was still light outside. It still is light outside.
Everything feels possible. Daily tasks that used to exhaust me just to think about no longer feel so crippling. I have an apartment inspection next week I need to clean up for. Yesterday that felt impossible. Today, I’m already breaking down tasks and giving them a rough schedule in my head.
The amazing thing about all of this is that I still feel like me. Part of me was worried I’d feel completely alien, or — worse — that my imagination would be gone, and I wouldn’t be able to enjoy my stories inside my own head without being forced to write them down first. None of that has been true. I’m still me. My imagination is exactly as strong, just as vivid. The only difference is that now I don’t feel like I’m in a rush to write things down before I forget them. Things are coming at a pace I can handle. Thoughts are coming slowly enough for me to address them one-by-one, instead of all at once. Today has revolutionised my understanding of executive function, and what the mental baseline should be.
I want to emphasise that this isn’t going to make self-publishing suddenly easy. Developing habits will still be a process. My reaction to the medication might change, and I might have to trial different brands or different dosages. I will still encounter challenges and obstacles on the way to my goals. It’s just that now, I want to meet those challenges, instead of surrendering to them to avoid breaking down. I have a better foundational baseline now. Things feel possible now. For 6-9 glorious hours every day, I will have the focus and motivation I need to build good habits, and I cannot stress enough how different my attitiude is now that I’ve glimpsed what it’s like to be neurotypical.
If there’s one thought I want to leave you with, it’s this one:
There is no such thing as ‘being lazy’. There is always a reason. For me, that reason was ADHD. Just because the reason isn’t obvious or easy to find doesn’t mean it isn’t there, and giving someone the tools they need to succeed — no matter how belatedly — can change a life.
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