I have a neurodevelopmental disorder. ADHD. Most people think of it as an attention disorder, but it has been more accurately described as a motivation disorder. The space between me and a task is much greater than it is for everyone else. I need a very long, detailed, comprehensive planning phase, or everything I do will stall out. I need to know what the next step is, or I’ll get lost. I need to maintain stimulation throughout a task, or my brain will stop working.
“I know what I need to do, I just can’t do it!” - Dr. Hallowell
I can solve all sorts of problems except for the actual doing.
What is ADHD?
ADHD is an executive function disorder.
Self-awareness
Inhibition
Non-verbal working memory
Verbal working memory
Emotional self-regulation
Self-motivation
Planning and problem solving
The ADHD brain has deficiencies in all these areas.
ADHD is genetic, linked to a gene responsible for the production of dopamine. Every person’s brain uses dopamine to complete synapses between neurons. If you don’t have enough dopamine, then the synapses can’t fire. The chemical needs to be recycled, and our brains have a system that pumps out excess dopamine to make room for fresh dopamine. ADHD brains have too many of these pumps or these pumps work too well, so too much dopamine is pumped out and the synapses can’t fire.
“ADHD is not a damaged or defective nervous system. It is a nervous system that works well using its own set of rules.” - https://www.additudemag.com/secrets-of-the-adhd-brain/
There are many ways to regulate dopamine levels, and many ADHD medications seek to increase the amount of dopamine in our brains, so the pumps can’t pump too much out. These are known as stimulants, like adderall. Adderall was originally developed as a weight loss drug, and obesity is common in people with ADHD, so it can actually kill two birds with one stone. Though it's not FDA approved for weight loss, so don’t take it if you aren’t prescribed. Other medications seek to slow down the pumps. These are non-stimulants.
Things that increase dopamine:
Coffee
Food
Cocaine/drugs
Exercise
Medication
Sex
Video Games and other pleasurable activities
People with ADHD often self medicate with alcohol or drugs (15% abuse alcohol or substances, 3x as likely as the neurotypical).
Although ADHD is one of the most well-researched and most treatable psychological disorders. it is one of the most ignored. 25-40% of federal penitentiary inmates have ADHD and "people with ADHD face a risk of premature death 1.5 to 8 times greater than those without the disorder.” - Sciencenordic.com
My Story
I struggled a lot in college. Parents cover a lot of the executive functions when you grow up, and moving out and learning how to manage these yourself is problematic when you have ADHD.
You are expected to be able to choose your life’s direction as a teenager, and when you have ADHD that can be exceptionally hard since your ability to focus on even things you thought you love can be inconsistent. It’s normal for kids to make it through school just fine undiagnosed and all of a sudden not be able to handle college because we are dealing with learning to manage executive functions on top of an already unsustainable workload. If I went back to college now I’d probably be able to handle the workload just fine since staying busy is healthy for the ADHD brain, and I was able to handle it once I got my diagnosis.
“We do best when we are busy. If we’re not busy we often get depressed. But you don’t wanna be stupid busy, you wanna be smart busy. You wanna be working on something that’s useful and productive.” - from Crazy Busy by Dr. Hallowell.
I started out in music school studying electric bass with an emphasis on performance. This was an example of me finding a creative outlet. I love music, I love playing instruments, but I struggle with translating what’s on the page to the instrument. I can play improvisationally for hours, but I have trouble following chord charts or sheet music and have an even harder time memorizing them.
After three semesters I switched to entrepreneurship because I wanted to open a coffee shop. I had trouble getting started and sticking with my vision. I had a vision but was unable to reconcile it with reality. I ended up taking a philosophy gen ed class that I’d been avoiding since my first year because I knew if I took a philosophy class I’d want to change my major. I did.
In order to graduate with a degree in philosophy you have to take two years of a foreign language. I chose Koine Greek. The language the new testament of the bible was written in. This is an extremely hard language to learn, and learning a language is one of the hardest things someone with ADHD can do. I was having trouble. I couldn’t keep up with the readings in my many philosophy classes, and I was failing gen-eds I wasn’t interested in, like statistics, speech and music history.
ADHDers tend to become perfectionists because we are frequently critiqued as children simply because we have a different way of being in the world. Others don’t understand why things are difficult for us (neither do we) so they can get frustrated, blaming us, and eventually we start blaming ourselves, leading to depression.
I got depressed. One night I googled “why am I so worthless?” Much to my surprise most of the results were about ADHD. I took a 75 question self test and scored highly likely to have ADHD. I proceeded to tell my mom who found a child psychiatrist who could treat me under her insurance plan. Child mental health professionals are more likely to be trained in ADHD, so don’t feel weird sitting next to a bunch of kids in the waiting room as an adult. I actually found it more fun because kids are more interesting than adults.
In order to be diagnosed with ADHD you have to meet the following criteria:
You have to have symptoms of inattention and/or hyperactivity.
The symptoms have to have been present for at least 6 months.
The symptoms have to have been present before the age of 12.
The symptoms have to be present in 2 or more locations (home, school/work, with friends, relatives).
The symptoms are not better explained by some other medical condition.
My doctor had me take some more tests, and I scored very ADHD and exceptionally high in the hyperactivity category, which was a surprise to me but not to my family or friends I had growing up. It turns out fidgeting is your body trying to stimulate the brain to focus. So letting yourself fidget actually makes it easier to focus! Sometimes hyperactivity manifests internally, so externally you seem fine, but inside you are restless and all over the place.
I was prescribed Strattera, a non-stimulant medication. Proper treatment of ADHD requires both therapy and administration of medication by a medical professional. Getting the dose right is crucial to a positive experience. When ADHD medication is properly administered it works in 80% of patients with almost no side effects. I experienced increased anger and a near constant feeling that I had to pee (it also hurt to pee), so I stopped taking it after college. In hindsight if I had properly communicated these side effects to my doctor he likely would have adjusted the dose or prescribed something else.
After receiving treatment, my GPA went from a 1.8 to a 3.5 in 3 semesters, and I was able to keep my Tennessee lottery scholarship, which I was at risk of losing because you need to maintain above a 2.0 GPA. I had to apply for accommodations because of my recent diagnosis and was granted an extension to get my GPA up above the threshold. I went from being a D student to getting straight A’s almost immediately.
It is estimated that 2 -5% of the world’s population has ADHD.
95-98% of the world has a fundamentally different way of being in the world than me. The world I live in was built for them. There isn’t anything wrong with me. This is why we like to be called neurodivergent (as opposed to neurotypical) which also includes dyslexia, autism, and dyspraxia. It’s like being left handed but in the brain. It is very difficult to find my place in a world built for the neurotypical (or normies as I call them). We have to build our own systems to fit our differences. Things aren’t designed for us, so we have to customize them to fit our needs. We can ask for accommodations in school and the workplace but that can be met with adversity and we often don’t feel comfortable asking for assistance and often don’t know what we need.
"Fifty percent of those who are diagnosed continue to have symptoms throughout adulthood." https://psychologytoday.tests.psychtests.com/bin/transfer
This can lead to cycles of failure where we don’t ask or don’t get the assistance we need to succeed because our measurement for success is designed for normies. We can feel like there is something wrong with us because we can’t do what everyone else can seemingly do easily. If we can break through the large barriers between us and doing the thing, we can accomplish extraordinary things oftentimes out of reach of the neurotypical. This can lead to the normies in our lives getting frustrated when we are struggling with life’s basics. “Why aren’t you living up to your potential?”
When I was waiting in line to receive my degree the person in front of me (a psych major!) was complaining out loud that ADHD is overdiagnosed. This stigma against treatment for the most treatable mental disorder is why I didn’t get diagnosed until I was 20 and why I was determined to live life unmedicated until even now at age 32. I lost three decades of my life to struggling because our culture doesn’t accept incredibly well-researched science as fact and doesn’t believe in medication as a valid form of treatment. Mental health is a real treatable thing folks. Get over it!
I’m finally accepting that ADHD is a huge part of who I am, and in order to thrive I need to build a framework for being in the world that is fundamentally different than the way the world is designed. I’d like to share the tools and wisdom I’ve collected along the way. I’ve included a toolbox at the end of the article for reference.
It can be really lonely being a divergent thinker.
People with ADHD don’t grow up wanting to be different, and it’s possible my neurodivergence might be why I feel like people don’t listen or value me.
It’s not that we shouldn’t compare ourselves to others, it's that we can’t. It’s like comparing apples to oranges. We have a fundamentally different way of being in the world. Our divergent thinking allows us to think thoughts that haven't been thought before—to have visions that haven’t been seen before. And it is incredibly difficult to find support for that because no one else can see what we see.
We should embrace and explore our big ideas and share them with the world. We can be the philosophers and thought leaders of our time, but we need to develop and keep our ears open to criticism. We can be the Noahs that foresee the flood even when everyone is saying we’re crazy. Start with a hunch or a notion and then root it in reality.
We must have the confidence to manifest our vision in the world, and we often fundamentally lack the ability to do so due to years of failing to conform to a world not built for us. We have to construct environments for ourselves in order to thrive. The struggle not only lies in taking the first step but in taking each step thereafter. Every transition brings with it an opportunity to fail, an opportunity to fall off course from our dreams. We shouldn’t suffer alone, there are more of us out there and with the advent of social media connectedness technology we can find each other easier than ever.
We are living in the ADHD century
The world is changing rapidly due to the rate of technological advances. What took decades or centuries to shift in the past happens in years, sometimes months, today. In order to be successful in today’s world, you must be able to quickly adapt and learn new systems every few years. ADHDers are uniquely able to adapt, learn and iterate extremely quickly. We are the ones who will be able to see trends before they happen or at the very least be able to be first adopters. This will give us an edge in the ever changing world of the 21st century.
Do not underestimate the value of ADHD in a world like this.
Employers will begin to seek(some already are) these qualities whether they realize it’s an ADHD superpower or not. If not, it is easier and cheaper to start our own companies than ever before.
Here is a list of famous people with ADHD:
Will Smith
Justin Timberlake
Howie Mandell
Solange
Channing Tatum
Emma Watson
Richard Branson
Jim Carrey
Jim Caviezel
Charles Schwabb
Erin Brockovich
Tommy Hilfiger
Danny Glover
Whoopi Goldberg
Orlando Bloom
Albert Einstein
Cher
Leonardo da Vinci
Galileo
Mozart
Walt Disney
Jules Verne
Thomas Edison
ADHD and Energy
It takes more energy for us to do anything because of our executive function impairments. The more executive functions we can offload from ourselves, the less energy we will be spending on them.
There are a few strategies for ADHD energy management. Increase the size of the tank (exercise, sleep), use less energy (efficiency), and refuel (eating, sugar intake, sleep).
“Your body will tell you when you need to rest” - Dr. Hallowell
The Perception of Time
There is a thing people with ADHD experience called hyperfocus. It is a state of flow where time seemingly bends around us, and we have intense singular focus on whatever we are doing. This is my superpower, but it's difficult to control entering or exiting hyperfocus.
“A Ferrari engine for a brain with bicycle brakes.” - Dr. Hallowell
When I am in this state, I forget to take care of myself. I’m literally only focusing on what I’m hyperfocused on. I forget to eat or drink, I can get stuck in a really bad posture, I forget to pee, I forget to stretch, I forget to go to class or work, sometimes I even forget to breathe. Despite all this, hyperfocus is when I am at my best; it is when I feel most alive. It is when I can get done in 1 hour what it takes others all day to do. Hyperfocus is what makes ADHDers great writers and creatives. We get lost in our work for hours, sometimes days on end. One of my goals for 2020 is to engineer my environment to be more likely to bring about these states of flow.
What comes along with hyperfocus is the inability to accurately perceive time, more specifically how long it takes us to do things. When planning my day I have to allocate at least double the amount of time I think I will need for every task. If I want to get somewhere on time I have to get ready to leave at least 15 minutes before I think I have to. I’ve been late for work so many times because I misjudged how long it would take me to put my shoes on or find my keys or play another game of Hearthstone.
Storing your shoes and bag/backpack by the door can help mitigate the amount of time it takes to leave the house since you won’t have to go look for everything you need. I’ve been an hour late to work because I couldn’t find my keys more times than I care to admit. Even if I set myself up for success I still need to allow for the chance that I forget something, because I will ALWAYS forget something. I’ve even started keeping second sets of necessities in my car like masks, allergy meds, jackets, hats, sunscreen and cell phone chargers.
Finding a Career
“So many of the problems people with ADHD suffer derive from one of two things:
Not having the right partner
Not having the right job”
-Dr. Hallowell
I’ve figured out the first, but not the second. In this video Dr. Hallowell says to write down all of the things in the following categories:
What you love to do
What you are really good at
What someone is willing to pay you to do
Where these intersect should be your career. I’ve found the second category isn’t as clear as the first, and the third is even less clear. So, I’ve decided to focus on what I love to do and do it over and over publicly until I get good at it and then someone is willing to pay me for it. It’s not always clear what people are willing to pay for.
Finding something I’m truly passionate about can allow me to channel my hyperfocus as a superpower.
Emotional Dysregulation
The part of the brain that regulates the expression of emotion in the moment does not function in an ADHD brain. We can not hide our emotions. It’s not that we feel emotions more strongly than others, it's that we can’t focus on anything else when we have them.
For me this has led to a fruitless attempt to suppress any and all emotions. I believed the suppression of good emotions would suppress bad ones as well. This just led to me feeling numb and didn’t actually stop the negative emotions like anger, frustration, and sadness.
Anger management is specifically hard in the workplace. It can be difficult to work alongside me when something has upset me because I have to process it before I can move on. My old boss had a habit of upsetting me during my shifts in ways that I couldn’t respond to, and it would linger at the front of my consciousness until long after I got home and had to enlist my wife’s help to process it. Which takes a toll on her and is the primary reason (among many) I left my last job.
I grew up being told I was too sensitive or overreacting (this continued well into my marriage). I still believe I’m too sensitive sometimes, and I’m 32 years old. I’m not. I just have a brain that processes through emotions differently. I have to deal with them in the moment because my brain can’t regulate them the same way. It can be intense, and it can be uncomfortable. The good news is I’m learning to be okay with expressing positive emotions with the same level of intensity. I’m talking about letting myself cry at something beautiful or telling someone I love and value them when the overwhelming feeling of gratitude washes over me.
How I keep myself focused
With all of this, it is incredibly important for me to customize my own systems for measuring success. I need to set goals based on my own dreams and desires and evaluate them in a way that makes sense for me.
The first thing I do each year is write down what I want to accomplish that year.
The first thing I do each month is write down what I want to accomplish that month.
The first thing I do each week is write down what I want to accomplish that week.
The first thing I do each day is write down what I want to accomplish that day.
How I’m setting myself up for success
I’ve learned to alter my environment to mitigate the chances something will go wrong. For example I moved to Pacific Grove, CA, primarily for the mono climate of 50-60 degree weather year round with very little rain and 250+ sunny days a year, so that I could minimize the impact of seasonality and allergies on my routine. I need to be able to impulsively run out the door to workout and not worry about the weather. I need to have sunlight most of the year to mitigate the effects of Seasonal Affective Disorder.
Lately I’ve been building my home office to fit my personal way of being in the world. I bought an ergonomic office chair to mitigate the effects of hyperfocus on my body so that I can keep working longer without having neck or back pain.
I bought a sit/stand desk so that i can move around while working but also have the option to sit and type for hours and hours on end. I also made this decision so that I can stream on twitch longer. If I need to get up and stretch while streaming, I can just raise the desk to standing height and keep playing from that position. The chair also rises high enough for me to sit at standing height. I also like to have lots of windows open on my computer at the same time because I get lost down the research rabbit hole, so to keep things organized I need lots of screen space. I’m going to get an ultrawide monitor, and when I’m working I can dual screen with my 60” OLED TV because it's in the same room as my office. Since my office doubles as my TV room, I also have a couch in there so I can change position quickly and recharge in the middle of the day or take as many breaks as I need to keep going.
I’ve learned I always need a project, and I need that project to feel like it has meaning or impact on the world in even the smallest of ways. I had this emotional block between me and productivity. That if I keep producing I will eventually run out of stuff to produce. That I would somehow become empty, but the reality is I have an endless supply of creativity because of my ADHD brain—since coming up with things to do is kind of my superpower. Also, I’ve found my body will tell me when I need to take breaks and recharge.
Something Dr. Hallowell said in Delivered from Distraction is recharge by watching mindless television. This is often frowned upon in our culture, but I tried it, and it definitely works. Pick a TV show that is your go-to mindless consumption show.That way you don’t have to make a choice to watch it.Then just veg out until you feel like doing stuff again. Right now mine is Parks and Rec. It turns out it's not that mindless, but not having to make a choice on what to watch is the important part of the equation. (The season 2 finale predicts the government shutdown of 2018-2019 immediately rolling into the flu epidemic of Pawnee in season 3 episode 2. It’s eerily similar to the COVID pandemic, M-83 masks and all!!!)
I listen to loud stimulating music while I work (this is called “stimming”). The normie focus playlists don’t work for me. I need bumping house electronica or hip hop/R&B. Sometimes Jazz, sometimes Indie, sometimes chillhop, sometimes video game/movie soundtracks. It depends on the day because inconsistency is a hallmark of ADHD. What works one day might not work another day, so building a toolbox of things to try is paramount to sustaining success with ADHD. Maybe I will build an ADHD focus playlist at some point.
I started a Bullet Journal to make sure I stay on task and the tasks are things I’ve articulated for myself not tasks given to me by someone else. It turns out you can’t meet a goal if you don’t articulate it.
My wife and I meet on Sundays to keep each other on track in our individual lives and on Wednesdays to keep us on track for the week. Accountability is a huge thing for people with ADHD. We lack internal self-motivation (an executive function), so having others in our lives that care about our success keeping us motivated and on track is crucial to our individual success in life.
“The goal of independence is a foolish goal. What you want to be is effectively interdependent. So you can give and you can get. No one is independent.” - Dr. Hallowell
If you don’t have someone who is willing and able to do this for you, there are ADHD coaches you can hire. I’ve been thinking about doing this since they would be able to speak into my life where Liz can’t, since ADHD coaches generally have ADHD themselves. https://embraceyouradhd.ca/services/
Conclusion
I've been moving through life in a fog. I’d like to finally have direction and some sort of focus. I don’t want to cope. I want to thrive. I don’t want to just be good enough, I want to be the best. I want to appreciate myself as much as the world does. I want the world to appreciate me as much as my mom does.
Appendix I: Toolbox/Resources
Dr. Hallowell - https://www.drhallowell.com/
HowToADHD YouTube channel https://www.youtube.com/howtoadhd
Self Tests
Official self-test - https://add.org/adhd-test/ It’s a pdf that needs to be printed which is too many steps for ADHD brains
Here is one that’s all online that only takes 2 minutes https://psychcentral.com/quizzes/adhd-quiz/. The questions in this quiz seem weak to me so let me find another, just so you can be comfortable with your self diagnosis.
https://psychologytoday.tests.psychtests.com/bin/transfer. For me all the self diagnostic questions felt skewed to reading ADHD, but that's probably because I have ADHD and I have all of the symptoms pretty much exactly as described. I scored 10/100 on this test (the lower the score the more ADHD you are).
Fidget Cube
Time Timer
https://www.timetimer.com There is also an app. Which is free right now because of the pandemic.
Books
Podcasts
ADHD Rewired - Eric Tivers
Translating ADHD https://www.podbean.com/media/share/pb-wwt48-e56c54
Bullet Journal
HowToADHD’s interview with Bujo creator https://youtu.be/TTlHT3d2Grs
HowToADHD’s tutorial https://youtu.be/jkZEEQG6IVE
HowToADHD’s argument for using Bujo https://youtu.be/5hLnY9L1c-M
ADHD and Friendships