‘I think I have ADHD’ I say to a friend as we take a socially distanced walk in the summer of 2021.
‘No way! I think I do, too!’
I had seen the videos and infographics and lists of symptoms on social media for a few months at that point: 10 signs you might have adult ADHD, Females less likely to be diagnosed with ADHD in childhood, things you might not know are symptoms of ADHD. The symptoms read like my daily experience of existenting: trouble staying focused, or (alternately) hyperfocusing, poor time management skills, disorganized, easily distracted, forgetful, avoiding tasks that feel overwhelming and being easily overwhelmed.
Her feed had recently become filled with the same videos and infographics. She said they made her feel seen. We agreed that there was something relieving about considering that all of the things we were struggling with could be neatly filed under a diagnosis.
For an adult to be diagnosed with ADHD they must exhibit at least five symptoms in more than one setting (i.e. home, work, school, etc.) and a mental health professional is required to talk to someone who has known the patient since before the age of 12 to confirm that they’ve exhibited ‘several’ of the symptoms long term. Had I always been this way? It was hard to remember a time before the ever-present low hum of anxiety and feeling that I was forgetting something, but I couldn’t be sure. Both of my parents are dead and I didn’t know anyone who could positively identify a behavioral pattern from before I was 12. I had done sudden, 90 degree turns in my ‘career’ every few years throughout my 20s, but had been working from home for the better part of a year, so I couldn’t even identify different settings within my life (bedroom, dining room, chair by the window?).
I did know that when I studied abroad my junior year of college I received messages from three separate friends back at school telling me they missed procrastinating with me during finals week. For years I would get irrationally flustered trying to follow even the simplest recipe or assembly instruction. Any communication from an institution felt like a personal threat. I have always kept a messy room. My personal mantra is ‘never leave just once’ because I would rather laugh than cry about the fact that I always, always have to doubleback to the house to grab something I forgot (phone, keys, wallet, water bottle, jacket, shoes). For as long as I can remember I’ve had a wandering mind and been easily distracted by my own thoughts, often spiraling internally while trying to maintain outward composure.
I knew that more recently I had been blowing job opportunities and struggling with deadlines. I would stare at a to-do list and do nothing. I would disassociate for hours. My mess had spilled from my room to the entirety of my home. I had daily stare-downs with the bills I hadn’t paid, before giving up and going to make myself a snack. I knew this wasn’t sustainable.
After disclosing my self-diagnosis to this friend, I talked to five other friends (all female) who had also seen the infographics and videos, felt seen and were seriously considering professional diagnosis for ADHD. We all had the same general desire: external validation that there was something fundamentally wrong with our brains, that they weren’t functioning the way a brain was ‘supposed to’ function. And yet, there was something disquieting about amount of my friends suddenly recognizing a shared neurodivergence all at once and it seemed a little too ironic that we were all learning to self-diagnose an attention disorder from an infographic or a video on an app that is programmed to distract us.
Whenever I notice a pattern, especially one that I am a part of, I like to look at the bigger picture. All parts reflect the whole. If there are this many of us who think that we have an attention disorder is it really us? Or is it the soup that we’re swimming in? The soup of summer 20211 included the collective whiplash from quarantine (remember when we didn’t hug anyone for months?) and the bulldozer of unprecedented events both political and presumably personal as well. There had been murders, uprisings, elections, insurrections, millions of dead. There were the ever present demands of productivity from capitalism that did not allow time for us to process any of this. And we were committed to the act of pretending like we were holding it together through extreme stress and overwhelming grief.
Personally, my father died in winter and my heart was shattered in the spring. The first friend that I talked to had just survived a year and a half of online teaching. Other friends had graduated into a work-from-home workforce, separated from their partners, moved to a place without a network of support. Of course we were stagnated. Of course we were scattered. Our bodies wanted to process the immensity of loss and change we had experienced over the last few years (and our entire lives) and our brains were trying to override that desire because it was both terrifying and inconvenient. It was a stalemate.
So, why did I feel so attached to this diagnosis of ADHD? As a culture we love to pathologize, to name our broken parts. There is power in naming. When I investigated my personal desire for a diagnosis with a critical lens I realized the power of naming my diagnosis gave me the possibility of a remedy. To my mind that remedy was medication. Something outside of myself to propel me into a better version of me. Now don’t get me wrong, I have taken your run of the mill study drugs before. In college I had friends who already had the diagnosis I was seeking and had pills enough to share. I remembered the sensation of those orange, time release capsules kicking in as I finished papers and studied for exams with determined fury. In reality, the college version of me was grieving the death of my mother and my father’s psychotic break. I had the same executive function issues then and I did override them with ample help from substances (stimulants [both prescription and not], nicotine, alcohol, etc.) for as long as I could. I was pressed to concede that at the core of my craving for a diagnosis was legitimized access to a drug that might help me do that again.2
Every single one of the symptoms listed for ADHD is also a symptom of grief. Because grief can be anything and maybe that’s why it's so terrifying: it's unpredictable. Half the time we don’t even know what we’re reacting to there is just so much of it. I admitted that a dose of amphetamines might get me through the season, but wouldn’t get me through the storm. At some point I would have to reconcile the disconnect between my brain and my body. My attention issues seemed less and less clinical and more and more holistic. I needed gentle, long term care.
For me, long term care meant working towards intentional, embodied awareness of my interconnectedness. I needed to name all of the parts, broken and whole. Biologically, emotionally, spiritually, mentally. To care for one is to care for all. Something I had known intellectually for years but had yet to fully put into practice.
To understand my biological baseline I got my blood tested by a naturopath. It turned out I was deficient in vitamins B and D. I started taking a B complex vitamin and a double dose of a D3-K2 sublingual. Within a month I found myself better able to regulate my mood and sustain focus. The validation I sought was there all along: there was something wrong and biologically it did have an affect on my brain, but my brain wasn’t the only part of my body that mattered. To find my mental/emotional/spiritual did my own research on somatics and parts work. I did this Richard Schwartz IFS mediation on YouTube a lot (can’t find it now, but something like this). I went to the chiropractor. I worked to re-pattern my relationship between thoughts and feelings (mind and body), which took a sustained, daily, effort that I am still practicing today.
My long term care plan includes consciously adapting and evolving around the understanding that my grief isn’t going anywhere and neither is the metaphorical soup. I have the power to choose how I interact with this. I choose one day at a time. Some days I am finally able to sink into the comfort and pain of my body and cry and laugh and scream and some days I demand distractions, wanting to stay strictly cerebral. Some days I knock things off the to-do list and some days I stare at the wall. I still feel seen by ADHD content because it reminds me that I’m not alone out here struggling to do this life thing in the 2020s. Even if I never got that diagnosis, I am still very aware of how my attention issues have continued and also how I’ve learned to co-exist with them. I'm writing this at a desk covered in papers and books, three different beverages, a bag of pistachios, a bow for their shells, a bottle of hair supplements, a few unpaid bills and only 30% of my to-do list accomplished. I’ve also been drinking lemon water first thing in the morning, stretching, eating more vegetables, writing everyday, washing my dishes more often and staying hydrated. I’d say I’m doing fine in the scheme of things.
NOTE
I was very excited to come across Johann Hari’s Stolen Focus: Why You Can’t Pay Attention–and How To Think Deeply Again, published in 2022 (he has also written books on depression and addiction). If you are struggling to pay attention I recommend diving into his research. He outlines what he believes are twelve causes of what he calls (and I agree) our attention crisis. While he does not point directly to collective and individual grief, he speaks at length about the impact of our environments on our ability to pay attention. In his chapter on The Rise of ADHD and How We Are Responding to It he writes:
“between 2003 and 2011 alone, diagnosis of attention deficit hyperacitivte disorder (ADHD) soared in the United States by 43 percent overall, and by 55 percent among girls. It has now reached the point that 13 percent of adolescents in the U.S. have been given this diagnosis…”
“huge numbers of adults are now being told they have this disability, with over three million of them already being prescribed stimulants. The market for prescribed stimulates is now worth at least $10 billion”
“[Dr. Sami Timimi, a leading child psychiatrist in Britain] told me that when people hear a child has been diagnosed with ADHD, they often imagine this is like a diagnosis of, say, pneumonia—that a doctor has identified an underlying pathogen or illness, and is now going to prescribe something that can deal with that physical problem. But with ADHD, there are no physical tests a doctor can carry out. All she can do is talk to the child, and to people who know the child, and see if the kid’s behavior matches a checklist drawn up by psychiatrists. That’s it. Sami says: “ADHD is not a diagnosis... It is just a description of certain behaviors that sometimes occur together. That is all it is.” All you are saying when a child has been diagnosed with ADHD, is that a child is struggling to focus. “It doesn’t tell you anything about the ‘why’ question".” It’s like being told that a child has a cough, listening to the cough and then saying “yes, the child has a cough.” If a doctor identifies a child with attention problems, that should be the first step in the process—not the last.”
“It turned out that neurological status at birth didn’t help at all in predicting which kids would develop serious attention problems. So what did? they discovered that “the surrounding context is the most important thing,” Alan [Sroufe, professor of child psychology] told me, and a crucial factor was “the amount of chaos in the environment.”
“The latest research shows that “genes aren’t destiny; rather they affect probability.” Alan Sroufe…said the same thing: “Genes don’t operate in a vacuum. That’s the main thing we’ve learned from gene studies… Genes are turned on and off in response to environmental input.” As Joel [Nigg, former president of the International Society for Research in Child and Adolescent Psychopathology] puts it, “our experiences literally get under our skin” and change how are genes are expressed.”
On prescription stimulants: “But James Li, assistant professor of psychology, who I went to see at the University of Wisconsin in Madison, told me what I found to be the most worrying thing: he explained: “we simply don’t know the long-term effects. That’s a fact.” Most people assume-I certainly did-that these drugs have been tested and found to be safe, but he explained “there hasn’t be a lot of research done on long-term consequences to brain development.” This is especially concerning, he says, since “we’re so quick to give them to young kids. Kids are our most vulnerable population, because their brains are developing… These drugs operate directly on the brain, right? it’s not an antibiotic””
I also recommend Be Water, My Friend: The Teachings of Bruce Lee by Shannon Lee, which came out in 2020, but I didn’t read until 2022. Reading this book brought me further into my body and helped me become more intentional about how I move through and react to the world around me.
“We shall find the truth when we examine the problem. The problem is never apart from the answer; the problem is the answer.”
And finally, because sometimes all you can do is laugh:
Musical context for summer 2021: Vince Staples’ Vince Staples, Greentea Peng’s MAN MADE
This is not to say that medication is not the right choice for some people. My father was on lithium for 13 years and those were the most stable years of his entire life. And almost everyone I know is self-medicating all the time. Alcohol, weed, psychedelics, nicotine, stimulants (coffee), sugar. I mean, the list goes on. These days I prefer smoking weed and occasionally microdosing mushrooms, but those don’t necessarily help with attention issues.