Earlier this week, I was formally diagnosed with Attention Deficit Disorder by a psychiatrist.

I am forty-one years old.

Looking back, I have been struggling with this for my entire life. My adult life has been plagued by an inability to get things done. I take wild flights of fancy from one chaotic idea to another. New interests explode into my mind, followed after some random length of time with an inability to engage with them. I dislike authority. I struggle to establish a routine pr perform maintenance work. My mind is constantly lurching in a thousand directions, circumambulating whatever I’m supposed to be doing but never staying on-task. For years, I have had a quiet, nagging suspicion that something was wrong with me, but for many reasons I never had the wherewithal to follow through.

The breaking point came from my therapist. I began seeing a therapist after my family began family therapy to sort out some dysfunction in our household. Early in our therapeutic relationship, my therapist asked me directly if I had ever been diagnosed with ADD or if I was on the spectrum. I told her I’d never been diagnosed. She nodded and gently suggested that I should see someone.

Taking her advice, I asked my PCP for help. Unfortunately, due to the endless nightmare that is the American healthcare “system”, my PCP does not manage ADD or anything more complicated than simple depression. Disappointed, I vowed to find a psychiatrist, but in classic form, I never managed to follow through.

I did, however, keep going to therapy. As my therapist and I have excavated ever deeper into the mines of my dysfunction, she suggested more urgently that I see a psychiatrist, and something finally coalesced in my mind. I made a consultation appointment.

Before the consultation, the psychiatrist had me complete two evaluations. One focused on childhood experience, the other on contemporary adult experience. I filled the forms out and sent them in. When I had the consultation, the psychiatrist told me that my scores on the ADD assessments were “off the charts.” There was no doubt in her mind that I had a significant case of ADD.

Yesterday was my first day on ADD medication. I am floored at what a difference it makes. I almost want to cry. My mind is clear. I can think in one direction. I don’t have a million different channels turned on in my head. I can accomplish simple tasks and focus on what’s happening at work even when it’s dreadfully boring.

I should have done this years ago.

Ancient History

When I was a kid, ADD was seen as a “new phenomenon.” The media, the boomers, and the schools in my area were generally quite dismissive of the concept of ADD. People would say things like, “These goddamn kids just need to sit still,” or “The problem is you’re not beating your kids. Spare the rod and spoil the child,” or “These kids are just coddled and undisciplined.” The general consensus was that some kids were just rotten little brats, and that the way to fix them was to beat them, denigrate them, shame them, or otherwise maltreat them. Kids who took meds were ridiculed. Parents were criticized for getting their kids diagnosed. People were wildly unsympathetic. ADD was treated as a bullshit condition peddled by pharma companies who only wanted to addict kids to drugs. Sound familiar? Despite a much wider acceptance of the reality of neurodivergence, the same assholes are still crapping out the same shit to this very day.

These ideas penetrated deep into my psyche. The message was clear: complain about your mental health, talk about your struggles, and you’re not only weak, but so broken as to be unworthy of respect. Struggling the way you struggle is a one-way ticket to being shamed, humiliated, and mocked. I kept my mouth shut. Speaking up was a recipe for disaster.

Ironically, my mother (a masters-degree wielding therapist who worked with children) did nothing to disabuse me of these ideas. She always spoke with great sympathy about her clients, but when I would struggle with something…schoolwork, chores, trouble with teachers, difficulty listening…I was treated like an incapable moron. The message was clear: other people might have real problems, but you are your own problem.

As a student in the supremely mediocre public schools of the state of Maine, I was just another faceless idiot child from the woods. Most of my teachers were malignantly unsympathetic, mean-spirited little tyrants. The guidance counselors were thoroughly useless. I maintained average grades, but struggled to get work done, remember test days, or pay attention in class. I just chalked these things up to being kind of a moron, because that’s the message I received from literally everyone in authority.

Modern History

I managed to graduate in the middle of my class and went on to community college, which was a vastly better experience. My professors were generally kindly or indifferent; never malicious. The work was more engaging. Questions, Socratic dialogues, and an open exploration of ideas were the norm. I finished my A.S. and managed to launch a career as a respiratory therapist, a field where ADD tendencies can actually be quite beneficial.

While I did succeed in finding gainful employment, my young adulthood was filled with chaotic, impulsive decisions and half-baked ideas that rarely went as planned. I started to apply to a bachelor’s degree program but lost the paperwork and missed the deadlines. I haphazardly got married to someone I barely knew and moved out of the country with no money and no plan, which went about as well as you’d expect. Ultimately, I ended up back in the U.S. and landed in Florida, which became the site of many more chaotic and often destructive decisions, the full scope of which is beyond this story.

Ultimately, things have worked out well for me. I am eleven years into a much more stable and happy marriage. I have escaped the nightmare of bedside clinical work and found a niche in healthcare technology. I have managed to build a pretty average, successful life, and I am happy.

But every day is a struggle. Nothing is finished. The project graveyard and hobby graveyard are full up. I often think that it is a miracle I can stay employed. The ceaseless spinning of my cognitive apparatus has worn me down. I am tired.

Thank God for Amphetamines

Yesterday was Day One of my post-diagnosis life. My psychiatrist prescribed me Vyvanse, an amphetamine derivative. I took my first pill yesterday, my second one today, and the difference is incredible.

A “normal” day for me is an endless series of loosely intertwined threads of chaos. The environment inside my head is like trying to listen to a dozen radios at once, all tuned in to different stations, volumes constantly in flux. Need to do the dishes. Fuck, need to feed the cats. Uh oh, time to work. Let me get some coffee. Who left this shoe here? Where is my phone? Where did that coffee mug go? Every encounter with a half-completed task, a forgotten chore, a lost item, is a reminder of my failure and incapacity to achieve. The noise in my mind is the endless spinning of a thousand disconnected gears, an engine running at full bore but not engaging the transmission. It is a constant fog of distraction and noise, an unfiltered intake of every thing that is happening in my immediate environment except the things I am supposed to be paying attention to. Any place with people is a firehose of crude sensations, the smells and noises and motions of the other humans an unbearable stream of input that leaves my consciousness reeling. The mental chaos manifests as spaciness, forgetfulness, inattention, irritability. This is just what it is. This is why I am depressed and grumpy: the world is a constant overbearing presence from which there is no escaping. It is exhausting.

But not today.

An hour after taking my Vyvanse, I felt the bottom fall out. My stomach dropped. The chaos gradually melted away. My consciousness became clearer, like a still mountain lake. It was… quiet… in… my …head. The radios turned off. The endless chatter, the ceaseless input, stopped. I could work without a constant sense of dread, a searing fear of forgetting some crucial detail, fucking up and getting fired. I could listen on calls with a more normal level of inattention, a boredom level versus a pathological level. On my breaks, I tidied up the house without going on a thousand side quests. I felt calm and in control. Is this how it is for normal people? Do people without this disease live without the haunting murmur of a thousand unfinished tasks, free from the anxiety and stimulation and endless bedlam of their own minds?

A New Age

I am very early in my experience with this medication, but the difference in my lived experience is absolutely earth-shattering to me. I simply cannot believe that this is possible. I am waiting for the other shoe to drop, for someone to pull the rug out from under me. Will it be a sharp crash? Addiction? A slow boil of tolerance, leading me back to where I came from? A random cruel decision from my insurer that will make my meds unaffordable?

Or will this continue to work out for me?

Only time will tell. But I can tell you this right now: I wish I had gotten medicated decades ago. I can’t imagine how differently my life could have gone. It could have been so much easier. There could have been much less chaos, many fewer stupid choices, legions of unmade mistakes. But that’s in the past. And despite the challenges, I’ve built a good life for myself. All I can do now is look forward, think about what to do with this gift I’ve been given. After a lifetime of drowning in my own dysfunction, I feel like I finally have the ability to execute something good, to do the things I’ve dreamed of doing, to finally fucking relax and make things happen. The future is uncertain, but I am grateful to have made it to where I am now and optimistic for the future. Thanks, Amphetamines – I couldn’t have done it without you.