Attention Deficit

The first time I had therapy, several years ago, I remember talking to my therapist, trying to slowly back into the problems I was facing and I found myself saying "I just want to fix whatever it is that's wrong with me." He replied, not unreasonably, "Why do you think there's anything wrong with you?" He was right inasmuch as that vague sense of wrongness wasn't the primary problem I was having at that time, but with the benefit of hindsight I think whatever answer I gave to him would have been in some way deficient. If I'd been in a position to listen to myself better, to get the other stuff out of the way, I might have been able to articular that I did feel like there was something wrong with me. In a way I couldn't put into words, I felt like I was somehow broken. For years and years, I felt like this. I tried to slow things down and work out what it was but I was never quite able to; there was something stopping me. All I knew is that there was something wrong with my capacity to do what I wanted to.

The trouble stemmed from my teenage years. I'd been a precocious little sod as a child: school work seldom a challenge, able to do all my homework at the last minute and be at or near the top of most classes. However, around sixth form my ability to just be able to show up and ace everything without trying took a nose-dive. In retrospect, the cracks were visible before—I had never been able to achieve results with quite the same ease in foreign languages (which required a certain level of focus and effort) as I had in everything else. My A-levels were all maths and science subjects, which required a greater level of consistent concentration than I'd had to apply previously, and it was a real struggle. I thought my natural ability had let me get away with not working hard in school and now I'd bumped up against the limits of what I could do without trying—which was sort of true, just not in the sense that I thought it was. Some part of it stuck, however; I beat myself up for years thinking I was lazy.

It continued in that vein: university was a blur of things-done-at-the-last-minute; I always finished the work but never quite in a way that satisfied me. There was always a sense that I was pushing against something, that this should all be so much easier. Getting a job saw things become relatively easy again, as the work was less mentally taxing—but that, if anything, was more tricky, as the lack of challenge meant a lack of impetus to do the work before the last minute. Mostly that was fine, and partially compensated for by the addition of more direct supervision for the first time since school, but any unanticipated problems and I'd be in a real jam.

For many years I continued like this. These were not years of unhappiness or lack of activity and achievement. My friends would probably tell you I am someone who likes to be busy. I've written hundreds of thousands of words, recorded hundreds of podcasts, performed music, organised political groups, run events, spoken at conferences, run courses, made things. I almost stood for elected office; I've started two businesses. When I was doing well, I could even believe that I wasn't lazy. But no matter how much I did, I always felt like I wasn't fulfilling my potential. In particular, anything that required deliberate focus seemed completely out of my grasp. The writing, for instance, was mostly blog posts; any attempts to write things longer tended to founder. Most of the time, if I can't fit it all into my head at once, I can't do it.

Then: some chance conversations, some articles linked to. I first read this post on Gekk in March 2019. It's saved in my Pinboard with the note "To the best of my knowledge, I don’t have ADHD but I do find some of the stuff in here an extremely good articulation of problems I’ve experienced." (If you ever find yourself thinking this, I would suggest you investigate further immediately!) I read this newsletter by Klint Finley when it was published in August of last year. Accompanying note in Pinboard: "the stuff here on adhd is pretty relatable and makes me think that maybe I could do with getting tested". But one of the tricky aspects (pointed out in a quote in the post) is that described in the abstract, a lot of ADHD symptoms sound very much like normal human behaviour. Difficult to focus on boring things, you say? Do tell! So I shelved the thought, again. Eventually, though, I read this Raptitude post. While reading it, I finally thought: you know what, I really should maybe look into this. And I did, and guess what? I do, in fact, have ADHD.

It did feel good, knowing that I wasn't broken, but rather different in a rather annoying way that would fortunately be amenable to treatment. The more I read, the more I found it explained all sorts of things I wasn't expecting: why I ate so much, particularly sugar (reliable source of stimulus!), why caffeinated drinks never seemed to give me the "kick" everyone talked about (insufficient source of (chemical) stimulus!). But suddenly, a lot of my brain was trying to unpick everything else about my to see what was "real". I think I do like being busy, but a lot of the why for that historically was subconsciously gaming the condition: if I'm doing a lot, it creates a constant low-level sense of anxiety, which spurs me to do things, whatever they might be. (What that means, regrettably, is that historically I only really feel like I'm at peak performance when I'm on the edge of burnout.) So much of my life has been trying to find tricks to help myself do things that most people don't even think about.

(This hopefully explains better a question that I ask myself in my darker moments: if I can do all this stuff, then where's the problem? The best description I've been able to come up with is reliability to myself. Unlike a lot of people with ADHD, I've never had a rep as being unreliable. I have created over the years a number of systems to ensure that I remember things that are told to me, that I perform tasks that are given to me, that I don't lose things. My perpetually-morphing to-do systems (there's a bit in the Gekk article linked above about that which describes this precisely, search the page for "Scorched Earth Effect) means I don't 'lose' things I want to do. Because of my deathly fear of letting people down, unless there's an absolutely impassable impediment, I always, always get something done if I tell someone I will. The trouble is, while I am externally reliable (the job will always get done), I am not internally reliable (I have little to no control over when I will be able to do the job). As you might imagine, this creates a significant amount of stress, also often I'll want to be doing something but find myself unable to do so.)

After diagnosis, treatment. I've been taking medication for a couple of weeks now, and the best way I can describe it is that before, when I tried to do something that was boring, uncomfortable or uninteresting, the voice of distraction, the part of me that wanted to do something else, exerted the strongest force on me—unless it ran up against greater forces, chiefly my fear of letting other people down or my fear of deadlines. The medication doesn't remove the voice of distraction, but reduces how loudly it can speak. I can choose to ignore it now, and pretty easily. I joked to someone that I wasn't expecting it to be like the pill from Limitless. It isn't, obviously—but the first week I was medicated, I was able to do two days worth of work every day (partly under the pressure of the previous week's COVID and the following week's holiday, but still). I wouldn't recommend doing that, as it was A Bit Much and I've subsequently had a bit of a crash, but it's good to know I can now turn that on if I need to. I don't know what kind of multiplier I'll be able to apply to my previous performance (particularly given my lingering Covid fatigue etc at present), but I'm confident that at very least I'll be able to start doing work when I choose, with more comfort and ease. At most... it turns out that for the last 29 years I've been Goku wearing training weights, mentally speaking. I'm excited to see what I can do now that I can selectively apply focus.

Afterword & Stray Thoughts

I linked above to a few blog posts which say a lot of this stuff, and better, so you might ask why I've written this. It's because people who read this blog, presumably have some level of emotional investment in me, and are more likely to read the post. Reading a post like this is what set me down this path, and I think the more things there are like out here, the better. If any of the above resonates I would strongly recommend looking into it. This self-diagnostic form is a good place to start.

If you're in the UK and thinking about looking for diagnosis: NHS waiting lists for ADHD diagnosis are bonkers (1-3 years is what I've been told)—apparently COVID work-from-home measures lead to a lot of folk realising they have it, so if you can't afford to go private, have a chat with your GP ASAP so you can get on a waiting list. If you can afford to go private, the whole process, from initial contact through diagnosis to medication can be as short as a couple of months—but it will cost you. Once you've got your dosage sorted you'll also have to have annual/semi-annual (depending on your GP) private appointments to make sure you're still ok on the treatment. I had the immense luck of my realisation coinciding with going freelance and my income increasing, so I was able to eat the cost. Obviously not everyone will be as lucky.

Thinking about how situations like mine can be prevented in future: a lot of the reason it's taken me this long to realise what was going on is that ADHD (in kind with most mental conditions) is very poorly-understood, and the colloquial vision of it is (still!) a hyperactive ten-year-old boy unable to sit still in the classroom. That wasn't me. Screening for ADHD in gifted students whose grades drop off around 16 seems like it would be a relatively low-cost intervention with a high return, not just in productivity but also individual happiness. At the very least productivity books should come with a note at the front suggesting that if you've read more than one of these in the last year, you should take an ADHD test.

My therapist told me that some people are resentful after receiving a late-in-life diagnosis. I should stress: I'm happy where I am right now and I'm happy with my life to date. An earlier diagnosis wouldn't have solved all my problems, but even untreated I could've got here without beating myself up so much. Treated, I could've done more (I try not to dwell on this but had I been diagnosed in my teens, my life could have been very different).