Middle AgeDHD

Nobody should have to self-diagnose as ADHD. But nobody else did, so I had to.

I am 46 years old. I was raised by a mother with nothing but contempt for everyone else’s troubles, because they might take away from her own. Her niece (her sister’s daughter) was eight years older than me and frequently lived with us. She had several kids in short order after a shotgun wedding at 17.

Her second child, a boy, was diagnosed with ADHD around age six. He was very hyper indeed. My mom dripped with contempt about the diagnosis and medication. Her niece was simply not disciplining him enough, in her view. If she beat him properly, as she had done with my brother and I, there would be none of this ADHD nonsense.

The implicit lesson of this, given that, yes, my mom had beaten my brother and I quite liberally whenever our behaviour deviated from her wishes, was that there was no way I could have AD(H)D.

I was certainly not hyperactive. I was great at sitting still (it kept me safe). Maybe not so great at paying attention but school was boring; too easy for me. I literally slept through a semester of advanced math in grade 12, taught myself the whole course the night before the final exam, and proceeded to get one of the best marks in the entire province. The exam was miscalibrated in its inaugural year, far too difficult, and the province-wide parental outcry resulted in the exam not counting towards a student’s final marks if it lowered their grade. I was the only one to keep it.

The inability to focus until crunch time is a classic hallmark of ADHD, but since I perceived that it was impossible that I had it, I must therefore simply have a character flaw of too little discipline. I was too smart to have learned to work hard.

University life was more challenging. Standards were higher and my lax habits were put under strain. I would procrastinate term papers until the last minute, pull an all-nighter, and still get solid grades. I felt smugly superior to those who had diligently worked on their paper all term. Why bother when the last minute produced manic focus at last? I could spend all the rest of that time partying.

But partying took more and more of my time and energy, to the point I dropped out of school in my second year, literally to get refunded my tuition so I could party harder. I returned home with my tail between my legs once the money ran out. I could only see myself as an abject failure. I had tried to live life on my own terms. I was near-suicidal when I had a religious experience of a personal god who spoke love to me. I was undeniably transformed by this experience.

Three months later, I was a TA at the high school I’d only just graduated from, working with mentally handicapped students. I was also an unpaid (and laughably unqualified) youth pastor, additionally volunteering 3 nights a week at the aggressively evangelistic local youth drop-in. I had never been so busy. I loved it. I thrived. It was also doomed to fail, not due to business, but due to my restless mind that could tell most everything we believed was full of shit. I got kicked out of the drop-in first, and later the youth pastor gig because I tried to deviate from the party line with the kids.

Now I was home a lot more and that was Not Good. My parents had tried to get back together and our house was toxic. I fled my small town for the big city and never looked back. But I never again recreated that magical year of busyness. I had aptitude to spare in many things but I only wanted to chase intensity. I got involved with a cult-ish church that chased spiritual experience, later nearly joining an even cultier group that left due to the main group’s perceived low energy for big experiences.

The reasons I dodged that cult were that I had just gotten married to a very intense young woman and moved across the country (again) to go to a small Christian university to prepare for the pastorate. I was gonna be the right kind of pastor for the right kind of church, unlike all the disasters I had been a part of up to this point.

Upon graduation I knew that paid pastors were subject to the perverse incentives of telling people what they wanted to hear to keep the offering plates full. I wanted truth in all its unvarnished intensity. So I would need a side hustle to pay the bills. I’d heard of several pastors with similar convictions being web designers on the side. This is how I accidentally became a programmer in the late 2000s, where the same dynamics of procrastination and cramming as in university would repeat.

The point in all that oversharing is that I was easily bored, had trouble consistently applying myself until the pressure got so high that I could finally be completely absorbed in intensity. Bust and boom. I was at my best when I didn’t have time to sit still. But unfortunately I also had something like C-PTSD of the freeze and fawn variety that tried to hide in dissociation from everyone all the time. This tendency became stronger and stronger as I rejected the path of the pastorate, convinced that it wasn’t just this or that church that was sick, but the whole stinking edifice of modern/Western Christianity. I took a programming job with the “benefit” of working from home. I retreated from the public. My wife and later, kids, were enough. Fuck ‘em.

I finally got serious about finding out what the fuck was wrong with me around four years ago, doing my first big psilocybin trip. Vividness returned. Passion returned. But quickly dissipated by the intensity heatsink of dissociation. I learned what C-PTSD was and boy did I have it. I started doing all the explicit somatic and emotional therapies that would target it. I reached a healed-enough place with it this year where I was no longer triggered and dissociated all the time. Responding rather than reacting became an option.

But I couldn’t fucking figure out motivation for the life of me. Even though I wasn’t chronically dissociating any more, I just couldn’t keep my focus, even on the monumental task we’ve set ourselves of starting a new life as pizza bar owner-operators in Mexico after both my wife’s and my careers came to a sudden halt (with good payouts) within five days of each other this past spring. I have a LOT to do. Way too much. But each thing itself is not very interesting or engaging. This called for a capacity I just didn’t seem to have: set a future goal and stick with the process through understimulating tasks.

I was close to pulling the plug on the whole thing, thinking I’m not cut out for this entrepreneur shit, despite the wonderfully warm promise of making food for people and getting the fuck away from Winnipeg winters forever. I tried some desperate measures, like quitting my Twitter account, cannabis, and porn. I instituted a strict schedule. And it would all crumble the second I had to decide what to do next. It didn’t even matter if my wife and I had drawn up a list that I should follow. I would look at it and nothing seemed like an emergency so nothing seemed important enough to do right now.

And then I read Gena Gorlin’s wonderful My journey from ADHD skeptic to Adderall enthusiast post:

At 22, I thought ADHD was fake. An excuse for underachieving kids to get “accommodations” for procrastinating on their homework. From what vague knowledge I had of stimulants like Adderall, I regarded them with the same scorn as the accommodations.

I’d even seen the viral tweet that prompted the piece, and (to my shame) joined (silently) in the smug judgment of her as somebody using drugs to avoid her children:

But I read on, for some reason. I wanted to see how a former skeptic had deluded herself into believing that she was ADHD and needed medication. I read about her pulling all-nighters to write term papers, an immediate resonance. Doesn’t everyone do that? She described missed flights and lost phones and wallets, which has never been me, so I thought, well, yeah, maybe she has it but I sure don’t. Summarizing all of her failings, she says:

As far as my inner drill sergeants and I were concerned, these were all shameful moral failings that I “should” have been able to fix by now, if only I were less lazy and weak-willed. If I could write a solid paper the morning it was due, then I should be able to write one anytime. And indeed, I could pretty much always muster enough focus and discipline when I wanted something badly enough to try.

Until I couldn’t.

Oh, yeah. I could muster it, sometimes. But not reliably. I, too, had always thought of this as a character flaw. I should be able to summon that crunchtime high performance at will. But the beginnings of the parting of self-hating clouds was happening, the first rays of sunny “maybe I’m not just horrible??” breaking through.

But then she described something new, to me. She described it in terms of *intention*, which she discovered would just… stay put:

What Adderall didn’t do: give me a high or erase my bad habits overnight.

What it did: turn my fleeting bursts of focus into something I could summon and sustain on demand. As a result, my efforts to change or override my habits went much further than they ever had before. If I put my phone away and set the intention of “listening and taking notes during this 2-hour training session,” that intention stayed with me for the entire 2 hours. Not only did I have more energy available (as would have been the case if I had guzzled coffee), but I could aim that energy more precisely and enduringly toward my chosen, values-aligned goal.

It was like I had gained access to a purer, more stable, and more malleable form of the raw material that powers my agency. What I did with that raw material was and is, as ever, up to me.

Imagine a car whose gear shift jerks unpredictably between Drive, Reverse, and Park unless you keep your hand on it, and sometimes gets stuck entirely. That’s how I experience my attention off Adderall. On Adderall, the gears click into place and stay until I decide to shift.

This description in terms of stable intention is what got me. I’ve never had anything like it. Every time I would get into a panicked state over a term paper or negative performance reviews at work, I would slip into panic mode and finally, finally be able to sustain intention, briefly, until the threat had passed and I would slide back into the mode of always wanting to be doing something other than what I’m supposed to be doing. I thought this was just something everybody dealt with, just better than I did because I suck.

How would I find out? I have a family doctor, in theory (just an initial meet and greet), who gave me a kickoff bloodwork requisition almost a year ago that I haven’t gotten around to for some reason. I would have to do that first. Fuck.

But then: oh shit. I have some 2-FMA, don’t I. I could just try some at a therapeutic dose. If it goes well I can put myself through the process of getting a Ritalin or Adderall prescription.

So I tried 8mg. Too high a dose, can feel the amphetamine as such, but HOLY SHIT. Just tearing through the todo list. Doing the things that matter to me without trying to escape them. Hoping I’m not just fooling myself by being productive on a stimulant, as anybody might be.

I halve the dose to 4mg the next day. No longer feel the amphetamine itself, I think, so now the fear of “I’m just getting high on meth” has been downgraded from 50/50 to almost certainly not. I also start coming down with a cold that day, which usually triggers a collapse in me pretty quickly (relief at no longer feeling like I’m required to push myself) but I just work at cleaning out our basement (a task my wife has been begging for for years).

Out of commission (man cold) for the next few days. Get better and try a 2mg dose, just to see if that’s enough. It’s definitely still enough to notice improvement in ability to stay with a task without trying to get away from it. Stay at this dose for a week, before returning to 4mg to see if that’s more functional, which it turns out to be.

Make an appointment with my doctor to try to get an Adderall prescription. We laugh about that bloodwork requisition from nearly a year ago that I hadn’t done. He seemed chill but I wasn’t going to tell him about the 2-FMA, instead said that a friend had given me some of his Adderall and it had worked wonders. Gave me a questionnaire to fill out.

I get frustrated that maybe my C-PTSD was all downstream of coping poorly with ADHD. But then I have two separate conversations with ADHD-diagnosed friends who are still struggling with something like C-PTSD symptoms. So there seems to be some kind of mutually-reinforcing fuckery there. It’s probable that my C-PTSD was partially a way to cope with the pain of my ADHD-induced feelings of futility.

And the C-PTSD seemed to be a way to squeeze myself into performing anyway. Once I was no longer doing this, my ADHD was actually so much more apparent. I started forgetting things in a way that I never allowed myself to previously. Initially I was very concerned that I was going into cognitive decline, maybe from too much chronic weed use. But it turned out to be much more surprising than that. It was good that I had finally unclenched long enough to not have to be perfect, when being perfect hurt so much (and didn’t always work anyways).

That’s what the weed had been for. And the alcoholism through most of my 30s. Quenching the pain of trying to force myself, always forcing and squeezing and tensing myself into a shape that my bodymind rebelled against.

The doc called me a week after I’d filled out that self-assessment questionnaire. I was worried I’d undersold my symptoms (I’ve been in denial for so long) and I was waiting to jump through a lot more hoops but he just laughed and said “yeah this looks like ADHD to me” and wrote me a 20mg prescription for Adderall XR on the spot.

I circled back to this piece while on my first dose of it, and it actually feels a hell of a lot closer to that initial 8mg dose of 2-FMA (that freaked me out a bit) than the 4mg dose I’ve been subsisting on for the past month or so. I feel alive, a mixture of terror and exhilaration.

I can just do things. 😭

I wrote most of this while it was fresh, before I even met the doc for an official diagnosis and prescription. It’s rambly and disorganized and passionate, like me. I can’t fucking believe all of the people who failed me over four plus decades. I should not have had to self-diagnose. But I did, because fuck yeah I did.

Look out.