#and now i’m an adult and i NEVER take adhd medication for obvious fucking reasons
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my mom wants to medicate me at all costs
#for context#she has had me on adhd medications since i was in first grade#every single one of them has had horrible side effects#she said one of them made it where i didn’t smile for a month#and after years of this#instead of thinking maybe my child doesn’t need meds#she just kept going!!!#and eventually she found one she liked#and it gave me an eating disorder but nobody cared because i’ve always been skinny so obviously it’s natural for me to not eat much#(it’s not natural. i was gourging myself in the middle of the night when the meds wore off.)#and i genuinely had no emotions or personality but thats fine bc 13 year olds are shy and they pull away from their parents#and every time i said ‘hey mom and psychiatrist i don’t like the meds’ they’d fucking ramp them up#to the point that i was on a dosage that does not exist. i was taking multiple pills. because i was the only person on that dose.#i was fifteen.#and now i’m an adult and i NEVER take adhd medication for obvious fucking reasons#but any time anything negative happens with my emotions#like i’ll be like ‘ugh im frustrated at this video game’#my mom is like MAYBE YOU NEED TO BE ON 115 MG OF CONCERTA AGAIN. THAT WOULD FIX YOU.#i have the absolute lowest dose of vyvanse and i only take it when i ABSOLUTELY am sure i need to focus#and my mom wants me to take it to do shit like go to the arcade#she genuinely once said she likes me more when im medicated#so no#the red dye thing isn’t a genuine suggestion#it’s an attack on me. because she wants her freak kid to be normal so badly she’s willing to ruin its life.
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With the mental health stuff (if you don’t mind me asking), how open about it have you been with your friends? You’ve also talked about how your family isn’t supportive, so how has that played out?
I’m super transparent with my friends about my medication. I got my prescription called in, looked at my roommate, and went
I haven’t really brought it up to a ton of people, but I make no effort to hide it. Like, if it comes up I’ll talk about it. I’m not going to hide my meds from them or something.
Thankfully, most of my friends are people who haven’t internalized the stigma surrounding mental health treatment. Some of my acquaintances have cold takes, but ehhhhh fuck em, ya know? I’m taking steps to help myself. I’m not too hung up on Susan’s opinion on the mater.
With my parents, they don’t want to believe I have depression. They could be convinced of my anxiety, but their solution has always been ‘just stop thinking about it.’ With my ADHD it has been ‘just try harder’, and with my depression it was ‘go for a walk or something.’ And hey, I do believe in the power of taking a walk to clear your mind, but that doesn’t change the fact I barely have the energy to get out the door in the first place.
Needless to say they aren’t too pleased I’m getting on prescription medication, and my mom is wrapped up in how having two kids with depression reflects on her raising of us and I’m just...... listen there were issues with how you raised us, but I’m also pretty sure that’s not how depression works? You don’t need a reason to be depressed? Whatever.
But I’m an adult. I have my psychiatrist in my corner supporting me through this. With our insurance, my two prescriptions end up costing around $13 total, so they can’t complain about costs. I’ve told my mom that I’m taking steps to help myself, and she can feel however she wants about it, but that I know myself best and I’m doing what’s best for me. I think that has changed her perspective on it a bit, and has agreed to help me find someone to do an in-depth neuropsychological evaluation at home so I can do that over break, at the recommendation of my psychiatrist, in order to conclusively see what is happening in that regard. He agrees I exhibit a lot of ADHD symptoms, but since I have an atypical schooling experience, a lot of the obvious tells for it on the general behavior health eval I took didn’t exhibit for me, just because I was never in an environment when they would present.
It’s... weird. My closest friends can tell you I’ve been fighting for this openly with my parents for about three years now. It’s been an experience being reassured that no, it isn’t just ‘just me’ and that there is a reason for why I’m struggling. And also realizing I have to be my own advocate, because I’ve learned the adults in my life have not done, and will never do, it for me.
Essentially: they aren’t pleased about it, but they have enough respect for my autonomy as an adult to make my own choices regarding my mental health, within reason.
#mental health stuff#asks#ashe speaks#future note: these are all okay to rb!#i’m talking about this stuff in order to maybe help anyone else considering seeking help#i only had my brother for reference and that was......... an ordeal
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Congratulations, Me; You’re Slow
Surprise, me! You’re literally slow. As in, your processing speed - the rate at which your brain takes in stimuli and makes sense of it - is below average. Quantitatively. The average is 100. Yours is 94.
Three years ago, I was given a cognitive battery. I’ve had an unusually high number of these in my life. Most people will never have even one. I’ve had four; one to assess for the Gifted and Talented program in kindergarten, one to reassess for the same when I changed school districts, one to assess for ADHD, and yet another, the latest, to assess for the same, as the prior records were lost. ADHD runs in my family, but I seem to have been one of those kids who compensated really, really well. Was I organized? Not even a little. Lose things? Constantly. I procrastinated like a motherfucker, too, but it was usually easy to make up the work in class before it was due. I would drive hard to complete the GT project-based assignments at the last minute, and always did fine. Better than fine, even. Sure, I used to obsessively braid yarn or draw in class, but nobody had any reason to suspect I would have issues with things like maintaining attention or executive function later on. If they did, I never heard about it. Even today, it’s not obvious; people associate a certain flightiness with ADHD and that isn’t me. People associate a lot of things with ADHD that aren’t me. This has been so much of an issue, in fact, that despite meeting diagnostic criteria over and over, as admitted by clinicians, people have been hesitant to give me the diagnosis. The argument deployed tends to be: you have all the symptoms, but you also have chronic depression, which has the same symptoms, so we’ll just go with that one. The underlying rationale, the unspoken answer to “why can’t it be both? they often co-occur” seems to be: you are too articulate and self-aware to have ADHD. It boils down to you’re too smart to be slow.
This is unfair to me, and demonstrably untrue, besides. I recognized this long ago. I am the one who has to figure out some way to compensate for the symptoms. Yes, the symptoms of depression and ADHD overlap (especially if you are depressed for a long time), but the treatment of those symptoms is not the same. I have been in treatment for depression for over ten years. Am I better than I was? Unquestionably so.
Do I function at a level sustainable for an adult not on disability? Can I get places on time? Can I catch a plane without showing up 14 hours early, lest I show up 14 hours late, or at the wrong airport entirely, instead? Do I remember things people told me yesterday? Can I go to Target without the possibility of getting caught up in a weird cognitive trap where I want bananas, but am too guilty to buy them unless I do the rest of my grocery shopping, which I don’t have the mental energy for? Do I remember enough of my meds when I go on trips? Can I stop persistently putting things in places that make no sense, and then having no idea that I’ve done it 15 seconds later? Can I manage an adult’s schedule? Can I remember to pay bills on time? Can I remember what I’ve spent money on in the last week? Can I remember what I ate this morning? Can I hold down a job that is, honestly, below my abilities in many ways?
The answer is, of course, sometimes yes. Distressingly frequently, it is no. Where travel is concerned, it is always no, and somehow, I have managed to show up at the wrong airport entirely more than once.
Yes, I recognize that these are problems all people have, to some degree, at some time in their lives. If people are willing to act on the belief that I am too smart to be slow, why is it that when I account for my concerns and attempt to articulate the impact they have on my life, I am suddenly not self-aware anymore, and am only overreacting to what obviously MUST be the same degree of these problems that other reasonable adults experience? Why am I credible in other areas, but not this one? If I am so smart, why is it assumed that I’ve failed to account for my own emotional bias when gauging the difficulty I am experiencing? Why is it more satisfying to assume that I am not trying hard enough, then it is to accept that a smart, self-aware person may, in fact, have some kind of Brain Problem that, really, there is no logical contraindication to, and much evidence, for? When I do the responsible thing and insistently pursue all reasonable options to address my mental and neurological health, with the goal of being a functional contributor to society, why is this so persistently reduced to a fetish specifically for an ADHD diagnosis? I’m smart when it’s convenient for others, but not when it comes to the ability to draw cause and effect relationships from my own behavior, and make comparisons between those and the behavior of others? If I got treatment that worked, I wouldn’t care what the diagnosis was. Come the fuck on. I’m tired of this.
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Anyway. I sat down with the results of that three-year-old cognitive battery. I’ve read the summary before; it’s peppered with lines like
“There is also considerable other evidence in this testing consistent with a diagnosis of ADHD”
“In my experience, some individuals who are very bright are able to compensate for some of their disability”
“this distribution of index scores is very typical of individuals with ADHD”
“Many of the behaviors she describes are certainly typical of individuals who suffer from ADHD. Unfortunately, the coexisting history of chronic major depression and PTSD make that differential diagnosis based on history alone difficult”
When I first read that last year, I was shocked because the therapist who requested the cognitive battery, only expressed surprise that I was “very smart” and said that my “scores were fine.” When I later confronted him after having read the summary myself, he merely admitted that some of my scores were “lower than others”. He never entertained the possibility that I had ADHD, which in an of itself, wouldn’t have been a problem if he’d been willing to just try the treatments for it, since clearly the two industrial-strength doses of antidepressants I was already on, were not cutting it. Alas, he was not, and it wasn’t until after he retired that the issue was addressed again.
Surprisingly, I was not the person who addressed it. When my therapist-MD retired, I needed at least a primary care provider to manage my medications. Since the appointment was for psych med management, I had to fill out a bunch of related intake forms - you likely know the kind. While looking them over, my new doctor peered up at me and asked, “Has anybody ever suggested that you might have ADHD?” I was taken aback by the question and wasn’t sure where to start. Them? Asking me? if I have ADHD? She asked me?
I told her that I’d had two full cognitive batteries done, and that both of them concluded roughly the same thing: yes, all the symptoms are there, no, we do not know if it’s ADHD because there’s too much background noise from other psych issues. Without skipping a beat, she said the most amazing thing to me:
Well, whatever it is, you have the symptoms, so let’s treat them.
God. Why didn’t someone say that years ago? Diagnoses are human constructs; we use them to group symptoms that tend to occur together, when they’re thought to have the same causes. Depression and ADHD have many (but not all) of the same symptoms, but the overlap doesn’t qualify as a diagnosis because the causes are assumed to be different. I think we often forget that diagnoses are containers for commonalities that we use to make talking about medicine easier, not necessarily biological phenomena unto themselves. If you remember that they are containers - a sort of conceptual shorthand - then it follows that if one treatment for a set of symptoms isn’t solving the problem, you ought to try a different treatment often used for the same symptoms, even if the minutiae of diagnosis means you aren’t sure you can apply the diagnosis typically associated with that second treatment*.
I am now on Vyvanse. Does it magically solve my problems? No. Does it help? Yes. I am in a much better position to actually address the bad habits and coping mechanisms someone like me builds up over the years. The notable insomnia should wear off over time, and besides, as a person with an existing sleep disorder, having fucked up sleep isn’t new. It’s a price I’m willing to pay.
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Anyway. So I sat down with the results of that three-year-old cognitive battery, because I had to dig them up for my new therapist. Instead of reading the summary, I dug into the raw numbers: the related tests are the Weschler Adult Intelligence Scale IV (WAIS-IV), and the Weschler Memory Scale III (WMS-III). I couldn’t find sufficient guidance on interpreting the WMS-III, so I’ll stick with the WAIS-IV scores:
At first inspection, these scores do look “fine”. Anything within 10 points of 100 in either direction qualifies as “average”, even if 100 is “the average”. But on further reading, both in the summary and out:
-Examination of these results reveals considerable significant variability between various functional capacities, with VCI of 141 a full 3 standard deviations above PSI of 94.** Problems with both working memory and processing speed impacted her overall IQ considerably, bringing her Full Scale IQ down to 120 (from 133).
-A significant difference among subtest scores can suggest a problem in the particular skill being tested; this might underlie a learning disability. A significant difference among standard Index Scores might also indicate a learning disability, ADHD
-when I see a difference in IQ scores such that the verbal and nonverbal scores are far superior to the processing speed score, I try to discern what could be causing the discrepancy.
-LD diagnoses are also reliant on score discrepancies. On the WAIS, a gifted individual with ADHD may look like this.
Verbal comprehension - 132
Perceptual Reasoning - 129
Processing Speed - 97
Working memory - 101
Absolute scores aren’t the only diagnostic tool. Relative scores are also important. For example, average scores across the board wouldn’t be indicative of a working memory or processing speed issue, whereas great discrepancies between those parameters and others, is - even if the working memory and processing speed scores themselves are the same in both examples. What I’m saying is, it’s right there. It’s in the numbers. There’s no wiggle room. My old therapist saw these numbers, and not only did he choose not to act on the information, he pointedly refused to do so. If he hadn’t retired, I’d look into suing for malpractice. It’s in the god damn numbers, my dude. I don’t care what you want to call it, the deficit is right. there.
What did I ever do to him? Did he just... not believe ADHD is real? More to the point, did he think I somehow, without knowing the ins and outs of the WAIS-IV, faked the deficits or something? Really, guy, what the hell?
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Do I feel bad about being slow? Honestly, no. I might have if I found this out 10 years ago, or in circumstances wherein that reality didn’t perfectly explain aspects of my experience that other people have been prone to downplay, or dismiss entirely. Instead, it’s the closest I can get to scientific verification that I’m not just losing my shit over nothing over here; that something has, in fact, gone awry, and may always have been awry. I couldn’t compensate forever (though the ways I’ve done it are many, and in retrospect, interesting) and now I’m on the other end of it, trying to rebuild. I am, as I like to say, building an exoskeleton - something that will hold me up when my brain insists on faceplanting. I’m just grateful there’s someone out there who isn’t too caught up in the semantic navel-gazing of diagnosis, to help.
*There are obvious exceptions here, such as when the two diagnoses have causes whose treatment is contraindicated in the other diagnosis. This is not the case with depression and ADHD.
** You see that Percentile Rank of 34? That means I performed better than 34 percent of people my age, at least according to the test sample. That’s. Not great.
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Why my ADD was undiagnosed and what finally tipped me off
I’m going to be going over some things that prevented my diagnosis for so long, some symptoms I never knew were symptoms, and some of the impacts that came from my unchecked ADD. If you’re wondering if you have ADD/ADHD or just want a Hot Take™️ from someone who’s been rocking with it for nearly 15 years now, keep reading. TL;DRs for each paragraph if you don’t do well with long blocks of text.
When you think of someone with ADD/ADHD, you probably think of the little kid who won’t stop fidgeting and running around and acting up, or maybe the adult who went into art or something because academics were never their strong point. Either way, it’s usually a hyperactive, quirky, blissfully unfocused kid-at-heart. That view is why I didn’t get diagnosed until after my freshman year of high school. I’ve never been super energetic, I can get serious when I really need to, and I used to absolutely adore school! Because I didn’t fit the usual profile of the ADHD kid, no one ever expected that I would roll into adolescence showing major symptoms, and once those symptoms hit, everyone chalked it up to teen angst. Because of this profile, my parents refused to get me tested for ADD or even entertain the possibility that I needed any sort of treatment but good ol’ fashioned negative reinforcement for my falling grades, taking away privileges and taking me off the debate team (which I’m sure you can guess set me right the fuck off) and policing my grades to the point that I dreaded any conversation with them after missing an assignment. They also thought that ADD medication would make me “dependent on drugs” and “not myself anymore”. After doing about 5 minutes of Googling, I knew that neither of those are true at all, which has been confirmed after starting medication. It took me almost failing out of my school and having to drop an advanced course before they listened to my doctor and got me tested. To the surprise of absolutely everyone except me, I actually had ADD. Who would have ever guessed???
TL;DR The stereotypes and profiles of ADD/ADHD aren’t always right, and they prevented me from diagnosis and medication.
The other big reason I went undiagnosed was because I’m a Former Smart Kid (which sounds like a humblebrag but my intelligence is balanced out by my incompetence so let it slide). See, a smart kid is a young person with above-average intelligence, whereas a Former Smart Kid is the kind of person who did incredibly well in school for a while, and then it just all went downhill. Basically up through 4th grade, I was a special little sunflower who was excellent at academics because in those years you can sort of just slide by with very little actual effort. I was so special, in fact, that I skipped 5th grade and went straight to the very challenging one-year 6th grade Smart Children School, where I discovered that when you’re presented with things that require full attention, you can’t just not give them your full attention. I got my first D (the grade) there and cried a lot because I had thought I was smart but smart people just don’t get bad grades. But from there, bad grades and all, I went to my local Smart Adolescents Middle-High School, where my grades just got worse and worse. Only this time, it wasn’t just my grades in classes I didn’t like. I was slipping in my favorite classes, even the ones I was strongest in. Combine that with a bunch of assorted life problems and pubescent angst, and boom: Clearly it’s not ADD because I was so smart up until then. I’m just being lazy, I’m getting rebellious, I’m getting brain damage (seriously some people have found that more likely than ADD), it’s that damn smartphone, etc.
TL;DR If you’re a good student when you’re little but your grades fall as you age, no one is gonna think you have ADD because clearly you didn’t have it as a kid.
Being smart as a kid was fun and all, but when ADD symptoms rolled up to the party, it really, really hurt. The thing is, if you spend your whole life being told you’re a fucking prodigy, and then suddenly you start failing, it makes you feel like you were never smart to begin with. I threw all evidence of my intelligence away and dwelled on every bad grade, convincing myself I was only pretending to be smart, that I’d tricked everyone into thinking I wasn’t an idiot. Understandably, that did a number on my self-esteem. It also really messed with my ability to succeed in the things I love. I mentioned debate earlier, but I’ll expand here in case you’ve never met me and heard about how it is literally the only thing I do ever. I do speech and debate at my school, and I love it more than anything. But debate, and even non-debate individual events, require a lot of attention and focus. Guess what ADD really fucks with? So I went through a couple years feeling like I was too dumb to succeed in my passions, and like I was dragging down my partners/teammates/coach/anyone who ever wanted to be proud of me. That wasn’t great for my mental health, as you can probably guess.
TL;DR If you start out as a good student then turn into a worse student with apparently no reason, it’s not the best thing emotionally?
Here are some ADD symptoms a lot of people don’t know about:
Trouble getting to sleep/waking up in the morning- Pretty self-explanatory, but these are pretty common symptoms that I never really thought about.
No reference for the passage of time- You know when someone asks you about how long a length of time has been, and you just… can’t possibly guess? Or when you think 5 minutes have passed, and look up to see it’s been an hour? Or when an hour passes in 5 minutes?
Interrupting people- I’ve always had this problem. I usually cross my fingers or put one finger up when I have something to say in the middle of someone’s sentence. Of course, I usually forget what I had to say wishing 5 words, so it sort of works sometimes?
Aggression/irritability- Keep in mind, this one’s a symptom of LOTS OF THINGS. Don’t let this be the deciding factor. But it could be something to bring up with your doctor if you’re looking into a diagnosis.
Not listening- Looking back, this seems really obvious, but my parents used to think I had hearing problems because I just wouldn’t listen. Rethink some issues you’ve had with this, they could be ADD.
Side note on self-diagnosis
If you haven’t been certainly diagnosed by a legitimate doctor or just can’t access one, but you’re pretty sure you have ADD, or even just display a few symptoms, you should absolutely try non-medical methods of dealing with your symptoms, which you can find online pretty easily and can help almost anyone, ADD or not, to get through tough tasks. But don’t try to access accommodations, medications, or other things specifically intended for people with ADD. Doing this will perpetuate the very false stigma that ADD is just a way for neurotypical people to get away with putting in less effort.
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