I've been diagnosed with depression, an anxiety disorder, and ADHD. I've felt all three very deeply. Would you believe that of those three, living with ADHD as a grown woman has been by far the hardest to deal with?
I was diagnosed with Attention Deficit/Hyperactivity Disorder as a child of 12 – not an adult, but I still recognized myself in Rae Jacobson's fabulous essay about living with ADHD for The Cut. I've felt almost everything she describes at one point: Panic over starting a new job; depression and feelings of low self-worth from consistently failing at tasks that other people find easy; and, most of all, skepticism and condescension from other people who think it's not a "real" disability. I'm far more embarrassed telling people I have ADHD than telling them I take antidepressants. Even though all mental health is stigmatized to some extent, depression advocates have made real headway on getting people to understand what depression means; furthermore, serious depression is singled out by the Equal Employment Opportunity Comission as being worthy of protection from discrimination. ADHD, however, is not.
ADHD is a joke to many. People will say "I'm so ADD" to mean that they have a messy desk in the same way a neat freak will say "I'm so OCD" to describe their tidiness habits. (It probably doesn't occur to these people that ADHD and OCD are actually quite similar, in practice.) ADHD, I'll admit, also might be over-diagnosed (your kid got a B in school? Have you tried putting him on highly addictive medication that's chemically similar to meth?), which engenders a lot of skepticism in people about whether it actually exists. Added to that, people are often misdiagnosed as having ADHD when they actually have a different disorder, or they have ADHD in addition to other disorders, which creates a lot of confusion about what ADHD actually looks like.
Let me clear up some of this stuff. Hi, my name is Jaime Lutz, and I definitely have ADHD. I was diagnosed with it as a kid, and again as an adult; both times I had to take a rigorous test to narrow out other diagnoses. My life has been severely impacted by it. Here's what you need to know about the myths versus the reality of living with ADHD.
1. MYTH: ADHD just makes you "hyper."
REALITY: ADHD affects your IQ.
For many people, it's astonishingly easy to get your hands on ADHD medication like Ritalin and Adderall – oftentimes, pediatricians will just ask parents a questionnaire about their child's personality, which may or may not actually be all that effective. This was not how I, and many other people with ADHD, were diagnosed, however. When I was a child, and again when I was in college, I was diagnosed using an IQ test.
Most IQ tests measure different parts of intelligence – for instance, the WAIS-IV IQ test measures verbal comprehension, perceptual reasoning, working memory, and processing speed. For each intelligence category, the WAIS-IV gives a different, IQ-like score. It also gives two "total" IQ scores: One that incorporates all four intelligence categories, and one that just incorporates verbal comprehension and perceptual reasoning, which supposedly measures intelligence potential. (With me so far?)
People with ADHD often score much higher on verbal comprehension and perceptual reasoning than they do on working memory and processing speed. For instance, while I received a very high 147 on the verbal comprehension part of the test, I scored a mere 75 on the working memory part of the test – making this section of my IQ the same as Forrest Gump's stated overall IQ. In other words, people with ADHD have an abstract intelligence much higher than their working intelligence.
What this means is that people with ADHD are constantly perceived as not living up to their high potential, something that is an incredibly depressing thing to hear when you're really, really trying to do so. Effort has nothing to do with it, though – people with ADHD find normal tasks much more challenging than do neurotypical people.
2. MYTH: You grow out of ADHD.
REALITY: Most likely, ADHD will stay with you into adulthood.
IQs don't change much with age, and there's no sudden leap in IQ when people with ADHD graduate school. People with ADHD often follow a pattern of struggling in school through high school and then, suddenly, doing really well in college. Unfortunately, this is then frequently followed by another period of struggle as people with ADHD enter the workforce.
Why is this? It has to do with the inability of people with ADHD to regulate their attention. Grade school through high school requires a lot of rote tasks, which are notoriously difficult for people with ADHD. In college, people get to pick their own schedule and curriculum, focusing on subjects that interest them and which utilize more abstract intelligence skills – and here, they can really shine. However, the "real world" has more in common with high school than college: the ability to do rote, repetitive tasks becomes prized in the entry-level workplace again, and employees with ADHD struggle not to make mistakes.
Some people do "grow out" of ADHD; about 40 percent of kids diagnosed with the disorder don't have symptoms of it as adults. In part, this is because the hyperactivity part of ADHD tends to fade away as people get older, and for some children, this is their primary ADHD symptom. For kids with primarily attention difficulties, though, it can be harder to change.
3. MYTH: People with ADHD can't pay attention to anything.
REALITY: It's hard for people with ADHD to switch focus or multitask.
I'm not distracted by bright, shiny things, and to be honest, I find that stereotype pretty insulting. It's actually much harder for me to switch my focus, even if I want to – so I'll find myself focusing on something dumb instead of something I really should be doing. This tendency is called hyperfocus, and it's a distinguishing feature of people with ADHD. "Children and adults with ADD have difficulty shifting attention from one thing to another," Psychiatry Professor Russell Barkley told ADDitude Magazine. "If they're doing something they enjoy or find psychologically rewarding, they'll tend to persist in this behavior after others would normally move on to other things. The brains of people with ADD are drawn to activities that give instant feedback."
Remember, ADHD isn't just about distractibility. It's also about the inability to manage your attention and impulses.
4. MYTH: ADHD is a minor problem.
REALITY: ADHD puts you at risk for depression, anxiety, relationship problems... and unemployment.
ADHD puts a significant strain on my life and relationships. I've ruined friendships because of things I've said impulsively, gotten into fights with my boyfriend over interrupting him too much, and gotten in trouble at work because of mistakes I've made without realizing them. This has resulted, unsurprisingly, in feeling like a bad, worthless human being. Is there any surprise that depression is nearly 300 percent more likely among adults with ADHD than neurotypical adults?
Writes Jacobson in The Cut:
By high school, I had fully internalized the fact that I was a screwup and began acting the part with teenage gusto. “Fuck you, fail me,” I spat at a particularly hateful teacher, middle fingers aloft. “It’s not my first time.”
Then I’d go home and cry. Repeated failure is destructive. It chips away at your self-confidence and eats at your resolve. It makes you hate yourself.
“Why am I like this? Why am I fucking like this?” I’d ask myself, over and over.
I've had those moments, too. The worst thing, in my experience, is being caught between the battling thoughts of "I can't help acting this way because I've tried to change it for years and just can't" and "My disability is no excuse." I don't know what the right answer between those two poles is, but both answers make me feel despairing.
5. MYTH: It's easy to get ADHD medication.
REALITY: It's easy to it get prescribed, yes. It's not easy to actually take it regularly.
Everyone knows the stereotype (which has a basis in reality, in my experience) that there are some doctors offices you can walk into, complain about daydreaming, and walk out with a prescription for Adderall. But if you actually need medication for a stimulant, it's much harder to take it on a consistent basis.
First of all, where I live, in New York City, doctors can't prescribe a year's worth of refills for my standard 20mg Ritalin LA – I would have to pick up my prescription up at the doctor's office every single month before going to the pharmacy. When I got to the pharmacy, usually they didn't have Ritalin in stock, generic or otherwise. It would be typical for me to have to go to four or five pharmacies before finding one that actually carried the drug I need, thanks to addicts causing stimulant shortages (by the way, this is one of the many reasons I will not sell you my meds) – making hours of work just to get a drug I needed.
Sometimes, I wouldn't find any pharmacy carrying Ritalin at all. In these cases, I'd have to wait a few days until the pharmacy ordered another shipment – all the while experiencing the effects of stimulant withdrawal and suffering at my job. Fun stuff.
6. MYTH: ADHD can be solved with medication.
REALITY: Medication doesn't work alone – and that's the biggest struggle facing ADHD sufferers today.
You'll notice that I talk about my struggles with medication in the past tense. That's because I don't take it anymore.
It's not because I think Ritalin is evil, or even harmful, if taken correctly. In fact, it helped me out a lot. It worked great – until it didn't.
Remember how I mentioned how ADD is linked with anxiety? Unfortunately, stimulants like Ritalin exacerbate anxiety disorders. For me, that meant that my jaw would clench up during sleep and give me significant joint pain and headaches. At a certain point, I had to choose between treating my ADHD and living in pain.
Ritalin and Adderall are serious drugs. I remember the first time I went on Ritalin, I told my pharmacologist that it felt like I was on speed – I think I, an innocent college senior who had never tried cocaine, even used the phrase "coked up." She checked my low dose, shrugged, and said that this is what it should feel like. When Ritalin is working, it feels speedy. With anxiety on top of that, it's a tough way to live.
Lots of people have similar or dissimilar issues with ADHD medication – some people have even worse side effects than that. Other people have addiction issues (after all, that often goes hand-in-hand with an inability to control your impulses) and shouldn't take stimulants. There are non-stimulant medications for ADHD, but they are not effective for everyone, myself included.
When I went off medication, the first thing I tried to do was find a specialist who focused on treating ADHD through talk therapy. After all, some studies show it actually may be more effective than medication alone. I live in one of the biggest cities in the world, and I figured it would be easy to find a talk therapist who specialized in ADHD on my insurance plan.
I was very wrong. To my distress, every single talk therapist I found through Blue Cross Blue Shield who treated ADHD was either not accepting new patients, or only treated children.
Right now, I'm trying to manage my disability the best I can through standard time management stuff – to-do lists, frequent communication with people I work with, that kind of thing. But it's still incredibly tough. I wish that I, and everyone else who suffers from ADHD, had a better guide through this. I wish that friends of sufferers, who want to be supportive, also had the right tools and support system.
More than that, though, I wish institutions (particularly the workplace) were more adaptable for people who don't fit into the neurotypical box. Even though ADHD is definitely a disability in this world, in an ideal world it would just be another, diverse way of thinking and being – after all, people with ADHD also report positive side effects to their so-called disability, including increased creativity, entrepreneurialism, and leadership. Albert Einstein was thought to have ADHD, and he credited his genius to his daydreaming. Unfortunately, most real-world jobs don't actually reward real creativity (they reward productivity, which looks similar and which is the real talent of most so-called "creatives"), and they rarely make adaptions for people who have the negative traits of ADHD. That's why I don't really care about ADHD jokes, I have to say (except as a comedian, since that's a pretty lazy premise) – I care about systemic, unthinking discrimination.
Images: Photo of the author taken by Spencer T. Campbell; Giphy (7)