So, fun fact, I was diagnosed with ADHD recently.
Its been something of a wild ride to get to this place, so I thought I'd write this post as a form of catharsis, as it hasn't been an easy journey. It also serves as a message to anyone out there that needs to hear it, and that if they relate to some or all of the things I talk about, it might be a good idea to go chat to your GP/psychologist/psychiatrist.
Things may get heavy at times, so I'd consider this a trigger warning for discussion of general mental health issues, suicidal ideation and self-harm.
The Diagnosening™, part 1.
I was browsing Twitter one day, and came across these comics by Dani Donovan. I started poking around, and was initially like 'haha #relatable amirite', but the more comics I read the more I was like 'holy shitsnacks, I think there's something here'. So, so, so many of my behaviours, which I'd assumed were Just Me™ were listed, along with all the destructive side effects of said behaviours all of which I've experienced first-hand. General hyperactivity, struggling to maintain focus, difficulty dealing with overstimulation to just name a few of the core symptoms.
I started digging in and doing some research (with a healthy dose of skepticism going in, because I know what Dr. Google can be like), and came to the end of that and was like:
'... well, shit...'
Maybe there is something there. I even encountered a term I'd never heard before, that seems to go hand-in-hand with ADHD; 'rejection sensitive dysphoria'. That shit clicked (and writing this has reminded me I still need to confirm this aspect though). I've struggled with suicidal ideation for many years, and when viewed in the context of this and ADHD in general it made a lot of sense.
My original diagnosis (pre-ADHD) was high functioning borderline personality disorder due to the incredible amount of emotional spikes I would experience and be unable to control (among other things). However the one aspect where my presentation differed from the general rule of thumb with BPD was self-harm. I'd come close to that point several times in my life, and suicidal ideation I had in droves. But actual actions? That was one path I never really went down, and one aspect of the diagnosis of BPD I wasn't sure about. At the time however, given how many other aspects of BPD that did line up, I didn't think much of it.
The difference this time was it felt like ADHD fit me like a glove. It clicked in a way nothing had before, and I was excited to potentially, finally, have some answers as to how/why I felt like shit all the time. And one of the clear crossovers between BPD and ADHD is emotional dysregulation, so I felt a misdiagnosis was a possibility.
So, next steps were to book a chat with my psychologist. I've been seeing her for quite a few years now (that 'not easy journey' I was talking about, which I'm not going to cover today), and she knows me pretty well.
Initially, she was doubtful. I'd never really talked about this sort of thing before, and from her perspective I'd never really presented in that fashion. From my perspective though, so many more things just made more sense, and I explained the vast list of things that led me to this question. She said 'well, lets dig in anyway and see where we go'. So she got me to do an intelligence test, specifically the WAIS-IV. Most of my areas were ok, except for two aspects, Working Memory Index and Processing Speed Index. And as it turns out those two specific drops (when compared to the rest of the aspects of this test) were strongly correlated with people with ADHD! So that, combined with all of my own experiences I was describing to her, was my first diagnosis of ADHD. And, to make matters more interesting, with Generalised Anxiety Disorder thrown in on top. I then asked 'do you think medication would benefit me?' and she responded with 'hmm perhaps have a chat to your psychiatrist'.
The Diagnosening™, part 2.
So I got another referral from my GP, and sent it off to my psychiatrist. I'd not seen them in a few years, meaning I was considered a 'new-old' patient. It took them two weeks just to look at my referral, because they were so swamped at the time. Gosh, I wonder why. :: side-eye at the year ::
Eventually I got the green light (thankfully, as I really liked and trusted this guy), and the first thing they said was 'hey can you bring your academic records for basically all of time, and can you also have someone who knew you as a kid come along (or be available via phone) for an interview'.
And I was like 'holy shit'. Do they not believe me? Do I really have to go through this entire assessment thing again (because the WAIS is fucking exhausting tbh). Am I going to have the one thing that has helped me order things in my brain and provide an explanation for how I generally felt stripped away? I really started stressing, and my anxiety went through the roof. And I needed to have someone available for an interview, either in-person, or phone, who knew me as a child. So it felt pretty overwhelming, and very serious business™.
I managed to hunt down most of my high school grades and reports (primary school is lost to the mists of time). And amusingly, hilariously, I see the comments on the report cards. 'You really need to spend more time preparing'. 'You tend to get quite distracted in class'. 'You are usually attentive in this class'. 'You are often "off task"'. The other thing I noticed was that my grades gradually decreased over time. By the end of grade 12, I'd barely passed my subjects. Pretty much straight Cs. People with ADHD suuuuuck at studying stuff they don't give a shit about, and I very clearly remember how much I used to struggle with certain things. Not that I hated studying as such, but more if I was studying something I was passionate about (hello software development!) I was fine. Anything else, and I was a useless wreck.
So the day (finally) came for the appointment with the psychiatrist. I tell him whats going on, and what my psychologist (clinical psychologist, and this distinction is important as only clinical psychs and psychiatrists are able to diagnose someone with ADHD) has said I've got, and what I think I've got. And his first words were pretty much 'hmm you don't really present as having ADHD'. Haha 🙃. We start the interview with Mum (thanks Mum!), and he's asking a bunch of very specific questions and she's giving a bunch of specific answers. I was extremely hyperactive as a kid as it turns out. To the point where the teachers would be exhausted with me at the end of each term lol. Not that I misbehaved as such, but more would bounce from one desk to another talking to anyone and everyone. I'd always get my work done fairly quickly, but then would distract everyone else. And in grade 1 I'd also get bored very quickly and ask for the grade 2 and grade 3 work. Good times. Poor teachers lol.
We finished the interview with Mum and I give him a few more bits and pieces, and he says the words™:
'Yep, ok, you've definitely got ADHD, both inattentive and hyperactive'.
How I felt.
Wew. Ok. There are some complicated feelings™ to go through here, so bear with me. It may (will) get sweary.
Firstly a clear, sharp sense of relief and joy. Because all the years I struggled with crippling self-esteem issues - 'why the fuck am I so lazy, why cant I push through X, why cant I focus, why does everyone else seem to manage better than me?' - were explained with reasonable, twice-validated diagnoses. My brain was wired differently than most people. Cool. Cool cool cool. I've spent a few years in therapy unravelling those self-esteem issues (with varying degrees of success), pre-diagnosis, which is great, but it was wonderful to have a logical explanation for some of the overarching frustrations of my life.
Ive started to understand certain aspects of myself and my personality. Why I like to work from home, for instance. As it turns out, it's a known thing with people with ADHD that some of them have trouble with external stimuli, leading to them feeling extremely overwhelmed. Our office gets super busy (and loud) and I struggle to stay on task when I'm there, but if I'm working from home, I don't have that stimuli to overwhelm and drain me, and I can get so much more done. And I feel in general much calmer and happier.
Next, and this may be familiar to anyone that knows me personally, I think I finally understand why I'm so fucking exhausted all the time. Having that hyperactive aspect of ADHD, means everything is dialled up to 11 in terms of energy input. Someone merged a PR for me? They are the greatest person to have ever lived. Someone did something that makes my life difficult? I am angry beyond reason. I fucked up somewhere? I am the worst person to have ever lived, don't look at me I'm fucking hideous. So when you have that level of emotional intensity across all aspects of your life, I think I finally understand why I'm so exhausted. I'll still need to validate this over the next few months as I adjust to my medication (which I'll get to in a sec), but I think there's a strong case for an explanation here.
Those are just two examples of the newfound understanding I have for my brain, but I'll save the rest for another day. I already suspect this will be a long post.
After the relief and joy faded I got hit with a wave of overwhelming sadness, frustration and rage (remember the emotional dysregulation I was talking about earlier? Yeah...). How the fuck did it take over 30 fucking years to get this point, and no-one thought to mention this as a possibility to me!? I started crying after I left the psychiatrist because the pain of what I've dealt with, untreated and unmedicated all these years has been excruciating, and I've felt completely alone for most of it. The amount of times I've had people come up to be and say 'you're looking so well!' and I smile and nod, but internally I'm just thinking 'What the fuck are you talking about, its absolute fucking chaos in my mind, why cant anyone see this?! I don't understand.'.
As it turns out, my psychiatrist explained that the reason it went undiagnosed for so long was due to my general intelligence being able to compensate (at least to the external eye) for some of the shitty parts of ADHD. How delightful.
I've lost count of the amount of times I've seen my close friends, colleagues or family, be just so fucking calm™ no matter what life throws their way. Then I get frustrated with myself, because I simply couldn't be that calm. I remember so many times thinking to myself 'what the fuck is wrong with me, why cant I be like that, what am I doing wrong?!'. No matter how many times I tried, no matter the many, many techniques learned from years of therapy (shout out to Dialectical Behavioural Therapy for having the most positive effects on my life!), it just never stuck.
So it was a wild, wild ride that first 40 mins after the psychiatrist appointment. A maelstrom of intense emotion.
Now this is where things get interesting. I've started taking Ritalin, the brand name of a chemical called Methylphenidate. This is a stimulant, and tends to be the first port of call when treating ADHD. I've gone on a dose that tapers up, and specifically the short-acting (where each tablet lasts 4-6 hours) form for the time being. According to my psychiatrist, this gives me control around the peaks and troughs of its effects throughout the day, and will serve to help figure out the correct dose going forward, at which point he'll put me on the long-acting one (where each tablet lasts 10-12 hours).
The first time I had Ritalin, it was fucking world changing. But not in the way you probably think, reading that sentence.
I took a small dose after breakfast, and went for a walk with my wife to see how things went. We walked to our local-ish tea place and sat down for some tea. I started to feel pretty good. Not good as in euphoric, but good as in just... calm? It's so hard to articulate the difference it made. Think about it this way. Imagine you're in a room, with 15-20 kids, all just being kids. Screaming (and you know that particular high-pitched scream kids are great at), yelling, just being kids™, and the place echoes like crazy. And you cant escape, or cover your ears, or actually do anything about it. That's what its like inside my brain normally.
For the first time in my entire life (and I'm not being hyperbolic there, at all), I was able to step out of the room and into the peace and quiet of the scenery outside.
It was such a profound difference that I started to suspect a placebo effect may be in play, so I googled it. 'How long does Ritalin take to work'. And the first result I found was this. I'm going to take a portion of it out, and quote it here, because it blew my (and my wife's) minds:
Some people notice improvements in their ADHD symptoms on the first day of taking their medication. They wonder if their medication could really be working that quickly or whether the difference they felt was a placebo effect.
So, not a placebo effect it seems. Holy shitsnacks.
I was able to sit with my wife for about 45mins and just talk. Thats it. Just talk, and sit still. I was in no hurry to go anywhere else, wasn't hyperactively drinking tea until I could burst (I normally do this and will go through about 3 or 4 pots in a single sitting lol). I was just calm and talking and we were both having a wonderful time... The difference made us both pretty emotional.
See what I mean? World changing...
At the time, I could also feel the emotional spikes doing their thing. I was intensely happy I could be so calm, but I was able to (for the first time ever) stay in control of that intensity and not let it overtake me. And then I'd recognise that ability, and start to feel really happy again and then be able to control that intensity and it kinda got into a loop for a good 20mins. But through it all, I could control it. For the first time in my life I was able to get a better handle on my emotions. And then I realised something...
This is how normal people feel...
It kinda blew my mind. I could finally understand how those friends, colleagues and family could still be calm despite what gets thrown at them... because they had a level of actual control over their emotions that I never did. I could understand how people would sit through a 3 hour meeting and not want to rake their eyes out because it feels like you're wanting to crawl out of your skin because its so hard to stay still and focused on whatever crap (that likely could've been an email) they're talking about.
Going into this, I was initially worried about two things; losing my personality, and losing my sense of humour. Thankfully I can report those are both very intact, and if I could describe it, I'd say its more refined. I still laugh at things, enjoy things, but I don't get overwhelmed or lost in things. It's incredible. THIS IS HOW NORMAL PEOPLE FEEL. Fucking hell.
Im also more focused. My brain has slowed down, and with it comes the ability to easier articulate my thoughts to those around me. Its strange, but also wonderful.
So, What Now?
Well, now I keep going with my medication. Experimenting (with the support of, and at the direction of, my psychiatrist) until I get my dose right, and then starting from there with a newfound lease on life.
For the first time in a very, very, very long time I've got something I haven't had in a while. It's cliché as fuck, but it's 'hope'. A while back, I saw a pretty bleak, but accurate, description of how I've felt the last 20 years or so, and it was: 'It's not that I want to kill myself, but it's that I don't want to live anymore'. This has actually, fundamentally changed with getting diagnosed and treated for ADHD. There's hope for me, for treating the chaos inside, and being a stable, functional human being.
I think a big part of the reason I'm still here, and have been able to function to this point, is due in large part to my wife. She gets me™, and is extremely accommodating with the various quirks of my personality. She proactively gives me space when I need it (hell, she bought me some pyjamas that had Marvin the Martian on it and read: 'Need my space' lol), and has helped me through the various emotional spikes, and general ups and downs that comes with someone with ADHD. And this is pre-diagnosis. Fucking hell.
She's fucking incredible ❤️
This feeling of hope is probably the main reason I wrote this post, aside from my own catharsis of rage, frustration and sadness.
Hopefully someone out there reads this, and gets the help that they need, and gets to the point where they can feel like they've got hope again. I know you're feeling pretty fucked at the moment (and probably have for a long, long time), but it can get better. Reach out to those you can, and talk to the professionals™. It may take time, but it can get better.
Peace out ✌️.
Some links, for the folks that need it ❤️
Beyond Blue - A great place for those needing support across a variety of mental health issues.
ADHD Australia - A good place to start if you want to dig around about ADHD.
National Education Alliance for BPD - A good place to start if you want to learn about BPD. And a special mention to The Dialectical Behavior Therapy Skills Workbook (not a sponsored link, just something I really liked). I honestly think the techniques in this book could benefit everyone, irrespective of a diagnosis of BPD, ADHD or otherwise.
Center for Clinical Interventions - A place with so, so many good resources on a variety of conditions, providing coping mechanisms, worksheets, exercises and connections to other helpful resources. There are also resources for those who care for those with mental health conditions. Huge fucking shoutout to all of you out there ❤️ You're awesome.
ADHD Comics - The comics that started it all for me, by Dani Donovan.