ADHD Scrabble Letters

ADHD: A New Reality

mental health, personal

I’ve known something was wrong for a long time.  I just didn’t know what it was.

There were a lot of moments where someone recognizing my ADHD were excruciatingly close, only to have it slip away.

And like a lot of people with ADHD, the first big warning signs came in elementary school.

I nearly failed fourth grade, despite scoring in the 94th percentile on the Iowa Test of Basic Skills (a nation-wide standardized test).  The score was well above most of my classmates, but only a late-year parent/teacher conference saved me from repeating the year.

I actually failed 7th grade English class, and 10th grade Algebra II – and I’d go on to land a 32 on my ACT, including a nearly-perfect score on the English section.

So what was the problem?

I’ve always said that I just had a better-developed sense of work/life balance than most six year olds, and that’s followed me ever since.

But the real problem was the homework.  I went to schools that gave out homework in every subject, every day.

And that’s why my inability to do work outside of the classroom created a lot of problems.  For as long as I can remember, we always had at least an hour every night.  By the time I was a senior in High School, the load was usually around four hours of extra work every night, on top of whatever extracurricular activity I was doing.

Or it would have been an extra four hours of work, if I had done it.  I didn’t.

There were many parent/teacher conferences, from elementary school through high school.  They always centered around what were ostensibly character flaws.  From the language my parents and teachers used, it was clear that they suspected that I was either lazy, or I just didn’t care.

I developed patterns to cope with my chronic inability to do homework.  While most of my friends did just fine with basic organization, I was completely incapable of doing it.

I knew something was wrong.  I didn’t know how to put it into words.

Everyone else can do it, I’d tell myself.  What can’t you?  Don’t you know your grades today will affect the rest of your life?  You’re so much smarter than this!  What if your friends find out about how stupid you are?  What will Mom and Dad think when the hear about this again?  You’re a disappointment.  A failure.  And you’ll never be good enough.

Despite the interventions, on most day-to-day homework pieces, the work just never got done, and I’d feel like a miserable wreck at the end of the day.

Sometimes, the shame and fear would catch up with me and spur me to action.  This was particularly true on large projects with big impacts and immovable deadlines.  Unfortunately, it was never until the night before they were due.

And because I truly was a very bright person capable of doing great work, I managed to pull off incredible feats of academic output in single nights.

As a senior in high school, I wrote my final US Government paper – a 5,000 word essay justifying my approach to balancing the federal budget for the State Department, with an appendix showing income and outlays for each program – in a single night.

Receiving an A- on the paper was a welcome surprise, but ironically reinforced for me a very unfortunate lesson.  It was a lesson that had been driven into me by my years of experience in the cycle of avoidance-shame-procrastination-panic-production.

I “learned” that shame, anxiety, guilt, and procrastination were my friends, and that they were my only reliable to be produce acceptable work.

This only held true, of course, if you conveniently ignore all the times that the same cycle lead to my brain simply refusing to allow me to start any assignment that was too dull or emotionless.  I long ago had decided to not pay attention to those.

This Disorganized Child

Surprisingly, organization has never been my strong suit.

In elementary school, we had a single teacher and an assigned desk.  We kept our books in a cubby under the chair.  And we had a seatback cover for our chairs, where we kept our supplies and assignments.

Example of seatback cover.

How a seatback cover should look.

To say the organization of my desk left something to be desired is an understatement.  It was constantly disorganized.  Books were never placed neatly under my seat, but jammed into any available space, as quickly as possible.  My setback cover was full of broken pencils, old papers, and missing, half-completed homework crammed into every orifice.

It was the bane of my teacher’s existence.  In fifth grade, one teacher, a former nun, was particularly vexed.  So frustrated with my complete inability to keep my desk organized, she fipped my desk over in the middle of class.

“Why can’t you just keep your desk organized?” she yelled at me.  “It’s not a problem for anyone else!”

I wasn’t in my desk when this happened, but that didn’t make things easier. I was shocked, embarrassed, and upset, and the contents of my desk went everywhere.

I was forced to clean up the mess while the class watched and the teacher waited, refusing to teach any more until my desk and seatback cover were sorted.

Social Distortion

Events like this didn’t help me socially, but I also didn’t do myself any favors.

I was a sensitive kid, which made me an easy mark for anyone who wanted to get under my skin.  Even little things could swing my mood from content to angry very quickly.

And it never helped that I’ve never felt comfortable talking with people I don’t know well.  I often find myself focusing on the interactions rather than the conversation.

Was my greeting appropriate?  Am I making good eye contact?  Ugh, my laugh sounds ridiculous.  He doesn’t look very comfortable – am I doing something wrong?  I know he gave me his name 30 seconds ago, but now I can’t remember it.  Why does that always happen?  Maybe I can find a way to get him to mention it again. Oh shit, my mind’s been wandering.  What was he saying?  I don’t want him to think I’m not interested in the conversation, but I have no clue what we’re talking about now.  Shit. Shit shit shit.

Wash, rinse, repeat with every new person I met.

The Saga Continues

Predictably, these patterns carried over into my post-academic life.

I still forget the names of probably about 90% of people I meet within the first 30 seconds of meeting them, as I think about everything else about them and our interaction.  It’s safe to say nametags are my friend.

And although I’ve managed to climb my way up in my career and personal life, every day has been a struggle with the same shameful and anxious voices that kept me going.

Equally predictably, I developed problems with anxiety and depression as a result of the nasty tricks my brain was playing on me to push me to do just enough to keep moving forward.

It wasn’t late this past December, just before I started in online therapy for the first time, that I began to understand that my problems weren’t just a character flaw.

I’ve had issues with my working memory  – the ability to maintain/rearrange information –  for some time.  Worryingly, it seems to have gotten worse in recent years.

I knew that Generalized Anxiety Disorder (GAD), which I was diagnosed with in 2010, can cause some memory problems.  I was curious, however, if there might be something else at the core of my issues.

I began to do some research on what else might be causing the issue, to have some idea of what I might be up against.  Like any good Xennial, my first stop was Google.

Working Memory Screenshot

Never trust the first result of a Google search… but that doesn’t mean it’ll be wrong.

Out of the issues that were listed in my first result for potential issues, a few I could throw out without much extra thought.  Down syndrome and Rett Syndrome (a genetic mutation affecting brain development in young girls) were definitely out.  Developmental language disorder also seemed unlikely.

That left me with ADHD.  It was something I knew a little about.  My wife had been diagnosed with it when she was young, as had one of her sisters.  My wife was even one of the first juvenile testers of Strattera, a non-stimulant treatment for ADHD.

For some time, her ADHD has been well-managed, however.  We had talked in the past about how getting diagnosed and on medication for it had drastically affected her academic performance and thought process.  However, this revelation was so long before we met that I had no real grasp on how it impacted adults.

Was it really something that I could be struggling with?

Adult ADHD and Me

As I delved deeper into the symptoms of ADHD, I was shocked at how well they described me nearly perfectly, from the time I was a child.

Impulsiveness. We don’t talk about Bruno, or my Amazon shopping habits.

Disorganization and problems prioritizing.  I’m still cleaning up that spilled desk from 5th grade.

Poor time management skills. Why do something useful, timely, and important when you can do something fun and interesting but completely useless instead?

Problems focusing on a task.  See above.

Trouble multitasking.  Multitasking isn’t the problem. It’s too much multitasking.

Excessive activity or restlessness. The brief popularity of fidget spinners were a too-short-lived godsend for me.

Poor planning.  Seeing the big picture has never been the problem.  Planning the small steps to get me from A to Z has been.

Low frustration tolerance. One need look nor listen no further than my behavior when assembling the famously easy-to-follow IKEA instructions.  I’ve banned my wife and children from being around me while I’m doing an IKEA build.

Frequent mood swings.  It’s not uncommon for me to swing back and forth between extremes, within minutes of each other.

Problems following through and completing tasks. See my entire academic and professional career.

Trouble coping with stress. My generalized anxiety is more reliable on greeting me prominently each morning than my 4-year old son.

Take A Seat

So what did I do with this information?

I sat on it for a couple of years and let the shame of not seeking help and the anxiety that there might be even more wrong with me than simple anxiety eat away at me.

When I started a new job as a UX/UI Director in late 2021, I decided I could wait no longer.  This job came at an absolutely pivotal point in my career.  Success here has big implications, both for the company and my professional life.

Also in late 2021, I began to write The UX Design Field Book, a project that I’d thought of completing for several years.

In order to get the project done, I used a familiar strategy.  I set a deadline – January 18th, 2022 – for the book’s release and announced it to my 36,000 followers on Twitter.  I proceeded to procrastinate as long as possible before actually working on it, letting the shame and guilt of putting off a large project with a promise to literally tens of thousands of people build into a panicked frenzy of writing and revision.

Of the 23,244 words in The UX Design Field Book, I wrote and edited around 18,000 of them in the final two weeks before publication.

When I published the book, I felt no joy in what was an unequivocally huge accomplishment.  I was ashamed that the work did not reflect my full capabilities, and was sure that, despite my 12+ years of UX and design expertise, this would be the piece that finally exposed me as a fraud.

The result?  The book went to #1 on of Amazon Best-Sellers lists in the Usability, Graphic Design, and Web Design categories.  About a month and a half after release, it has a 5-star rating and has sold hundreds of copies.

And yet, like everything else I’ve ever done, I knew that wasn’t the best work I was capable of.  Once again, I relied on the same cycle of motivation.  Once again, my considerable abilities dug me out of the whole I created for myself. I created something that was objectively tremendously valuable and useful.

As the release date drew closer and my anxiety built, I felt more clearly than ever that I had a problem.  It was time to get help.

I’m So Much Cooler Online

One of the strangest things about my adult life is the incongruence between my online persona and my day-to-day experiences.

I’m so much cooler online.

I met my wife online.  I built my following and made lasting friendships online.  I’m seen as an authority by many.  I come across as confident, funny, even entertaining.  The content I create and the conversations I moderate get millions of views every year.  I’m lucky enough to get notes from many about how my work has positively impacted their careers and personal journeys.

My day-to-day life could not possibly feel more different.  Both of  people I’ve considered my good friends in the past ten years have moved away.  One I still exchange texts with a couple of times a week. The other drifted away from me, as those relationships separated by physical distance often do.  I feel unsure as a parent, a husband, and a professional, despite my apparent success.  Getting a note from anyone who knows me outside of the professional realm is exceedingly rare.

The online world, for me, is the biggest blessing I could possibly imagine.  It acts as a filter to give me time and space to think about and moderate my interactions.  I can review what’s been said in a conversation again if I’ve forgotten.  I don’t get distracted by people’s non-verbal language, or by my own awkwardness.

It’s not surprising, therefor, that when I chose to get involved with a therapist, I chose an online service.  I had been turned onto Better Help by the guys at the Crime in Sports podcast, who have had them as a sponsor for quite a while. (Note: neither Better Help or Crime in Sports are sponsors of mine.) The onboarding process was quick and easy – kudos to the Better Help UX team! – and I was quickly matched with my therapist, Kathi.

The Epiphany

Kathi has been a godsend.  Not only has she worked with patients with ADHD for decades, she herself lives with the condition.

When I signed up for therapy, I stated that I had a couple of goals.  I wanted to address my anxiety, and I wanted to understand whether or not ADHD was something that was worth investigating further as a possible source of my anxiety and other symptoms.

From our first meeting, I’ve felt exceedingly comfortable discussing my problems with her.  We spent a few sessions discussing (among other things) whether or not it ADHD could be something that was holding me back.

This part was key.  As a therapist, she couldn’t give me a formal, medical diagnosis of ADHD, but she could give me some thoughts on whether or not it was something that I should pursue with a psychiatrist or my primary care doctor.  I was determined to go into therapy with an open mind, despite my research on what my issues may be.

However, the more we talked, the more it became apparent to me that ADHD not only was something that I likely had, but that it could indeed be one of the primary drivers behind my generalized anxiety.

The Most Important Homework Assignment I Ever Had

Kathi gave me a key piece of homework early on – to read Driven to Distraction by Edward M. Hallowell, MD, and John J. Ratey, MD.  Though it was released in 1994 – when understanding of adult ADHD was still in its infancy – she told me that the book holds up superbly well.  It is an intimate insight into the stories and treatment of adults with ADHD, and she was interested to hear how my experience lined up with those patients who shared their stories for the book.

My life is exceedingly packed, and finding time to read a book – any book – can be problematic.  Luckily for me, it was available as an audiobook, and I was able to listen to it as I made diner every night and drove around as part of my daily errands.

This book changed my life.

The book gave first-person accounts of what it’s like to suffer from ADHD.  The disorganization. The complete inability to start and finish projects.  The distractability The shame, anxiety, and guilt that drive many ADHD sufferers

Here I expected a roadblock.  ADHD is often treated with controlled stimulants.  Their prescription online had been banned at one point, and I expected to have to both find a psychiatrist and make a an appointment with them – a process that I found could not be done online.

Did I mention that things like finding doctors and making appointments fall into the category of “things Doug’s brain won’t let him do without a huge effort?”

If anything good has come from this pandemic, however, it’s been the impact it’s had on finding mental help online.  The rules, in the US at least, have been relaxed, and finding a psychiatrist that would be able to assess me and prescribe appropriate medication was simple.

I ended up going with a company called Cerebral.  The process was very similar to getting setup with BetterHelp.  I was able to meet with a psychiatrist within a day, and after some discussion and testing I was able to get setup with a prescription for medication.

Let it Go

It’s probably not very common for grown men to tear up while doing the dishes and listening to Frozen’s “Let it Go” while doing the dishes.

But I can verify that it has happened.

While doing the dishes after dinner the other night, the song came on my Spotify (as it tends to crop up unexpectedly when it’s your daughter’s favorite song.)  I had never really listened to the lyrics before, but as my hands were soapy I was able to listen as I scoured a pan.

It’s funny how some distance makes everything seem small
And the fears that once controlled me can’t get to me at all
It’s time to see what I can do
To test the limits and break through
No right, no wrong, no rules for me
I’m free

I could feel myself welling up, because words cannot describe the change that I’ve seen in myself.

“Driven to Distraction” describes ADHD medication as akin to eyeglasses – they don’t solve the underlying medical condition, but they help bring things into focus so you can do work.

My ADHD meds work the same way for me.  They’re pivotal in allowing me to focus and do the things that my brain just simply wouldn’t before.  They’ve allowed me to start doing all of the the other things that neurotypical people are capable of just sitting down and doing on a daily basis.

I can start projects that seemed impossible.  I can finish projects ahead of time, doing better work than I’ve ever been able to do.  I’m learning how to manage the tasks, the organization, and difficulties that come with ADHD.

And I can do it without relying on the nasty shame cycle that my brain has been using to drive me my whole life.

Even though I’ve tried to be as open and honest as possible with my wife about my journey, I’m glad the water was running and the music was on.

What’s Next?

My journey with ADHD has been going on all my life.  The difference is that now I know what I’m up against, and I have tools at my disposal to help me be my best self.

Like any journey in my life, there will be ups and down.  I’ll have successes and failures.  I’ll have times when I’m tremendously proud of my progress, and times where it feels like I’ll never move forward again.

There is no cure for ADHD, but I’m determined that my ADHD will never define me again.