Another round of emails, which get more and more nuanced:
Thank you so much for featuring this discussion about ADHD. It has been wonderful reading the experiences of others in similar circumstances and I’ve taken away a real sense of solidarity from your other readers who have written in.
I was diagnosed with ADHD inattentive type last year. I had never been diagnosed before, because I did well in school and went to an elite university (although, tellingly, I was a mediocre standardized test taker). Upon graduating from school and entering the workforce, I collapsed. I didn’t have the structure of academics to keep me in check and I flubbed it. For several years I was stuck in the entry level, totally flummoxed at the apparently effortless advancement of my peers while I was spinning my wheels. I became depressed and indifferent, and I withdrew from any hope of a real and meaningful career. For several years I was treated with antidepressants and anti-anxiety medication, which did eventually help the depression and enabled me to do enough to get a foot in the door at my dream job.
The efficacy of the antidepressants promptly waned; I was mortified at the prospect of blowing what I felt was my last real chance to start a proper career.
In one session with my psychiatrist, I related the power this profound fear of failure had over my internal monologue and how I couldn’t tune it out (amplified by the persistent presence of very talented and pedigreed professionals several years my junior). It was suggested that the depressive issues were caused by attention problems, and I was prescribed an amphetamine-based psychostimulant regime.
It was like turning on a light switch. I feel good about myself for the first time in a long time, and I feel like I can finally get on with my life instead of gazing at my navel and wondering why I can’t make it work. I’ve been promoted, twice, in the time since my diagnosis. To this day, I’m still drunk on the sensation of possibility.
Despite this, every time I go to the pharmacy I’m given looks like I’m a faker who’s chomping pills to get ahead. Persistent over-diagnosis for troublemakers in middle school and casual pill-sharing in college has undermined the notion that ADHD is a legitimate problem. I’m infuriated when I see authors asserting that it’s not a thing, and that if I were only diligent enough to eat well, exercise, and sleep properly that all of my problems would be solved.
Another argues that “drugs are helpful, but even just the knowledge that you have an ADHD brain can be empowering”:
I’m in the under-diagnosed population of non-hyper girls who did phenomenally on tests. I did well in school even though I would procrastinate and lose my homework before I could turn it in. My struggles really began after law school when I was unable to perform the many administrative tasks and planning duties necessary to be a good junior attorney. I could understand complicated legal issues, but I’d forget to book a court reporter for a deposition or even forget the deadline to file a motion. I wasn’t even learning from my mistakes, forgetting once again to book a court reporter on the same case.
My diagnosis of ADHD was a breakthrough. The knowledge that I just wasn’t good at certain things, like organization, planning ahead, time management, and other things that some people take for granted, was a great relief. I read Delivered From Distraction and learned strategies to help me function better. Knowing how my brain works, along with methylphenidate, has helped me compensate for my tendencies.
Another blurs the line between needing and wanting:
The issue of under- and over-prescription of stimulant drugs has two main problems which cause the controversy. First, ADHD, like most psychiatric illnesses, falls along a continuum. Second, the stimulant drugs are effective for increasing focus in everyone. The result is you have a large number of people who are right along the line between really needing the treatment and being able to get by without it, and a huge number of other people who would like to use it anyway.
My personal perspective is as a final-year medical student who has gotten through without using these drugs. I am also one of those people who falls along the borderline. Could I have gotten a prescription? Absolutely! My parents even mentioned that a few teachers brought up the possibility while I was in grade school, though my physician father disagreed and no action was ever taken. I have actually been driving one of the medical tutors at school a little crazy this year because I have difficulty sitting still when nothing is happening, and he seems to think I have ADHD.
However, I function pretty well, and it hasn’t caused any problems which I couldn’t overcome. Would being diagnosed and getting a prescription make work easier? Yeah, almost undoubtedly. Am I going to get one? No, I don’t think the side effects are worth it. Of course, if their use became incredibly widespread and I found I was at a significant competitive disadvantage by not using them … well … that might be a discussion for another day.
Another wants it now:
I think that all this discussion about how many people really have ADD or ADHD misses the point. The real question is: How many people could benefit from regular or occasional use of ADD meds? If I’m an adult who doesn’t have ADD, but I’m 40-percent more productive on a day when I take Adderall, why shouldn’t I be allowed to make that choice when I’m behind on work?
The Dish 