Two years ago, I looked in the mirror and realized that I no longer recognized myself. Physically I looked the same, but somehow I knew that whatever it was that made me, ‘me’ was gone. I also knew—or so I thought then—that if I didn’t do something I was going to lose everyone in my life who loved me. As difficult as that realization was, the most frightening thing was not the potential loss, but the fact that I had no idea why.
I was profoundly depressed, but that was nothing new. Thirty pounds overweight, I hadn’t exercised in any meaningful way in years. (I also wouldn’t walk my beloved young Labrador, even while knowing it was cruel not to do so.) My diet was abysmal.
I endured unending advice from friends and family. I should, they said, practice yoga, walk vigorously every day, get some fresh air, drink less alcohol (sadly, one of the few things that really made me happy), eat the right foods, do volunteer work, or just, “get over it.” The problem was that I knew exactly what I should be doing. I clipped every article I could find about eating healthy, how to lose weight, how to reach my full potential, or whatever else I wasn’t doing. Then I would put them in a file and never look at them again.
I had been ignoring, in fact actively avoiding, even the most basic steps needed to stay healthy and productive, for as long as I could remember. Despite all indications to the contrary, I instinctively knew that what was wrong with me wasn’t due to a lack of willpower, or laziness, or depression (although depression was certainly a large part of it). However self-aware that may have been, this knowledge was useless. I knew what wasn’t wrong with me. But I did not know what was.
I had what many would consider a perfect life: a loving and supportive husband, a family who I adored, close friends. Like most people, I had experienced my share of tragedy and hardship, and had gone on to survive, to thrive, in fact; at least that’s how it must have appeared to those outside my immediate family. Up until then I had been able to hold things together. I met with friends, went out to dinner, worked on my novel.
But, for some reason, things had suddenly gotten worse. I had gone from a garden-variety, depressed underachiever to a supremely uncomfortable person to be around, judging from my husband’s reaction to my behavior: near constant mood swings, unchecked anger, and a complete lack of empathy towards others. And that was on a good day.
I had stopped writing, and reading, because I could no longer grasp the meaning of words on the page. I developed an extreme sensitivity to sound, to touch, and to bright light. I could no longer track conversations. I lost my sense of humor (never a good sign), and began to have irrational fears that the changes in my personality were permanent, or that I might die before knowing what was wrong with me.
To say that I had lost my life is not an exaggeration. I was still breathing, of course, but I wasn’t living. I was eating, sleeping, buying groceries. But I wasn’t doing anything that makes life, well, life. I wasn’t suicidal, although I can’t say that wouldn’t have changed had I not reached out for help. Eventually, this lack of attention towards my health, both mental and physical, began to take its toll. After a particularly stressful Christmas holiday, I shut down completely.
Finally, one night, as I sat staring at the TV with absolutely no clue what I was watching, I turned to my husband and said, “I think I need to talk to someone.” He looked at me, really looked at me, for the first time in many weeks, and nodded. “Yes,” he said. “I think you do.” And so it began.
If someone had set out to design a disorder most likely to confuse even the most levelheaded of individuals they could hardly have done a better job than with attention deficit hyperactivity disorder, or ADHD. It is, in almost every way, confusing as hell, and one of the most misunderstood mental disorders. Many people believe it’s a myth, including many doctors and psychologists.
Part of the problem is how it’s diagnosed. It can’t be done with a blood test or a brain scan. It involves a large degree of subjectivity to make a correct diagnosis, because it is comprised of a series of traits, not symptoms, and those traits are evaluated differently depending on the age of the patient. Also, these traits are similar to those present in other conditions, and it is often misdiagnosed as something else entirely.
Adding to the confusion is that, technically, ADHD it is not a psychological condition at all, but a neurochemical one, caused by abnormal levels of neurotransmitters in the brain that control three areas of behavior: attention, activity, and impulse control. The conflicting theories, treatments, co-existing conditions, and misunderstandings surrounding it, can make an ADHD diagnosis an overwhelming experience, particularly for someone who is as distracted as I am.
Before my brain shut itself off (and this is the only way I know to describe it), I had, over a period of several years, experienced what felt like an unending amount of stress: financial problems, depression, aging parents, etc. These things did not make me unique, but I had done nothing at all to alleviate those stressors, either through exercise, diet, therapy, or any of the other things people do to deal with the realities of modern life. I would later learn that unmanaged stress, particularly in adults, often triggers acute episodes of ADHD, provided you have it to begin with. (It’s likely that I’ve had it all my life, and probably before. A high percentage of premature babies end up with ADHD in one form or another, and I was born six weeks early, weighing just over four pounds.)
When I started looking for a doctor I was hesitant, skeptical that I could find one with whom I would be a good fit. Somehow, I found a psychologist who had been working with ADHD patients for years, but who was also a person I genuinely liked. The strange thing is that ADHD wasn’t even on my radar; I simply needed to talk to someone who might be able to help me. I called four or five doctors at random and, after two days of waiting, he was the first one to actually call me back. Was it simply a matter of luck? I don’t know, and I don’t care. I do know that this man is the primary reason I have found my way back from a very dark place.
During our first session I brought my sister with me because I, literally, couldn’t form sentences. I had no memory of certain events in my childhood, as she did, that may or may not have contributed to my current state. She and the doctor talked as I sat, alternately crying and trying to concentrate on what was being said. Over the course of the next few sessions, once I was better able to verbalize what I was feeling, the doctor and I discussed my life, both as a child and as an adult, and he eventually came to the conclusion that I was likely suffering from ADHD.
Because I trusted him, and because everything he said to me just made sense, far from being frightened by the possibility of an ADHD diagnosis, I was overcome with relief. What I was suffering from was something. It was real.
Unfortunately, as a psychologist, he couldn’t give me an official diagnosis or prescribe medication. I would need to find a psychiatrist, an M.D., who could do both. That meant more money, and more waiting. He gave me the names of two doctors he trusted. Again, one did not return my calls. The one who did wouldn’t accept my insurance plan and charged $400 an hour for the initial consultation. Although we were shocked at the amount of money involved, my husband and I agreed that we had no choice but to move forward.
During the initial evaluation I barely understood what the doctor was saying. That was a problem, because he was the person who would be giving me a diagnosis, if there were one to be made, and the person responsible for prescribing a drug that might give me some kind of relief.
He was, like everyone else in my life at that time, talking much too quickly for me to follow, and I asked him to repeat himself several times. This was laughable because there was no way I’d remember any of it later. Writing anything down was impossible, even if I could put words on paper, because listening and writing simultaneously was out of the question. One phrase, however, came through loud and clear. “You are ‘textbook’ ADHD,” he said. Okay, I thought. Now what?
If I were asked for one word that has best described me throughout my life, it would be, “restless,” an unending mental and physical restlessness; restless to go, to move, to be somewhere else. My brain doesn’t have an off switch, and my body rarely stops moving either, at least when I’m awake.
As a child I had virtually no impulse control. As soon as I learned to walk, (and before I could swim) I would, without warning, hurl myself into swimming pools, march out into the street to wave at neighbors, and total strangers, or just simply disappear. On a trip to the Grand Canyon when I was six, I slipped through a small opening between two guardrails, presumably so I could get a better view. My father turned around to see his daughter peering over the edge of the canyon, with nothing but air between me and a 6,000-foot drop.
As frightening as this behavior must have been for my parents, as an adult that lack of impulse control was problematic in other ways: addiction, reckless behavior, extreme clumsiness and lack of coordination, and the inability to sustain intimate relationships. Thankfully, most of these things have lessened over time, with the exception of my coordination, which has steadily gotten worse. I still misjudge distances, often walking into walls and tripping over furniture.
One of the most common questions I’m asked by those who don’t know me is if I’m in a hurry, a confounding question because, nine times out of ten, I’m not actually in a hurry. By the time I was in my thirties I began to understand that I must appear to others as something like a human hovercraft. I’m not, however, chronically late. In fact, I’m almost pathologically punctual. I’m not prone to getting fired, unlike many with ADHD. It is a disorder filled with contradictions, which may be why some people question the fact that it’s real. I was diagnosed over two years ago, and am only now starting to really understand what it is that I have.
My official diagnosis was ADHD/Predominately Inattentive, along with a co-existing diagnosis of Atypical Depression, which simply means that I’m not depressed when something good happens, as opposed to other types of depression, where a person remains depressed regardless of circumstance. While that description may seem simplistic, it really is just that simple. Inattentive ADHD isn’t as easy to describe. I have heard people say that it feels as if you’re forever stuck in a spider web. As the demands of life, or strings in the web, require more and more attention, they begin to pull in opposing directions, each one demanding immediate action, with little or no sense that one pull has a greater level of importance over another. Eventually, it becomes so overwhelming that most people simply stop trying. That was certainly the case with me.
When I received my diagnosis I felt a huge sense of optimism, even though I had no idea what any of it meant. My therapist suggested several books on the subject, which, of course, I didn’t read. My psychiatrist assured me that ADHD patients often respond very well to medication, specifically to stimulants, which, ironically, tend to calm them down and help them to focus. This made no sense to me, but I had no problem with the idea of medication as a means to recovery. In fact, I grasped onto the idea with such enthusiasm that I feared the doctor might be hesitant to give me any kind of prescription at all. But he did, and, as so often happens in life, things got a whole lot worse before they got better.
Sadly, there is no magic pill that will ‘fix’ ADHD. (If only.) Finding the right pill, or combination of pills, to manage it, followed by the right dosage, can take weeks, or even months. For someone with ADHD, waiting that long for relief is a terrifying prospect. Even more daunting is that, for some people, there is no right pill.
I started with Ritalin, the drug that most people are probably somewhat familiar with, at the lowest possible dose. Over the next two weeks I suffered through what is often referred to as the “Ritalin Roller Coaster,” because of the intense, emotional peaks and valleys associated with the drug. (Note: Ritalin is a controlled substance for a damn good reason.) To give you a visual example of what that time was like, here is what my writing looked like after my third day on Ritalin:
Feweling frazzled and anxious. Dose too high. Not sire where to turn,. Afraid of contaraindication (spelling?) w my Benicar. Can’t eat or slepp. Mark is frustrated but try9ng to hoide it from me, Lovehim for trying but wisgheh he would try harder. Can’yt write or track my thoughts. At leastI’m bnot self-editing. That’s a good thing, isn’ty uit?
My inability to write was the least of my problems. After two days, my life went from being merely unmanageable to a complete horror show. Intense concentration was required to do even the most ordinary tasks. Laundry, washing dishes, making the bed, all became overwhelming obstacles. Cooking was out of the question, which was fine because I had absolutely no desire to eat.
My sense of balance, already iffy to begin with, evaporated. If I wasn’t completely focused on what I was doing I could have easily tripped over a curb (or the dog), dropped a pot of boiling water, stepped in front of a car, or fallen sideways into our swimming pool which had, quite suddenly, become a major hazard.
Driving was truly frightening. I was afraid to change lanes or to make turns outside of a designated lane for fear that I would cause an accident, or worse, hit someone in a crosswalk. But, incredibly, no one had said not to drive. Eventually, I avoided leaving the house unless it was absolutely necessary. The energy and concentration required to avoid hurting myself, or others, became too much, the consequences too high.
I was convinced I was going to have a heart attack. When I wasn’t high as a kite, I was asleep. It took a few days to realize that this must be some form of drug-induced psychosis. When I called my doctor he suggested that I had an unusually high sensitivity to drugs. Good to know, I thought.
The second drug was an amphetamine that was, like Ritalin, also a controlled substance. My willingness to try this drug after what I’d just been through is an indication of how badly I feared returning to what my life had been like before my diagnosis. With this drug, I lasted about a month. Around that time, I became convinced that my marriage was not likely to survive. I took my husband by the hand and, yet again, begged him to forgive me. I look back now and see the insanity of asking your partner to forgive you for something that you have no control over. He told me he loved me and that he wasn’t going anywhere. I didn’t believe him.
I finally found a measure of success with the third drug, a combination stimulant and antidepressant that was, thankfully, not classified as a narcotic. Although I had to play around with the dosage, which meant that some days were a lot better than others, the lack of disturbing side effects is not what convinced me that this might be the right drug. After the first week I realized that I actually felt happy. It had been such a long time since I’d felt simple happiness that it took me several days to recognize it for what is was.
Despite my doctor’s tongue in cheek use of the phrase, there is no such thing as ‘textbook’ ADHD. Like many others with the disorder, I am both hyperactive and inattentive. I fidget. I interrupt and talk over people. I am still sensitive to noise, touch, and bright light, all classic symptoms of ADHD. I talk fast, eat fast, and walk fast. In fact, I’d be hard-pressed to think of anything I have ever done slowly.
The confusion and controversy surrounding ADHD doesn’t really matter to me. It didn’t really matter when I was diagnosed. I just wanted my life back. Before my diagnosis I was not a functioning person, and now I am. Drugs have been a big reason for that, which, admittedly, isn’t ideal, and many of the therapies that don’t require medication still remain a challenge, but, like everything else, it’s a process. Although I wouldn’t want to relive the last two years, because of that experience I’ve rediscovered how to be happy, and that is no small thing; in fact, on most days, it is the only thing.
Sandy Ebner lives and writes in Northern California. Her work has been published or is forthcoming in Connotation Press: An Online Artifact, Dead Mule School of Southern Literature, The Doctor T.J. Eckleburg Review, the HerStories/ My Other Ex anthology, and other publications. She holds a bachelor’s degree in journalism from California State University, and is an alumna of the Community of Writers at Squaw Valley. She previously served as the creative nonfiction editor at MadHat Lit and MadHat Annual (Mad Hatter’s Review), and is working on her first novel.