Living with ADHD

written by Claire Tobin

Most of us get into our cars and drive to places that we need to be, without much thought. We are able to drown out all the sensory information passing through our five senses. Only if we pay attention, can we hear the hum of the motor in the car we are driving, listen to the traffic that passes us by, see cars in our peripheral and adjacent traffic lights – details which are not relevant to the direction we are travelling in. We can smell the dust coming from the air vents and feel the vibration of the steering wheel underneath our hands. However, it is not something we often pay attention to, it is something our brain filters out so we can concentrate on driving and being alert on the roads in order to not cause accidents.

People struggling with Attention-Deficit/Hyperactivity Disorder (ADHD) often have difficulty filtering out all of those sounds, sights and sensations, which can make an ordinary everyday task, like driving, much more difficult to accomplish. The sensory information that most people are able to filter out of their attention, is exactly what a person struggling with ADHD is focusing all their attention on, and more. What exactly does it feel to be someone living with ADHD and how does it impact a person’s life? Our Foundation asked some questions to someone who has been grappling with ADHD his entire life.

Justin (24) was diagnosed when he was almost six years old and has been on medication to treat his ADHD for most of his life. He was first prescribed Ritalin when he was in Grade 1. Throughout school, he enjoyed water polo and he excelled in his musical ability. He attended the Berkley School of Music Summer School in Boston, when he was in Grade 9 and he was also among a select group of 18 students to sing in the choir at international events. Justin was working as a bartender and talented bass player in various bands in Gauteng at the time of the interview. Justin has also been in a long term relationship and lives with his partner.

We asked Justin some questions to find out what is was like for him growing up with ADHD and his current experiences.

What did it feel like for you as a child being diagnosed with ADHD?

“Didn’t feel like anything really. It was me and a few other guys that would all have to go to Miss Morgan [the teacher] to take our Ritalin before class started. Didn’t bother me at all, as far as I remember. Nothing much really bothers me.”

What were some of the comments that stood out for you that peers and teachers made about your ADHD related behaviour or difficulties?

“Don’t remember anyone commenting anything. I made jokes about myself pretty often (still do), but I can’t actually remember anyone ever making a comment.”

What were your hardest challenges at school?

“I guess because I was medicated from so young I don’t have a reference to a before and after I started taking meds. School has always been school and medication. On the odd occasion that I would forget to take my meds, I found focusing was impossible. Even now, I can hardly do activities that are second nature, like driving, if I haven’t taken my Concerta for a day or two.”

How has ADHD been of benefit in your life?

“I’m not sure if ADHD has been of benefit to me, but I’m sure it helped with the hyperfocus* needed to learn songs. I tend to be very aware of my surroundings, often much more aware than people around me. I don’t know if that’s from the ADHD or if I’m just generally a more attentive person.”

 *Hyperfocus occurs when someone is completely engrossed in a task to a point where they are able to completely ‘tune out’ or ignore what is happening around them. It is often found in the context of ADHD (Ashinoff & Abu-Akel, 2019).

Do you prefer to be on your medication? How do you feel when you do not take your medication?

“I most definitely prefer to be on my medication. If I forget to take my meds, I will generally feel okay until about 1-ish. A few hours later I feel hotter than usual and will often say things out loud to myself to remind me what I’m supposed to be focused on.

I recently tried about a week off my meds and I really battled to function. I’m hungrier off my meds, but will also forget to eat. So if food is around, I’ll eat way too much, and if I don’t think about it I can go a day and a half without eating. Sometimes my skin prickles a bit. My hearing isn’t as good, so I have to turn things louder to hear them properly and will often need to repeat things to get them in my head. I really struggle to multitask, at all. My impulse control is essentially non-existent. I have hundreds of thoughts running through my head and find it difficult to latch on to any of them, then I’ll forget what I was thinking about and a whole new wave of thoughts will run through. I get extremely bored and will have 3 or 4 things happening in different rooms so I can cycle through them unless hyperfocus kicks in. I noticed a few days into my “detox” experiment that I was occasionally forgetting to breathe when I was falling asleep.”

How do you think ADHD has changed for life?

“I think ADHD has made me more aware of many things in life. It doesn’t really affect what I do in my day to day except when I forget to take my pills. It wouldn’t faze me at all if the pills weren’t so expensive. When I was on my 72mg dose (which I should technically still be on, I just halved my dose and am coping fine) it costs around R1600 per month. I have been diagnosed with depression once (maybe twice) and was on antidepressants for maybe 6 months.

Do you think things would have turned out differently for you if you did not receive a diagnosis?

“I think life would have turned out very differently. Since I’m in a field of work where the majority of staff are not university-educated, I can often see signs of ADHD in them. If they were medicated maybe they could get a boring desk job and earn some decent money instead of having fun running around a bar all night. I can’t imagine what would have changed for me, but my marks definitely would have been worse.”

This interview was conducted before lockdown began. In order to determine how lockdown has affected Justin, a follow up interview was conducted. Justin mentioned that he has changed jobs due to the lockdown regulations around bars. He managed to secure employment at a call centre.

How has lockdown affected you?

“Honestly hasn’t really changed much. Throughout lockdown I’ve managed to keep myself busy most of the time. Wasn’t too stressed about anything and I still took my 36mg every day. After I started the new job [call centre agent], all I’ve changed is that I’ve gone back up to 72mg. I find it a bit difficult to focus later in the day, and I guess the drop off [when the medication wears off]** is worse from 72mg than from 36mg. It feels like I lose more thinking capacity when it wears off, which I find odd if I’m on the higher dose.”

How are you finding the new job and how you are you coping with the call centre environment?

“It’s like a new adventure. I’ll probably get over it at some point but I don’t have anything else right now. The environment is okay, I just really struggle in the late afternoon when my medication stop working. I think it’s more difficult now because it’s something new. Should be easier when I’m more comfortable.”

**Justin should discuss the “drop-off” feeling at the end of the day with his treating psychiatrists. A top-up of short-acting Ritalin may be beneficial.

Justin has experienced many ups and downs throughout his life. Although he faced many challenges, Justin has managed to complete his schooling and become a qualified bartender. Aspects of Justin’s hyperfocus has assisted him develop musically and he is currently a talented bass player. He has played in the opening act for music stars Jack Parow and Freshly Ground, he is a member of three different bands and has played in various music festivals.

Luckily, Justin was diagnosed at an early age and received early intervention. Justin noted that he also received support from his family and teachers, which made a positive impact on his self-esteem.

It is important to remember, that with the right medication and support, someone living with ADHD can develop to their full potential and can cope with some of the challenges. Early intervention is important to minimise the negative impact that untreated ADHD can have on individuals for the rest of their lives.

References:

Ashinoff, B.K., Abu-Akel, A. Hyperfocus: the forgotten frontier of attention. Psychological Research (2019). https://doi.org/10.1007/s00426-019-01245-8

Schoeman, R. (2017, April 23). Is ADHD a fairytale? Retrieved from https://renataschoeman.co.za/is-adhd-a-fairytale/