...It's something that has been affecting me my whole life, and it took until I was about 33 years old to even consider it was something that might be affecting me.
Attention Deficit Hyperactivity Disorder - is not something anyone who knows me would really describe me as, purely because i've never been hyperactive in my life.
The first part though? Attention deficit? absolutely. It's always felt like i've been trying to think through a haze - like thooughts have to be extracted or forced, and it's been like that since I was 15.
When I was 15, I had my first panic attack, and from that day going forward, i was diagnosed with GAD, and any 'brain fog' was blamed on that, or the SSRI medication I had been put on.
Suspicion began that it might be ADHD when I was passed this video from Andrew Huberman about ADHD and concentration.
The explanation of the condition, how it affects you, and your life, blew me away.
So decided to chase a diagnosis - my doctor didn't even know how to proceed, he had to send me home and get the practice to call me when they found out the procedure.
After writing a very detailed letter to the practice with all my symptoms, I was finally referred to the ADHD service, which is a private company paid for by the NHS.
I waited nearly 2 years.
Diagnosis
Diagnosis took 3 sessions with a Psychiatrist over video chat (this was only shortly after covid). He was lovely and very thorough.
They looked at my entire life history of both physical and mental health, I was also referred to my GP for routine blood tests to rule out anything physical that might cause the symptoms.
Not only was it emotional, but it was incredibly eye opening. Things i'd previously attributed to anxiety and depression I realised were actually (probably) just side effects of (the as yet undiagnosed) ADHD.
Eventually, after three sessions and more than a few tears I was diagnosed with ADHD-C (Combined Hyperactive and Inattentive).
And boy, it felt like a weight off my shoulders.
But it was a 6 month wait, again, for Medication.
Medication
Proper medication application for ADHD requires titration - a process of starting you on low doses of the medication, and monitoring your pulse and blood pressure as you raise the dose into the effective range.
I started on Xaggitin XL, a time-release generic variant of Concerta XL.
Now, i'm a big guy, so i knew the effective dose for me would be higher than it would be for others, so the first week i felt pretty much nothing, same with second week (2 tablets), and I even originally went up to an off-label dose without "feeling" anything (4 tablets a day).
I think I expected to feel like Bradley Cooper in Limitless, but I simply noticed that it I wasn't tired all day any more, or thinking through a fog.
I actually thought they weren't working, so I asked to try another type of medication - Elvanse. It's more modern, with a focus on treating ADHD, where as most other stimulants being used these days were invented for other purposes originally.
Yeah, Elvanse was not for me. Even on the lowest dose, I spent the first 3 hours of the day with a 100BPM heart rate, grinding my teeth, and then by 2pm it would wear off despite being designed to "last all day".
I stuck it out for a couple of weeks before asking to be moved back to Concerta/Xaggitin. But the weirdest thing happened: when I moved back, i had a lower tolerence - I couldn't take more than 2 tablets without feeling too "wired".
So, not sure what happened there - human bodies are weird. But now i'm settled on 2 x 18mg Concerta XL a day, with the option to take a booster third tablet around 12pm/1pm if I feel like I need it.
Long term.
I don't have to take these for the rest of my life, the idea is that the stimulants re-forge pathways, and I can even take breaks from the meds (usually when i forget to take them) and still operate fairly normally if not a little more fogged.
The idea is that in 12 months, we do a review, and potentially even try taking a break from the medication to see if I can get along without it.
The idea is always to not take something if you don't need it.
Weekends.
At weekends I usually skip a dose on Saturdays so I can still have a few beers or just to give my body a break, sometimes on i'll take half the dose (1x18mg) so I can be effective if I'm doing things around the house or prepping work for the week ahead.
Side effects
Luckily, Xaggitin XL has been kind to me and I've not suffered so many side effects: i do get a little bit of "tongue thrusting" where i tend to shove my tongue into the back of my teeth, but as with any medication, it's a trade off: doing this is an acceptable side effect if I can function 9-5 more neuro-typically.
When starting the medication I was told to look out for a euphoria that I would get in the first week but it never really happened to me.
I did get some headaches in the first week or two, make sure you drink enough water.
I did also notice that I got really short and angry with people while on Elavanse, another reason why I switched away from it.
Luckily, my sleep has actually been better rather than worse since starting the medication, too.
Self Doubt.
About 3 months after I started on medication, the BBC aired a documentary criticising private clinics that had been prescribing ADHD drugs "too easily", and the trailer for the doc gave the impression that certain people who had previously been diagnosed with ADHD by these clinics were then assessed by a "proper" doctor, and told they didn't have it.
I panicked: am I a fake? is this clinic just after money from me or the NHS?
Also, a prominent female celebrity had a documentary on the BBC called "ADHD and me", and the backlash on Twitter was awful with sentiments of things like:
- "Everyone is a little bit like this ,it's just more woke BS"
- "Just another made up condition to charge people for"
- "putting people on amphetamine is putting their life in danger".
etc.
Very hurtful to see. Mainly because i've suffered stigma because of my anxiety and depression before: including bosses and coworkers who just don't get it and are feral with their interpretations of it.
I finally plucked up the courage to watch the BBC doc on iPlayer, and to my shock: these clinics totally were misdiagnosing people, but mainly:
- These clinics are totally private, not ran through the NHS.
- People were having one assessment from non-clinical staff (sometimes non-medical staff!) and just ticking boxes on a form.
- Medication was to pay for, not on the NHS, and often over-priced.
Turns out it was just a good old fashioned "racket" - rinsing people in dire need of a true diagnosis for money for false hope and medication. Sickening, but, hardly surprising.
Talking about it
I've been incredibly open about it, including on Twitter and with my co-workers, because my quality of life has increased, I want to try and encourage anyone who might think a diagnosis would benefit them to persue it if you can (through the right NHS channels).
But some people aren't so lucky, they feel they can't talk about it for fear or losing their job or being labelled as "damaged" or ineffective.
Even more scary, ADHD is a registered disability in the UK, so can be seen as such by some employers.
My Mental Health: before vs after
Since finding out and starting medication (and getting stable on it), I've managed to drop down my SSRI medication to one tablet a day from three. And eventually I'm hoping to stop taking it altogether.
Now, I feel like I can hold together a full day of work, whereas before, I would quite often "fake" work through the day, and end up having to catch up in the evenings when distractions and nuisances were less frequent.
Not only that, but I would often get drowsy - not just tired but drowsy, including falling asleep mid-day quite often, and the stimulants have solved that through not only stimulating my CNS, but meaning that I don't have to stay awake until 4am doing work I had struggled to do through the day.
I feel like a more complete and "normal" person.