#adhd102

so you relate to like every ADHD/ADD mood/feel post on your dash!

but when you look up ADHD/ADD diagnosis guidelines, you see things like:

 ‘symptoms must have started in early childhood/by the age of 3/7/12’

‘symptoms must be disruptive in at least 2 out of 3 life arenas throughout life’

which ... isn’t the case for you.

if you suffer from ADHD/ADD-esque concentration & follow-through issues as a late teen/adult, but you’re pretty sure that you weren’t having those symptoms early on/growing up: you might be dealing with burnout.

An increasingly-common affliction in the American working class, burnout is related to the brain being overworked &/or frequently or constantly flooded with stress hormones. 

things that can trigger/lead to burnout:

having a stressful/high-stakes life/job

working long, tedious hours doing something that does not stimulate or relax the brain (such as rote homework)

being bombarded by new information (i.e. social media)

constant anxiety about money/health/basic life necessities

lacking the means for/neglecting necessary self-care (getting enough sleep & eating properly)

having to constantly choose between too many options without meaningful ways of narrowing the choices down (i.e. shopping online)

all of the above w/a minimal or nonexistent support network

in other words: burnout is induced by living the average life of like 90%* of American adults under the age of 40!!!!

(*not a real statistic. I’m just saying a lot of us millennials/gen z ppl are burning out.)

burnout can look a LOT like adult ADHD/ADD because it seriously fucks with executive function. some symptoms ADHD/ADD & burnout have in common:

struggling to concentrate

feeling paralyzed when asked to make decisions

procrastinating on ‘simple’ or ‘nonessential’ tasks

difficulty prioritizing work/errands/tasks

burnout also takes on depression-like symptoms such as:

feeling tired, exhausted, &/or irritated all the time

feeling like nothing matters/everything is ‘the same’

isolating oneself from others

changing appetite

the thing about burnout is: even if it looks like ADHD/ADD (or depression) to you, the treatment for burnout is nothing like the treatment for ADHD/ADD (or depression). it mostly involves getting rest & reducing stress (as if most of us have this option, but that’s a post for a different blog!) this is why it’s important to get the correct diagnosis - so the treatment can be the right one.

of course, that being said:

people with ADHD/ADD can also get burnout. in fact, ADHD/ADD can exacerbate burnout symptoms: it’s already hard enough to make decisions when the brain is healthy, much less when it’s so stressed you can barely think!

tl;dr: 

because capitalism is a cruel mistress, a lot of people are just struggling to executive function b/c we’re burnt out by stressful, non-stop lives with no work-life separation and too many too-same buying options every time we try to buy something as simple as dish soap.

if you’re pretty sure you don’t have ADHD/ADD (or cousin developmental disorders such as ASD) but severely struggle with concentration/executive function, or you feel like you have ADHD but lack the developmental history to back it up: you might have burnout.

I don’t think it’s present in every ADHD person, no. and I know non-ADHD ppl who experience tiredness after drinking caffeine in coffee or tea, so coffee having a non-arousing effect is not ADHD specific either.

(part 1 of the answer to an ask i received:

what does hyperactivity look/feel like? (this post)

how does it feel to be on effective adhd medication?

the answer to the second question will come soon (I hope).)

disclaimer: I’m NOT an expert - I’m just a layman diagnosed with ADHD who’s read a lot & experienced a lot! also: my experiences are NOT universal! other people may experience/feel hyperactivity differently from me.**

ANYWAY

the symptoms of hyperactivity (& impulsiveness) doctors look for to diagnose ADHD (list based on DSM-V criteria, pulled from here & here) & what, ime, they actually mean/look like:

hyperactivity:

fidgeting/constantly changing position, unable to stay still/seated. for example:

the Legg Bounce(tm)

chewing pens

fussing with necklace

body-focused repetitive behaviors like pulling hair or picking nose

getting up to pace often

unable to play ‘quietly’

I read this as: unable to regulate volume/contain their feelings when happy, so ends up shouting or being loud without noticing

seriously, I have no idea how loud I’m being. I don’t hear it

constantly ‘on the go’

once done with one thing, it’s time to do the next thing

no waiting, no time to relax, no chill

we’re done eating, right? so we can leave the table and do something else? right now???

talks ‘excessively’ (this is the form of hyperactivity that tends to get afab ppl &/or women diagnosed as hyperactive).

stories tend to start way earlier than needed & end someplace other than the point

don’t give other ppl a chance to talk ... unless interrupted, which usually doesn’t bother me as long as the addition is interesting

impulsiveness:*

interrupts others in conversation/finishes sentences for them

I read this as: ‘I’ve anticipated the end of your sentence & want to answer you before my brain bolts in another direction’

‘you’re taking too long to get to the point, hURRY UP’

has a hard time waiting their turn/waiting in line

and by ‘hard time’ I mean ‘being asked to ‘wait a second’ while someone else completes a thing is nigh unbearable’

seriously there is a 50/50 chance I will need something to do within 10 seconds of being asked to wait

if there’s something engaging to do in the meantime, it will take my mind off the wait. hence: I bring coloring books everywhere

interrupts/intrudes on others. examples:

interrupting conversations, even private ones, to ask questions

‘borrowing’ stuff without asking b/c it’s there & the hyperactive person finds it more convenient to use than looking for their own stuff

doing things without being asked to b/c it was interesting at the moment

*In regards to ‘impulsiveness’: imho: it’s not so much that hyperactive adhd people are ‘impulsive’ as ‘hyperactive adhd ppl have brains that are also hyperactive, which makes them do things that look impulsive to outsiders’.

hyperactive ppl physically fidget and constantly move & jump from activity to activity because their brain’s neurons are doing the same thing, but with thoughts: fussing/chewing on things at random, constantly roaming from place to place, and always thinking about SOMETHING - unable to rest or be still.

for example:

interrupting ppl I’m conversing with: if I don’t talk right now, I’m going to lose whatever it was I was going to say - the thought going in and out of my head before it’s my turn to speak.

waiting is hard: if I’m doing nothing, that’s time for my brain to remind me of the 27 things that are SUPER IMPORTANT that I COULD BE DOING RIGHT NOW. so I get anxious & impatient b/c I’m wasting valuable time just WAITING MY TURN.

intrudes on others: if I think of a thing & get up to tell the relevant person & they’re busy, I know I’ll forget before they’re free - so I interrupt.

takes things without asking: if I see a thing that belongs to my roomie that reminds me of something I want/need, I just use my roomie’s thing b/c I’ll forget if I look for my own version of the thing.

takes over tasks inappropriately: If I do a thing without being asked & it turns out I wasn’t supposed to, I probably forgot I wasn’t supposed to or justified it to myself at lightning speed.

tl;dr my brain moves too fast for life. to compensate, sometimes I do things too fast for other people. then they say I’m impulsive for doing it.

Yes.

in fact: the US government offers financial aid for people whose adhd causes them distress that disrupts their childhood wellbeing &/or their ability to work for income as an independent adult. (help for this here)

US public schools are required to offer help to students with mental disabilities like ADHD under 2 laws: Section 504 & IDEA.

even without official backup: 

ADHD is a developmental disorder with ongoing symptoms like a chronic illness. These symptoms raise the difficulty of a variety of mundane tasks in such a way it decreases our capacity for completing/ability to complete them.

First, a disclaimer/reminder: I’m not a professional! I’m just an ADD/ADHD person (who .... might ... have hyperfixated on learning about ADHD for a while and decided to blog about it). so this is not a professional opinion or advice - just my feelings/thoughts as a layman.

--

You gotta self-diagnose - at least to start out - because nobody knows you better than yourself. 

self-diagnosis is NOT ‘making up excuses for your behavior’; it’s an important tool in our arsenal when it comes to mental health in particular, where the core symptoms are happening in your brain.

if something is you can’t seem to control is chewing on your mental space and negatively impacting your life - making it hard to think positive, get out of bed, get work done, remember what you need to do, clean your spaces, etc - you are NOT:

making things up

being a lazy bum

making excuses

deliberately ruining your life

a bad person

you ARE:

noticing something is wrong with your health

in need of assessment and treatment to get better!

and often that starts with self-diagnosis based on symptoms - the same way we go to WebMD every time we get a sore throat to check if it’s strep or something else.

Frankly:

 chances are pretty high that you won’t get much help from anyone if you don’t start out by doing research on your symptoms & determine what you think you need treatment for.

BUT ... after you’ve done the self-diagnosis step, I firmly believe that it’s in one’s best interest to get a professional diagnosis/a professional’s opinion if or when it becomes possible (though obviously, this is not always an option). 

Not only does having a professional’s stamp on your diagnosis often get you access to better/more comprehensive support/care: it also helps ensure you’re not being treated / performing self-care for the wrong thing & unknowingly causing more harm.

sometimes self-diagnosis is the only tool we have available. but it’s not a very accurate tool. 

if your only option is self-diagnosis, keep your mind open to other possible explanations. 

(& don’t take prescription meds for something based on a self-diagnosis alone!! that’s a good way to end up addicted or worse.)

I’m mainly ok with self-diagnosis because it can help make the professional diagnosis step faster/more accurate & provide peace of mind. and if you’re going to self-treat with behavior modification, mindfulness, etc etc, in the absence of professional backup, it can help direct your self-care research too.

adhd is a terrible name for this disorder because it’s not that we lack the capacity to pay attention to things (a deficit of attention): it’s that we lack the capacity to control what we pay attention to (failure of prioritization).

The ADD/ADHD person’s focus center is just ... hideously bad at self-regulating.

(& the reasons are poorly understood, though we’ve identified some pretty effective treatments.) 

where most people’s brains are able to prioritize tasks based on weighing time sensitivity, ‘importance’, how long it will take to complete, cost-benefit analysis, etc, ADHD brains prioritize tasks based on two things:

is it interesting? ('new’ also counts as ‘interesting’.)

is it due now? aka: is it urgent? (if not, it is due ‘later’ and is ‘not urgent’.)

if nothing is interesting and/or due now, we cannot prioritize. everything is equally unimportant (boring).  otoh if something is interesting and/or urgent, our brain can seize on that thing and focus extremely well, going into hyperfocus and totally shutting out everything else.

by the way: the only understanding we have of time is ‘now’ and ‘not now’. like

Calendar: *shows the final is tomorrow* ADHD Brain: fuck the calendar! everything after today is *~THE FUTURE~*! ADHD Brain: and *~THE FUTURE~* is far away. like millions of years away. ADHD Brain: so that’s why we’re going to read about a totally random subject for 10 hours instead of studying.

but then the next morning is like

ADHD Brain: HOLY SHIT THE FINAL IS TODAY ADHD Brain: CRAMMING TIME

and has no problem focusing on the important subject material that it couldn’t focus on the night before.

that’s how you know it’s not a lack of care, by the way. if you didn’t care about it, urgency wouldn’t change how much you can focus on it. it’s just that your brain can’t tell how urgent it is until it’s too late, because it lacks the ability to prioritize ‘normally’. 

and those problems can’t be fixed by willpower alone. here’s an example of some tools we use to help:

meds can make it easier for our focus center to self-regulate by giving it the chemicals it needs to reward itself for prioritizing properly, the way non-ADHD brains do. and because we usually do understand prioritization, it can make it easier for us to focus on the stuff that’s important at the time we want to.

otoh, it’s also very helpful to practice good organization habits until they’re so habitual they bypass the focus center, happening on autopilot. it keeps us from self-sabotaging our efforts to be focused on the right thing by reducing distractions like clutter or not having the tools we need to do a thing. day planners can help with this, for instance.

it’s also helpful to have a person who doesn’t have focus problems to check on us and help us stay on task, or guide us in selecting which tasks are most important to get done.

it is absolutely totally 100% possible to have adhd and depression at the same time. in fact, adults with adhd are more than twice as likely to have major depression disorder than non-adhd people. D: we’re also 3 times as likely to have any mood disorder and 2.5 times as likely to have an anxiety disorder. 

for reference, here’s a chart I borrowed from this free-to-read study comparing incidence rates of mental ilnesses.

in short, adhd is comorbid with a lot of mental health problems such as depression, anxiety, behavioral disorders, and substance additions :( (science-y folks think adults with adhd often don’t know about the adhd and only get treated for the comorbid problems, contributing to undertreatment of adults with adhd.

(cw: dieting, weight, weight loss, weight gain. if these topics stress you out, I recommend hitting ‘J’ to skip this post immediately.)

I can tell you a little because of my own history with weight loss from stimulants but for safety reasons b/c this blog is public I need to say some things first to anyone else reading this:

i'm not a professional. I am speaking on this subject out of personal experience and research. you can easily duplicate my research via google most of the time.

do not ever take stimulants for weight loss purposes unless a doctor tells you to. ever ever ever

in fact don't take stimulants at all unless a doctor tells you to, in case it isn't really damn obvious how bad that can be for you

in general, being 'overweight' is not a function of impulse control failure. in fact, your weight indicates surprisingly little about your health!* long story short the stigma against being fat is bs

I also feel the pressure to Be Thin. but my point is: weight loss is a thing that many people want because society is dickballs. but know that being Thin(tm) is not the same as being healthy.

OKAY.

stimulants tend to suppress the appetite. nicotine, caffeine, and amphetamines all fall in this category. as long as you are consuming stimulants in sufficient amounts, you will not be hungry as often.

in adhd people like you and me, snacking on impulse can be a symptom of feeling understimulated all the time. stimulants often reduce the snacking habit by suppressing the appetite, which makes this type of stimulation less rewarding. in my case it happened without me even noticing for a while.

this often results in weight loss during the early stages of taking medication. but no; it doesn't last forever.

in my experience, many bodies can hit plateaus of both weight loss and weight gain - points at which calorie burn equals calorie intake - depending on a person's lifestyle. there can be more than one weight at which this is the case, and some people's weights are easier to alter than others. (and 'lifestyle' counts in a looooot of stuff besides exercise and how much you eat!)

you probably know a lot of this stuff already, but just in case: when weight loss is caused by low calorie intake alone - such as reduced intake because you've started taking a stimulant that suppresses your appetite, the first weight loss will be quick because water weight drops off, etc etc. but it slows, stops, and can occasionally even reverse when your body's natural tendency towards wanting all systems to be in balance - that is, homeostasis - starts kicking in hardcore. ';asldjf;salj we’re using the stored energy,' warns the systems in charge of keeping your systems in balance, which think they're playing a JRPG and are concerned that your extra energy might be needed for the final boss fight more than right now. 'we gotta cut the metabolism rate somehow!'** (and that somehow is partially ‘eating some muscle too so that the amount of cells that need energy is smaller’.)

if you are not making a concerted, specific effort to continue to lose weight, this is the point at which your body will find its new homeostasis and your weight will stabilize. (but a lot of factors go into what this point is and whether it's actually lower than your starting weight.)

in addition, your body will eventually develop a tolerance for the stimulant and it may not zap your appetite as effectively after a time.

In my case:

I smoked cigarettes for 8 years. no matter how much I ate or didn't eat, my weight rarely varied by more than 5 pounds.

when I quit smoking cold turkey 4.5 years ago, my metabolism dropped and I started snacking more. I gained 25 pounds, whereupon I got stuck again; eating the same number of snacks that had started the weight gain did not continue the weight gain. 

I lost a bit of weight when I exercised daily, but when I stopped I gained the weight right back.

when I started taking Adderall, a salt-amphetamine, to control my adhd symptoms, I dropped back to my smoking weight.  increasing the dosage of stimulants did not make me lose more weight. 

I expect that if I stop taking stimulants, I will gain those pounds back unless I make a specific, concerted effort to avoid impulse snacking. I will probably still gain weight because my metabolism will drop regardless.

so ...

in short, there's no way to use stimulants alone to continue weight loss at a quick rate. it can help you lose some pounds and keep those pounds off because of decreased appetite/better impulse control/higher metabolism, so you might quickly lose more weight than you would without a stimulant. and you can probably keep that quicker weight loss going a little longer if you make a concentrated effort to fight back against the appetite loss to avoid slowing your metabolism.

but nonetheless, your body will figure out how to balance itself with the stimulant in your system and weight loss will slow or stop. after that point more traditional weight loss methods will be necessary to keep dropping.

(notes under cut!)