WARNING: This story deals with issues of mental health, drug abuse and suicide. Helpline information below
My ADHD diagnosis arrived with high drama and a massive amount of collateral damage. It
Doctors used to think that kids grew out of ADHD; now there’s a consensus that many people go undiagnosed and suffer all the more in adulthood. Photo / 123rf
WARNING: This story deals with issues of mental health, drug abuse and suicide. Helpline information below
My ADHD diagnosis arrived with high drama and a massive amount of collateral damage. It took a suicide attempt, dependency on cocaine and vodka, and the end of a 12-year relationship for me to finally seek help.
The psychiatrist peered out from her digital lookout on Zoom: “You have severe ADHD, Max.” These five words would explain so much of my life: how I didn’t have a job, had frittered my money away and how I had become an addict.
The classic image of ADHD, or attention deficit hyperactivity disorder, is a child terror causing havoc in school, but the reality is a lot more complex. Doctors used to think that kids grew out of it; now there’s a consensus that many people go undiagnosed and suffer all the more in adulthood.
I was diagnosed at 34. Others in the late-diagnosis club include Sue Perkins (diagnosed at 53) and Johnny Vegas (52). Videos on TikTok are racking up tens of billions of views, so some people say that it’s just an excuse for Gen Z and millennials being workshy and easily distracted.
But people with severe ADHD, if it is unmedicated and out of control, will struggle to do pretty much anything. It smashes the psyche, wrecks self-confidence, and often combines with comorbidities such as addictions, self-harm and binge eating. One in 10 men with ADHD have tried to take their own life.
ADHD brains lack dopamine and noradrenaline, neurotransmitters that are associated with reward and focus. I sought these missing chemicals through other sources, self-medicating with alcohol (reward) and cocaine (focus).
Throughout, I was high-functioning – I could write poetry and occasional journalism. But I also self-harmed, forgot to wash, and had debt collectors sending me letters for unpaid bills that I had forgotten to open. I felt worthless. During the pandemic, I spiralled into someone who woke up and reached for the bottle and the bag of cocaine.
My life fell apart. I jerked from crisis to crisis, trying to give up booze and drugs but my brain chemistry made the hold of those substances that much stronger, they stuck like a leech I couldn’t shake off.
Finally, feeling like my life was not worth living, I set out on February 25 this year to kill myself. On the way, I phoned a priest friend, who told me to go to St Paul’s, where I was detained by the police and taken by ambulance to a mental health unit. I realised I had to escape London, to leave the relationship I was in, and to return to my family. And, on the advice of friends and doctors, to finally tackle the fact I probably had ADHD.
For the best part of a decade, I’d had a hunch I might have the disorder. The signs were all there. Sober and clean, I recognised the true extent of my condition. My mind was like a crossroads with no traffic lights, no road markings, and cars going everywhere. I could barely move; I was paralysed by indecision. In a Tesco supermarket, hungry, I cried because I couldn’t decide what to eat. When I did choose something, I didn’t want to eat it. You feel at sea without knowing why, which can be confused with depression or anxiety. You have no idea how other people can sit and work for hours without getting fidgety.
Patients in Greater Manchester, near to where I live in Lancashire, might now have to wait seven years for an ADHD diagnosis on the NHS. So finally, in March, back home and sober from drugs and drink and recovering from my suicide attempt, aged 34, I paid £825 ($1750) for a virtual ADHD assessment with a private psychiatrist. I had to supply the psychiatrist with school reports and statements from my parents about what I was like as a child. Apparently, I would fall over, sometimes as many as 30 times, on walks in the Lake District, racing around like a little demon. In nursery, I couldn’t stay put. In school, I had mood fluctuations. I am also gay and was bullied extensively for it, and that masked traditionally “male” traits of ADHD associated with raucousness.
When I told my psychiatrist how substances made me feel normal, not high, that I was able to sleep on coke, and that alcohol was the only way to shut off the noise in my head, she explained that where others feel more awake taking stimulants, with me it makes me feel more “normal”, balancing out the hormonal deficit. She prescribed me methylphenidate, a drug that helps to wake up the sleepy part of the brain, which orders the other bits about. It seems counter-intuitive to give a stimulant to someone who is hyperactive, but in brains like mine, it helps corral my endless thoughts into some order. Combined with my sobriety programme and meetings, it makes me less likely to be impulsive and reckless.
When I get an idea in my head, I often fixate on it. It’s as if I’m stuck in a groove that I can’t get out of.
One day at university, I decided to buy two rats. I was not high back then. My housemate had one and I was particularly fond of it. I wanted my own. Forget coursework. Forget tutorials. I fixated on pet rats. By the end of the day, I had two, a cage and all of the equipment and food. I woke up the next day feeling dejected; I needed more rats. I bought four more. This impulsivity is known as hyperfocus and means we can fixate on anything: a person, an impulse purchase, a new hobby, or, if we are lucky, something that actually benefits our work. A sudden shift away from this interest inevitably occurs. Until that point we think that this is our new-found career, the thing we have been searching for all our life.
The rats took over my bedroom. I couldn’t cope with looking after them, and they saw me as the intruder to their colony. They learnt how to open their cage, hid in my dressing gown, and took over my closet. In the end, I rehomed them to a loving rat lady who cared for them far better than I ever could.
The ADHD mind is understimulated and overstimulated. Living is exhausting. Just today, for example, I have headed to the toilet four times and got distracted on the way, then realised I needed it again sometime later. I have been unable to prepare meals; I have to be reminded to drink water. I can’t sit still. I feel uncomfortable around other people unless I trust them, because I find making noises (called stimming) helps me to focus. I am regularly “beep beep beeping” as I type. I still haven’t got the knack of showering unless reminded.
Strategies help. I have an electronic “ReMarkable” tablet, which means I can scribble down ideas wherever I am. They’re automatically uploaded to the cloud and are accessible from my phone. I pin up signs to remind myself of deadlines. The reminder app Due is a lifesaver, constantly buzzing to tell me at key points in the day to follow up on projects, to go for a run, and to feed the cat. Without these things, life falls apart.
While writing this article, I haven’t bought six rats, but I have created a how-to document on converting a van into somewhere I could live, complete with what fridge-freezer to buy and how to create a lightweight sink so as not to go over the weight limit. I do not have a van, and I haven’t passed my driving test, yet I somehow know everything about #vanlife in extraordinary detail. ADHD makes us specialist researchers. Often on topics that randomly appeal to us out of the blue without any warning or prompting.
Some people have deep resentment about this missed period of their lives without a diagnosis. But I’m just happy I finally know. I worry for those like me who might end up surrounded by nefarious people because they crave excitement, or are easily manipulated because their self-esteem has been shot to pieces. I worry about the stigma developing around the massive increase in diagnoses – society should not be chastising people by saying, “Everyone has ADHD now,” but rather, “How did schools not notice your learning difficulties at the time?” Those affected suffer later in life with bigger issues that could have been prevented by guidance and support. An ADHD study on the prison population would be illuminating because people with ADHD are more prone to reckless, impulsive behaviour that gets them into trouble.
I know my idiosyncrasies are down to the way I’m wired up. And my leanings towards addictions, emotional outbursts, and general dysregulation can be managed through medication – a stimulant which releases slowly through the day and helps me keep on track. I’m able to do the hard work required to recover. If I weren’t, I’d probably have turned back to booze and drugs to cope with the way my brain naturally is. I don’t think it’s hyperbole to say that the diagnosis saved my life. As of today, August 23, 2024, I am 171 days sober.
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