On ADHD

Last week I was both excited about and disheartened because of a news story and the inevitable evil internet comments surrounding it. US Olympic Gymnast and gold medalist, Simone Biles, had her medical records hacked and leaked, revealing that her drug test had tested positive for methylphenidate, a banned substance. Well, methylphenidate is Ritalin and is used to treat ADD (Attention Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder), and Simone had received an exemption because this drug was prescribed to her to treat this medical condition.

After this medical data was leaked, she tweeted, “Having ADHD, and taking medicine for it is nothing to be ashamed of nothing that I’m afraid to let people know.” – (https://twitter.com/Simone_Biles/status/775785767855611905…). There were many positive responses, thanking her for being open about this condition and her treatment and showing support for her in a difficult situation. There were also many mean, insensitive, and ignorant replies accusing her of lying (claiming that there is no such thing as ADHD) and cheating and worse. I could only read a handful of those before I was extremely angry.

I was diagnosed with ADD when I was 7, and I took Ritalin, myself, for the next 7 years until I decided as a teenager that I just didn’t want to take pills anymore.

I will not claim to be an expert, I have no medical training in behavior or psychology or neurology. I only have my personal experience and information I have gained from conversations with different doctors and friends.

This is what I know and believe about ADD.

I think ADD is over diagnosed and often not by any trained medical professional. There are many people I have met who believe they have ADD or ADHD, with no formal diagnosis. Some may, some probably do not.

I have read that ADD was diagnosed a lot in the 1990s, often by using a placebo test with Ritalin or something similar. When a child did better on Ritalin than without it, it was determined that they had ADD. Unfortunately, Ritalin is a stimulant and most people will be able to focus and concentrate better with it than without it. Which is why it is used so often on high-pressure college campuses. This placebo test is not great and led to an over-prescribing of Ritalin.

This leads me to my next major point, and a major misunderstanding of ADD and those who have it.

It used to be described that children with ADD were overactive and needed medication to calm them down so they could sit still. But then, why prescribe an amphetamine or a stimulant? I have heard it explained recently that we now believe that those with ADD are actually not getting enough stimulation to keep their minds engaged – they are not being engaged enough with whatever is currently happening, so their minds seek additional stimulation through fidgeting or bouncing around or any of the other behaviors associated with ADD. Their attention is not being held sufficiently by the current subject, so their attention wanders seeking something more interesting. So, giving them a stimulant gives their brain the stimulation it was seeking, allowing them to focus and concentrate on the task at hand.

This is certainly what I have felt and experienced. There are times, both in school and in my professional career that I find myself simply not able to focus on one thing, and I bounce from one thing to another not really multi-tasking but doing parts of multiple tasks in rapid succession. Sometimes it works but often I actually miss something important with some of the tasks.

I could tell, and my teachers could tell, fairly quickly when my morning dose of Ritalin had worn off if I had forgotten to take my afternoon dose. It was fairly obvious, but I distinctly remember several occasions where I knew what I was doing was inappropriate at school, and I didn’t want to be fidgeting and talking so much or so loud, but I actually could not stop myself, I could not control it. It was scary to not have full control of what I was thinking or doing. Ritalin helped me. I, personally, needed it to do well in school and to help me learn to control my body and mind.

Like many, if not most, neurological or psychological or mental conditions, ADD and ADHD is not something you can simply stop having through sheer force of will. It does come down to some chemical imbalance that needs medication to correct. It requires careful observation and honest conversation with trained medical professionals. ADD and ADHD and depression and anxiety and any of these other similar conditions need to be talked about and better understood by those who have them and the public at large. We need to stop joking about them, stop stigmatizing them and those who have them. We need to be more open and honest with each other about how we are feeling and how we are thinking and how others feel and think.

We do not fully understand what exactly ADD is or how it affects people and I know from first-hand experience that it manifests itself in different people in different ways. My brother was diagnosed with ADHD and I with ADD and we were very different people. My brother was very much like you would expect from a typical young boy with ADHD – he fidgeted a lot, played with little things in his hands, had a hard time sitting still in school and paying attention, etc. I, on the other hand, did very well in school. I have often said that my brother had a physical ADD, where he physically could not sit still, but I had a mental ADD, where my mind could not sit still. I could sit for hours just fine, as long as I had something to do with my mind that kept it engaged – like reading a good book or working out math problems. But my mind needed something constantly, and I was not able to sleep well as a child because my mind would not shut down. I could not relax my brain to fall asleep, and I was prescribed a medication to help me sleep. If, on a sleepover or campout or something, I forgot to bring my medicine, I did not sleep. I remember pulling an all-nighter at a friend’s house, I stayed up all night and his dad was impressed and joked that it would be useful in college, but at around 1pm the next day I literally crashed on the living room floor and slept so soundly that my family was forced to walk over and around me for a few hours while I slept.

I am glad that there are those who have fame and wide influence who are able to stand up and say, “I have this and this is how it affects me, and I am still a functioning member of society.” It is okay to be different, that is what makes this country and this life so great. But, we also need to be more open and understanding of others. We never really fully understand what exactly is going on in someone else’s head. But, certainly, being kinder to each other is never a bad thing. The world could use more kindness.

Thank you for letting me express some of my thoughts on this subject, if this writing seemed a little disjointed – forgive me, I have ADD!

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