Out of focus

ADHD was once thought to only afflict children, but the illness is increasingly being diagnosed in adults. Caitlin Still explores the issue.

I have a confession to make. I’ve spent five years on my L-plates, and I still can’t drive to save myself. My learner logbook lies gathering dust somewhere at my parents’ house, forever at 90 hours. My last attempt at parking was an ordeal that involved my terrified mother squawking, “That’s an Audi on your right! Don’t hit the Audi!”

Flustered and distracted, my head was full of irritated thought-noise. I had meant to brake, but instead, my foot hit the accelerator, shunting the car forward. The near-crash resulted in a screaming match between me and my mother that went down in history, if only for the fact that it ended as quickly as it had begun, in hysterical laughter, when I got out of the car and glanced once more at the so-called Audi.

“Mum,” I seethed. “That’s a fucking Kia.”

Having Attention Deficit-Hyperactivity disorder, also known by the older term Attention Deficit Disorder, can itself be likened to driving an unreliable car. Great to drive, perhaps, once you get on the road. If you can get it to start, that is. All too often, the ADHD brain will just leave you turning the key in the ignition to no avail, stalled in the middle of the road. While ADHD is best known as a neurobehavioural disorder affecting school-aged children, it is estimated that between two and five percent of adults worldwide are affected. It is, however, a little-understood disorder, leaving many adults suffering undiagnosed and untreated from chronic impairments in attention, impulse control, and short-term memory, just to name a few. It is a disorder associated with significantly lower levels of educational attainment and success in work and relationships, as well as higher levels of substance abuse, criminality and accompanying psychiatric disorder. Despite the pervasive effect that ADHD can have on a sufferer’s life – especially when undiagnosed – the effects of the disorder on sufferers are frequently trivialised by the media and general public alike. That is, if its existence is acknowledged at all.

Focus, in the context of ADHD, is a complex thing. In the words of Thomas Brown, psychologist and leading expert on the disorder, focus consists of  “a complex, dynamic process of selecting and engaging what is important to notice, to do, to remember, moment to moment.” It appears then that focus, under this definition, is essential to numerous every day tasks—safe driving among them. Little wonder, then, that being behind the wheel gives me the feeling of being in a moving steel death trap. Despite my best efforts to stay in my lane beneath the onslaught of road signs, changing speed limits and angry horn-beeping, I could not conceive of how it seemed so effortless for everyone else. After all, the sick brahs doofing around the Cross on a Friday night seemed to have no trouble, even as they poked their heads out the windows to wolf-whistle at short-skirted women. Perhaps, I wondered, I was even dumber than they were.

For many, a diagnosis of adult ADHD comes as a relief. I was no different. Like many diagnosed in adulthood, I received a diagnosis after moving out of home last year. The significant increase in responsibilities, on top of a larger study load, saw the day-to-day of my life progressively unravel. For as long as I could remember, I had been used to being chaotic, messy and disorganised. I was not, however, used to the feeling of narrowly dodging death or serious injury as I rode my bike to uni, as my mind took protracted excursions into nowhereland. More than once I found myself jolted out of an involuntary reverie by a large four-wheel drive hurtling towards me, angrily beeping its horn. More than my academic slackness and my sink full of dirty dishes, these numerous, unnervingly close calls made me suspect that something was afoot. Within the month, I was diagnosed with ADD, or Attention Deficit-Hyperactivity Disorder, predominantly inattentive. Far from being a surprise, many aspects of my life up to that point began to fall into place.inattention

While we all suffer at times from inattention and impulsivity, from difficulty completing essays and blurting out statements we immediately regret, these symptoms must have a pervasive and chronic impact on day-to-day functioning to warrant a diagnosis of adult ADHD. Many adults who receive a diagnosis later in life report a sense of having been different to their peers from the beginning. Many experience feelings of anger or grief in the months to follow, having had their ADHD tendencies dismissed as character flaws by unhelpful teachers, peers, parents and carers, especially in childhood, when obedience and attentiveness are frequently moralised. Many adults with ADHD therefore carry feelings of inadequacy well into adulthood, having internalised accusations that they are lazy, stupid or just plain bad. A long history of depression or anxiety is therefore common in those diagnosed with ADHD in adulthood. The low self-esteem and mood swings characteristic of the disorder are even known to lead to misdiagnoses of other conditions such as bipolar disorder, and perhaps more damningly, borderline personality disorder, resulting in further roadblocks to appropriate treatment.

Among the most serious consequences of ADHD is persistent underachievement, especially in education. It is a common misconception that anyone with adequate intelligence should be able to overcome issues of inattention and impulsivity, despite ADHD being present in people at all levels of intellectual ability. According to a study at Yale of ADHD sufferers with an IQ range in the top 1-9% of the US population, 42% had dropped out of post-secondary education at least once. In fact, it is now thought that even Albert Einstein demonstrated significant ADHD characteristics, before the disorder was so-named. The fact that ADHD affects people of all levels of intelligence and educational attainment makes the issue of adult ADHD all the more relevant to us as university students, with studies showing that greater academic inclination correlates strongly with delayed diagnosis. It appears, therefore, that high intelligence and a passion for learning do not necessarily safeguard against chronic difficulties in applying oneself to study.

The use of stimulant medications such as dexamphetamine and Ritalin for ADHD remains a controversial issue. Sensationalist media on ADHD deals overwhelmingly with the supposed overdiagnosis and overmedication of hyperactive children, as well as the well-known potential for abuse that these drugs carry. Stories of children being turned into “zombies” by Ritalin or adults on dexamphetamine being pegged as “drug-seekers” only worsen the stigma attached to taking medication for a genuine disorder. For those who choose to take them, medications can make an enormous difference to the lives of sufferers, allowing for far greater functioning in work and study. Even so, the use of psycho-stimulants still attracts unhelpful commentary from those uninformed about the disorder. Some support their judgements with complete denial of ADHD as a real disorder, unwittingly siding with others who have accused sufferers of sheer incompetence. Others may simply tell a sufferer that they don’t “need” their medication. Given that ADHD is a neurobiological disorder, this equates to telling a short-sighted person that they don’t “need” their glasses, despite only having seen the world in 20/20 vision. For someone with no lived experience of ADHD to make such judgements is simply uncalled for.

Despite the challenges my ADD has presented over the years, I don’t resent having it. It has made me who I am, and I know that it has even served me in many ways. ADHD is associated with imagination, originality and a love of fun. Difficulties with following simple instructions also mean that few with ADHD are in the habit of toeing the line as a matter of course. Although treatment can make a significant difference to an ADHD sufferer’s quality of life, as it has my own, there is no real fix for the disorder. Despite my best intentions, the writing of this very article has been fraught with lengthy periods of procrastination, unsavoury quantities of caffeine and counterproductive power naps. I even lost my laptop charger in Fisher Library. If, however, I can improve someone’s understanding of adult ADHD as a real disorder, or even encourage someone blundering through life as I have with undiagnosed ADD to get some help, these last few days of chaos will all have been worthwhile.

As for learning to drive, I’m no longer in a hurry to get my licence. I know now that stupidity and distractibility are far from being one and the same. Despite his messianic genius for physics, Einstein never learnt to drive either. For the man who brought us the theory of relativity, operating a motor vehicle would remain “too complicated.” As the unreliable car of my ADD brain continues to remind me, everything in its own time.