by Glen Herbert
I was diagnosed with ADD last year, when I was 43. All my life I’ve had issues with anxiety and depression, moodiness, and just getting things done. I was diagnosed with anxiety almost 10 years ago, and have been treated since, though I was at the maximum dose and still struggling. My doctor suggested that I might consider trying ADD meds. That’s how she said it. Not “you might have ADD,” because she knew that I would tell her that she’s crazy. Instead, it was “why not give it a try” and then a discussion as to why she was considering it, and why I might as well.
Well, I tried the medication, reluctantly, and my life has changed considerably, drastically, for the better. There are some things that I don’t even want to admit to—such as the fact that I don’t have angry outbursts at my children any more—because, well, I used to do that. Just like my dad, and it was something I hated in him. And then, there I was, doing it to my kids, unable to control myself. Now, I can, and I do control myself. Do you know how important just that one thing is for me? It’s huge.
But, that’s just one thing. There are so many others. My self concept has improved, I’m outgoing, and I feel in control of my emotions. I talk to people at the gym or at the school yard. People who have no idea that I’m taking medication have commented that, wow, you seem really great. My wife and I don’t fight. I sleep better. I’ve decided to dress better in order to show people that I take myself seriously and would like them to as well. I’ve gotten fit because I want to care for myself, rather than hurt myself through eating crap or smoking.
All of that. Huge. I used to think that ADD was made up, and that kids were being medicated for the wrong reasons, such as a need to normalize them or something. But, of course I see things differently now. If I were to describe it simply, this is what I’d say: I used to struggle just to get to baseline. Just to get to that point where I’m not yelling, or crying or struggling to contain an inexplicable irritability. I used to struggle to get to the point where I don’t mind being with other people because I lack confidence or self worth. I’d struggle to get past the point where all my energy and focus is spent just trying to get to baseline. Now, the baseline is the starting point, and my energy is focused in living life, in enjoying life, in interacting with others, in enjoying the time I spend with my kids.
Yes, there are people who are misdiagnosed, but that’s not unique to ADD. My father’s rare form of cancer was misdiagnosed by three dermatologists as a skin irritation caused by the soap he was using. By the time someone finally recognized what it was, he was past the point of effective treatment. So, yes, it was misdiagnosed and while it would have likely killed him anyway, it killed him faster. He had a year instead of ten. Thankfully, a misdiagnosis of ADD isn’t as dire. The meds work for you, or they don’t; you take them, or you don’t. Whatever. If it helps you, great. If not, then maybe it’s not the right diagnosis.
People are hung up on the suggestion that meds are the only answer, and you spend some time in the article deriding that idea, though who are the people who suggest that? No physician of any worth would say just meds to the exclusion of everything else. Of course everyone should be exercising, eating good, not smoking, not drinking. No matter what you have—we don’t really need to say this, do we?—there is no single operator that determines your level of health.
People are also hung up on the idea that the only way that ADD presents itself is through being Chris Farley. But, that’s not it. It’s complicated. It involves cognitive flexibility, anxiety, social maladaption, impulsivity. There is, actually, some delicacy in our understanding of ADD beyond separating the class from the clowns.
People wonder if ADHD exists, or if it’s real, as if it might exist in the way that an earthworm does, and that we can find it if we look in the right places, such as under a rock or a microscope. It doesn’t. Rather, ADHD exists in the same way that a centimeter exists. Are there centimeters in the world? Most people would say that there are, but you can’t point to one. We can point to rulers, but they’re rulers, not centimeters. Still centimeters are real, we use them every day; they represent a powerful conceptual tool—measurement—that we use in order to better understand, interact with, and communicate ideas about the world around us. I’d suggest that ADHD exists in the same way: it’s not a virus or an injury, but rather a conceptual tool that helps us to make better sense of, or bring order to, some aspects of development and mental health. The concept is always being refined, and I suspect that the term will change to better reflect the constellation of symptoms it intends to represent. That’s how science works, moving from the rudimentary to the more refined. When I was young, living in a small town, there were still people that referred to those with neurological issues as “touched.” That was the conceptual tool available to them in order to express a range of difference, including everything from being slow, as they would have said, to having Down Syndrome, and everything in between. It was an archaic term, though there really was a time when it was as fine an analytical tool that anyone had available to them. We’ve, thankfully, come a long way since then. Is “touched” real? There were differences within the population that the term allowed people to talk about, albeit clumsily, so, at least in that sense, it was. Thankfully, we’ve moved a long way since then, and we’ll continue moving forward into a greater understanding of the complexity, and the treatability, of mental health.
Still, we don’t like diagnosing kids with mental health issues, including depression or anything else. Chronic fatigue is suspect, too, though no one is writing articles about whether chronic fatigue is real, or gluten intolerance is real. We allow some things, and criticize others, and mental health is the Justin Bieber of the paediatric medical world—it’s all right to boo, at least that’s the prevailing consensus, and everyone is joining in. All of mental health, especially paediatric mental health, remains veiled and suspect, not just ADD, and all these articles perhaps unwittingly are continuing to spread the message that anyone who suffers with a mental health issue is weak and lacks the desire to help themselves. In terms of mental health, we’re all still living in the 60s. That’s a problem. If a misdiagnosis of ADD gets parents on a path toward investigation—if they use it as a starting point, and if the ADD therapies are wrong, they continuing to ask questions toward a more correct diagnosis—I’d say that’s a pretty good thing. We approach other things that way, as a clear diagnosis isn’t always available at the first visit with the doctor. Yet, we don’t give ADD that latitude, and so many kids, those with ADD or a range of other independent issues, ultimately so many kids aren’t getting any help at all.
Every perspective is valid, or so we believe. But informed perspectives are more valid than others. Some believe that vaccines cause autism, but they’re wrong—they’re free to say it, but in fact, there are other more valid perspectives, and that comes out of being thoughtful, curious, and informed. Ryan D’Agostino, who wrote the Esquire piece, doesn’t have an informed perspective nor a curious mind—he’s just rehashing the water cooler kind of discussion. And, so far in the media generally, that’s all we’re getting. “When I was a kid …” Well, when I was a kid there was spanking, and smoking in cars with children, and smoking in restaurants, and no laws about wearing seat belts, and no bike helmets, and they fogged the trees in town for insects … and yet, we still think exactly the same way about mental health as we did back then: suck it up. We think (or want to think) that if we just pulled our socks up, we could all achieve more, or be better, or whatever. We think that seeking help for mental health denotes weakness. That’s what we all used to think. But, I have to wonder—and indeed, I’ve spent a lot of time wondering—how my life would have been different if I’d been helped appropriately when I was young, rather than when I was 43. I ache to remember events, behaviours, or periods of my life that simply would have been different. That would have been better, or easier. I think of relationships that I squandered, and opportunities that I couldn’t act on. I can now recognize all the struggling that I did, and all the self-medicating with booze and other things I did, just trying to bring myself to my baseline. It’s an idea that haunts me.
Is ADD real? Who knows? Perhaps it depends on how you ask the question, or why you ask the question, or the kind of answer you expect to hear. But mental health is real. And the medication that I’m taking is real. My doctor really suggested it because of some of the symptoms that she was seeing in me. And, as a result, I’m now taking a medication that allows me, finally, to be the person that I want to be, and to present myself to the world in the way that I’ve always wished I could. Do you know how important that is for me? It’s huge. Some people who read your article will decline treatment for their children, and some of those boys will have my experience. And one day they’ll mourn, too, for all the things that might have been.