Letter magnets arranged to spell ADHD
Photo credit to Amen Clinics

I’m in the midst of a lengthy evaluation for ADHD. Lots of interviews, lots of surveys, a lot of hoops to jump through. I’ve long suspected that ADHD is one of the things that has been a challenge in my life, but up until recently, the process of getting evaluated was too much of a hurdle to clear. Two things changed that. First, a second brother (of my three) got his diagnosis and said the treatment was life-changing. Second, now that my husband and I are with Kaiser, there was a much more straightforward path to getting evaluated than there had been with UHC.

The finish line is approaching rapidly, so I’ve been reading the books recommended by my clinician — specifically Taking Charge of Adult ADHD by Russell A. Barkley. And I’ll be honest: it’s been discouraging. Not because the book is full of bad news — it’s not. But the ADHD it describes has very little to do with my direct experience. I just don’t see myself being described. There have been moments during my reading where I’ve genuinely wondered if I actually have ADHD, or whether the problems I’m dealing with are symptoms of something else entirely. So I’m doing the thing I often do when something’s rattling around in my head: writing it out to explore it, and sharing it in case others are dealing with the same and have some insight to share.

The symptoms I’ve been calling ADHD are varied. Some are merely annoying, while others have significantly limited my ability to do my job (a factor in my decision to retire early) and to do things I actually want to do, like writing novels. Over the years I’ve developed workarounds for a lot of what used to be more prominent symptoms — making lists, self-rewards for completing minor tasks, optimized playlists for when I need to focus, self-medicating with caffeine pills. But not everything has yielded to workarounds. There are still challenges that are genuinely getting in the way of my life.

Some of the minor annoyances involve being easily distracted. I’ll think of something I want to do on my phone, pick it up, unlock it — and the moment I see a notification, I impulsively open that app and completely forget what I originally intended to do. If I’m lucky, I’ll remember it soon enough to act on it. I’m usually not that lucky. This happens multiple times a day.

Then there’s self-regulation. For example, I’ll know I need to be in bed by a certain time because of something important the next morning, but I just can’t put my phone down. I keep cycling — email, social media, Substack, news, Reddit, back to email — aware the whole time that I’m wasting time, aware that I should have been asleep an hour ago, and still unable to stop.

My relationship with time is its own peculiar thing. I’m not talking about losing track of time while engrossed in a good book — I genuinely hope most people experience that. I mean something stranger. I’m often completely unable to estimate how long a task will take, which used to cause recurring problems at work. I’ll also convince myself I have plenty of time for something that’s due very soon. (Could I research and write a 25-page term paper in under 48 hours, on an electronic typewriter, before the age of word processors? Yes. I even got an A.) But the flip side is equally strange: tasks that are nearly a year away can feel urgent and imminent, like they’re happening tomorrow. When my husband and I decided to move to Spain, I spent several days in a panic about everything we weren’t doing right now — even though my rational mind knew perfectly well that we had plenty of time to plan and act methodically. The irrational mind was convinced we were already behind a schedule that didn’t exist.

The biggest challenge, however, is something I sometimes call engagement and effort inhibition, and sometimes just call work avoidance. It kicks in when I have an important, complicated task ahead of me — writing a scene in a novel, drafting a test plan, documenting a process for handoff — anything requiring sustained, deep thinking. I can have it all planned out: I know what the scene needs to accomplish, I know what needs to be tested and what tools I have, I know the details of the process. But when it’s time to actually do the work, my mind balks. Instead of starting, I feel a near-physical need to distract myself. Grab my phone and scroll. Tidy the desk, the room, the kitchen. Write a blog post about my inability to write the scene. Practice Spanish. Watch another YouTube video about moving to Spain. Anything but the work. And if I manage to force myself to actually sit down and do it, the pull of distraction slowly ramps up until it becomes unbearable.

I do have some partially effective coping mechanisms. Caffeine pills take the edge off the urge to flee into distraction (without making me feel wired, oddly). Certain music helps me focus. Small rewards — a bit of dark chocolate every so many words — can be motivating. I’ll use a Pomodoro timer. But even deployed all at once, it’s still monumentally difficult to get these tasks done, even when it’s something I genuinely want to do, like writing. It’s not that the work is hard, or unpleasant, or unfulfilling. I’m a skilled writer. I enjoy writing. I love the satisfaction of a well-crafted scene. You’d think it would be a simple matter of saying “I’m going to do this now.” It never is.

The one exception had been NaNoWriMo. The need to write roughly 1,667 words per day to hit fifty thousand words by the end of November gave me real daily deadlines with real consequences for missing them. I still struggled with focus, but the deadlines were genuinely, significantly helpful. Deadlines are often cited as a workaround for the focus difficulties that come with ADHD, and I believe it — but self-imposed deadlines don’t work for me. What worked about NaNoWriMo was that an external agency would validate my completion, reward me if I succeeded, and withhold that reward if I didn’t. That accountability was strangely powerful in a way that my own intentions simply aren’t.

So, those are my major challenges with what I’ve been calling my ADHD. The fact that the book’s examples and symptoms feel so different from my own experience has been discouraging. What I most want to get past is the engagement inhibition — I’m not going to get far as a writer if I’m constantly battling myself just to sit down and work. Thankfully, the book isn’t my only resource. I have an appointment with a psychiatrist in a couple of weeks, where I’m hoping to get a formal diagnosis and a treatment plan. I’ll bring up my concerns then. Hopefully he’ll have better answers than I’m finding in the book.

One final thought: Several people have suggested I might have co-occurring autism — sometimes called AuDHD — and that this could be why the ADHD described in the book doesn’t align with my experience. It’s a real possibility. My mom has suggested I might be autistic, and it’s a trait that runs in my family. Unfortunately, when I began the ADHD evaluation intake, a friendly technician warned me not to bring up autism during the process. Kaiser apparently treats autism differently, and if it’s raised, the evaluation gets redirected toward an autism evaluation — which is harder to get a positive diagnosis for, and a negative result would end both evaluations. I don’t know how accurate that is, but I wasn’t willing to risk it. Once the ADHD process is complete, I’ll bring it up with my psychiatrist.