Between a rock and a crazy place

I've been diagnosed with ADHD

31 Aug 2016

tl;dr: I've been diagnosed with ADHD. I ramble incoherently for a while and I might do some less rambling posts about it in the future.

As the title says, I've been recently diagnosed with ADHD and I thought I'd try to be as open about it as possible and share my personal experiences with mental illness. That being said, I am also adding the disclaimer, that I have no training or special knowledge about it and that the fact that I have been diagnosed with ADHD does not mean I am an authoritative source on its effects, that this diagnoses is going to stick or that my experiences in any way generalize to other people who got the same diagnosis.

This will hopefully turn into a bit of a series of blog posts and I'd like to start it off with a general description of what lead me to look for a diagnosis and treatment in the first place. Some of the things I am only touching on here I might write more about in the future (see below for a non-exhaustive list). Or not. I have not yet decided :)

It is no secret (it's actually kind of a running gag) that I am a serious procrastinator. I always had trouble starting on something and staying with it; my graveyard of unfinished projects is huge. For most of my life, however, this hasn't been a huge problem to me. I was reasonably successful in compensating for it with a decent amount of intelligence (arrogant as that sounds). I never needed any homework and never needed to learn for tests in school and even at university I only spent very little time on both. The homework we got was short-term enough that procrastination was not a real danger, I finished it quickly and whenever there was a longer-term project to finish (such as a seminar-talk or learning for exams) I could cram for a night and get enough of an understanding of things to do a decent job.

However, that strategy did not work for either my bachelor, nor my master thesis, which predictably lead to both turning out a lot worse than I would've wished for (I am not going to go into too much detail here). Self-organized long-term work seemed next to impossible. This problem got much worse when I started working full-time. Now almost all my work was self-organized and long-term. Goals are set on a quarterly basis, the decision when and how and how much to work is completely up to you. Other employers might frown at their employees slacking off at work; where I work, it's almost expected. I was good at being oncall, which is mainly reactive, short-term problem solving. But I was (and am) completely dissatisfied with my project work. I felt that I did not get nearly as much done as I should or as I would want. My projects in my first quarter had very clear deadlines and I finished on time (I still procrastinated, but at least at some point I sat down until I got it done. It still meant staying at work until 2am the day before the deadline) but after that it went downhill fast, with projects that needed to be done ASAP, but not with a deadline. So I started slipping. I didn't finish my projects (in fact, the ones that I didn't drop I am still not done with), I spent weeks doing effectively nothing (I am not exaggerating here. I spent whole weeks not writing a single line of code, closing a single bug or running a single command, doing nothing but browse reddit, twitter and wasting my time in similar ways. Yes, you can waste a week doing nothing, while sitting at your desk), not being able to get myself to start working on anything and hating myself for it.

And while I am mostly talking about work, this affected my personal life too. Mail remains unopened, important errands don't get done, I am having trouble keeping in contact with friends, because I can always write or visit them some other time…

I tried (and had tried over the past years) several systems to organize myself better, to motivate myself and to remove distractions. I was initially determined to try to solve my problems on my own, that I did not really need professional help. However, at some point, I realized that I won't be able to fix this just by willing myself to it. I realized it in the final months of my master thesis, but convinced myself that I don't have time to fix it properly, after all, I have to write my thesis. I then kind of forgot about it (or rather: I procrastinated it) in the beginning of starting work, because things where going reasonably well. But it came back to me around the start of this year. After not finishing any of my projects in the first quarter. And after telling my coworkers and friends of my problems and them telling me that it's just impostor syndrome and a distorted view of myself (I'll go into why they where wrong some more later, possibly).

I couldn't help myself and I couldn't get effective help from my coworkers. So, in April, I finally decided to see a Psychologist. Previously the fear of the potential cost (or the stress of dealing with how that works with my insurance), the perceived complexity of finding one that is both accepting patients that are only publicly insured and is specialized on my particular kinds of issues and the perceived lack of time prevented me from doing so. Apart from a general doubt about its effectiveness and fear of the implications for my self-perception and world-view, of course.

Luckily one of the employee-benefits at my company is free and uncomplicated access to a Mental Health (or "Emotional well-being", what a fun euphemism) provider. It only took a single E-Mail and the meetings happen around 10 meters away from my desk. So I started seeing a psychologist on a regular basis (on average probably every one and a half weeks or so) and talking about my issues. I explained and described my problems and it went about as good as I feared; they tried to convince me that the real issue isn't my performance, but my perception of it (and I concede that I still have trouble coming up with hard, empirical evidence to present to people. Though it's performance review season right now. As I haven't done anything of substance in the past 6 months, maybe I will finally get that evidence…) and they tried to get me to adopt more systems to organize myself and remove distractions. All the while, I got worse and worse. My inability to get even the most basic things done or to concentrate even for an hour, even for five minutes, on anything of substance, combined with the inherent social isolation of moving to a new city and country, lead me into deep depressive episodes.

Finally, when my Psychologist in a session tried to get me to write down what was essentially an Unschedule (a system I knew about from reading "The Now Habit" myself when working at my bachelor thesis and that I even had moderate success with; for about two weeks), I broke down. I told them that I do not consider this a valuable use of these sessions, that I tried systems before, that I tried this particular system before and that I can find these kind of lifestyle advise on my own, in my free time. That the reason I was coming to these sessions was to get systematic, medical, professional help of the kind that I can't get from books. So we agreed, at that point, to pursue a diagnosis, as a precondition for treatment.

Which, basically, is where we are at now. The diagnostic process consisted of several sessions of questions about my symptoms, my childhood and my life in general, of filling out a couple of diagnostic surveys and having my siblings fill them out too (in the hope that they can fill in some of the blanks in my own memory about my childhood) and of several sessions of answering more questions from more surveys. And two weeks ago, I officially got the diagnosis ADHD. And the plan to attack it by a combination of therapy and medication (the latter, in particular, is really hard to get from books, for some reason :) ).

I just finished my first day on Methylphenidate (the active substance in Ritalin), specifically Concerta. And though this is definitely much too early to actually make definitive judgments on its effects and effectiveness, at least for this one day I was feeling really great and actively happy. Which, coincidentally, helped me to finally start on this post, to talk about mental health issues; a topic I've been wanting to talk about ever since I started this blog (again), but so far didn't really felt I could.

As I said, this is hopefully the first post in a small ongoing series. I am aware that it is long, rambling and probably contentious. It definitely won't get all my points across and will change the perception some people have of me (I can hear you thinking how all of this doesn't really speak "mental illness", how it seems implausible that someone with my CV would actually, objectively, get nothing done and how I am a drama queen and shouldn't try to solve my problems with dangerous medication). It's an intentionally broad overview of my process and its main purpose is to "out" myself publicly and create starting points for multiple, more specific, concise, interesting and convincing posts in the future. Things I might, or might not talk about are

Let me know, what you think :)