Wondering What a Pill Will Do to Me

Those who have ADHD were born with it. You learn everything with an ADHD brain and never know what learning, living or executing a plan are like for folks without ADHD. When you figure out that others have better emotional and executive self-control than you, you can’t really imagine what it’s like to be them. Imagining better self-control is about as easy as imagining living on the other side of the world. You can guess dozens of details, but thousands never occur to you, till you get there.

When I held the very first ADHD pill I took in my hand, I tried to imagine what I would be feeling in an hour. An hour later, the answer was ‘nothing’. By the end of the day, the answer was still ‘nothing’. I felt no joy, no elation, no energy, no buzz, no euphoria, no calm, no peace and no different. But looking back on the day, there were a thousand differences from the patterns of the previous forty years that were all small, but collectively stunning.

I learned a lot about ADHD in the first few days after I started medication for it by what changed and what stayed the same. I found myself able to do things that I had never been able to do before. It was far more exciting for me in some ways, than for my wife.

“Guess what I can do?” I prodded her excitedly. “I can simultaneously talk to patients AND keep mental track of the time!” This was very new and different. I could think of a world of useful things that could be done with such a super-power. Not get an hour behind my schedule every day for example.

Her response couldn’t have been more deflating. “Yeah, hon, everybody can do that.” She didn’t even look up from the book she was reading.

“Well I couldn’t before the meds, and I can now,” I replied.

She looked at me with utter incredulity, like I had just told her I’m Martian and need to catch a shuttle back there now. Her concept of ADHD was changing just as fast as mine. The surprise in her eyes relaxed, and she grew more reflective.

“I never imagined you couldn’t do that,” she said. “I thought you were choosing not to.”

We had been married almost 20 years, and she had never known this stunningly basic fact about me. She assumed that I wanted to come home late every night more than I wanted to be with the family. There were plenty more surprises those first few days.

I drove home from work one night (an hour earlier than usual) in crowded, but fast-moving traffic. The driver in front of me was very erratic and irritating. I felt the manly impulse to drive right up her rusty tailpipe, flashing my lights and generally intimidating her into driving less erratically. (“Great plan with a high chance of success!” you’re probably thinking.) The thought of arriving home safely and calmly also flashed through my mind, and I backed off a couple car lengths.

“Does this pill make me a driving whimp?” crossed my mind. The only answer I could think of to my own question was “No, given the choice, I’d rather relax and think my own thoughts than to be a butt-head.”  Once again, it was a brand new thought for me that I had a choice of reactions to this annoyance, and the simplest choice was to relax and not be obnoxious.

The most remarkable thing, though–and it occurred time and time again–was how simple small work tasks became. I could look at several necessary jobs, pick the top priority and start working on it with less effort than it takes to read this sentence. People who don’t have ADHD probably never imagine how much effort goes into the smallest task, the simplest morning routine, nor do they know how frustrating it is to spend that much effort and still do it badly.

With ADHD, the amount of internal wrestling you go through to start a mundane task is many times the work of the task itself. If you’ve ever spent 10 minutes getting your teenager to spend 2 minutes taking out the trash, you know what I mean. People with ADHD cajole and plead with their inner teenager to finish every item of the morning routine, to start every simple task of the work day, to pick up every piece of clutter.

Experts refer to this as “motivational impairment”, but it really deserves a much more descriptive name, such as “the soul-wrenching effort to shame yourself into doing small, mundane tasks, by imagining that God and your ancestors will hate and disown you if you don’t”. “Motivational impairment” is the short-cut the experts use to save time in their busy research labs.

The need to start a task occurs hundreds of times in a day. People who do hundreds of tasks in a day deserve to feel tired, and they deserve their rest at the end of the day. People with ADHD may only accomplish dozens of tasks, because of the exhausting inefficiency of wrestling our minds from task to task. We may be working harder than anyone knows behind the scenes, but only get credit for the work accomplished. There is no credit for the motivational “pre-work”.

Being able to do a full day of simple work is the most amazing thing I experienced after starting medication. It’s like waking up and taking a deep, delicious breath of the morning air, and realizing that—as far back as you can remember—all you’ve ever known is breathing through a straw.

About Oren Mason MD

Physician specializing in diagnosis and management of attention deficit disorders and related conditions.

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Tagged with: Initiation
Posted in ADD, ADHD, attention, medications