On the Advantage and Disadvantage of ADHD for Life

And what it has to do with New Year's resolutions.

Photo by Dmitry Demidov

Last year, at something of a personal nadir, I haltingly told my doctor I was desperate, that sometimes I simply could not make myself do basic adult things I needed to do, sometimes with serious and embarrassing consequences. I said I had struggled with focus and completing tasks my entire life, that everyone I had ever been close to had told me I should get evaluated for ADHD. (I was careful to add that this was long before it turned into a TikTok trend.) I expected that would be an initial conversation that would lead to more evaluations, but to my surprise, he asked me a few questions and prescribed me a low dose of a stimulant. When I was outside the office I found myself, also to my surprise, sobbing with relief.

Months later, I picked up a book called ADHD 2.0 from the wall of my local bookstore’s most popular titles. I had planned to read more about ADHD but hadn’t gotten around to researching books, so I decided I’d make it easy and start there. Normally I would be skeptical of a pop-psychology book on a bestseller wall that one might assume proffers just-so stories about brains or evangelizes a trendy narrative on top of what is probably inconclusive and contested research.¹ I think part of my resistance to seeking treatment came from being a historian of social science and knowing how strongly such narratives are shaped by cultural and political ideology—the psychology discipline being both one of the worst historical offenders and currently one of the most popular bases for flimsy, Thought Leadery theories of everything.² In addition to an inchoate, irrational fear of medication and a moralizing self-critique, I had a reflexively social constructionist view of ADHD: it had to be that I grew up in a chaotic, unstructured environment, or was addicted to screens, or didn’t sleep enough, etc etc.³

By the time I got the book, I already considered this to be an insufficient explanation. Then I opened it and read this list of common manifestations of ADHD, reproduced here in truncated form:

• Unexplained underachievement

• A wandering mind

• Trouble organizing and planning

• High degree of creativity and imagination

• Trouble with time management, and a tendency to procrastinate

• Strong will, stubbornness, refusal of help

• Generosity

• Restlessness, especially in boys and men

• Unique and active sense of humor

• Trouble sharing and playing with others early on, but at the same time, a desire to make friends

• Exquisite sensitivity to criticism or rejection

• Impulsiveness and impatience

• An itch to change the conditions of life

• High energy

• Uncannily accurate intuition

• Transparency, to the point of being honest to a fault

• Susceptibility to addictions and compulsive behaviors of all kinds

• Tendency to externalize or blame others while not seeing your role in the problem

• Distorted negative self-image

The authors make these more precise in the elaborations I’ve cut out, but even so a list so long and varied is inevitably a bit of a Rorschach test for self-diagnosis; most people have some, if not quite a few, of these characteristics. Still, the number of them that fit and the precision with which they fit my exhausting lifelong struggles was sobering. Even if it turned out to be simplistic or contested, the book at least offered a theory to account for, say, the mysteries of how I could be capable of almost manic, passionate, and fanatically detailed devotion to some things sometimes and helpless before mundane tasks the rest of the time, or why my brain tends to conceive of anything that isn’t happening right now right in front of my face to be basically unreal. If I was so lazy and underachieving, why had I spent my life trying to do relatively ambitious and scary things? Reading that list produced a divided feeling: some of the same relief I felt at talking to the doctor, having it confirmed by a external source that this is was actually a thing, mixed with grief that I had dismissed it for so long and perhaps suffered needlessly.

Reading the rest of the book, I realized that I had not only established a “phenomenology” of how my mind felt that closely matched that of the authors, but had already discovered most of the effective coping mechanisms for it. The authors claim that ADHD people need stimulating challenges, lots of positive reinforcement, and an environment of extra routines and structures to do some of the work their brains don’t. I had already accepted, for example, that despite tending to be a loner and introvert, my natural solitude was terrible for my mental health. That I found self-directed work without collaboration or positive feedback to be unmotivating and demoralizing. That the times I succeeded were when other people went out of their way to encourage me, show me how to do things, and frequently reiterate their confidence in my abilities. That even though I had a natural aversion to routine and structured expectations, I accomplished more and felt better within them. That I had to be a slave to lists, apps, calendars, etc. to remember things—that the more I externalized things and made them “automatic,” the less inchoate anxiety and mental spiral I experienced. That I could get the dopamine hits ADHD brains apparently crave by doing easy things like checking off a habit-tracking app or logging various data, and create my own positive feedback by watching the data add up and spit out charts that showed acceptable equilibrium or improvement.

Even just getting more information about environmental strategies—the lack of which I have no one to blame for but myself—might have helped me realize these things sooner and with less difficulty. It is regrettable to think that medication could also have helped sooner, maybe even changed my life in significant ways. The book argues that medication is the most powerful solution to ADHD, even if it requires experimentation and is insufficient on its own. I haven’t experimented much, since the combination of what I was initially prescribed and environmental changes has helped enough to consider significant improvement.

But I want to try to extract a broader lesson from this experience. The mental shift I was inching toward on my own and with the help of therapists, even before thinking in terms of ADHD, was separating brain from self, seeing my brain not in moral terms but as a machine that works with a predictable logic that can to some extent be tricked, hacked, and managed. I think that paradigm would be valid even if the neuroscience in a book like ADHD 2.0 turned out to be bullshit, even if “the brain” is just a useful fiction. (I don’t think that, to be clear, though neither am I competent to evaluate the book’s scientific underpinnings.) Part of the emotion I felt after talking to the doctor was about simply admitting out loud that this was serious and that I needed help. We are ultimately responsible for ourselves, but there are more and less effective ways of taking responsibility. Locating the problem outside your “self”—blaming it on your brain—doesn’t absolve you of responsibility, but de-escalates it, shrinks it down to a concrete, practical challenge. It also helps you communicate with other people about what you’re dealing with and seek social connection and support that ameliorates it.

The reason I decided to write about this subject now is the way it connects to the things we tend to think about at the end of the year: ambitions, goals, efforts at self-improvement, what we are doing with our lives. As the first item in the list above suggests, ADHD can have a massive impact on your desire to make something of your life. And the environmental and behavioral strategies that help people with ADHD people are probably helpful for everyone, especially in an age of information overload and technology-induced distraction. One of my life philosophies, before I consciously thought about ADHD but certainly as a result of struggling with it, was Work with yourself, not against yourself. Maybe a more precise way of putting would be, Figure out how to work against yourself in order to work with yourself. It’s a well-worn self-help cliché, but setting up structures that steer you toward your desired outcome, rather than depending on “feeling like it” in the moment, makes the inevitable moments of breakdown or “not feeling like it” less derailing.

For me personally, collecting data about my goals and productivity at work, and my workouts, health, reading, etc makes it easier to take the long view I am naturally so terrible at, and has become a kind of game that is fun and stimulating in its own way.⁴ It allows me to feel secure that I’ve covered the bases and allow temporary detours when they are necessary or just inspiring. (Of course, not everything about ADHD is negative or bad.) I try to knock out easy, mundane tasks before I start something I’m interested in and is likely to induce hyperfocus—to make stimulating things a reward for non-stimulating things. I lean into hyperfocus to get books read, subjects researched, or essays written, but have gotten better at forcing myself to “reset” at an appropriate time, even when I violently don’t want to, by stopping to eat, going to the gym, or socializing—which data and habit have helped me to also see as stimulating projects with tangible rewards. Or if I really want to skip the gym and obsess over an essay for a month, I can look at the graph of my weight and see that it didn’t do much damage to the long-term goal, that letting my brain do its thing comes out to a reasonable cost-benefit analysis. I try to force myself to commit to social obligations I will inevitably dread until I get there and thank myself for doing so. If I have a complete breakdown, I can go, oh, this again, lol—and attempt a practiced strategy to dull the impact.

What I’m describing might be something akin to what BDM recently called, in the context of accepting chronic physical illness, “an ode to incapacity.” Accepting that you can’t do certain things, or can’t do them in certain ways, or even just the obvious fact that you’re a limited human being who cannot do everything you want or that you imagine other people do, has the peculiar effect of freeing you to do the things you can do, or figuring out a different way you can do them. Nobody really wants to think of themselves as having a disorder or even a natural limitation, but being realistic about those things can be liberating, and maybe even have a silver lining. The coping mechanisms I’ve developed to deal with ADHD are, of course, a perpetual work in progress. But they are useful more broadly in that they force—or enable—me to think more globally and intentionally about what matters to me, what I want I want to expend effort on, what is actually possible, and how to make it happen. Just keeping all the important pieces in motion, even if they don’t advance as much as you’d like, is often a win. And sometimes, some years, you manage to inch the baseline further in the right direction.

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1. I should say that my blanket prejudice against popular psychology books was unfounded in this case; though the book does have the genre’s typical breezy tone and quirky terminology, the authors seem to handle the existing research with care and nuance.

2. Economics being the other, with the double whammy that it borrows a lot of its concepts from….psychology.

3. The authors of ADHD 2.0 would certainly not discount these factors in aggravating ADHD or leading to destructive coping strategies.

4. Some people find it the idea of quantifying themselves incredibly tedious or revolting, and indeed I can’t overstate my own previous aversion to doing so. I probably even said at one point that it was “neoliberal,” or imagined it in opposition to my romantic, narrative, hermeneutic vision of selfhood. But as a practical matter—after the startup costs of figuring out apps or methods—collecting personal data is so easy you barely notice it. And as an epistemic matter, data is just a different kind of building block for plot and narrative, something else to tell stories with. I even did the very ADHD thing of learning more about data just so I could figure out how to tell data stories different ways and make prettier graphs. But I’m insane, so.