After nearly 38 years of life, and having seen many success stories on Blue Sky, I’m stoked to share my main ADHD challenges in life before and after starting ADHD meds and the wonderful difference they’ve made.
Challenges -Distraction & Focus
Neurotypical brains produce enough dopamine to allow them to filter out excess sensory information, subconsciously. Apparently, they don’t wander into the classroom and immediately think of five different things they should be doing, and actively try to push four of those things away so they can focus on and complete one thing at a time. And they don’t check their email, and get distracted by a random email that isn’t important right now, or check the digital notice board and get distracted by another non-urgent thing. And interrupt setting up their Reading session with setting up their Writing session. Then get distracted getting a resource for an individual child, then get distracted by packing up something they forgot to put away yesterday, then get distracted by asking a colleague a question, etc.
My entire work day is me using vast amounts of energy trying to push all the non-urgent things clamouring for my attention away, so I can attempt to focus on and complete one thing that needs to be done now at a time. You know what requires even more of my energy? Not forgetting everything I’m not doing in that moment but do need to do sometime, and keeping track of it until I actually do it. This is made harder by the fact I can remember a thing, fully intend to do it right that moment, then get completely distracted by something else and not remember whether I actually did it or not (half the time I didn’t).
Related Challenge: Keeping Track
Diaries and calendars and apps are no good, because if I can’t see everything I need to be doing in front of me at all times; I forget to check the reminder and half the things its reminding me of, for up to a few days. So at work and at home, every incomplete digital task that needs doing in the next two weeks is an open tab (I always have the max number of tabs open). Everything I can’t do right that moment at work gets written down.
I often don’t have the time or headspace to check if I already wrote it down, and sometimes the mere idea of checking what I have recorded is stressful because I’m already overloaded. So there are multiple to do lists, some things duplicated across them, others not yet recorded.
Welcome to the world of hyper active and inattentive ADHD! (Unmedicated).
Challenges -Noticing and Meeting Basic Physical Needs
With all the above going on, who has room in their brain to notice incidental things, like being hungry, tired, needing the bathroom or being sick or in pain? Other writers are doodling their characters and making Spotify playlists for their works in progress, meanwhile I forget multiple characters names, where my characters are or what they’re doing.
I’m also running out of clean clothes because I haven’t noticed the washing basket is overflowing. There’s a small pile of clutter building on the side of my bed, because if I interrupt whatever it is I’m struggling to remember I should be doing to clear that pile, I’ll forget that thing I can hardly remember I’m supposed to be doing.
Challenges: Urgency and Never Stopping
Everywhere I walk at work and in my house, I’m clinging to memory of multiple things I should be doing but haven’t written down yet. Meanwhile sights, sounds and people talking about other things are all around me, clamouring for my attention, all day, every day. And while I struggle to batter away everything that isn’t essential, and at the top of my to do list, all the less essential things that still need doing keep itching to be done.
This is why I was often found at school, half an hour after most of my colleagues had left, rushing around my classroom completing literally five end of day pack up, and next day set up tasks at once. This is why my to do list had to be a physical piece of paper on top of my (messy) desk in a bright colour that screamed for my attention and no other form of task management worked.
The tendency to be distracted, to interrupt my own thoughts, let alone my own task completion created a sense of ongoing urgency. I need to do this —right now—before I forget. Then I need to do this right now —before I forget. And all the other things visually, or auditorily distracting me? I need to urgently block them out to urgently get anything done.
Challenges: ADHD Brain Jam
I assume its somewhere around here that fellow humans with ADHD work too hard, too long on something and experience burn out. I’ve rarely, if ever experienced ADHD burnout. But I’ve had days at work where I’ve taken in so much information that I forget what I learnt today, what I knew yesterday and pretty much everything I need to be doing is melting out my ears. A point where I simply can no longer hold onto or process information. The only solution I have found is drop everything (usually between 4-5pm), and take the rest of the night off.
I started having multiple days of brain jam/ cognitive overload in a row, worrying about meeting deadlines, and just plain feeling far too tired and drained on an ongoing basis in 2023. That’s because I don’t just have ADHD, I also have a chronic illness (courtesy of long covid in 2022). Fibromyalgia was steadily eating my stamina, and ramping up my chronic fatigue, pain, and in hindsight; brain fog, by the end of all four 2023 teaching terms.
This is the point that made me re-evaluate my 2020 decision not to get my ADHD diagnosed because it was clear my ADHD does impact me significantly at work and was making my life harder; possibly A LOT harder.
Diagnosis, Medication & Clarity
Having waited six months for my appointment, and another two for the follow up, and another two to see a psychiatrist to back up the GP, I got diagnosed with ADHD early in 2024. Only with that diagnosis, only with the psychiatrist explaining to me how lack of dopamine impairs an ADHD brain’s capacity to filter out excess information, only after starting medication did I have the clarity to write the above.
For a contrast of my clarity prior to both, read the jumble that is my blog of ‘I Think I’m Neurodiverse, ADHD? Autism?’ I tried to put it some kind of order, in a way that meaningfully sequenced the content, but having written and edited it before starting meds, I kept losing track and wasn’t sure if I succeeded in sequencing and structuring it well.
Want to hear the really interesting part? I’m writing this blog having not taken my meds for two days. Because after four days on a helpful dosage; I have the clarity to clearly, meaningfully organise and structure my thoughts. This is the clearest my head has ever been while writing. The only other thing that can trigger a state of mental clarity like this, as opposed to chaotic, highly distractible chaos, is the two or so hours after running 4 kilometres (which I still do daily, because even with ADHD meds, it still helps).
I’d like to take this moment to tell people in the US claiming the number of people taking ADHD meds is a ‘problem’ to educate themselves and stop talking shit.
Medication: The Journey
My doctor gets his patients to start ADHD medication gradually, with written instructions on how to mix the powder inside the capsule and water to get 10mg (the starting dosage) up to 70mg. Its a trial and error process with guidelines, where you figure out what works best for your brain and body (and consult your doctor if problems arise).
Day One: Dosage 10mgs, Notable Difference
My mother noticed hardly anything on a low dosage. I noticed a difference within one hour. I could pause the big thing I was doing to do other small things, like make a phone call or brush my teeth. Then I could return to what I was doing.
This is BIG. I can easily forget to reply to emails, messages or phone calls for a few days. Then I can wait hours after feeling hungry before dragging myself off for food. I often run of an evening when I’d rather run by daylight during winter.
This is because it takes me hours to focus my attention on big things, like writing or editing novels. If I’m nearly focused, I don’t want to give up the hours I spent getting nearly focused to interrupt myself (writing at home lunch ‘breaks’ can last three hours due to distraction). So if I was kind of focused, I’d opt to be hungry for an hour or two as I tried and get something done.
I also found I could choose when to get off social media and just get off it. I didn’t need the dopamine I always need it to provide to help me focus.
After three hours: I could switch off and zone out. That’s something I normally manage perhaps every few weeks, even months and am TERRIBLE at as an adult. My ‘holidays’ are as busy and jam packed as work days, they’re just fun and adventure busy instead of work busy. The ability to mentally switch off is HUGE.
Day Two: Dosage 20mgs, Again, Good Differences
I was more aware of hunger and needing the bathroom. My brain wasn’t fighting off umpteen other distractions, so it was becoming possible to do that thing neurotyoicals apparently do all the time: listen to my body.
Started my day eating breakfast at the kitchen table so I could talk properly to a housemate. I NEVER do this. I always chat briefly, then rush off to finish the thing I don’t want to loose focus on. Not only could did I focus on the conversation for over an hour, at the end I still remembered to bring in the clothes horse I’d noticed mid-conversation was outside. Normally I’d have to fix the thing I notice so I don’t forget it, and can then focus on the conversation.
The other difference is, instead of urgently rushing to start the day’s proof reading (the clock was ticking, I had to upload a finished novel to online bookstores soon), I was able to take stock. Clear some dirty dishes and put a few things away, instead of zoning out everything but today’s big task.
This was the beginning of a less cluttered, less messy, calmer and nicer environment to live and work in. Again -not a small thing!
Day Three: Dosage 20mgs; Inconclusive —External Factors
My doctor’s advice was if you think its having an effect, stay on that dose for three days. So I took twenty milligrams again. This was the day we learnt our landlord was selling the house and we’d have to move out in two months. It was hard to tell if it was the meds that had me so hyper focused I couldn’t get off my computer to exercise, and so agitated I had to run to calm down. I got none of my main task done this day.
Also, my whole body and heart rate were slowing down so much that that night I went to sleep easily despite not exercising. Only when I’m sick or with chronic-illness-levels of fatigue can I normally do that.
Day Four: Dosage 30mgs: Meh!
In hindsight I should have gone back down to 10mgs, but I wanted to get past the wonky I was feeling, so I went up. I felt like I could focus, but lacked the spark and impetus to do anything. Only listening to music got me editing my novel, and I soon became distracted.
I also felt very flat. I’m normally full of energy, smiling and on the go. But that day I just sat there, not feeling like doing anything, just kind of watching the hours tick past. I had to wait for the meds to wear off and go for a run before I got some of the day’s big task done (starting at 9pm, not ideal).
Day Five: Dosage 40mgs: I’m Me AND Focused!
The ADHD urge to rush on to the next thing was strong, so I went up to 40mg. That was when the magic started. My heart rate picked up, my energy levels reset to normal and I felt more like me. I also read the opening chapters of my novel aloud to proof read them, something I have NEVER previously found the patience to attempt. This marked another significant increase in focus, and interestingly; focus on something that normally bores me (which usually requires vast amounts of discipline to attempt, and is usually completed with impatience and frustration).
Time was the other big thing. In the weeks before starting medication I was highly distractible, often staying up to between 2am and 4am. During the day the hours would rush past and I had no idea what I was doing in them. Now, I was focused enough that I was getting the main task done, and looking up to see it had only been tens of minutes, not hours that had past. Time had slowed RIGHT down, which made me feel much more in control of my day.
Day Six: Dosage 50mg ???
Whoops. This should have been day two at 40, followed by day three at 40. All I noted was that I felt settled within 15 mins, much faster than other days.
Day Seven: Dosage 60mg; Brain Jam Unlock
Oh dear. I was now 20mg’s up what I should have been on because it had become too many days in a row to A. re-read dosage instructions, and B. do so correctly.
And yet, before I even took my meds that morning, I was remembering and noting the sort of things my brain jam normally locks up until that blessed ten seconds of quiet when I turn out the lights at night, then recall multiple things I forgot to do. My brain was decluttered of its usual excessive information input overload, and functioning better than usual as a result.
And yet, my heart rate was too fast. I was becoming more distractible throughout the day, didn’t get much done until after my evening run and then still had trouble sleeping. Oddly, my distractibility seemed to be getting worse, to the point it kept me awake until I think 3am. This dosage made my ADHD worse overall.
Day Eight: Dosage 50mg; Not So Good
I remembered myself here and dropped back 10mg, helped by the fact my heart was still beating too fast. It continued to beat too fast and I remained somewhat distractible and didn’t get much of the main task done until after running again in the evening this day.
Day Nine: Dosage None
Having hardly slept the night I uploaded my novel, I wasn’t in a good state to accurately mix meds, so I skipped them.
Day Ten & 11: Dosage 50mgs -Not Right
My heart was still beating too fast for someone sitting still. My focus wasn’t as good as the meds had made it earlier. The next morning, I still didn’t like my heart rate (long covid wreaked havoc with it for weeks and I suspected high dosages of AHD meds were an issue because of this). So on day eleven, I took a break to ensure the incorrect dosage was fully out of my system.
Day 12: Dosage 40mgs -Might Be Good?
This was another day of big external factor. My book was live at online stores, I was posting on all my social media and my friends were congratulating me on getting the whole 360k trilogy out into the world, despite long covid and the chronic illness it caused throwing spanners between book 1’s release and book 3’s.
I let myself make quality launch day graphics, splurge on social media, drank wine, ate chocolate pudding and had a good day. And despite all those other dopamine factors, my heart rate seemed more settled, and I felt better overall.
Day 13 & Beyond: Dosage 40mgs – What is This Magic?
Often when I finish a big project, like the end of a school year or releasing a book, I take time out, take stock, do some cleaning. The strange thing about releasing my third book was; I was up to date with housework, and grocery shopping, and cooking and baking.
But I forgot what else I needed to be doing, so I made a To Do List in a Google doc. Then I attempted the most boring thing I ever do, successfully, for hours. I deleted 500 screen shots from my desktop. Then I organised every file on my desktop into folders, combining four different folders for book files into one. (My computer files haven’t been this organised since since I graduated from high school in 2004, and maybe 90% of the files on my computer now didn’t exist then).
The next day I deleted all duplicate images from my downloads, and sorted images I will reuse into my folders. Then I went through my third party inbox, my personal inbox and cleaned out nearly 1,000 emails from each. I even organised receipts into a folder for this year’s taxes (never done that before).
Then I filled in forms left on open tabs and closed half my many tabs.
30 Mgs
Things were going MUCH better, but I was still hyper focused on organising things and not stopping to eat meals or exercise as often as I wanted throughout the day. And my resting heart rate was still fast. So I went down to 30mgs. This time, I had a good enough handle at 30mg on my focus, not getting distracted and still had energy. I made a call and headed and headed back to work; casual teaching.
I can’t quite focus as well on boring organisational things at this dosage, but my overall focus and organisation are quite good, and distractibility is down. There’s now a calendar with all my pre-booked teaching days, days and times I’m inspecting houses to rent and multiple appointments. I’ve NEVER had the headspace, calmness or clarity to put some much on a calendar.
What Did the Meds Change?
My dopamine levels were now at a stage where my brain filtered out excess information, letting me focus on what I chose, even when the task was so boring (aka so dopamine depriving) I wouldn’t normally attempt and would never otherwise succeed at it.
My To Do List was getting added to, then rearranged into priority order, then subdivided by topic. It was double the length I would ever normally write down, because brain jam and being overwhelmed weren’t holding me back anymore, because they stopped! In other words, I can record and effectively keep track of EVERYTHING I need to be doing, for the FIRST TIME in my life, without being stressed or completely overwhelmed on a regular basis.
I’m also less frustrated by technology. Slow loading pages used to stress me out, because by the time the bloody things loaded I’d thought of three other things I could be doing and had no idea why I was on that page. Now, I can wait. Stay on the slow page, get the job done, move on the next.
Time has slowed. I can take breaks, pause, take stock, tidy things, not just rush through the day with hours flying by, barely getting that day’s main thing done and not touching most others. I feel much calmer, more focused and actually in control. This means I don’t have to go side ways, or risk leaping ahead or involuntarily falling behind as was common when everything was too much to track and process. I can actually keep up with other people in life. Maybe even get ahead, something I rarely aspire to, let alone achieve, for more than a day, or a week.
I feel like a different person. One whom life has become MUCH easier for!
What Didn’t Meds Change?
Initially, this almost put me off diagnosis. I’m a sociable, bubbly, energetic and creative person with lots of ideas. What if medication changed those things? As you may have noticed, for me a too low dosage did suppress those aspects. A too high dosage also mucked them up.
But my goldilocks dose of 30-40mgs leaves me energetic, still sociable when I choose to be (as opposed to permanently too often on social media) and as prone to smile as I normally am (which is a lot more than the average person). I still feel like me. I just have this drastically increased ability to organise and focus.
Going running has been fascinating. I’ve added around three plot ideas to my novels, or three marketing ideas for my books to my list on multiple runs recently. Its like my brain, which was in recent years struggling with the strain of teaching and life to have new ideas, is now having FAR MORE ideas for novels. Because its no longer straining with the effort of compensating for its partial information input filtering and accompany severe distractibility and resulting forgetfulness.
On the whole, I feel far more organised and able to keep track. I have more ideas and feel more creative than ever. I’m still energetic, upbeat and my old self. And I can’t wait to start writing my fourth fantasy novel with the benefit of ADHD meds!
Related Reading
I Think I’m Neurodiverse, ADHD? Autism?
Managing My ADHD
Simple ADHD online Test by Clinical Partners UK.
ADDitude (lots of great ADHD blogs, resources etc).
Writing Diverse Characters Part 1: Problematic Rep to avoid (especially neurodiverse and disabled).
Living with Longcovid —My Experience
