Tuesday, December 2, 2014

Little White Pill

When I read ADHD sites, I see a lot of concern from parents about whether or not it's right to "drug" their kids. I think there's a perception that, since ADHD medications calm children down, it must be similar to giving a kid a dose of valium - the new Mother's Little Helper, only this time we apply it directly to the source of the problem.

This isn't valium.

I can only offer my experience with this medication and with this condition, but, if you are a parent and you are wondering about whether or not medication is ever right (I can't speak for always right, but I can say something about ever right), I do want to offer that experience and that perception. I'd like to try to give you an insight into what ADHD is like - what I suspect it's only possible to understand it's like when you have lived with it untreated and then had it treated.

These drugs aren't even remotely like valium.

Being on them isn't a dulling down. It isn't doping. It isn't drugging oneself into quietude.

Having untreated ADHD is like having your body embedded with a thousand fishhooks, with lines pulling you in every direction at once.

It's being unable, physically unable, desperately, despairingly, hatefully unable to stop watching a television. No matter how much you want to stop watching the television. No matter how hard you are trying to stop watching the television. No matter what price you are paying for watching the television. No matter what abuse you are pouring on yourself for continuing to watch the goddamn television. And then you get the drugs and you don't have to beg someone else anymore to please turn off the television and set you free.

Having ADHD is having the feeling that desserts were amputated from your mouth. You can go for weeks being acutely and persistently aware of the absence of a turtle brownie sundae from your tongue. You work on increasing your self-discipline. You try to deal with it as an emotional problem (maybe the sundae reminds you of something you want to experience again, like a childhood pet! a day at an amusement park! a beloved grandparent! your first date! a simpler time!) but the reality is that the food isn't about love and it isn't about security and it isn't about sex. That food is about carbohydrates and their ability to trigger the rush of dopamine that your brain is starved for (even if your body isn't) and all the self-discipline and therapy and weight watchers in the world aren't going to get you that dopamine, and the longer you put off getting it, the more and more trouble you're going to have functioning without it. You can get the dopamine pumping as needed by exercising yourself to a "runner's high" every two to three hours, but your body isn't going to take that kind of treatment indefinitely, you can get it by eating the sundae, which is an entirely different kind of way to mess up your body, or you can take the drug.

Having a kid with ADHD is exhausting. Having ADHD is even more exhausting. Until the diagnosis, until the drugs, I thought that the barrage of impulses and craving for stimulation that I experience was normal. If life on these drugs is what life is like for non-ADHD people - and the neurologists certainly seem to indicate that that is the case - then I'm at a loss for why the normals haven't solved all the world's problems by now, because life on these meds is life on easy mode. I used to berate myself for having poor self-discipline and poor impulse control, but that's hardly a fair assessment when the impulses and the cravings just never stop. With ADHD, you're catching yourself and pulling your attention back on track and knocking the distraction or the stimulation out of your hand not once an hour or even once every five minutes - you're chasing yourself down and rapping your own knuckles two or three times a second, every second of every day. The truth is, I'm amazingly self-disciplined and I deny myself about 99.9% of my impulses, but 0.1% of a staggeringly large number is a pretty substantial number in its own right. From the outside, it can look like I'm out of control; on the inside, I'm Nurse Ratchet.

This is not valium. This is a break, a step outside of a torrent of impulses and demands for attention, a sudden relief from the merciless, punishing pressure that, until you get the drugs, you didn't know life doesn't have to be like.

We are all captives of our own experience. Just as it is impossible for someone who does not have ADHD to truly understand the experience of having it and what they struggle with, it is impossible for someone whose ADHD has gone untreated to understand that, while their failures of restraint are visible, their almost infinite successes, unseen and uncounted, may dwarf those of the giants around them. I have never before understood the experience of people who found it natural to behave themselves. I have marveled at people who achieve success by "just doing the work." I have stood in awe of people who simply pay their bills on time every month, who rake their leaves as soon as they fall, who mail birthday presents on time and who don't feel a sense of overpowering need when confronted by a bowl of tortilla chips. I could not compare experiences, only results, and I could not understand how others managed to perform what are to me herculean feats as a matter of course. I was constantly berating myself for failing to live up to the examples set by my friends and colleagues, who made it all look so easy, because I could not understand that for them, it almost certainly is as easy as they make it look. To me, not having experienced the regulation that their brains naturally produce, it seemed like I was just a careless, irresponsible, thoughtless slob. Until the drugs allowed me to experience what life is like with a brain that is well regulated, I could neither produce visible achievements at the same level as my peers nor even give myself credit for my invisible success.

This is not valium. This is not a way to pep up or check out. It does not stupefy. It does not make you mellow (although being set free from the anxiety that comes with having to constantly police one's attention is a very relaxing thing). It doesn't turn you into a zombie or a drone. It only sets you free.

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