So You Have, or Suspect You Have, ADHD

I recently earned the dubious honor of being named a Quora Most Viewed Writer in the topics “ADHD” and “Adult ADHD.” As I understand it, that has more to do with the fact that I write about these topics a lot than it does with the actual quality of my answers.

As one might expect, the most commonly-asked questions in these topics can be grouped into a few basic categories. There are the medication questions. There are the closely-related “alternatives to medication” questions. There are the “is this a symptom/is so and so ADHD” questions. And so on.

The biggest category of questions, by far, is the “I’ve just been diagnosed with, or suspect that I have, ADHD” category.

I find myself fielding answer requests to questions in this category over and over. Since my answers to the most common iterations are always the same, it made sense to list them somewhere for posterity. Think of this as a FAQ for Folks Who Have, Or May Have, ADHD and Holy Crap What Does That Even Mean.

I took an online test and it said I probably have ADHD. What do I do?

First: No online test is sufficient to diagnose you with ADHD. For that, you need a doctor, psychologist, or similar professional with experiencing in diagnosing ADHD – and you’ll probably need to take one or more tests that can’t be administered online. So take that online result with a grain of salt. (After all, you can just as easily find an online test that will “diagnose” you as an Idaho potato or as Dorothy Szbornak.)

If you took the test because you suspect something is up with your brain and you wonder if ADHD is its name, schedule an appointment with your primary care doctor (or your psychologist if you happen to have one already). Bring along the results of your online test. They’re not official, but they can serve as a good conversation-starter.

Talking to a doctor is optional. If you don’t feel like the answers you gave on the test or its results are any big deal, you don’t have to make an appointment.

If you think the results are a big deal but you cannot talk to a doctor for any reason, Googling “non-medication treatments for ADHD” may give you some ideas about how to rearrange your life to better accommodate your brain. The good part of these interventions is that they often help people stay more organized and focused whether or not they have ADHD. So even if you don’t qualify for an official diagnosis, you’ll still be doing something good for yourself.

How did this happen? Did I give myself ADHD? What did I do to deserve ADHD?

ADHD is a neurodevelopmental difference: It is a specific type of way the brain forms in utero that is different from the way most brains form. Your brain was structured for ADHD before you were even born.

ADHD doesn’t happen “to” people, any more than having blue eyes or particularly small hands happens “to” people. You can’t give yourself (or your baby) ADHD, nor can you “catch” ADHD from some outside source.

There’s a lot we don’t know about how or why, exactly, ADHD forms. There does appear to be a genetic component – namely, if you have one or more relatives with the same symptoms you have (whether or not they were ever diagnosed), there’s a higher chance that you’ll have ADHD too. But some cases of ADHD appear even when there’s no obvious genetic link.

What we do know is that ADHD is not a punishment. You didn’t do anything to “deserve” it, and you can’t do anything to “deserve” not having it. ADHD is not a statement on your worth or value as a human being.

Does this mean I have a mental illness?

No. ADHD is not a mental illness.

As mentioned above, ADHD is a neurodevelopmental difference. It is a difference in the structure and function of your brain as compared to most other brains. It’s a very specific difference, once we can study and measure and identify pretty clearly through various tests. Most importantly, ADHD’s status as a neurodevelopmental difference doesn’t change based on how you feel about having it.

Why do your feelings matter? Because mental illnesses are typically defined as conditions that cause “clinically significant distress” to the person who has them.

In fact, this is how psychiatrists and psychologists draw the line between a “personal quirk” and a “mental illness.” If the person isn’t distressed by the symptom, they aren’t likely to be diagnosed with a mental illness. The “illness” part happens when the symptom or quirk starts to interfere with your daily life, even when you don’t want it to.

ADHD can certainly feel like a mental illness, especially if it’s not treated. After all, if you could sit still or concentrate on demand, you probably wouldn’t be looking for answers about why you can’t do that. But even when your distress is managed – usually by managing symptoms – your brain structure will still be different in ADHD’s unique ways. You will still have ADHD; you’ll just have managed ADHD.

Untreated ADHD can also cause or contribute to a number of other mental and emotional conditions, like depression and anxiety. Some of the symptoms of ADHD, like the inability to concentrate or to get started on a task even when you want to do it, also appear in conditions like PTSD for some people. Some people find that they can’t get a reliable ADHD diagnosis until they deal with other conditions first.

What if the doctors want to put me on medication? Aren’t ADHD meds basically meth?

First: Whether or not you try medication for ADHD, and which medications you try, is between you and your doctor. Your doctor will not follow you around and shove pills down your throat.

That said, ADHD meds come in two basic forms: stimulant and non-stimulant. Stimulant medications for ADHD are generally Schedule II controlled substances, which means they’re subject to a lot of rules and restrictions in the United States. (Medications on Schedule II are understood to be addictive, but also to have useful medical properties, so they’re not banned for all uses like those on Schedule I.)

ADHD meds and methampetamine are both potentially addictive stimulants, but the similarity ends there. Meth is a Schedule I substance with no recognized medical value. It is also notorious for doing significant damage to the human body and brain.

In addition, the risks of addiction to stimulant medications appear to be somewhat lower for ADHDers than for people without ADHD. They’re not zero, but if you have ADHD, your chances of being able to use a stimulant medication without developing an addiction are higher.

Stimulant medications treat ADHD, generally speaking, by increasing the amount of dopamine circulating in key areas of the brain, like the anterior cingulate cortex – the part responsible for impulse control, focus, planning, and response to reward and punishment. (Sound familiar?) By increasing dopamine circulation, the meds help ensure that these parts of the brain have the dopamine they need to function – but not more.

Extra dopamine, beyond what your brain needs to function, is what causes the feeling of a drug “high.” It also leads to greater tolerance and dependence over time, as your brain adjusts to the extra dopamine.

But since ADHDers don’t get extra dopamine from stimulant meds, their brains never make the adjustments that result in tolerance and dependence. Their brains just work like they’re supposed to, because they finally have the right amount of fuel.

Non-stimulant meds for ADHD are generally not controlled substances, but they also tend to be less effective for many people. The only way to know if any ADHD medication will work for you is to try it yourself under your doctor’s supervision.

Am I stupid? Am I retarded? Am I a freak? Does this mean my life is over?

No, no, no (or maybe but in the good way), and only if you let it.

Sadly, these are the questions about new ADHD diagnoses that I field the most. As the choice of derogatory language indicates, they’re very often asked by people who still have a very particular idea of what is “good” or “bad” in the human brain – and they fear ending up on the “bad” side of that fence.

However, ADHD doesn’t mean you are an [insert slur here], because no insult or slur can capture who any person really is. That’s where their power to hurt comes from – the fact that they reduce a glorious complex living human to a single point of derision or hate.

ADHD means nothing about who you are as a person. It means that you think differently and respond to some stimuli differently from most people. It means that ways to accommodate your style of thinking and approach to the world probably weren’t ever taught to you by your parents or in school.

But, if you’ve gone undiagnosed for many years or decades, you’ve probably heard a lot of messages that feed the idea that there’s something irredeemably “wrong” with you. A lot of people with ADHD – even those who were diagnosed and treated as kids – grew up hearing things like “You just need to focus more,” “I can’t believe you’re so lazy,” and “If you’re so smart, how are you so dumb?”

When you first get an official diagnosis and start treatment, you may also benefit from talking to a therapist about your childhood and life pre-diagnosis. An ADHD diagnosis, especially for older teens and adults, tends to stir up a lot of painful memories of being punished or harassed for things that you didn’t know were ADHD symptoms at the time. It’s important to be kind to yourself and to take those stirred-up pains, if any, seriously.

Finally: ADHD doesn’t mean you’re doomed to a life of failure. In fact, getting ADHD properly diagnosed and treated can help you unlock levels of success you always wanted to reach but never could figure out how. Many highly successful people have ADHD; some even use their ADHD to their advantage.

If an Internet quiz told you you have ADHD, you might have ADHD – or you might not. It’s up to you to decide what to do next. ADHD or no ADHD, you remain in charge of your own life.


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How I Wrote a Novel in 10 Months With Untreated ADHD, Part 3: The Notebook

Part 1, I talked about how I organize my schedule, or when I write. In Part 2, I talked about my workspace, or where I write.

Now let’s talk about how.

ADHD III

Part 3 is the story of the heart of this entire operation: The Notebook.

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“The Notebook” makes it sound portentous, like I spend hours searching for just the perfect vessel to hold my Great American Novel(TM) and I might die without it.

Not going to lie: I went through that phase, in my late teens. I still have the two Moleskines I filled back then. But it was only about eight months before I realized that putting The Notebook on that kind of shrine was actually making it harder for me to write.

These days, I use single-subject college-ruled notebooks I pick up during the back-to-school sale at my local big-box store for about $0.25 apiece. I buy at least a dozen every year, and I keep the unused ones within easy reach:

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Back in the days before I published the vast majority of my work on the Internets, I filled a notebook a month. These days, it takes 1-3 months for the same amount of handwriting.

The used ones occupy several different shelves. This photo is the central repository but by no means the only one:

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Once, in 2009, I went through all the notebooks I’d filled since 1998 and broke them down, discarded everything I thought wasn’t “useful,” and put the rest in a giant three-ring binder. I have regretted it ever since, which is why I will not be repeating the process anytime soon.

It took me quite a while to make the notebook work for me. I loved it from the start as a writing tool, but like a lot of folks with ADHD, I really didn’t grasp how to make it work as a planner and an extension of my memory. For years, I juggled The Notebook, notebooks for work, notebooks for school, a day planner, a to-do list, you name it.

I tried a Franklin planner. I tried OneNote. I tried bullet journaling. And it all made me even more confused.

Then, while browsing the Intertubes one day late in 2015, I stumbled across a system that was far simpler than keeping a bullet journal. The blogger I read this from claims to have learned it from a Japanese businessman he was sitting beside on a flight once.

I just know it works for me. Here’s how:

The very first thing I do with any new notebook is flip to the back side of the final page.

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Here, I write the major categories of stuff in the notebook, and make a little “tab” by blacking in the edge. I like to space my categories widely because it makes the tabs easier for me to find.

Often, I’ll start with the first thing going in that particular notebook. This one, for instance, has outlines for Nahara and The Ambassador on the first few pages, so the top tab is “novel.” The first not-novel page I used had a to-do list on it, so that went under “personal and journal.”

You can tab as many things as you like, or as many as you have lines for. In theory, you could also flip to the second to last page and tab again in different colors, too. I rarely have more than five tabs in any notebook, and these four are always on the list.

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Each page then gets a corresponding tab. Here are the first three pages in this notebook, all of which are outlines.

(I am sorry to report that the rumors are true: Nahara does not feature fully automated luxury gay space communism.)

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Every time I start a new page, it gets a new tab. This is the page I started for the outline for this blog post series.

I love this system for two ADHD-y reasons:

  1. It cut me down to one notebook. Much harder to lose, especially since it lives with my wallet and keys on my desk. (Not impossible to lose, though, which is why my name and email address are always on the inside of the front cover.)
  2. I don’t have to care what order the pages are in anymore. I used to juggle two notebooks because I cared about page order. A lot. I hated having a to-do list pop up halfway through a chapter I was drafting, for instance. I found it super distracting.

Now I don’t have to care, because every page has its tab:

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I also appreciate how the tabs help me see where my time went over the past month or two. This notebook, for instance, makes it obvious that I spent a huge chunk of time on marketing and “outside” writing smack in the middle of it, taking a pretty obvious hiatus from the novel to do so.

Those chunks, btw, include both the pieces I submitted to Spoon Knife 3: Incursions, which you’ll all get to see in a few months.

Here are two pages from the draft of Nantais:

 

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When I sit down to write, I date the margin, just because I like to see my own progress. I tab each page as I start it. Notes about things I need to go back and fix, scenes that are relevant to this scene, or character background I don’t want to dig into here but that I’ll need for consistency later on all goes in the margin as well.

My goal, in my nightly two hour writing slot, is 350 words. That’s it.

They don’t even have to be story. If I’m particularly stuck on the story, I’ll spend time sketching what could happen next, or working out character motivation, or detailing someone’s history or mythology. As long as it’s related to the novel and written with the intent of helping me get unstuck, it counts.

After the Notebook But Before Editing: The Typing Stage

Approximately every ten pages, every chapter, or just when I’m starting to get a little lost as to what the heck happened to get me to this point, I’ll take the handwritten draft and type it up. But the first draft of all my fiction is always written longhand.

 

The reasons are a mix of practical points and straight-up “I like doing it this way so there”:

  • I find the Intertubes distracting as heck. “I went to look up one thing and eight hours later I realized I had 422 Wikipedia tabs open and also it was Tuesday” isn’t a meme; it’s literally my life. If I drafted on the screen, nothing would ever get done.
  • I revise as I type. The first typed draft is always my second draft. Rewriting the entire draft this way allows me to address a lot of mistakes and clunky text. It also lets me do things like write “[nearby star with habitable zone]” in the draft, then Google that when I get to the typing phase, saving me from the Wikipedia hole.
  • I feel free to screw up. Since I know no one will ever see the handwritten draft, I can cross things out, rewrite entire sentences mid-draft, draw giant arrows to move pieces from one place to another, and write things like “FIGHT PIRATES, DO A SCIENCE” or “THIS BOOK DOESN’T EXIST WTF IS HE READING” in the margins (two comments that actually exist in the margins of the handwritten draft of Nantais).

…And, perhaps most selfishly but also most importantly, I just like the way it feels. I like the feel of writing and the look of my own handwriting covering pages and pages of notebooks.

Writing longhand greatly increases my joy in the process. It feels like making something. And that’s really the only reason I need to do it – and the reason I never insist other people do it the way I do.

The whole point of the entire system is to move the crap out of the way in order to find the joy in the work.

Ironic twist: While starting Ritalin has changed my life with regards to my work, my relationships, my ability to eat and sleep, and the general orderliness of my house, it has actually made fiction writing harder. I don’t write on Ritalin. I wait till it wears off first.

Why? I’m still trying to pinpoint the reasons, but the biggest one appears to be that having everything on the whiteboard of my brain at once, while a major challenge in ordinary life, is actually exactly what I need in order to keep track of all the moving parts of a story as it unfolds.

I wrote Nantais before I ever started Ritalin, and now that I have, I only write fiction after it wears off. Go brain!

Part 2: The Workspace
Part 1: The System


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How I Wrote a Novel in 10 Months With Untreated ADHD, Part 2: The Workspace

In Part 1, I talked about how I organized my time to ensure I had both the gap in my schedule and the mental wherewithal to write every day.

Here in Part 2, I’ll talk about how I organized my writing space.

ADHD II

This is where I write:

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I got lucky in our current house: this desk fits perfectly into this alcove in our spare bedroom. On the walls of the alcove are Chalkboard Left and Chalkboard Right, which I mentioned in Part 1.

You can see some of the paperwork hanging off the bottom of Chalkboard Left in this photo, next to the lamp.

Chalkboard Left contains my weekly schedule; Chalkboard Right contains the basics of whichever novel I’m working on at the moment. Right now, that’s Nahara, the sequel to the novel I just released.

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On the left is the outline for the novel in progress. On the right are some notes I need nearly every time I write, and above those are the list of works I want to write or that come after the novel in progress. (The list on the top right is a recent addition; I got tired of keeping that list in my head.)

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I use Blake Shelton’s “beats” system to outline each novel. It was designed for outlining screenplays, but since I tend to write off the movie screen in my head, the beats system was remarkably easy to adapt.

The outline helps me remember the central theme or idea of whatever point I’m at in the story, as well as how I got that far and what needs to be set up in order to move to the next scene or chapter.

In addition to this outline, I typically write an outline or synopsis of each chapter as I’m working on them. Since I only need those for as long as I’m working on that part of the draft, they live in my notebook (which I’ll cover in Part 3).

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These are photocopies out of my notebook, which I pinned to the board after I got frustrated flipping back and forth between pages and (later) with remembering where I had put this particular notebook. The top one is a bit of core mythology; the bottom is a general outline of all three novels in the trilogy. Behind it are a few more pages I refer to frequently, like main character bios/histories and a timeline.

The list above is works in progress. On the left are short story ideas; on the right, book-length ideas.

Because the desk sits so closely between these two walls, my peripheral vision is pretty well filled up by the chalkboards. But then there’s the view. Take another look at my desk:

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That view is many writers’ dream, but for me, it’s distracting as heck.

One of the main reasons I write from 9 to 11 p.m., aside from the fact that I can focus then, is because it’s dark out. About the only thing I can see is the neighbor’s yard light, which doesn’t light up much – and the neighbor is usually in bed well before dark anyway.

I keep a few fidget toys in the mug along with my pens. The Pygmy Puff to the left of the mug is also a cozy fidget, and the disapproving stare of Mr. McShade on the right keeps me motivated.

Apart from the writing space and the lamp, the desk is allowed to hold only certain items:

  • My wallet and keys. If they’re not here, I don’t know where they are.
  • Things that urgently need my attention. When I took this photo, those included returning a purchase (the small box), sorting out my business receipts (the paper pile), and giving my cat her nightly meds (the pill bottles and the other box).

Other stuff does end up on my desk from time to time, usually on its way to the trash, my backpack, or one of the drawers. The drawers are the nightmare clutter hiding beneath my otherwise sorted desktop.

I do nearly all my novel drafting here and 100% of my novel revision here. I also work from home as a freelance writer, but I do that writing downstairs, in our office/library. Other essential desk stuff, like my noise-canceling headphones, live in my backpack, since I need those out in public more often than I need them at home.

Part 1: The System
Part 3: The Notebook


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