At age 12, I—the perpetual space cadet who constantly loses my jacket and backpack—am told I have Attention Deficit Disorder, ADD. I'm sitting with my mother and sister, lounging on pillows, and my mother pulls out a book that has an unofficial diagnostic checklist. She's a psychologist, so it's not totally out of the ordinary. Do I go off on tangents easily? Am I more prone than the average kid to make careless mistakes? There is something pleasurable in the yesses. I'm winning at this game, and the questionnaire seems to know me so well. But then my mother tells me there are enough answers to diagnose me with ADD, and my stomach tightens. The stakes, all of a sudden, seem high, although I don't understand them.
I've recently started at a new school, one that doesn't let me wander around during class if I need a break, one in which the teachers don't always let me doodle because it helps me listen. The classes are bigger. There's more homework. Although teachers say I am one of the brightest in my classes, I have trouble keeping up.
A behavioral pediatrician diagnoses me officially, and prescribes me medication. It's 1994, and the prevalence of ADD diagnoses are about to increase in kids my age, reaching 15 percent in boys and 7 percent in girls by 2013. In New Jersey, where I am, about a third of those will be medicated.
Each of my Dexadrine pills is a capsule containing tiny peach and orange balls. I take one every morning. I wear a locket to school that I got to pick out, with paisley swirls in its metal, that holds my afternoon dose. Each day I swallow the second pill at the water fountain. My teachers fill out forms that rate my attention and focus. ADD, the adults tell me, is just like an illness; you have to take medicine to make yourself better.
The medicine helps me focus in class, on homework, on chores. It is easier to get through my homework and pay attention in class. As I continue taking it, through middle school and then junior high, a question bubbles in the back of my mind: Where does the pill end and I begin? If my achievements are enabled by medication, are they truly mine?
I continue taking the pills through high school, though I switch to small round white Ritalin, then blue oblong Adderall. I study psychology and sociology at a good college. I learn that mental "disorders" are socially constructed and historically specific. What is "crazy" in one culture or time may be normal or preferred in another. Diagnoses often include nebulous criterion like "clinically significant impairment," subject to interpretation.
I have long known that ADD people don't suffer from a lack of attention; when they're interested in something, they can hyperfocus, focusing for longer periods and more intensely than other people. Medication for ADD begins to seem more like a quick fix that avoids the main problem: School is often rote and only works well for linear learners. It's more complicated and expensive to create compelling curriculum, or dispense with classroom learning completely, than to feed kids pills. The prevalence of diagnosed adults is 4.4 percent, which suggests that people age out of the disorder. It could also reflect that many adults learn how to structure their lives around their tendencies better and don't seek out treatment. I start to understand ADD as a personality type, not a disorder.
I start writing fiction. I take creative writing workshops and become devoted, obsessed. While churning out short stories, I notice that Adderall doesn't help me write, but interferes. I start skipping my medication when I'm writing.
In the fall of my final year of college, I do a research project on medication for ADD/ADHD. There are myriad studies about the positive effects of medication—at least partially a consequence of the extensive research funded by pharmaceutical companies—but I seek out the negative effects. Some research suggests that better behavior, as reported by parents and teachers, is associated with higher anxiety. Other research suggests that for non-creative people, stimulant medication can enhance creative thinking, but for creative people, it can impair it.
A larger understanding begins to click into place: Medication interferes with both my creativity and the identification of my true interests. It has allowed me to focus on anything, inherently reducing the pull of those topics I find truly compelling—like fiction writing, like art, the things on which I hyperfocus.
During my research project, I stop taking the medication, to the chagrin of my parents. The next couple of years are rough. Without using medication as a crutch, I must repair broken skills: how to have a conversation with someone without interrupting him or her, how to sit still and focus on my work, how to remember my appointments and organize my things.
Like many other ADD people, I learn by trying things out. Over the next decade, I try on careers: teacher, organic farmer, sustainability consultant, landscape architect, graphic designer, salmon fisher. None stick, but at least I am eliminating possibilities.
My story, and my decision to stop medication, is shaped by privilege. If I don't make rent, I can stay with friends and family. I don't have dependents. I've graduated from college. I'm smart and have connections. My friends are all weirdos and accepting of my quirks. If any of these things weren't true, life without medication might feel like too much of a risk.
Being ADD and unmedicated carries tangible perils. People with ADD are more likely to struggle with addiction, drop out of school, have few friends, and become pregnant as teenagers. If I had not been medicated for the first ten years of my life, would I have suffered these fates? What choices remain for those stuck in a broken educational system, in a culture that favors linear thinking over creative?
I fall into journalism accidentally, starting a project with a friend, interviewing female street artists. It grows into a book. Focus on the project comes easily, because I'm obsessed with the task. I dedicate my life to nonfiction writing, and doors open around me. I wonder how many people have been medicated out of this journey, have popped a pill that allowed them to clock in at an unsatisfying office job to pay the bills. I have never met a dull person with ADD, one without passion. If they cannot focus on their work, I believe either they haven't found their calling, or it's difficult or impossible to center their life around it. I do not believe that ADD is an illness or disorder, but that its "symptoms" are the real drawbacks of having one type of unconventional mind.
I'm a freelance writer and editor now, with odd jobs thrown in to pay the bills. I don't have trouble focusing on writing, though I still lose track of my notebooks and drift during conversations with others. I lose water bottles at a rapid clip and have trouble sitting through an entire movie. Though I try to adapt to the world, these traits and tendencies are a fundamental part of me, not something I'd like to erase anymore than I would the freckles on my shoulders or my angular nose. None of this adds up to a normal job or life, and I'm not sure I'll ever have one. And in a few years, I may decide to change my focus. But now the pieces of me that sometimes seem like liabilities—hyperfocusing on what I find interesting, my intense curiosity and obsessiveness, my stubbornness—have become assets. I may struggle to structure my life, but I have complete clarity about what I want to do with it.
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