Thoughts on ADHD, half a year in

2009-01-05 11:32

A little bit over half a year ago, I started treatment for ADHD. Medication is amazing, but it doesn’t fix everything (and no one, I think, really expects that it does). So a bit of an update may be in order.

Medicated or not, I’m still pretty forgetful. Unmedicated, my forgetfulness achieves epic levels. You know that thing where sometimes you’ll start to do something, but by the time you get there, you’ve forgotten what it was? Most people have this experience sometimes. For me, it’s practically the normal state of affairs. Being medicated changes that noticably.

I am apparently one of the folks who acclimates to methylphenidate. Nearly everyone does some; dosage is normally gradually adjusted to some stable level. In my case, there is no stable level; if I take 36mg/day, after a while it stops working. Increasing dosage makes it work again… for a while. Solution? Go off it for a while. I spent a month off my meds, most of which I spent on vacation. Now I’m trying to make a point of skipping the ADHD meds at least two days a week, which seems to help, although I will probably eventually need a slightly higher dosage anyway.

What fascinates me most, still, is the number of things changed by this that I don’t think of as ADHD symptoms. For instance, when medicated I have depth perception. I have always been able to tell how far away things were, but it was cognitive metadata about them; suddenly, on meds, things sort of “pop out” and look closer or further, instead of just being a knowable distance away. Very odd. Changes in how I hear things, and see things, are fascinating to me. My normal unmedicated perception seems to be time-slices; I don’t see movement, I just infer movement from the fact that things have come to be in new places. I always described this as seeing motion, but now I’ve had the very different experience of seeing things moving. I don’t know how to describe this difference.

Language is poor at communicating perception. My friend Dave is red/green colorblind, but didn’t know this until he was in his 20s. He can tell red and green apart most of the time by staring at them. It’s harder for smaller objects, and some red/green pairs are harder to separate. He can tell often enough to have passed tests and so on. And yet… He can’t easily pick out a hot pink frisbee on spring grass. So clearly, his vision is wildly different from mine, and yet, most of the time we can use words to distinguish things and they work.

(Interestingly, both his wife and I can generally tell, looking at two things, whether he’ll be able to tell them apart or not, but people who don’t know him can’t.)

Peter Seebach

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