Why I Take Drugs to Answer Emails: My Journey with ADHD
by cicely belle blain
A light skinned Black woman sitting on a bed looking sad.
CW: medication, healthcare, weight loss, systemic oppression
I recognize the irony of posting a 4,000-word blog post for a community of folks who, if they are anything like me, have trouble making it through a 30-second TikTok. I wrote this in a hyperfocus frenzy and could do nothing else until it was complete, despite having no blueprint for what “complete” meant.
TLDR: You are not alone, adult ADHD sucks, and capitalism makes it worse.
Feel free to jump ahead to:
ADHD over the years
How I got diagnosed
Survival Mechanisms/Life Hacks
Things I’m letting go of
ADHD content creators I love
Definitions
I was recently prescribed Vyvanse for my Attention Deficit Hyperactivity Disorder (ADHD), and it changed my life.
The most remarkable transformation was the stillness. My head-- which usually feels like it's filled with five stereos blasting a combination of self-doubt mantras, climate anxiety, internalized oppression and a couple of commercial jingles-- was suddenly so quiet.
This opened up a world of possibilities for me. Tasks that I had procrastinated for months got done in a matter of hours -- and I realized they were not even that hard anyway. I opened piles of mail that had sat on my desk; I reached out to friends I was convinced hated me, I got my inbox down to zero. I started and finished a project. I started a new hobby and have actually kept it up for several weeks. I bought a box of salad and ate it before it went bad. I am less anxious, more focused and happier.
Yet, I am unsatisfied.
While this experience has been transformative, I can’t help thinking about how ridiculous it is that I take drugs to answer emails. Whenever I feel useless, incompetent or lazy, it is because I am comparing myself to neurotypical people whose brains are centred in a capitalist and white supremacist world. Systems of oppression will always centre those whose identities match the original designers -- white, cis, straight, non-disabled, neurotypical men. For neurodivergent folks like myself, especially those facing additional intersections of oppression like racism, fatphobia and misogyny, the marginalization of our experiences results in feelings of shame, isolation and self-hatred. When we live under capitalism, our productivity defines our worth. And when we are unable to “produce” like other people, we face systemic barriers in accessing education, healthcare and employment.
We can pretend there is no such thing as “normal” - that we live in a society that values diversity - but ultimately, neurodivergent folks are cast out, shamed and punished for what is perceived as their inability to function in professional, educational and social settings.
I feel ashamed and can spiral into depression when a client follows up on an email I haven’t answered or a deadline I’ve missed. What a lot of people don’t understand about executive dysfunction is that my enthusiasm and desire to do a task is not necessarily lacking; I am just physically unable to do it. As ADDitude magazine explains, executive dysfunction can look like:
time blindness, or an inability to plan for and keep in mind future events
difficulty stringing together actions to meet long-term goals
trouble organizing materials and setting schedules
trouble controlling emotions or impulses
difficulty analyzing or processing information
Answering an email is never just answering an email.
As many people with invisible disabilities will attest, the labour of explaining what’s happening on an internal level is just as exhausting as the experience itself. Neurotypical peoples’ unconscious biases, growing up in a world that caters to their way of functioning, cause them to assume that everyone can do things the way they can. And when those people are the ones with the most power, they define the social and professional norms.
This can look like:
Despite the positive experience I have had over the past weeks due to the medication, I hate that I have to take it. I hate that I spend hours on “life hacks” and hundreds of dollars on tools, apps and devices to manage my ADHD - and don’t even get me started on the price of Vyvanse. Why must I change for the system and not the other way around?
It’s the same kind of individualism and victim-blaming that places the onus onto marginalized people to pull up their bootstraps and overcome their circumstances without acknowledging the rigged systems and the complicity of those with more privilege.
ADHD over the years
With all that being said (well, ranted), I do have to answer emails (and other much more complex tasks) to pay for rent and food and other things that should be free until I’m spiritually booted off this spinning rock. And I know this is the case for many others too.
When I posted on Instagram about my experience with ADHD, it felt ten times more nerve-wracking than coming out as queer. Years ago, when I called my mum told to tell her I was queer, my dad shouted “I f*cking knew it” somewhere in the background. When I told them I was diagnosed with ADHD, they asked, “are you sure?” and “but you’ve done so well!” and proceeded to prescribe multivitamins.
Even when I started to speak to my doctor about the symptoms I was experiencing, she said, “adult ADHD is extremely rare.” We have all been conditioned to unquestioningly accept the knowledge of people with titles and white coats and letters after their names, but I could not believe this statement to be true. I know social media is an echo chamber of confirmation and affinity bias. Still, I refuse to believe that something “extremely rare” would have 1.9 million tags on Instagram (as one example). The internet has long been a place for outcasts and unsupported people to find answers and affirmations.
Is it extremely rare, or is it underdiagnosed?
I am no medical professional, but my personal experience affirms the latter. When I look back at my childhood and especially my adolescence, I see ways that I was struggling, but as someone raised as a girl, attending a competitive academic school and placed in gifted-and-talented streams, my symptoms were overlooked. The stereotype of someone with ADHD is a young, white, boisterous boy with lots of energy who can’t sit still. If parents, teachers and doctors alike have this image in mind, it is no wonder that people with ADHD who are girls, non-binary, racialized, quiet, shy, “hard-working,” and/or grown-up are excluded from the narrative.
With no language or resources to describe my experience, I lived with the shame of feeling broken and useless. I compared myself to people who succeeded at a system that was biased in their favour, unaware my brain was operating in a totally different way. Thankfully, my parents have always encouraged me to strive to be happy above all else, which helped remove some of the pressure.
However, when I got to university, the elitist and competitive environment became overwhelming. I was alone, and the stakes were much higher. The university had gambled a full scholarship on me, and I had to deliver. I tried incorporating study hacks and worked with peer mentors to plan out essays -- feeling totally crushed when those things did nothing for me. Remember those study hacks like “place gummy bears at the end of the paragraph, and the reward will motivate you to read the whole page.” Yeah, that doesn’t work for me.
“Key aspects of the reward system are underactive in ADHD brains, making it difficult to derive reward from ordinary activities. These dopamine-deficient brains experience a surge of motivation after a high-stimulation behaviour triggers a release of dopamine. But in the aftermath of that surge and reward, they return to baseline levels with an immediate drop in motivation,” says ADDitude Magazine.
University was challenging because of the content of the work, the scholarship pressure and the microaggressions on campus, and because so much of my identity in elementary and high school was centred around being smart* and suddenly I felt stupid. I remember my grandma would always ask me how school was, and I would proudly say, “boring and easy!” School allowed me to be creative and expressive, hyperfocus on special interests and face fewer consequences for being distracted in a way that university did not.
*The whole concept of “intelligence” is riddled with ableist undertones, and that’s before you even add on the layers of being described as “articulate,” “well-spoken,” and “highly educated.”
In my second year, I was diagnosed with anxiety and depression and began taking Escitalopram. I have always felt it helps somewhat but wondered why I still felt like I was treading water, my head just above the surface. As I look back, things I thought were likely depression and anxiety (although I still think I have those) were actually ADHD. Mood variance, substance use, self-loathing, intense sensitivity to rejection, hypersensitivity to certain noises and crowds -- smells like ADHD!
As an adult, I am extremely lucky to have a job with creative freedom, a flexible schedule and a four-day workweek (let’s be honest though, hyperfocus doesn’t actually allow this). At Bakau, a few of my team members also experience ADHD, and we’ve found comfort in sharing our experiences. Like with any other kind of diversity, neurodiversity is an asset -- our similar and different experiences improve our shared empathy for each other and the people around us. (Research suggests that people with ADHD are more sensitive to and therefore more passionate about justice, which may explain our higher-than-average ADHD population.)
When I started working on a project with another team, most of whom are neurotypical, the contrast became really clear. They wanted to do really weird things like plan a project from start to finish, write a first and second draft, talk on the phone, meet up for drinks and weigh up all the options before making a final decision.
How I got my diagnosis
I want to share my diagnosis experience and the route to medication because many people have asked me. I got to this point due to people courageously sharing their experiences on the internet, so it’s only fair I do the same. I recognize that many of the things I will explain are not available to many people, and reaching this point has resulted from many intersections of privilege.
I self-diagnosed in 2019. This alone was transformative. It gave me the power of language -- being able to Google “ADHD symptoms” instead of “what the f*ck is wrong with me?” mattered.
And for many folks, this is the only option. Systemic barriers prevent many marginalized people from getting the healthcare they need. There is a lot of shame and imposter syndrome surrounding self-diagnosis, but for me, this step was crucial in the ensuing parts of the process.
While I know that medication is not for everyone and doesn’t solve all the problems/address all the symptoms, I grew frustrated with trying to “life hack” my way to survival. As a leader, the sustainability of my business and, therefore, my ability to continue employing my incredible team relies on me showing up and pulling through.
A few months into the pandemic, I felt my symptoms becoming heightened. Again, despite what it felt like, I was not alone in this. People with ADHD are often motivated by the stress or intense emotion of something last minute or spontaneous (hence why the gummy bear trick doesn’t work). But suddenly, there was a constant underlying sense of stress -- and the motivation never came. I noticed myself missing deadlines, letting people down and losing touch with friends. As winter came, pandemic depression met seasonal depression met ADHD depression.
In the Spring of 2021, I pushed myself to take the next step in a formal diagnosis, encouraged by friends and strangers alike speaking up about their experiences and the benefits of medication. I reached out to a few local ADHD clinics who came back with four-figure price tags for an assessment. When hit by roadblocks like this, I tend to feel instantly demoralized and triggered from a lack of mental health support in my university days.
Eventually, I brought it up with my GP. Even though I’m 27, going to the doctor without my mum is still terrifying, especially as a non-Canadian. I’ve found the healthcare system confusing enough, so I know it is exponentially more challenging for immigrants from non-Western countries who don't speak English as a first language. I spent years doctor-hopping, attending youth clinic drop-ins before eventually finding a family doctor who was taking new patients and was LGBTQ2S+-inclusive.
My doctor is kind and very thorough, but it was hard for me to dismiss previous healthcare experiences and the experiences of other Black femmes from my mind. In our first conversation, she suggested vitamin D and iron supplements. She said if I take them daily, I should see signs of improvement in my focus… in a year.
I realized I needed a different approach. I came to my next appointment with a long list of ADHD symptoms from WebMD -- every RealMD’s nightmare. I felt ashamed in doing this because we have been conditioned to not question experts but have they ever been taught to question their biases or the institutions that educated them? This worked, and she sent me away with two assessments to fill in -- the Weiss Functional Impairment Rating Scale (WFIRS-S) and the Wender Utah Rating Scale (WURS). Now, I am not suggesting one should research how to “pass” these tests (because they are filled with red herring symptoms that can either misdiagnose or dismiss you) but if you happen to find the answers online and allow them to guide you through the assessment…
I was then sent for blood tests, urine tests and an echocardiogram, which felt excessive, mainly because a few friends (notably white and cis) were able to complete the process in one appointment, but I do appreciate my doctor’s thoroughness.
Prescription in hand, I braved the outside and headed to Shoppers for my prescription… to discover 3-months’ worth of medication would cost me $481. Furthermore, this type of drug could not be covered by my health insurance. Another roadblock. Back to Google.
My doctor prescribed me this specific medicine because many of the other ADHD medications interact with my anti-depressants. I discovered this the hard way when, in 2017, I took one of my brother’s ADHD pills (unsurprisingly, he was diagnosed as a child without too much hassle) out of frustration at my own lack of motivation. I vomited and passed out.
Anyway, the next step is to advocate for an exemption from these steep prices; with some bureaucratic haggling, it is possible to convince PharmaCare BC to cover Vyvanse if other prescription drugs are not available for the patient.
Ultimately, this has been the right choice for me at the moment. I feel so much more in control of my life, but in that, I have had to accept the fact that I take these drugs to conform to a system on the days when I don’t have the energy to tear it down. I must remind myself of Audre Lorde’s words: “Caring for myself is not self-indulgence. It is self-preservation, and that is an act of political warfare.”
I don’t claim to have a fix for the systemic oppression embedded in our healthcare systems, however, watching celebrities like Serena Williams, Meghan Markle and Naomi Osaka advocate for their own health, I realized that some of my barriers were internalized (although still equally as real). To put it simply, we were taught to see ourselves as worthless, so why would we advocate to keep ourselves alive?
The medication I take does have some side effects. There is still a slight interaction with my Cipralex which means my heart rate sometimes elevates randomly. It also causes dry mouth and weight loss (yes, my internalized fatphobia did a momentary happy dance). While the medication can cause calorie burn, the weight loss is mainly because I literally would not remember to eat if my partner did not place food in front of me. (I have written almost all of this 4,000+ word article in one day; it’s 10 pm, and I only just realized I need sustenance).
Survival Mechanisms
While the medication has been really helpful, it only goes so far. There are still ADHD symptoms that it does not address, like rejection sensitivity dysphoria, sensory overload, time blindness and lacking object constancy (definitions for these are at the bottom of this post). For these, I turn to survival mechanisms that I have learned or developed over the years.
I prefer the term survival mechanisms to life hacks. Life hacks are nifty tricks like folding your tortilla in a way that doesn’t let the cheese escape or stuffing socks inside one another, so they don’t get lost in the washing machine.
Learning to manage something like ADHD requires survival mechanisms, many of which are uncomfortable, painful or nonconsensual. “Masking” is one of these. Masking is like a form of code-switching -- an ability people develop to present themselves in a way that is acceptable and palatable to the dominant group. Ultimately, it centres the dominant group’s feelings of comfort by avoiding things they may perceive as socially awkward or uncomfortable.
People who are assigned female at birth (AFAB) and socialized as girls in their younger years often mask more and, likely as a result, are underdiagnosed. The nurturing, caring, supporting, vulnerable characteristics ascribed to femininity mean a systemic expectation to cater and even submit to the comfort and will of cis men.
“Neurodivergent women often slip through the cracks of diagnosis because they can appear smart or gifted. This is because we’re more likely to be perfectionists or suffer from low self-esteem, so we work extra hard to prove ourselves,” says Noelle Faulkner.
[The 12-hour Vyvanse high wore off at this point. I shall resume this stream of consciousness tomorrow.]
Anyway, as frustrating as it is that society necessitates these survival mechanisms, they are helpful band-aid solutions (while we work on overthrowing the ableist system).
Here are some that I have found helpful:
Visualization
People with ADHD are more likely to be visual learners. I realized this a few months ago when I was trying to help my brother understand a concept for his Grade 11 exams. We both instinctively searched for images in Google instead of articles or even videos. I’m sure videos also work for many people, but ever since I scored 3/100 on an auditory comprehension assessment in elementary school, I realized that I can’t listen for shit. Netflix without captions? No, thanks.
Anyway, I have found that visualizing as many things as possible in my personal and professional life has really helped me. If you’ve worked with me, you’ll know I have made a cute Canva diagram for literally everything.
Here are some visualization ideas:
Visible Fridge
The phrase “out of sight, out of mind” really applies to ADHD-ers. Carton of milk obscuring some fresh lettuce? That lettuce will not be seen or thought of again until it has turned to mush.
A visible fridge is a fridge where you can see what’s inside, so you don’t keep buying the same pack of minced meat over and over again or letting your vegetables go bad because you forget they were in there. I am not suggesting you drop $14K on a fancy fridge with a clear door (yes, they really are that price).
You could:
Stick a big whiteboard to the outside of the fridge and freezer, and when you go grocery shopping, update the contents of the refrigerator and when you eat something, wipe it off (this is what I do).
Create a “phone fridge” in your notes app.
This idea can apply to creating inventories more broadly -- write down what’s in your cupboards, wardrobe, toolbox. You only have to do it once-ish. This really helps with object permanence and object constancy.
Visible Time
Adults are “supposed to” have an innate awareness of time passing. Remember when March 2020 felt like it went on forever? That’s how it feels for people with ADHD almost all the time. If I don’t set a timer when cooking, the chances of me burning the food are about 95%. I have no idea how much time has passed. Some describe the ADHD world as “curvilinear” -- present, past and future can easily blur.
You could:
Get a big-ass visual clock like this one.
Set hourly timers to remind you to drink water, get up and stretch or go to the bathroom.
Buy or print out a calendar.
Set double or triple alarms, e.g. 7 am, 7.02 am, and 7.05 am.
Put meal times and other mundane things in your calendar.
Have a mug warmer at your desk so your tea doesn’t get cold when you inevitably forget about it.
Let energy levels guide you.
This may be dependent on your job but there are some ways you complete tasks based on your energy levels.
Sometimes I have a burst of energy in the middle of the night and complete an entire project (like this post) and other times I can get through 2 emails and I'm maxed out for the day.
Nap often, too.
Visible Faces
“Object constancy is a psychodynamic concept, and we could think of it as the emotional equivalent of object permanence. To develop this skill, we mature into the understanding that our caregiver is simultaneously a loving presence and a separate individual who could walk away. Rather than needing to be with them all the time, we have an "internalized image" of our parents’ love and care. So even when they are temporarily out of sight, we still know we are loved and supported,” explains Imi Lo.
ADHD can really impact relationships. When I don’t speak to a friend for a while, I can accidentally forget they exist, which can really fracture relationships. When time blindness is added to this, I don’t realize how much time has passed since I last spoke to someone. At the same time, rejection sensitivity dysphoria means if someone doesn’t get in touch with me, I assume the worst.
NeuroClastic describes this as the “insidious treadmill of RSD” -- we are often simultaneously people-pleasers who have trouble saying “no” but also find it difficult to keep in touch with people and honour commitments.
You could:
Have at least one photo of each friend and family member on your wall.
Pin or bookmark your Whatsapp or Messenger conversation with close friends to your homepage.
Use an app like Shift to view all your social media platforms and work apps in one place.
Add events like birthdays directly from Facebook to Google calendar - you may want to do this manually, though; otherwise, your Grade 9 bully’s birthday might pop up and surprise you.
Be transparent with your friends and family about why you may respond in certain ways; ask them to communicate with you in a way that feels good instead of trying to conform to social norms
Set parameters around socialization so you don’t get overwhelmed - e.g. certain lengths of time, locations or number of people
Letting Go
Ultimately, the hack I’ve found most helpful is just… letting go. I realized that many of the survival mechanisms I was incorporating into my life also conjured up feelings of shame. Is this silly? Does this make me lazy? Will people judge me?
While a shift in mindset doesn’t solve everything, life is easier when you stop fighting unwinnable battles.
I give myself permission to let go of:
Feeling embarrassed at being socially awkward. You are welcome to just not talk to me.
Small talk.
Eating three meals a day or doing anything with any level of structure or consistency.
Having a morning routine.
Worrying about my accent (people often comment that I have lost my British accent, but many neurodivergent people often mimic the accents of people around them to appear more “normal”)
Having a bedtime.
Successfully following recipes.
Organizing inside cupboards. They have doors for a reason.
Ascribing negative connotations to food.
Meditating or being silent for more than five minutes.
Saving money.
Feeling incompetent for using Google maps on every single journey, even if I’ve been there 100 times.
Trying to anticipate my period.
Setting and keeping New Year’s resolutions.
Reading instruction manuals.
Trusting my own self-perception. To others, I am apparently cool and interesting.
Having an aesthetic bedroom. My clothes will be remaining on the floor.
Feeling lazy for ordering food, grocery deliveries or using meal-prep kits.
Feeling like a quitter for going through phases or suddenly switching interests.
Feeling guilty for not finishing a book or jigsaw puzzle.
Feeling ashamed for oversharing, mood swings or talking too much.
Credit to @callmepaulhollywood for her series called “Battles I’ve Decided to Let ADHD Win.”
I hope some of what I have shared today helps you with your ADHD (or helps you support a colleague or loved one with ADHD). I am not a medical professional and this has been my personal experience but I wanted to offer some solutions and ways to reduce the anxiety and pain that comes with neurodivergence. I also wanted to disrupt the stereotypes that surround ADHD, especially for those whose only support system is the internet.
Most importantly, while the “life hacks” can help us get by, it is important to remember that having ADHD does not make you less worthy of a safe and joyful life. We should not have to conform to the system or appease neurotypicals, but I recognize that often we have to, to get and maintain jobs, housing, healthcare and friends. Ultimately, if all you do is get through the day, that’s enough. You are enough.
ADHD Content Creators I Love
TikTok
Definitions
Executive dysfunction
Executive dysfunction is a term used to describe a range of cognitive, behavioural, and emotional difficulties. Individuals with executive dysfunction struggle with planning, problem-solving, organization, and time management. Read more here.
Object constancy
Object constancy is related to the idea of object permanence. Both refer to the stability of an idea held in a person's mind, but object constancy describes our attitudes toward interpersonal relationships, while object permanence refers to our understanding of concrete objects. Read more here.
Rejection sensitivity dysphoria
Rejection sensitive dysphoria (RSD) is extreme emotional sensitivity and pain triggered by the perception that a person has been rejected or criticized by important people in their life. It may also be triggered by a sense of falling short—failing to meet their own high standards or others' expectations. Read more here.
Sensory overload
Sensory overload happens when something overstimulates one or more of the senses. There’s suddenly too much information coming in for the brain to process. Read more here.
Time blindness
Time blindness is a term coined by doctors who treat people with attention deficit hyperactivity disorder. Dr. Ari Tuckman, a Pennsylvania-based psychologist who specializes in ADHD, said adults typically develop an innate awareness of time and an ability to track its passing. Read more here.