I have often fantasised about living in a lighthouse. There is a definite allure with the isolation and solitude it offers. However, I am also drawn to the idea of bearing witness to a battle that is aeons old: the claim for dominance between terra firma, and the sea. One is fixed, rigid, and constant, whilst the other’s capricious nature yields, accommodates, explores, but also holds violent, powerful potential.
I imagine the exhilaration watching from above, furious waves railing against the land’s implacable nature, whilst feeling safe from harm within my own lighthouse of solid, grounded protection.
However, the purpose of a lighthouse is to offer orientation and a point of reference for travellers on turbulent waters. I try and imagine the sense of desperation, confusion and fear for sailors navigating through the night in dark, angry storms. I wonder what it must feel like when, just as all thought of hope is lost, through that stinging rain and roaring storm, you spot a piercing shaft of light. That beacon, that solitary building on a precipice between two worlds offers guidance and hope to all those at risk of drowning.
I wonder about my own inner conflicts, and the battles for dominance. I think of my mindfulness practice like the lighthouse; it offers sanctuary, grounding, and a beacon of hope when I am tossed about like a dandelion seed in the wind.
I hope that may be one day, I will feel the gentle ripples of thoughts and emotions lapping against the shores of my mind, with the occasional storm I can witness inside my lighthouse sanctuary knowing, it too will pass. I hope that may be one day, my lighthouse could also become a beacon for other lost souls, frightened and confused.
Generalisations, this piece is full of them and I can only apologise if I represent your group in a way that excludes you. I have no medical degree and the following can only represent my opinions, for what they are worth.
For all its faults, it is my experience that ADHD is handy in moments of crisis. At such times there is nothing to bear in mind or to forget to remember. There is only the situation right now, and how you respond to it. People with ADHD are great in such scenarios because they are largely incapable of doing anything other than thinking in the moment. Further to this, people with ADHD are very used to crisis. We are all so often late with deadlines, appointments and bills that we carry a sense of urgency with us throughout life, wearing it like a second skin. I have made a conscious effort in recent months to curtail my “battle stations” response to things because it is stressful and alarming for the people around me. I don’t mind intensity in dealing with problems. I’m very used to it, but most problems do not require intensity. They require diligence and hard work.
What I’m trying to say is people with ADHD are good in a tight spot because they are very well practiced at being in a hurry, and living life in the moment.
It seems strange in our culture to regard living in the moment as a problem when so many people long for it. They desire the ability to let their worries and responsibilities go, and to instead focus on being present with every sensation and thought. Really when you look at it like that, we’re blessed aren’t we? This ADHD crowd, with our of-the-moment thinking and our quick-witted emergency responses. Well living in the moment is all well and good, but if you are permanently stuck there you face a different set of problems.
Poor planning is the crux of it. ADHD means I have a poor sense for how long things will take. I don’t write things down because I am not considering the ‘later’ when I’ll need the reminder. And even if I did write it down: when later comes, due to my stimulus-response style thinking, I’ll only think to read my reminder if prompted to. I am no more thinking about the past than the future.
I won’t engage with anything boring because it seems like there is always later. And what could be so valuable later that would be worth the boredom now? When, because I am glued to the present, now is all I am capable of thinking about and a dull task can seem to take an eternity. These are the academic woes of ADHD, we require in-the-moment rewards for long-term hard work. It is difficult to write an essay because it will take hours to complete and no one will grade it for weeks anyway. The consequences are separated from the actual doing by vast oceans of impassable time and because I cannot see what lies ahead, I am incapable of steering towards it. In short, the thought of failing a few weeks from now does not motivate me at all.
Setting up artificial rewards has been one of the more useful tips I have learned for ADHD. There must be something at stake now which you care about in order to function. For example, I need to write an essay, but I want to play Elite Dangerous. Easy! 1 hour of essay writing is worth 1 hour of playing Elite Dangerous as a reward. But no ED until you’ve written for the time. And the alarm clock which chunks this time is god. IT MUST BE OBEYED. Yes, it would be quicker to just write the whole essay without the hour-long breaks, but I am not in the least bit motivated to do that.
This whole issue is why ADHDers will work ineffectually and sloppily right up to the moment the deadline rears its ugly head and only then will they get down to business. Because the thing they care about (the degree, continued employment etc) has finally come into their line of sight. Their short-sighted view of the future hid it from them until now. This is what is meant by time blindness.
There are many ways this myopic relationship with time causes problems. The morning suffers for the evening. The later suffers for the now. And most of all you suffer when you denigrate yourself for missing appointments and deadlines. For not having done what you should and for not being capable of the ordinary level of time management which most people perform relatively effectively.
Time blindness is a very helpful way to view ADHD. It is my go-to, when asked to describe what ADHD actually is. I say I am glued to the moment, responding to stimulus as it appears and dealing with threats as they come, unable to ignore either. I generally don’t get into how this stunts my ability to have long-term goals, or my ability to achieve the things I should. That part doesn’t make great natter at parties. But you know and I know that while living in the moment has its perks, it isn’t all it’s cracked up to be.
I’m starting to ramble now. This is just an interesting angle I wanted to approach our disorder from. I respect that some people with ADHD are better at time management than others. And I realise they probably aren’t all great in a crisis. After all there are different kinds of crises to be involved in. But I think the point stands. ADHD means time blindness, and I hope you appreciate this extra-poetic way to describe yourself.
Family occasions can be an intense time for many people, and particularly challenging for people with ADHD. Why? ADHD often doesn’t provide that valuable space between a trigger and our response. The outcome can be explosions of emotion, or opinions shared without pause to rationally review the material for appropriateness and intended outcome.
Family engagement makes us particularly vulnerable because we meet with childhood history, and potential unresolved issues. Managing conflict is problematic, especially when we are filled with emotions difficult to control.
I was talking to a colleague about the intensity of seasonal celebrations with family, and why they can be so exhausting. I reflected on the effort required to maintain a congenial environment, and the personal guilt and self-recrimination when the façade of equanimity crumbles.
My colleague recounted a period in his life when he lived with relatives in Pakistan. He had no personal space or opportunity for solitude. He was in the company of others from the moment of waking, to falling asleep. I looked at him in bewilderment. “How did you survive?” I asked. He admitted initially it was very challenging, but eventually adjusted and found return to England created its own difficulties. He reflected how time on his own felt uncomfortable for a while, and created a sense of unease.
I thought about his experience. There is a growing body of evidence loneliness can be damaging to our health (Heinrich and Gullone, 2006; Klinenberg, 2016; Valtorta et al., 2018). I thought about my network of family and friends. I can’t remember the last time someone came to visit without planning and scheduling beforehand. Outside of work, I rarely see family or friends in person regularly or predictably.
I struggle with planning, and work on impulse. I have experienced the bitter reality of scrolling through my list of contacts during a dark hour of the soul to find no-one available for a shared cup of restorative tea. I have been left humiliated to reach-out for help and fail at the endeavour, ashamed I have given the message to others I could not cope, and angry with myself for my lack of self-sufficiency. These situations put vulnerable people at risk of turning to more responsive addictive activities to manage uncomfortable feelings and self-soothe, sometimes with regrettable consequences.
In situations where people are in regular company, (although I find the concept unpleasant and anxiety inducing) will eventually release the effort to create a false, but potentially less noxious presentation of themselves. If conflict and arguments arise, opportunities to reconcile and repair will present often. There would be an imperative to manage different opinions and perspectives so life in constant contact becomes bearable.
I have witnessed occasions where anger has been expressed in the presence of family. An emergency escape plan is rapidly deployed (it would surpass a building evacuation in terms of coordination and response). This is often followed by a period of quarantine by way of communicative silence, and the opening of backroom channels to make sense of the event and create endless hypotheses. Sometimes, a negotiator may be nominated to broker some form of resolution but an elephant will often be present in the room for weeks to follow.
Social media and the temptation to hide behind the written word of a text message, is all too alluring. However, hurt is easy to achieve by accusatory typing, but seeking sincere repair through apology is less certain when you are not physically with the person involved. Even a video call feels detached, and shrouded by an anxiety the conversation may be terminated at any moment by a press of a button.
The solution to the issue of reduced inter-personal contact is the intensification of amicability and social niceties. The challenge for someone on the Hyperactivity Attention Deficit Disorder spectrum is the sheer effort required to manage the requirement. I find myself oscillating between resentment against falsehood and dishonesty, versus an animalistic need for escape and time to recover.
Where does this leave us? Well, the wonderful saying, “Give me the strength to change what can be changed, the grace to accept what can’t, and the wisdom to know the difference” rings true here. We need to choose our battles, and plan our coping strategies.
I have accepted the need for time-out of social situations, and recovery time. I still feel selfish and anti-social, but the consequences of denying my needs is much more damaging. I would like to practise and learn the skills of expressing my feelings safely and without judgement. An excellent book by Rosenberg and Chopra (2015) provides a toolkit of language to navigate the thorny issues of expressing our wants and needs. However, as with all new skills, it takes practice and perseverance; but perhaps more importantly, requires opportunity to work with patient, understanding and willing participants.
Heinrich, L.M. and Gullone, E., 2006. The clinical significance of loneliness: A literature review. Clinical psychology review, 26(6), pp.695–718.
Klinenberg, E., 2016. Social isolation, loneliness, and living alone: Identifying the risks for public health. American journal of public health, 106(5), p.786.
Rosenberg, M. and Chopra, D., 2015. Nonviolent Communication: A Language of Life: Life-Changing Tools for Healthy Relationships. PuddleDancer Press.
Valtorta, N.K., Kanaan, M., Gilbody, S. and Hanratty, B., 2018. Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing. European journal of preventive cardiology, 25(13), pp.1387–1396.
Go even faster, and you think “If I just hurry-up, it will all stop.”
Now stand still.
Trace the path of queasiness in your stomach.
Recall the things that didn’t happen, and the mistakes you’ve made.
Now bow your head and let shame wash over you.
Buckle at the knees. Submit, and experience every failure in slow, painful detail.
Shout —perhaps — scream, “ENOUGH!”
Close your eyes, take a deep breath, and listen.
Music ripples through your body. Embrace emotion that consumes completely, shudder at the intensity.
Now open your eyes.
See stretching shadows. The setting sun dreams of escape from darkness.
Start to move.
Feel your pulse quickening, your breath deepening.
May be there is life, passion and promise? Feel your skin tingle, your head lighten.
Move — breathe — move — breathe.
May be there is hope? See beauty others take for granted.
Move — breathe — move — breathe.
Rolling, rushing thoughts of everything, and nothing drift away.
I wrote this after a recent experience of Seasonal Affective Disorder. I have been unable to counteract the effects so far. I thought medication for ADHD would solve many of the challenges I face. Although it is helped considerably, my hard-wired brain is not keen to let go of many life-scripts embedded over 40 years of undiagnosed ADHD.
I would be interested in other’s experience of ADHD and Seasonal Affective Disorder and what has helped? I often feel like a rare, precious Orchid requiring constant, specific environmental conditions to thrive. I rebel against feelings of weakness and sensitivity to such an extent that I apply denial, and a veneer of toughness to bulldoze through problems — with unsurprisingly damaging consequences.
Writing this blog is hard because it is boring. There are not many ways to make writing a blog interesting, unless you have particularly interesting subject matter. For instance, I could write a blog about advanced guitar technique with far more pique to my interest than this. ADHD is not something I would ever choose to obsess about. The only reason I do, is because it creates such problems for me. Unlike advanced guitar technique, because learning how standard modes as scales separate from their Ionian mothers IS fascinating.
For most people, boring is a problem. For people with ADHD, boring is an anathema, the nemesis. It crushes freedom underfoot and blockades the passage of time. Boredom is like being under siege, nowhere to go and no ability to go there; surrounded by the same old same old, and a little bit of martial law. I wonder if boredom is just as stark for everybody? Maybe it is particularly bad for ADHD because we keep placing our wandering minds on how bored we are. We refuse to stop thinking about it. I find it difficult to stay focused when I actually am interested, it cranks up to 11 when it is something I simply have to do.
There are some people, who on hearing a description of the symptoms of ADHD, take offense at the idea this issue could be considered diagnosable. They hear things like, “I really can’t stand doing boring things” and feel annoyed that they must. After all, boring is, boring no matter who you are. It is fundamental to the human experience, and only childish and selfish to indulge in the unpleasantness of it. Why should I be given a pass? Why am I even talking about it? Life contains boredom, get over it, with your “Oh-so-special disorder”.
Well, I will quite literally walk for miles to alleviate boredom. I have done. Boredom will lose you your job. Boredom will drive you to addiction. I spent many years addicted to alcohol largely because I could not bear the thought of an evening alone with my boring, vanilla thoughts. Boredom gets you kicked out of school, boredom means you pay too much for too little. Boring means you do not go out with friends because it will involve a lot of sitting and talking, that is, unless they are doing something interesting. Boring renders you rude. Boring makes you talk during films.
I feel like I’m leading up to an advertising slogan.
What boring is, is fu##ing boring. I’m bored of writing about it. I was going to write about the ways I might attempt to make writing a blog about adult ADHD not boring. But writing about the boredom itself did seem somewhat appropriate.
Just before I go though, it may be that my experience of boredom is not a standard feature of ADHD? Everybody copes in different ways, perhaps I have just gone for the most childish option – that of saying BOOOOORING loudly and not trying to engage? I would be very interested to hear what my fellow ADHDers have to say about it. Just so you know however, I can’t promise I won’t get bored…….
For a long time after I was diagnosed with ADHD, I was reluctant to make friends and socialise with anyone else with the disorder. I grieved the loss of normality for a long time after my diagnosis and it stopped me from being kind to myself or accepting my “new normal”. The first year after my diagnosis was spent trying desperately to prove the diagnosis was wrong, but however hard I tried to fake it I was never going to be like everyone else – and it hurt. I felt boxed in, and smothered by my diagnosis.
I thought if I hung out with others with ADHD, it would be embarrassing and it would be like having a sign around my neck saying “Yep! I’m a weirdo too.” I would have to admit to myself that I had it, and I just wasn’t ready. I wanted to carry on pretending I was normal and that I could function like any other; even though my life was a complete shit show before my diagnosis and underneath my stubborn attitude I knew there was a reason I had pursued an ADHD diagnosis.
Shortly after I was diagnosed, I was invited to a psycho-education course run by the Leeds ADHD clinic to learn all about my disorder. There were three other newly diagnosed people in the group with me, all in the same position, and yet while I was perfectly pleasant to them, I knew in my head that I would never see them again. I’d already made that decision before I entered the room.
My first foray into willingly hanging out with others who have ADHD was a meeting of the Leeds Adult ADHD group about 14 months after my diagnosis. If I’m honest, I felt lonely and fed up. I had let my diagnosis affect me. I had received quite a few negative reactions from my friends and family about my diagnosis. I felt regret at even revealing it, and hadn’t seen my life change drastically like I thought it would. I desperately needed some support.
I hated it!
I vowed never to go back.
I made excuses in my mind why I shouldn’t go back:
“The cost of a taxi there and back is astronomical”
“I derived zero benefit from it”
“I hate the seating layout”
“They were looking at me”
“I’m not like these people”
“I don’t fit in”
Another reason I didn’t want to go back to a meeting was because of personalities I didn’t like, or get along with. Due to my dysfunctional and defensive attitude it was even harder to separate my feelings from the people I met and liked, and wanted to hang out with. I actually met a lot of cool and lovely people that night, but in my biased mind it was easy to say, “Well that’s just proof I shouldn’t go back.” Looking back to that first meeting, I was standoffish; even in the break instead of socialising with the others, I chose to go out for a cigarette on my own.
I recognise now, that even though I made the effort to go, I still subconsciously had my back-up script prepared. This defensive and negative thought process won the day, despite consciously believing I had dealt with it. I spoke to my Gran when I got back. I was in floods of tears and she knew what a hard time I’d been having with it all. She gave me a good talking to (as she always does!) My Gran encouraged me to be non-judgemental, and persevere. As always, she was right!
She convinced me I had to give it another go.
It was during the next meeting that things changed for the better. I got talking to Adrian as soon as I got into the room, he was so lovely, friendly and welcoming. He told me he felt like he’d found his tribe, and even though I agreed with him out loud, inside I couldn’t have felt further from that. Despite being welcomed by everyone I again felt intimidated, uncomfortable and overwhelmed. Regardless, I vowed to carry on and stay till the end and I even remained in the room with the others during the break. I also met a very funny woman called Hannah who put me at such ease, we laughed a lot and connected very fast, and I think it was this relationship that made me want to stay. At the end of the meeting Hannah offered to give me a lift back home, and we chatted all the way about the group and how we felt about our diagnosis.
I began hanging out with Hannah away from the meetings, and I started chatting to the others from the group over social media which helped me realise just how much I needed others with the disorder around me. I also explored my feelings in therapy, and both helped the shaming process I was caught up in over something beyond my control. I started owning the fact I was different.
I have recently finished a mindfulness class run by the NHS ADHD clinic. I absolutely adore everyone from that group. We get along so well. A lot of funny stuff happens, including at the end of one session seeing how long we could all hold our pelvic floors! There is no judgement, we all just laugh and I come away from them feeling less burdened, and a lot happier. I doubt it was all due to the mindfulness (sorry Jo!) It finished just before Christmas, but I’ve kept in touch with everyone and hung out with a few of them. I’m organising a pizza night for us all so we can catch up and have a laugh!
It is so invaluable to know people who just get it; people who understand the way you think and behave, don’t judge your flaws, and give you the breathing space to discuss your feelings honestly. They don’t care that I blurt out answers, interrupt others, and swear like a trooper because they do it too! I can’t believe due to my previously protective pre-judgements, I missed out on 14 months of amazing friendships. They make me feel so much better about myself, and they raise my self-esteem instead of denting it. As a result, I approach myself with much more kindness when I make a mistake or have a meltdown. They make bad days better, they have the rare ability of being able to quickly turn my frown upside down, and they make me feel loved and accepted.
I now have a big supportive circle of friends with ADHD and I can turn to them for anything whether it be in times of humour, crisis, or just for a natter. I can text them at any time of the day being like, “Great, I just spent the last 3 hours fantasising about my math’s teacher, and now I don’t know how to calculate the area of a compound shape” or, “I just spent half my rent on shoes that don’t even fit me.” Instead of getting a judgemental reply, you’ll get something like, “I feel you mate! I’ve been there” or, “How big do you reckon it is?”
I admit, we can be a bit forgetful, we can be disorganised, and we can be loud; but you’ll never meet a more compassionate, friendlier or funnier bunch of people than those with ADHD. It’s been a bumpy road to friendship but Adrian was right, I had found my tribe, it just took me longer to realise.
P.s I still don’t know how to calculate the area of a compound shape!
Hello! It’s me, Francis. I appear in a couple of the Adult ADHD videos! This is my first attempt at a “blogpost”. It is supposed to be my experience from the perspective of ADHD which I find a little difficult to separate from my experience in any other way. I suspect it may resonate with a lot of people when I say I have never not inhabited my mind and so compartmentalising it is tricky. Like asking a colour-blind person to spot the wrong parts in their field of view.
This beginning bit isn’t very good, its mostly to get me into the flow of the thing. I tend towards flowery writing for some reason. When I was in college it would amuse me to approach essays in as grandiose a manner as I could for comic effect and I am afraid I just kind of got used to it. Thus, you may find I overuse words like thus, or that my writing might take an unexpected and upsetting alliterative lurch. It doesn’t help that I fancy myself a poet either. Perhaps it is true to say that this was the way I was able to push my ADHD mind to the end of writing essays in college. I made it a treat to myself and it worked. Because I was always taking such linguistic liberty, I felt obliged to back it up with some good hard fact. Such barefaced academic cheek could only be tolerated if I was also begrudgingly right about some of it.
However, this style had far less traction at university. We poor students were obliged to observe referencing and style guides up to the placement of the very last comma. Why, I ask you and indeed did ask anyone who wasn’t wearing noise cancelling headphones, is this punctuative pettiness worth actual marks??? Who, the giddy fuck, cares?
Apparently, a lot of people care and I crashed out of uni after one year. Using the time-honoured defence mechanism of ADHD I convinced myself that I never really wanted the degree anyway. This was easy to do because it was after all a music degree and who needs one of those to get busy musicing? So I did that, I started a band.
Performing was easy, all the other bits were hard. But let’s not make this a life story. I imagine I’ll want to write some more of these blogpost thingys and I should save some of my frankyfuel. (I just made this up and I am pleased with it).
Truth be told ADHD has always been for me, a little shameful. For one who was diagnosed so early I did a fantastic job of not educating myself about the thing. Thus, I didn’t know until my early 20’s which of my problems were squarely at the feet of our little disorder. I just thought it came down to not putting my foot in it and tablets were how I did that. Even that idea, that I must take tablets to function properly was a little shame-making. Knowing as I do now that my inability to do any homework or commit myself to anything boring are also camp ADHD, I can see I might have excused myself quite a bit of strife and warded off some of the anger from those around me.
Mind you, was it ever my responsibility to be the educated one at the age of 7? Surely that wasn’t my gig. You don’t trust 7 year olds to get a bus by themselves let alone understand the complex inner workings of a developmental learning disability. Here’s the problem as I see it. In a perfect world, or a perfect childhood for me, every adult would have been educated to PhD level about this disorder in particular and would have made it their mission at every opportunity to help me understand why I was having the difficulties I was having. Tad unrealistic no?
So, how to protect a child from the ravagings of the world around them when neither the world nor the child knows enough to excuse them their failings? After all ADHD is a disorder made most profound and hurtful by its developed comorbidities, its coping strategies and defence mechanisms. Without knowledge ADDers learn to retreat, to avoid social gatherings. They learn as a matter of fact that they can’t do what others can, and they are less valuable because of it. I’m preaching now. Let me sum up before I go all day.
Despite the luck of my early diagnosis and treatment I still retain some shadow of the difficulties faced by my less fortunate colleagues. I am deeply sympathetic towards them and anything I can do to help a rising person (child) grow up in a slightly more enlightened world, I will do. Empathy, that’s the thing. Let’s spread it around a little.
My first job was working in McDonalds at the age of 19 whilst studying at University. It was a highly stressful environment with electronic buzzers and machines dictating your pace of work, orders shouted from the frontline, managers criticising your efforts, and hot kitchen temperatures. I wasn’t very coordinated. I panicked often and took impulsive decisions with disastrous consequences (like turning the conical sauce dispenser upside down to see what was blocking one of the nozzles….I overshot the sauce-to-burger ratio that shift). I felt a bit of a joke and a buffoon, I was embarrassed to say I was a Medical student. I just quit in the end, deciding a student loan debt was preferable.
What does your CV look like?
My CV is a long list of jobs lasting two to three years. I quickly realised the institutional environment of hospitals didn’t suit me. Also, I struggled with the medical exams required to be a consultant. I hated multiple choice questions and couldn’t understand the need to learn endless facts and statistics. I liked principles, concepts and ideas. I wanted to understand things, not learn them — there were books, journals and the internet for reference and research. Unsurprisingly, I failed the multiple choice exam for the Royal College of Medicine and couldn’t face another attempt.
I moved into General Practice believing it was a more dynamic, responsive and innovative organisational model to deliver Medicine. There was something authentic, earthy and real about Community Practice. General Practice in the medical profession doesn’t have the same perceived gravitas as a Consultant or Professorial role. Through the culture of medical school training and early hospital jobs, it is often thought to be chosen as a lifestyle preference, rather than a legitimate career path.
Unfortunately I was sued by a patient during my General Practice training. It deeply affected my confidence and was an experience I struggled to reconcile. The claim was relatively small, and the patient suffered no longterm complications, but it was deeply upsetting to think a medication I prescribed caused avoidable, unintended harm.
Dopamine and adrenaline are believed to be depleted agents people with ADHD seek in order to feel pleasure or focus on a task (Scassellati and Bonvicini, 2015). Hence, those of us with ADHD are often drawn to high risk and “thrill-seeking” activities, also sadly, towards chemical agents of addiction. I realise now, I would manufacture internal stress to pump my system with adrenaline. With my sympathetic nervous system fired-up I could focus, manage complex situations and demands. Unfortunately, it also meant tipping into feelings of panic and desperation. On odd occasions I had to excuse myself from a patient to manage an anxiety attack.
I tried various models of the profession: employed and self-employed, but none seemed to fit. Unbeknown to me at the time, and before my diagnosis, I often applied catastrophic, binary thinking when faced with an obstacle. My default position was to quit, rather than consider a number of potential alternatives.
I found it hard to join an organisation and just sit back, and observe. Despite previous experience and awareness, I kept repeating the same pattern of behaviour. Within weeks of joining a new team, I would be proposing system changes. Now, I realise my motivation came from fear for my own safety in the work environment. I needed systems to protect and support me. If I was feeling anxious and overwhelmed I could easily miss important steps in a process, and make rash intuitive decisions without clear reasoning.
Pre-diagnosis I had enough self-awareness to know what made me vulnerable at work. However, trying to change organisational systems is an incredibly exhausting and demanding process. I constantly underestimated the work involved, and would feel resentment over perceived work inequalities. I found it hard to delegate and form alliances within the team. I felt the archetypal disconnected, lone ranger. I was so wrapped up in my own internal turbulence I had little time to build relationships or empathise with my peers.
I read endless books about effective change management. I believed any failing rested squarely on my shoulders. I recently took a “drivers” questionnaire (Brefi Group Ltd, 2018) and scored high across all domains: try harder, please others, hurry up, be perfect, and be strong. It is no surprise burnout was a common occurrence in my career, and especially within a Medical profession where no agreed threshold between professional responsibility and patient accountability exists.
A turning point came when I attended a careers seminar at the “School of Life” and from the various topics discussed, I mapped my work history. I documented the triggers for change, and realised they always came from a place of stress and negativity. I tended to be pushed away from situations, not attracted or drawn to them.
I realised my passions were in creating, aesthetics, values and principles. I am an academic by nature but believed this to be something nerdy and uncool. I had learned by fear through Medical training, so to rediscover learning from curiosity and interest was a revelation. Unfortunately, re-directing such a vocational career has not been easy. In the early months of leaving my profession I went through an existential crisis. Also, I thought limitless unstructured time would be restorative and healing, only to realise I could not independently manage and prioritise my activities.
How long is the longest you have been in a job?
Over the last four years I have provided appraisals to my General Practice colleagues and it has been my longest job role since University. I am now 44 years old! I work independently and the meetings are agreed between myself and the doctor. The time it takes can be relatively flexible according to the need of the individual, and I enjoy the process of written reflection. There are some mandatory boxes to tick and hoops to jump, but the engagement with colleagues is generally rewarding when I see their personal growth emerging.
There are three principles we often seek in work for satisfaction: autonomy, competence, and relatedness (Reis et al. 2000). I see the value in the work I offer because my colleagues continue to serve the General Public despite sometimes facing hostility, suspicion and mistrust both within the NHS and from patients. I probably spend more time than necessary over the process, but it is my way of “giving back” within a role I am currently able to manage and sustain.
What would be your ideal job/career?
My ideal job/career would be portfolio based. I now want to be an independent contractor. I recognise I do not fit well into corporate machines and office-based environments. I enjoy helping people discover themselves and learn new strategies to manage their lives.
I spent two years at Art College and attended evening classes. Every time I entered the building I would feel a wave of emotion. It was if I was experiencing the sensation of returning home. I felt safe and accepted, the old building breathed patience, experience and understanding. It was worn and damaged, but felt loved all the same. Judgements were relaxed (they never truly dissipate) and mistakes managed as opportunities, not with shame.
Sadly, art is not present in my life at the moment; childhood values, and upbringing sabotage my attempts. I feel it too indulgent, and I hate having to interrupt and break-off from creative flow. Hyper-focus is not very family-friendly. I still can’t quite manage the risk of feeling guilty and then resentful for breaching pre-arranged plans and time limits, so better to avoid altogether….I’ll leave you to consider how that is working out! I have a strong “Obliger”trait (Rubin, 2017) and need to find an accountability vehicle to make artistic expression a validated exercise.
Have you received any reasonable adjustments?
Since diagnosis I have not been in a work situation where I would require reasonable adjustments. I left my clinical medical career just over two years ago with another episode of burnout and the realisation I couldn’t face another cycle again. It happened before my diagnosis.
I am not sure how a small business such as General Practice would accommodate my condition. In an ideal world I wouldn’t be required to provide an on-call/duty doctor role. This is where a person is assigned to manage unexpected and urgent issues for the day, but often alongside routine, scheduled work. People with ADHD can be good at managing emergencies but in General Practice it is often about prioritising work that can arrive simultaneously such as: an important medication not dispensed, a serious blood test result, a late afternoon home visit, a hospital investigation needing action……and don’t forget the waiting room full of people because you are running late.
I would require more catch-up time between appointments to accommodate a certain level of disorganisation and time management issues. With my inability to say “no”, and constant curiosity for innovation and change, I would need a firm colleague to supervise my work. Although quite an experienced doctor, I was corroded with years of uncertainty and self doubt by undiagnosed ADHD. I needed a lot of reassurance and feedback on my clinical performance that is not part of established culture due to time pressures and workload.
I think with all the adjustments, I would not feel like an equal member of the team. My ADHD would make me conscious I was working with a disability, and not a strength. I would worry I might become a burden and liability, rather than an asset. I would also need to reduce my earnings to accommodate the additional time requirements; unless I was experiencing a lot of pleasure and reward from the work, I don’t think it would prove worthwhile after deductions for tax, pension, medical defence fees, and professional registrations.
What was your worst work experience and why?
As part of my research into ADHD there are associated issues people can face with the condition. These include: Oppositional Defiant Disorder (ODD) and Rejection Sensitivity Dysphoria (RSD). I have come to accept the many contradictions of ADHD. For example, I can be impulsive, suffer strong emotions, and hence risk saying something hurtful or thoughtless. However, I am also extremely sensitive. I absorb emotions expressed from others, and sometimes risk losing myself in their moment.
Working with sensitive colleagues was my worst experience, but also aided my self-awareness. Low self-worth and self-esteem can be dangerous in a work environment. Your belief that what you say is unimportant, unheard and dismissed can lead to reckless comments and behaviour. I was unnerved that someone valued my thoughts and opinions to such an extent that it actually caused them personal distress.
However, it is difficult navigating the terrain of a sensitive individual. I likened it to “emotional censorship”. The effort of vetting and double-checking every opinion and idea for a potential negative response is exhausting and frustrating. I value authenticity, and grew-up in a family environment where true meaning was gleaned through sub-text and nonverbal leakage. Living in an environment of constant second-guessing, doubt, and uncertainty brought back challenging memories.
What positive things do you bring to the work place?
If I manage myself well with “healthy” stress, and keep feelings of overwhelm in perspective, I can bring ideas and solutions to complex problems. I am autonomous and self-motivated in the early stages of a project, and can get a large amount done in a short space of time, but usually need assistance to see things through to completion. My sensitivity is both a strength and an Achilles heel. In the right environment I can be thoughtful and compassionate towards colleagues, but under stress tend to withdraw and become critical.
What is the most important advice you could give someone with ADHD about work?
Know your condition inside-out. Insight is not a common strength for people with ADHD (Meaux, et al. 2009). Can you name your emotions when they happen? How much influence do your feelings have on your decision making? Can you separate facts from that internal voice? Building self-awareness will help determine what is in your power to change, and what needs to be present in your environment to keep you safe, satisfied, and connected with colleagues.
I find regular alarms, although irritating, keep me checking-in with time and where I am supposed to be. Reducing interruptions, and distractions makes a big difference. This includes: turning off mobile devices, using ear-plugs (either noise reducing, or noise cancelling), and having visual prompts/reminders to keep on-track.
Hyper-focus is unforgettable, and if work can tap into my ability to move into this zone, I get a lot more satisfaction.
Celebrate success. ADHD people can be very dismissive of achievements. I found it was usually because I had already moved on to something else, or I considered it a twist of fate. It doesn’t feel culturally comfortable to make a noise about achievements (we all like humility and self-deprecation), but a celebration could involve something private and personal. I became so accustomed to my short comings, and negative thinking, I felt uncomfortable to say “Well done, Adrian”. It’s risky to seek external praise for validation, but if it comes unsolicited your way — make sure to take the time to embrace it rather than dismissing with embarrassment.
What is your story? Please share with us what you have learned on your ADHD journey.
Working through the many tasks and challenges of daily life with, and without medication for ADHD has been a strange experience.
Recently, I watched with my Son an episode of “Thomas the Tank Engine and Friends”. The fire rescue engine got wheels to drive on the road. He had been so used to the train tracks for travelling that during his first outing on the road another engine laughed at him because of his “wobbly wheels”. For a while he was too embarrassed to try again, but found courage and resolve when he finally reconnected with his values and purpose: to put out fires, and be part of the rescue team.
It was probably no coincidence a children’s story should connect with my own life experience. Before medication, I read endless self-help books, mainly about becoming organised, time efficient, happy, effective in work and general life. However, I was like the engine on the train track, I could appreciate the scenery and get to my destinations, but the mode of travel remained unchanged.
With the wobbly wheels of medication I was able to explore different routes, but it was tiring to think differently, and to sustain the activity. I wanted to stay on familiar tracks, and my brain was unnerved by these new possibilities. It was tempting to fall back on old habits, although now it was with conscious awareness and choice. I could no longer pretend to myself I wasn’t in control; a space had opened between trigger and response.
I had been given an opportunity I didn’t want to grab, and then waste. Over time, I began to understand how to use my values and purpose to keep me persisting, practicing, and learning. I couldn’t just expect the “wobbly wheels” to work and make things better.