Attention Deficit Disorder, So-Called

When this condition was first beginning to be recognized, I was already in high school. My parents knew that something was going on, and they made various attempts to get someone to tell them what it was. Unfortunately, they had no luck. I suspect that this is partly because at that time (early to middle 1960s) people had a belief that ADD/ADHD (which they may not even have been calling by that name) magically went away at puberty. As with so many early ideas about things, We Have Learned Better Since Then.

If we figure that I started having trouble about the time I was 5, it took me 39 years to get diagnosed and medicated. Argh...

Now, I want to say right here that I think ADD is overused (and in fact abused) as a diagnosis of kids who are problems in school. Ritalin (brand name for Methylphenidate), also overused, is not my idea of a righteous way to deal with a kid who won’t pay attention, or is obstreperous for reasons that can be understood without reference to neurology.

That said, however, there is a vast difference between won’t and can’t; and when Ritalin works, it works. I sometimes tell people that I’m the Ritalin Poster Adult. I was headed over the edge when I finally got diagnosed with ADHD; it took me only a few months to stabilize and become more or less capable of holding down a real job. Mind you, I will never be truly capable of holding down or fitting into any ordinary job, and I am very fortunate that my current position does not require me to behave like an employee.


My neurology, while not fully straightened out, has definitely undergone some long-term changes, and seems to work a bit better than it used to. Ritalin, though, seems to have made only some long-term changes in the way my neurology works. Instead of calming me down, it now makes me antsy and irritable, so I can only take small quantities, and only from time to time. Such is life; at least it did what I needed at the time when I needed it the most.

[Note, added much later: That may have been more a problem with the generic than with Ritalin. They can say what they want about generics being the same as the original, but it’s clearly crap in this case.]

You may notice the lack of links to ADD/ADHD pages and support groups. That’s because I don’t know anything about what’s out there. I find myself quite reluctant to get involved. I’m sure you’ll find stuff if you search for it — there’s a ton on the Web.

A few words of advice: if you think you may have ADD or ADHD, read a good book on the subject and find a careful and sympathetic neurologist. ADD is fairly easy to self-diagnose, but physicians (in many cases with good reason) don’t like getting their toes stepped on, so be gentle and gracious about it. (Good books include Lynn Weiss’s “Attention Deficit Disorder in Adults”, and the now-famous “Driven to Distraction”, by Hallowell and Ratey.)

If you are diagnosed with ADD/ADHD, find a good therapist as well. I am not kidding. You’re going to need one, and it had best be someone who has a good solid understanding of the condition and its ramifications & implications.

Recent Developments:

(September, 2008)

As I mention above, I was having some trouble with Methylphenidate, and my doctor and I decided that it would be reasonable to try an Amphetamine, to see whether I would tolerate that any better. It very rapidly became apparent that the Amphetamine was not the drug of choice, so we decided to try Concerta® instead.

Going into this, I was really uneasy. I had ended up chopping the 20-mg Ritalin SR tabs into quarters, because I couldn’t deal with anything more than 5 mg; the smallest size of Concerta is 18 mg, and I was afraid it would just about kill me. I was thoroughly surprised to find that I couldn’t even tell that I was on it — the stuff is incredibly gentle.

Other people, however, had no trouble telling. About a week after I started taking Concerta, two of them asked me whether I had changed my meds recently. I said yes, and they said, “Well, it’s working. Stay with it!”

I have been on it ever since. I am now taking 27 mg per day instead of 18, and I can just barely tell that I’m on something, if I think about it. This stuff definitely gets my vote.


Last modified: Tue Sep 9 13:05:44 EDT 2008