A study on self advocacy I
Trigger warning: Self harm. This post will include pictures and admission of self harm, please proceed with caution.
By the time you are done reading this, if you are applying any critical thinking at all or if you understand general rules of social behavior, the one question you would probably be asking is “why is she sharing this?”
Well, you’d be asking that as well as wondering if I am okay. This is not a trauma dump per se, so in the end, you will not feel powerless to help. You would be duly informed as to how, if ever you can. I need you to understand that I am a fully capable human being who is a little soft in the middle and can therefore not handle too much weight, lest she be crushed.
You are surrounded by many people like me and they are not falling to their deaths by the minute. They are a little more exposed to peculiar troubles, yes, but so are you many times. The difference is in the explanation. You have troubles because you’re human and it is human to fail sometimes, or life just has a way of aligning our faces perpendicularly to its arse so it can shit on it a couple of times.
People like me, on the other hand, have troubles because we have to a life-defining degree, all the things that make you human as well. What you have in little amounts — forgetfulness, impulsiveness, impatience — those pesky little traits that impact your bad days sometimes, we have in good measure; pressed down, shaken together and run over.
We have lives shaped by forgetfulness, impulsiveness and impatience. We optimize relentlessly to take out the punch that comes with living with these things as a daily reality, but most times, it doesn’t quite cut it. Also, a bad day for us can simply happen because we wore the wrong T-shirt and it kept stinging our skin in such a weird way it was a miracle we did not get it off and walk around topless.
What constitutes a bad day for you is the almost a daily reality for us. And this usually is from childhood.
So when you come to the question of why I am sharing this, my answer is simple.
I am sharing this for me.
Someone out there is going to be me really soon and they will need to understand why they act the way they do, and they will find this post, see me, and their lives will make sense. And then they can double down on measures that ensure that what constitutes bad days for a sizeable amount of the world’s population does not become their life. I share this because I want people like me to be bolder in their pursuit of a better quality of life.
There will be two starts to this story.
Start 1 goes thus:
ADHD describes a condition that involves an inability to focus or pay attention. ADHD is split into 3 subtypes- inattentive, hyperactive and both. Other experts further categorize ADHD into 7 subtypes: classic ADHD, inattentive ADHD, Over-focused ADHD, Temporal Lobe ADHD, Limbic ADHD, Ring of Fire ADHD and Anxious ADHD.
While not recognized by the American Psychiatric Association, the development of the 7 subtypes of ADHD are all attempts to impress a simple reality on the public: no two individuals with ADHD are the same.
And the second start to the story; start 2, if you will:
Sometime in May, close to month-end, in the wake of another episode of deep emotional distress and cutting myself, I reached out to a therapist and told them something that I always suspected — that I could be depressed and I could have ADHD.
Paraphrasing one of my favorite psychotherapists, when a person checks themselves into therapy, the presenting problem is not always the real problem, it usually is something deeper. But the therapeutic process does not run on assumptions or suspicions, as valid as they may seem.
On reaching out, I was told to take a couple of self assessments based on the DSM-5. The DSM-5 is a manual used by clinicians and researchers to classify mental disorders. Though it attempts to standardize mental health, it is not dogma and psychiatrists and mental health professionals will still have to draw inferences and tailor interventions to individual peculiarities. Further tests could still be required to rule out underlying health conditions or determine more specifically the presence and severity of mental disorders.
But then, I had presented with something that was already affecting the quality of my life significantly.
In the same month, I would have taken two ECGs in the space of a week, trying to determine the cause of a tightness I was apt to feel in my chest at night — which I knew was not a heartburn or as a result of a chest infection. Interestingly enough, I did scans as well, but deterred by the confusion of the doctor who was trying to read my test results, I never went back for my papers. I really was done. I did not have a lung condition, my heart seemed normal. I was obviously coping with significant stressors that were causing my chest to feel like I was having a heart attack. My pain could very well have been psychosomatic, mediated by anxiety due to an inability to cope with my life, but I would not figure this out until I took the tests that I felt were necessary.
I took the DASS-21 test and the ADHD test.
Everyone has issues with focusing every now and then, but that doesn’t mean everyone has Adhd. Adhd has genetic risk factors as well as environmental ones and it is usually determined by a consistent presentation that must have been present since before the age of 12 and considerably impacts ones daily activities and quality of life.
I know myself to have had had episodes of being consistently blue since I was a child, but it usually was quite manageable. If anything, it helped me slow down my ever-running rotor of a brain. I was the precocious student who could never complete their class notes and as early as age 6, I was already running around, borrowing notes from classmates because I was distracted during class. It did not help that I was also short-sighted but did not use glasses.
I lost things like crazy — pens, gifts, my lunchbox. I was that girl who always pocketed her pen the wrong way and there was always a tell-tale large ink stain visible from inside my uniform pockets — all of them.
Growing up, it never really got better. In secondary school, I lost whole uniform sets and in Uni, I lost 3 phones before I learnt how to hold on to my gadgets.
The low moods kept increasing in intensity and I know myself to navigate life with a general numbness that keeps me a little disembodied most times, like I am existing besides myself. An incredibly stressful situation I passed through about two years ago increased my urge to self harm and soon, I started sporting scars on my arms.
ADHDers usually end up building their lives around their ADHD symptoms, so they naturally gravitate to professions where they are able to maximize their strengths, or leverage on the novelty that comes from trying something new. The novelty aspect is also as a result of low levels of dopamine in the ADHD brain which leaves the individual craving a dopamine boost.
Individuals with adhd are twice as likely to have negative life outcomes such as job loss, divorce and addiction.
Besides low dopamine levels in the brain, there is a marked underdevelopment of the prefrontal cortex in individuals with ADHD. The prefrontal cortex is the part of the brain responsible for the ability of an individual to plan, prospect and account. It is also the part responsible for controlling impulses and emotions. In an ADHD brain, the prefrontal cortex is weaker and less structured which is what is responsible for the inattention, inability to focus, difficulty sustaining attention to details, difficulty planning, executing and switching between tasks.
It’s not that ADHDers cannot focus, it is that they cannot sustain attention on things that are important but not salient or interesting, so a video game might command the attention of an ADHDer, but not what their teacher is saying. I could stay glued to the TV and my mind would not wander because I am watching my favorite cartoon, but I could not stay glued to what my teacher was saying in class.
This is why most ADHDers build their lives around what they consider important to them because focus is a huge part of what sustains life.
I quit my career as a pharmacist for instance because the idea of being a designer captivated me enough to sustain my focus and learn how to be a designer.
It should also be noted that as ADHDers grow up, activities get more boring and not so salient, so some start to engage in risk-seeking behavior while others lose their zeal for life and are even diagnosed with depression, whereas these are all symptoms of ADHD and a life optimized to work around their symptoms might do them some good.
The inability to plan properly and execute also accounts for the reason why many ADHDers live on the edge or below potential and are apt to just scrap by in life. Depending on the levels of societal expectations, some eventually develop anxiety as they become hyperaware of how their symptoms impact those around them. These people would react to such behavior by calling the ADHDers flaky, stupid, unserious, careless, e.t.c. This is usually the situation for many women living with ADHD.
I had three sessions of cognitive therapy where I learned that I had to build my life around my core values and progressively disclose my areas of weaknesses and struggles to my friends as well as people around me. And that aspects of my personality also play a role in the development and expression of my symptoms.
In my next article, I will tell you about how an unexpected pause in my therapy taught me a little something about self-advocacy.
For now, I hope I have been able to educate you a little about what it means to be an individual living with ADHD.
