ADHD and Adrenaline

I perform phenomenally when I'm under the gun, a deadline breathing down my neck, a series of anxiety attacks experienced before I settle in and prove my brilliance. Some of my best work has been completed at 11:59 PM the day before something is due. I never really thought to explore what was behind the behavior because its been with me throughout my life. From frantically completing long division assignments on the front steps of school the morning they were due when I was in 3rd grade, my Senior research paper on the tragedies of the Holocaust the night before, to my research on community based service provision satisfaction among individuals with Schizophrenia submitted online right before I walked into class when I was in graduate school, I always thought it was just me, that I was just an avoider, a procrastinator and had no real reason as to why I approached tasks in this manner. As a practitioner of mental health therapies with my own business, this behavior continued, pushing deadlines on court reports, billing, or reports to Disability Services, returning calls much later than necessary.

I noticed I'd feel tired at night, go to bed, and in an hour of laying awake, develop a play therapy intervention, create a flow chart demonstrating the cross over of cognitive behavioral therapy and Polyvagal theory, add a page to my unwritten children's book about the amygdala and then get up and post a Facebook status about it to trigger my memory in the morning so I didn't forget and could re-create it all, but then struggled to do just that. I had wondered why I couldn't just settle in and accomplish these things during the day like a reasonable person., feeling it was some sort of character defect. But deep down, I knew.

I'd worked with countless children over the years diagnosed with ADHD. I'd heard their parents talk about how these kids could do the work assigned in the allotted time if they were just motivated enough or "wanted to". I frequently heard about failing grades until the end of the 9 weeks or semester and the child then, like pulling a rabbit out of a hat, would get everything done with astonishing brilliance and pass the class. "See? They CAN do the work and there is no reason for this!!"

I mulled over the similarities between myself and these children. My parents never berated me about my grades, I always passed with decent grades and excelled in several areas, scoring high in spelling, vocabulary and reading comprehension while slogging my way through math, and sometimes, the various sciences. I was the playground bully, something I tell my clients to their absolute astonishment. I was often loud and awkwardly navigated interactions with my peers. I attended a tiny country school, usually around 3-5 students per grade at any given time. We were often provided out of the box activities and assignments throughout elementary school and I thrived for the most part.

Enter in the increased demands of Jr High/High School, life in general, and navigating socially, I continued to struggle. I was often anxious and escaped into books, frequently late on assignments, which leads me to the point of this post. I finally discussed my suspicions of having ADHD with my doctor, providing my history and my knowledge as a mental health professional, sharing how I always struggled to keep up with documentation and the more tedious tasks of being a therapist in private practice. Unfortunately, since I have Multiple Sclerosis and a history of depression, AND I appeared to have a wonderful career and business with no apparent failures in my past, my doctor wanted bloodwork and for me to speak to my neurologist. A few months later with stellar bloodwork and no apparent MS related cognitive issues determined, I was referred to a psychiatrist. You'd think it would be fairly straight forward at that point. Nay. It was decided my anxiety levels simply had to be dealt with first. Placed on a new medication, my old one discontinued, I embarked on a miserable month long journey of increased inattention and constant tiredness and then, because I was getting even further behind, horrible anxiety. I had completed a questionnaire for adult ADHD and, as suspected, scored positively for ADHD, Inattentive Type. An ADHD medication was added but the prior medication change continued to cause problems with lethargy that made it difficult to get work done. Before my next appointment, I discontinued the first medication due to the lethargy and the suicidal thoughts beginning to creep in. The 3rd appointment yielded a switch back to the medication I had been on and the ADHD medication, which eventually achieved the desired results. Work started to get done with some mild task avoidance and decision paralysis persisting.... I'm a work in progress.

This gave me an immense amount of empathy for the children in my therapy practice and I increasingly addressed the areas of executive functioning with parents and teachers, reinforcing these things they viewed as character defects, laziness, lack of caring to be seen as symptoms of ADHD instead. I began to realize, like myself, these kids could sometimes perform to the level demanded, but I wondered, why was that and what was the ultimate cost? I found the pressure and the push to perform, usually with "motivation" applied in the form of punishment that increases with every perceived infraction, causes enough distress in the child (and myself) that a boost of adrenaline courses through the brain, the deficits of ADHD temporarily are masked, the task gets completed and the child (and myself) collapse with the relief of getting it done.

The adult then believes the child was able to do it all along, that the child simply wasn't trying hard enough. The child has completed the task in a state of panic but that doesn't mean the child learned how to complete it without the boost of adrenaline. It also begins to teach the child to use survival states of fight and flight to deal with every day difficulties and that refusing a task, regardless of its potential harm or the child's deficits, is unacceptable. This fuels the need for adrenaline rushes in order to feel competent and confident and the child then learns how to obtain the adrenaline rush, possibly developing an addiction to the rush and engaging in increasingly risky behaviors. A cycle of crash and burn ensues with frenzied, adrenaline fueled production combined with absolute exhaustion until the next hit of adrenaline can kick in.

For children, forced compliance doesn't fix a problem. It merely teaches them that their struggles don't matter, that it doesn't matter HOW you get a job done, just get it done at any cost to avoid an unpleasant consequence, even at the risk of further mental harm to self. If you have a child or anyone in your life with ADHD, please realize there is more to what is going on than meets the eye. The brain is an amazing organ, but there are types of brains that function differently (not lesser than, not broken, just different) and that is okay. They need support to be able to create methods of performing tasks which will work for them, not what works for society, teachers or parents. Pushing them to the limit is not the answer.