2 for 1 Special

from 11/01/2024

This past October was both Hispanic Heritage and ADHD Awareness month. As a Dominican with ADHD, it is only fitting that I considered preparing content on November 1st.

Attention-deficit/hyperactivity disorder, or ADHD, is a condition that I happen to know quite a bit about. Even though I’d completed at least over a hundred diagnostic interviews for research studies by my early twenties, asking about the 18 ADHD symptoms every single time, never once did I consider that I, myself, might have ADHD until I was about twenty-six.  

I’d tried stimulants in college to write papers and study for tests I’d procrastinated on, and they helped a lot with focus, but I didn’t consider that I could qualify for a prescription. Even so, scheduling an appointment was too overwhelming. That should have been a good indicator that I did have ADHD, but few outside of academia are well-versed in the insidious nature of the executive function deficits common in people with ADHD.

Executive functions are a set of cognitive skills which include inhibitory control and working memory. While the former is the pause we give ourselves to consider consequences before making a decision, the latter refers to the short-term memory required to store bits of information until you can put it to use (such as remembering that consequences are a thing).

Every person with ADHD is different; we each have our own dynamic constellation of a consistent set of symptoms. My Achilles heel combo of executive function deficits is time blindness and difficulty prioritizing. Having an unstable perception of the passage of time makes it impossible to estimate how long a task will take to complete. Then I imbue the task with dread, overestimate the duration required to complete it, and avoid it like the plague until I get it done against my will, or it’s subsumed into the doom pile of unfinished tasks in the corner of my brain. With ADHD, everything feels urgent, important and overwhelming because we perceive it all at once and not stretched out over time.

Still, I love my brain. I love learning new things. Prior to my diagnosis, I was adventurous, sometimes reckless. Until, invariably, I realized I’d forgotten some very important thing that I was supposed to have done and ruined my own good time. And the intensity of that sinking feeling, of having no real excuse for not doing the thing (except, of course, that I had completely forgotten about it and was living my best life instead), of scrambling and finding a clever way to beg for more time—it was an all-consuming dread and strangling anxiety. But I still managed. Coffee in hand, I’d go to work after work, I was always busy. Part of it was poor planning, but also pre-existing poor money management skills (and general lack of money). If I spent too much, I’d just find a way to make it back.

For better or worse, ADHD means that instead of telling ourselves “No!”  we ask ourselves “How?” It’s an optimism that captures the difficulty prioritizing and sense of FOMO when we’re forced to do one thing at the expense of not doing another. Yet, instead of asking ourselves “how?” to get started on important but boring tasks, we start new hobbies, reinvent ourselves, and hatch complicated, implausible plans. I once sold a Balenciaga bag I’d gotten at a sample sale on eBay for $600 so that I could fund a trip to Europe and attend a scientific conference in Nice. I missed my 7am poster session due to raucous night out—during which I blissfully forgot that consequences existed. I reframed my absence that morning with the rationale that few attendees would have gone to a 7am poster session and that spending time exploring the city and enjoying nightlife was a better use of my time than going to bed early and standing in a carpeted room next to a digital poster, under fluorescent lights. Me and my remaining two neurons made it to the conference later that day, struggling to talk about affective disorders with other scientists until finally giving up.

Although we cannot manipulate time, people with ADHD time travel frequently. Time stands still when I’m in a boring lecture. And I time travel two hours into the future whenever I open the TikTok app before bed. I need external markers of time passing, such as music or a podcast. Otherwise, I’m untethered to the physical realm and can easily get sucked into imaginary epic journeys of whimsy and self-discovery—all while standing in the middle of the room because I forgot what I came in to get.

ADHD can be hard because the struggle is invisible, which unhappy people weaponize to diminish the severity of impairment people experience due to ADHD symptoms. Decision paralysis, procrastination and overwhelm can all look like someone lying on the couch watching Netflix and playing on their phone. People without ADHD don’t understand that we also procrastinate starting activities we want to do, but find ourselves stuck and unable to transition, literally frozen in time and space but internally trying to will ourselves to shift. A million false starts, a million failures you can’t see. ADHD can be wearisome.

ADHD is buoyant, it’s optimistic, it’s also savagely elusive and mercurial. Every day is the same but different. Our minds move lightning fast but everything we do takes longer. We’re desperately trying to hold onto one thought before getting sucked into a multiverse of possibilities. These days, I’m not a passive observer, though. I’m aiming for perseverance rather than consistency. This means that I expect my attention to falter and can gently route it back on task. I trick myself into getting started on things I don’t want to do. Baby steps and overestimating how long things take me to finish have helped me develop a sense of my cognitive rhythms and adapt to how they fluctuate during the week. On poor focus days, I can do small tasks that will set me up for success when I have a more sustained focus. Planning, time estimation exercises, and Eisenhower matrices are important foundational skills for Cognitive Behavioral Therapy targeting executive dysfunction in ADHD. Like an itchy wool sweater with extraneous tags, they’re so uncomfortable to learn and implement, but their consistent application can significantly improve our lives.

I know I didn’t write about being Latina, but like never applying diagnostic criteria for ADHD to myself because I felt like that was just my personality, I feel the same about being Dominican. It’s just who I am, and my bi-cultural upbringing allows me to be both participant and observer in both Dominican and American spaces. I do think that cultural stereotypes of Latin women and my compensatory behaviors masked many of my ADHD symptoms and made it harder for clinicians to identify, especially since I was the eldest and arguably the most competent person in the household growing up. This can be its own topic, though. And I have almost a whole year until the next Hispanic Heritage month to procrastinate writing about it.