Sensing I'm on to something, I read Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder From Childhood to Adulthood, by Dr. Edward Hallowell, and in it find my diagnosis.
As it happens, The Hallowell Center -- which offers diagnostic and treatment services for adults and children with ADD and its off-shoots -- opened an outpost on Manhattan's Upper West Side the year prior. So I call the office and ask for his next available appointment, feeling it kismet that I should be treated by the same doctor whose book brought me to this latest turn.
During the hour-long consult with Hallowell, I answer a battery of diagnostic questions, which we then discuss at relative length:
- Were you considered an underachiever in school? (Yes.)
- Given an unexpected chunk of free time, do you often find that you don't use it well or get depressed during it? (Yes.)
- Do you often find that you have an itch you cannot scratch, an appetite for something "more" and you're not sure what it is? (Yes.)
- If you have ever tried cocaine, do you find that it helped you focus and calmed you down, rather than making you high? (Yes.)
And so on.
I tell Hallowell about the cocaine, about how I'd never before had any interest in drugs, but that coke made me feel better, brighter; about how I feel lethargic and loopy from the passel of psychotropics cycling through my nervous system, and from the snuffed-out half-lives of the ones I've already quit. Like an old doorframe that has become over-tight from all its layers and layers of fresh paint, I am just not working right. Hallowell confirms the diagnosis and is the only practicing professional right-minded enough to defy the illogic of giving prescription speed to a past-tense coke user. "You should be on Adderall," he tells me. "And probably quite a lot."
Of course, no medication will rid a person of their ADD; as treatment, the chemical effects are corrective, not curative.
The pharmacodynamics of the drug are imprecise and largely speculative; the common thought is that the amphetamine stimulant works in the central nervous system to spark and speed up the release of neurotransmitters -- like dopamine and norepinephrine -- which, on its own, the ADD brain misdirects and manages inefficiently. With the neurotransmitters' circulation mediated in this way, such "executive" abilities as decision making, impulse control, and work/reward motivation -- all of which are typically ill-functioning in a brain with ADD -- will operate at optimal levels.
With my first dose comes the most trenchantly transformative feeling. Unlike cocaine, whose nasal dosing delivers a full-body chemical climax, Adderall's neural efficacy is localized, and its oral administration prevents the sudden surge of a cocaine "high."
Adderall comes in two distinct forms. The extended-release formula, Adderall XR, comes in a glossy cellulose capsule with a Tang-colored lip and a clear, colorless cup; within its plasticy shell are hundreds of amphetamine beads the color of Circus Peanuts candy. The beads comprise four types of amphetamine -- two sulfate salts and two dextro isomers -- which together and in this form allow the drug to be meted out through the bloodstream over a period of six to 10 hours. I swallow one 30 milligram extended-release pill each morning. Its effect is not particularly sensate, but it sustains me through the hours and days.
The second type of Adderall is an immediate-release amphetamine tablet. It is small and round like an eraser-head but flat as a nickel, with a bilateral score-line clear down its middle, and a taste sweet like Aspartame on my tongue. At 10 milligrams' strength, it is the color of melty blue cotton-candy. Three times daily, I swallow two of these pills, and within 15 minutes affect an almost-four-hour agency and efficiency to my workaday doings.
The medication grants me access to a chasm in my flip thinking, a narrow channel through which I may engage an idea or activity or project, see it through to completion, work without surcease. I make neat piles of all the books and magazines and loose paper clippings that have forever carpeted my life -- and I remember to read them. I scribble tiny notes on those sticky plastic tabs from the stationery store -- which I now buy in bulk -- and flock the pages with all my thoughts and ideas. I discover that writing -- which had only ever been a project of putting down enough words to fulfill the quota, something to do and be done with -- is something I can delight in and excel at, and I want to do it all the time.
Of course, no medication will rid a person of their ADD; as treatment, the chemical effects are corrective, not curative. And on the days I go without taking any, days when I'm sick or overtired or perhaps away on vacation to some slow-moving place, the soda goes flat. I may forget to remember things, leave my wet laundry in the washing machine overnight, lose scarves, trains of thought. But this happens less often. And everyone loses things, now and then.
What lasts, though, irrespective of the time elapsed since my last dose, is my revised self-perception. So much of my life was spent adrift, my every interest a fading thought, it's almost as if I'd been too distracted to recognize who I was or what I enjoyed. Since discovering that it wasn't just me -- or rather, that it is -- I've found the confidence and ambition I'd never before felt, the once missing parts of a person I'd not known myself capable of being. And because confidence tends to breed more confidence, I feel for the first time a sense of boundless potential.
In Driven to Distraction, Hallowell writes, "The syndrome is not one of attention deficit, but of attention inconsistency," and goes on to say that those with ADD are in fact able to hyperfocus at times. For me, figuring out what to hyperfocus on was the crucial part, and regulating my wandering mind was necessary for that to happen. Adderall, with all its illuminative abilities, didn't save me but provided the clarity I needed to find so much of myself. The pill collects my mind, makes it quiet and calm, a snowy radio retuned after losing its station.
Images: Wikimedia Commons.