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What It's Like to Live With This Lesser-Known Symptom of ADHD

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I was 49 years old when I decided to see a psychiatrist who specializes in diagnosing and treating attention-deficit/hyperactivity disorder (ADHD).

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For as long as I could remember, I struggled with reading comprehension, often scanning material, and hoping to retain a few details. My mind often wandered during movies, resulting in rewatching films for which deep thought and focus were not necessary. During conversations, I often drifted away when I detected certain details were irrelevant, and I mastered the art of picking up the last sentence a person would say so that I could appear attuned by a head nod, or asking a related follow-up question. Most painful of all, whenever I tried to formulate thoughts for writing, I could feel them slamming into the wall of my brain, oftentimes never making their way into the world.

It has always been painful to try to present as smart, while privately feeling “stupid.” Sometimes the accompanying feelings of fraudulence were more troubling than the symptoms of the disorder itself, and as I’ve aged, I’ve detected the presence of new symptoms related to the way I hear the world.

After a two-hour evaluation during which I was bombarded with questions, and my wife was asked what it is like to live with me, the doctor said, “Considering how your brain works, it’s amazing how far you’ve gotten.” Where I had gotten was a Master’s degree in Social Work, and licensure that allows me to practice as a psychotherapist in private practice. If anyone reading this is wondering about the challenges and insecurities of being a psychotherapist with ADD (inattentive subtype), I can attest to the fact that there are many. Maybe most so is the fear that some clients will read this, and suspect I’ve never paid attention to them at all.

My doctor prescribed a common ADHD medication, but its stimulant effects triggered nausea-inducing anxiety. When I reported this to her, she suggested a different ADHD medication because it is not a stimulant. Unfortunately, that one did nothing, and rather than continue down the trial and error path of psychopharmaceuticals, I decided to live without medication, and instead work to maintain focus while being honest with others when I struggled. Sharing with people that I struggle to maintain focus reduces my shame, and helps me understand myself less as “stupid” and more as symptomatic.

What allows me to maintain a successful therapy practice is the quiet that exists in the space between me and my clients. Quiet is what makes living with ADD tolerable for me, but this particular preference has also rendered me misunderstood, and somewhat difficult to live with. To be clear, when I reference “quiet,” I am referring not to silence, but to as little noise traffic as possible. “Noise traffic” is what I label sounds I struggle to filter out so I can maintain focus where it needs to be.

My struggle to filter out noise traffic is part of how I experience sound sensitivity, a symptom of ADD I only discovered existed in recent years. Although I didn’t know what it was at the time, I can trace my first experiences of it back to 1988 when I felt a compulsion to punch a man in the midst of a coughing fit 20 yards away from me.  I categorize coughing, car horns, and other unpredictable auditory stimuli as intermittent explosive noise. When I experience them, I feel a jarring electric shock up my spine, followed by anger.

My reaction to explosive noises is not reserved for strangers, and I have gotten agitated with my wife when she coughs and sneezes. While my agitation often paints me as lacking sympathy, or being apathetic, I am neither, and I have shamed myself for not being more sympathetic when sympathy was needed. What makes this so hard to manage is the fact that these are emotional reactions to what feel like threats to me. There is no thought to them, and working on reducing these reactions means trying to slow myself down enough to realize no one is trying to make me feel uncomfortable.

Sound sensitivity manifests differently for me depending on the setting. At the last agency for which I was employed, I had to be open with colleagues about my struggle in staff meetings so that my tendency to “zone out” was not misconstrued as disinterest. When I heard only the voice of the speaker, I was able to focus, but once I detected the sidebar whispers that tend to occur in group settings, my focus was lost, and I heard a blend of indecipherable sounds. That was usually when my brain would shut off, and I drifted away. A sympathetic colleague agreed to “bring me back” with a wave, and fill me in on any information I missed during my time away. His sympathy reduced my embarrassment and helped me focus on managing only my symptoms as opposed to the combination of struggle and shame.

Being understood by the people closest to me is of paramount importance, even though I believe it could be challenging for them. I recently accompanied my wife to her hand surgery at a hospital with valet parking. When it was time to leave, I handed my ticket to a parking attendant as my wife began sharing the experience of having a benign tumor removed from her finger. As she provided details, the man who took my ticket began simultaneous conversations with another customer and the attendant that he asked to retrieve our vehicle.

In an instant, all I heard was an untuned violin mixed with fingernails on a chalkboard, accompanied by a jackhammer. Overwhelmed, I snapped at my wife to stop speaking because snapping at the people I know is easier than snapping at strangers. In that moment, I could not employ the “Cocktail Party Effect” necessary to focus on only her voice, and although I hoped she would accept my explanation for snapping, but she didn’t, and instead implored me to “find out what your neurologist is gonna do about it.” I was frustrated, and explained I held out little hope that my neurologist, who I see for cervicogenic headache, would do little more than refer me to another specialist, or suggest a medication I’ve already tried.

Navigating the shame or embarrassment connected to mental illness is arduous, but in my experience, the sharing is well worth the risk. People have expressed relief when I share my experiences because they might have experienced something similar for a long time, or they are experiencing some other mental health struggle about which they have not spoken openly. Other people have acknowledged what it means to them to understand me better.

I have also shared my experiences with clients who struggle with similar conditions, and they have benefitted from understanding that no one is immune to a mental health diagnosis. We are less alone than we think we are, and less dysfunctional than long-held stigma would lead us to believe. Revealing my struggle has been a risk well worth taking because allowing myself to be vulnerable has resulted in more emotional closeness and less likelihood that I will remain misunderstood.

Getty image by jossnatu

Originally published: December 15, 2022
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