People tell me I’m ‘one of the smartest’. Do I need drugs to overcome my chaos?

“Will you take the drugs?” This is the question on everyone’s lips upon learning of my ADHD diagnosis.

I’ve always considered medication a last resort remedy for mental health and there’s a lot of noise about ADHD diagnoses right now.

The number of Australians prescribed ADHD medication exploded from 186,000 to 414,000 between 2018 and 2022. Some say it remains underdiagnosed, particularly among women. News this week, that GPs in NSW will be able to diagnose the condition and prescribe medication, is viewed by many as a breakthrough that will help more people find the treatment they need.

Others say ADHD is being overdiagnosed, particularly due to people rushing into self-diagnosis and shopping for a psychiatrist who will dole out the meds and this latest step will exacerbate the situation.

My mind is a traffic jam of thoughts and ideas. Credit: Matt Davidson

My own diagnosis in Victoria took about six months, via a psychiatrist. The wait can be extensive in the public system so those who can afford the exorbitant gap fees end up seeing a private practitioner. Some children are waiting up to 18 months for diagnosis and treatment.

Many around me questioned the value of my diagnosis.

“Good lord,” messaged an old friend. “I applaud the therapy … but you are one of the most well-adjusted and smartest of any cohort.”

I suppose I’ve done OK, but a nagging sense of unfulfilled potential lingers into my 40s. I know such thoughts are unconstructive, but there’s a kernel of truth. Life has long seemed harder than it should be, yet I could never quite figure out why. When I read up about ADHD, I guess you could say it resonated.

My mind is a traffic jam of thoughts and ideas. Motivating myself out of bed is a daily battle. Most of the time I’m floundering in a tide of self-inflicted chaos.

I struggle to pay bills on time, save money, and ensure I have clean clothes to wear on Monday. I rarely leave home without returning at least twice to retrieve forgotten items, and I’ve burned thousands of dollars on lost valuables and penalties for unpaid fines. I forget people’s names within seconds of them being introduced.

I’d long believed laziness to be the cause and more effort the cure. Decades of frustration and internalised rage have contributed to low self-esteem, masked by bravado and self-deprecation.

At the heart of ADHD lies dopamine, a neurotransmitter affecting mood, motivation and attention. It regulates thoughts, emotions and behaviours, and helps us plan and organise, among other things. ADHD is attributed to dopamine dysregulation, but other neurotransmitters are also involved. An ADHD diagnosis requires evidence of inattention or hyperactivity during childhood. It was all hidden in plain sight among my old school reports.

My prep teacher said I was bright but “occasionally lazy” and tended to daydream. Being “easily distracted” and inattentive were common refrains throughout primary school, but things started to get wild in secondary school.

My year 8 textiles teacher complained of me gleefully sabotaging others’ sewing machines. The metalwork teacher called me a “safety risk” to myself and my classmates. My English teacher called me “relentlessly incorrigible”. I recall a food fight in home economics being a highlight.

I excelled at tasks I found interesting or easy, but I was otherwise bored and ravenous for stimuli, so created my own. Reading those reports brings me tears of laughter, but also a sense of sadness at being misunderstood. I don’t blame anyone. Knowledge of neurodivergence has come a long way since then.

Fuelled by fear, in year 12 I applied myself sufficiently to scrape into law school (a score of 90 was enough back then). The dean wrote to congratulate me on my first semester contract law exam, but the sheer effort needed to study left me burnt out. I remained mired in mediocrity for the remainder of my course, graduating a year or more after most of my peers.

What’s puzzling is that I can sometimes work intensively through the night without so much as a drop of caffeine. I’ve learned this is called hyperfocus – a tendency among ADHDers to fixate or become immersed in what they find interesting. I love that state, but the sleep deprivation inevitably catches up.

There are also different flavours of ADHD. Some find it debilitating. Others manage to mask the symptoms and compensate, but the effort can be exhausting. Anxiety and depression are common companions, and I’m acquainted with both. Twenty-five years’ worth of intermittent therapy has brought me mixed results. Some psychologists helped me through difficult times, but none proposed ADHD as a possibility.

Caffeine, nicotine, alcohol and recreational drugs all cause dopamine surges, and substance abuse is two-to-three times more common among those with ADHD. One former therapist suggested I get a girlfriend as a remedy for the binge-drinking problem I had at the time.

There’s a spectrum of opinion about ADHD’s causes. Some say distractibility and impulsivity are evolutionary adaptations that were useful in hunter-gatherer societies. Others blame unresolved childhood trauma and criticise mainstream psychiatry for reducing ADHD to genetics and brain chemistry.

What do I think? The human brain may well be the most complex object in the known universe, and everyone’s is different – whether due to nature, nurture, or both. There’s always more to know and perspectives will no doubt change as knowledge deepens. But all that really matters right now is whether diagnosis and treatment improve my life.

Some influencers peddle a dopamine detox as an alternative to medication. Fasting from activities like social media, YouTube, coffee and sex can help address dopamine dysregulation, they reckon.

We could all benefit from curbing technology from hijacking our attention, but the dopamine detox has virtually no scientific basis. By contrast, ADHD has proven highly responsive to stimulants like Ritalin, which have been around since the 1950s.

My psychiatrist agrees ADHD is overdiagnosed, which makes me inclined to trust their advice. So yeah, I’m taking the medication, but the treatment is 50 per cent pills and 50 per cent skills. Luckily, I can (only just) afford some ADHD coaching on top of the eye-watering out-of-pocket costs of the cardiovascular assessments, psychiatrist consultations and medication required.

It’s early days, but I’m more productive, derive more pleasure from work, and the tide of chaos is slowly receding. But most importantly, my diagnosis has opened a door to self-forgiveness.

Gary Newman is the director and producer of How to Capture a Prime Minister. He was previously a policy advisor and journalist.

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