Pharma and ADHD

Please don’t think that I am utterly opposed to medications which help people function in the face of emotional problems. What concerns me is the over-prescription and the lack of attention to ways of improving the underlying issues that keep people from having a satisfactory life.

I recently referred a client to the county mental health facility. When she called, the ONLY service she was offered was prescriptions for medication. There was no psychotherapy or counseling available. They suggested that she go to one of the non-profit counseling programs which are overbooked and where the “sliding scale” doesn’t slide down to a level low enough for people who are really poor. But they didn’t really encourage even that. They simply recommended that she take the meds they were offering.

Other friends deal with ADHD, and various other problems. The psychiatrist’s first choice and often only choice is a prescription. Not that medications might not help, but counseling/psychotherapy, at least in addition, can make a much greater difference in the life experiences of people.

This is a column by a woman who has made the real mental discoveries for herself. (She is not commenting about medication, but about the ways she is helping herself.) Psychotherapy doesn’t always require  professional. In fact the goal of an REBT/CBT therapist is always to teach the client to use the tools for herself. The same is true for some other modalities. Our job is to work ourselves out of a job.

Driven by ADHD? Context is Everything!


Have you ever noticed how your ADHD symptoms seem a lot worse in some situations than others?

Or that your symptoms were a lot worse at one point in your life than another? Say, for example, the time you cruised through high school on raw talent, but ended up flunking out of first year college because you had no study skills and your ADHD symptoms went into overdrive?

These are both because ADHD is a context-driven syndrome. Recently, I had an Aha! moment about that.


No cure

It’s not that I’m cured or anything, but I’m noticing my ADHD less and less (and no, that’s not because I’m distracted!)

Besides the obvious things I’m doing to keep my ADHD at bay (yoga, self-coaching, meds, etc.), I realized that if ADHD is a context-driven condition then somehow my context(s) must have changed, right?

Driving the context

With treatment, it feels as though instead of my ADHD being context-driven, I’m now driving the contexts. No wonder a line from Gone with the Wind has always appealed to me (clearing my throat, in my best Southern Belle accent):

Satisfying work lifeI’ve changed the context of my work life. In 2010, I vowed to devote myself to my writing. Lo and behold! I’ve got lots of (paying) writing projects; lots of opportunities, and most important, I’m happier and more productive than I’ve ever been (not that there isn’t room for improvement).

And – with the context change, so too have my ADHD symptoms lessened. Here’s an example of the “BEFORE.” Imagine ME as an executive secretary (a job I once held. For two weeks.)

You know, doing stuff like:

– Reading and analyzing incoming memos, mail, faxes, e-mail, and reports; prioritizing same

– Filing and retrieving corporate documents, records, reports

– Greeting visitors and deciding who should be given access to certain individuals

– Ordering supplies, maintaining records management systems, basic bookkeeping

– Maintaining submissive stance to domineering, verbally abusive male boss (this is not necessarily a part of ALL exec secretary positions, but it was a perk of mine)

ha ha ha ha ha ha ha ha ha…

It doesn’t take a huge leap of imagination to realize why THAT context didn’t work for me. My ADHD symptoms were on overdrive for the entire two weeks. TWO WHOLE WEEKS! Nightmare.

I’ve been at my new part-time job (which I like) for a record length of time (for me).

Stable home life

I’ve lived in my current residence longer than I’ve lived anywhere since moving out of my family home at 19. I’ve saved money, emotional angst and time from staying put. I’m not even bored (too busy working on stuff I love!)

Lasting friendships

My friendships went through an initial shuffle in the first few years after my diagnosis. Some friendships lasted, some have dropped away, and new friends have been made. I’ve been conscious to choose friends who know about my ADHD traits, and who love me anyway (and some, believe it or not, partly because of!)

Having chosen wisely (setting up a new context), my friends help me manage my traits; I’m relaxed with them, and therefore my ADHD behaviors are minimized.

A couple loose ends

There are two loose ends, and not surprisingly, they’re probably more fraught with emotional minefields than those contexts already mentioned. Family and romance.

“Hopefully I can postpone dealing with all-things-birds-and-beesy until I’m finished writing my book.” ~ Miss Zoë O’Hara

It’s not easy to change the context of family connections, and I’m still mulling over how to stay in touch with family members I’d like to stay connected with; and how to decide whom it would be better to avoid, given past negative reactions and treatment.

As for romance, well, I’ve sworn off it. I know, I know, avoidance is no way to cope (I can hear Dr. Ned Hallowell’s voice; this is exactly what he told me during one of our interviews).

Besides, spring has sprung and I’m not dead yet! I might not be a bird or a bee or a teenager but, heck, I’m a feisty, passionate ADHD woman… I’m not sure I can avoid this particular context forever.

But hopefully I can postpone dealing with all-things-birds-and-beesy at least until I’m finished writing my book. I have a rule: NO getting distracted by the boys until I’m finished writing! (I admit, I’m wary of testing out my new-found ADHD-minimizing superpowers in this, er, context.)



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