He is just lazy

Ever since I was a little kid, I noticed I acted a bit different from other kids. For a long time, I didn't know it was a specific cognitive condition with a name. In elementary school, my classmates often saw me as disorganized, spacey, forgetful, or just plain dumb – and that's what they called me at times.  Teachers with good intentions often saw me as talented and smart, but inattentive. They'd often say to my parents things like, "If only he could pay a little more attention!"  The assessment that I was capable but lazy followed me throughout my school years. My parents often repeated it at home to encourage me to work harder. My dad often said my actions had low "efficiency," meaning I put in a lot of effort but got very little done. I wanted to get good grades, but I just couldn't stick with a working learning routine for any length of time.

Constantly doing poorly in school really hurt my confidence and self-esteem, which just made things worse. At the end of every school year, I'd promise myself I'd pay more attention next year, do all my homework, and stop skipping school. I'd be motivated for a few weeks, but then I'd fall back into old habits by the end of the first month. Some invisible nefarious force held me firmly in its grip and all attempts at gaing self-control appeared to be destined to fail. It drove me to exasperation.

I stood out to teachers because I was always losing or forgetting things at home. Once, I even forgot my backpack with all my stuff in it – notebooks, textbooks, pens, everything! The teachers were dismayed, and my classmates thought it was hilarious. The P. E. teacher always smirked when she saw me because I almost never brought my P. E. clothes, let alone sneakers. When I did remember to bring everything I needed, she almost looked shocked, like she couldn't believe it. Well, even a broken clock is right twice a day.  On the days I actually finished my assignments, teachers would say, "You do very well when you just stay focused!". But the good feeling from that praise never lasted long enough to keep me committed, and I'd always slip back. I wished I knew how to become focused whenever I wanted. It sounded like a superpower in my ears: one I would propably never have. 

In elementary school, being different really affected my grades and how I got along with other kids. Because it was so hard to make friends, I withdrew and became a loner. In fourth grade, I almost had to repeat the year because I haven't finished a single home assignment for my English classes, but my parents stepped in and prevented the disaster.  Not being able to bring myself to do the homework in subjects I disliked undermined my school performance all the way till graduation.

I was really struggling to keep up in school, but instead of recognizing I might have a learning disability, my teachers just thought I was lazy and didn't care. It was kind of embarrassing, but in fifth or sixth grade, a classmate questioned if I should even be in the same class as them. Back then, I was kind of a space cadet. I was shy, anxious, and quiet.  Since I was always forgetting things and spacing out, other kids would tease me. They thought I was a loser because I was in my own little world and clueless about what everyone else was doing. I was always on the outside looking in. Kids didn't include me in their games or conversations. In gym class, I was always the last one picked for teams. I was more of an observer, watching other kids mess around in class, but I never caused any trouble myself. I spent a lot of time daydreaming and doodling in my notebooks. I was always happy when classes were canceled. At home, I'd get lost in my own world playing with Legos or watching cartoons like Samurai Jack and Courage the Cowardly Dog. I could spend hours completely absorbed in those things.

By eleventh grade (senior year), things had gotten so bad that I had to switch schools.  I was clashing with some teachers, I was sick of being a loner, and to top it off, the girl I had a huge crush on wouldn't give me the time of day. It all just became too much, and I had a meltdown. I flat-out refused to go back, so my mom had to scramble to find me a new school.

In my last two years of high school, I got really into history, literature, and foreign languages. I started participating more and actually doing my homework, so my grades improved a lot. But I wasn't a very good student. My approach to learning was pretty chaotic. I'd often get caught up studying things we weren't even covering in class, which meant I'd sometimes show up unprepared even for my favourite classes. I read a ton but still struggled to finish the assigned reading on time.

My teachers liked that I was so interested in those subjects, but they also pointed out that I wasn't very focused or efficient.  Math and science were still a lost cause for me – I didn't do any of the work.  The teachers didn't seem to mind, though. They mostly paid attention to the students who were actually trying. I just sat quietly in the back and basically flew under the radar for those two years.

The Ukrainian school system is very different from Germany's.  They don't have separate schools for different academic levels, so everyone ends up in the same classes, regardless of how they're doing.  Basically, they just pass you along whether you're learning or not.  And if you struggle, they don't think it's something that needs to be addressed, like a learning disability or something. They just blame it on you, your parents, or say you're not smart enough.  My parents believed that, too, so nobody thought I could need some help.

5 years later

At the start of the COVID-19 pandemic, things got a bit easier for me. We had shorter work hours, online classes, and I decided to change universities. This meant less work overall, giving me more free time. With less pressure, my ADHD symptoms actually became less of a problem. I felt my confidence level rising and decided to take on a new commitment and signed an Erasmus traineeship agreement. Working in France at a tourist office turned out to be a nightmare. I couldn't seem to get it together, even after two months on the job. I messed up constantly, which really ticked off my coworkers and bosses. They got especially annoyed when I had to explain for the tenth time that I'd just spaced on something or missed a detail Understandably they were tired of my constant excuses. It felt like I was repeating the same mistakes and having the same conversations again and again. This caused a lot of friction with my coworkers, and they started to lose trust in me. They saw my mistakes as carelessness and irresponsibility, which really got to me. I felt depressed, exhausted, and trapped in a vicious cycle I couldn't escape. It was clear that this wasn't just about the job itself – something else was going on. I realized I needed to seek professional help.

In late August of 2020, I finally decided to do some research. After reading a ton of articles and personal stories about ADHD, I started to think I might actually have it, even though I wasn't hyperactive like some folks with this condition.  It wasn't just a random thought, either.  I'd felt this way for years, and the same problems kept popping up in every job I had – seven different jobs in different countries and fields.  Everyone kept saying the same things about me – my coworkers, bosses, friends, and family. Plus, I had my own journal entries and notes about how I was struggling. It all pointed to ADHD, and I knew I needed to get help.

I couldn't just shut work off when it was time to go home.  My mind would race, obsessing over every little detail – did I turn off the computer? Was the cash right? Did I put everything back in its place?  It was exhausting. Those worries followed me home and at times even determined the contents of my dreams. 

Fast-forward to February 2021

Whether it can be attributed to the "magical" effect of the medication, or the resolution of old behavior patterns through better living conditions, I appeared to be satisfied with myself. The formerly shy and frightened child seemed to be gone. The self-confident and assertive adult was about to take his place.

One day I was absolutely sluggish, powerless and almost unable to work due to fatigue: At noon I fell asleep and only woke up again after an hour and a half. However, at 8 p.m. I was once again overcome with sleepiness and could not stay awake for long. The medication has reduced the need for sleep in the short term. But now the body demanded a well-deserved balance. The initial enthusiasm started to dissipate and the expectation of a true miracle appeared increasingly childish. I had to take responsibility for my own life and internilize the insight that the medication could not make good decisions for me, as it is only supposed to provide foundation for it by restoring a chemical balance in my brain.

I considered going into behavioral therapy. The idea that I could do without it was firmly anchored in me since I saw myself as a self-reliant individual and it took a while to shake my conviction: The psychotherapy was neither helpful nor appropriate, I thought.  The medication seemed to be having the desired effect and I had been feeling quite well mentally over the past two months.

In the weeks and months after I started taking dextroamphetamine, however, it dawned on me that things were not going at all as they should. Not least, it was my forgetfulness and lack of planning in relation to the ongoing module registration phase at the time. Without a doubt, I have become more efficient, productive and committed on dextroamphetamine, but I still lacked   perspective and structure in many areas of life, even though I invested a huge amount of time and energy in creating new checklists, daily schedules and other stuff. Now I think that I doubted the usefulness of going to psychotherapy out of sheer arrogance and complacency.

After two months, my life was admittedly no longer a nightmarish half-sleep, but I had by no means mutated into an efficient and rational cyborg either, but just remained me with slightly better cognition and a better mood, which no longer fluctuated as wildly as it used to.

I had to learn to cultivate a healthy approach to my deficits. I was finally able to say goodbye to the thought that I was mentally underdeveloped, because some cognitive deficits were significantly alleviated by taking dextroamphetamine. I have never been so confident that my life could be a success and that I was solely responsible for it.

In early February 2021, I finally got a new appointment with a different psychiatrist. He actually had experience with ADHD patients and really listened to me. I made sure to clearly describe my symptoms, focusing on how they were affecting my life. After my last bad experience with a psychiatrist, I was desperate and really hoped he could help.

When he finally said I had ADHD and started talking about medication, I was ecstatic. I had to bite my tongue to keep from grinning. I felt saved.  At that moment, all my worries vanished. It was like that one conversation, that life-changing prescription, had cured me forever.

Was I getting ahead of myself?

I was about to start a new chapter in my life, because I was going to start taking dextroamphetamine – the miracle drug that was supposed to make my symptoms better. I had to take the 30 mg capsules (which I later increased to a whopping 70 mg) by mouth, and they were supposed to start working in my brain 2 hours later. Full of hope and curiosity, I swallowed a capsule and washed it down with water.

Was I a different person two hours later?

Honestly, I didn't suddenly become Elon Musk or Albert Einstein. It was hard to tell if anything had really changed or improved, because there's usually a pretty strong placebo effect at first. I felt amazing since the night before, but that was mostly because I'd finally gotten the diagnosis I'd been waiting for. When the meds wore off, it was like my ADHD went into overdrive.  I was messing up at work, even had a little bike accident because I wasn't paying attention.  Classic ADHD stuff. But hey, I wasn't discouraged. This was just the first step. I had a diagnosis, I had medication, and I knew behavioral therapy and maybe a higher dose were next.

Side effects

I haven't experienced any significant side effects, but there are a few minor things that are worth mentioning. 

Lack of appetite

I don't feel hungry until lunchtime, so I have to force myself to eat enough during the day. In my first year on dextroamphetamine, I lost 15 pounds. Luckily, I've managed to gain 22 pounds in the years since by lifting weights and using supplements like whey protein and maltodextrin.

While this might sound awesome to anyone who wants to lose weight, it's not ideal for me. I've always been skinny and had trouble gaining weight, so getting enough calories while on medication can feel like a chore sometimes. 

Losing your appetite can take the joy out of eating. It becomes this mechanical process of just refueling your body. That's probably a nightmare for any foodie, but I can cope with it.

Difficulty falling asleep 

If I take dextroamphetamine too late in the day or with other stimulants like caffeine, it messes with my sleep.  I try to avoid taking it after noon if I want to fall asleep before midnight. Even then, I sometimes have trouble sleeping and have to lower my dose to get back to my normal 7.5 hours of sleep.

I sometimes drink caffeine in the afternoon, but I try to cut myself off after 3 pm because I've found it negatively affects my sleep.

Impatience 

When I'm on dextroamphetamine, I feel this urge to be productive, to get things done.  If I can't, I get impatient really quickly.

Waiting in line is a psychological torture – and it wasn't exactly a picnic before medication either.  Thank goodness for audiobooks; they keep my mind occupied and make waiting bearable.

What happens if I don't take it on any particular day? 

I'm tired and have zero motivation to do anything that requires some mental or physical effort. I get worn out easily and basically become the embodiment of laziness. I crave instant gratification and have a hard time resisting temptation.  Overall, I feel like a lesser version of myself, but not necessarily sick. Besides feeling tired, my body seems to be working fine. I'd probably take a day off the medication more often, but I'm worried I'd just waste time and end up doing unhealthy things to feel good.  This fatigue is a real pain, especially when I'm trying to be productive. It undermines my discipline and motivation, and it becomes hard to stay focused on things that matter to me.

Conclusion

ADHD medication is a helpful tool in my everyday life, but it's not a magic bullet. It works best when I have clear goals and a realistic understanding of my own strengths and weaknesses. It can help me achieve my goals if they're actually attainable, but it can also make me delusional and lead to wasted time and effort if I'm not careful.  It's important to remember that medication doesn't give me any new skills, even if it feels that way sometimes. I don't become smarter, more creative, or stronger. But it does help me use my intelligence, creativity, and strength to my full potential.

Before I started taking lisdexamfetamine, life was a struggle full of setbacks and disappointments. Every day was a battle with my own mind, sometimes pushing me to be reckless, and sometimes draining me of all my energy and leaving me feeling like a wreck. My energy levels were all over the place, and I couldn't rely on myself because I never knew how I was going to feel. If my brain decided it wasn't "in the mood," I'd drop everything and do whatever mindless thing popped into my head, hoping for a quick dopamine hit. I had no concept of delayed gratification.

Right after I started taking the medication, I went through an "I'm unstoppable" phase where I thought I could do all the things I used to avoid.  My list of projects quickly grew out of control, and I lost track. I told myself I could learn two foreign languages at the same time, finish school a year early, then get degrees in computer science and business administration, then start a company and become successful, rich, and sexy. I thought I could achieve all my wildest dreams because nothing could hold me back anymore.  I was so eager that I didn't bother making a plan or realistically assessing my resources and abilities.

It probably won't surprise you that nothing turned out the way I'd hoped. I crashed and burned, realizing I'd exhausted myself without achieving a single goal. I had completely overestimated myself.

During tough times over the past few years, the medication has helped me stay hopeful, even when things seemed really bad. At first, I mistakenly thought it would also help me control my impulses.  Unfortunately, that wasn't the case, and I had to work even harder to manage my behavior. I had to accept that lisdexamfetamine wasn't enough on its own, and I needed psychotherapy. But I knew I would be okay because I was strong.