I was diagnosed with Attention Deficit Disorder (ADD) at the age of seven. My level of impulsivity was extremely high. Lying about trivial things came naturally, and my academic behavior was objectively self-destructive. At the time, I presumed that my problem was simply one of cognitive divergence. I didn't feel like I had a disorder of mind or brain. Everyone else just seemed stuck up.
Many scientists and laypeople (though substantially more laypeople) claim that ADD might not exist at all (Timimi, 2004). Some believe that ADD is a condition manufactured by the pharmaceutical industry. To them, ADD is an idea propped up by frantic "helicopter parents" whose undisciplined kids are strung out on video games and sugar.
Exponents of this perspective point to the relatively low rate of diagnosis for the disorder outside the United States. As I have learned by studying neuroscience, this line of reasoning can apply to many psychiatric diagnoses (and unless one wants to jettison the entire concept of mental illness, one cannot single out any particular disorder as having these socially-constructed characteristics). My acceptance of ADD, though, was simple and personal: I felt different from other kids.
Like any kid, that argument did it for me: I loved thinking of myself as different. Maybe I was even better than the kids who ran circles around me in school. The problem, I asserted then, was a society that failed to recognize the promise of people like me. It took an adult education in neuropsychology to see this idea as hugely problematic, and plainly wrong.
The strain I felt of trying to wrest cognitive control towards externally assigned tasks sent me into a panic. I would sit at my desk, oppressively gray and green Algebra 1 textbook in hand, and write out math problems onto a sheet of paper. Every three or four digits, my hand would go weak. I thought: I don't want to do this. Someone else is making me do this. What's the point? There is no point.
My mind wandered until all the anxiety and anger dissipated. When I checked the clock again, three hours had passed and I had accomplished nothing.
I sought out psychotropic medication.
The way that Adderall (Dextroamphetamine) works is relatively simple from a pharmacological standpoint. It is virtually identical to "speed," or amphetamines (Madras, Miller & Fischman, 2005). It is speculated that in ADD, the pre-frontal circuitry associated with anticipation of reward—and the process that links rewards to replicable experiences (learning)—is in some way dysfunctional. The neurons in brain regions associated with immediate reward-experiences and novelty-seeking communicate with, and activate each other by secreting the monoamine neurotransmitter called dopamine. Dopamine is broadly associated with the sensation of reward. Such signaling occurs all day long in these areas, but increases considerably when a reward is present. When the reward is removed, dopamine signaling decreases via a process called the dopamine pump. Adderall reverses this process, causing the dopamine pump to discharge this neurotransmitter into the space between cells. This action continues the reinforced chemical activity associated with reward even after that reward has been withdrawn.
The new but indiscriminate focus Adderall gave me felt odd; like my old brain had been forcibly replaced. My personality changed. I became fixated on things I'd never cared about before. I lost my sense of humor. I began to see the world in a dour, engineer's light. For the first time in my life, I could focus on math. But who was I?
If by altering my brain's dopamine signaling activity I could change the way I think, was my personhood and sense of reality nothing more than an ongoing chemical reaction? The interaction between chemistry and behavior betrayed the notion that my behavior was internally and organically produced. It was an introductory puzzle in neuropsychology.
If consciousness operated the way I understood it, then it should be inviolate: no chemical activity should be able to fundamentally alter it without changing it into something else entirely. My understanding of how chemistry interacts with physiology in order to modify executive functioning and behavior has progressed from my initial considerations. But I am still haunted (and driven) by the philosophical questions that emerged from my early experiences with the medication.
My old friends lost interest in me, and I wasn't making any new ones. I grew irritable and paranoid, ruminating on innocuous glances that I interpreted as staring, stalking or worse. I had to stop taking Adderall, lest I become completely reshaped by it.
Most of us liberal-artsy types have read enough Plato to suspect that there's something we miss in our day-to-day lives, if not an outright metaphysic. Most of the people I talk to about the relationship between our sense of reality, and sensory or cognitive experience, are familiar enough with Nietzsche and Foucault to accept the proposition that there is no single objective experience. Some propose that reality is defined by interpretation and discourse.
For me, though, these abstract approaches don't cut it. They lack the biological aspect of the question. I want to understand, or at least pursue, the question of how people construct their realities on a physiological level.
The two years I've spent working on my Master's degree in Psychology (with a focus in Neuropsychology) have been in many ways a response to the questions that emerged from my experience with Attention Deficit Disorder and psycho-stimulant medication. I think that this field of study is investigating the most critical level of what it means to be a human. There are, unfortunately, no easy answers or grand unifying theories of mind to be found. For now—based on coursework, research and personal experience—I believe that agency is an illusion, and that self-hood is the interaction between physiology and environment. Nonetheless, I intend to make it my life's work to answer questions about how the physical and chemical structures of our brains interact with our environment in order to produce behavior.
Adderall produced euphoria and a sense of intense concentration.
My parents avoided giving me powerful psychiatric drugs at such an early age; but performance issues had me taking Adderall of my own volition by age 15. Adderall produced euphoria and a sense of intense concentration. It was only after a year or so of taking the drug, and having the potency of its effects diminish, that I realized: These psycho-stimulants had altered something essential about me.Many scientists and laypeople (though substantially more laypeople) claim that ADD might not exist at all (Timimi, 2004). Some believe that ADD is a condition manufactured by the pharmaceutical industry. To them, ADD is an idea propped up by frantic "helicopter parents" whose undisciplined kids are strung out on video games and sugar.
Exponents of this perspective point to the relatively low rate of diagnosis for the disorder outside the United States. As I have learned by studying neuroscience, this line of reasoning can apply to many psychiatric diagnoses (and unless one wants to jettison the entire concept of mental illness, one cannot single out any particular disorder as having these socially-constructed characteristics). My acceptance of ADD, though, was simple and personal: I felt different from other kids.
We ran like caveman Rambos, blazing through field and forest high on dopamine.
One element of the ADD debate was critical to the development of my professional interest in a personal condition. Early on, I heard some evolutionary psychologists promote the idea that people with ADD were not “disordered” or pathological. Rather, sufferers might exhibit an evolutionary adaptation (Hartmann, 1997). This theory posited that, unlike the main herd of humans, we select few with ADD evolved a brain structure more conducive to high-stakes, split-second decision making. While the “normals” of a tribe sat around planting maize for next season, we ran like caveman Rambos, blazing through field and forest high on dopamine.Like any kid, that argument did it for me: I loved thinking of myself as different. Maybe I was even better than the kids who ran circles around me in school. The problem, I asserted then, was a society that failed to recognize the promise of people like me. It took an adult education in neuropsychology to see this idea as hugely problematic, and plainly wrong.
The truth of the matter was that I was unable to sufficiently regulate my attention.
When I reached high school, the pressures attendant to hyper-competitive college preparation made me realize that my nifty difference was in fact an impairment. I'd always assumed I was a smart kid who just did poorly on tests because I didn't care about them. The truth of the matter was that I was unable to sufficiently regulate my attention in order to get the grades I needed. It was not a matter of effort.The strain I felt of trying to wrest cognitive control towards externally assigned tasks sent me into a panic. I would sit at my desk, oppressively gray and green Algebra 1 textbook in hand, and write out math problems onto a sheet of paper. Every three or four digits, my hand would go weak. I thought: I don't want to do this. Someone else is making me do this. What's the point? There is no point.
My mind wandered until all the anxiety and anger dissipated. When I checked the clock again, three hours had passed and I had accomplished nothing.
I sought out psychotropic medication.
The way that Adderall (Dextroamphetamine) works is relatively simple from a pharmacological standpoint. It is virtually identical to "speed," or amphetamines (Madras, Miller & Fischman, 2005). It is speculated that in ADD, the pre-frontal circuitry associated with anticipation of reward—and the process that links rewards to replicable experiences (learning)—is in some way dysfunctional. The neurons in brain regions associated with immediate reward-experiences and novelty-seeking communicate with, and activate each other by secreting the monoamine neurotransmitter called dopamine. Dopamine is broadly associated with the sensation of reward. Such signaling occurs all day long in these areas, but increases considerably when a reward is present. When the reward is removed, dopamine signaling decreases via a process called the dopamine pump. Adderall reverses this process, causing the dopamine pump to discharge this neurotransmitter into the space between cells. This action continues the reinforced chemical activity associated with reward even after that reward has been withdrawn.
The new but indiscriminate focus Adderall gave me felt odd; like my old brain had been forcibly replaced. My personality changed. I became fixated on things I'd never cared about before. I lost my sense of humor. I began to see the world in a dour, engineer's light. For the first time in my life, I could focus on math. But who was I?
For the first time in my life,
I could focus on math. But who was I?
As a child, I had always felt a directing agent seated in my mind. I had no awareness of my brain’s physical or chemical state. So the later notion that a drug could somehow modify my ability to regulate attention—thus fundamentally altering this seat of agency—rattled me deeply. Adderall changed the way my mind prioritized information and objectives—processes that, in the past, I had attributed to an independent or irreducible “me.” I could focus on math. But who was I?
If by altering my brain's dopamine signaling activity I could change the way I think, was my personhood and sense of reality nothing more than an ongoing chemical reaction? The interaction between chemistry and behavior betrayed the notion that my behavior was internally and organically produced. It was an introductory puzzle in neuropsychology.
If consciousness operated the way I understood it, then it should be inviolate: no chemical activity should be able to fundamentally alter it without changing it into something else entirely. My understanding of how chemistry interacts with physiology in order to modify executive functioning and behavior has progressed from my initial considerations. But I am still haunted (and driven) by the philosophical questions that emerged from my early experiences with the medication.
I am still haunted (and driven) by the philosophical questions that emerged from my early experiences with the medication.
The long-term result of all the pharmacological activity described above is that my neurons, having frenetically pumped dopamine into my synapses, ran out of said dopamine. After years of taking Adderall, the cumulative effect (Breggin, 1999) emerged: I became humorless and robotic. Once the class clown, I became stilted, professorial and anti-social. When I tried out for my junior year high school play, I remember feeling like an unspeakable fraud. I couldn't work up any feeling inside myself to match the lines I'd been handed to read.My old friends lost interest in me, and I wasn't making any new ones. I grew irritable and paranoid, ruminating on innocuous glances that I interpreted as staring, stalking or worse. I had to stop taking Adderall, lest I become completely reshaped by it.
I had to stop taking Adderall,
lest I become completely reshaped by it.
I ultimately took myself off of the drug without consulting my psychiatrist. I wanted myself back. Whether or not I actually succeeded is impossible to say. I changed immensely from my early adolescence to late teenager years. I’ll never know much of that was just growing up, and how much of that was the lasting neuroplastic effect of the drug.lest I become completely reshaped by it.
Most of us liberal-artsy types have read enough Plato to suspect that there's something we miss in our day-to-day lives, if not an outright metaphysic. Most of the people I talk to about the relationship between our sense of reality, and sensory or cognitive experience, are familiar enough with Nietzsche and Foucault to accept the proposition that there is no single objective experience. Some propose that reality is defined by interpretation and discourse.
For me, though, these abstract approaches don't cut it. They lack the biological aspect of the question. I want to understand, or at least pursue, the question of how people construct their realities on a physiological level.
The two years I've spent working on my Master's degree in Psychology (with a focus in Neuropsychology) have been in many ways a response to the questions that emerged from my experience with Attention Deficit Disorder and psycho-stimulant medication. I think that this field of study is investigating the most critical level of what it means to be a human. There are, unfortunately, no easy answers or grand unifying theories of mind to be found. For now—based on coursework, research and personal experience—I believe that agency is an illusion, and that self-hood is the interaction between physiology and environment. Nonetheless, I intend to make it my life's work to answer questions about how the physical and chemical structures of our brains interact with our environment in order to produce behavior.