For #ADHDAwarenessMonth, I’m sharing a piece of writing I did about two years ago on diagnoses, parents, and the social theory of disease.
There are so many words that imply that things are untrue, unreal, ephemeral, but the things they refer to are solid and undeniable. Take the idea “Societally constructed” for instance. It reeks of disdain. “This is only societally constructed.” we might say, “it has no natural existence, no biological basis.” But try going up against your society. Try stepping one toe out of line. Feel the weight come crashing down.
My disease is societally constructed. The truth is, the chemicals inside me, the balances of humors, the delicate interplays of lightning between cells, all that ticks away smoothly and surely. Instead, what is out of balance are the people around me, their hopes and fears for me, their hopes and fears OF me. I have known this from a young age, even when I parroted back ideas like “chemical imbalance”, even when I trustingly took pills from my father’s hand and swallowed them.
Psychiatric diagnoses are like first kisses, both a culmination and a beginning. Just as it’s hard to pinpoint that first moment when you want to kiss someone, find them desirable, hope they want you as well, so too it’s difficult to know precisely when you begin to suffer, when a fear becomes anxiety, when sadness deepens into depression. And just as first kisses are erotically and romantically tinged with everything that can come after, sex, a romance, a marriage, children, a life spent together, so diagnoses borrow gravitas and tragedy from all they imply: struggles with symptoms, treatment and its side effects, and of course, death. Even diagnoses that should by all rights be framed as “good news, it’s just X” come shaded with the near miss of “I’m so sorry, I’m afraid it’s Y.” We never forgive doctors their proximity to death, and they seem to bring it into every pronouncement they make.
My father is a doctor.
In second grade, my teacher took my scissors away. I couldn’t be trusted with them. I had a tendency to use them to snip at my sleeves. Then I would explore the holes I had made, unravelling my sweaters around me, endlessly fascinated by the patterns in the weft of the fabric as I pulled and pulled the loose strings I had created. I have often found this project of destruction cathartic and revealing. I learn best about something by taking it apart to the point where it no longer functions. But teachers aren’t there to make sure that you learn best, they are there to make sure that you conform to certain practices that are called an education, that you sit still, and absorb information dutifully and quietly. Teachers are there to discipline.
My mother is a teacher.
What was so frightening, about a small boy who chewed holes in his clothes, wrote dismal poems about God, and spent too much time by himself? The truth is, quite a lot. Children are unnerving, we do not like who we are in their eyes, how they reflect so much back. My father procrastinates, my mother worries. A child who daydreams is called “Inattentive” a child who grows agitated is called “Hyperactive.” Later on, he may be depressed or anxious or narcissistic.
I was diagnosed with Attention Deficit Disorder when I was 9, the year after they took my scissors away. It apparently doesn’t exist anymore. Only Attention Deficit Hyperactivity Disorder, and its three subdivisions: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined. Where do diagnoses go when they no longer exist? What becomes of us patients who are treated for Hysteria, Idiocy, Nervous Agitation, Attention Deficit Disorder (no Hyperactivity)? Some of us get new diagnoses, sure. I myself have been awarded Major Depressive Disorder and Generalized Anxiety Disorder. Sometimes multiple diagnoses present at the same time. That’s a rather contented but crowded feeling, like wearing one layer too many on a cold day. Sometimes you get stripped of your diagnoses when they give you a new one. That’s quite sad, like when your friend who lives next door moves away and a new kid your age moves into the house and your mom sets up a play-date with him. The house is more familiar than your new friend. You still feel depressed and anxious, but no, apparently you’re just fooling yourself and others, because what you’ve really got is a Personality Disorder.
I could teach you about ADHD. It would involve doctors with grandiose names like Melchior Adam Weikard, or Sir George Frederic Still. But I am not a teacher (like my mother) and the history of doctors (like my father) is not a history I’m interested in. Instead, I wonder about the boys. ADHD is diagnosed more in boys, about twice to three times as much as in girls. I wonder about these boys, these fidgeting boys, these daydreamy boys. Mooncalves and luftmenschen. And I wonder what happened to them before the ritalin, before the classroom aides, before the doctors were even consulted. Did the teachers take their scissors away? What about in a time before teachers? Were boys daydreaming as hunter-gatherers, as peasants and serfs, as mill and farm laborers? What happens to a boy who can’t take an education, if you don’t give him one? I worry about them, these long dead boys. What happened when they were caught with their minds wandering? Did they fail to see that saber-toothed tiger leap? Were they beaten for failing to notice that the local lord or priest was passing by? Did they get their fingers caught in the mill’s wheels and machinery? I fear that inattention at crucial moments decreased the survival chances of those with ADHD. We are being bred out of the species. Soon there will be none of us left.
Of course, that brings up the question of genetics, which in turn brings up fate and destiny. Then again, the mere fact of a psychiatric diagnosis and treatment brings up questions of brain chemistry and then that brings up free will. All this because of a few holes I cut in my sweaters! And a few twirled pencils. Doodles in the margin. Never finishing a thought. Long hours spent staring out windows when I should be, oh, I don’t know, doing math, quietly, in a chair? Or playing politely and not overly-robustly with the other children? There are any number of things a child should be doing, should be prepared for, should be educated for. We have so much we want to say to them, so much we want to teach. And they just want to stare out windows, or cut holes in their sweaters. Education is a process where our dreams of adulthood, which is to say, our regrets of what we were unprepared for and our hopes for the future, meet children. Regrets and hope and children. Put them all in one big building and you have a school.
But you put all those children together and you start to notice things. Or maybe it’s more that you don’t notice things. When you have 30 children in a room, after all, they start to blur together, tiny voices at half your height, running around. But what stands out? One child doesn’t sit when he’s told to sit. Doesn’t seem to even hear. You write to his parents, they say, he doesn’t pay attention when we say sit either. And after enough of this muttering between adults, it’s off to the doctor. And the doctor administers tests. Long tests. Standardized tests. Hard tests. The doctor analyzes information. Medicine is a process where ideas about Science meet the human body in distress. Science and distress and bodies. Put them all in one big building and one thing you’ll have is a hospital.
I have read Foucault. When you are skeptical of things like education, or psychiatry, inevitably someone gives you Foucault. Foucault makes it easy to grow philosophical, and cynical, about education, and easy to grow philosophical and cynical about medicine. If you can’t tell by now, I am skeptical of the projects of psychiatry and education, and their relationship. The school room becomes the hospital, or, in my case, the psychiatrist’s office, all too easily. But there’s a missing room from my story: The Jail cell. There are worse things to do with children’s bodies besides pump them full of odd drugs, and too many children in this country, usually black or brown children, have their inability to be educated-that is, disciplined-not medicalized, but criminalized. Put regrets and bodies and distress into a big building, and one thing you’ll have is a prison.
But skepticism aside, one still needs to learn, and one still needs to heal. And for all the Freudian analyses coupled to the Foucauldian ones, my father is not some sadistic mad doctor, sticking me with pins and filling me with pills, and my mother is not a harsh school marm humorlessly demanding I behave. They have only ever wanted me to learn and heal, which is to say, to grow up. It’s not fair to tear down the projects of education and medicine just because I like cutting holes in things.
ADHD makes growing up difficult, because fundamentally, it is an atrophied sense of time and consequence. The ADHD child has difficulty understanding the connection between an action and its result. The longer a result takes to make itself known, the more unfathomable its connection to the action for the ADHD child. This is why I never practiced my trombone, this is why I never joined a sport. I could not understand the correlation between a skill becoming less frustrating, less difficult, and the suffering through it being both. Suffering always felt like just suffering, never suffering towards a goal.
This profoundly impacted my sense of right and wrong. If suffering is not redemptive, does not repair or teach, then it is just cruel. And so I find myself opposing my parents’ disciplines, their disciplines that discipline, medicine and education, and the hospitals and schools and prisons that that disciplining entails. To force the body to sit when it would run, to drug it until it will sit, to jail it if it will not sit, this is abhorrent to me. And so is growing up.
Mental illness is many things, but surely it is also a discordance between what is socially agreed to be reality and what an individual experiences. I was told I was just growing up. To me, it was Kafkaesque torture. Classrooms full of activities I couldn’t see the point of. Being told to rely on skills I couldn’t master instantly, and so, couldn’t imagine ever mastering. My mind racing at some moments, and some moments, taking hours to simply gaze at a leaf, thinking nothing. In love with books and stories, I was powerless to make sense of my own narrative. I awoke every day in a body that was constantly getting older, having new needs and abilities, unsure of how I’d got there.
I have been on and off prescription grade stimulants since I was 9 years old. I have been in and out of therapy since I was 9, too. I have been in and out of school since I was 6. I am now 31. I do not know how dishes get clean, even when I wash them. I do not know how this essay got written, though I wrote it. There are thoughts I’m not allowed to go near, and one of them is the idea that my parents were complicit in my medicalization as an indirect way of addressing their own short-comings. I don’t know if I should or want to say that. For one thing, it might not be true. But for another, it is not as productive as saying, “Society medicalizes all Mad people because of the shortcomings of society.”