ADHD 20 Years in the Making

Hey friend, pop a squat. Today, we're not deep-diving into ML architecture, nor are we dissecting the intricacies of a particularly gnarly distributed system. Nope. Today, we're talking about something far more personal, something that, frankly, still feels a bit weird to talk about: I was just diagnosed with ADHD.

Yeah, me. The guy who has often lost himself in code for 12 hours straight, prides himself on delivering perfection, and has spent ~20 years meticuluously planning out every detail of his life. Supposedly that guy has an attention problem (imagine a laugh of derision here).

It's a diagnosis that, in retrospect, has been about those same 20 years in the making, and because I'm a sucker for structure, I present to you its tale in four parts:

Act 1: Denial - Wherein I, young Patrick, scoff at the very notion of ADHD and firmly believe it's a made-up excuse for lazy people.
Act 2: Deterioration - Wherein adult Patrick starts to notice the carefully constructed Jenga tower of his life beginning to wobble.
Act 3: Epiphany - Wherein the universe (and a misplaced milk bottle) finally smacks me upside the head with a rather large wake-up call.
Act 4: Treatment - Wherein I tentatively dip my toes into the world of ADHD management and share my results.

So, buckle up. This will get a little weird, but hopefully, also illuminating for anyone out there who's ever felt like their brain might be a bit too excited for its own good.

Act 1: Denial – "ADHD? That's for Other People."

Growing up, I wasn't exactly the poster child for neurodiversity empathy. Okay, that's putting it mildly. I didn't hate kids with ADHD, but I definitely side-eyed the diagnosis. It felt like this convenient label some kids used to excuse disruptive behavior, snag extra time on tests, and generally make life harder for the rest of us. The irony, of course, is that my very thought – "everyone experiences that, you're just milking it!" – probably should have been my first clue. But, alas, the disdain was strong with this young padawan.

If the stigma I'd personally manufactured wasn't enough, my actual experience seemed to be the polar opposite of the symptoms I heard about. "Trouble focusing?" Puh-leeze. I'd get so laser-focused on a fascinating problem that popped into my head mid-conversation that the actual conversation might as well have been muted. "Need extra time for tests?" Ha! My MO was to treat tests like a speedrun to make them more interesting. Finish first, double-check if I felt like it (rarely), and then spend the remaining time planning out my next video game.

If "hyperfocus" and a "compulsive need for intellectual stimulation" had been the headline symptoms, maybe I'd have connected the dots sooner. But they weren't, so here we are.

Despite all this, I aced grade school. Looking back, the signs were there, subtle as a whisper I suppose, but I'd unknowingly built quite the arsenal of compensatory mechanisms:

Homework? What Homework? I almost never remembered if we had assignments. But, since I could usually knock them out in a few minutes once someone (usually a frantic classmate just before class) reminded me, teachers and parents never really knew. Crisis averted, mostly by sheer processing speed.
The Curse of Careless Mistakes: Tests were a battlefield of knowledge I usually conquered, marred only by a smattering of truly dumb errors. My scores were still great because, hey, if you know 99% of the material, a few "oops, skipped the instructions again" moments don't tank you. Yet.
Selective Classroom Engagement: You know that kid reading a fantasy novel under their desk or sketching out plans for a far future activity during a lecture? Yeah, that was me. Thankfully, I'd usually already learned the material elsewhere, so my high recall (for things I found interesting at least) kept my grades afloat.

College, surprisingly, was arguably better for this particular brand of brain. Penn threw down the gauntlet with challenging coursework, offering endless rabbit holes for my hyperfocus to dive into. The stakes for careless mistakes got higher, though. Competing against a cohort of incredibly bright (and presumably many non-ADHD?) Wharton students meant that every slip-up on a curved exam mattered a helluva lot more. My academic life became a strange paradox: the harder and more intellectually stimulating the class, the better my grade. True story: Class average a 91? I'd scrape by with a 93 and a B+. Class average a 42 (looking at you, STAT430)? I'd pull a 107 (extra credit, baby!) and an A+. Go figure.

After graduation, I curated my life like a bonsai tree, pruning away anything that didn't offer intellectual stimulation or opportunities for deep work. Software engineering was a godsend. We're talking about a culture that... Shuns meetings? Check. Idolizes uninterrupted "flow state"? Double check. Tends to toxically value overly complex solutions to even trivial problems? 🧑‍🍳😘 It was perfect.

Act 2: Deterioration – The Jenga Tower Wobbles

Despite my carefully orchestrated post-college life, a troubling pattern began to emerge: I couldn't seem to relax. Ever. Up to that point, the idea of "downtime" was pretty much an alien concept. Given my early life circumstances (a tale for another time, perhaps involving less self-diagnosis and more actual entrepreneurial angst), I was wired to constantly invest in my future. College wasn't for keg stands; it was for maxing out course loads, juggling four jobs, and sprinting towards that high-paying tech gig.

Once I got that job, any attempt to simply be was met with a low-grade restlessness I couldn't shake, no matter how many CBT techniques I threw at it. The allure of deep focus and continuous career investment was a powerful and easy enough antidote, so, why not lean in? I worked 100-hour weeks at a startup, my "free time" was crammed with open-source contributions, and every remaining second was spent meticulously planning out my next move. This strategy, while exhausting, worked pretty well... until I had kids that is.

Now, let me be clear: I adore my children. They are tiny, hilarious, brilliant chaos agents. But anyone who tells you the first year of parenthood is a hotbed of intellectually stimulating problems is either lying to you or has a very different definition of "intellectual stimulation." Challenging? Absolutely. Exhausting? You bet your sweet, tired ass. Rewarding? Beyond measure. But the stark reality is that vast swathes of your time, previously under your meticulous control, are suddenly commandeered by nap schedules, feeding frenzies, diaper blowouts, and toddler tantrums.

To give you a sense of the structure I had grown accustomed to at this point, each day of my week had an assigned meal at an assigned time at an assigned place. Wednesday at 1pm is an Italian sub from Potbelly, Fridays at 12:30 are Sesame Chicken at Pei Wei. Even my leisure time was structured. Every Friday is obviously movie night with In 'N Out for dinner. Saturday is a long run starting at 8am followed by Chick-Fil-A for lunch. It should come as no surprise that it's much harder to maintain such a predictable life once you thrown the tiny humans into the mix.

Slowly, things started to slip. An increasing number of responsibilities at home and work were falling through the cracks. I'd put laundry in the washer and forget to press "start." If a task wasn't recorded on that meticulously maintained master to-do list or blocked out on my calendar, its chances of being remembered plummeted to approximately 0%. I could still summon the hyperfocus for stimulating work, the world melting away as I dove into a complex problem. But those interstitial moments, the transitions between tasks, became a no-man's-land of swirling indecision and forgotten intentions.

Act 3: Epiphany – The Milk Bottle Buffoon

Now, you might be thinking, "Patrick, life gets harder with kids and more responsibility. That's just... life." And you wouldn't be wrong. That's exactly what I told myself too, and that alone wouldn't have been enough to make me reconsider my decades-long ADHD skepticism. It took a few more nudges from the universe, a confluence of events, and one particularly salient dairy-related incident.

First, there was the family factor. Over the last decade, a significant number of my extended family members – we're talking something like 25 out of 30 people – have been diagnosed with ADHD. I grew up surrounded by these wonderful people. Their experiences, their ways of thinking, their shared anecdotes – these things shaped my definition of "normal." If they were all getting this diagnosis, maybe my "normal" wasn't as universal as I'd assumed.

Then, there were the voices from my professional sphere. Several open-source developers I admire, folks whose work I had followed closely for years, began to publicly share their own journeys with ADHD: the initial denial, the dawning realization, and their eventual paths to diagnosis and treatment. Their stories resonated...a lot, uncomfortably so at times.

But the real catalyst? The moment the final Jenga block of denial toppled? T'was but a milk bottle. It was a Friday evening, and I had just put the kids to bed. "Alright, let's put this leftover milk back in the fridge. Don't forget this time. Don't forget this time. Don't forget this time." I had thought on my way down the stairs. Alas, dear reader, this was not meant to be. Despite there being approximately 6 steps left on my journey to the fridge from my last "Don't forget this time" mantra, I found myself thinking about the laundry instead, and so, for the fifth day in a row I found myself in a room other than the kitchen, holding that milk bottle, forgetting yet again to complete the task at hand whilst I was in the middle of doing it. I've come to learn that this is a routine daily experience for people with ADHD and a decidedly less common experience for people without ADHD, so much so that it's been studied and written about in textbooks. It's called "the cough drop sign".

"Someone left a cough drop on the dashboard of our car. The other day I saw the cough drop and thought, I’ll have to throw that away. When I arrived at my first stop, I forgot to take the cough drop to a trash can. When I got back into the car, I saw it and thought, I’ll throw it away at the gas station. The gas station came and went and I hadn’t thrown the cough drop away. Well, the whole day went like that, the cough drop still sitting on the dashboard. When I got home, I thought, I’ll take it inside with me and throw it out. In the time it took me to open the car door, I forgot about the cough drop. It was there to greet me when I got into the car the next morning, Jeff was with me. I looked at the cough drop and burst into tears. Jeff asked me why I was crying, and I told him it was because of the cough drop. He thought I was losing my mind. ‘But you don’t understand,’ I said, ‘my whole life is like that. I see something that I mean to do and then I don’t do it. It’s not only trivial things like the cough drop; it’s big things, too.’ That is why I cried.”

An excerpt from "Driven to Distraction," co-authored by Dr. John Ratey

It was in this moment, standing in the closet with a fistful of cold milk, that I finally had my own cough drop sign. Maybe, just maybe, the things I'd always dismissed as "everyone does that" were part of a larger pattern. A pattern that, for many people, had a name.

I still don't subscribe to the idea of ADHD as some magic binary label you either have or you don't. And I'm certainly not about making excuses. I'm still not even 100% convinced that the behaviors I exhibit are necessarily caused by a disorder. But what I do fully recognize is that there's a spectrum of cognitive function out there, and when a particular cluster of behaviors consistently starts to inhibit your ability to navigate daily life, to meet your responsibilities, and to generally not leave dairy products in your closet, well, it becomes useful to label that cluster and consider possible interventions. For me, for the sake of my family, and for my own sanity, it felt like I'd finally crossed a threshold where seeking an intervention might just make life a bit smoother for everyone involved.

Act 4: Treatment – Turning Down the Noise

So, armed with this newfound (and slightly reluctant) self-awareness, I sought a professional opinion. Diagnosis confirmed. I don't have much to say on the diagnosis process right now other than it definitely would have been juicy fodder for my former denial-filled self, so I'll save that for another blog post. For now, the next step was treatment.

My goal was to take the least invasive approach possible. I'm wary of anything that feels like a cognitive crutch, and, to be honest, I've noticed I get pretty easily addicted to experiences. The last thing I wanted was to trade my current set of problems for a dependency on stimulants. Plus, I'd managed to build a pretty successful life up to this point (if I do say so myself 😁), so I couldn't have needed that much help, right? I wasn't looking for a personality transplant, just a little help sanding down my roughest edges.

I started a non-stimulant medication a few weeks ago. And while I don't think the ultimate outcome of my work or life has been drastically different, the feeling of getting there, and the sheer amount of energy I need to expend, has dropped dramatically.

These are the three concrete changes I've noticed so far:

The "What Am I Doing?" Count: The number of times a day I'd literally stop, look around, and ask myself out loud, "What am I doing right now?" has plummeted from an estimated 20 (no, I'm not exaggerating) to pretty much zero.
Reduced Tab-Switching/Pacing/Wheel-Spinning: That unproductive void between tasks, where I'd aimlessly click through browser tabs, pace my office, or just stare blankly at my screen? That used to eat up probably 60 minutes a day, fragmented into a thousand tiny moments. Now? Maybe 5 minutes, if that.
The Red Light Compulsion: This one is oddly specific. Before, if I came to a red light and there was the ability to take a right turn to take a longer path to my destination, I'd feel an almost irresistible urge to take it, just to avoid the agony of waiting. Now? I just... wait. Like a normal person (I think? Normal people wait at red lights, right?). It's bizarrely bearable.

Perhaps the easiest way I can illustrate the effect of the medication is to share a glimpse of my internal monologue. Previously, at every single interruption during the day I used to go through a 5-10 minute loop of...

"Okay, what do I need to do? I need to write that design doc. But wait, what about that bug I need to investigate? And I cannot forget to message Jane about the presentation next week. Oh, shoot, I never texted Matt for his birthday last week, is it too late now?! Crap, where's my phone. OK here it is, wait, what are we going to get my son for his birthday next month? I absolutely, positively cannot forget that one. Must make a note. Where am I keeping my to-do list now? Evernote? No, they went crazy with subscription pricing, and I had to move. Ugh, subscriptions! I forgot to cancel Peacock again!

to...

"Dang, today's a busy day. Let's start by fixing this bug."

And then... I just start. The funniest part? If I do catch myself doing any of these things, it's now an almost foolproof indicator that I forgot to take my medication that morning. 🤦‍♂️

Overall, this journey, while long and initially paved with denial, has been an incredibly positive experience. I think my raw prioritization might be a bit less... aggressively optimized? But I spend so much less time attempting to prioritize (and re-prioritize, and re-re-prioritize) that I actually end up accomplishing more of the important stuff.

More than anything, I've found myself becoming a little more forgiving. More forgiving of my current self when I occasionally lose my train of thought between tasks. And, perhaps most importantly, a little more forgiving of my past self – the kid who made all those careless mistakes on tests, the young adult who constantly forgot homework, and the man who, for years, wondered why he just couldn't seem to relax.

It's still early days, but for the first time in a long time, the bouncing ball in my brain feels a little less frantic, and a lot more... manageable. And that, my friend, is a pretty good feeling which I cannot deny.

Disclaimer: I'm an engineer and a dad, not a medical professional. This is my personal experience. If any of this resonates with you, please talk to an actual doctor or mental health specialist. They're much better at this than I am!