Before I learnt about ADHD as a psychiatrist, I would have never thought that I lived with it...
Dr Stephen Ilyas, BSc (Hons), MBBS, BDS, MRCPsych
I am a Consultant Psychiatrist working for Psychiatry UK. More importantly, I have ADHD.
I always knew I had struggled sometimes and at certain things. I spent a long time dwelling on this but never found answers. Perhaps this was part of the reason I was drawn to think about mental health problems. When I began my psychiatric training, I learnt about many aspects of mental health, from depression and anxiety to personality disorders and more. Although I could see myself in some of these conditions, they certainly did not fit my problems. I thought it was more just me, my character. Many things in life do not interest me, and many things that are important to other people are lost on me like I simply don’t care. This is something I find embarrassing as this is to admit that I sometimes see myself as a selfish person. I value my close family but still, my thoughts as more geared towards my own agenda.
When I was younger, I was always fascinated by the torn artist, the person that is driven toward a particular theme but neglecting other aspects of life. When I learnt more about mental health I thought about this more, and I held onto an instinct that everyone has some ability. I also explored notions of creativity in those with mental health struggles, and it led me to wonder if it could be that those individuals who have more minor forms of mental disorder could perhaps apply their take on the world and be able enough to work with these ideas and produce good art (in whatever form this might be). This of course is a massive generalisation (and perhaps psychiatrists are guilty of doing this, a bit like thinking about stereotypes and so categorizing people), but I like the idea.
Then came my exposure to ADHD, and these feelings and notions became much clearer in this new context. The ADHD temperament fitted well with this view. Driven by an interest but hopeless in other areas, some might ‘make it’ but many will not because of these failings. Given that ADHD is on a scale, there are many people who are much more severely affected and would resent hearing about those people with ADHD who have a drive in certain areas and can apply themselves with success. I know many people can feel bitter towards those who talk of their ‘ADHD superpowers’ as every aspect of their life is unmanageable, and they absolutely cannot see any positive side to their ADHD. That I can understand. Avoiding causing distress for those who struggle is important
Like many people I have met with ADHD, I have ideas in niche areas which for me is the visual world. I was always lost in looking at pictures, whereas reading took too much effort. Although I have developed some of my ideas into pictures, it took many years to really establish this. I would think about various notions, I might have done the odd painting, but I spent more time wasting my time in various pursuits with short-term gain. Although I might enjoy painting or drawing, it was too complex to engage in; it might lead to nothing. If it did not work out then what would I do?
Before I learned about ADHD as a psychiatrist, I would have never thought that I had this. And I still didn’t really accept it for quite some time. I could relate to many of the descriptions that patients reported, but I thought that my own experience probably would not add up to a diagnosis; after all, I was not that unwell. I could certainly get on with important things, and I am highly structured in my work. Mistakes could have major consequences, and so I cannot allow them to happen. Nonetheless, there is reading and rereading, too rapid communications with emails full of typos. I engage well with people on a one-to-one, but I am often quite out of sync in meetings, and I contribute little.
I am fortunate to be working in an area that has a lot of personal meaning to me and so I am interested and want to help others. My wife organises our family affairs, and I follow her instructions. I might take the initiative with the odd aspect, but this is rare, if at all. We are both busy people, and there can be a lot of ‘did you understand, did you hear what I said’ moments. If things are important, I will retain them, but if they have lower importance to me, they can just go. Regarding social life, staying in touch with people takes too much effort, and my thoughts relate mainly to my interests, so I have lost contact with many. I do have some long-term friends who accept my lack of contact, and, like many of my patients, I probably gravitated to people with ADHD traits when I was younger, so there is probably more acceptance.
When I was young, I was not the typical ADHD person that people think of but I was a classic ‘daydreamer’ type. Friends of my parents would often remark how well-behaved I was because I was generally smiling, but I would not do much. I certainly did not connect well with other children, and I think I frustrated my older brother with my lack of engagement. My father was highly academic, and so learning was important, and we were pushed to learn. Like many of my patients I see, some areas were easier for me, and some were lost on me. Learning maths did not seem to be so hard, but reading and spelling were the opposite. When I was 8-9 years old, the teacher told my parents not to have high hopes for me.
I can recall that when young, I would only look at the pictures in storybooks; when older I would take a book out that I liked the cover of, then return them to the school library unread. I can recall assignments in middle school and being in class close to deadline time, while other pupils would have written pages I had only written a few lines. Somehow the need to have done this work was lost on me, and it seemed to have taken me by surprise when we had to produce the work. I think this all led me to feel stupid when I was young, and I can only think of two activities I enjoyed at school; one was guitar lessons with the headmaster and the best moment was that I took it upon myself to make a model of the ship, the Mary Rose that was sitting in an opened box in the school when I was aged 10.
I did better at secondary school as I had to do the work; my parents would not have let me do otherwise. I found sciences easier to learn, and biology was my best subject, and the one left entirely to me. I got a C. When my family talk about how I revised for my A-levels, I had taken to studying in the ‘sun-lounge’ room in the house, as we called it. They seem to think that I only would draw the garden rather than revise, actually, I only did one drawing of the garden, and that was not even half finished. At the time, I put all this down to not caring and not having any direction in life.
Things changed at university. Early on, I came close to failing a piece of work, and it was clear that I might not be allowed to stay. I was really enjoying being at university and the thought of losing this, and how I would tell my parents that I had failed, meant I worked hard, then won a prize in physiology in the exams. That was it, finally, I was good at something, and so studying became my life. I would go off to the reading room at university, study and then socialise. The success kept coming, and I left with a gold medal; my family were quite stunned.
I think after that time, many of my signs of ADHD I just accepted. I had no idea what I wanted to do, but changing jobs was quite accepted in my field of training. I was quite hopeless personally, but this was me, probably when children came along, and the need to be organised and responsible made certain aspects more of a problem.
I think I was also quite fortunate, I was pushed to work, and as much as I resented this, it got me somewhere. I am now engaged in something I enjoy.
I like being able to help people with ADHD. There is often a lot of mutual understanding that goes on in the appointments. I think the acknowledgement and recognition of the problems is a big part of what helps people. They have often gone to great lengths to explore ADHD, but having a professional go through it and confirming it is a big deal, and I feel very privileged.
Author: Dr Stephen Ilyas.
Editor: James Brown PhD.