ADHD — it’s a household name by now. In 2016, 6.1 million children had been diagnosed with it. For many, the acronym brings to mind the mental image of hyperactive six-year-old boys being chased around the grocery store and classroom by helpless parents and teachers. But ADHD is a far more complex diagnosis and the repercussions that come alongside living with it last into adult life, including college years.
ADHD has several different facets; there's hyperactivity, which is perhaps the most obvious symptoms, and tends to appear more commonly in boys. The other area, the “attention-deficit” has more to do with the inability to focus and poor working memory. This group of symptoms is also sometimes known as “ADD,” though it falls under the umbrella of ADHD.
Chase Whitener and Annie Payne were both diagnosed with ADHD, specifically in it’s “attention-deficiency” forms, around the same time. Payne was just starting high school, and Whitener was in eighth grade when they sought out a diagnosis. Both of them were prompted by their struggles with their schoolwork. “I knew I was smart because I could grasp subjects a lot of people couldn’t grasp and I often loved having smart conversations. But the problem was I didn't do too well in school and I would often spend a lot more time doing homework than others. So we got tested and turns out I have ADD.”
Payne had a similar experience; after struggling with the workload during her high school classes, she approached her mother. “[I said] ‘I really think I have ADHD and it wouldn't be nice to talk to someone about it.’ So we went to my pediatrician. I told her ‘I think I have ADHD’ and she didn't really ask me a lot of in-depth questions. We talked about it a little bit and then and then she gave me a prescription for Vyvanse.”
On a fundamental level, brains with ADHD work differently. Attention-deficit/hyperactivity disorder has significant effects on brain structure and chemistry. The amygdala and hippocampus, parts of the brain responsible for emotional processing and impulsivity, often are smaller in people with ADHD.
They also tend to have decreased blood flow in areas of the brain responsible for executive function; things like staying organized, planning, or paying attention. Additionally, people with ADHD tend to have poorly working dopamine release; they don’t have the same emotional “payout” as a reward for tasks. This is also connected to the documented overlap between ADHD and elevated levels of anxiety.
For college students, learning to live with ADHD is a lifelong process they’re still figuring out how to balance. Managing a diagnosis comes in more than one form; medication, self-management and organization, and outside resources can all be part of a balanced “treatment.”
Both Whitener and Payne experimented with medication in high school to figure out if it would be helpful. ADHD medication taps into the side of your brain that helps you focus, releasing dopamine and norepinephrine; it creates a sensation akin to an approaching deadline, which can help, but it also has the potential to create anxiety.
Different people react differently to many medications. “A lot of ADHD medications, including Vyvanse, are stimulants.” Payne explained. “And I'm extremely sensitive to stimulants. And so I think I tried it for maybe a week. And as I continued to take it I had trouble sleeping at night. I was super anxious and wired all the time. I did notice it helped me be more present and help my brain be on one track. But by the end of the week, I had a panic attack and I was like, I can't do this. And so I stopped taking it.”
Whitener tried a number of medications later in high school, cutting back on medication as he moved into college. Now he only takes it occasionally, when he needs the extra help it provides. “I've been through several different types of medication. I took Adderall for a while. Right now I take Focalin. I switched depending on which medicine brought different side effects. So right now the only side effects from my medicine are maybe one, two hours of anxiety right after I take it, and then after that, it gives me the drive to work.”
Medication can help, but it’s only one piece of the puzzle. Like Payne, many people with ADHD don’t like how the medication makes them feel, or like Whitener, prefer to use it only when necessary. So in the interim, they must seek out coping mechanisms and strategies to help them stay focused and productive.
Whitener seeks out certain study spaces where he feels most focused. “I have to be intentional about how and where I do my work.” He often goes to a busy, but quiet space, and uses his noise cancelling headphones without music, so he gets a maximum amount of silence. He also does his best work at night; the pressure of a deadline helps him focus.
Payne has also learned how to work with herself. “I think I definitely have learned to tap into my hyperfocus more to help me get things done and learn how to go around certain loopholes when it comes to doing work.”
Hyperfocus is one aspect of ADHD that many students have a more positive relationship with. It’s a state of extreme focus making it hard to think about anything but whatever project is in front of them. They can forget to eat or sleep, or do other work. Unfortunately, hyperfocus isn’t exactly predictable, and usually zeros in on an area of interest to the person; anything from an art project to a video game to a good book to a 2 AM wikipedia binge. Learning how to channel that to more productive ends is one way to manage ADHD.
There are other things that students can do to help them focus on what they need to do. “A huge huge thing is always writing things and taking notes.” Payne said. “ADHD is like you needing constant stimulation and doing that through movement so focusing that energy into writing down what the person is saying helps me keep on track of what's happening in class.”
Outside resources may help as well. Whitener feels like he’s benefited immensely from the center for student success, led by Becca Moore, which offers students with ADHD extra time to take tests, and a quiet space to do it in. “I feel comfortable talking to Becca Moore about these things. I’ve been dealing with it a long time so I know what I’m up against. I get one and a half time. She gives me that time window and that's very nice for exams. She puts me in my exam in an area that's very secluded.”
For students who don’t understand why having ADHD gives him what appears to be an immense advantage when it comes to testing, Whitener tried to explain. “During the exam maybe someday somebody will shuffle their feet and then I'll be thinking about that and miss maybe 15 minutes. For another person, they’ll think about that for a second and they go back. But to me like my mind will go on tangents.” The space and quiet help pay attention to the test without trying to constantly wrestle his brain back into focus mode.
Payne doesn’t go to the Center for Student Success however. She doesn’t struggle with finishing tests on time. “I just assumed that they wouldn't really have services that catered to my need specifically, or would maybe not even know how to help me do better.” she said.
For Payne and Whitener, ADHD shapes the way they do their schoolwork, but it also shapes their social lives. Doing homework takes longer when it’s harder to concentrate on what you’re doing at any given moment, meaning that time they’d like to spend with friends is spent on assignments instead. Even conversations can be difficult. Both Payne and Whitener talked about the embarrassment that comes with zoning out when someone is talking to them.
Both of them have strong feelings about the misconceptions surrounding ADHD, and hope that as more people become aware of the reality that is living with it. “It's not just about being hyper and it's not just about not being able to focus. It's about specifically the ability in your prefrontal cortex to make executive decisions. It's a loss, lack of dopamine reward payback. It's a lot more complicated, nuanced, and also it's not people who are just lazy, who just don't want to do things. It's actually a deficiency in your brain.” Payne said, when asked what she wished people knew about ADHD.
Whitener agrees, doubling down on the fact that being ADHD doesn’t just mean you’re lazy. “It’s not being distracted. That's a very easy way to say it. That's very surface level. It has to do with how you sort information and how you process it.”