Women and ADHD writer’s block: a crash course

From time to time, I suffer from a terrible side effect of ADHD — not of ADHD medication, but of attention-deficit hyperactivity disorder itself. It is highly destructive, perhaps especially for women, and it has a name: ADHD writer’s block.

Girl-with-pen-in-hand-writing

What is ADHD writer’s block, you ask? Well, first you have to understand the science behind ADHD. Now, full disclosure: What I am about to tell you *may* not actually be correct. You see, even though I’m confident that the cause I’m going to provide is right, so far, it’s politically correct just to say ADHD is thought to have that etiology. I know in my bones this explanation is accurate, and I’m pretty sure scientists haven’t thrown their weight behind it definitively only because they’re terrified they’ll turn out to be wrong. Still, this should not be taken as credible medical advice. Having said that, the primary source of ADHD is almost definitely, in a word, dopamine — or rather lack thereof. I think Jessica McCabe explains it best:

Dopamine is a neurotransmitter that’s part of the reward system in our brain. We do a thing; we get a hit of dopamine; we feel good. The problem is, in ADHD brains, there aren’t as many dopamine receptors as there are in the average brain. We kind of have to flood our brain with dopamine to feel the effects. You’ve heard of heat-seeking missiles? We are dopamine-seeking missiles.

The kicker is that estrogen modulates dopamine systems. According to a November 1988 article in the New York Times, “In two studies involving 200 women … the women performed better on tasks involving verbal skill or muscular coordination when estrogen levels were high than they did when the levels were low.” In other words, the higher your estrogen levels, the higher your dopamine levels; and the higher your dopamine levels, the stronger your verbal acuity. Thus, women are left experiencing heightened difficulty expressing themselves, both in conversation and in writing, during certain times in their monthly menstrual cycle and throughout their lives. 

During a bout of ADHD writer’s block, I, for one, feel tremendous amounts of frustration. I cannot overstate how aggravating it is to have half-formed brilliant ideas floating around in your head, but then be unable even to start typing when it comes time to write them down. Sometimes snatches of individual sentences will flit in and out of my mind, but when I set out to complete them and commit them to paper (well, to WordPress, anyway), they come out as gobbledygook, or worse, they don’t come out at all. This was a dangerous game for my brain to play with me back in grad school when I would need to write multiple-page papers on very imminent deadlines. And if you’re a professional writer, like me, it can actually put your career in jeopardy. Not to mention, it’s just plain annoying!

OK, great. But what are we supposed to do about it? Is there even anything to do about it? The answer, fortunately, is yes, there is:

Coffee.

As Devon Frye explains,

Caffeine is most commonly used to overcome sleepiness and increase productivity; in some people with ADHD, it’s thought to combat common symptoms like distractibility and inattention in the same way that stimulant medications do. […] Caffeine works by stimulating the autonomic nervous system — responsible for regulating heart rate and other involuntary bodily functions like digestion. In the brain, caffeine stimulates the release of certain neurotransmitters, like dopamine, and blocks the absorption of others, like adenosine — a chemical linked to sleep and relaxation.

So, there you have it. I usually am able to get my writing work done thanks to caffeine* — caffeine delivered in coffee form, that is. Personally, I get the most potent benefits from a regular coffee drink such as a Starbucks Grande Caramel Frappuccino (100 milligrams of caffeine) with an added shot of espresso (about 64 mg caffeine) thrown in. Of course, your mileage may vary. After all, I’m pretty sure I have the severest ADHD in literally (yes, literally, literally) the whole world; you may need less caffeine to achieve the same effects.

Coffee-with-pen-and-paper

In any case, after about 15 minutes of intermittent sipping, I’ll suddenly notice myself finishing incomplete thoughts and finding the language that will enable me to evoke them. Now, that’s my kind of ‘java-script!’


*For the record, coffee is not the only palliative for ADHD writer’s block. More suggestions on how to combat ADHD writer’s block can be found in Beth Harvey’s February 2016 post on her blog Smart Girls with ADHD.

ADHD is a Battlefield; Meli is an Ally.

If you’ve ever heard of ADHD (or, more likely, ADD), you’ve probably also heard that people usually get over the disorder when they grow up. But I’m going to let you in a little (horrifying) secret: Many people don’t get over ADHD, but get more ADHD when they enter adulthood. And there is a name for these people: women.

Members of the ADHD medical community have observed for decades that women seem to experience an amelioration of ADHD symptomology during pregnancy. (This is great, because physicians will tell you that you should only continue taking ADHD stimulant medication while pregnant if you feel that the benefit to you, the mother, outweighs the risk of harming your baby in utero; basically, the implication is that you’d have to be a sociopath to continue your treatment regimen if you have a bun in the oven.) However, it has also been observed that women seem to experience an exacerbation of their symptoms during menopause, and as young adults every few weeks or so.

As it turns out, studies in recent years have shown, an average woman’s mental acuity is proportional to her estrogen levels. An ADHD woman, of course, struggles with inattentiveness and lack of focus just as a baseline. Thus, she may be able to get by and even thrive during the first half of her menstrual cycle each month, thanks to medication and/or therapy of some kind. But when she hits her PMS week, her hormone levels deplete, and stay low until the end of her period, leaving her feeling out of it for virtually half of every month.

I mentioned in my last post that I’ve been empowered by acknowledging how real — and how limiting — my ADHD has always been. It became particularly acute starting around age 18, and now we know why: In a word, hormones. If I weren’t aware, or didn’t believe, that my disability has a biological foundation, I would inevitably suffer even more, because I would be left believing that the cause of my troubles were some flaw in my character, my quality as a person. I can’t adequately express how significantly my mental health has improved since I’ve learned to acknowledge my own limitations (and their neurological basis) and forgive myself for not always being able to exceed everyone’s expectations.

But that’s only half the battle. To win that battle, you need allies. I have at least 20. Let me tell you about one of them.

Me and Meli, May 8, 2015

Me and Meli, May 8, 2015

This is Meli. She and I were roommates at the University of Oregon’s Living-Learning Center residence hall during my freshman year of college. We definitely did not have a perfect roomie-roomie relationship back in 2009, but with every passing year she and I have grown closer and closer, so much so that today each of us considers the other one of her best friends. There is a lot to love about Meli: She is adorably small in stature and unabashedly nerdy; I can’t do justice to her particular syntax, but trust me, it’s completely unique and utterly hilarious. Above all, though, I love Meli because she loves — and supports — me, ADHD and all.

About two months ago, on the second Friday in May, Meli accompanied me on a trip to Newport (one of Oregon’s coastal towns) for the wedding of my friend Dana to her longtime boyfriend, Nick (Dana and Meli get along really well, which isn’t surprising, because they are both awesome), in which I was to be a bridesmaid. The members of the wedding party had all chipped in to rent a beach house for two nights. Around 10:30 p.m., after everyone had returned from the rehearsal dinner and a complimentary boat ride around Newport Bay, Dana knocked on the door of the bedroom Meli and I were sharing to inform me that in about 10 minutes we were all to congregate to go over the logistics of the wedding day. “Is that okay?” she asked. “Yes,” I deadpanned. “As long as you understand that I am heavily unmedicated and will not retain any of what you say.” Dana, of course, gracefully accepted this, she being an ADHD ally herself, though we were left wondering what to do in light of the current situation. But then, Meli chimed in and gamely offered to attend the confab as my proxy and take notes on the scheduling and my responsibilities for me to read the next day when I was medicated once again.

Now, granted, I was pretty emotional already, seeing as how I was about 15 hours away from witnessing the nuptials of two incredible people, but I almost burst into tears because of what had just happened: Rather than chiding me for being lazy, or even encouraging me to have some faith in myself, Meli simply accepted that I couldn’t handle the task at hand, and offered to do it in my stead. Why? Because she could. It was a far cry from my senior year of high school, when a girl who at the time I counted as one of my closest friends told me that I had done a good job “not saying anything stupid yesterday.”

A true ADHD ally embraces an ADHD woman for all that she endures, and for all that she is unable to endure. My friends support me when I push myself, and support me when I don’t. Meli is the epitome of an ADHD ally. I’m hanging out with her tonight, in fact.

I can’t wait.