Life as an Adult with Learning Disabilities

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When people think of learning disability, they usually think of dyslexia. This is a reading disorder in which a person has difficulty associating sounds with written words. Their ability to read and write is therefore pretty challenged; but a lot of dyslexics are very imaginative, and make great writers once they learn to compensate for their disabilities.

I do not have dyslexia. I have the lesser-known disabilities of dyscalculia and dysgraphia. Dyscalculia is a math disorder, and dysgraphia is a writing disorder. You probably haven't heard of them, but they're both quite real. They're in the Diagnostic and Statistical Manual -- DSM 315.1 and 315.2 respectively -- and recognized by the World Health Organization as well. I also have inattentive ADHD.

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Dyscalculia keeps me from accurately reading phone numbers and addresses, let alone remembering them. Balancing my checkbook is right out. But its effects don't end there.

I'm not sure what it has to do with math, but it turns out that people with dyscalculia also have trouble playing games and sports. I was always the last kid picked for teams in gym class, because I was guaranteed to be offsides while I completely mishandled the ball. Sometimes I have trouble even watching sports; the rules of American football have been explained to me hundreds of times, and I still have no idea what's going on. (Football is the game with the big orange ball and the baskets, right?)

I am also the worst card player in the known universe. "Go Fish" is actually too complicated for me. I once played this game with my Girl Scouts. We merrily played along, taking turns in order, until play came around to me -- but I had run out of cards. "What do I do now?" I asked them. "Um, you won," one of the girls told me. "You won at your last turn, when you ran out of cards. We were waiting to see if you'd notice!"

What can I say, I'm a role model.

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Given my learning disabilities and my mental health situation, I hear about a lot of studies and medical trials that seem like they might have a bearing on my life. One day, the headline will be "Studies prove that Medication X is the most effective way to improve symptoms in patients with ADHD and depression!". The next day, the headline will be "Studies prove that eating asparagus is more effective than Medication X at improving symptoms of ADHD and depression!" I try to take care of myself, and I want to do the best thing for my brain. How can I tell if that's Medication X or asparagus?

I'd like to be able to look up the studies in question and evaluate them myself, but I have no way to understand the numbers, let alone the methodology. I recently asked my husband if he could give me a qualitative explanation for what a "statistically relevant" sample size is. He majored in physics, took econometrics for fun, and has been known to dream in equations. He gave me that look, the one that pities me while it respects me for trying, and said, "It depends on what you're studying, and it depends on what you're doing to the numbers. Beyond that, I can't explain it without getting quantitative. If I could, they wouldn't need to use math to do it."

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A few days later, I mentioned the conversation to a friend who's writing her dissertation in clinical psychology. The study I was wondering about was comparing MRIs in fourteen patients. "Actually," she said, "any sort of neural imaging is so expensive that 14 is a pretty good haul. It's really hard to get enough funding even to do those studies."

The conversation with my friend made me appreciate how flawed medical research can be. Not only does it depend on statisticians massaging numbers, but any single study needs to be funded well and carried out by competent people in order to be useful. Then, in order to have any scientific validity, somebody else needs to independently fund and carry out a similar study in order to verify the results. But that's the boring, unglamorous part that's never covered by the evening news.

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My husband Stuart is a bright guy. He's a successful, respected network engineer who studied physics and economics in college. He does not have "learning disabilities". On the one and only occasion when I asked him for help with some elementary physics homework, he gave up in despair, saying, "I don't understand how anyone can't comprehend this. How can I explain something that's just so obvious?"

I glared at him. "Obvious?" I said. "Let's talk about obvious." I sang a note. "Sing it back to me."

He looked at me. "You know I can't sing," he said.

"Well, I've been able to do that since I was six," I said. "Probably even younger. I don't understand how anybody can't do something so obvious."

I can sing. I'm an accomplished instrumental musician. I can also draw and paint. Stuart can't do any of these things -- but he's "normal", and I'm "disabled".

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Ever heard someone complain about a "senior moment"? Usually it's after they've forgotten something blatantly obvious, or because they've walked into a room and can't remember what they went in for.

That's been happening to me my whole life. For instance, this morning it took me 15 minutes to find a pair of socks and put them on. I knew that they were in the laundry basket, and I even knew where the laundry basket was ... and yet ...

"Socks!" I thought to myself as I was standing near the laundry basket. The next thing I knew it was several minutes later and I was in the living room.

"Socks!" I thought to myself, and headed back to the laundry basket, only to find myself with my head in the fridge, looking for breakfast.

"Socks!" I thought to myself when I was back in the living room, checking my email, and wondering why my feet were cold. I looked around and realized that I'd actually grabbed a pair from the laundry basket and put them on the couch next to my lap top.

It still took me another five minutes to put them on.

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Inattentive ADHD is Attention Deficit Disorder without the physical hyperactivity. When a kid has ADHD with the hyperactive subtype, it's usually pretty obvious -- it's hard to miss a kid who's constantly talking, getting out of her chair, and running around the classroom. The inattentive subtype manifests in daydreaming and forgetfulness. Since it's less disruptive, it can often go undiagnosed for years. I didn't get up and run around the classroom when I was a kid. I didn't have to. My brain wandered in and out of the classroom of its own accord, exploring its own imaginary worlds. It didn't need to bring my body with it.

Most children develop executive function skills as they grow up. By the time they are adults, they have learned to deliberately focus their attention, and to sustain their focus, even if what they're doing is something boring like their taxes. Children with ADHD never develop this ability. They become into adults whose minds have minds of their own.

Adults with this learning disability are often thought to be immature and selfish. The people around them wonder why they won't just grow up and face their responsibilities like everyone else. Unfortunately for the adult with ADHD, it's not that simple. We actually try very hard to get it together. It's just that our brains can't direct and sustain focus like other peoples' can.

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Due to brain differences, people with ADD have difficulty with "executive functions" like planning, decision-making, learning new habits, and delaying gratification. The executive functions are mediated by neurochemicals like dopamine and norepinephrine. These chemicals are part of the brain's reward system, and in a normal brain, they're triggered by a number of things -- from eating your favorite food to finishing your taxes.

In an ADHD brain, these chemicals are not as abundant or available. Without sufficient norepinehprine, someone with ADHD is unable to be as mentally alert as a normal person. Without sufficient dopamine, there isn't the sense of reward or accomplishment when completing a necessary but boring task. Thus, adults with ADHD zone in and out, trying to focus our brains on those stupid taxes, and getting distracted by whatever is more interesting (and, let's face it, that's pretty much everything).

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If someone with a normal brain were to take my medication, they would likely experience some of the same benefits that I do when taking it. They would feel energized, their ability to concentrate would be improved, and their mental stamina would increase. On the other hand, it is likely that they would feel restless, agitated, and irritable. They would probably feel extremely anxious, and be unable to sleep that night.

When I started taking my meds, the first thing I noticed was that I felt calm. I could look around the room and focus on one object at a time. The pile of papers on the coffee table didn't overwhelm me. It was as if, for the first time ever, I had the mental space to consider what I needed to accomplish that day, and choose something from that list, and start doing it. When I went to bed that night I fell asleep easily, instead of tossing and turning for an hour and a half.

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ADHD drugs have generated plenty of discussion and controversy over the years. I respect the fact that treating children with psychoactive medication is a thorny medical and ethical issue. I do not think the decision to prescribe psychostimulants to a child should be made lightly, and I respect every family's right to make an informed decision on the matter.

On the other hand, the media hype is truly out of control. Every day there's a new headline along the lines of "Is ADHD Overdiagnosed? Are we OVER-MEDICATING our CHILDREN?!? Won't SOMEBODY think of the CHILDREN!!11!". The sheer amount of space given to the medication "controversy" by the media has empowered a lot of completely ignorant people to form opinions about whether ADHD meds are "healthy" or "justified", even for adults. These opinions are generally based on complete falsehoods. As an adult with ADHD who has chosen to take medication, it's pretty obnoxious to have to listen to it. Allow me to refute some of them for you.

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ADHD meds are not "the same thing as meth". Crystal meth is a completely different amphetamine than any of those used to treat ADHD. Besides, prescription pharmaceuticals are made in controlled laboratory conditions. The guy selling meth on your street corner ... doesn't.

ADHD medications are not dangerous. As with any drug, including caffeine, some people shouldn't take ADD meds for health reasons. Nonetheless, stimulants are one of the oldest and best-understood class of medications that are prescribed today (compare that to aspirin, which has been around awhile, but NOBODY knows how or why it works). ADHD medications are safe for most people when taken in prescribed doses.

ADHD medication is not "over-prescribed" Only 4.3% all children have ever taken medication for ADHD. Of those children, most are in the 9-12 age group. Medication use falls off sharply in teenagers, often because they feel that taking it sets them apart from their peers. Adults with ADHD take medications in low rates as well, for various reasons -- including the fact that we forget about things like doctor's appointments and prescription refills.

ADHD medication is not a "crutch", used to avoid taking responsibility for behavior problems. "Taking medication" and "taking responsibility" are not mutually exclusive. By taking medication that allows me to plan, evaluate, and execute tasks, I am in fact able to take much more responsibility for my behavior than I can when I'm not on meds.

ADHD medication does not give ADD students an "unfair advantage" over others. This is a tough one for many people, because it's widely understood that anyone who takes a stimulant will perform better on exams. However, there's a big difference -- legally and ethically -- between a non-ADHD student who takes a stimulant as a performance enhancer before a test, and an ADHD student who takes stimulants daily so she can remember to go to class in the first place.

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The popular image of adults with ADD just "popping pills" to "solve all their problems" couldn't be farther from the truth. It is true that, in order to function, I have to have my medication just right, but I also have to exercise, get enough sleep, and eat right. If any one of these gets off-kilter, my brain is toast.

One of the best things I ever did for my ADHD was to stop drinking coffee. This is sad, because coffee is one of my favorite things in the universe -- but caffeine is terrible for the ADD brain. I also have to severely restrict sugar intake, but this is much easier because I don't like it much. As for what I do eat, I've found that protein is absolutely critical to keeping my mind running, and that eating plenty of greens throughout the day keeps my mood and attention stable.

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In addition to dealing with the cognitive effects of my disabilities, I have to deal with other people's attitudes towards them. A lot of people don't understand adult learning disabilities. They become impatient when I lose something or forget something or can't do basic math upon request. Since my disabilities are not visible, I have a choice: I can keep quiet, and be judged for failing to meet expectations, or I can disclose them, and be judged for being "different".

I have lost jobs because I've disclosed my disabilities to the wrong person. What's that you say? Sounds illegal? Why yes. It is illegal. It's also incredibly hard to prove, and people get away with it all the time.

For that reason, I do not use my real name on Squidoo or on my blogs. I do not use my own image without significantly altering it. I would very much like to be completely "out" about my disabilities, but I simply can't be. To do so would be to put myself at all kinds of risk, from denial for health coverage due to pre-existing conditions, to ongoing employment problems.