The Universe of Discourse


Sat, 30 Apr 2022

Mental illness, attention deficit disorder, and suffering

Freddie DeBoer has an article this week titled “Mental illness doesn't make you special”. Usually Freddie and I are in close agreement and this article is not an exception. I think many of M. DeBoer's points are accurate. But his subtitle is “Why do neurodiversity activists claim suffering is beautiful?” Although I am not a neurodiversity activist and I will not claim that suffering is beautiful, that subtitle stung, because I saw a little bit of myself in the question. I would like to cut off that little piece and answer it.

This is from Pippi Longstocking, by Astrid Lindgren (1945):

'No, I don't suffer from freckles,' said Pippi.

Then the lady understood, but she took one look at Pippi and burst out, 'But, my dear child, your whole face is covered with freckles!'

'I know that,' said Pippi, 'but I don't suffer from them. I love them.'

I suffer from attention deficit disorder. Like Pippi Longstocking suffers from freckles.

M. DeBoer says:

There is, for example, a thriving ADHD community on TikTok and Tumblr: people who view their attentional difficulties not as an annoyance to be managed with medical treatment but as an adorable character trait that makes them sharper and more interesting than others around them.

For me the ADD really is a part of my identity — not my persona, which is what I present to the world, but my innermost self, the way I am actually am. I would be a different person without it. I might be a better person, or a happier or more successful one (I don't know) but I'd definitely be someone different.

And it's really not all bad. I understand that for many people ADD is a really major problem with no upsides. For me it's a major problem with upsides. And after living with it for fifty years, I've found ways to mitigate the problems and to accept the ones I haven't been able to mitigate.

I learned long ago never to buy nice gloves because I will inevitably leave them somewhere, perhaps on a store counter, or perhaps in the pocket of a different jacket. In the winter I only wear the cheapest and most disposable work gloves or garden gloves. They work better than nothing, and I can buy six pairs at a time, so that when I need gloves there's a chance I will find a pair in the pocket of the jacket I'm wearing, and if I lose a pair I can pick up another from the stack by the front door.

I used to constantly forget appointments. “Why don't you get a calendar?” people would say, but then I would have to remember the calendar, remember to check the calendar, and not lose the calendar, all seemingly impossible for me. The arrival of smartphones improved my life in so many ways. Now I do carry my calendar everywhere and I miss fewer appointments.

(Why could I learn to carry a smartphone and not a calendar? For one thing, the smartphone is smaller and fits in my pocket. For another, I really do carry it literally everywhere, which I wouldn't do with a calendar. I don't have to remember to check it because it makes a little noise when I have an appointment. It has my phone and my email and my messages in it. It has the books and magazines I'm reading. It has a calculator in it and a notepad. I used to try to carry all that crap separately and every day I would find that I wanted one that I had left at home that day. No longer.)

There are bigger downsides to ADD, like the weeks when I can't focus on work, or when I get distracted by some awesome new thing and don't do the things I should be doing, or how I lost interest in projects and don't always finish them, blah blah blah. I am not going to complain about any of that, it is just part of being me and I like who I am pretty well. Everyone has problems and mine are less severe than many.

And some of the upsides are just great. When it's working, the focus and intensity I get from the ADD are powerful. Not just useful, but fun. When I'm deep into a blog post or a math paper the intense focus brings me real joy. I love being smart and when the ADD is working well it makes me a lot smarter. I don't suffer from freckles, I love them.

When I was around seventeen I took a Real Analysis class at Columbia University. Toward the end of the year the final was coming up. One Saturday morning I sat down at the dining room table, with my class notes, proving every theorem that we had proved in class, starting from page 1. When I couldn't prove it on my own I would consult the notes or the textbook. By dinner time I had finished going through the semester and was ready to take the final. I got an A.

Until I got to college I didn't understand how people could spend hours a day “studying”. When I got there I found out. When my first-year hallmates were “studying” they were looking out the window, playing with their pencils, talking to their roommates, all sorts of stuff that wasn't studying. When I needed to study I would hide somewhere and study. I think the ability to focus on just one thing for a few hours at a time is a great gift that ADD has given me.

I sometimes imagine that the Devil offers me a deal: I will lose the ADD in return for a million dollars. I would have to think very, very carefully before taking that deal and I don't know whether I would say yes.

But what if the Devil came and offered to cure my depression, and the price was my right arm? That question is easy. I would say “sounds great, but what's the catch?” Depression is not something with upsides and downsides. It is a terrible illness, the blight of my life, the worst thing that has ever happened to me. It is neither an adorable character trait nor an annoyance to be managed with medical treatment. It is a severe chronic illness, one that is often fatal. In a good year it is kept in check by medical treatment but it is always lurking in the background and might reappear any morning. It is the Joker: perhaps today he is locked away in Arkham, but I am not safe, I am never safe, I am always wondering if this is the day he will escape and show up at my door to maim or kill me.

I won't write in detail about how I've suffered from depression in my life. It's not something I want to revisit and it's not something my readers would find interesting. You wouldn't be inspired by my brave resolve in the face of adversity. It would be like watching a movie about someone with a chronic bowel disorder who shits his pants every day until he dies. There's no happy ending. It's not heroic. It's sad, humiliating, and boring.

DeBoer says:

This is what it’s actually like to have a mental illness: no desire to justify or celebrate or honor the disease, only the desire to be rid of it.

I agree 100%. This is what it is like to have a mental illness. In two words: it sucks.

And this is why I find it so very irritating that there is no term for my so-called ⸢attention deficit disorder⸣ that does not have the word “disorder” baked into it. I know what a disorder is, and this isn't one. I want a word for this part of my brain chemistry that does not presume, axiomatically, that it is an illness. Why does any deviation from the standard have to be a disorder? Why do we medicalize human variation?

I understand that for some people it really is a disorder, that they have no desire to justify or celebrate or honor their attention deficit. For those people the term “attention deficit disorder” might be a good one. Not for me. I have a weird thing in my brain that makes it work differently from the way most other people's brains do. In many ways it works less well. I lose hats and forget doctor appointments. But that is not a mental illness. Most people aren't as good at math as I am; that's not a mental illness either. People have different brains.

Some variations from standard are intrinsic problems, but many are extrinsic. Homosexual orientation used to be a mental illness. But almost all the problems that queer people face are extrinsic: when you're queer your main problem is that other people treat you like crap. They hate you and they're allowed to tell you how much they hate you. You're not allowed to love or marry or bring up children. It sucks! But “I'm unhappy because people treat me like crap” is not a mental illness! The correct fix for this isn't “stop being queer”, it's “stop treating queer people like crap!”

DeBoer says:

Today’s activists never seem to consider that there is something between terrible stigma and witless celebration, that we are not in fact bound to either ignore mental illness or treat it as an identity.

I agree somewhat, but that doesn't mean that the stigma isn't a real issue. Take away the stigma from queerness and you solve almost all of the problems queer people have that straight people don't also have. With mental illnesses the problems are deeper and harder to solve, but some of them are caused by stigma and should be addressed. Mentally ill people will still be mentally ill, but at least they wouldn't be stigmatized.

Many of the downsides of ADD would be less troublesome for everyone, if our world was a little more accepting of difference, a little more willing to accommodate people who were stamped in a slightly different shape that the other cogs in the machine. In Pippi Longstocking world, why do people suffer from freckles? Not because of the freckles themselves, but only because other people tell them that their freckles are ugly and unlovable. Nobody has to suffer from freckles, if people would just stop being assholes about freckles.

ADD is a bigger problem than freckles. Some of its problems are intrinsic. It definitely contributes to making me unreliable. I don't think losing gloves (and books and jackets and glasses and bags and wallets and everything else) is a delightful quirk. People depending on me to do work timely are sometimes justifiably angry or disappointed when I don't. I'll accept responsibility for that. I've worked my whole life to try to do better.

But when the world has been willing to let me what I can do in the way that I can do it, the results have been pretty good. When the world has insisted that I do things the way everyone else does them, it hasn't always gone so well. And if you examine the “everyone else” there it starts to look threadbare because almost everyone is divergent in one way or another, and almost everyone needs some accommodation or other. There is no such thing as “the way everyone else does”.

I don't think “neurodivergent” is a very good term for how I'm different, not least because it's vague. But at least it doesn't frame my unusual and wonderful brain as a “disorder”.

Returning to Freddie DeBoer's article:

There is, for example, a thriving ADHD community on TikTok and Tumblr: people who view their attentional difficulties not as an annoyance to be managed with medical treatment but as an adorable character trait that makes them sharper and more interesting than others around them.

Some people do have it worse than others. I'm lucky. But that doesn't change the fact that some of those attentional difficulties are more like freckles: a character trait, perhaps even one that someone might find adorable, that other people are being assholes about. Isn't it fair to ask whether some of the extrinsic problems, the stigma, could be ameliorated if society were a little more flexible and a little more accommodating of individual differences, and stop labeling every difference as a disorder?


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