A month ago I was officially diagnosed with ADHD and prescribed lisdexamfetamine, better known in the United States by the brand name Vyvanse. In truth, this did not come as much of a surprise. About three years ago I went down an ADHD rabbit hole - reading, watching, writing up notes - and concluded that I almost certainly had it. That realization led me to lean more deliberately into running, meditation, and a largely ketogenic diet, all of which I had read could help. They did, and they do.

But I also wanted to see what would happen if I addressed it more directly. I was curious to try a pharmaceutical approach and to find out what, if anything, medication would change. It has changed a lot.

So let me begin by explaining what my ADHD feels like. Broadly speaking, ADHD tends to present in either a more hyperactive or a more inattentive form. Mine is inattentive, which for me comes down to uneven control over attention. I can focus intensely on something for long stretches if it really grabs my interest, but when it doesn’t, starting, organizing, and following through become inherently difficult. I do not really have hobbies so much as month-long obsessions, during which I read everything, understand everything, and then abruptly lose interest to the point where I can barely bring myself to think about it. There is a frustrating gap between what I know I should do and my ability to do it consistently.

That is the main thing, but there are a few other related elements. I have a tendency to get lost in my own head and, now that I have experienced Vyvanse, I can describe the inverse more clearly. My subjective world has a pressured, loud, and jaggy quality to it; there is no interior calm unless I force it. Part of this also seems to involve a weak sense of time passing, so that a slight digression in thought can easily result in forty-five minutes disappearing.

So I went through the ADHD evaluation process: questions about my childhood, my education, my experience, my medical history, and so on. I did the online cognitive tests designed to measure attention, working memory, and response consistency. Then came the agonizing wait, during which I second-guessed everything I had thought and wondered whether I was barking up the wrong tree. And then finally came the answer: I did indeed have ADHD. The various pharmaceutical options were discussed and I was prescribed Vyvanse; I picked it up that day, and started it the next morning.

Vyvanse is a long-acting medication. You take one pill in the morning, you don’t feel anything for about an hour and a half, and then it comes on. What strikes me, reading other people’s accounts of the drug, is just how varied their experiences are. I suppose whenever you’re talking about psychoactive drugs, drugs that change your mental state, you are by definition in the realm of the subjective. So I am underlining that point to make it clear that I am now talking about my own subjective experience on Vyvanse.

Vyvanse is both dramatic and in a paradoxical sort of way, experientially subtle. What strikes one first is the calm: all that background noise I described suddenly being turned down. ‘Is this what it is like in other people’s heads?’ is a common sentiment expressed amongst those who take it. There’s a mixture of feelings that come with that, the fact that one is cognitively atypical is no longer an intellectual hypothesis, it becomes phenomenologically grounded. With that there is also a sense of regret: for my entire life I have, unknowingly, had it unnecessarily more difficult. It’s obviously good now, but it would have been so useful to have been in that mind space at school, at university, in my ministerial job, and so forth.

I have, what feels in contrast, a now effortless ability to stay on task. I just feel motivated by whatever thing I am working on. That’s it. There’s not any impulse novelty-seeking itch. I can just be present with whatever I am doing now.

It’s experientially subtle because it has very quickly become my new baseline. It doesn’t feel like I’m euphoric or in an altered state, but if I cast my mind back to how I was, that is when it becomes apparent how different things now are.

It raises certain philosophical questions in my mind - questions about consciousness, identity, and aesthetic appreciation, the sorts of things I write about on this website. So I will pursue some of those threads now. The most obvious is the question of who one really is. If you take a drug like this and find yourself in a different state of mind, many people’s intuition, I think, is to say that the unmedicated you is the ‘real’ you, and the medicated you is not. It’s an interesting thing to think about, but I don’t experience it as existentially jarring. I have long since disregarded the notion that I have a fixed self. There is no particular state to which I owe my elegance. I equally find the notion that, because I am cognitively atypical, taking such medications brings me into my ‘real’ state just as absurd.

It affords a different texture to my inner life, one that I experience as functionally more desirable, but I could still imagine the possibility of further refinement, and indeed, as I have written about before, I think traversing a landscape of such refinements is in our future.

Closely linked to such questions of identity is the question of taste. The very difficult distinction between what you like and why you like it. Or: do you find it fun, versus why is it fun? My intuition tells me that what I like and what I find fun has been subtly shifted by Vyvanse, although I can’t quite articulate that shift. I think perhaps superficial fun is rendered more hollow, but I am talking about something very subtle. Do more exacting forms of satisfaction become easier to access? It seems like that would be true. Again, this is a subjective textural shift, a textural shift in appetite.

It also occurs to me that there is a moralizing temptation here, which I dislike. I do not want to imply that the medication has simply sorted pleasures into the noble and the base. What interests me is something subtler: that a change in mental state may alter the felt quality of enjoyment itself, making some pleasures seem flatter and others more available.

Anyway, as I said I am only a month in, so these are still very much early days.