This article follows on from ‘ADHD, Vyvanse, and Taste,’ my thoughts one month into being diagnosed and prescribed medication. These are my reflections three months in. I have a lot to say, because the diagnosis has begun to change how I understand my childhood, my habits, my social instincts, and even parts of my temperament.

There has been an unsettling part to all this: the growing sense of how omnipresent this condition has been in my life. Diagnosis has not felt like discovering one new fact about myself. It has felt more like watching an old explanation give way to a larger one. I was diagnosed with dyslexia very early, around the age of six. It was actually my dad who "diagnosed" me first, trying to reconcile two facts: a son who was clearly intelligent, and teachers who placed me at the bottom of my primary school class.

For two decades after that, dyslexia was the planet my life orbited. Special schools, phonics, sounding out words, reading comprehension, word searches, audiobooks, early text-to-speech software, extra time, the use of a word processor in my exams, and on and on it went. But alongside all that, I also had the symptoms I now recognize as undiagnosed ADHD: drifting attention, weak follow-through, poor working memory, unfinished tasks, lost instructions, emotional dysregulation, and the constant stressor of trying to look as though I was coping.

I think many of these signs can easily be mistaken for the burden of dyslexia taking its toll. The fatigue, avoidance, missed instructions, and slow work all sound a lot like a child really struggling with dyslexia, hence the understandable lack of a childhood diagnosis.

Narratives are doing a tremendous amount of work in all this. We are always thinking in terms of narratives. Dyslexia is a kind of explanatory narrative: it allows others to contextualize who you are and weigh their expectations accordingly, for better or worse. ‘Dyslexia’ has been tremendously useful to me as such a narrative, affording me all the tools and support I mentioned above. But of course, there is a sense in which it is not really true, not in any final sense. It is a crude diagnostic approximation for what it is like to have my brain. It is an interpretive category imposed on a much messier reality.

But in life as actually lived, diagnostic criteria matter far less than the vague cloud of associations that gather around the word. What matters is what people think dyslexia means. The word carries a story with it. It suggests certain struggles, certain allowances, certain limits, certain expectations. It gives people a way of making sense of you before they have really understood you.

This is where I think the question of masking begins. I think I understood this very early, though not consciously and certainly not in these terms. Once you sense that other people are always building some rough explanatory model of you, you begin trying to manage that model. You learn, often without quite realizing it, which parts of yourself can be shown, which need to be softened, which need to be explained in advance, and which must be hidden altogether. You are not only trying to manage your attention or your memory or your emotions. You are trying to manage the constructed narrative of yourself that lives in other people’s heads.

I think I have often fallen into the trap of becoming so fixated on how other people perceive me that I end up damaging the very impression I am trying to manage. I can come across as more serious or judgmental than I am. The effort to appear composed can itself begin to look like coldness, and the effort to make myself understood can begin to look like self-importance.

So, it might not be obvious yet, but I am still talking about ADHD. Not ADHD as a list of symptoms on a diagnostic form, but ADHD as it is lived socially: the missed cue, the forgotten instruction, the overlong answer, the sudden intensity, the weak follow-through, the mismatch between intelligence and performance. These things happen in front of other people, and other people draw conclusions from them. A forgotten instruction becomes carelessness. An overlong explanation becomes vanity. A sudden intensity becomes arrogance.

This is one of the crueler social tricks of ADHD. The very effort to manage yourself can make you appear more self-involved than you are. From the inside, you are watching your tone, your timing, your memory, your next sentence, your last mistake. You may also be trying to explain the larger pattern of your life, the thing you are trying to unfold. From the outside, I fear it can simply look like self-absorption, which is difficult to deny while producing, as evidence, an essay about myself.

The Word Search and the Tower

One memory keeps coming back to me. I am sitting at a breakfast table in Houston, Texas, in 1997. My computer is upstairs, a Macintosh with ‘SimTower’ on it, a game I had been waiting months to play. Through the window I can see the pool and the diving board. In front of me is one of the word searches I was so often given as homework.

I cannot do it. Or rather, I cannot make myself do it. The task is not intellectually difficult in any grand sense. It is simply unbearable. Somewhere upstairs, a whole little world of elevators, tenants, commercial zones, and hotel rooms is waiting for me. Downstairs, I am being asked to find "butterfly" in a grid of letters.

For most of my life, I understood this scene through the lens of dyslexia. I thought: this is a reading task, reading tasks are hard for me, therefore I avoid them. That was not wholly false. But in retrospect, it now seems that ADHD may have been the main problem all along. Dyslexia explained part of the difficulty, but not the strange unevenness of it: the inability to attend to a word search at the kitchen table, followed by hours of intense concentration upstairs on a computer game that required a nine-year-old to think, with a kind of effortless intensity, about elevator placement, zoning, population density, cash flow, and the internal logic of a functioning skyscraper. The issue was not simply words. It was the inability to summon attention for something that did not grip me.

In retrospect, there is something almost funny about the idea that the main intellectual work was supposed to be happening at the kitchen table. That was where the homework was, so that was where the learning was presumed to be. But I am not sure that was true. Much of my interior life was being formed elsewhere: in games, films, stories, maps, systems, and imagined worlds. What looked from the outside like avoidance may also have been a displaced form of intelligence, looking for a world complex enough to hold it. I think the line from those things to my later interests in philosophy, theology, psychology, and the structure of human experience is much straighter than it might appear. The important continuity was not subject matter. It was the kind of attention involved: entering a world, learning its rules, sensing the hidden mechanics at play, and trying to understand what sort of life could be lived inside it.

The Shape of a Day

I used to be someone who would occasionally stay up late, sleep in late, and adjust as necessary pretty easily. That is much harder now. Vyvanse gives the day a sharper structure. Sleep matters more. I am far more sensitive to the effects of caffeine and alcohol. I still get my eight hours, but I have to be careful about it. The margin for messing around feels much smaller than it did before.

There is also a strange moral pressure that comes with being able to do more. Before, the day’s failures could disappear into vagueness. I had not quite chosen not to do the thing; I had simply failed to arrive at the point of doing it. Medication makes that harder to sustain. The task is more visible. The next step is more obvious. That is helpful, but it is not always comfortable.

The other thing worth saying is that Vyvanse does not make attention wise. It makes attention more available. That is a different thing. I can work longer, stay with a task more patiently, and return to it with less internal resistance, but I still have to decide what deserves that attention. In some ways, that makes distraction more serious, not less. If I give the day to the wrong thing, I may now give it with much greater efficiency.

It would feel slightly absurd to say that I have become more productive and then leave no evidence of that productivity behind. So I will say this much: I am working, quietly and quite seriously, on a historical computer game set among old streets, churches, ledgers, parlors, and decaying Southern grandeur. I am not ready to say much more about it yet, except that I think it may be the most substantial thing I have made to date.

There is also a physical side to it. The medication seems to increase a certain muscular tension in me, and because it helps me work with greater focus, I can remain stationary at a computer for much longer than I could, or probably should. The result is not dramatic, but it is real: more backache, more bodily tightness, more need to remember that a focused mind is still attached to a body.

I have had very few days off Vyvanse since I began taking it on March 2, 2026, and I increasingly dislike them. I am far more conscious of my limitations than I was before. I can think of things I ought to do, but the old difficulty of beginning returns, now sharpened by comparison. As a result, I tend to feel shit. This is compounded by the slightly dangerous knowledge that I can simply do the thing when I am back on the medication. So the lethargy I felt before, if anything, is intensified by contrast.

I was asked after my first article what the main negatives were, and honestly, they are pretty limited. Vyvanse has been, overall, a very positive experience for me. I found that it was tailing off a bit later in the day, so after the first month I had my dose increased to 40 mg. Everything else I have described here covers the drawbacks. And obviously I am describing my own experience here, not offering advice about medication.

A Bygone Temper

At school, I think it is fair to say that I was known for my temper. That was simply part of who I was, or seemed to be. I could be funny, the class clown, witty, imaginative, and socially at ease, but I could also become suddenly angry in a way that felt disproportionate even to me. The anger usually had a trigger, but rarely one that justified the scale of the reaction. It often began with some small sense of injustice: being misunderstood, dismissed, interrupted, blamed unfairly, slighted, mocked, excluded, or treated in a way that felt wrong. Whether or not that perception was accurate almost did not matter. The feeling arrived first.

That is the part I recognize now. The anger did not usually feel like a considered judgment. It felt like a verdict delivered way before any trial had even begun. Something in me registered unfairness, rejection, or humiliation, and the emotional response came with immediate force. It was more like weather than argument: a pressure system moving through before language or thought had put any structure on it. Because I was bright and verbally quick, I could often supply the argument afterwards. The explanation came later, but it could feel as though it had been there all along.

I do not care to excuse anything. It makes no difference now. But I do think ADHD changes the frame. I am not talking about something I only began to master after diagnosis. In many ways, I had learned to manage it long before I had any name for it. Age helped. Experience helped. The ordinary pressures of adult life helped. Diagnosis and medication have added clarity, but they did not create self-control from nothing. They have simply helped me understand more precisely what I had already spent years learning to contain.

I am cautious about this, because I do not want ADHD to become too convenient an explanation. There is something distasteful to me about using a diagnosis as a standing pardon for one’s own worst habits. I am cynical about people hiding too readily behind labels, especially when the label becomes not only a way of understanding oneself, but a way of compelling others to accept one’s preferred account of events. At that point, the diagnosis stops being an explanation and becomes a demand: you must understand me this way, and no other reading is permitted. That seems false to me, and faintly coercive. But neither do I think skepticism should harden into blindness. The point is not that anger, impatience, or oversensitivity were never really mine. They were mine. The point is that I now understand more clearly what I was trying, often clumsily, to manage.

Since being diagnosed, I have read more about emotional dysregulation in ADHD, and about rejection sensitivity: the way perceived criticism, disappointment, exclusion, or disapproval can land with absurd force. That has been one of the more uncomfortable recognitions, because it does not feel like learning something new. It feels like finding a name for something I have known intimately for decades.

What comes back to me now is not only the times I reacted badly. It is also the times when anger almost got the better of me and, somehow, did not. I remember moments when a reaction rose in me too quickly and too fiercely, when I came close to saying or doing something I would not have been able to take back. And yet some last restraint held. The sentence remained unsaid. The damage did not happen.

Again, this is where ADHD becomes difficult to separate from character. If you spend years being intense, impatient, reactive, or oversensitive, at some point people stop seeing those things as symptoms of anything. They become you. And, in a practical sense, they are you. But a diagnosis complicates that. It suggests that some of what I took to be temperament may also have been dysregulation; some of what looked like anger may have been overwhelm; some of what looked like certainty may have been hurt moving faster than thought. That is a useful revelation, but not exactly a comforting one.

Believing in ADHD

Narratives are doing a tremendous amount of work in all this. Fifteen-odd years ago, while I was training for the priesthood, I did a placement at an Episcopal church in Tennessee. As part of becoming familiar with the life of the congregation, I was encouraged to spend time with the various groups connected to the church. One evening, I went along to an Alcoholics Anonymous meeting that gathered weekly in the church hall.

Afterward, I found myself talking with an older man. He told me that he had never, in his entire life, had a single drop of alcohol. And yet he knew he was an alcoholic. He had grown up around alcoholism, I inferred that he had probably experienced firsthand abuse from an alcoholic, and I think he mentioned his father. As he understood it, he had the "disease." That was his word. In a moment of desperation as a teenager, he had made his way to a meeting, and he had been going ever since.

I have thought about that conversation many times since. It became one of the ways I began to understand the intersection between belief, narrative, identity, and self-understanding. In what sense is it meaningful to think of this man as an alcoholic? Is that an absurd question? It feels almost impossible to push a wedge between this self-narrative and "reality." Clearly, this had become his lifelong reality.

Of course, I am not suggesting that ADHD and alcoholism are the same kind of thing. Nor am I saying that diagnoses are merely stories. But the distinction is not as clean as we might like. In some respects, an ADHD diagnosis involves testing whether your subjective account of yourself comports with a recognized diagnostic pattern. You describe your attention, your restlessness, your failures of organization, your habits of delay, your history of effort and collapse, and the clinician listens for a shape within it.

And now, in this strange new period, you can rehearse that self-account with a large language model before ever speaking to a doctor. You can ask whether your experience sounds like ADHD, whether the pattern coheres, whether the words you are using are likely to clarify or confuse. There is something slightly unsettling about that. It can feel like trying on different beliefs until one begins to feel true.

In some sense, I am choosing to have this label applied to me. Not because I think it explains everything, or because I imagine it names some fixed object inside me, but because it has proved helpful and self-clarifying. It gathers things that had previously felt scattered. It gives a shape to difficulties I had learned to explain in other ways.

But could someone with a very similar brain to mine decline the label altogether? I think certainly they could. They might call it temperament, anxiety, laziness, intensity, creativity, immaturity, or simply "the way I am." They might distrust the language of diagnosis entirely. They might prefer an older moral vocabulary, or a less medicalized one. They might even live decently under that description.

So what, then, is the reality? I am not sure it is the sort of thing that can be cleanly separated from the words we use for it. ADHD is not an object sitting somewhere inside me, waiting to be discovered like a stone in a field. It seems closer to a recognizable pattern: of attention, motivation, memory, emotion, inhibition, behavior, and consequence. The label is not the thing itself, but neither is it merely invented.

Not a Final Explanation

Three months in, I am not sure ADHD has made me simpler to myself. If anything, it has made me more complicated. It has not turned my life into a neat diagnostic diagram. It has not made dyslexia irrelevant, nor has it made temperament, habit, choice, or character irrelevant. But it has changed the scale of the picture. ADHD may be the larger explanatory frame, or at least the one that now makes more of the evidence cohere.

That may be the real change. Not that everything is solved. Only that certain things now make more sense than they did before, including the strange relief of medication, and the equally strange discomfort of seeing how long all this may have been there.

But I want to be careful about what kind of explanation this is. I do not think a diagnosis reaches back through time and turns every weakness into a symptom, every failure into an inevitability, every wound into a misunderstanding. That would be too easy.

It would be its own kind of dishonesty to pretend the account has not changed. A diagnosis can make certain failures more intelligible without making them less real. It can revise my own understanding of events without requiring everyone else to revise theirs. That is a difficult balance: to accept the usefulness of the label without disappearing into it.

Perhaps that is why the language of belief feels relevant to me. I do not mean belief in the sense of pretending something into existence. I mean the quieter and more ordinary act of consenting to a description because it seems to illuminate more than it obscures. ADHD is not the whole truth about me. But at the moment, it is one of the better names I have for a pattern that had already been shaping my life long before I knew what to call it.

Medication has made this stranger, not simpler. Vyvanse has not made me into someone else. It has not made attention wise, character complete, or life suddenly orderly. But it has changed the texture of effort. It has made certain tasks more reachable, certain failures harder to hide from, and certain old limitations more visible by contrast. That visibility is useful.

I do not feel as though I have discovered a new self. I feel as though I have found a better explanation for the self I had already been living with. Better, but not final.