"Treating" undiagnosed ADHD with alcohol - what if you actually have ADHD?
 

Forgive the long introductory post about this, but it's something I've been stewing on for a while.

Embarrassingly, it took me about 15 years after learning in a higher education setting what ADHD is to finally realize that... oh yeah I guess I have that! I had read the symptoms, and usually thought about it as a thing kids struggle with (and a few adults too). But I never looked seriously at myself through that lens.

And speaking at least for myself, issues with ADHD and issues with alcoholism are basically woven together, almost impossible to disentangle, and therefore I think my recovery is going to have to involve simultaneously addressing not only the common alcohol/addiction challenges, but the challenges associated with ADHD.

What really is ADHD? It's an inherited brain type, a "neuro-atypical" way of experiencing the world. It's associated with some common strengths, skills, and abilities as well as obvious deficits or challenges. Dr. Ed Hallowell, perhaps the foremost expert in ADHD, suggests looking beyond the DSM-V criteria for ADHD (because that's focused heavily toward children) and suggests adults instead consider the following. Specifically he says if a person identifies with 15 of the following 20 symptoms, there is a very strong case for ADHD:

1. A sense of underachievement, of not meeting one’s goals
2. Difficulty getting organized
3. Chronic procrastination or trouble getting started
4. Many projects going simultaneously; trouble with follow-through.
5. Tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
6. A frequent search for high stimulation
7. An intolerance of boredom, or rapidly swinging into different action at the first internal cue of boredom.
8. Easy distractibility, trouble focusing attention, alternating with ability to hyperfocus at other times or on other tasks
9. Often creative, intuitive, and/or highly intelligent
10. Trouble in going through established channels, following “proper” procedure
11. Impatient; low tolerance for frustration
12. Impulsive, either verbally or in action, e.g. in spending of money, changing plans, new schemes or career plans, etc.
13. Tendency to worry needlessly, endlessly
14. Sense of insecurity
15. Mood swings, mood lability, especially when disengaged from a person or a project
16. Restlessness, e.g. “nervous energy”: pacing, drumming of fingers, shifting position, feeling edgy while at rest
17. Tendency toward addictive behavior, especially to alcohol, marijuana, and/or cocaine
18. Chronic problems with self-esteem
19. Inaccurate self-observation, e.g. failing at times to accurately gauge the impact they have on other people.
20. Family history of ADD or manic-depressive illness or depression or substance abuse or other disorders of impulse control or mood

Elsewhere in Hallowell's book "Driven to Distraction," he shares the following observations/arguments:

"Of the many masks that ADD wears, substance abuse is one of the most difficult to see behind because the substance abuse itself causes such problems. When someone is alcoholic, is abusing cocaine, or is dependent upon marijuana, we often become so preoccupied with the problems the drug use creates that we fail to consider what purpose the drug must be serving for the user. ADD is one of the underlying causes of substance abuse that is particularly important to look for, because it can be treated...

...Alcohol tends to quiet the internal noise many adults with ADD complain of. It also reduces, in the short term, the anxiety commonly associated with ADD. Unfortunately, in the long run, alcohol is a depressant, and the daily withdrawal or hangover associated with chronic abuse increases anxiety...

For those addicts who do in fact have ADD, it is essential that the ADD be treated as well as the addiction. By treating the ADD one reduces the likelihood that the individual will go back to abusing the original drug."

Source: Hallowell, Edward M.; Ratey, John J.. Driven to Distraction (Revised)

For anyone struggling with alcohol, past or present, who has never considered whether or not they might have this , I'd suggest exploring it a little, with the intention to confidently rule it out or rule it in. Would be interested to hear any thoughts, experiences, or revelations people have had along these lines about themselves. It's been quite an epiphany for me over the last few months to connect these things together.

I have adult ADHD, found out a long time after I quit drinking. In my case, I did not feel the two were related, but who knows. I am living better through medication, but there are a lot of ways to tackle it.

Main thing, don't drink, and don't quit the decision. The rest falls into place.

I would just say, get professionally diagnosed...after some sober time. Like, give sobriety a good year before jumping on that wagon.


Alcoholism is also famous for creating mental health problems or exacerbating existing human weaknesses. Self-diagnosis with an online questionnaire? I wouldn't put a lot of stock in it. A lot of those questions would apply to most people.

Welcome to SR BatDad and glad to hear you've reached clarity and self awareness in diagnosing/finding your way. I think what you describe is very common and not just with ADHD - I could pretty much write the same story for myself with Anxiety replacing ADHD. I was fortunate that I found a counselor to work with on my Anxiety issues that was also well versed in Addiction and a recovering alcohlic herself - so we are able to explore both issues separately and as they relate.

I agree with this. I actually work in the mental health profession and am familiar with psych disorders and many of the diagnostic tools, yet my perception and judgement was not too accurate while drinking and diagnosed myself with a host of disorders a few years back - turns out, sober (even for a short while), I don't have anything except mild-to-moderate generalized anxiety. I think a lot of those self-(mis)diagnoses were driven by the anxiety itself, which was a million times worse when I was drinking, especially during short withdrawal periods. I think it's not a bad idea to see professionals even before getting stably sober, if you feel it might help, but I would be wary of anyone solidly diagnosing an actively drinking or very newly sober person with any psych disorder other than a substance use disorder.

I agree that any underlying issues have to be dealt with along with the alcoholism. Treating one will rarely fix the other - but +1 for a professional diagnosis first.

I don't have ADHD but I know folks here that do - if you do have ADHD there must be ways to treat adults with ADHD who also have an addictive history?

D

I’ve long thought I might have it, but, both my kids do, and are treated for it, my daughter with both therapy and meds, due to other comorbid mental health issues. Her therapist once suggested I might have it when I identified/empathized with my daughter in a session. It makes a lot of sense in hindsight. I think alcohol abuse can exacerbate the trouble with easy distraction, completion of tasks, organization, for obvious reasons. Drunkenness and hangovers pretty much disrupt getting things done.

Sobriety brings more focus and clarity for me. Alcohol never helped me there.

My adult daughter thought she had ADHD and did her research. She found a doctor who specializes in it and made an appt. The doctor, after giving her some tests and talking with her, diagnosed her with adult ADHD and prescribed meds for her. She has no history with addiction to any substance and the meds seem to be helping her.

But yes, see a doctor for a professional diagnosis.

I actually have it, and found that alcohol both helped and hurt my ADHD. Alcohol can increase dopamine in low doses before higher doses wipe out the negative effects. As others have said, do get a diagnosis. It can be treated with medication and behavioral modification but be aware that there may be some hesitancy to prescribe them to former addicts of any kind since some of the drugs are known to be involved in addiction. I used to use one and had no problems with addiction to it in the past, but it did cause high blood pressure.

Early recovery can mimic other mental challenges. Like biminiblue said, wait a good year or more, then get a diagnosis (or not)!