I have an analogy I sometimes use:
Imagine you’re in a football stadium on the centre spot, and there’s just you and a referee.
The referee is talking to you, but you can’t hear them. You only hear the crowd. And they’re booing and yelling.
ADHD medication (which are controlled substances btw), will, in theory*, allow you to block out the crowd so you can hear the referee, concentrate on what they are saying, and understand the instructions.
Without the medication, you hear snippets of what the ref has to say, but the booing is louder. It’s all you have ever known. You take that as normal, that you can’t do stuff. That the booing is aimed at you. After all, they’re watching your every move, they know what they’re talking about. It isn’t just one person, it’s everyone.
The game starts but you have no idea what the rules were or what the ref told you. You forgot them already (short term memory deficiency), or misheard them (because your mind was wandering off) and went off and did your own thing. You played the game, but not with rules anyone else could fathom.
Others don’t understand what you just did – you invented something new, but you don’t know how or why, it just felt right. You went with it, it worked out. You scored a goal, using a contraption you built. The crowd doesn’t understand what happened. Somehow it works. You have created something no-one else could see, and did it skillfully. But you’re judged against every else’s expectations – they came for football, so you’re seen as a bad player.
Now, that thought process above can all happen in a split second, but you take away the feelings of inadequacy, unworthiness, shame and other negative emotions. Not the inventiveness, end result or ingenuity. That never seems to matter. The negativity thought pattern lingers. (Actually part of ADHD is an issue with lack of dopamine uptake, so pleasure and satisfaction are rarer and very specific, often not in situations where neurotypical people experience it).
* I say in theory because I am non-responsive to ADHD medication, after ~9 months of trial of all 3 available medications (another post on that perhaps in the pipeline).
I’m going to mention a condition that is a close “friend” of ADHD (of which there are many, including ASD [autism]. In particular I want to mention RSD (Rejection Sensitive Dysphoria). In a nutshell, it is intense emotional pain from a perceived or actual slight/rejection/criticism. Personally I experience this. Especially #2.
I am going to quote the section that is most pertinent to me:
RSD can make adults with ADHD anticipate rejection — even when it is anything but certain. This can make them vigilant about avoiding it, which can be misdiagnosed as social phobia. Social phobia is an intense anticipatory fear that you will embarrass or humiliate yourself in public, or that you will be scrutinized harshly by the outside world.
Rejection sensitivity is hard to tease apart. Often, people can’t find the words to describe its pain. They say it’s intense, awful, terrible, overwhelming. It is always triggered by the perceived or real loss of approval, love, or respect.
People with ADHD cope with this huge emotional elephant in two main ways, which are not mutually exclusive.
1. They become people pleasers. They scan every person they meet to figure out what that person admires and praises. Then they present that false self to others. Often this becomes such a dominating goal that they forget what they actually wanted from their own lives. They are too busy making sure other people aren’t displeased with them.
2. They stop trying. If there is the slightest possibility that a person might try something new and fail or fall short in front of anyone else, it becomes too painful or too risky to make the effort. These bright, capable people avoid any activities that are anxiety-provoking and end up giving up things like dating, applying for jobs, or speaking up in public (both socially and professionally).
Some people use the pain of RSD to find adaptions and overachieve. They constantly work to be the best at what they do and strive for idealized perfection. Sometimes they are driven to be above reproach. They lead admirable lives, but at what cost?Extract from Additude Magazine article “How ADHD Ignites Rejection Sensitive Dysphoria” by William Dodson MD
There you have it – if I get upset because of actions, real or perceived, trust (which is hard to earn) is lost, and crushing self-esteem issues ensue along with avoidance and bouts of anger and depression, cycling rapidly.
YMMV but I can only speak for myself.