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Am I too old to have ADHD?

Tim Lott on his late diagnosis for ADHD.

Tim Lott may have written nine books and won a Whitbread award, but he also suffers from depression, struggles to finish tasks and has a poor track record in relationships. It is only since a doctor diagnosed him with an attention deficit disorder – at the age of 61 – that his life has begun to make sense.

December 2016. I am travelling on the 11.10 to Crewe, where I will change for Liverpool Lime Street. Shortly after I arrive there, in a city of which I know practically nothing, I will at last find out who I am.

This journey into the unknown was prompted by a response to an article I recently wrote about what I called “forgettory” – the flip side of memory. I said that I counted it to be important – that the ability to forget things was not far from forgiveness.

I gave an account of my own personal struggle with poor memory, which I took to be problematic but not extreme. Like many people of my age – I am 61 – I put keys down and did not know where to find them. I walked into rooms not understanding why I had done so. I was asked to do things by my wife andI wouldn’t do them, not out of laziness but because they would simply escape my mind.

A reader wrote and suggested I might not just have a bad memory. I might have ADHD (attention deficit hyperactivity disorder). This made no sense to me at all. ADHD was a condition – I thought – that affected children and made them climb the walls. I associated it with autism and learning difficulties and “special needs” and an inability to focus.

As far as I knew, ADHD didn’t affect adults, and certainly not those with degrees from the London School of Economics. I was also writing my tenth book, and proudly displayed my Whitbread First Novel of the Year award on my wall. Anyway, wasn’t ADHD something of questionable reality, a sort of junior “yuppie flu” that excused difficult or disorderly children from what were either character defects or the outcomes of bad parenting? Certainly the Daily Mail would have you believe so – it enthusiastically ran extensive coverage of a book called There’s No Such Thing As ADHD by Richard Saul a few years back.

Although I had been pretty jumpy in my teenage years and twenties, highly ambitious, always on the go and very verbal, as success-hungry young men tend to be nowadays, I was pretty quiet. I was usually the first person to leave parties and go to bed. I was often at my happiest alone without any of the pressures of people around me. I was not unduly restless (although my mind was – I often wake up at 5am with my thoughts in overdrive).

The first book that caught my eye as I began my research was You Mean I’m Not Lazy, Stupid or Crazy?! – the Self-Help Book for Adults with ADD. (ADD – attention deficit disorder – is the non-hyperactive version of ADHD.) All these negative traits the women in my life had suggested at times that I suffered from – although they might say, with some justification, that they did most of the suffering.

My wife was sure I had ADHD and that it had had a disastrous effect on our marriage

As I continued to research, a further number of the character traits associated with the condition began to gather into focus. My inner life could be chaotic – I would constantly switch from one task to another without being able to finish any of them. The sight of me, say, clearing up a kitchen was almost slapstick in its lack of structure and co-ordination. It would take me five times as long as anyone else, however much I tried to concentrate and structure my activity.

Historically, I had always struggled with intimate relationships – also typical of ADHD. My second marriage was in a delicate state and often looked like going the way of the first one by ending in divorce. ADHD sufferers have low emotional resilience – a single brief, traumatic radio interview two years ago that probed the reasons for my mother’s suicide 30 years previously had resulted in a year-long depression. And I had the symptom of poor motivation – the words, “Why bother?” came to me often enough, even without an incidence of depression to accompany them.

I was certainly abstracted. I will bump into people in my neighbourhood whom I have known for years and be unable to name them, still less their children. I could be impetuous and take sudden actions without thinking through the consequences. I had never held down a proper job for more than a year or two.

For an author, I had the odd characteristic of finding it very difficult to finish books, even ones I was enjoying. The bookshelves were scattered with volumes of which I had only read the first 50 pages before abandoning them. Then, perhaps they were just bad books.

Still more symptoms loomed out of the fog. ADHD people often pour their heart out to strangers. I was a “confessional” writer who had shared my intimate life with the world – not least with my highly personal memoir, The Scent of Dried Roses. They also tend to be guilty of “emotional affairs” – inappropriately close relationships with members of the opposite sex, and I have a considerable number of very close female friends.

ADHD sufferers procrastinate a lot – I rarely get down to work until a deadline looms. They also suffer low self-esteem – and despite a considerable number of career successes, I often feel, from an internal perspective, that I have woefully underachieved.

They are inclined to be locked in a private emotional world – the original paperback cover of my memoir showed me sitting as an infant on a beach, alone but for expanses of sand and sky, which is roughly how I feel, even today, much of the time.

Any one of these things, or quite a few of them together, could amount to nothing more than normal, if annoying, behaviour. But so many of them in a cluster? I showed the research to my wife. After digesting it, she was more or less convinced. After reading a book I subsequently purchased, The ADHD Effect on Marriage by Melissa Orlov, she had no doubts left. She was convinced that I had ADHD – and that it had had a disastrous effect on our marriage.

I remained sceptical. Surely I was just a typical low-functioning man – a bit on the spectrum perhaps, slobbish, narcissistic. Plus, I was a writer – abstracted, with a wandering, magpie mind. Surely it wasn’t pathological to be someone who left everything to the last minute, got bored quickly and who didn’t listen with sufficient focus?

There were, after all, a number of counter-indications. ADHD sufferers cannot keep appointments and are always late. I am very punctual and, although it is not unknown, I rarely miss appointments through disorganisation (although my iPhone tools may have a lot to do with this). ADHD sufferers are bad with finances. I have made a decent amount of money over the years both running businesses and making investments (although my accounts are usually an unruly mess).

But my main objection was, “How can someone who suffers from attention deficit disorder manage the herculean willpower, strength and focus required to write books?” This task requires a tremendous amount of application and concentration.

I continued to try to compare the pluses and minuses. ADHD is inherited, and my maternal uncle had quite severe, if undiagnosed, ADHD (I think – he certainly never stopped talking and had severe learning difficulties). His brother was also eccentric and was highly garrulous. Neither spent much time in employment or in successful relationships – or relationships of any sort.

I had been terribly clumsy and forgetful as a child – the most common remark on my school reports was, “Timothy lives in a little world of his own.” I once walked into the local swimming baths having forgotten to put my swimming trunks on. This was very typical of “inattentive type” ADHD (or ADD).

My mother may have been taking medication for psoriasis and perhaps depression when she was pregnant with me. I had a traumatic birth – born with cancer and three months in hospital drifting between life and death. Both maternal medication and difficult birth are highly associated with ADHD.

If this diagnosis is accurate, then at long last the puzzle of my life has been solved

I often offended people – or made them laugh – through my outspokenness (sufferers “blurt out” without thinking). I sometimes spoke loudly and talked over people before they had finished their sentences. ADHD was also highly associated with clinical depression, of which I am a lifelong sufferer – ADHD sufferers being six times more likely to have an episode. It is also comorbid with autistic spectrum disorder, of which, so far as I know, I do not have symptoms. My ability to write books could be explained by an aspect of ADHD called “hyperfocus” – a sort of superpower that enables sufferers to focus intensely on a task to the exclusion of all else.

But surely ADHD sufferers were a bit, well, strange. Certainly my talkative uncle was known brutally by me as a teenager as a “loony”. ADHD sufferers often ended up in prison (like my other uncle, who did time on a number of occasions) or unemployed, and had difficulty forming relationships. I had lots of close friends, none of whom had ever suggested there might be anything “odd” about me (other than the depression). At least, not to my face. And a good number of those same friends I was telling now were highly sceptical if not straightforwardly dismissive of the idea I might have ADHD. This included several therapists and a GP and medical writer who told me I was “the least ADHD person” he knew.

However, on the other side again: I sometimes behaved in ways I simply couldn’t understand – a few of my media appearances I have regarded with despair and embarrassment as I have veered off into weird tantrums and near-ranting, which I have listened back to with incredulity, thinking, “But that’s not me,” in a way I’m sure Nigel Farage never does.

It remained a matter of uncertainty – for me, at least – so after I received a Twitter message from one Dr Tony Lloyd, CEO of the ADHD Foundation in Liverpool, inviting me to come to see him for a test, I agreed. (I had previously asked for an NHS test, but there was a very long waiting list.)

So here I was on a train, two days before Christmas, with my very self at stake. I mean this literally. I said to my wife the day before leaving, “I may have ADHD but I am not the condition.” People’s perceptions of me were going to change, just as my perception of myself was going to have to change – just as those perceptions had changed 30 years previously, when I came to understand that what I thought was just a melancholic, irritable disposition was in fact clinical depression.

In any case, I am relieved that I am finally going to know – the test by all accounts is 80 per cent accurate and supposedly “objective”. And it would be a great relief to discover that many of the things I had put down as personal failures over the years turned out to be the result of a clinical condition. But then again, I would no longer be “normal” – and not an equal as a marriage partner, but a case for treatment, a problem to solve. Our marriage was already in dire straits. Could this save it – or would a diagnosis act as the final blow?

First, I needed to find out if I really had the condition By now I was increasingly convinced that I did.

Tony Lloyd clearly was used to dealing with ADHD sufferers. He gives meticulously clear instructions: “Come out of the station. Turn right after 100 yards to a cobbled street; this is William Brown Street. Go to the end. At two o’clock there’s a white building with ‘LVRS’ on it.” He then repeats it exactly again and tells me not to wander around. Or am I getting paranoid now, seeing ADHD everywhere?

Thirty minutes after arriving, I did the test. It is known as the QB test and it involves sitting in front of a computer screen for 20 minutes, responding to changes in sequences of certain shapes and colours. The test supposedly measures three indicators of ADHD – impulsivity, inattention and activity (ie fidgeting). It works simply – if you anticipate a coming symbol in a sequence too readily, you are impulsive. If you lose concentration and make an increasing number of mistakes over time, you are inattentive. And if you fidget a lot during the process, you are overactive.

Half an hour later, I had my result. It was inconclusive. I had scores “compatible with” ADHD – on the high side, but not definitive on impulsivity and inattention. However, I fidgeted more than was normal (which surprised me, since I hadn’t thought of myself as a fidget, although I sometimes rock back and forward and make persistent odd hand manipulations which my wife calls “alien hand syndrome”).

Since it was inconclusive, I returned a few weeks later for a further interview with a psychiatrist who specialised in ADHD, an NHS doctor, Dr Peter Mason of the Wirral ADHD Service. He spent an hour questioning me about family history and my historical and childhood behaviours. At the end of it, he was quite clear – I had inattentive adult ADHD. This, he stressed, was not a mental illness, but a different way of processing the world, with advantages and disadvantages. He stressed the concept of neurodiversity – the idea currently in vogue that many mental “disorders” are just differences within the normal variation of human behaviour. “Normal” or not, it responds to treatment – through changes in diet, exercise and lifestyle, and, crucially, drugs.

A four-page letter was duly dispatched to my doctor in London and I was sent a copy. Towards the end came these comments: “There were no abnormalities in his speech, thoughts, perceptions or cognitions … [but] … my impression was that Tim does indeed meet the criteria for adult ADHD … predominantly the inattentive type.” The letter went on to recommend a trial dose of methylphenidate (Ritalin), an amphetamine-type drug that increases the activity of dopamine and noradrenaline in areas of the brain that play a part in controlling attention and behaviour.

I heard all this in something of a blur. I remained somewhat unconvinced. After all, didn’t the ADHD Foundation have skin in the game itself? I was a relatively high-profile “catch”, who might serve to publicise and support its charity. Also, if I were lacking in abnormalities, how come I was so positively diagnosed?

All the same, I couldn’t ignore the diagnosis. It rang too true for that. At times, I felt a deep and profound sadness for the inner life I had lost, or never had in the first place. I have done well in my external life, despite the suicide of my mother and the experience of divorce. But my inner life, where life really counts, I have always been vulnerable, fighting some kind of hurt or apathy, or depression or confusion (although that confusion has fuelled a compensatory curiosity that has led to my writing career).

But in that outer life, I have been given much – a certain amount of income, freedom and career success, for starters. And even the inner life – I have discovered things intellectually beyond my natural talents, just out of that restlessness, that I need to understand.

So, to add to the confusion, I seem to have a deep blindness combined with an acutely clear sight, and I am never sure which one is dominating me at any particular point. I have procrastination married with fanatical determination. My impulsiveness has led me to be married twice and have four children – choices that if I did not have ADHD I would probably not have made and now am deeply grateful for. I feel sorrow for my wife – and my previous wife – who could not possibly have understood what was going on in my head, any more than I could understand it.

My self seems more uncertain than ever. Despite the diagnosis I remain somewhat unconvinced. I took the Ritalin for a few days, but it made no difference to me, other than producing an irritable edginess. This added to the doubt I had that I was “really” ADHD.

Admittedly, sometimes I just want the voice in my head to stop, instead of tormenting me in the morning before it is diluted with the voices of others. On other occasions, I enjoy that voice as intelligent and interesting. And as I write this, I ask myself, does that voice belong to the depressive, the ADHD sufferer or the person called Tim Lott? Or are they all the same?

‘Isn’t it convenient,’ said one friend, ‘that ADHD applies to all the things you don’t want to do – like housework and chores’

And yet I feel a great sense of relief. If this diagnosis is accurate, then at long last the puzzle of my life has been solved. Paradoxically perhaps, this has meant that I feel more at peace and “complete” than ever before. None of the depressive symptoms that have troubled me throughout my life have assailed me since the diagnosis. No poor sleep, outbursts of temper, melancholia, confusion. It is as if the invisible enemy I have been fighting has suddenly, having been identified, called off the battle. Even if the diagnosis is misguided, then I think of it nevertheless as a remarkably powerful placebo.

It is a shame I am already 61 years old. I don’t know if my marriage can survive such trauma. I wouldn’t blame my wife if it couldn’t. I wouldn’t blame me if it couldn’t.

“Oh, isn’t it convenient,” said one friend, “that ADHD applies to all the things you don’t want to do – like housework and chores.” My wife used to say something similar when I needed to sleep in the middle of the day, or failed to complete a household task. I don’t mind doing those chores – but in my own way and in my own time, according to my own lights and knowing that I will never ever be able to do so with the speed and efficiency that my wife is able to.

My wife says she has a new game called “ADHD or twat”. I think this is pretty funny, but she acknowledges that the condition isn’t remotely amusing.

Do I feel sorry for myself? No. That would be ridiculous. I could have died of that cancer I was born with. I could have jumped when I stood on that rooftop when I was 30 years old in the grip of terrible depression. I could have been born in Aleppo or Rwanda. Also, it might be worth mentioning that there are many positive qualities associated with ADHD – empathy, forgiveness, creativity, curiosity, humour, a sense of fairness and a powerful capacity for love among them.

So there is nothing to feel self-pity about. There is only the way things have turned out. Everyone’s choices are limited. Mine may have been more limited than I realised, but perhaps that’s true of everybody. And I have survived. Somehow, I have survived.

Whoever “I” turn out, in the end, to be. 

Tim Lott has now separated from his wife

http://www.thetimes.co.uk/article/am-i-too-old-to-have-adhd-76czn8gkl