The Dangers Of Alcohol & ADHD
It's ironic to hear stigma about how ADHD medication is 'addictive', because it helps me regulate my use of other drugs - especially alcohol.
For as long as I can remember, I've been obsessed with figuring out how to turn my extremely noisy brain off. At age 13, I discovered the answer: tequila.
I grew up in Cyprus, spending the majority of my teenage years in Ayia Napa, drinking cocktails that I'd quite literally pick up off the street. When I moved to London for university, this got worse, as I was constantly bombarded with 'free' nights out with club promoters, every single day.
After I graduated from university, my life fell apart. This was largely from losing the structure of full time education, and having no idea of how to get or transition into a 'real' job. Suddenly, my functional alcohol use also spiralled out of control.
I would go out to get drunk most nights of the week (including Sunday), because I wanted to be hungover. Being hungover was the one time that I would allow myself to watch tv without feeling like my brain was exploding from anxious overthinking. Feeling like I had a justifiable reason for my unhappiness that day gave me a false sense of control over my otherwise uncontrollable life.
I used to think it was perfectly rational to kick dates with strangers off with tequila shots to 'reduce the awkwardness'. Whenever I felt awkward in social situations, such as in a bar, I'd get everybody shots. It became a way for me to navigate socialising, feeling like I was being 'useful' by being able to organise nights out with free alcohol.
Living on this alcohol rollercoaster stopped me from being able to trust myself, and I'd end up in all sorts of terribly dangerous situations as a result. For example, my friends once lost me in a pub on a night out, and found me under a pile of coats in the corner. I genuinely cannot believe I am still alive.
I have now learned that Alcohol + ADHD = impulsivity x impulsivity.
It lowers our inhibition and self-awareness, executive functioning skills that we already have a neurodevelopmental delay in. 43% of people with ADHD are at risk of developing Alcohol Use Disorder.
ADHD is 5-10 times more common in adult alcoholics than those without it.
When I was first diagnosed with ADHD, my life was like living in series 7 of a terrible television show, where the bored writers are making up random things as they go along. I felt utterly powerless over it, with no idea of what I'd do by the end of the day. It was from pacing a park trying to stop myself from spontaneously moving to Mexico that fortunately led me to the psychiatrist's office instead of the airport, by pure luck.
That first year, I was so impulsive that I didn't return from my 2 week holiday to Bali to finish off my diagnosis and access the medication - instead, I moved in with someone I met on the beach. Fortunately, that person was sober, and my entire life changed as a result.
It led me to build other friendships and to discover activities that weren't based on alcohol, like yoga. It felt extremely hard at first, but making friends with people whilst sober increased my overall self-esteem, because I didn't feel like people just liked one ('fun') version of me.
When I returned to London and accessed this medication (Elvanse), I was finally able to stop going out clubbing, despite being in the same toxic environments. For the first time, I was able to say no. It meant I lost many friendships, but I finally learned that it was much better for me to have quality over quantity of friends.
Above anything else, the ability to not impulsively say yes to nights out, or to control how much alcohol I drink, has been the most life changing for me. It's meant I've been able to trust myself over time, and not to put myself in situations I don't want to be in in the first place, like clubbing. Not exposing myself to consistent dopamine rollercoasters through alcohol has meant much less opportunities to spontaneously destroy my life, until now.
This week I realised just how much of an important part my ADHD medication plays in my ability to do this.
Since the medication shortage was announced a few weeks ago, I have been rationing the medication (as it will take me 7 years to talk to my NHS specialist, apparently). One of the biggest changes I've noticed is the executive functioning skill of an 'inner monologue' (i.e the internal chatter inside your brain) which has virtually exploded, especially in social settings as I'm hyper aware of any differences due to the changes in medication.
Fortunately, because I have strong support systems around me, I've been able to spot these old habits creeping back in. (Ok, I was forced to become aware of it when I thought it was perfectly normal to get super drunk to watch Taylor Swift at 3pm on a Sunday afternoon. Everyone else seemed to enjoy my enthusiastic stage dancing at the front of the cinema, but I woke up MORTIFIED and covered in blood from cutting my finger open, despite being passed out in bed by 9pm.)
Becoming aware of these symptoms and 'danger areas' is super important, because ADHD impacts everybody differently. It will have made some people able to regulate themselves in particular areas of challenge, usually whatever it was that made them end up being diagnosed in the first place.
I'm sharing this to raise awareness of the dangers of people with ADHD just being cut off from medication with no support in place. My medication doesn't just 'help me focus' - it quite literally helps me to keep myself safe on a day to day basis.
We can control our environments, so if you are impacted by this, I'd suggest:
Setting a reminder to fill this ADHD symptom log in each day, to strengthen your self-awareness of particular challenges and strategies that work for you.
Talking to someone about how these changes are affecting you, such as a therapist, doctor, coach, friend, family member, or colleague. You can use this template to notify your employer.
Make the things you want to avoid or need to remain cautious of harder. For example, I know that I need to become a lot more structured around my phone use now, so I've deleted certain apps from my home screen. I also am avoiding situations where I'm likely to get drunk!
Ask for help to prioritise your wellbeing. Body doubling and accountability can work wonders for ADHD-ers. I have prioritised my daily calls with Beth Lewis to set out my daily objective and to confirm with her that I've made it to yoga! Coaching with Jacqueline McCullough has helped me to get the foundations set up and know what I need to do to get back on track.
Be kind to yourself. This is maybe the hardest of all, speaking as someone who seems to be their own worst enemy. I try to remind myself that there is literally no point in beating myself up - it just wastes my energy.
Read Chapter V is for Vices of ADHD: an A to Z!
Alcohol in particular can increase the cycle of toxic thoughts and beating yourself up, being a depressant and all. Waking up with a hangover gives us a permission slip to feel bad for getting drunk and causing our own misery. If you've got ADHD and struggle with self-awareness and impulsivity already, this is likely to multiply the impacts and leave you disentangling the mess your uninhibited alter ego may have created for you overnight.
I would argue that most people I know have an 'unhealthy' relationship with alcohol, just like food, but our society sees this as perfectly normal. Pubs were prioritised above schools in a national pandemic, with children's futures put last on a list of 'freedoms' like the ability to drink alcohol in a group of 6.
It's only once you stop drinking alcohol that you can see how foundational it is to so many parts of our society. From navigating 'work drinks' in the workplace, to opening champagne to celebrate, alcohol is held up as some sort of treat, instead of something that can ruin lives.
For all the general stigma I see around the medication I take in the media being compared to 'illegal drugs like cocaine', I see nothing about how alcohol is responsible for over 5% of all global deaths per year. In fact, alcohol dependence is specifically excluded from the Equality Act as being a disability protected from discrimination. Ironically, so are people who are 'drug addicted'.
Nobody chooses to become addicted to alcohol, or drugs. I would absolutely love a world where I didn't need to take any medication - there's no part of me that enjoys having to navigate an obstacle course each month to access these pills. I'd love to be able to control my life without needing them.
But the fact is, the environments around me and the brain I have been born with, make it exceptionally difficult for me to do this. I have quite literally written the book on strategies to help manage ADHD, but unless I'm going to go and handcuff myself to the side of a mountain for the rest of my life, I'm going to need some extra support.
If you want to help, please do sign and share this petition calling for a Public Inquiry into pre and post diagnosis ADHD support.
If you know someone with ADHD, take this as your reminder to check in on them. They need you.