Hyperfocus: ADHD, addiction, recovery — a yogi’s story

If you have ADHD, the science says you’re much more likely to have a substance use disorder in your life than someone who’s neurotypical. 

ADHD brains often lack dopamine. Drugs and alcohol can provide a hit of dopamine, albeit a temporary one. That’s why it’s so common for people with untreated ADHD to self-medicate. 

Elaine O’Brien used to fit that ADHD archetype to a tee. Eventually, though, she entered recovery and also started practicing Ashtanga yoga, a style that she describes as “very rigorous and very codified.”

She fell for the physicality of the practice and the routine it demands. “It got me in my body and I started to feel good,” she says. “I really started to feel good.”

For years, Elaine had struggled with substance issues and untreated ADHD. She’s been in recovery for almost two decades but recently began to wonder if the ADHD diagnosis she’d rejected in high school might actually be right.

How did her journey take this path? Listen to this week’s Hyperfocus episode to find out. 

We love hearing from our listeners. Email us at hyperfocus@understood.org.

Related resources

• Elaine’s studio: Second Story Pilates and Yoga

• Study: Medication reduces risk of drug abuse for people with ADHD 

• ADHD and addiction: Knowledge is power

• Does exercise help ADHD?

Timestamps

(3:04) Elaine’s diagnosis story

(7:09) ADHD and substance use

(13:52) Exercise and sobriety

(19:28) “Isn’t your job to help people calm down?”

Episode transcript

Rae: Traveling through life with ADHD can be unpredictable. It sometimes feels like trying to read a map that's written in a code you can almost but not quite crack. It can get tiring. So, I've often fantasized about finding the perfect ADHD path, a smooth way of moving through the world. No snags, no stress. But of course, it's not that simple. It never is. Because if you're being honest, that route has a name. It's the path of least resistance. And I'm sensible enough to know that that path isn't really the one that leads to happiness.

In reality, the road to finding your ADHD place in the world is twisty and rambly, and tough. So, when I find someone with ADHD, a person who seems to have built a world that works for them, I get nosy. What was their journey like? How did they get there? Elaine O'Brien is one of those people.

Elaine has that ineffable thing, a mix of being obviously cool and obviously kind. The sort of thing that makes you think, "I want to know that person." I met her on my first day of class at the Community Yoga Center she runs in our bustling Queens neighborhood.

I made various attempts to do yoga over the years, and for the most part, any questions I have usually run along a pretty predictable line, is this over yet? How did she get her leg to do that? What are the chances I'll actually remember to cancel my membership after I inevitably stopped coming?

But in Elaine's cozy studio, I felt calm, happy to be there, even. She has a way of teaching that feels knowable. Cheesy, I know. But in her classes, I never feel lost or out of step. It's refreshing. A tiny escape before going back into a world that's basically the opposite. After that first day, we started chatting and the conversation wound around ADHD. "I have ADHD," she said, open, thoughtful, and happy to talk about it. A mode I've come to learn, two years in, is simply who she is.

And still, when I visit the lovely soft world that Elaine has made for herself and her community, I wonder how she managed to build it. This tiny universe that seems so right for her brain. What stops and swerves and setbacks did she meet along the way, and how does she make it work? And yes, fine, I'm only human, how does she manage to speak normally while doing a headstand? So I asked. I'm Rae Jacobson and this is "Hyperfocus." Today on the show, Elaine O'Brien.

Rae: Hi.

Elaine: Hi, Rae.

Rae: This is so fun to see you like in, I don't know, not yoga pants.

Elaine: I know, I know. When you mentioned that earlier, I was like, you know what? She's right. Except I'd see you on the street once in a while, but, you know, I'll run into you or used to see you across the street with your kid or something, and you're like in an outfit. And it's really, it's great. It's great.

(3:04) Elaine's diagnosis story

Rae: So, can I ask you a little bit about how you came to get diagnosed because you got diagnosed pretty late, right? Like it's a pretty recent diagnosis.

Elaine: Well, yes, and also no. So, I was actually technically diagnosed when I was in high school. But I kind of abandoned that diagnosis until, yes, a couple years ago, I was in therapy and, you know, speaking to my therapist about some...I was basically talking about how I absolutely had to go running. This was a kind of like and has been a thing that has definitely helped me focus.

But I was a little annoyed in that moment that, you know, no matter what else is going on, no matter what else I wanted to do that day, even if I was tired, I just thought if I don't run around outside, like I kind of thought of myself, like a little like a horse or something. It's just like you've got to go outside and run until you get that part done and then you can move on and do the the other priorities.

Then I was explaining that to her and then she was like, "Continue, you know, tell me more." And I don't remember what I said, but I explained a little bit about the feelings I had — I'm sure it signaled to her that I have ADHD. And she said, "You might want to look into this." And I told her I had been diagnosed when I was a kid, but I did not think it was relevant.

As an adult, I thought that it was one of those, you know, I mean, I was a teenager in the '90s and it was very common for people to be medicated for ADHD then. And I was medicated for a period of time, and then like a true ADHD person, I couldn't maintain my own like kind of plan of care. It just wasn't something I could do in college. And so, I just stopped taking it. And I never got any other like tools around that at all. So, I kind of forgot.

Rae: When you say that you rejected it in high school, what do you mean?

Elaine: So, this is you know, I think it's important for me and obviously, this is my situation, not everybody's, but, you know, I've been in recovery, like 12-step recovery for a long time, and my introduction to recognizing that I had ADHD or maybe that I reacted well to stimulants was because I was a, you know, kind of like a drug-seeking person in high school, not kind of, like absolutely a drug-seeking person in high school. And my little brother, he has autism, he had ADHD meds, and I like just took some one day, and I was amazed as to how much more capable I felt in school.

And I guess I must've told my parents that I had been like skimming my little brother's medications, which is not a like, you know, not good news for them, you know, but they were, you know, they accepted that. And then they, you know, they said, "OK, well, let's you know, they had already been in that network of, you know, doctors that treated people, you know, with autism, ADHD, whatever else. And so, I saw somebody, they prescribed me some medication, I was on it for a time, it was helpful.

And then, like I said, you know, I wasn't really able to maintain my own treatment plan in college. I mean, that's when things really started to escalate. And, you know, being out on my own, I was definitely partying a lot. And then just being also not an adult yet, you know. And so, I just fell off with that.

And in my early days of recovery, I kind of chalked that up to just one of those like, just like a drug thing, you know, like just like, "Oh yeah, of course. Like, I'm going to take Adderall." I would take anything you put in front of me. And so, I never thought of it as having to actually do with how my brain has always been or that it was something I maybe should pursue as legitimate treatment.

(7:09) ADHD and substance use

Rae: So, a little bit about ADHD and substance use. There's a lot to unpack around addiction and ADHD, and every person's experience is different. But there are some facts that can give a little context to a complex subject. Around 15% of people with ADHD experience a substance use disorder at some point in their life, compared to about 5.5% people who don't have ADHD. The why of all of this is complicated and still being studied.

But we do know that drugs and alcohol temporarily provide a hit of dopamine, something our ADHD brains lack, and that factors like impulsivity and genetics play a role. Also, many people with undiagnosed ADHD end up self-medicating. It's a way to compensate for the differences in our brains.

For me, it was smoking. The perfect combination of nicotine and fidgeting and a reason to escape from parties all rolled into one. I've quit now, but it wasn't easy. For Elaine, things were more serious.

For a lot of folks I know with ADHD who are in recovery, if you're OK talking about it.

Elaine: Sure. Yeah, yeah.

Rae: But the medicine itself is a stimulant. It's controlled. And I know a lot of people who are in recovery who take it and say it makes it easier to stay sober because they can kind of manage their symptoms more effectively. And, you know, one of the big pieces of ADHD that I feel like people kind of don't talk about is that it makes you more likely to have any like substance use issues. And it's something where I don't know that there's like, I mean, you can tell me, what is it like to have ADHD in recovery and then kind of process that at the same time?

Elaine: Well, it's another layer, you know, and one of the kind of phrases that I've heard a lot that resonates with me in recovery is that, you know, two, I'll give you two cliches, two of which I really like. The one is, "I wish you a long and slow recovery," which means that you're always kind of unpacking, you know, and recovering in a way that's like, you know, you treat the acute issues, and then as things continue, as you continue to maintain abstinence from drugs and alcohol, but also, you know, in my case, like practice, the sort of the program, you know, you start to discover things that maybe are a little bit unexpected.

And sometimes like a little, a couple layers down. They also say like it's like you're you're peeling away the layers of an onion. So, you know, there's the things that are obvious and overt. And then, you know, as you continue on and sort of, you know, in my case, a couple of years down, new things or maybe unexpected things start to show through.

And so, let's see, I just celebrated 18 years of recovery. And so, I was probably like 16 years, I guess, when I began ADHD medication or even became aware that I was possibly actually ADHD and not just looking around for stimulants when I was a teenager.

And so, I had at that point, I had already been in treatment for depression, which I had accepted, that I, you know, have this other layer that I have to address. I'd had more than one depressive episode in sobriety, many, many before I got sober, and I wasn't ready to play around anymore. I was pretty sure that depression was just a part of my chemistry and that being in treatment for depression is fine.

You know, being in treatment for meaning, like being in therapy indefinitely is fine. For me, I'm lucky I respond really well to SSRIs. Like, you know, being on a, you know, an antidepressant. And definitely it's okay. You know, like I'm I want to live I want to live my life. I don't want to have to do nothing but manage symptoms because I'm too stubborn or my ego is too big.

And I don't know. I don't, everyone's different. But like, I didn't want to engage in these really significant health issues and act as if I got treatment for them, that I was somehow compromising my recovery because I know I'm not. And so, but that said, I was a little bit more reluctant with ADHD meds. It took me a little while to come around, not long, but I thought about it. I did think about it because it's a stimulant and like that was something that I used a lot.

Now, looking back, maybe for reasons that are more, a little more clear than they were at the time, so I was a little worried about feeling like I was on drugs, like I like being sober. I don't want to feel like I'm on drugs. And it turns out I don't feel like I'm on drugs at all. Treating my ADHD helps me, it just takes the edge off of the things that are related to ADHD so that my recovery is a lot more in focus. You know, like anything else.

Rae: You know, that makes so much sense to me. I've never been in recovery, but I have experience with drugs and there are moments I remember when I was in high school and I would sort of like find something that worked for me that was fun. And I would think like, "Oh this is how people feel all the time. This is how normal people feel," which is like the way that I conceived of things at that time, you know?

And now, looking back, I can see that it was like kind of what you're saying, like, you know, you find something that like, basically does what ADHD treatment does and you take it and you're like, "Oh OK, I feel better." But at the time it was the same thing. I just thought, it's just drugs, and drugs are supposed to make you feel better. But it was like, you know, everyone around me seemed high and I was like, I just feel normal. Like, this is what it's like to just, like, do all the things you need to do? Oh totally.

Elaine: I mean, I think, you know, I definitely had that experience. But, you know, for the most part, I mean, I would just take it to the level of like...

Rae: Yeah.

Elaine: You know, and that's kind of the distinction there. I think that like people who play around with drugs, like they, their appetite for it is somewhat limited.

Rae: Yeah.

Elaine: Where, for me, it was like, oh if I turn that little light switch on, I don't know when I stop.

Rae: Yeah. There's no end.

Elaine: No, there's no end, you know. And it's like the cravings are really so strong. It just seemed almost like, OK, it's like, it's like breathing. It's just like, keep going, you know? But there were times where I was like, interesting how this, like, moment in an acid trip would make me feel like, "Oh yeah, I'm focused and relaxed."

Rae: Yeah. And clear-headed.

Elaine: Like before the, like, you know, the fireworks would start to go off or whatever, you know, was like, I was just sort of like there's like, brief little pause where I felt like I was, you know, relaxed and at ease and in a way that I think was probably closer to how I imagined other people.

(13:52) Exercise and sobriety

Rae: So, you've been sober, you said 18 years, which is incredible. And like, just congratulations. That's amazing.

Elaine: Thanks.

Rae: But also, when did you get into, like, exercise and dance and yoga and, you know, when did you start practicing the sort of, like, mindfulness exercise piece? And did you, where in your recovery did that step in?

Elaine: So, I've always been physical. I'd always gotten a lot of ease out of being physical. As a kid, going to basketball practice was like, I just want to...,I just it was like the best feeling, you know, like, whatever had happened that day, that was frustrating or upsetting, I would forget about it for that hour that I was just playing basketball. And then, and I would be shocked when I would return to the bad mood, you know, like sort of was over or whatever.

Rae: Yeah.

Elaine: But the relief was really clear. And so, that's always been something I've been attracted to. And I was also, as a teenager, really into performance, really into theater. That was what I pursued in college and what I actually continued to do for a lot of my adult life. But even before recovery, I would definitely self-soothe with exercise. And, you know, I don't know, maybe it was like, you know, body shame or something that kind of launched me into it, you know, or trying to meet some sort of physical standard.

But it definitely was well beyond that. It wasn't just like, "Oh I'm like staying fit so that I could be attractive or something." It was like, it was clear to me that it was doing something for my brain. And it was also very obvious to me, to my dismay, that like, I could not work in a sit-down and type kind of environment. I would just fall asleep.

Rae: You'd fall asleep?

Elaine: Like fall asleep. I would fall asleep. I had jobs in college where I was sitting, you know, and it's just like, if I'm, this is how it was at the time and maybe now I'm a lot more balanced, my energy is a lot less up and down. But it was just I felt like if I wasn't in constant motion, I was going to just completely pass out. So, anything that related to doing something, you did, it usually be physical.

Rae: Yeah.

Elaine: So, I always worked in restaurants and cafes and you know, in my twenties.

Rae: Very mobile.

Elaine: Exactly. If you wanted me to work in a office it was like, you know, nap time. I was like, I was not going to make it. And then, and I did OK with that. I was not, you know, always, obviously not always great, but sometimes fine. And then when I got sober, I, and the whole time I was doing performance stuff, you know, theater, some dancing. And then when I got sober, I guess maybe a couple months into it and I've been running, I've been running most of my adult life, I thought I kind of just like forced myself to go to a yoga class because it seemed like people who did yoga were calm and they enjoyed their time, you know?

And I was just like, I'll try anything. I mean, I was just really raw, really vulnerable. I went and I tried it and I went to an Ashtanga yoga class, which is, for people who know Ashtanga yoga, is pretty, it's very, very rigorous and very like codified. You do the same thing, every time, repeat, repeat. And it's pretty weird and very, just very demanding. And there's something about demanding physical practice that was repetitive, that got me in a routine and it got me in my body and I started to feel good. I really started feeling good.

And for the first time in my life, feel good, you know, in a way that was completely different from how one would feel good when they were using drugs. I felt relaxed and at ease and connected to the world. So, I started, I did a teacher training. I started teaching right away and then just kept doing that. Yeah.

Rae: It just fit. As a person who does not like to exercise — can you tell? — it pains me to say this, but exercise has been broadly and consistently found to help reduce symptoms of ADHD and improve mental health. Researchers think this is because exercise affects dopamine levels in the brain. Dopamine is a chemical that helps regulate memory, motivation, learning, pleasure. It does a lot, and people with ADHD don't have enough of it.

ADHD medications partially work by boosting the amount of dopamine in the brain and exercise has a similar, if smaller effect. It helps you feel better and makes ADHD symptoms less intense. Interestingly, yoga has been found to be extra helpful for ADHD because it combines physical activity and mindfulness techniques which can help calm the racing brain and make it easier to focus.

On the days when I come to class, which I try to do as consistently as possible and often do not achieve, I feel better. And, you know, there is a lot of evidence that exercise and mindfulness are helpful for ADHD, just managing symptoms, dealing with stress. Like you said, like you run, you feel better. You don't run, you don't feel better.

(19:28) "Isn't your job to help people calm down?"

Doing what you do, because a lot of times you do the class with us, like you show us the positions in it you're actively. You're very active all the time. So, on top of this admin stuff, you have a job where you're basically, as far as I can tell, practicing exercise and mindfulness like 100% of the time. Didn't one of your family members say, like, "Isn't your job to help people calm down?"

Elaine: No, my family member said "Elaine spends all of her time learning how to calm down." So, it's like, I mean, it's for me as well as the class.

Rae: But does it, you've noticed like I, I guess I'm trying to figure out like this job that you have is basically it's something that a lot of us use to treat ADHD. I come to yoga because it helps me manage my own brain. It makes me feel better, and I can get through my day in a different kind of way than I can if I don't. And it's noticeable. Have you noticed that, like that equilibrium that you found in your life, all of these things, it's like, is that supported by the actual physical kind of work that you do?

Elaine: Oh absolutely. Absolutely. I mean, for me, movement and mindfulness, breathing, tending to my breath, are all vehicles for attention. And so, I can't access that attention as easily as like, say, I love to read, but my husband has the capacity to read for like hours. And I could, I will only be able to read an hour if I've already put in the physical time moving my body. It prepares me, it prepares me for whatever else I want to do.

And, you know, and I do put a lot of time into that. But it, you know, I guess to the theme of just like, this is my brain, this is how my brain and my body interact and I have to accept it. And, you know, I'm lucky if that's what it takes to feel well, fine. You know, fine. I'm grateful to have those tools at hand. Really grateful.

Rae: I'm very grateful for you passing them along and very grateful for you coming on the show today. Thank you so much.

Elaine: Thank you. Thank you, Rae. This is so fun. It was so fun to talk to you.

Rae: It was so fun. And we're very normal clothes.

Elaine: I know. I know.

Rae: That's a thrill.

Thanks for listening to this episode of "Hyperfocus." If you have any questions or ideas for future topics, write me an email or send a voice memo to hyperfocus@understood.org.

"Hyperfocus" is made by me, Rae Jacobson, and Cody Nelson. Our video producer is Calvin Knie. Our music comes from Blue Dot Sessions and Justin D. Wright mixes the show. Ash Beecher is our supervising producer. Briana Berry is our production director and Neil Drumming is our editorial director.

This show is brought to you by Understood.org. Our executive directors are Laura Key, Scott, Cocchiere, and Seth Melnick. Understood is a nonprofit organization dedicated to empowering people with learning and thinking differences like ADHD and dyslexia. If you want to help us continue this work, you can donate at understood.org/give.