“You don’t seem like you have ADHD.”
“Thank you, I’m heavily medicated.”

To give you an idea of how heavily debilitating ADHD can be, writing is probably my most innate skill other than breathing. And with my asthma, even that’s up for debate.

Without my medication, I have trouble writing in complete sentences.

I was always a good student. I was valedictorian in high school and graduated from an Ivy League school.

Without medication, I have trouble reading more than a few pages at a time and have to spend an enormous amount of energy reading and rereading paragraphs for comprehension.

Seriously, when my mom wanted my kindergarten teacher to recommend me for the gifted program, my teacher wouldn’t because she thought I was developmentally delayed.

Before medication and tutoring, I tested at the 99.6th percentile for math and the 3rd percentile for reading.

Without medication, I have trouble even holding conversations with people. Some people read that as disinterest but it’s genuinely just me not being there. I’m not unfocused. I’m just hyperfocused on something else and have little control over where that focus is directed.

It takes an exhausting amount of energy to focus on a conversation and remember what I was going to say. If I don’t say it immediately, it vanishes into the ether, leaving the choice of potentially being rude by cutting someone off or not contributing to a conversation.

I’m really good at my work. Within a few months of working in tutoring sessions, I’ve gotten 2nd graders to go from picture books to reading at a 6th grade level. I’ve got 7th graders incorporating writing elements that I wasn’t talking about until my senior year of high school.

But because of the way my ADHD presents, I’m unhirable when unmedicated. I can’t write prose, copywrite or copyedit, and I’m useless at any job that requires me to talk to people (a pretty important part of tutoring and stand-up comedy).

Sans medication, my mind lives in a haze.

Without insurance, the medication that I need to function costs $1000+/month. When I was on private insurance, it still cost $150/month in addition to a $350 premium and a $50 co-pay to see a doctor to fill the prescription.

That’s just not something I can afford.

Thankfully, I qualify for Medicaid which covers those costs. But as an otherwise healthy 30yo single-person in the state of Washington, I have to earn less than $1468 per month to qualify and maintain access to a medication that, I’ll reiterate, I need to function in society.

Because of this, I have to be conscious of limiting how much I earn. If I slip up and have to get private insurance, it adds a $500+ cost to my monthly expenses and forces me to choose between eating and paying the co-pay on my meds.

Both because ADHD isn’t taken seriously by neurotypicals—it’s seen as a quirk and not a disability—and because of austerity limits on who can receive government healthcare, I can’t escape poverty in our society without fear of no long functioning in it.

So please be a bit more understanding of your friends with ADHD and consider supporting universal healthcare. I’m lucky to not have worse ailments but my story is far from unique for poor people with health problems who can’t better themselves for fear of worsening themselves.