Before my stroke, I was already dealing with ADHD and the daily chaos that comes with it: 40 ideas a minute, a sudden urge to reorganise the living room at 11pm, the ‘where did I leave my keys’ game, and looking for my phone while holding it.
I had some coping mechanisms, and was on methylphenidate (Elevanse), which helped a lot with focus.
After my stroke, everything changed. Not because my ADHD disappeared. Oh no, it got a roommate.
My ADHD and acquired brain injury (ABI) now both live in my head pressing buttons they should absolutely not be pressing.
The kicker with having both ADHD and a brain injury is that so many of the symptoms overlap. (As an aside, secondary ADHD exists, and brain injury is one of the causes.)
Brain injury can affect memory, concentration, processing speed, language, planning, problem-solving and emotional regulation. ADHD can also affect attention, working memory, task initiation, motivation, emotional regulation and impulse control.
So when I forget something, which is it?
ADHD?
Brain injury?
Fatigue?
Seizure/Epilepsy?
Medication?
Pain?
Stress?
All of the above in a trench coat?
The answer is often… ‘yes’.
It’s not just forgetfulness
People often think that cognitive difficulties mean forgetting names or forgetting why they walked into a room. And yes, that can happen. Memory is one part of cognitive difficulty. But so are attention and focus, executive function and language. And because of the overlap with ADHD, this just ends up amplifying everything.
It’s knowing what I need to do, but not being able to start.
It’s opening my laptop with the intention of doing one life admin task, and somehow ending up with 14 tabs open, a shopping basket full of crafting supplies (which my physical limitations means I wouldn’t be able to do!), and no idea what I was originally meant to be doing.
It’s needing clear instructions, written and broken down, because my brain can’t hold too many steps at the same time.
It’s getting overwhelmed at choices that used to feel normal.
It is having ideas, good ideas, exciting ideas, proper little glitter gremlins of possibility, but not always having the brain battery to make them real.
And that part hurts.
Because I am still creative. I am still ambitious. I still want to build things, write things, make things, advocate, connect, be useful, be funny, be me.
But I can no longer access myself on demand anymore.
The coping systems broke
Before my stroke, I had systems and medication to help. I was taking methylphenidate (Elevanse), which helped with my focus immensely.
I also had a lifetime of coping strategies. Were they foolproof and perfect? Absolutely not. They were ADHD systems, which meant they were often cobbled together with good intentions, possibly new stationery (because that always makes something feel official), caffeine, shame and vibes. But they worked well enough. I was a somewhat functional adult, doing adult things like paying bills.
After the stroke, they stopped working. I couldn’t just push through anymore. Pushing comes with consequences. Sometimes that’s days or even weeks of extreme fatigue. Sometimes it’s seizures. Sometimes it’s regression with speech and language. Sometimes it’s the tell-tale ‘wonky face’ that I can no longer control.
That has been one of the hardest adjustments.
ADHD often makes me want to chase the shiny thing. Brain injury means chasing the shiny thing can flatten me.
So I live in this strange tug-of-war between wanting stimulation and needing rest.
My ADHD wants novelty, momentum, dopamine and snacks.
My brain injury wants quiet, pacing, routine and for everybody to please stop making so much noise.
I am the exhausted referee.
Fatigue changes everything
Brain injury fatigue is not just being tired.
It is not “I stayed up too late watching TikTok” tired.
It is a full-system power cut.
My thinking gets slower. My speech gets worse. My body gets heavier. My tolerance for noise, decisions and basic human admin drops dramatically. Even things I enjoy can drain me.
And when you add ADHD to that, it gets complicated.
Because ADHD can make it harder to pace. It can make it harder to stop when something is interesting. It can make rest feel boring, frustrating or even mildly offensive.
So I am learning that pacing is not laziness.
Rest is not failure.
Stopping before I crash is not “giving up.” It is maintenance.
Annoying maintenance, yes. But maintenance.
I need support, not character development
One of the most frustrating things about living with ADHD and a brain injury is how easily people mistake symptoms for personality flaws.
Disorganised. Unmotivated. Too emotional. Not trying hard enough. Always late. Forgetful. Dramatic. Inconsistent.
But cognitive disability is not a moral failing.
Needing reminders is not childish.
Needing things in writing is not being difficult.
Needing fewer steps, more time, less noise or clearer instructions is not special treatment.
It is access.
My brain has changed. That means the way I interact with the world has changed too.
What actually helps me
I am still figuring this out, but these are some of the things that help:
Written instructions, not just verbal ones.
One task at a time.
Fewer choices.
Visual reminders.
Rest breaks before I am desperate.
Not booking too much in one week.
Asking: “What is the smallest version of this task?”
Letting good enough be good enough.
Accepting that some days are maintenance days.
Using tools, apps, notes, alarms and other tiny external brains.
Being honest when I cannot do something safely or reliably.
The biggest thing, though, is compassion.
Not fluffy, inspirational-poster compassion.
Practical compassion.
The kind that says: this is hard, so let’s make it easier.
I am still me
Living with ADHD and a brain injury means I am constantly renegotiating with my own brain.
Some days I feel sharp and funny and full of ideas.
Some days I feel like my brain has been replaced with mashed potato wearing a party hat.
Most days, I am somewhere in between.
But I am still me.
I am not less intelligent because I need support.
I am not less creative because I need rest.
I am not less capable because my capacity changes.
I am not broken because my brain works differently now.
I am glitched.
I am adapting.
And yes, I am still cute.
Glitch ≠ broken.
Further Reading:
Headway: cognitive effects of brain injury
Headway: executive dysfunction after brain injury
Headway: fatigue after brain injury