Smiley Faces
Getting a little bit better
Article by Anonymous, art by Alex Wollinka
Content Warning: Mental illness, disordered eating
After I was diagnosed with ADHD in fourth grade, I was given a clipboard full of pink worksheets. Every day, I had to fill in a smiley or frowny face bubble for each subject. The faces had no correlation to mood, of course. A smiley face meant I did a good job paying attention and a frowny face meant I did a good job keeping track of the birds that landed on the tree by the window. If other kids asked me what it was for, I gave a convoluted excuse about how it wasn’t mine. For a few days, I stayed under the radar. But I didn’t get very far.
It was craft time and I was cutting out a paper thermometer with a face, the type of face that seemed to be plastered on everything for kids—that big, stupid grin with those close-set eyes. I glanced away for a moment, but my scissors went off track and I cut right into its cheek. As soon as the teacher's assistant noticed, she scolded me sharply and told me to fill in the sad-face bubble.
I remember one girl turned to me, wide-eyed, and asked, “Is that sheet for you?”
I insisted that it wasn’t, but I was unable to look up from my hands. I had nothing to explain myself with and my burning face gave me away.
If the teacher’s assistant noticed my embarrassment, she didn’t show it. “Fill in a frowny-face, please,” she reminded me, more firmly this time. In her mind, my failure to follow directions chalked up to inattentiveness, a fact that might have warranted a second frowny-face if it were possible.
I was already an easy target-- in addition to being labelled as dumb, I was incredibly shy. I didn’t come from the same cookie-cutter American home that most of the popular girls in my school seemed to be from, but I was desperate to fit in. I wanted blonde hair and bubblegum lip gloss, I wanted new clothes instead of my oversized hand-me-downs, I wanted to sing along to the same songs and talk about the same things as them. The more I wanted to be accepted, the less I stood up for myself. Even though I knew when I was being made fun of, I had the idea that my classmates might like me if I was nice enough, if I pretended they were laughing with me instead of at me. As many people may know, this only made me more fun to tease. So when my classmates found out I took medication, I never heard the end of it. Even the people who were normally kind to me didn’t want me in their group projects and some students took it upon themselves to “check whether I was paying attention” in class. The teacher didn’t see any issue with it; she would thank them for helping me. I thought adults just didn’t understand how mean kids could be. I figured they just forgot it as they grew up. But now that I’m older, it’s hard to imagine forgetting.
I’ve been told that ADHD is a scam used to line the wallets of corporations, or that it’s an excuse to be lazy and that I just need to push through like everyone else. Other people refer to ADHD as a gift and tell me that meds will dim my true personality, dismissing the struggles that come with untreated ADHD as the cost of being “unique”. On the other hand, many people in favor of medication argue that meds are necessary for me to live a happy, successful life. The claim that medication is either a sign of weak willpower or meant to fix something broken is ultimately what made my relationship with it a toxic one for a large part of my life.
Everyone experiences ADHD and medication in a radically different way, so the decision to take meds is a very personal one. In many ways, my meds help me manage symptoms of ADHD that affect me negatively-- I can think more clearly, stay on top of day-to-day responsibilities, and handle stressful situations and sensory overload in a much healthier way. However, my relationship with medication had a rocky start. As soon as I was diagnosed, my mom wanted to seek treatment. My dad didn’t want me on meds because he believed it would change my personality, but she convinced him otherwise, and as soon as I started taking them, my academic performance skyrocketed. I was no longer the kid who got yelled at for zoning out. I didn’t have to spend recess time indoors while impatient teachers explained long division time and time again. I was no longer the one frantically searching for my crumpled homework while other kids giggled and whispered. My mom said it was an answer to her prayers and she was rigorous about making sure I took my pill, even if it meant bringing it to me at school. I was “smart” now. I was reaching my potential. She told me she knew all along I wouldn’t just be a C-student. I couldn’t pin down what frustrated me so much about those comments, but in my ten-year-old mind, part of me was screaming, It’s still me, isn’t it? Am I smart enough on my own?
Although my meds helped me a lot once I started taking them, I had been told nothing about ADHD other than that it made me unable to focus. No one explained that it was rooted in dopamine deficiency, or that it had all kinds of symptoms that weren’t related to focus at all. My attention was what showed up on my report cards. My attention was what people wanted. Whenever I seemed to start struggling with school again, my mom would bring up increasing the dosage of my medication. If I forgot my notebooks and my room was messy and the teacher said I had my head in the clouds, the question was immediately on the table: "Do you think you need a higher dose?"
I didn’t have a concept of how the pills should feel-—if I wasn’t focusing, I figured they must not be working. And so, my dosage routinely increased as I grew older, climbing every year or so. I didn’t know much about mental illness, and I didn’t consider that it could affect me, or my ability to do well in school, just as much as ADHD could. Most of what I heard on the topic was from the adults in my life. Adults who tsssked and whispered about mental illness being responsible for homelessness and school shootings, adults who gossiped about each other’s kids and spouses at church, adults who laughed at the whiny “snowflakes” of the younger generations.
I came to understand that the smiley faces and frowny faces were a representation of how others felt about me, and how they thought I should feel about myself. My worth was measured through a binary of failure and success, and that way of thinking stuck with me long past fourth grade. Starting middle school, I had frequent anxiety attacks and stomach cramps so persistent I would worry I was getting my period and check my underwear for pink spots. I didn't know that my medication could make these feelings worse. I didn't see anxiety as something that was hurting me, I saw it as a friend—something I needed to motivate myself, something that kept me in the parameters of who I needed to be. It felt like a part of myself that I couldn't and shouldn't get rid of.
Once I hit seventh grade, I was partially taking my meds for focus, but mostly as an appetite suppressant. Controlling my body became one of the coping mechanisms I latched onto. Seeing how long I could go without food was a game that never ended, a goal that was always reliably just out of reach, and I became eager to agree to every suggestion that I needed a higher dose. I even suggested it myself, telling my parents and doctor that I needed a secondary prescription to make the effects last throughout the day.
By senior year of high school, I was on a high dose in the mornings and two lower ones in the afternoon, which continued into college as well. Since I was rarely allowed to go out with friends in high school, I was looking forward to meeting people freshman year, but making friends seemed more and more impossible. Isolation made my newfound freedom feel like cold water, too big and too empty. I told my new doctor about the sharp pain in my ear and jaw that made it hurt to open my mouth more than a crack. The ache had been building up over time, making simple things like chewing, yawning, or smiling hard to do. My last doctor had said it might be a symptom of an ear infection. This one told me I was just clenching my jaw too much. He said my prescription was extremely high, and suggested I lower it to see if that helped me sleep. So I decreased my morning dose, and I found I didn’t get the usual heart-pounding and dizziness in the mornings. In addition, I clenched my jaw a little less, and the ear pain subdued.
I knew the effect the meds had on me, but I still felt like I needed a higher dose to function. I wasn’t thinking about focus anymore—the medication compensated for my tiredness, suppressed my appetite, and made me feel detached from my emotions. It made it easy to sit blank-faced and silent, watching the world from a bubble of superficial calmness.
I had several extra bottles of my supplementary meds on hand, since I hadn’t taken them over summer, and as my mental health declined, I depended more and more on the bubble of silence that overmedicating brought me. It kept my mind off things, and at that time in my life, there were a lot I wanted to avoid thinking about. As long as I was on my meds, my thoughts went in tight, repetitive circles within the lines of what I wanted—safely contained, instead of scrawling rampant across the page. I started taking them later in the day than I knew I should, taking more than I knew I was supposed to. The effect was a cycle that didn’t seem like it would end. The less I slept, the more I needed them to function. Five hours of sleep slipped into less than four, and all-nighters became routine, even when I was taking sleeping pills out of desperation. It felt like I was perpetually taking one to cancel out the effects of the other, always having both in my system. I hated the looks I got in public when I could hardly walk in a straight line, or when my hands shook, or when I started to feel my breath getting shallow. Coupled with my anxiety about eating in general, suppressing my appetite became far easier than leaving the sanctuary of my room to get food. I kept telling myself it was what I wanted. I wanted to believe that running on nothing meant I was succeeding. I wanted to fill in a happy face and move on.
When I was around people, I got more familiar with the hands waving in my face and people saying I was zoning out. Usually I wasn't; it just took too much energy to move my eyes and change my expression. But that was harder to explain. As time slipped by, classwork took up all my energy, and the rest of life melded together into a haze. I didn’t think I was going to get better. I was waking up with chest pains and losing consciousness more often, and my eyes felt like they had been erased and redrawn too many times, red-rimmed and dark-shadowed. In the back of my mind, part of me kept wondering when and how things would end.
One night in late March, I suddenly couldn’t stay cooped up inside any longer. I pulled on a winter coat and headed out at 2 a.m. I wasn’t sure where I was going until I stumbled down to the side of the river west of campus, where I sat with my heels digging into the bank.
I didn’t feel like the person I envisioned myself being in college, I felt like a haphazard mass of all the things I was taught to feel ashamed of. But I knew I wanted to live. I had come up with endless lists of little things I wanted to do in life—I wanted to finish writing my disorganized novel even though I knew it was packed with plot holes and random pointless scenes, and I wanted to figure out where to put the stickers I’d been saving, and to finally wear the dress I bought for the school dance that was cancelled last spring.
Even if I never ended up being who I wanted to be, I decided it was worth fighting to make life just a little better. Just to have a little more room to breathe.
That’s how it always starts, I think. With wanting to get just a little bit better.
I knew using my meds to cope with anxiety was never going to end well, but it took a long time to change my mindset. It started with keeping myself alive. I needed to eat, I needed to sleep. I had to acknowledge my right to have my needs met, whether or not I felt like I earned it. That was the first step in being aware of the smaller things I needed in order to function—taking breaks when I was burned out, grounding myself when I was overwhelmed, and guiding myself away from an all-or-nothing mentality. I had always thought I had to just push through, be strong, and make myself do things, like I had always been told. But I didn’t need strength. I needed gentleness. I could see myself apart from anxiety, I started to respect myself enough to see that I deserved to get better.
I had thought I would rather just wake up and be fully recovered without having to do any of the work myself, but it turns out that feeling myself heal, day by day, was the best part. I wanted to live through the small and difficult victories, to notice the first times and to live through new experiences. Even when I feel like I’m back where I started, I know it won’t last forever.
Now that I've started taking the right amount for the right reasons, I don’t mind mentioning that I use medication as casually as someone might mention wearing contacts. Even backhanded responses never bother me as much as I expected. I have nothing to hide. And there’s nothing they could say to take away that part of me.
Even now, I'm still adjusting to how I feel and act with the right prescription. I still sometimes forget that my facial expression changes on its own, after having to consciously align it with emotions for so long. I sometimes catch myself unintentionally scrunching up my face or smiling while I’m in public, and a lot of times I can’t stop my initial reactions from being completely readable. I no longer force myself to smile the right way, to fill in the right bubble. But for now, I don't mind wearing my heart on my sleeve.