In the ghostly quiet of the Queen Elizabeth II Library in St. John's, a young man sits alone next to a bare concrete pillar in the cavernous reading room, gazing into his laptop screen and struggling to stay on task.
Ahmed Hassanin, 25, is a graduate student at Memorial University, working toward a master's degree in computer engineering.
Though he has managed to succeed so far within a difficult discipline, Hassanin is encumbered by something beyond his control: a neurodevelopmental disorder that until fairly recently he did not know he had.
Like roughly three to five per cent of Canadians, he lives with attention deficit hyperactivity disorder, or ADHD.
"It's not something you can just power through," he said.
Hassanin describes some days as better than others, and the worst ones he calls bad ADHD days. On a bad day, his focus becomes like a loose cannon that he cannot control. He says no amount of mental effort is enough on these kinds of days.
The condition makes low-stimulation tasks like reading completely onerous for Hassanin. As a grad student, that can be a problem.
"I keep losing focus every few words," he said. "I end up totally losing track of what I was reading."
He prefers instead to work on the more practical parts of his studies, where concentration isn't quite as much of an issue as with reading. At home, domestic chores like sweeping the floor or doing the dishes can also become unduly tricky for Hassanin to complete.
"All the small tasks you can't do keep piling up," he said. "You can't work when you can't take care of all those little tasks."
A life-changing diagnosis
Hassanin's diagnosis came only last fall. After months of doctor's appointments, pre-screenings and a referral to a psychologist, he was diagnosed with ADHD in October. He was 24 at the time.
According to a counsellor specializing in ADHD management, a diagnosis can be life changing.
Janet McDonald, a Canadian certified counsellor, has for the past two years been focusing on helping people manage their ADHD.
"Getting a diagnosis can be like finding a missing piece of the puzzle," she said. "People can start to understand why things are so difficult for them."
Day in and day out, McDonald sees people who live with ADHD struggling with their self-esteem because they don't understand their disorder or can't manage it on their own. There is often less understanding about ADHD in adulthood, leading to some people questioning their own competency.
"A lot of people can start to label themselves," she said. "There can be a lot of shame involved."
McDonald said things become even more complex when ADHD presents itself in people who, on the surface, appear to function at a high level. A person like Hassanin may succeed in areas like academics but struggle in other areas of life.
"There's this idea like, 'your grades are too high to have ADHD,'" said McDonald.
'Just barely on the affordable side'
ADHD can present in different forms, including an inattentive type, a hyperactive type or a mixture of both known as combined type. McDonald believes people with ADHD fall somewhere on a continuum, and each person needs a personalized management plan just for them.
Six months out from his diagnosis, Hassanin still grapples with finding a treatment that works for him. Medications can be fickle, with side effects that can sometimes outweigh their benefits. Agitation and restlessness made him shy away from pills altogether for months. So far, he has been on three different drugs during four different stints and has yet to settle on a dose that fits just right.
I'm learning to work with it instead of fighting it. - Ahmed Hassanin
As an international student, Hassanin had to pay for the drugs out of his own pocket. He said a month's supply of pills can cost him between $150 to $200, and all while he still didn't know exactly what he should be taking.
"It's just barely on the affordable side. At least, for now I can afford it, and it's worth it," he said, explaining that he recently found a dosage of Vyvanse that seems to help his symptoms without side effects overshadowing things.
"I'm learning to work with it instead of fighting it."
Hassanin says he gets by with a supportive network of friends and colleagues. His supervisors at work know about his condition and have shown support for him, even suggesting some resources that might be helpful for him.
ADHD is a neurodevelopmental disorder and not a mental illness. Since there is no cure, McDonald believes it's important to keep track of progress and recognize positive steps taken forward, however small they may seem.
"It's important to give yourself credit for doing something small," she said.
"Those things do matter."