Finding the Way in Japan

Panoramic photo of large group of students sitting on track.
Miles (formerly Melissa) MacDonald, a man with ADHD, has found community while pursuing an English teaching career and a childhood dream to learn about Japanese culture.

Miles first discovered his interest in Japan in elementary school. His best friend was always wanting to show him the latest manga and anime that she had discovered, but Miles wasn't interested and would always say that he would try to look at it later. That "later" came when he was 13 years old and he read his first piece of manga. That led to him watching an anime show. Between the Japanese language, storyline and school uniforms, Miles was hooked.

I said to myself, 'one day I'm going to watch this live action and understand everything'. It was a real turning point and I started learning about what foods people ate in Japan, what holidays they practiced, the history, etc.

Miles quickly started studying the basics of Japanese writing and self-introductions, and at the age of 16 he got his first break, spending a semester at a Japanese high school with Youth for Understanding (YFU). Despite challenges studying the Japanese language, Miles had discovered the interest that would motivate him through what was about to come next.

At the age of 18, he entered his first semester of college at Portland State University, and found himself struggling a great deal with motivation. It seemed like he and his classmates were aimlessly going through the motions of college life without a clear direction. He visited a therapist, who recommended that he get tested for ADHD. That same year, he got an official diagnosis and began a regimen of Adderall. He also made the decision to stay with his parents while spending some time at community college to find that direction that he felt was lacking. Having the support of people who cared about his success and the flexibility to study a variety of subjects helped him get back on track.

My interests always pointed back to Japanese language, culture, and history, so I just followed what I liked and focused my degree on liberal arts and foreign language with a focus on Asia.

He ultimately decided that he needed to get his Bachelor of Arts degree, since he knew that it would be necessary in order to teach English in Japan. He began preparing an application to transfer to Tokyo International University where he thought he might like to finish that BA.

Meanwhile he applied to spend a semester at Kwansei Gakuin University studying Japanese in Hyogo Prefecture through University Studies Abroad Consortium (USAC) in affiliation with University of Nevada Reno. Since Adderall is prohibited in Japan, even when legally obtained elsewhere, it was necessary to change to a permitted medication before setting out for his adventure. As of 2018, the only legal medications in Japan were Strattera and Concerta, and after consulting with his doctor, Miles chose the latter.

He discontinued her Adderall a couple weeks before departure to Japan and started up on Concerta after getting in touch with a local therapist who could prescribe it. He located the Japan specialist with the help of USAC staff. After answering some questions over the phone, he took his Japanese insurance card and a letter from his American Doctor to his first appointment, where an English-speaking specialist wrote his Concerta prescription. "I tried to make the switch to Concerta before flying over, but my insurance provider wouldn't cover it."

He spent the first month of Concerta on the lowest dose possible, before he and his therapist agreed on the amount that worked best. He meets with his therapist each month when he comes for a refill to check in and discuss any adjustments to the dose. "They're really great at making sure you're doing okay and ask for your input on if you think your dosage is too high or low for your lifestyle (like if you're on a summer holiday and not taking the Concerta, you can delay filling it or if you lower your class load you can lower your Concerta dose."

During his semester with USAC, he focused on getting the dose right and adjusting to the Japanese education system. He asked around and identified an easier class load. His Japanese teachers were understanding, and available if he needed any extra assistance. It also helped that he was making the transition at the beginning of the semester.

The timing was lucky because I didn't have to worry about homework until I already had my routine down and my Concerta. That wasn't the case for all of my classes though, but it helped that every teacher I met had office hours and there was always school tutoring available because they really wanted to help every student do well and pass.

After finishing the USAC program, Miles found out that his Tokyo International University application was accepted. So the following semester he enrolled as a full-time student planning to finish his BA in Saitama Prefecture just outside of Tokyo.

Since he was now a full-time international student no longer affiliated with his American University, Miles had to find a specialist on his own, but even without the assistance of an American exchange program, all he needed to do was ask a nurse with his new school for a referral. For his first appointment with the ADHD specialist, he brought his medical records from Hyogo Prefecture as proof that he had been receiving treatment from a Japanese position the previous semester.

Currently his specialist speaks only Japanese. In order to get treatment in English, he would have to go to Tokyo, and he prefers to practice his Japanese and not have to travel as far for his appointments. There is a lot of paperwork in Kanji. He uses an app that pronounces the words in Japanese, getting help from his Japanese boyfriend if there is something in Kanji that he does not understand.

He checks in monthly with his doctor, and receives his Concerta prescription at the pharmacy next door. He is enrolled in the Japanese national health plan, which covers 70% of his medical costs. He pays a small monthly premium, or tax to support his enrollment on the insurance plan.

I've had an easy time finding clinics and people to help, and I feel that I'm given quality treatment with psychiatrists that ask plenty of questions and that really care about how I'm doing.

While there is not as much knowledge about ADHD, Miles has found his communities to be welcoming. He has made Japanese friends. After he finishes his BA, he hopes to stay in Japan and become an English teacher.

You can keep up with Miles's studies in Japan on her YouTube channel under the related links. Also be sure and review our tipsheet for applying for a Yakkan Shoumi, certificate to bring your medication with you.


Justin Harford