How My Internal Monologue Affects My Attention Deficit Disorder

My name is Ryan Langdon and I accidently blew the minds of over 10 million people this week. It has been a wild experience. I have received thousands of messages from all types of people. I have received interview invites, messages from celebrities, and even had a little filipino man photoshop himself into pictures with me. I have heard input from a lot of you, however I feel like you guys do not know where I stand on this situation. It appears to me that having an internal monologue is a spectrum. There are some people that do not have it, which I have decided to call “hyponeurovocalism.” In contrast, there are people who have a strong internal monologue, aka “hyperneurovocalism.”

I was diagnosed and treated for Attention Deficit Disorder (ADD) in 2009. After this whole post blew up I realized that my inability to focus in school was caused by the inability to control my inner monologue. I could be sitting in class, trying my best to focus on what the teacher is saying, but my monologue just drifts off and I lose focus on what is being lectured. After speaking with a few people who are hyponeurovocal, I realized that they report that they do not daydream often (I know it is a small sample size). Therefore, I believe that the cause of ADD is directly related to the internal monologue. 

When it comes to ADD, no one ever talks about what goes on in their head. It is a common stereotype that individuals with Attention Deficit Disorder are distracted by shiny things, but that’s not the case at all. It’s a much more subtle thing in my experience. People only talk about what medications they are on, rather than how the disorder actually manifests inside their head. Most conversations go a little something like this:

“I have ADD”

“Me too.”

“Adderall or Vyvanse?”


“I heard Concerta sucks”

“It works for me.”

No one ever explains that no matter how hard you try to focus on something, that internal monologue will take you into a different world. There are many physicians who still do not believe that ADD is a real medical diagnosis. However, as someone that has spoken with many people on this subject and has studied medicine, I would have to respectfully disagree. 

ADD is not correlated with IQ level, rather, it is a problem with controlling that inner voice. I can drift off into another world in the blink of an eye, until I snap back to reality by the sound of my entire class typing notes. “Oh shit, I must have missed something important,” is something I have said inside of my mind many times before. If I do not take my medication, I can not read more than two sentences without my internal monologue shifting gears and talking about something unrelated. If I am reading a book, my internal monologue could be vocalizing the words, but then it can slowly transition into an entirely different topic. Although my eyes are scanning the page still, I will absorb absolutely nothing and have to restart from the point I lost focus. It is exhausting and frustrating, because as much as I want to remain attentive to the words on the page, I can not keep my thoughts anchored to a particular subject. 

My entire life, most of my learning came from outside the classroom. It takes a lot more work than people realize to teach yourself everything. I hardly absorb any information in class, therefore studying requires much more time for me. People are jealous that I have adderall, but all it does is even the playing field. I’m sure it gives hyponeurovocal people a strong advantage, however all it does is allow me to focus for more than 7 seconds without daydreaming about different scenarios in which I am saving my entire class from a masked gunman. 

I am not sure if this is how everyone else with ADD operates, however I have a strong suspicion that their experience is very similar to mine. If that is the case, then this whole inner monologue news may be a helpful screening tool in diagnosing Attention Deficit Disorder. It is a wildly misdiagnosed/undiagnosed condition. So understanding exactly what is going on inside of people’s heads could lead to a more accurate way to treat the individuals with this problem while simultaneously avoiding overdiagnosing and over treating patients who do not fit the criteria. I would like to hear how other people with ADD relate to my experience.


There Are People Who Are Unable To Visualize Their Thoughts

If I told you to close your eyes and picture your bedroom, I’m sure the majority of you can do that. You can probably see the color of your walls, where your bed is, and the pile of (clean?) laundry in the corner of your room. However, there are people in this world that do not have this ability. If you ask them to picture something, all they see is black. The inability to visualize something in your head is a condition called, “Aphantasia.” 


I received many messages from people after my last post who reached out to tell me that they have Aphantasia. To this day, it remains largely unstudied considering that the name was coined only 5 years ago by a professor from England named, Adam Zeman.

Once again, I was puzzled by the lack of knowledge I had for what goes on in other people’s brain. It is crazy that people can live their whole life without knowing that they think differently from the majority of others around them. I received a message from a woman who said that, thanks to my post, her husband finally realized that he had Aphantasia. “People used to think he was crazy or a liar when he told them he couldn’t see images in his mind,” she told me.


Now, let me put this into perspective for you. Imagine (if you can) if a loved one passes away. Your wife, brother, friend, etc. A person with Aphantasia has the inability to picture their face and their mannerisms. The majority of the world can close their eyes and remember these loved ones, however there are people out there that lack this skill set. More questions kept coming to my mind. How does it affect their day to day life, relationships, and education? So I reached out to one of my followers that told me that they have this condition to ask them a few questions.

Below is an interview with @ginger_days_

What is Aphantasia?

“Aphantasia is the lack of imagery in the mind. There’s different degrees of it for some people. For me, I just see black in my mind. Some people can vaguely see an image, faintly, however it may fade quickly. 

When did you realize you had Aphantasia and that it was not normal?

“I realized when I was young. I couldn’t picture things in my mind. But I thought everyone was the same and that when a teacher or someone told us to visualize something, I thought it was just a way of phrasing what they wanted us to do. I didn’t realize they actually meant to picture it in our mind. It wasn’t until about two years ago when I learned what Aphantasia even was.”

How did it impact your education?

“It never really impacted my schooling apart from art. I love to draw but I can’t just do it from my head. I need some sort of reference so I can check back to see what it looks like. 

Do you wish you could visualize things?

“I wish I could visualize things all the time, but I find it hard to even comprehend what that would be like.”

@ginger_days_ went on to say, “I find it hard to imagine a future because I can’t see how it would look. I can’t imagine what my girlfriend will look like when I eventually marry her. I can’t imagine what we would be like with a baby. I can’t see it. I feel a lot though. I am a very emotional person.

RNwapF7STK2K6DZJP5OUPQ_thumb_1465.jpgThere are 7,794,798,739 humans on Earth, so it is very clear that everyone is bound to think a little differently. However, it has been very eye opening to realize the huge differences that we do have that I was previously unaware of. I am just glad that this topic has resulted in so many different stories and has allowed us all to talk about our thoughts. While mental health continues to be a huge burden with most people, I am just hoping this open dialogue can make a difference. I am glad we are starting to normalize talking about what exactly is going on inside of our extremely complex minds. 



Link to my interview with a person who does not have an internal monologue.

My Thoughts On The Internal Monologue Post

My last post blew up unexpectedly, which is nice. But I feel some responsibility to try to rationalize this whole thing. I am hoping that some good can come from this realization. I hope it gives scientists a better understanding of the brain, which can eventually lead to breakthroughs in mental health. A lot of depression and anxiety stems from that “little voice in the back of your head.” I had a theory that maybe people that do not have the internal monologue could be better defended against depression. Nowadays, so many people are being diagnosed with mental illness, so maybe it is an evolutionary benefit if we are talking in terms of Darwinism. Darwin always preached that animals that survive the longest are the ones that are the best at adapting and overcoming disadvantages. So maybe it is our way of preventing unwanted deaths from suicide, addictions, and other adverse effects caused by mental illnesses. I am not saying that any of this theory holds any scientific weight at all, but it does get you thinking. This theory can easily be tested through surveys and polls, so I hope this sparks the interest of anyone with a passion for psychology/neurology. Who knows, maybe this will cause a domino effect of theories and experiments which can ultimate improve our understanding of this batshit crazy world we live in. Whatever comes out of this, I am just glad that people are using their brains and connecting with others around them. Everyone is so distracted by the external world and forgets to look inwards.




Today I Learned That Not Everyone Has An Internal Monologue And It Has Ruined My Day.


My day was completely ruined yesterday when I stumbled upon a fun fact that absolutely obliterated my mind. I saw this tweet yesterday that said that not everyone has an internal monologue in their head. All my life, I could hear my voice in my head and speak in full sentences as if I was talking out loud. I thought everyone experienced this, so I did not believe that it could be true at that time.

Literally the first person I asked was a classmate of mine who said that she can not “hear” her voice in her mind. I asked her if she could have a conversation with herself in her head and she looked at me funny like I was the weird one in this situation. So I began to become more intrigued. Most people I asked said that they have this internal monologue that is running rampant throughout the day. However, every once in a while, someone would say that they don’t experience this.  


My life began to slowly spiral out of control with millions of questions. How do they get through the day? How do they read? How do they make decisions between choice A and choice B? My friend described it as “concept maps” that she sees in her brain. Another friend says that she literally sees the words in her head if she is trying to think about something. I was taking ibuprofen at this point in the day because my brain was literally unable to comprehend this revelation. How have I made it 25 years in life without realizing that people don’t think like me? 

NoUkL6drTiahwkMY0qqBJQ_thumb_13d6.jpgI posted a poll on instagram to get a more accurate assessment of the situation. Currently 91 people have responded that they have an internal monologue and 18 people reported that they do not have this. I began asking those people questions about the things that they experience and it is quite different from the majority.

I would tell them that I could look at myself in the mirror and have a full blown telepathic conversation with myself without opening my mouth and they responded as if I had schizophrenia. One person even mentioned that when they do voice overs in movies of people’s thoughts, they “wished that it was real.”

gfva7cPSQEGZvIHGIM0vlg_thumb_13e5And to their surprise, they did not know that the majority of people do in fact experience that echoey voice in their head that is portrayed in TV and film. Another person said that if they tried to have a conversation with themselves in the mirror, they would have to speak out loud because they can’t physically do it inside of their mind. 

 I started posting screenshots of these conversations on my instagram and my inbox started UNADJUSTEDNONRAW_thumb_13e2to flood with people responding to my “investigation.” Many people were reassuring me that I was not crazy for having an internal monologue, while others were as absolutely mind blown as I was. People were telling me that I ruined their day and that they now do not understand anything about life. Maybe you are all just a figment of my imagination, but regardless, yesterday made reality seem even more skewed. 

How do they think? How does this affect their relationships, jobs, experiences, education? How has this not been mentioned to me before? All of these questions started flooding my mind. Can those people without the internal monologue even formulate these questions in their mind? If they can, how does it happen if they don’t “hear” their voice? I mentioned earlier that I was spiraling out of control. Well, as I write this and as I hear my own voice in my head, I am continuing to fall down the rabbit hole. 


Whether people just have different definitions of their thoughts, or if people literally don’t have an internal monologue, there is one thing that we do know… you will definitely get a headache if you keep thinking about this. Just trying to wrap my head around it is causing irreversible brain damage. I suggest asking people around you what they experience. If you are one of the few that do not have this internal monologue, please enlighten me, because I still do not understand life anymore. Send help.



Purgatory; Stuck Between Undergrad and PA School

paI was nearing the end of my final semester at Syracuse University. I switched majors after my freshman year, so I required an extra semester; Or as I liked to call it, a “victory lap.” I was sitting in an EMT class that I was taking in order to boost my PA application.

Buzz Buzz

My phone began to ring. The number was not saved in my contacts, however it was a Boston area code. I knew I was waiting to hear back from my #1 PA program, Boston University, so I was eager to listen to the voicemail they had left. The clock moved fairly slowly as I waited for the end of the class to listen to the message. I remember daydreaming about an acceptance and thinking, “I can’t wait to quit this class.”

Class ended and my very average looking classmates all flooded to the door. I unlocked my phone, listened to the voicemail, and I sighed. “Hi, this is Boston University calling to let you know that your transcript never reached us.” That sucked to hear, but they allowed me to still submit my grades after the deadline. I had a 3.6 GPA, played a sport, and had an exceptional number of shadowing hours. At this point, I was confident that I was going to get accepted to a school and start my pursuit of becoming a Physician Assistant.

Boy, was I wrong.

I quickly realized that this goal I had set a long time ago was going to be harder than I imagined. For those of you that do not understand the difficulty of getting into a PA program straight out of undergrad, I will try to put it into perspective. The average age of a 1st year PA student is 26 years old. They are required to have upwards of 2,000 hours of hands-on experience working in the medical field, and the average program has only about 30-35 seats. Your application must be in the top 10% of all applicants to even get a chance to interview at a school.

That being said, I knew I needed to gain hands-on experience. I got a job as a medical scribe in the Oncology Clinic at Connecticut Children’s Medical Center (CCMC). There, I was writing medical notes in the perspective of the doctor in real time. I was expected to understand hundreds of different diagnoses, treatment plans, and medications. Every day I would learn something new and apply it to my job to become a better scribe. Oh, yeah, I forgot to mention… I got paid minimum wage for this. I had to get a second job on the weekends to pay $700 a month for tuition loans. I was working 7 days a week, one time going 63 days without a day off. I was living paycheck to paycheck, unable to save any money.

After I started gaining some more hours, my applications were looking a little stronger and interviews started to roll in. My first interview was in Richmond Virginia. I took a break in my busy work schedule to drive 8 hours to interview. I was really nervous. The first person I met was a guy who’s name was literally, “Success.” I’m fucked. 

My nerves started to decline as the day went on though. This interview was 7 hours. It went from group interviews, to tours, to two individual interviews, and finally a financial aid presentation. One thing that I did not read about was how physically exhausting it is to try to be the perfect person for 7 hours straight. Smiling, holding doors, shaking hands, remembering names… it was physically and mentally draining. My one on one interview was with this older gentleman who seemed to like me. I boxed at Syracuse and we bonded over that. He literally said, “alright you sold me, we’ll just talk about that for the rest of the interview.” I got a sense of relief and felt confident on my drive home back to Connecticut.

A week had past and I was fairly confident I was about to go 1/1 with my interviews. I got a letter in the mail. “Hi, Ryan. We appreciate your interest in our program, however I am sorry to-” Fuck. Waitlisted. I was upset, yet still optimistic. I was still waiting to hear back from 6-7 different schools. I’ll have another shot!

Denied. Denied. Denied.

I would be lying if I said that getting three straight denials didn’t crush me. I was learning so much as a scribe by this point. I was about a year in and I felt like I was really starting to fully understand all the medicine that I was documenting. I was now working in 9 different specialties; Hematology/Oncology, Infectious Disease, Urology, Orthopedics, General Surgery, ENT, Immunology, Neurology, and GI. I had learned so much and felt that I was now a strong candidate for PA School. Current PA students kept telling me that I was far ahead of them before they got into PA school.

I had a glimpse of hope when I received my second interview invite. The joy quickly dissipated when I realized that I was interviewing for a program with only 3 open seats. That being said, I drove another 9 hours to western Pennsylvania where I interviewed alongside 100 candidates for “at most, three seats.” Confidence level? Low. However, I decided to go in there with the mentality that I am the best candidate in the room. I studied all of the program faculty’s names beforehand, reviewed common interview questions, and memorized facts about the program. I absolutely crushed this interview. Every answer was strong and I felt that they got a chance to understand what makes me tick.

One week later…

Waitlisted. Fuck. My hope really started to decline after I got a few more denial letters from schools. Another few months had passed and I got a chance to interview for the third time in the same city as my undergrad, LeMoyne College.

If you know anything about Syracuse, you know that they get a metric fuckton of snow. That day they had a blizzard. I had a rough night of sleep already and had to wake up at 4:30am to clean off the car. I drove over an hour in a complete whiteout to make it to the interview on time (early). I saw 6-7 cars that drifted off the road into roadside ditches. I kept saying to myself, “don’t crash now, you can crash after.” I was wearing a slightly small suit, firmly gripping the steering wheel for over an hour. I needed to keep the heat on full blast so my windshield wouldn’t freeze, so by the time I got there I was drenched in sweat. I was not off to a good start.

One of the Doctors I worked for at CCMC was good friends with someone on Faculty there. Prior to the interview, this woman came up to me and told me that she spoke with the Doctor I know and that I should just relax. Confidence level? Highest it’s ever been. That morning commute was quite a doozy and I was mentally exhausted going into it. This was by far my worst interview. The man interviewing me was this boring, monotone military vet. I must have fed off his energy, because I was not myself that day. I could not answer questions fully and I didn’t feel like I showed off my personality, which I thought was one of my interview strengths.

A few weeks had passed, I was sitting in my little work station in the neurology clinic when I received an email from LeMoyne. My heart sank and I was excited to see the results. Opened it up… denial. Not even a waitlist. I was crushed. I had a connection on faculty and I thought I was fully prepared to enter PA school after this two year battle. This was the lowest I had gotten in the whole process.

Immediately after reading the denial letter, I started looking for Jobs in Boston. While I was working as a scribe, I was also a boxing trainer on the weekends. I applied to some boxing jobs in Boston and started apartment hunting. I actually got a job interview within a few days at Title Boxing Gym as their head boxing coach. I started calculating the cost of living, loans, and how much money I would need to earn to survive in a fairly expensive city. I passed my phone interview and I was scheduled to take a tour of the facility in Boston. It was time for a change.

This was going to be my new life direction. I had been denied from all of my schools and it was time to get a real job that wasn’t minimum wage. I would look at my best friend’s life and be jealous. He had a house, a stable long term relationship, and even a puppy. I told him about my plan to switch career fields. He handle the situation really well without making me feel unsupported. The best thing he said to me was, “everyone is on their own path and are at different points in their career. Don’t compare to people and focus on what you want to do.”

I wanted to be a PA really bad. I had worked hard for two years, obtained unmeasurable knowledge, and matured along the way. I decided that I was not going to give up on the PA route, but I still went up to Boston for the tour of Title Boxing Gym. It went well.

I was literally parking my car in the driveway after returning home from Boston and I got a call from Francis Marion University inviting me to schedule an interview. I kind of forgot about this school because I applied to them later in the application cycle. It was in South Carolina, an hour west of Myrtle. My brother lives in Charleston, so I was kind of familiar with the state. I flew down there and was prepared to interview to the best of my ability.

I felt like I crushed the interview. However, I knew from the past that getting your hopes up only hurts you more when you get denied. I still felt strangely confident. I knew I wanted to be a PA whether I got in or not, so I wasn’t going to give up. I denied the job offer in Boston within minutes of completing my interview. I was never going to give up on what I had worked so hard for.

Three business days later…

I worked a lot, so I enjoyed my occasional nap. I was awoken from one of my naps by buzzing. I had a missed call from a South Carolina number. I didn’t have a voicemail because I would later find out that my voicemail box was full. I called back immediately.

Hi, we would like to offer you a seat in our upcoming class. 

I would not be able to put the feeling into words. So much weight was lifted off my shoulders. Stress that had built up over long work days, denial letters, and waitlists had finally been released. I could only describe this as, “that feeling when you have to pee but you’re stuck in traffic and you think you’re going to pee your pants. But you finally make it to the bathroom and go ‘ahhhhh.”‘ I think that quote came out when I celebrated with my friends that night.

Really, really long story short is don’t give up. If you want to be a PA you have to keep working, keep applying, and keep learning. This experience was extremely stressful, however I learned so much and met so many people in this process that I will never forget. We are all on a different path, don’t give up if you know that being a PA is the best thing for you.





A Letter to You

Dear Meg,

I sat here for about 15 minutes trying to figure out what to say. I wanted to write something to show my appreciation for all that you had done; not just for me, but for the entire community. Friends, family, and strangers are expressing their sadness in many ways and it seems like you may not have truly understood what your life meant to everyone around you.

This letter is not just for you, but for everyone that is feeling this heartbreak. I think that everyone can agree with me when I say that you were the most genuine person and treated everyone as an equal. You always stayed true to yourself and everyone around you. You may be gone, but our memories will live on.

After hearing the news, I lied awake for hours. Memories kept rushing through my mind from our past. My overwhelming feeling of sadness started to be numbed by these memories. They are a gift that I can hold on to for the rest of my life and can never lose. I can keep them with me wherever I go and I am thankful you blessed me with this. You may not even know it, but you gave this gift to everyone that you crossed paths with in the short time you were on this earth.

For some fucked up reason, this world that we live in allows for the most amazing people to fall into a dark, dark place; a place that I cannot truly understand. Many can feel sympathy towards your situation, but only an unfortunate select of people can really empathize. It is like you were in a foreign country, one in which you never chose to visit. I can only view what it’s like from the border, but I cannot experience its culture or feel the climate. I can speak the language, but you are the only one that can understand its meaning. I can only imagine you were a prisoner to this horrible place looking for any possible way to escape.

You have freed yourself from the shackles of sadness, no longer a prisoner to this ghastly place. You can now spread your wings and live on in the hearts of many. I know that wherever you are, you will continue to make an impact on people’s lives. Thank you for being a part of mine.meg

You were an angel then, now, and always.

Rest Easy,

Ryan Langdon

Syracuse University

twitter: @RyanLangdon_9