Latest / Hopestream: Parenting Kids Through Addiction & Mental Health / Lost in the Haze: A Primer on The Perfect Storm of Teens, ADHD, and Marijuana, with Dr. Mariely Hernandez

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Lost in the Haze: A Primer on The Perfect Storm of Teens, ADHD, and Marijuana, with Dr. Mariely Hernandez · Hopestream: Parenting Kids Through Addiction & Mental Health

0:03
Mariely: People with childhood ADHD are more likely to initiate substance use earlier than people without.
0:09
Mariely: And part of that is novelty seeking, part of that is like either wanting social acceptance.
0:15
Mariely: There is this normative period of experimentation in teenagers, right?
0:20
Mariely: Like 16 years old or whatever, but that's also coincides with this really big brain developmental period.
0:27
Mariely: Where the emotion, like, part of your brain grows at a faster rate than the frontal lobe, which is the part that has some common sense and, like, can organize your life and tells you, hey, wait, think about the consequences.
0:41
Mariely: You know, that's why teens feel like they're impervious.
0:52
Brenda: Welcome to Hope Stream, a podcast where you'll hear interviews, conversations, and encouraging words for parents of teens and young adults who struggle with substance misuse and mental health.
1:05
Brenda: I'm Brenda Zane, your host, and a fellow parent whose child struggled.
1:09
Brenda: I'm so glad you're here.
1:11
Brenda: Take a deep breath and know you're not doing this alone anymore.
1:16
Brenda: Hi friend, you are going to love today's episode if you have been hit with what I call the triple whammy.
1:24
Brenda: A teenager or young adult with ADHD.
1:28
Brenda: Who is also using marijuana to self medicate?
1:33
Brenda: It is a doozy to navigate between your child's brain still being under construction, the complications of parenting a child with ADHD, and then laying on the fear and worry that comes with marijuana use.
1:47
Brenda: I get it because it is exactly what I dealt with and I know how overwhelming it can be.
1:53
Brenda: Luckily, I got to sit down with Dr.
1:55
Brenda: Marilee Hernandez to pick apart so many questions I had around this topic.
2:01
Brenda: Dr.
2:01
Brenda: Hernandez hails from the Dominican Republic, but was raised in the Bronx.
2:06
Brenda: She's currently a postdoctoral research fellow in the Division on Substance Use Disorders at Columbia University Irvine Medical Center.
2:16
Brenda: Dr.
2:16
Brenda: Hernandez completed her undergraduate studies at Columbia College.
2:20
Brenda: majoring in neuroscience and behavior.
2:24
Brenda: She earned a master's degree in general psychology from Teachers College and then spent seven years doing research on bipolar disorders across various age groups before she decided to pursue her doctorate in clinical psychology at the City College of New York Graduate Center.
2:41
Brenda: Dr.
2:42
Brenda: Hernandez's research interests then shifted to focus on ADHD and substance use risk.
2:48
Brenda: Alongside her postdoctoral research fellowship, Dr.
2:52
Brenda: Hernandez runs a part time private practice specializing in helping adults with ADHD recognize their strengths, which leads to more fulfilling lives.
3:03
Brenda: In an interesting twist, Dr.
3:05
Brenda: Hernandez identifies as part of the ADHD community herself, having been diagnosed as an adult.
3:12
Brenda: She is also a mother to two very active boys, the eldest, who was recently diagnosed with ADHD.
3:20
Brenda: Dr.
3:20
Brenda: Hernandez actively advocates for increased ADHD, particularly with marginalized populations.
3:29
Brenda: We dove into topics like why young people with ADHD gravitate toward marijuana, sleep problems, psychosis, abstinence versus a reduction in use, medications, and a bunch more.
3:44
Brenda: And as a quick note, you'll hear Dr.
3:46
Brenda: Hernandez talk about a product that she found that helps her with being overstimulated by noise.
3:52
Brenda: I've added a link in the show notes so that you can try it out.
3:55
Brenda: If you or your child has a hard time with noisy environments, they're called flare calmer earbuds.
4:02
Brenda: They're not for music and they don't connect to any devices.
4:06
Brenda: They help redistribute sound as it enters the ear.
4:09
Brenda: And I know they work because I'm extremely sensitive to noise.
4:14
Brenda: And they have saved my sanity for a while now.
4:17
Brenda: Okay, I think you are going to find this conversation incredibly interesting and it may also help you find some extra empathy for your child if they have ADHD.
4:27
Brenda: Here's me and Dr.
4:29
Brenda: Marilee Hernandez.
4:30
Brenda: Enjoy.
4:46
Brenda: Dr.
4:46
Brenda: Hernandez, thank you so much for joining me today.
4:49
Brenda: This is such a great topic.
4:51
Brenda: I can't think of you like you're an expert in ADHD, adolescence, and some to some degree, substance use and marijuana.
5:00
Brenda: So it's like, those are the, if you had to ask like parents in our community, what are the top three things?
5:07
Brenda: That's it.
5:07
Brenda: Like, please help me untangle this huge mess that I've got going on.
5:13
Brenda: So thank you for joining me on Hope Stream.
5:16
Brenda: I really appreciate it.
5:18
Mariely: Oh my gosh.
5:19
Mariely: Thank you for inviting me.
5:20
Mariely: I'm so happy to be here and, you know, speak to your audience.
5:24
Mariely: Hopefully I can help.
5:25
Brenda: Oh, I'm sure I'm sure you can.
5:28
Brenda: I have never done a formal Survey of our podcast listeners or the members in Hope Stream community, but I would have to hazard a guess that it's probably like 90% have A DHD or a DD.
5:43
Brenda: And I wanna ask you about whether there's still like a distinction there between those two.
5:48
Brenda: It's just so common and you, it can't just be coincidence, right?
5:53
Brenda: That these kids are struggling with substance use.
5:57
Brenda: It's primarily marijuana, cannabis, and this ADHD, it's like they go hand in hand.
6:03
Brenda: So this is why I stalked you until I got you for the podcast because it's so tricky.
6:11
Brenda: So I guess I have like a thousand questions, but I would love to just start off because there was some research.
6:18
Brenda: Is it SAMHSA that does that national, the N D S U H, or whatever the acronym is?
6:24
Mariely: The, the, the, I know, I know, I just like, yeah.
6:27
Mariely: I think in our heads, everybody says it differently, but that's right.
6:30
Mariely: It's the National Survey of Drug Use and Health, or something like that,
6:33
Brenda: yeah.
6:34
Brenda: I was looking at that, and there's just some really scary and shocking numbers, especially about young adults, so the, I think they consider that.
6:44
Brenda: 18 to 24 or so.
6:46
Brenda: Is that right?
6:48
Mariely: Yeah, the 18 to 25 year olds, which is like college age, right?
6:52
Mariely: So Those are kind of the the age group that uses the most You know that the percentage wise and that are less likely to seek treatment.
7:04
Mariely: So this is alcohol.
7:05
Mariely: This is cannabis And part of that might be a little normative, right?
7:10
Mariely: Because that's the age of experimentation people are in college You know, there's greater access But the, the reason why that's alarming is because these behaviors or these habits that you develop in college around drinking and drug use, don't just leave when you graduate, right, like, a lot of them are kind of maintained and are precursors to Developing just sort of, you know, use problems as an adult when there's like no longer appropriate to binge drink necessarily.
7:38
Mariely: Or maybe it is, but they have difficulty stopping.
7:41
Brenda: Yeah, it was really surprising and to see sort of the inverse relationship between adolescents who struggle and have a substance use disorder and the number of them who get treatment is actually pretty high.
7:54
Brenda: And then it's the reverse in the young adults.
7:58
Brenda: They're the ones who have a higher prevalence of needing treatment and way less of getting it.
8:05
Mariely: Part of that may be because, you know, they may have a mild presentation, which means that you only have like In terms of, you know, the criteria for a disorder, for any substance, there is, I think, between, I think, either 7 or 11.
8:21
Mariely: And so if you have, like, 2 or 3 that's considered mild, so it could be, like, if you had several instances of maybe drinking too much, or not being able to stop drinking, or having a negative consequence from drinking, then that would qualify you for kind of a disorder.
8:36
Mariely: But that may not be enough.
8:38
Mariely: You know, a lot of people have the perception that they have to hit rock bottom.
8:42
Mariely: There's a lot of stigma, a lot of shame.
8:44
Mariely: not enough screening, you know, and, and psychoeducation on kind of safer drinking practices, harm reduction, drinking practices.
8:52
Mariely: And then with, with drug users, like no indication, right?
8:55
Mariely: Like what the advice we got is just saying no,
8:58
Brenda: just don't do it.
9:01
Mariely: Right.
9:01
Mariely: And, and like teenagers are not really going to respond to that.
9:06
Mariely: Right.
9:06
Mariely: Like they, and it's the peer pressure, like this is a developmental period where what their friends say, their social life matters, right?
9:14
Mariely: tremendously.
9:15
Mariely: Yeah.
9:16
Mariely: And so there's different ways I think that you can do some motivational interview or just some psychoeducation to kind of steer teens in the right direction.
9:27
Mariely: If anything, just tell them to delay, like even delaying initiation until after you're 18 can be protective.
9:35
Brenda: There was somebody I was talking to who said that was actually one message that did get through because not a lot of messages get through to teenage brains, right?
9:43
Brenda: It's like, yeah, whatever mom.
9:45
Brenda: But one message that it did seem like was getting a little bit of traction is that delay message to say, if you want to be able to use recreationally every once in a while, When you're older, maybe you want to have champagne at your wedding or you want to have a beer after golf.
10:01
Brenda: The way to make sure that that is more possible is by not doing it when you're a teenager.
10:06
Brenda: So I thought that was pretty interesting.
10:08
Brenda: I think that's still a hard pill for parents to swallow to say that, but anyway, it might be worth trying.
10:17
Brenda: Um, I would love to have you just talk a little bit about ADD, ADHD.
10:23
Brenda: What that actually is in the brain, I don't, I think even those of us who have kids who've been diagnosed, we don't totally understand what that means.
10:32
Brenda: So maybe clarify for us what that actually is, how it feels, what they might be experiencing.
10:39
Brenda: Because if we don't have as a parent, we're like, ah, I don't know.
10:43
Mariely: ADHD or attention deficit hyperactivity disorder.
10:46
Mariely: That encompasses ADD, which is like, you know, disattention deficit.
10:50
Mariely: So we don't really use that anymore.
10:52
Mariely: It's all under the umbrella of ADHD.
10:54
Mariely: And so it's cat, people can fall under the different presentations, which is inattentive, hyperactive or combined type.
11:02
Mariely: And so the hyperactive impulsive.
11:04
Mariely: You always think about, like, kids who are just restless, active, kind of bouncing off the walls.
11:10
Mariely: But in girls, it could actually be, like, very chatty, which is kind of socially normative.
11:14
Mariely: So a lot of girls are missed because of that.
11:16
Mariely: And also, like, you're mind racing.
11:18
Mariely: It could be, like, a thought hyperactivity, and you can't really settle in one.
11:22
Mariely: It could show up in teens and young adults as like shopping and the impulse of shopping or even like sexual promiscuity kind of like not thinking about the Consequences and maybe jumping into something before you've really thought about the consequences And then that's kind of shameful to talk about so, you know, you kind of have to pro for that And you don't even need to like if you mentioned it, like the, the, you know, people, the women that, you know, if I ask this question in an eval, they're like, Oh yes, actually, like that has happened and I wish I hadn't, like, or even just sharing too much with a stranger at a party, that kind of impulsivity that, you know, maybe it happens once or twice or like interrupting or finishing someone else's sentences, it's, it's sort of can make people annoyed with you, but it's really hard to, To control that impulse, sometimes it's like you have to get it out because then you'll forget.
12:17
Mariely: Individuals with ADHD tend to have poor working memory and so it's almost like you're trying to catch a firefly and hold on to the thought before you lose it completely.
12:27
Brenda: That sounds a lot like menopause.
12:29
Mariely: Oh yes, yes, no, so many women like there are diagnosed with ADHD and menopause just because the symptoms get so bad that they can't manage anymore.
12:40
Mariely: If you don't have ADHD and you have menopause, you, you get, you definitely have a little taste of it.
12:44
Brenda: Yeah, that elusive, like, wait, it was just there.
12:49
Mariely: Yeah, yes, it's maddening.
12:52
Mariely: You know, walking into a room, not know, not remembering why you're there.
12:56
Mariely: You know, there's, there's a lot.
12:58
Mariely: I mean, the one thing I should say, which I think is very confusing to parents.
13:03
Mariely: Is that, you know, it's called attention deficit, but it's really a dysregulation of your attentional faculties.
13:09
Mariely: And what that means is that, you know, one, it's like an interest based disorder.
13:13
Mariely: So for people with ADHD, they can't pay attention on stuff.
13:16
Mariely: They're really like, cause parents would be like, why can my child game for eight hours?
13:20
Mariely: Why can they watch binge, watch a whole show?
13:23
Mariely: And it's like, yeah, it's easy.
13:24
Mariely: They really like this thing, but they can't do one word problem or something.
13:28
Mariely: Right.
13:29
Mariely: It's like, there's, The brain's ability to metabolize, like, or to use the dopamine is either producing it or using it.
13:37
Mariely: And that's really important in the motivation and reward system.
13:41
Mariely: It's not, it's not efficient in people with ADHD.
13:45
Mariely: So essentially for things we don't want to do, we need a lot more motivation.
13:50
Mariely: And even if we find a way to kind of, you know, Get started or stop pressing hitting on something Sometimes we need a lot more strategies because those strategies may stop working you may get used to them and stuff So you need a lot of novelty, you know game to find certain things I don't want to talk for too long but another thing that I think is really important that I think there's a lot of silent suffering in ADHD and part of that is like with procrastination and a lot of it is just not knowing how to get started.
14:20
Mariely: And so a lot of people with ADHD are perfectionists, though, like, they may struggle to start because they are worried about it not being good enough.
14:30
Mariely: or they don't know where to start.
14:33
Mariely: The executive dysfunction in ADHD means that it's really hard for us to plan and to organize, even to determine what to do first.
14:42
Mariely: So if we don't know where to start, we can't get started.
14:44
Mariely: And that may look like your teen laying on the couch on their phone, but they're kind of paralyzed.
14:50
Mariely: There's a decision paralysis, and there, it's not like a very leisurely, like, luxurious, Lay on the couch is very anxiety ridden Stressful and so I think that sometimes they may need a little nudge or interrupt, you know They're kind of zoned out to help them get started with the I'm co leading a group with Dr.
15:13
Mariely: Mary Salanto, a CBT for ADHD group at a college, and one of the things that she says, which I use for myself, is if you can't get started, the first step is too hard, it's too big.
15:24
Mariely: So you break it down into an even smaller step.
15:26
Mariely: And so if you're paralyzed on the couch, Maybe the first step is you put one foot on the floor, right?
15:31
Mariely: Like maybe put your other foot on the floor.
15:33
Mariely: And so just making it manageable.
15:36
Mariely: And then the last thing I promise is last thing is that part of the, the issue with ADHD is it's really hard to stop something we like doing and shift to another path.
15:47
Mariely: So that's why people with ADHD may, they call it like hyper focus, but then, you know, hyper focus is not like you're in slow.
15:55
Mariely: It's like, you don't eat, you don't sleep, and you don't pee until you You finish and then you're like, Oh my God, you know, it's really late.
16:02
Mariely: And so that kind of sets you up for burnout.
16:05
Mariely: So it's not a sustainable thing.
16:07
Mariely: And what that does for people with ADHD is that they think that that peak performance that's unnatural.
16:13
Mariely: Is their goal, what they should aim for.
16:16
Mariely: And so if their productivity doesn't match that absurd level, they feel like failure.
16:21
Mariely: So even if, you know, the, you know, the saying like the perfect is the enemy of the good, totally applies with ADHD.
16:27
Mariely: It's just extraordinarily high standards because people with ADHD can do really amazing things, you know, when there's a deadline, especially, um, but that shouldn't, but that's not the standard for anybody, right?
16:38
Mariely: And so you don't want to insist.
16:40
Mariely: site this trauma stress reaction to get anything done.
16:44
Mariely: Part of the behavioral work with ADHD is to phase things out.
16:49
Mariely: So that you're not constantly relying on the cortisol to kind of push you through to the very end.
16:56
Mariely: But yeah.
16:57
Brenda: Wow.
16:57
Brenda: I hope
16:57
Mariely: that's been helpful.
16:58
Mariely: I'm sorry I was all over the place.
16:59
Mariely: No,
17:00
Brenda: that is so incredibly helpful because we can't see all of that going on in their brain.
17:05
Brenda: All we see is the outward lane on the couch with the phone or another thing that I noticed with my son, and I don't know if this is, um, ADHD is he would, if he didn't think he was going to be able to do it perfectly, he wouldn't do it at all.
17:20
Brenda: Like he got in Taekwondo to a certain belt, but then when it was time to go to the next belt, he, he just refused to go anymore.
17:28
Brenda: Like I'm done with Taekwondo.
17:29
Brenda: Cause he was, he had to want part of that belt upgrade or whatever you call it, was he had to get in front of the group and count to 10 and Korean.
17:39
Brenda: And he would not, and he was so good at Taekwondo and we were like, what, this doesn't make any sense.
17:47
Brenda: But he, later, you know, we figured out like if he didn't think he was going to be able to do it perfectly.
17:52
Brenda: And he was like, I don't know that I can count to 10 in Korean perfectly in front of this whole group of people that ended his Taekwondo career.
18:00
Brenda: Oh.
18:01
Brenda: Is that one, is that like an example of that where?
18:05
Brenda: Yeah, yeah.
18:05
Brenda: It was so sad.
18:09
Mariely: That could also be like part of like anxiety, but I, I think you pulled from one example, right?
18:14
Mariely: I would also probe people with ADHD because they also diminish the work they have done.
18:19
Mariely: My, my dissertation advisors, there was, you know, a student who didn't hand the paper in and all she had left was a conclusion.
18:26
Mariely: She was like, I didn't do it, but like it didn't, right?
18:29
Mariely: think the paper was good enough.
18:30
Mariely: And it was perfectly fine.
18:31
Mariely: Like she couldn't, she didn't even submit part of it.
18:34
Mariely: Like on Twitter, somebody was like, you know, you never get a rough draft from me.
18:37
Mariely: You either get a final paper or nothing.
18:40
Mariely: And so, because it's hard to write a rough draft, that like for ADHD, it's either, you know, you want every sentence to be perfect and this is your submission and you never want to see it again.
18:50
Mariely: Okay.
18:51
Mariely: Yeah.
18:52
Brenda: That makes a ton of sense.
18:53
Brenda: No, that's super insightful.
18:55
Brenda: And I think it's important what you said about girls.
18:57
Brenda: I just wanted to go back to that because I think, you know, as a parent who's listening, they might be noticing some of these traits, right.
19:06
Brenda: And thinking, yeah, but she hasn't been diagnosed with this.
19:08
Brenda: ADHD.
19:10
Brenda: So that could be something maybe if you're, if there's a lot of struggle to go back and try to get it, at least get an, what do you get an evaluation?
19:19
Brenda: Is that basically how it works?
19:21
Brenda: Like you would go to a psychologist, like who actually diagnoses?
19:25
Mariely: Yeah, psychologists can diagnose ADHD, kind of want them to be an expert in that, but you know, some people Historically or even now people get a neuropsychological evaluation That's more comprehensive and it can be helpful if you are still in school or looking to continue in your education And you suspect that you may have like certain weaknesses either in verbal and math and you want to identify What the strengths and weaknesses are?
19:52
Mariely: It's very expensive, and it's, and the waiting lists are long.
19:56
Mariely: And it's also not necessary to diagnose ADHD.
19:59
Mariely: You can't just use any questionnaire.
20:03
Mariely: on its own without a clinical interview.
20:04
Mariely: You want to know about childhood.
20:06
Mariely: You want to know about their academic history.
20:09
Mariely: And girls, especially if they have high IQ, they get diagnosed with like anxiety and depression before you get the ADHD.
20:16
Mariely: They're so anxious, and they're very rigid because they've adapted to the ADHD symptoms, and so they've overcompensated.
20:24
Mariely: And if anything of that is disturbed, then um, Like, they get really upset.
20:29
Mariely: And so, masking in autism and ADHD in women is very, like, very common because we're socialized to, like, prioritize everybody else's well being over our own and to be pleasant and, you know, to kind of just fit the societal rules.
20:47
Mariely: So, you kind of need to ask a little bit more detail.
20:51
Mariely: About, you know, how much effort it takes to get things done.
20:56
Brenda: Is that a good, I was going to ask, like, what are some conversations that a parent could have if, if you're seeing your kiddo struggle and you think maybe, you know, let me just ask a couple of questions to see how they feel about this.
21:11
Brenda: Are there ones that you would recommend that parents have a conversation with them?
21:16
Mariely: I think the parents are, would be really good just in terms of observations.
21:22
Mariely: Cause there's little things, right?
21:23
Mariely: You know, like if Derek hit like paces a lot, doesn't finish one task before moving to another, like even how they talk, you know, very.
21:32
Mariely: Like slaying from one subject to another there's like, again, it's hard to say cause everybody presents differently, but you know, the teachers may say something like they don't, Meet potential that potential is like oh everyone with ADHD has gotten that like they know that you're smart We just can't get it.
21:50
Mariely: You know, there's something and so that that's heartbreaking Yeah, I mean struggling with schoolwork and organization like not doing the most important thing for you First, like forgetting dates, like important dates, like test dates, losing homework, these losing keys, jackets, water bottles, my kids.
22:09
Mariely: I could open a store with all the water bottles my seven year old has lost already.
22:13
Brenda: The thing that just keeps running through my mind and that we see all the time is this trifecta of ADHD, undeveloped brain, right, because if they're teenagers, and then you add.
22:27
Brenda: Marijuana, and then as a parent, you just want to quit because it's so confusing and hard and they think you don't know what you're looking at, right?
22:39
Brenda: Is it undeveloped teenage brain?
22:41
Brenda: Is it ADHD?
22:42
Brenda: Is it the weed?
22:43
Brenda: Is it like what is going on?
22:45
Brenda: And I know this is really an area that you specialize in.
22:48
Brenda: So give us all the details.
22:53
Mariely: Well, okay.
22:54
Mariely: So there's a few factors that make.
22:57
Mariely: Cannabis or marijuana, like more risky.
23:01
Mariely: Now, one is that the, there's vapes, so there's more concentrated, more potent formulations of cannabis, which increases the risk of addiction, frankly, because the, the stronger it is and the more you feel the withdrawals right after.
23:16
Mariely: And so the constraint cravings are stronger.
23:19
Mariely: That's one.
23:19
Mariely: The other is the avail, increasing availability.
23:22
Mariely: Uh, of cannabis, you know, I, I think a friend's teenager, you know, he was interested in substance use, you know, and we were talking just like his boarding school, like, they're definitely not 18, but they can easily get cannabis products at any like dispensary or recreational dispensary.
23:38
Mariely: The access, the ubiquity, there's like a cannabis shop almost on every block now that it's been legalized in New York City.
23:46
Mariely: So there's ease of access, potency, and then there's different ways of consumption.
23:51
Mariely: There's edibles, there's drinks, there's, you know, all these different ways to do it.
23:57
Mariely: That's one risk.
23:58
Mariely: And then people with childhood ADHD are more likely to initiate substance use earlier.
24:05
Mariely: Then then people without and part of that is novelty seeking part of that is like either wanting social acceptance There is this normative period of experimentation in teenagers, right?
24:18
Mariely: Like 16 years old or whatever, but that's also coincides with this really big brain developmental period Where the emotion, like, part of your brain grows at a faster rate than the frontal lobe, which is the part that has some common sense and like can organize your life and tells you, Hey, wait, think about the consequences.
24:38
Mariely: Or like inhibitory control and all that.
24:40
Mariely: So, you know, that's why teens feel like they're impervious.
24:44
Mariely: To harm they dried recklessly.
24:46
Mariely: They also like if they do use drugs, they use that reckless recklessly too Like i'm, you know, remember the tide pod.
24:53
Mariely: It's just such stupid And it's like I was a teenager too.
24:57
Mariely: I did stupid things too.
24:58
Mariely: Thankfully not that.
25:00
Mariely: Um, but You know, like just even the, the dangerous ways of using any vapes, like that really does cause harm to your respiratory tract, but they're not thinking about the future, right?
25:13
Mariely: They're not thinking about long term.
25:16
Mariely: effects.
25:17
Mariely: Now, when you introduce substances to the brain at this sensitive period in your brain's development, that kind of rewires the brain in a specific way, that including your reward system, and this is what substance use does to everybody.
25:32
Mariely: Suddenly, the only thing that you find rewarding that makes you happy is the drug.
25:36
Mariely: And so you kind of start shaping your life around it.
25:39
Mariely: And when you do that as a teen, it's just much more difficult to then quit when you're older, Because it's such an integral, integral part of how your brain is wired now.
25:51
Mariely: That doesn't mean that it's impossible, right?
25:52
Mariely: So I don't want any teens, you know, parents to be like, Oh my god, my teen is like that.
25:56
Mariely: But there are some, there, you know, there's some studies that show kind of long term effects even after they've quit, right?
26:02
Mariely: And the thing is the brain is resilient.
26:05
Mariely: Like some parts take over others.
26:07
Mariely: I think that for teenagers telling them about more proximal consequences, you know, it affects your attention just within the 12 hours.
26:16
Mariely: It impairs judgment like cannabis and like thinks has people thinking like That they can drive when their judgment is still impaired, when they've done some driving simulations.
26:27
Mariely: Maybe 90 minutes, or 3 hours even, when they're not high anymore, they think that they're okay, and then they make a lot of errors on this driving simulation.
26:35
Mariely: So it's actually very unsafe and risky, because your judgment isn't good.
26:40
Mariely: You're more impulsive, not making good decisions.
26:43
Mariely: And so it is, it can be dangerous in that sense.
26:47
Mariely: And, and if you're already have elevated impulsivity, like people with ADHD, the threshold for it being greater is very low.
26:57
Mariely: So, for example, like with alcohol, after having that first drink, you're not going to make the best decisions about it.
27:05
Mariely: You know, drinks later.
27:05
Mariely: You need a plan beforehand.
27:08
Mariely: So, you know, once you get intoxicated, once you start using, the decisions you make after may not be the most sound ones.
27:17
Mariely: So, you know, it's important to be careful.
27:27
Brenda: Hey there, are you feeling stuck in a cycle of drama and arguments with your child?
27:32
Brenda: Worried sick about their substance use?
27:34
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27:38
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27:45
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27:53
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28:05
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28:15
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28:19
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28:21
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28:28
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28:31
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28:33
Brenda: Now let's get back to the conversation.
28:48
Brenda: I'm just thinking back to what you said about the different, I guess, form factors of cannabis today with edibles and, you know, vapes and shatter and waxes and all the crazy things that they have available.
29:02
Brenda: Is there a, is there one that is safer or more dangerous or is it just all equally kind of bad?
29:11
Mariely: Well, the thing is this potency, so the dabs, which I learned, like, maybe, like, earlier this year, last year, like, if you need a Bunsen burner to do the drug, like, this is not okay.
29:20
Mariely: Like, you can't, like, you need a torch to, like, really melt this thing.
29:24
Mariely: That potency, these high doses of cannabis increase the risk of psychosis.
29:30
Mariely: Especially for males.
29:32
Mariely: And also, girls are at risk because they feel the liking effects of cannabis more than boys do.
29:38
Mariely: And they get stronger cravings, and they have more withdrawal symptoms, right?
29:42
Mariely: And so, if you really like, if you feel really good on this, like, that's a risk.
29:47
Mariely: Right?
29:47
Mariely: Because you're going to want to do more of it.
29:48
Mariely: I think the vapes, the oils, the concentrations are dangerous.
29:54
Mariely: Um, one, because they're so easy to use in public, right?
29:58
Mariely: If they don't malice strongly, but they are quite damaging.
30:02
Mariely: We don't have enough research to say how, how damaging they are.
30:06
Brenda: Yeah.
30:06
Mariely: The other thing is that it's, it's daily use that I think, you know, I, when I've done my research, it affects sleep, predisposes to depression and anxiety.
30:17
Mariely: You know, apart from experimentation, like I think people with ADHD may be at risk or hazardous use because when they're bored, they just want to do something risky and stupid.
30:26
Mariely: Right.
30:27
Brenda: Right.
30:28
Brenda: Well, in the sleep thing, do all people with ADHD or most people have sleep problems?
30:33
Brenda: I know, I know that with my son, he just, and he still struggles with sleep and it's, you know, he's really managing his ADHD, but sleep is, you a killer and then weed will definitely work for a while.
30:48
Brenda: So it's hard to argue with that, right?
30:50
Brenda: When you have a kiddo who's like, yeah, but I can sleep.
30:53
Mariely: Yeah.
30:54
Mariely: Yeah.
30:55
Mariely: Well it helps you fall asleep.
30:57
Mariely: But the thing is This is a great question because the, first of all, the studies that they've done, yeah cannabis may help you sleep, they only do it for about 12 weeks and there was one that showed, yes, it can help with insomnia, but then it also noted that the people in that study needed greater amounts.
31:15
Mariely: to get the same effect, which is a drug, right?
31:17
Mariely: And you build tolerance, you need more.
31:20
Mariely: And after for daily users, you know, kind of longer studies or studies on people who are used daily or nearly daily for a while is that they actually get less sleep or they either sleep too little or too much.
31:31
Mariely: And it's kind of age dependent and both sleeping too much and too little, little are associated with adverse, like cardiac and metabolic effects over time.
31:41
Mariely: The thing that makes it hard with cannabis.
31:43
Mariely: is that once you quit, the insomnia is abysmal.
31:47
Mariely: And it lasts long, like, three weeks or more.
31:51
Mariely: And I mean, like, you know, when I did an eval on somebody who has ADHD, and they We're also using cannabis and I just gave some psychoeducation and then I met with them a month later and they had quit completely Like we're cold turkey and I was like really impressed but they were saying the first two weeks were horrible the insomnia and you and you also get a resurgence of dreams because cannabis suppresses REM sleep.
32:19
Mariely: So it could be that if you have struggled with nightmares, like you just don't have them.
32:23
Mariely: But then once you quit suddenly every night you're having like vivid dreams, you know?
32:28
Mariely: So you're not getting enough sleep and it's also not restful because you're just, you know, in a movie at night, but it does get better, right?
32:36
Mariely: There's a ton of reddits on like symptoms of withdrawal that sometimes it's helpful to just, I don't know what to expect, but Dr.
32:44
Mariely: Megan Haney at, uh, in our division at Columbia, she gave a lecture to the fellows and she was saying that in general, like these side effects kind of last, withdrawal effects last about two weeks.
32:55
Mariely: But I do think that what happens, she said that when you quit, uh, cannabis, uh, you You unmask the mental health issues that were driving the chronic use, which is usually depression, anxiety, and then you have to deal with all of that because you're not using the drug to deal with anymore.
33:15
Mariely: And so, you know, people need a lot of support.
33:18
Mariely: And actually, like one of the ways that you get people healthier, especially teens.
33:22
Mariely: Uh, a psychiatrist, you know, that I was working with, like he was saying, you treat the underlying condition.
33:30
Mariely: And so I think his issue is trying to get psychiatrists to treat teens with ADHD while they are still using cannabis.
33:39
Mariely: A lot of them won't.
33:41
Mariely: Right.
33:41
Mariely: But like, how else are you going to get, you know, start helping them?
33:45
Brenda: That's, that was going to be a question I was going to ask because it's that catch 22, right?
33:51
Brenda: Of like, well, if I keep using, then I can't.
33:54
Brenda: Get the ADHD meds, but if I get the ADHD meds, I have to go it's like how do you make that transition?
34:02
Brenda: Can they use could they use like is CBD okay to use for somebody who maybe is like had a Cannabis use disorder or been dependent on THC
34:13
Mariely: I don't think there's enough evidence for that.
34:15
Mariely: CBD, they, they, in the review, you know, it can help with certain things.
34:20
Mariely: The thing is, it's not really standardized.
34:23
Mariely: You don't know, like, some CBDs is like 1, 500 milligrams, some is 15 milligrams.
34:29
Mariely: There's no standardization of like what is, a therapeutic dose and for what indication?
34:36
Mariely: And I don't think that's been, it hasn't really been FDA approved, right?
34:39
Mariely: Any cannabis or CBD products are for like nausea related to like cancer and stuff like that.
34:46
Mariely: So not for these other indications, but the CBD market is definitely making you think otherwise, you know, they're putting it in, in everything.
34:54
Mariely: It's
34:54
Brenda: in everything.
34:56
Brenda: Like there was a shower steamer I saw the other day, like CBD infused lavender.
35:02
Brenda: You know, a shower steamer.
35:04
Brenda: It was crazy.
35:06
Brenda: Like with alcohol, right?
35:07
Brenda: I know that you're not supposed to go cold turkey if you have heavy alcohol dependence.
35:11
Brenda: Is there a risk like that with THC or can you actually quit knowing that you're going to have a few weeks of hell to follow?
35:20
Mariely: You can't quit.
35:20
Mariely: With alcohol, there may be cardiac ramifications because alcohol affects like electrolytes and kind of Your heart rate and in some tangential way that I'm not an expert enough to explain properly But the studies that have used any kind of medicine or anything for cannabis use disorder like previously they wanted abstinence as a outcome measure But when they looked at the data more closely, just reducing the days of use, you know, correlated or was associated with a greater, like, quality of life.
35:54
Mariely: You know, for some people, they just, you know, they want to go from everyday use to maybe weekend use, right?
36:00
Mariely: And so that may be enough for them to feel like it's manageable and for them to kind of recover more of their, like, functioning, uh, day to day functioning.
36:09
Mariely: The problem with that is that, you know, some people with ADHD, a lot of it is like all or nothing, you know, cause if there's a dopamine deprivation state where you like want more dopamine, then you're, this substance gives it to you right away.
36:22
Mariely: You're just like giving more, giving more.
36:24
Mariely: And so it can be really hard to then have like, you know, only recreational or periodic use.
36:31
Mariely: So, but, you know, some people can achieve it, so if, if they can, maybe that's better for them and that's fine if it's, you know, less harmful, but then if they find that they can't really achieve that or maintain that, then, you know, I would recommend just trying longer periods of abstinence.
36:47
Mariely: A lot of people don't think that they're dependent on cannabis because they've never actually tried to quit.
36:52
Mariely: But you can ask, just see if you can go for a couple of days and what happens.
36:56
Mariely: The other thing is that when they quit, the irritability is bad and teens are already irritable.
37:01
Mariely: So you're going to be really like living with somebody who's just so mean for a couple of weeks and you know, it's going to be rough.
37:11
Mariely: But like if you expect it, I think you can, you can prepare.
37:15
Brenda: Yeah.
37:16
Brenda: You mentioned psychosis earlier and we are definitely seeing that in our community of parents who are just, it's terrifying, right?
37:26
Brenda: When you're kiddos hearing voices and seeing things that aren't there and really struggling.
37:32
Brenda: Maybe just give us everything you know about psychosis and THC.
37:36
Brenda: It is, it is a real thing that is.
37:40
Brenda: super scary.
37:43
Mariely: Yeah, I mean, I think it's a high potency products.
37:46
Mariely: I don't think it's an ADHD specific risk.
37:49
Mariely: Okay.
37:50
Mariely: But like say that you have any kind of underlying vulnerability to schizophrenia or something.
37:56
Mariely: You're at risk, you know, and, and I think that risk is predominantly in males, you know, they're more likely to then have psychotic effects, but also THC binds to fat, right?
38:08
Mariely: And so like, if you're a thin person, right, and there's not enough fat, I guess, for the THC to kind of bind to, you're doing these dabs, which is very high potency dose of THC, it can, it'll go straight to your brain, right?
38:20
Mariely: And that's where the psychosis happens.
38:22
Mariely: And you know, you don't, you lose control.
38:24
Mariely: You don't know what's going on.
38:25
Mariely: And it's terrifying.
38:26
Mariely: And it terrifies the parents, too.
38:28
Mariely: I even, I've overheard this woman just talking about, I don't know, her niece or daughter or something, having that same exact experience.
38:34
Mariely: Like, she was in a, like, psychotic, almost manic state, and when she was hospitalized, they discovered that it was cannabis induced.
38:41
Mariely: So women can experience this.
38:44
Mariely: Also, I did read, you know, it's more likely to happen in men, but it could be that maybe not that many women were smoking before and now they are.
38:52
Mariely: So it might be an equal risk across sexes, but we just don't know yet.
38:57
Brenda: Right.
38:58
Brenda: Well, and it makes sense what you were saying about the kind of the all or nothing, right?
39:02
Brenda: With ADHD is like, Oh, I did that.
39:05
Brenda: That felt really good.
39:06
Brenda: Yeah.
39:06
Brenda: So then it's a more consistent thing.
39:09
Brenda: And if it's, it's the high potency stuff, it's, it's super scary.
39:13
Brenda: Do we know if that is like, does the psychosis then resolve once they stop using, or is there enough data to say like, I'm thinking in 10 years, what about all these kids who are smoking every day?
39:28
Brenda: It is not that uncommon by the way, for them to be smoking every single day.
39:33
Mariely: I know.
39:35
Mariely: It is not, but you want to know why, you want to ask about why they're smoking, right?
39:40
Mariely: And because when I was, you know, I was doing the research for an article I wrote about therapeutic, like ADHD and therapeutic cannabis use, you know, people with ADHD or studies have shown that even if they're medicated for the ADHD, they'll use cannabis to settle down.
39:55
Mariely: Like also for the irritability, if they're coming off of stimulants to stimulate their appetite, if their medicine makes them not feel like eating.
40:03
Mariely: And so part of that is like, you know, maybe we need, there's so many options for ADHD meds, like we can probably do better in offering them so that you don't have such negative side effects.
40:13
Mariely: The other thing is, you know, dealing with negative emotions, you know, like being really emotionally sensitive, any drug can give you a shield from that.
40:22
Mariely: And so that can be really great for people who have a lot of anxiety or dealing with a difficult situation.
40:30
Mariely: But what happens is that if you don't feel that discomfort, you're less likely to change the situation.
40:35
Mariely: So you actually suffer in it longer, or you're kind of just like not paying attention.
40:41
Mariely: And so things can get a lot worse.
40:43
Mariely: So then when you sober up, you realize like this stuff got out of hand, or like, once you feel the discomfort, you try harder to find a way out of that situation, this could be a bad relationship, this could be just a terrible job, you know, you feel like you can't change it.
40:58
Mariely: So you just try to Dull yourself until you can get through it, but in the end you end up staying there for longer And you haven't learned more adaptive coping mechanisms, right?
41:08
Mariely: Because why would you?
41:09
Mariely: You already have this very effective thing But then any kind of substance just brings a whole slew of other problems along with it So, you know, if anyone, like, people are asking, like, can I, like, use cannabis, like, to sleep?
41:21
Mariely: Sleep or something.
41:22
Mariely: And I'm just like, no, don't even start.
41:25
Mariely: Like, it's not effective.
41:26
Mariely: Like, what if you like it?
41:28
Mariely: And then you don't want to, you want to do it like every day.
41:30
Mariely: That's not just this expensive.
41:32
Mariely: Where are these T's getting money to smoke every day?
41:34
Brenda: Thank you.
41:35
Brenda: That is a really good question.
41:37
Brenda: Yes, it is.
41:39
Brenda: It's it's a little surprising.
41:40
Brenda: I just was recording another podcast with a guy who used daily for five years and he was like, if only I could get all of that money back, I would be so happy.
41:51
Brenda: Rich, you know, it's, it's a lot.
41:54
Brenda: Could you just talk a little bit about ADHD meds and what are they doing?
41:59
Brenda: I know, I know there's different ones that work differently, but in general, what are they doing?
42:04
Brenda: Because I think like what I saw with my son was such a different kid when he was on his meds.
42:11
Brenda: And I was so surprised.
42:12
Brenda: And I think part of why What I hear too now is, well, we tried this medication.
42:18
Brenda: It didn't really work.
42:19
Brenda: We had a lot of side effects.
42:20
Brenda: So then we had to try another one and we had to try another one.
42:22
Brenda: And so then you could be looking at a couple of months of testing these different, you know, doses or formulas or whatever.
42:31
Brenda: And the kid's like, forget it.
42:33
Brenda: The weed worked.
42:34
Mariely: Yeah.
42:35
Brenda: You know?
42:36
Mariely: Yeah.
42:37
Mariely: But yeah.
42:38
Mariely: Oh God.
42:39
Mariely: I'm not saying that's the right thing.
42:40
Mariely: I'm just
42:41
Brenda: saying that's what we hear from the kids.
42:42
Brenda: Yeah.
42:43
Brenda: Yeah.
42:44
Mariely: Well, the weed made you not care so much.
42:46
Mariely: That's what it's, it doesn't mean that it necessarily works.
42:49
Mariely: Right.
42:49
Mariely: So I'm not a psychopharmacologist.
42:51
Mariely: So there's one thing, you know, but I have worked with enough psychiatrists that, you know, if you're like kids metabolize drugs differently than adults.
43:00
Mariely: So it is trickier to find the right dose, so they may react differently than an adult at a certain dose.
43:05
Mariely: I don't know if that means you have to give more or less or anything like that, right?
43:09
Mariely: But, you know, having a psychiatrist that's more communicative or that can advise you, like, start with maybe half and then do the full.
43:16
Mariely: And then, like, you're gonna have these side effects.
43:19
Mariely: If they last longer than a week, then give me a call, right?
43:21
Mariely: But it's true.
43:22
Mariely: It can be really frustrating if you're trying these different things or they're not really working.
43:28
Mariely: But don't give up.
43:29
Mariely: You know, I think I worked in the depression and evaluation services at Columbia and you know, the, a lot of the psychiatrists there, they were like, I remember when Prozac came into the scene, there were people with really treatment, uh, resistant depression and Prozac like suddenly made such a difference.
43:45
Mariely: So, you know, you, they tell patients, like, don't give up because there And it's newer, like medicine, and more diversity, and for antidepressants there's actually quite a lot.
43:54
Mariely: Some of, so the, the way that, there's, there's stimulants and there's non stimulant medications for ADHD.
44:00
Mariely: The non stimulants, you know, I heard they're kind of better for inattentive presentations, and that's like stratera or etamoxetine.
44:09
Mariely: And it takes a little while longer to work, but it, it does work well for people.
44:14
Mariely: And it's actually great if you If there's any concern about substance use or stimulant diversion, which is like, you know, selling your ADHC meds, right?
44:24
Mariely: It's not as effective or as fast acting as a stimulant medication.
44:28
Mariely: So I was saying before that, you know, parts of the ADHD brain are not as effective in using available dopamine.
44:34
Mariely: And so, and then there's also like norepinephrine, but it just increases the brain's ability to use or produce like the dopamine, norepinephrine and other like neurotransmitters that focus, right?
44:51
Mariely: So, The thing is, my friend who's a psychiatrist, she's like, tills don't make the house.
44:56
Mariely: Because you can take your ADHC meds and then have the cleanest house and not get your paper done.
45:01
Mariely: Like, ask me how I know this.
45:02
Mariely: Right.
45:05
Mariely: So, so you do have to have some discipline and make sure that you're timing it appropriately and that, you know, you're in the right place.
45:12
Mariely: Right.
45:12
Mariely: But yeah, I, I think, you know, the, there are, there are so many different formulations of meds.
45:19
Mariely: I know there's one from Journey that, Boggled my mind because I guess you take it you give it to your kid before that when they go to sleep And so they wake up ready.
45:29
Mariely: Oh like they you know, it works overnight like it's a methylphenidate type of thing I know I was I don't know anybody who's been on it because insurance Won't pay for these kind of better drugs and so you fail everything.
45:40
Mariely: So part of that is also the healthcare system That, you know, you may know that this could work for this kid, but the insurance won't pay for it until you fail a bunch of stuff.
45:49
Brenda: Oh, that's so frustrating.
45:51
Brenda: It's just, yeah, it's hard to have a young person.
45:56
Brenda: I kind of talk about like, a lot of the things that will work are like a crock pot.
46:01
Brenda: And what they want is the microwave.
46:02
Brenda: And it's like, yeah, but the crock pot, it's gonna, it's gonna taste so much better.
46:06
Brenda: Yeah.
46:09
Brenda: But it's, you know, these things can be slow and.
46:12
Brenda: And especially for our kids with ADHD, they don't want slow.
46:15
Brenda: They want instant.
46:16
Brenda: They want now.
46:18
Mariely: That is true.
46:19
Mariely: I mean, like stimulant meds, if they work, they do work instantly.
46:22
Mariely: I think the, the, the trepidation that a lot of people have at a young or, or, you know, fully grown adults is that these meds are going to change who they are.
46:32
Mariely: And they, they don't like, I think if a, of a medicine really dulls you, Then that's probably not right for you.
46:38
Mariely: What it should do is allow you to be more of yourself because you can explain things coherently and not alienate everybody around you.
46:46
Mariely: You can follow one of your creative ideas through, you know, to, to, to the final product.
46:54
Mariely: I also think that, you know, I think you asked me earlier about parents and identifying ADHD and stuff.
47:00
Mariely: Parents do so much for their kids, they don't even realize it.
47:03
Mariely: Like, if you sit next to your kid while they're doing homework, that's body doubling and that's a behavioral support for ADHD.
47:11
Mariely: You structure their schedule, you send them reminders, you pack their bag, you organize their room.
47:16
Mariely: That's structural support for ADHD, right?
47:19
Mariely: Guilty.
47:19
Mariely: I'm guilty of all those.
47:21
Mariely: But, I mean, you do that because it helps your kid.
47:24
Mariely: Of course you want to help your kid, but what would be really helpful is to prepare them to do that on their own when they go to college or like to.
47:33
Mariely: Tell them this is what you need.
47:35
Mariely: You know, work in a group, do homework in a group setting in a quiet place, free of distractions, right?
47:41
Mariely: Like this is where you work best.
47:43
Mariely: The structure is something that people with ADHD needs really need.
47:48
Mariely: as a base.
47:49
Mariely: They kind of have this oppositional thing about it, but don't be deterred, you know, insist because it's really helpful.
47:59
Brenda: Yes, that's so true.
48:00
Brenda: And I remember my son when he was trying to, I think he must have been in like fourth or fifth grade maybe.
48:07
Brenda: And we were trying to, it was just, It was terrible.
48:10
Brenda: It was so hard trying to get homework done.
48:12
Brenda: He would be crying and I would be crying and
48:15
Mariely: somebody
48:16
Brenda: said, you know, have him listen to music when he's doing homework.
48:19
Brenda: And I just thought that was the worst idea ever because I can't focus if I have music on, but he, he tried it and it really worked for him.
48:28
Brenda: And I guess my message to parents is just because something doesn't work for you, don't assume it's not going to work for your kid because that really helped him.
48:36
Brenda: And it was like, almost like.
48:39
Brenda: Bach.
48:39
Brenda: Like it was, you know, classical music and I'm like, what?
48:43
Brenda: This is so crazy.
48:44
Brenda: But it, some, something in that just allowed him to really focus.
48:49
Brenda: So maybe they even know sometimes what's going to be helpful more so than we do.
48:56
Mariely: Oh, I would ask them because if you get them involved in deciding that, like sometimes even in the, in the group with the other students.
49:04
Mariely: You know, I'll just throw out some ideas, but like, it's so much easier to shoot down somebody else's idea.
49:10
Mariely: Cause the ADHD person would be like, no, that's not going to work for me.
49:13
Mariely: But then, then they'll come up with an idea that would work for them.
49:16
Mariely: And that's what I want.
49:17
Mariely: So I don't care if you don't like my idea, but we want to start generating some ideas, you know, and see what would actually work for you.
49:24
Mariely: Another thing about ADHD that I think people may not understand.
49:28
Mariely: Is that there's also like there's poor gating of sensory stuff.
49:33
Mariely: So there's, there's the default mode network, right?
49:36
Mariely: So it's a series of connect of brain areas that are connected that like when your mind, when you're daydreaming, they're kind of activated.
49:43
Mariely: But then when you have to focus on a task, they're inhibited.
49:45
Mariely: For people with ADHD, the fMRI studies show that they are not as good at inhibiting the, that default mode network.
49:53
Mariely: So that's basically like the people with ADHD struggle to corral the mind wandering.
49:59
Mariely: and to shut out environmental noise.
50:02
Mariely: So it's really hard to focus if you could hear the refrigerator breathing, if you could hear construction two blocks down, if it's too quiet.
50:10
Mariely: So, music with no words, sometimes white noise, like I like ocean sounds and rain sounds, to just give a uniform level of noise, like, that's really helpful.
50:21
Mariely: Sometimes I could read a research article on the train provided that no one is coughing on to each other like in a loud voice on the train that everything is kind of at a level.
50:31
Mariely: So, and that's not every person with ADHD, but sometimes the kids may not realize that they're overstimulated and they get very irritable and easily upset.
50:43
Mariely: So like having a quiet environment with distractions, maybe some with no distractions and maybe some white noise.
50:51
Mariely: can be like helpful.
50:52
Mariely: And there's also like noise cancelling headphones for kids or like the in ear loops.
50:58
Mariely: My kids, you know, their kids are loud, but the parlor and the staircase are shaped so that it echoes.
51:05
Mariely: We don't have a rug in there yet.
51:06
Mariely: We moved just last year and it amplifies and I would just be so irritable.
51:11
Mariely: And then I was like, I think it's just too loud.
51:13
Mariely: Cause I'm the only one who I guess is disturbed.
51:16
Mariely: And I put the loops in, okay.
51:17
Mariely: And I was like, ah, like my heart rate went down and I didn't, I hadn't, I didn't realize that that, that I was just overstimulated.
51:25
Mariely: And this is, this is one example.
51:27
Mariely: I think your kid will probably be more obvious that they're overstimulated.
51:32
Mariely: Shutting out some of the distractions might be helpful.
51:37
Brenda: Well, thank you.
51:38
Brenda: This has been so incredibly insightful.
51:40
Brenda: Before I let you go, is there a word of advice?
51:44
Brenda: Wisdom or encouragement you could give to a parent who's got one of these kids in this trifecta zone of ADHD, teenage brain, and substance use.
51:56
Mariely: Right.
51:56
Mariely: Yeah.
51:56
Mariely: Take care of yourself.
51:58
Mariely: Like, get your own therapist to, this part of the craft, right?
52:02
Mariely: To not tie your happiness to your child's sobriety or your child's happiness, right?
52:08
Mariely: Because then, you know, there's resentment that builds and, and you, you have to be able to.
52:14
Mariely: Set that boundary, but also it's good modeling and you know, when I worked on a study of depression, maternal depression, and child psychopathology, just the parent being in treatment helped improve child symptoms, even if the depression didn't really matter, right?
52:31
Mariely: Like it's just when you take care of yourself, it's good modeling, right?
52:36
Mariely: And, and, you know, You know, parents are always working harder than they think.
52:40
Mariely: So give yourself some credit, go on a mom's spa day.
52:44
Mariely: Like you're, you know, you're like, you've organized, like you deserve it.
52:48
Mariely: And also like a lot of times what parents need is more help.
52:52
Mariely: Right.
52:52
Mariely: And so try to get some, some help tap out, let somebody else tap in for a bit, take your break so you can be replenished.
53:01
Mariely: You know, for the next crisis.
53:03
Brenda: Yes.
53:05
Brenda: There's always another one right around the corner.
53:08
Brenda: Thank you so, so much is incredibly helpful and I'm sure we'll answer a lot of questions on this topic.
53:16
Brenda: Appreciate it.
53:17
Mariely: Thank you so much for having me.
53:18
Mariely: This is so great.
53:20
Brenda: Okay, my friend, that is a wrap for today.
53:22
Brenda: Don't forget to download the new ebook, Worried Sick.
53:26
Brenda: It's totally free and it will shed so much light on positive tools and strategies you can use right now.
53:33
Brenda: To start creating those positive conditions for change in your home and in your relationships.
53:38
Brenda: It is at hopestreamcommunity.
53:40
Brenda: org forward slash worried.
53:43
Brenda: And guess what?
53:44
Brenda: We have moved the entire podcast to our website at hopestreamcommunity.
53:49
Brenda: org.
53:50
Brenda: So now when you want the show notes or resources, or if you want to download a transcript, just go to hopestreamcommunity.
53:57
Brenda: org and click on podcast.
53:59
Brenda: And you will find it all there.
54:01
Brenda: You can search by keyword, episode number, guest name, and we have created playlists for you.
54:07
Brenda: Makes it much easier to find episodes grouped by topic.
54:10
Brenda: So we're really excited to have that done and hope you like the podcast's new home.
54:17
Brenda: Please be extraordinarily good to yourself today.
54:20
Brenda: Take a deep breath.
54:21
Brenda: You've got this and you are going to be okay.
54:24
Brenda: You're not doing it alone.
54:26
Brenda: I will meet you right back here next week