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ADHD: Are You Distracted or Is It a Disorder? (Part 1) · RECOVERable: Mental Health and Addiction Experts Answer Your Questions

• 0:13
  SPEAKER_01: I would say that ADHD is not overdiagnosed.
• 0:17
  SPEAKER_01: In fact, ADHD is underdiagnosed.
• 0:20
  SPEAKER_01: Dr.
• 0:20
  SPEAKER_01: Carrie Jackson is a child psychologist, speaker, and expert in ADHD.
• 0:26
  SPEAKER_01: We now know a lot more about what ADHD looks like in adults.
• 0:30
  SPEAKER_00: If somebody's listening and thinking, oh my gosh, I think I might have ADHD, what would be the first step to say, like, maybe I should check this out?
• 0:38
  SPEAKER_00: I would look for.
• 0:43
  SPEAKER_00: Welcome to Recoverable.
• 0:44
  SPEAKER_00: Today we're joined by Dr.
• 0:45
  SPEAKER_00: Carrie Jackson to talk about ADHD.
• 0:48
  SPEAKER_00: And you are the perfect person to talk to about it because you're not only a child psychologist, but an ADHD expert and you live with it.
• 0:55
  SPEAKER_01: Yep, exactly.
• 0:56
  SPEAKER_01: I always share with people that I have ADHD myself.
• 0:59
  SPEAKER_01: And so it's something that I feel like I can really relate to a lot of the families that I work with and from a personal and a professional standpoint.
• 1:06
  SPEAKER_01: So I love working with ADHD.
• 1:08
  SPEAKER_01: And thank you guys for having me here.
• 1:10
  SPEAKER_00: Oh, absolutely.
• 1:10
  SPEAKER_00: Welcome.
• 1:11
  SPEAKER_00: We're going to jump to the first question or the most asked and searched for question on the internet.
• 1:16
  SPEAKER_00: Do I have ADHD or am I just distracted?
• 1:19
  SPEAKER_00: I love this question.
• 1:20
  SPEAKER_01: I see this all the time on TikTok too and on Instagram, all social media.
• 1:26
  SPEAKER_01: It is important for people to know that the symptoms of ADHD, everybody experiences these symptoms.
• 1:32
  SPEAKER_01: Like they aren't unique to ADHD.
• 1:35
  SPEAKER_01: So, I mean, difficulty concentrating, most people probably have trouble concentrating at some point, right?
• 1:40
  SPEAKER_01: But what is different about ADHD versus just these difficulties with inattentive symptoms or hyperactivity is that does it impair your life?
• 1:50
  SPEAKER_01: Right.
• 1:50
  SPEAKER_01: So that impairment piece is what really separates yourself from like, do I have ADHD or is it something that I'm experiencing these symptoms?
• 2:00
  SPEAKER_01: And it's just, you know, something that everybody experiences these types of symptoms at times.
• 2:05
  SPEAKER_00: Is there a thing that you most wish people understood about ADHD, or the biggest misconception you'd like to correct before we keep going?
• 2:14
  SPEAKER_01: The biggest misconception that I hear about ADHD, and there's a good reason why it is a misconception, is ADHD is not a lack of attention.
• 2:25
  SPEAKER_01: It's not a deficit of attention, even though that's what the name is attention deficit, right?
• 2:30
  SPEAKER_01: It's a horrible name.
• 2:31
  SPEAKER_01: But ADHD is really about regulating your attention to the right things in the moment.
• 2:37
  SPEAKER_01: So can I regulate my attention to what I need to be focused on?
• 2:41
  SPEAKER_01: Or can I actually turn my attention that way?
• 2:45
  SPEAKER_01: Some people with ADHD, they have a lot of great attention towards things.
• 2:49
  SPEAKER_01: So hyperfocus, a lot of people talk about it's like this intense attention onto things at times.
• 2:57
  SPEAKER_01: And just because you are able to be focused on certain things at times doesn't mean that you don't have ADHD because it's really about how that attention is regulated.
• 3:07
  SPEAKER_01: Let me give another example too.
• 3:09
  SPEAKER_01: Like a lot of parents will often tell me, like, I don't think my child has ADHD because they can focus on video games for hours.
• 3:15
  SPEAKER_01: I hear that all the time.
• 3:17
  SPEAKER_01: And I always tell parents, like, it's still possible they have ADHD.
• 3:21
  SPEAKER_01: It's just that that is one thing that they are really able to focus on in the moment.
• 3:26
  SPEAKER_00: Is the focus of my understanding more at the things you really are into, the things that really captivate your interest you can focus on and the others less so?
• 3:34
  SPEAKER_01: Yeah.
• 3:35
  SPEAKER_01: The things that are really interesting to you are what can captivate your interest and also the things that are right there in the moment, like that urgency piece.
• 3:45
  SPEAKER_01: So if you are playing a video game, you need to act right then, right away, right?
• 3:50
  SPEAKER_01: So like you need to like press the controller, do all of these different things, and you get that feedback pretty quickly.
• 3:56
  SPEAKER_01: So like there's a lot of things that you're having to do right then and there.
• 4:00
  SPEAKER_01: But if you think about like studying for something or um even like making a doctor's appointment, there's not always a lot of urgency, right?
• 4:09
  SPEAKER_01: You may have a test that's coming up, but that's definitely not urgent in the same way that playing a video game is.
• 4:17
  SPEAKER_01: Always.
• 4:18
  SPEAKER_00: Or I mean five minutes before the test.
• 4:20
  SPEAKER_00: There you go.
• 4:20
  SPEAKER_00: There you go.
• 4:21
  SPEAKER_00: I remember that well.
• 4:22
  SPEAKER_00: So, how does somebody officially get diagnosed with ADHD?
• 4:26
  SPEAKER_01: So there are a lot of people who can diagnose ADHD, I will say.
• 4:30
  SPEAKER_01: So um, it's going to depend if you are diagnosed in childhood, if you're a teen or if you are an adult.
• 4:37
  SPEAKER_01: But as far as like the different types of professionals who can diagnose ADHD, there's primary care physicians, there's pediatricians, so those medical doctors that you're seeing for your annual visits, but also psychologists and psychiatrists.
• 4:52
  SPEAKER_01: So psychologists who do therapy or evaluations, they might specialize in ADHD and they're able to diagnose it.
• 5:00
  SPEAKER_01: There are also therapists, and this depends, like I would say, based on the state that you're living in.
• 5:06
  SPEAKER_01: So there's some therapists where they're not able to diagnose ADHD, just it depends on like their own licensing laws.
• 5:14
  SPEAKER_01: What I would say to just like the people who are listening is if you are concerned about if you have ADHD, there are multiple routes that you can look at.
• 5:22
  SPEAKER_01: And like a pediatrician, a primary care physician, psychiatrists or psychologists, and some therapists are all great tools.
• 5:29
  SPEAKER_01: The biggest thing is like, is this person actually trained in ADHD?
• 5:34
  SPEAKER_01: Um, you know, a lot of primary care physicians, they may not feel comfortable diagnosing ADHD.
• 5:39
  SPEAKER_01: So they may actually refer you to a psychologist, but there are psychologists who do not specialize in ADHD.
• 5:46
  SPEAKER_01: So if you're looking for someone, you should ask them questions like, how often do you work with ADHD?
• 5:51
  SPEAKER_01: How many of your clients have ADHD that you work with?
• 5:55
  SPEAKER_01: And asking them how comfortable they are is really going to help ensure that you find somebody that is a good fit for what you're looking for.
• 6:03
  SPEAKER_00: What's involved in diagnosing ADHD?
• 6:05
  SPEAKER_00: Because there's not a blood test or an x-ray that it'll show up on.
• 6:09
  SPEAKER_01: No, and that is one of the biggest misconceptions.
• 6:13
  SPEAKER_01: And it makes sense why it is a misconception too, because a lot of people think like there's a brain test, right?
• 6:20
  SPEAKER_01: Or a brain scan or a blood test, because it is a neurodevelopmental disorder, which means there are differences in the brain that develop and that you can see from a young age.
• 6:32
  SPEAKER_01: And then they are still there over time.
• 6:35
  SPEAKER_01: You would think if there are differences in the brain, why can't we just look at somebody's brain and say, do you have ADHD or not?
• 6:41
  SPEAKER_01: But it's so varied in how it can look.
• 6:45
  SPEAKER_01: So actually, the most effective way to diagnose ADHD is through a combination of like meeting somebody and interviewing with them to hear more about like your background, your history, what your childhood was like, how these symptoms show up.
• 7:00
  SPEAKER_01: And then often completing what we call like questionnaires or assessments or standardized questionnaires that will help determine like these unattentive symptoms or hyperactive symptoms you're experiencing.
• 7:13
  SPEAKER_01: Are they related to ADHD or something else?
• 7:16
  SPEAKER_01: And also are they like considered typical?
• 7:20
  SPEAKER_01: So with all of these symptoms, right?
• 7:22
  SPEAKER_01: They are something that our everybody experiences, but there's a level at which it becomes much different.
• 7:29
  SPEAKER_01: And so these questionnaires, they help us understand how often you're experiencing them.
• 7:34
  SPEAKER_01: Is it something that just happens once in a blue moon, or are you losing things every single week, multiple times a week?
• 7:39
  SPEAKER_01: So looking at those pieces is really important.
• 7:42
  SPEAKER_00: So as a child psychologist and ADHD expert, what do you look for when someone comes to your office to say, oh yeah, you've got this or you don't?
• 7:51
  SPEAKER_01: So as a child psychologist, I work a lot with kids and their families.
• 7:56
  SPEAKER_01: And I will ask a lot of questions about what is school like for you?
• 8:01
  SPEAKER_01: What is home life like for you?
• 8:03
  SPEAKER_01: Right.
• 8:03
  SPEAKER_01: And so I am often looking at like, when did these symptoms start?
• 8:08
  SPEAKER_01: Because since it's considered a neurodevelopmental disorder, there's often signs from a young age, but they show up differently.
• 8:16
  SPEAKER_01: So I'm asking a lot about like, is school hard for you in any ways?
• 8:20
  SPEAKER_01: Do you forget things a lot of the times?
• 8:22
  SPEAKER_01: Or is it hard for you to listen to directions when they're given to you by the teacher, by your boss, by your parents?
• 8:29
  SPEAKER_01: Um, and I will often ask parents, teachers, and the child about that because ADHD doesn't show up in just one setting.
• 8:38
  SPEAKER_01: It shows up across the board just in different ways.
• 8:42
  SPEAKER_01: That's one of the things that I am often looking for is like, how does it show up in these different settings for kids, teens, and families?
• 8:50
  SPEAKER_01: Because it's often there in some capacity, even if you are doing really well in school.
• 8:55
  SPEAKER_00: You brought up earlier one of the sort of standard things, the doing the homework but not turning it in.
• 9:01
  SPEAKER_00: That was a real frustration for me as a parent.
• 9:03
  SPEAKER_00: I was like, I know he did it.
• 9:05
  SPEAKER_01: Yes.
• 9:05
  SPEAKER_01: Oh, and with all of these like online submission portals, like school is moving online so much.
• 9:12
  SPEAKER_01: There are multiple steps kids can miss out on.
• 9:14
  SPEAKER_01: So they do the homework, then you have to complete it online potentially, and then you have to press submit so that your teacher sees it and they can grade it.
• 9:24
  SPEAKER_01: So many ADHD kids, they miss the submission, that last step.
• 9:28
  SPEAKER_01: And so they're getting like zeros on their homework, even though they did it, which is the most frustrating part.
• 9:33
  SPEAKER_01: And that's how you can often see like you can be very smart and have ADHD, right?
• 9:38
  SPEAKER_01: You're not necessarily able to show the skills that you have and to show what you're able to do because of like forgetting to do something.
• 9:49
  SPEAKER_01: ADHD is not a knowledge disorder.
• 9:51
  SPEAKER_01: It's not based on your intelligence, it's a performance-based disorder.
• 9:55
  SPEAKER_01: It is what you're able to do with the information in the moment.
• 9:58
  SPEAKER_01: It's how you're able to show what you know.
• 10:01
  SPEAKER_01: Um, I could tell an ADHD child, remember to do this, remember to do this.
• 10:06
  SPEAKER_01: But in the moment, they may know that is exactly what they need to do and still fall back on not doing it, right?
• 10:12
  SPEAKER_01: They may still forget to do it at times.
• 10:14
  SPEAKER_01: And that's what I see a lot with families I work with.
• 10:17
  SPEAKER_00: So when you can't show what you know and and maybe don't have the follow-through to click submit, what are the assumptions made about people with ADHD?
• 10:25
  SPEAKER_01: People may just think like they are being lazy.
• 10:28
  SPEAKER_01: Like ADHD people are just being lazy.
• 10:31
  SPEAKER_01: They're not disciplined, or they're not motivated, right?
• 10:35
  SPEAKER_01: Or they don't care.
• 10:36
  SPEAKER_01: I hear that all the time.
• 10:37
  SPEAKER_01: It's not about not caring.
• 10:39
  SPEAKER_01: It is truly about what's called executive functioning.
• 10:42
  SPEAKER_01: Executive functioning, they're all of those skills with planning, organization, time management, self-regulation.
• 10:49
  SPEAKER_01: We all have executive functioning skills, but for people with ADHD, they are often delayed with that.
• 10:58
  SPEAKER_01: I mean, they may struggle more so with those organizational skills, and it may look like they just don't care to turn in their homework when that is so far from the truth.
• 11:07
  SPEAKER_01: They care, but they're missing a step and it's not on purpose.
• 11:11
  SPEAKER_00: So the way it shows up, I understand there's a difference in gender that boys we literally call the bad boys when I was in grade school.
• 11:20
  SPEAKER_00: They had to sit in the back of the class.
• 11:21
  SPEAKER_00: And girls or people assigned female at birth have a different way of presenting, which was a surprise to me as I was doing a little research before meeting you.
• 11:30
  SPEAKER_01: Yeah, I uh as a girl with ADHD or a woman with ADHD, I would say that I present in the more typical way that girls can show ADHD symptoms.
• 11:41
  SPEAKER_01: So um I mentioned how there's like these inattentive symptoms, there are hyperactive and impulsive symptoms.
• 11:47
  SPEAKER_01: Girls are more likely to show the inattentive symptoms.
• 11:50
  SPEAKER_01: So those inattentive symptoms, they are the ones where like you may be daydreaming, you may just lose focus when you're talking, you may forget to turn in a homework assignment, you may lose track of your time and be late for things.
• 12:03
  SPEAKER_01: Those are not as noticeable to people.
• 12:06
  SPEAKER_01: So if you think about like these hyperactive symptoms and a child that is disruptive in class, disruptive.
• 12:13
  SPEAKER_00: Yeah.
• 12:14
  SPEAKER_01: They're teachers are more likely to notice it, right?
• 12:17
  SPEAKER_01: A parent may notice it more, but the child or the girl that is in class and they're daydreaming and off in their own world, they're not disrupting the class and they are not causing issues.
• 12:28
  SPEAKER_01: And so you may not even see that or notice that ADHD is potentially what's going on.
• 12:33
  SPEAKER_01: Girls are more likely to be diagnosed later.
• 12:36
  SPEAKER_01: I also want to talk about like some of the social pieces that you actually shared.
• 12:41
  SPEAKER_01: So you said like there are these boys in your classroom.
• 12:44
  SPEAKER_01: Yes.
• 12:45
  SPEAKER_01: Yeah.
• 12:45
  SPEAKER_01: Yes.
• 12:46
  SPEAKER_01: Yeah.
• 12:46
  SPEAKER_01: So I mean, you may have heard this too.
• 12:48
  SPEAKER_01: Like, boys will be boys.
• 12:50
  SPEAKER_01: That's a very typical type of thing that I will hear also.
• 12:54
  SPEAKER_01: And I think it contributes to this idea that ADHD is just a diagnosis for boys.
• 13:01
  SPEAKER_01: But um, girls, they are socialized to be like quieter, to kind of go with the flow.
• 13:07
  SPEAKER_01: Right.
• 13:07
  SPEAKER_01: And so for girls being socialized this way in a classroom setting, like you are sitting there quietly, you're not acting out, you're not being disruptive in class.
• 13:18
  SPEAKER_01: Those things that are reinforced at a young age to act a certain way really make it so that you don't see some of those more noticeable signs of ADHD too.
• 13:28
  SPEAKER_00: I think that disruption is the key, right?
• 13:29
  SPEAKER_00: The minute you're disruptive, somebody is disrupted.
• 13:32
  SPEAKER_00: Yeah.
• 13:32
  SPEAKER_00: And they're more likely to notice because it's affecting them.
• 13:35
  SPEAKER_01: Yeah.
• 13:35
  SPEAKER_01: And the disruption, like parents can see at home a lot of the times too.
• 13:40
  SPEAKER_01: Like it can look like um tantrums because emotions are a really big part of ADHD.
• 13:45
  SPEAKER_01: And so there are kids who will do really well in school, like academically, and they may not have trouble acting out.
• 13:52
  SPEAKER_01: You will often hear that parents talk about all of these tantrums or all of these like outbursts at home.
• 13:58
  SPEAKER_01: And it's like these kids are keeping it together and then they get home and it's just everywhere for the parents to see.
• 14:05
  SPEAKER_00: The way you were describing the symptoms in females sounds more like what we used to call ADD, it with the H missing, the hyperactivity.
• 14:14
  SPEAKER_01: Yes.
• 14:14
  SPEAKER_01: So it used to be called ADD, and I think in the 80s, not positive, but I'm pretty sure in the 80s was when this actually changed.
• 14:24
  SPEAKER_01: And so now what people used to think of as ADD is just under the umbrella term ADHD.
• 14:30
  SPEAKER_01: Okay.
• 14:30
  SPEAKER_01: There are three presentations of ADHD, or three like types, people will call it two.
• 14:36
  SPEAKER_01: So there's the predominantly inattentive presentation, which is ADD, or there's the predominantly hyperactive impulsive type.
• 14:44
  SPEAKER_01: And then there's the combined presentation, which is you have these inattentive symptoms, and you have these hyperactive impulsive symptoms.
• 14:51
  SPEAKER_01: It's important to think about with these like types that I'm sharing.
• 14:54
  SPEAKER_01: Like, yes, you may have a child that is diagnosed with the more inattentive presentation, but we know that actually like these presentations and types can change over time.
• 15:04
  SPEAKER_01: Um, so like the hyperactivity tends to decrease as people age, or it becomes more internal.
• 15:10
  SPEAKER_01: It becomes more in their mind, or it can show up actually as like these emotional outbursts, especially with like teens.
• 15:17
  SPEAKER_01: I mean, being a teen is tough already.
• 15:20
  SPEAKER_01: Parenting a teen is tough.
• 15:22
  SPEAKER_01: Yes.
• 15:22
  SPEAKER_01: Puberty, right?
• 15:23
  SPEAKER_01: Yes.
• 15:23
  SPEAKER_01: All of those emotions are hard, but ADHD can make it even tougher.
• 15:29
  SPEAKER_00: So when you say inattentive, what does that look like when you have the inattentive presentation of ADHD?
• 15:35
  SPEAKER_01: I often will share like some of the things that my mom used to tell me when I was a child about ADHD.
• 15:41
  SPEAKER_01: So like the lights are on, but nobody is home.
• 15:44
  SPEAKER_01: So, which is funny.
• 15:45
  SPEAKER_01: Like my mom, I love her, but like the lights are on, but nobody's home.
• 15:48
  SPEAKER_01: And it's like you're zoning out.
• 15:50
  SPEAKER_01: So, for example, like if you're in a classroom, the teacher is saying all these things and it's in one ear, out the other.
• 15:56
  SPEAKER_01: Or if you're at work and your boss is telling you these things that you need to do, or you're in a meeting that you have, you might zone out and miss it.
• 16:04
  SPEAKER_01: Are you thinking of other things or just not?
• 16:07
  SPEAKER_01: It could be both.
• 16:08
  SPEAKER_00: Yeah.
• 16:08
  SPEAKER_01: It could be both.
• 16:09
  SPEAKER_01: I have definitely had the experience where I am in meetings and then I zone out and it's like I come back to it in the moment and I'm like, oh my goodness, what did I just miss?
• 16:18
  SPEAKER_01: Like, and I want to ask a question, but I'm not sure.
• 16:21
  SPEAKER_01: Did somebody already ask it?
• 16:22
  SPEAKER_01: Right.
• 16:23
  SPEAKER_01: But also, yeah, it could just be these thoughts popping in and out of your head.
• 16:28
  SPEAKER_01: And they are often random thoughts.
• 16:30
  SPEAKER_01: So our thinking patterns, like they can look very different for somebody with ADHD versus anxiety, I would say.
• 16:38
  SPEAKER_01: So, like when you're anxious, you're often worrying and thinking about am I um going to do good on this work presentation?
• 16:46
  SPEAKER_01: Or am I going to fail this test tomorrow that I have?
• 16:49
  SPEAKER_01: Is my friend mad at me?
• 16:50
  SPEAKER_01: Those are the thoughts often popping up in your head versus for somebody with ADHD, maybe what's going on in their head is they're getting all of these different like musical thoughts, right?
• 17:00
  SPEAKER_01: So by that I mean like songs popping into your head, or oh, I need to go do this, or oh, did I forget to do this?
• 17:06
  SPEAKER_01: Or that sounds really cool for me.
• 17:07
  SPEAKER_01: Do I need to like look at that?
• 17:09
  SPEAKER_01: I will randomly have thoughts come up in my own brain about like things that I wanted to tell somebody, but then forgot to tell them also.
• 17:17
  SPEAKER_01: So that's definitely how the forgetfulness shows up.
• 17:20
  SPEAKER_01: Losing things.
• 17:21
  SPEAKER_01: I don't think I talked about that yet.
• 17:23
  SPEAKER_01: No, dude.
• 17:23
  SPEAKER_01: Everybody loses things at times, but for people with ADHD inattentive symptoms, they're often losing things on a regular basis.
• 17:33
  SPEAKER_01: So if you're a kid, you're leaving your water bottle at school every single day.
• 17:38
  SPEAKER_01: You're leaving your water bottle and your homework also at home when you need it at school, which in now you can see how that's like affecting your school also, right?
• 17:47
  SPEAKER_01: And your grades.
• 17:48
  SPEAKER_01: But for adults, maybe you are losing your keys or you're losing your passport or your driver's license or your phone.
• 17:56
  SPEAKER_01: You just cannot remember where you put it.
• 17:58
  SPEAKER_01: And when that happens on a regular basis, it makes you late for things.
• 18:03
  SPEAKER_01: It makes you maybe even mess up with like friendships or relationships, right?
• 18:08
  SPEAKER_01: Because you're not calling people back if you lose your phone or you're not able to get to work on time.
• 18:13
  SPEAKER_01: There are so many different ways that these inattentive symptoms can show up.
• 18:18
  SPEAKER_01: And it's also like, yes, there are these core symptoms, but it looks different for everybody.
• 18:24
  SPEAKER_01: It's there's no one way that ADHD looks at all.
• 18:28
  SPEAKER_00: Must make it harder to diagnose.
• 18:30
  SPEAKER_01: I agree.
• 18:30
  SPEAKER_01: And I think like there's so many misconceptions about ADHD.
• 18:35
  SPEAKER_01: And people, they often think that with like these inattentive symptoms and these hyperactive symptoms, that it's not something that can affect somebody if they look like they're doing really well on the outside or if they're holding a job and if they're smart, if they're doing well in school, or if they are more inattentive, right?
• 18:56
  SPEAKER_01: You don't see those, those as often.
• 18:58
  SPEAKER_01: But if you're a provider that is really well trained in ADHD, you know what it can look like and you know the different ways it can look.
• 19:06
  SPEAKER_01: And so you're able to really better support people when you have a clear notion of what ADHD looks like.
• 19:13
  SPEAKER_00: So you keep saying what it looks like, and and you know, parenting, you know, you can see when they're losing things when they don't have their water bottle, when they leave their homework at home or forget to bring it from school.
• 19:23
  SPEAKER_00: What's the other side of that?
• 19:24
  SPEAKER_00: What does it feel like?
• 19:25
  SPEAKER_00: What's the kid experiencing or the person experiencing?
• 19:27
  SPEAKER_00: Is it like this is just how I am, or is it like I am a total loser?
• 19:31
  SPEAKER_01: I see a lot of shame with ADHD, especially pre-diagnosis with ADHD.
• 19:37
  SPEAKER_01: If you are forgetting things, not turning in your homework, you think I'm not a good person, I'm a bad person, I'm not smart, I am not good at school.
• 19:49
  SPEAKER_01: Right.
• 19:49
  SPEAKER_01: So all of these ADHD symptoms, they feel like a personality trait often, like a weakness of somebody internally, and they feel like it's their fault.
• 20:01
  SPEAKER_01: And what I often hear is like, I am trying so hard to keep it together, to do all of these things, and I'm still not able to do it.
• 20:10
  SPEAKER_01: So I hear so many like thoughts about like feeling like I'm not good enough.
• 20:14
  SPEAKER_01: Like self-esteem concerns a lot.
• 20:17
  SPEAKER_01: And these things show up at a young, young age.
• 20:21
  SPEAKER_01: And I will hear also, I will say, with parents before their child is diagnosed, they will often say to me, Oh my gosh, I just thought that parenting was so tough.
• 20:31
  SPEAKER_01: Or I thought I was a bad parent because they they're trying everything, they're trying to support their child, and it's still not enough because you can't get rid of ADHD.
• 20:43
  SPEAKER_01: Like, yes, you can support it, but it's something that is there.
• 20:47
  SPEAKER_01: And when you view it pre-diagnosis, as like maybe a personality trait or just how you are, you think like there's something wrong with me.
• 20:57
  SPEAKER_00: Yeah, why can't I do this?
• 20:58
  SPEAKER_00: It looks so easy for everybody else.
• 21:00
  SPEAKER_01: Yeah.
• 21:00
  SPEAKER_01: And people they're like, just get a planner or just do this.
• 21:04
  SPEAKER_01: Yeah, it's not that easy.
• 21:06
  SPEAKER_00: Yeah.
• 21:06
  SPEAKER_00: It'd be nice if it was.
• 21:08
  SPEAKER_00: Those were all my questions.
• 21:09
  SPEAKER_00: I'll go back to the internet questions.
• 21:10
  SPEAKER_00: Sorry.
• 21:11
  SPEAKER_00: I I'm very curious.
• 21:12
  SPEAKER_00: Is ADHD overdiagnosed or finally recognized?
• 21:16
  SPEAKER_01: I would say that ADHD is not overdiagnosed.
• 21:20
  SPEAKER_01: In fact, I would say that ADHD is underdiagnosed in some cases, and particularly women and also BIPOC populations.
• 21:32
  SPEAKER_01: There's a lot of questions and like discussion lately around like, is ADHD overdiagnosed?
• 21:39
  SPEAKER_01: Because we hear about it more.
• 21:40
  SPEAKER_00: Right.
• 21:41
  SPEAKER_01: We see more about ADHD online.
• 21:44
  SPEAKER_01: I think on social media a lot too.
• 21:46
  SPEAKER_01: There have been a lot of different reasons why we're seeing more ADHD, even with like the diagnostic criteria of ADHD.
• 21:55
  SPEAKER_01: I cannot remember exactly when this changed, but one of the like symptoms when it comes to diagnosing ADHD is you have to have these symptoms present from a younger age.
• 22:06
  SPEAKER_01: Okay.
• 22:07
  SPEAKER_01: It used to be before seven years old.
• 22:09
  SPEAKER_01: If you're an adult getting diagnosed, can you remember what you were like?
• 22:12
  SPEAKER_01: Seven years old.
• 22:13
  SPEAKER_00: Remember this morning.
• 22:14
  SPEAKER_00: Yeah.
• 22:14
  SPEAKER_01: No.
• 22:15
  SPEAKER_01: So that changed to symptoms before 12 years old.
• 22:19
  SPEAKER_01: Okay.
• 22:19
  SPEAKER_01: And so now that that has changed, I mean, that also I would say opens up the potential for more diagnoses.
• 22:26
  SPEAKER_01: We now know a lot more about what um ADHD looks like in adults.
• 22:31
  SPEAKER_01: And that yes, you can be diagnosed with ADHD as an adult.
• 22:35
  SPEAKER_01: But with that diagnosis, also now you might need less symptoms.
• 22:39
  SPEAKER_01: So it used to be that as an adult, you needed six out of nine of these ADHD symptoms.
• 22:44
  SPEAKER_01: Now they reduce it to five out of nine.
• 22:46
  SPEAKER_01: I would also argue that it should be reduced even further because research supports that fewer symptoms often show up or are actually consistent with an ADHD diagnosis.
• 22:56
  SPEAKER_01: But also when you think about the awareness, like of course, if we know more about ADHD now, then we're going to be better able to diagnose it.
• 23:04
  SPEAKER_01: There has been some interesting research showing that there are some potential actual increases in ADHD due to a variety of things, such as um having a later birth age.
• 23:16
  SPEAKER_01: So in general, people are giving birth at a later age.
• 23:19
  SPEAKER_00: Okay, birth age of the mother.
• 23:21
  SPEAKER_00: Okay.
• 23:21
  SPEAKER_01: And the father too.
• 23:23
  SPEAKER_01: Yeah.
• 23:23
  SPEAKER_01: Um, and so there are some like, I mean, since ADHD, it's largely hereditary, genetics, biology based.
• 23:31
  SPEAKER_01: There are changes over time in those pieces.
• 23:34
  SPEAKER_01: And it does appear that that may be some of the reason why, also for an increase, an actual increase in these symptoms.
• 23:42
  SPEAKER_00: You mentioned the characteristics of the symptoms.
• 23:46
  SPEAKER_00: Give me the top ones when someone comes to you.
• 23:49
  SPEAKER_00: What are the ones that you're most tuned in to look for?
• 23:53
  SPEAKER_01: Yeah.
• 23:53
  SPEAKER_01: So let's start with, let's do inattentive first.
• 23:56
  SPEAKER_01: Difficulty sustaining your attention.
• 23:59
  SPEAKER_01: So sustaining it, that just means like you can't keep it for a long time.
• 24:03
  SPEAKER_01: Trouble following with directions.
• 24:06
  SPEAKER_01: So, like if you are having trouble following multi-step directions, if you think about like a larger project at school, that often comes up.
• 24:14
  SPEAKER_01: And I'm often looking for that in kids and adults.
• 24:17
  SPEAKER_01: The losing things and forgetting things, those are also inattentive symptoms.
• 24:22
  SPEAKER_01: Disorganization, I don't, I mean your room, right?
• 24:26
  SPEAKER_01: Yeah.
• 24:26
  SPEAKER_01: Your room, your car, your backpack.
• 24:29
  SPEAKER_01: That is one piece where you see disorganization a lot of the times.
• 24:33
  SPEAKER_01: Distractability.
• 24:34
  SPEAKER_01: That's another one.
• 24:36
  SPEAKER_01: Where like if there's a noise like in here, you may like not pay attention to what somebody is saying and get distracted by it.
• 24:44
  SPEAKER_01: So the hyperactive impulsive ones, these criteria, they were based on boys and kids.
• 24:51
  SPEAKER_01: So that may also give you a clue as to like why they're named this way.
• 24:54
  SPEAKER_01: So I already said difficulty playing quietly.
• 24:56
  SPEAKER_00: Yeah.
• 24:57
  SPEAKER_01: Yeah.
• 24:57
  SPEAKER_01: Trouble waiting your turn.
• 25:00
  SPEAKER_01: That one I think is much more childhood-based, but you can think about how trouble waiting can be an adult symptom too, right?
• 25:08
  SPEAKER_01: Um, blurting out or interrupting.
• 25:11
  SPEAKER_01: So that one happens with adults a good amount.
• 25:15
  SPEAKER_01: Like with kids, you might see it in school.
• 25:17
  SPEAKER_01: But with like adults, like if you're having a conversation and somebody's telling you something, you may want to interrupt and say exactly what you want to say before you forget it in your mind, what you're going to say.
• 25:29
  SPEAKER_01: There's also, well, this isn't actually a symptom, but like there's a lot more, like, I would say, like, not reckless behavior, but that impulsive behavior can show up and more risk-taking.
• 25:40
  SPEAKER_01: Yes.
• 25:41
  SPEAKER_01: And so you may see more accents, more injuries and those types of pieces as well.
• 25:46
  SPEAKER_01: Low frustration tolerance is a symptom that's a hyperactive impulsive symptom.
• 25:51
  SPEAKER_01: And a lot of people forget that ADHD affects emotions and they'll say, like, I feel frustrated or I feel like my child's always really angry or they get irritable really quickly.
• 26:03
  SPEAKER_01: That is that low frustration tolerance.
• 26:05
  SPEAKER_01: So if something makes you mad, you go from zero to a hundred.
• 26:09
  SPEAKER_01: And it may feel like a small thing to the people who are seeing it from the outside, but to you, it is a big thing that you're dealing with.
• 26:16
  SPEAKER_00: I want to I have so many of my own questions.
• 26:18
  SPEAKER_00: I'm trying so hard to keep to the internet ones, but I'm gonna go to mine.
• 26:21
  SPEAKER_00: What causes it?
• 26:23
  SPEAKER_01: Well, it's 75% of ADHD, we know it is genetics based.
• 26:30
  SPEAKER_01: Um, but we can't identify one single gene.
• 26:34
  SPEAKER_01: So it's considered like a polygenetic disorder where there's likely a combination of different genes that can lead to it being expressed in kids and adults.
• 26:46
  SPEAKER_01: There are some environmental factors that can lead to ADHD.
• 26:52
  SPEAKER_01: So most of these, though, like environmental factors, they're actually like um prenatal or related to like health and birth, right?
• 27:02
  SPEAKER_01: So low oxygen at birth, for example, does appear to affect ADHD.
• 27:10
  SPEAKER_01: Also, um, smoking and drug use for the mother when she is pregnant does appear to be related to ADHD, particularly cocaine use when pregnant does often lead to kids who present with ADHD symptoms.
• 27:26
  SPEAKER_01: But overall, we do see a lot of evidence that it is considered something that is genetic.
• 27:32
  SPEAKER_01: It's not something that you as a parent or like your parents for most circumstances could have done differently.
• 27:40
  SPEAKER_01: And like, it's not about like the sugar that you gave your child leading to them having ADHD.
• 27:46
  SPEAKER_01: It's really about like the genetics and how they're expressed.
• 27:49
  SPEAKER_01: The apple doesn't fall too far from the tree.
• 27:58
  SPEAKER_01: Yeah.
• 27:58
  SPEAKER_01: I have seen statistics estimating that like 50 to 80% of families, like if you have one parent that has ADHD, it's like 50 to 80% chance that your child will have ADHD.
• 28:11
  SPEAKER_01: Um, and there's been a lot of research on like twin studies, right?
• 28:14
  SPEAKER_01: And also looking at like for kids who have who are twins and who are biologically very similar but may grow up in separate environments.
• 28:22
  SPEAKER_01: Is there an impact on the environment?
• 28:24
  SPEAKER_01: And still it is hugely genetic, hugely genetic.
• 28:28
  SPEAKER_01: So, regardless of what the environment is like when you're a child, sometimes there are things that you just really cannot have done differently.
• 28:36
  SPEAKER_00: So, if the cause is largely genetic, what isn't the cause?
• 28:41
  SPEAKER_00: What do people think?
• 28:42
  SPEAKER_00: You mentioned sugar.
• 28:43
  SPEAKER_01: Sugar, yeah.
• 28:44
  SPEAKER_01: Uh, screen time, I hear a lot now.
• 28:47
  SPEAKER_01: Screen time does not lead to ADHD.
• 28:50
  SPEAKER_01: Yes, kids with ADHD may be more attracted to screens in certain cases, but screen time does not cause ADHD.
• 28:57
  SPEAKER_01: Um, certainly screen time can have effects on development in other ways, but it's not, or it can even like exacerbate and worsen some of like the behavioral symptoms of ADHD, but it's not a cause.
• 29:08
  SPEAKER_01: Um, I hear a lot about like different like foods and diets.
• 29:15
  SPEAKER_01: Um red dye.
• 29:17
  SPEAKER_01: Red dye.
• 29:18
  SPEAKER_01: And I will say, like, with red dye, it's not a cause at all with ADHD.
• 29:23
  SPEAKER_01: Some research has found that there's like a very, very small percentage of kids where it may exacerbate their ADHD symptoms, but it's still not a cause.
• 29:32
  SPEAKER_01: Um, and it's just if you have a sensitivity to it.
• 29:36
  SPEAKER_00: The fifth most asked question about ADHD is does it get worse with age?
• 29:41
  SPEAKER_01: I am so glad you brought this up because it reminded me of something else I wanted to talk about with women and ADHD.
• 29:47
  SPEAKER_01: So ADHD in general, it does tend to change over time.
• 29:53
  SPEAKER_01: I won't say that, yes, it does automatically get better.
• 29:57
  SPEAKER_01: Um, but what we often see happen is those hyperactivity symptoms decrease.
• 30:01
  SPEAKER_01: And so it's less apparent to other people.
• 30:04
  SPEAKER_01: Okay.
• 30:05
  SPEAKER_01: There are people where it worsens with age.
• 30:07
  SPEAKER_01: And there are, of course, people where it gets better with age.
• 30:10
  SPEAKER_01: Sure.
• 30:11
  SPEAKER_01: If you develop coping skills and strategies, when you're a kid and a teen and you can put them into use as an adult, um, you may not notice that ADHD affects you as much.
• 30:22
  SPEAKER_01: For women in particular, hormones affect ADHD symptoms a lot.
• 30:28
  SPEAKER_01: So there is a role that estrogen plays in how severe ADHD symptoms are.
• 30:34
  SPEAKER_01: And so when estrogen changes in your body, and there are a couple of really big times throughout a woman's life where they may change, you will see really big changes in ADHD symptoms.
• 30:47
  SPEAKER_01: So for teen girls going through puberty, you may see a worsening of ADHD symptoms given that there are these changes in your hormones during childbirth and afterwards.
• 30:58
  SPEAKER_01: A lot of moms realize they have ADHD at that time because there is a huge change in your hormones after you give birth.
• 31:06
  SPEAKER_01: Right.
• 31:07
  SPEAKER_01: And when those hormones change, it actually leads to worsened ADHD symptoms.
• 31:13
  SPEAKER_01: And because of that, like a lot of women over time, they may feel like their symptoms get worse as they get older.
• 31:21
  SPEAKER_01: But it's the changes in hormones.
• 31:23
  SPEAKER_01: And those changes in hormones, they can also actually change medication effectiveness, which I find very interesting.
• 31:29
  SPEAKER_01: So menturation and changes in your menstrual period over time can also be associated with just differences in how severe your symptoms are.
• 31:37
  SPEAKER_00: If somebody's listening and thinking, oh my gosh, I think I might have ADHD.
• 31:41
  SPEAKER_00: And to be really honest with you, I'm thinking that because I lose my, I lose things all the time and a lot of the other things you're saying.
• 31:49
  SPEAKER_00: What would be the first step or, you know, the a calm, not an overreactive next step to say, like, maybe I should check this out?
• 31:57
  SPEAKER_01: If you have concerns about if you have ADHD or your child has ADHD, I would look for who in your area might be a good person to reach out to.
• 32:07
  SPEAKER_01: I mentioned pediatricians, primary care physicians, for example, therapists and psychologists.
• 32:13
  SPEAKER_01: And oftentimes, like starting with your pediatrician or your primary care physician is a good place to start.
• 32:20
  SPEAKER_01: But I also would not be surprised if they are not comfortable with diagnosing ADHD.
• 32:26
  SPEAKER_01: And so because of that, I would say, like, hey, make an appointment with them and just bring up these concerns.
• 32:32
  SPEAKER_01: But if they say, you know what, I'm not comfortable diagnosing ADHD, then you have some other people that you can go to to look for if ADHD is what is going on.
• 32:43
  SPEAKER_01: And even if ADHD is not what is impacting you or your daily life, there are still options for support with it.
• 32:52
  SPEAKER_01: Even if the doctor says this is an ADHD or the therapist says no, this isn't ADHD, there are still ways to get support that you may need.
• 32:59
  SPEAKER_00: So even if it doesn't meet the criteria, there's something up that's causing a disruption in your life and there are skills you can learn to manage it or yep.
• 33:07
  SPEAKER_01: Yep.
• 33:08
  SPEAKER_01: So, or it could be, it could be something else um going on.
• 33:11
  SPEAKER_01: Or oftentimes, like with kids in particular, like ADHD can be diagnosed as young as four years old, actually.
• 33:18
  SPEAKER_01: And it's often accurate when you're diagnosed at that age because these symptoms they do continue.
• 33:24
  SPEAKER_01: But that being said, I've been in this position as a psychologist where maybe a child comes to me and they are four years old or they're five years old, and I do see these signs of ADHD, but I'm not positive that it is ADHD.
• 33:39
  SPEAKER_01: Okay.
• 33:40
  SPEAKER_01: If they're not in daycare, for example, or if you're not in school, I may have a harder time really understanding is this ADHD that's going on.
• 33:48
  SPEAKER_01: But there's still a lot of support that you can get, especially when they're at that age, four years old to six years old.
• 33:54
  SPEAKER_01: But I would say, like with like kids in particular, I see a lot of maybe pediatricians who aren't comfortable diagnosing at that age.
• 34:01
  SPEAKER_01: You know, a big concern people have is like if my child gets diagnosed at four years old related to the medication, will they be medicated?
• 34:09
  SPEAKER_01: Medication is actually not the first line of treatment for ADHD when you're ages four to six years old.
• 34:15
  SPEAKER_01: The first treatment is actually a parent-focused intervention to give you, as a parent, strategies to support your ADHD child at home.
• 34:23
  SPEAKER_01: It's not saying that you're a bad parent, but it's to give you the skills to support them.
• 34:27
  SPEAKER_01: That's why I think it's very important for parents if you're concerned your child has ADHD.
• 34:31
  SPEAKER_01: Like there are certainly skills that can support them.
• 34:35
  SPEAKER_01: And medication is not the only option.
• 34:38
  SPEAKER_01: And also, like medication, especially at that young age, will not be what they try first, likely.
• 34:45
  SPEAKER_00: That is the perfect segue to end this episode and go to the next, where we will continue this conversation.
• 34:51
  SPEAKER_00: We're going to talk about medications.
• 34:52
  SPEAKER_00: We're going to talk about parental interventions and some of the other ways we can support somebody in our lives with ADHD or ourselves.