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Is Technology Causing The Rise in ADHD? · Millennial Mental Health Channel

0:02
Sorry my following two episodes in a row, the dad jokes, I'm telling
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you man, I'm I'm so sorry. This is Millennial Mental Health Channel.
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I'm doctor Justin Romano, a Child and Adolescent psychiatry fellow, and I'm Adikoreo,
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a licensed clinical therapist. Our podcast is here because we wanted to start
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a much need to conversation about mental health. Our goal is to teach you
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as much as we can by sharing our own experiences and interviewing experts in the
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mental health field. We will discuss topics like mood disorders, psychotic disorders,
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substance use, personality disorders, and many more. Millennial Mental Health Channel buy
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Millennials for everyone. We hope you enjoyed today's episode. MMHC is a production
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of Speaker from iHeartMedia. I HEARTMA. Welcome back to MMHC. It's great
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to have you guys here. Yeah. I always do something a little crazy
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for the intro, but you know, I decided to just go very standard.
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I like it vanilla, very vanilla. How are we doing good?
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Yeah, life's good. Halloween was fun. Yeah, how are you doing?
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You know, I'm gonna fuck up the mood for a little bit.
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I didn't tell justin I was going to do this. Like a week ago
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at work, we had a really tough week. One of our teachers passed
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away. Oh my god. And as like the like mental health specialists for
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the high school, I've been trained in what's called like a flight team response.
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So it's like it's an agreement that the county has with all the schools
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where basically, if a tragedy happens out of school, we kind of coordinate
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additional support and have people from outside the school come in so they can set
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up a support room and all that good stuff. Because I'm trained as like
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the lead for the school, Like this was like my first unfortunately like tragedy
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where like I'm now a lead. So I got called about it. I
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knew that the teacher I was friends with her. That was really tough.
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I had to call all the counselors and let them know. Yeah, it
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was really tough, But I just wanted to share because like it was,
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it was a shitty experience in terms of like losing somebody. But I think
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if I want to find any positive out of it, it's just like how
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well the counselors and our coworkers, like work together to kind of not move
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past it, but work through it and help support the kids that were impacted
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and help support each other. And we got a lot of really positive feedback
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from the district. And I chuckle because it's like a flight team response is
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not something you want to do at because it means you're doing it a lot.
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But I don't know. It was helpful to stay busy and doing that,
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and I was at work a lot last week just getting there early,
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setting stuff up. We went in over the weekend of finished settings of stuff
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up and it was just a lot, and I wanted to share it,
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and I guess dedicate today's episode to Sheila Hurley because she was really cool.
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She was really special to a lot of our kids, and she was our
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one English as a second language teacher for the high school in the middle school,
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so she knew kids at both schools, so it impacted a lot of
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people. I just want to share that. Well, thanks, thanks for
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sharing. What a horrible thing, and I'm sorry that that happened, But
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in a way, I'm glad you were there because many I'm sure they really
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needed you in the aftermath. Fuck, man, I needed my coworkers.
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I think it helped me a lot, just to like know that I was
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working a lot, but it was for them and for the counselors and for
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the people that knew her and and all of that. Also a special shout
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out to Kevy just for letting me like work a lot and like really be
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support. Like I think the day the first day back at school, I
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was at school at like six thirty, so like almost an hour and a
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half early, just to like set stuff up, collect my thoughts, just
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kind of be ready. And so it was just a long week being at
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work, trying to make sure all the aftermath was taken care of and the
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kids were taking care of and teachers taking care of. So again, this
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one's for Shila. This one's for Shila. Well for Shila. Today we
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have ADHD. One thing that we hear about a lot in our culture is
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that ADHD is on the rise. A couple of decades ago, hardly anyone
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knew about it, and now it seems like more and more people are getting
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diagnosed, people are getting put on medications, and so we wanted to discuss
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it today, maybe go through some of the research. We'll start off with
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a mindfulness moment. How do you feel like your attention span has changed over
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the years. Okay, another vulnerable moment. I was thinking about this as
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we're getting ready, Like there are some times where I worry about my memory
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and my attention span, and like the immediate first thought is like what damage
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did football do to my brain? And I worry about it. But then
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where I start to remember tell myself like I'm probably okay. Is that like
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when it's stuff that I get told immediately and then like if I'm not giving
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it my full attention, that shit is just in one ear out the other,
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And I know it's not helpful, especially when I should be paying attention
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to stuff, but like it's something that I know it's if I pay attention
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to it, and I'm really like some I focused, I'll remember it.
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It's just when it's something that like I'm not fully paying attention to, so
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that at least gives me a little bit of hope of like, Okay,
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no, it's just my attention, Like it's not necessarily anything with my memory,
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because there's things that I like remember, Like there's just random shit that
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I remember, like two thousand's hip hop R and B lyrics, Like I
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got that stuff to do with like school sports, Like there's just things I
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remember. It's really my attention, So I have to remind myself that my
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concern can be my attention, not necessarily my memory. But I think it
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has changed. I mean, I think we're so used to grabbing our phones
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at any second where there's like nothing going on, looking at some kind of
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media, like there's we are just not a focused group of people across the
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board. Generations. Years ago, I would hear like my parents tell me
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like get off my phone or on my phone too much. But now I
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see them and they're on their phone too, so it's like they're the scrolling
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through social media. So it's not just us. It's not just the generation
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below us, the one's above us too. So I think our attention has
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changed a ton. I think we're stimulated all the time, from the time
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we wake up to the time we go to sleep. I don't know how
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many people are safe from not having their attention span like impacted totally. And
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I remember seeing things at a younger age where it was like, oh,
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cartoons are shorter and shorter screen or shot length, and everything in our society
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is made to just get your attention real quick sell you something and then move
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on. I feel like my own attention span has changed a lot, and
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I do think it's largely because of my phone. My wife and I watch
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a lot of football to stick on that theme. And the Broncos just snapped
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their sixteen game losing streak to their rivals the Chiefs, so shout out to
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the Broncos today. But I noticed that, like anytime I'm doing something,
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I mean I checked my phone at least one hundred times a day. I'm
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constantly looking down. Yeah, And it's just I feel like I cannot sit
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still, like I constantly have to be checking my phone or doing something.
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Like if I'm not doing something, my mind just goes okay, phone phone
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phone phone phone, phone phone. And so I know I did the Ted
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talk about phone addiction. I'm a big advocate for phone addiction stuff, and
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a big part of that is because I've seen a lot of this in myself,
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and it scares me how much it has changed my brain functioning in just
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a few short years. There's like a has it meme trope like that when
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people are at a party, they like stand there and like pull out their
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phone and they're just like staring at their phone. Yeah, and then when
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it like does like a zoom in of what the person's looking at on their
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phone, they're just like shifting through like the weather app like refreshing their email.
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And it's like, it's funny because I remember I definitely did that before,
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like at a party, if like I wasn't talking to anybody, didn't
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know anybody. And I think that like really speaks to how much like we
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feel like we need to be preoccupied with something. Like it's not just okay
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to stand there and take in the sights and sounds and probably smells of like
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a party and just enjoy the moment. We have to be preoccupied with something.
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So I think, I think, I mean, your ted talk is
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crushing it first off, but like your ted Talk does a great job of
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talking about it, and it's something that you and I both see in both
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of our work experiences, like day to day working with kids and teens.
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Speaking of the ted Talk, it hit one hundred and seventy thousand views,
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I cannot believe it. That is nuts to me, Like from a town
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of sixty thousand people, so the fact that it's like almost tripled that is
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just wild to me. So it's so cool. Everyone's watched it three times.
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Everyone in Cheyenne, Wyoming kicking butt right now. And he got these
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stories for me that you want to tell me about ADHD. I know we've
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already told a couple. Yeah. I mean I was at a conference like
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two weeks ago, and I think the first presenter was presenting about ADHD and
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just the treatment of ADHD as a clinician that may struggle with ADHD. So
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I'm like sitting here taking notes like you know, boom, writing stuff down.
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Oh that's a great point, boom, and just really finding myself like
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damn, I might have ADHD, Like this is she wasn't meaning to personally
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attack me, but I'm sure there was other therapists in the in the room
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where we were like damn, Like this is like me thinking about themselves.
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So that's my story is I think has been like this internal dialogue semi struggle
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of over the last you know, however, many adult years, thinking like
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maybe I have ADHD, like I might who knows, and I probably will
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never go to a doctor to get diagnosed. But do you feel like you've
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always been that way or has it only been recently, you know, I
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can't even like, I can't think to specific times in high school. Well
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maybe it is recent because or let me let me try and let me try
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and gather my thoughts. I think to like high school right, and there
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I was for sure times where I'd have a hard time focusing in class,
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paying attention, whatever. But I didn't have a smartphone that I could like
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reach to to like distract me. So if I did have one, what
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I've been doing that? And then in turn, would it have made it
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more clear that I'm struggling with my attention and my focus? I don't know,
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definitely, Like I mean, we had like a professional development at work
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today and I like, I don't know if it was because I was tired
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or what it was, but I was struggling to pay attention. So I
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don't know. If I really thought long and hard, I'm sure I would
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say it's probably gotten worse over the years, and it's probably started to get
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worse since twenty eleven when I first got a smartphone. Did I tell you
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about the time that I was watching the local news in Omaha and all of
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a sudden I saw a picture of my uncle Frank on the local news and
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it was said American lawyer was arrested in Palestine for opposing the destruction of a
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Palestinian villa, and it showed my uncle like in handcuffs, like giving a
11:03
double peace sign. It was wild. I did not expect that to see
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that on the Womaha, Nebraska news. So he's a carric What was that?
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This was twenty eighteen, twenty nineteen, so it's just not that long
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ago. But yes, he's a character. I think he has ADHD,
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and I don't think anyone's ever really officially diagnosed him, but he's pretty scatter
11:26
rained. There was one time I was visiting him in Oregon and he was
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like grabbing snacks for us, and he grabbed some chips and some ice cream,
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and then when we were done with them, he put the chips in
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the freezer and the ice cream in the cabinet, and like he does that
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kind of stuff all the time. So this can be a sign of ADHD.
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And just like making little mistakes because you're rushing so much, and it
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doesn't necessarily mean you have ADHD if you do those little things, but just
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kind of give you a funny story of some of the little things that could
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happen. I was in sociology social one on one freshman year. I don't
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remember anything else other than someone said it was probably the professor. She said
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something of if you look at other countries, they do not have a diagnosis
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for ADHD, and I have no other follow up information. I have nothing
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to solidify that. I have nothing to really be like. Wow, that's
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so profound. I guess there just something to think about. Yeah, I'm
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not quite sure. I think in England they do, at least they use
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a similar DSM. Well, doctor Phillips is wrong there, never mind,
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ye proved I wrong. We're going to give you guys a little history minute
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and hold on. I actually have a little bit for this too. So
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ADHD was first described by Scottish physician Sir Alexander Creighton in seventeen ninety eight.
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So the ADHD finally made it to the DSM in nineteen eighty seven, so
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it hasn't been around that long. But stimulant medications were actually tried for ADHD
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as early as nineteen thirty seven. What version of the DSM was nineteen eighty
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seven was that four? It was I think at the end of three to
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four. That seems like the same. I think eighty seven is when they
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also took homosexuality out as a mental health diagnosis. So eighty seven was a
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good year. Yes, my brother was born in eighty seven. Great year.
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Oh even look at that ye. Shifting over to some stats and facts
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from psychology today, I just used psychology today. Actually I use psychology today
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today to help a student fine services. So thanks psychology today. In the
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nineties, the estimated prevalence of ADHD it was about six percent. In twenty
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sixteen, this number jumped to ten percent. So the rise is largely thought
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to be due to less stigma around getting help, greater awareness and greater understanding
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of female ADHD. That is a great point because that was going to be
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my next point. You brought it up earlier. It is ADHD more of
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a thing because like people are more aware of it. Is it really just
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increasing, Like people are just like more impacted by their environment, so they're
14:11
like developing ADHD? Probably both, right, But I think it is important
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to think of, like there's a reason why we have more diagnoses of certain
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things. It's not all just because our kids are soft or people something's in
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the air or the five G is fucking with us. It's because there's just
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like more understanding of it and people are more aware. The female ADHD part,
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I think is really important. I did a presentation over the summer to
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some of our staff just of like mental health things to be aware of in
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schools, and when I talked about ADHD, the like stereotypes of the generalizations
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is that there's a three kind right. I don't know if we're gonna talk
14:50
about it later, but the three kinds of ADHD. There's an attentive,
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hyperactivity, and then combined type. Often times, or like the assumption is
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that if a boy is diagnosed with ADHD, they're like the hyperactive one.
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They're the one that's bouncing off the walls blah blah blah blah, whereas for
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females they tend to be diagnosed with the inattentive type. But then because no
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one considers not no one, because people generally will not consider AHD to be
15:16
like a female or girl diagnosis, they won't even think about it as a
15:20
diagnosis. So oftentimes girls will get undiagnosed for a long time. When they're
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undiagnosed, they start to think like, well, something is wrong with me,
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but it's not something like easily describable. So if something's wrong with me
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that can lead to lower self esteem, you have lower self esteem, you
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can develop other things like anxiety and depression, so really important things to think
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about. I always like to think a bit of it as like young boys
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who are hyper they're going to get the attention of their teacher because they won't
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sit in there. See, they're bothering other people, they're getting into other
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people's business. But young girls, they don't bother anyone. They're just struggling
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in their own mind to actually focus. And so that's, yeah, a
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big reason why girls have large gone undiagnosed and still do some other like things
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to notice, like if people have kids that go to like parent teacher conferences
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and things like that, is I feel like the kids that end up diagnosed
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with like hyperactive type are the ones that are like, oh, we always
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move their seat and they always find a friend to talk to, or like
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shares out a lot without raising their head. Things like that. Yeah,
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and I just realized we probably should be calling it lady HD. Oh my
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god, sorry my following two episodes in a row, the dad jokes,
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I'm telling you, man, I'm so sorry. How does he deal with
16:41
this? He doesn't understand English yet, my sweet baby. Once he learns,
16:47
he will be constantly disappointed in me. I'm not upset, I'm just
16:52
like, this is God pretty bad. It's just good, like a fit.
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It was punny, very punny. Two punny. I'll let you go.
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Usually about sixty percent of kids with ADHD will have it persist into adulthood
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at some form, usually gets a little bit better. I always learned the
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rule of thirds, like a third of cases will resolve get completely better,
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a third of cases will get a little bit better, and then a third
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of cases will stay about the same into adulthood for adults. There was recently
17:25
or there was a one hundred and twenty three percent increase in ADHD rates in
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just the timeframe from two thousand and seven to twenty sixteen. That's a lot.
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That's a lot done. And prescriptions for ADHD medications increased a lot over
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the pandemic too, and this led to like an unanticipated ADHD medication shortage,
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And the CDC believes that it's because of telehealth increased access to getting these medications,
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and so there were a lot of people looking to find them and it
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just depleted the market. Yes, okay, I have something on this God,
18:02
it's always so cool and like should I listen to? Like okay,
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anyway, okay, here we go. I can't remember what podcast. I
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think it was The Journal, but I might be messing that up. Last
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year actually they did a four episode series on services and it took the time
18:19
to shoot on the company Cerebral. Have I talked to you about this?
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Yes? Yes, okay, we're gonna do it again. So Cerebral.
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Yeah, like they basically they were this. They might still be around.
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I don't even care. Don't use Cerebral. Okay, They're this company that
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like basically wanted to. That's the other problem. Hold on, I'm going
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on tangents. That's the other issue is that I saw this TikTok recently and
18:45
this guy like had a tweet as a backdrop, and it was like,
18:48
oh, like, which investors like should I follow or talk to that are
18:52
looking to fix like the mental health crisis. And the person that like was
18:56
making the video was like, no, like, seeing the mental health crisis
19:00
is not like a fucking San Francisco Bay area tech company startup thing, Like
19:04
that's dumb, like that's just people are just trying to make money and capitalize
19:07
on people that need help. That's basically what Cerebral did. So Cerebral was
19:11
trying to take advantage of the fact that telehealth was now a thing, and
19:15
they were trying to get people connected to providers on like a subscription model like
19:21
Netflix, Hulu, Spotify, that kind of thing. Right, anytime you're
19:25
doing that, like you're not you're not in it to help people. I'm
19:27
looking at you better help. So they did that, and like you said,
19:33
at one point during the pandemic, the CDC or not, was it
19:36
the CDC or the FDA. The FDA, that's the one. They made
19:38
it so you could prescribe like not narcotic control, controlled substances. Where you
19:47
can prescribe controlled substances via telehealth, you didn't have to see anybody in person
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anymore. So Cerebral took advantage of that, and a ton of people were
19:55
getting like ADHD medication, and they were getting medication that they might not have
20:00
actually needed. And in the four part series they talked about a family who
20:04
had a teen who actually was not old enough to use a service, but
20:08
because there was not really anybody doing checks and balances, they had, like
20:12
a sixteen or seventeen year old using Cerebral that was getting help for depression or
20:17
whatever, got medications they probably that probably made their depression worse, and then
20:21
they ended up dying by suicide. So all of that to say, yes,
20:26
one per telehealth increased access to meds, specifically a company like Cerebral that
20:33
did it for the wrong reasons. Yeah, there are always going to be
20:37
a little bit of growing pains with new technologies. Yeah. So in terms
20:41
of some of the data and studies that have come out with ADHD and how
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it's changing, there's a study from raw at All in twenty eighteen. This
20:49
was published in JAMMA Adournal of American Medicine. This is a big paper and
20:55
it was a longitudinal cohort study, which is a good evidence there's low power.
21:00
There are only ten people that it actually followed, so not actually a
21:03
lot of subjects, but ten high school students that showed that they did have
21:10
more ADHD symptoms the more they use social media. And so small study so
21:15
limited that I couldn't find any like definitive studies that say, like, yes,
21:21
more time on the phone equals ADHD. There is a PhD from UC
21:26
Irvine named Gloria Mark who's also a researcher in this. She wrote a book
21:30
about how digital devices are shortening attention span. So we don't have like any
21:36
for sure data, but a lot of people are starting to realize, like,
21:38
yeah, phones are shortening our attention span big time. Not only does
21:44
like the use of social media like potentially like increase your having like ADHD symptoms,
21:48
but the other thing that it increases is like it is a higher chance
21:51
to someone that uses social media has like lower self esteem developed these other symptoms
21:56
like from depression and anxiety. So really, as much as we've talked about
22:00
like social media is bad, yeah, it is not good for our kids.
22:04
Did you see? This is actually just new It came out after I
22:08
wrote the script for this episode, But the Colorado Attorney General is actually suing
22:15
Facebook, with a bunch of other states jumping on too, as a to
22:18
say, like, you know that this is addictive, and yet you still
22:22
market to kids and you make no effort to mitigate any of the mental health
22:26
ramifications of what you're doing. So I think finally our world is waking up
22:33
to just how crazy this is well, do you remember like this time last
22:45
year, Maybe not this time, but like last year. At some point,
22:48
there's that whistleblower from Yes, we shouldn't even call her a whistleblower.
22:52
Like they were doing the right thing. Yea. They had seen the evidence
22:56
that Facebook was like had and was like not disclosed and that basically like social
23:00
media is not good for our kids. And at the same time they were
23:04
about to release I don't know if people remember this or I was really talked
23:07
about, they were about to release like a child or teen specific version of
23:12
like Instagram. They were about to and then all that stuff came out and
23:18
we haven't heard anything about it since then. So Mark Zuckerberg knows, like
23:22
these people know. It's just how much they can toll the line without really
23:26
getting in any in trouble. Yeah, and that whole whistleblower thing came coming
23:30
out was the big reason why they switched to Meta. They wanted to try
23:33
and rebrand and pull themselves away from the association that they're terrible for mental health.
23:41
Doesn't seem to have worked that much. Dang, we remember Pepperidge Farms.
23:47
Remember Pepperidge Farms never forgets so like some one thing that we talked about
23:53
a little bit already so far is in order to meet the diagnosis for ADHD,
23:59
and this is actually in the DSM, you have to have these symptoms
24:02
before the age of twelve. So I think that's a really interesting thing that
24:06
a lot of adults who are coming in for ADHD and they say like,
24:10
oh, yeah, I was like fine as a kid, but I mean
24:11
this is adult on set ADHD, which is a really controversial topic to say,
24:17
like is this really real? Is this caused by our society? We
24:21
don't know for sure yet. It's still kind of up in the air as
24:23
to whether or not adult onset ADHD is real. Shit, maybe I don't
24:27
have ADHD. I forgot about that part. You weren't paying attention when you
24:33
were reading the DSM. Dude, I'm over here fucking like tune in my
24:37
own whore, Like, oh is the clinician I would know obviously the fuck
24:42
not. Dude. Hey, it's impossible to remember everything in the DSM.
24:48
But I have met a lot of kids, or a lot of young adults
24:52
or even in middle aged adults who say like, yeah, I always had
24:56
this going on. I really struggled in school. My parents were very anti
24:59
med and then we do get them on ADHD medicines, and then they're able
25:03
to go to school, they're able to pursue their goals and they do it
25:06
really well. So, yes, adults can have ADHD, but the adult
25:11
onset ADHD is a little bit of the controversy. Hmm. It is not
25:15
agreed upon in the the medical world. What do you think about it?
25:21
Put your thoughts out there. You know, I don't think it's such a
25:23
black and white thing. I think it's possible. Yeah, I guess my
25:27
answer is it depends answer. Yeah. I do think the childhood onset ADHD
25:37
is what has been studied the most. That's what we know about. But
25:41
I'm always open to the possibility that our society is giving us things that we
25:45
don't really know anything about yet, and we need to study it a lot.
25:48
First. What are some things that like is a good word masquerade as
25:55
ADHD? Yes, so masquerading like to put on a mask and for you
26:00
or something else. I have a lot of young people I see who with
26:03
like really bad depression and anxiety, and they score really high on inattentive ADHD.
26:10
And then you treat the depression and anxiety and they get a lot better.
26:14
So there's a lot of mental health things that can look like ADHD,
26:18
and that's why it's really important to see someone who knows what they're doing,
26:22
usually like a mental health professional, because if you go into any old Joshmo
26:26
doc and say like, hey, I can't focus, like, there's a
26:29
lot of things you want to look into first to make sure it's not depression,
26:33
it's not anxiety, it's not vision issues or hearing issues, because that
26:37
can also look like ADHD too. I even had a really interesting case in
26:44
Omaha that I actually wasn't necessarily a part of, but I helped write up
26:48
the research paper on it. But it was something called Alice in Wonderland syndrome,
26:53
which is wild. I had never heard about it before until this case.
26:56
But this girl was having my grains and it was messing with her visual
27:02
processing center in her brain. So she was like seeing things that were out
27:07
of proportion, so like her neighbor next to hers sitting next to her would
27:11
be super small, or the desk or the pencil in front of her would
27:15
be gigantic, and so it's kind of like Alice in Wonderland. And one
27:18
pill makes you smaller. One pill makes you tall. And they thought it
27:22
was that she was just not paying attention in class and she's like, my
27:26
brain's tripping out, and like I like, everyone's like not the right size,
27:30
And she got put on ADHD medison. No, it's not like it's
27:36
not that she's not paying attention. It's like I'm paying attention too much,
27:38
just too much wild shit. Yeah, So they dug a little bit deeper
27:41
center to a psychiatrist found out that like, this is weird, researched it,
27:45
found out it was a real thing. Put her on migrain prevention medication,
27:49
and the whole thing went away. Wow. Speaking of medication treatments,
27:55
there is some options for people with ADHD. I think the common one that
27:57
we hear about stimulant medication. So justin tell me what stimulants we have.
28:03
And I have my question that I was thinking about earlier that I waited until
28:07
not how to ask you, So tell us what you got with stimulants.
28:10
So for ADHD, we know that the medications are the most effective treatment.
28:15
So most things in mental health, like depression, anxiety, even by polar
28:18
disorder, we say combination of therapy and medicines. Are the best. But
28:22
actually with ADHD, the medicines are so effective and the therapy has only been
28:27
found to be like, only very mildly effective that usually medicines are first line
28:33
treatment for ADHD. They're the most helpful thing that you could be doing.
28:36
There are the stimulant medications, which tend to be like your methyl fenidate ritilins
28:41
and your adderall amphetamines. Almost all the stimulants are those two medicines, just
28:48
repackaged or rebranded into different names, So like your vivants, your adderall your
28:53
metadate, you like your focal ands. They're pretty much all just those two
28:59
men medicines, just given a different name and a different packaging. And then
29:03
there's a lot of non stimulant medicines as well, So I like to call
29:08
this kind of like a one two punch with medications for ADHD. They're the
29:12
ones that kind of calm you down a little bit more. The ones I
29:17
like to use are technically called alpha two agonists. They tend to help with
29:21
irritability, anger, sleep issues, because kids with ADHD tend to struggle with
29:25
sleep in general because their mind is bouncing off the walls. But there are
29:30
also a couple of really interesting like newer techniques, non medicine ways of treating
29:37
ADHD, and they're not as effective as the medicines, but it's kind of
29:40
cool to think about. But biofeedback or neurofeedback, so you know, seeing
29:45
how your vital signs, your heartbeat, your breathing rate changes in response to
29:51
these certain situations or stimuli can help you gain feedback or knowledge about your body
29:56
to help better control your attention. And there's even a video game called Endeavor
30:02
r X which showed to have improvements in attention span. So I think we're
30:07
trying to find different ways as a society to improve attention span and I think
30:12
that's pretty cool. Okay, now my question is before we get to the
30:15
other questions. Okay, stimulant medications, right, not everyone has access to
30:22
a doctor or has insurance to cover those kinds of things, And like,
30:26
just prescribe medication is not, Ohays an option I have heard. I haven't
30:32
told anybody like, yeah, do this because that's not my job, but
30:37
I've heard for some people, consuming caffeine can have a helpful effect on people
30:45
who may have ADHD but are not medicated. What are your thoughts? Yes,
30:48
nice, yeah, short answer, Hell, yeah, you're right.
30:53
They're all stimulants. They all kind of do a similar thing to your brain.
30:57
And that's one of the things I like to ask kids if I'm evaluating
31:02
for ADHD, I'll say, like, when you have caffeine, what does
31:03
it do. Does it make you like have a bunch of energy and bounce
31:07
off the walls or does it slow you down, give you attention and focus?
31:10
And you have Most of the kids with ADHD say yeah, I feel
31:12
there's so much better when I have caffeine. I hoped, I can calm
31:15
down, I can focus. I actually just had a patient the other day.
31:21
There was the adderall shortage that happened, and they couldn't find any of
31:26
the medicine anywhere, and so they literally called the school and they were like,
31:30
give them a mountain do it lunch. Trust me, you're gonna want
31:34
to give them a mountain do at lunch. And they said it helped.
31:37
So I don't know of any like hard and fast data that says like we
31:41
tested caffeine, because most like caffeine is readily available, you cannot patent it,
31:48
and companies typically don't want to do research on things that they can't patent
31:52
and make money off of. But yeah, I think you're right. Caffeine
31:56
is a stimulant and a lot of people with ADHD. To even my uncle
31:59
Frank, he will Uncle Uncle Frank will pound like three cappuccinos in a row,
32:07
just tons of caffeine and just crank out a ton of work. That's
32:10
like, that's how he gets a bunch of stuff done. So yeah,
32:14
it's a real thing. You guys Italian at all? Have we talked about
32:16
this. I don't know if we've talked about it, but technically yes,
32:21
we are Italian, just because I think of uncle Uncle, Hey, Uncle
32:27
Frank, Frank. Justco Okay, that's all happened, Okay, So then
32:35
so there there there has to be and I'm pretty sure there is an age
32:37
correct for like how old someone needs to be before they can start to take
32:43
these medications. Right, Yeah, it's usually like five, six, preferably.
32:50
I have had a couple of people who are just so intensely hyperactive and
32:55
that they're like running into the street. They're so impulsive they can't handle themselves.
33:00
That will start medicines like as early as four. But yeah, five
33:02
or six is typically what we say. What can a family do then if
33:08
they maybe have a younger child that hasn't reached to five or six, to
33:13
maybe help with some of the symptoms, not using prescription medication, but something
33:16
that could be available for them. It's so hard, I'm putting you on
33:22
the spot. Yeah, well, this is my whole job, so I'm
33:25
used to this. Like pc T, like different therapies to try and learn
33:30
how to handle and get your kid to listen to you a little bit better.
33:34
Some different parenting strategies, being very preventive and just making sure that they're
33:38
safe, they have no access to do anything, making sure that they can't
33:43
run into the street or do anything impulsive like that. But it's tough.
33:45
It's really tough to have a kid with really bad ADHD and they're too young
33:50
for meds PCAT. For those who don't know parent child Interaction therapy, it's
33:54
actually pretty cool. They if they are doing it correctly. There should be
34:00
parent has a headset, therapist has a headset, therapist should be watching behind
34:04
like one of those glasses where you can only see in one way, and
34:07
they basically help coach a parent through like situations with their child to learn how
34:13
to best like support and work with them. So the more you know,
34:16
it's pretty cool. Yeah. PCOT is like one of our most effective behavioral
34:22
therapies for young people age two to seven. So here's my last question on
34:25
the medications Concerta. What is that one? Concerta is a methyl fenidate,
34:31
so like riddlin that has both immediate and long acting forms. So you get
34:37
a little shot of the medicine right when you take it, and then a
34:39
little shot of the medicine probably about five hours later. So Okay, that's
34:43
not the one I'm thinking of. Then is there one? You said non
34:45
stimulant medications, the something something to agonists? Yes, Xyz, Like a
34:55
nurse practitioner had told me that they we had like a mutual client was on
35:00
like medication for ADHD, but it wasn't a stimulant. It was basically a
35:05
like a blood pressure medication or something to help calm Oh is that Correctingo?
35:08
Yeah, that's the alpha two agonist. Those are old blood medicine that they
35:13
notice just helped calm people down, give them a little bit more focus.
35:16
So it's like your guand fhisine and your klanidine. That's what it is.
35:21
Is yep, I use tho all the time. They're really useful and really
35:23
helpful, and they're a little less less side effects than using the stimulant medication.
35:29
They're pretty useful. Yeah, dude, it feels so cool to no
35:31
shit and then for you to agree with it. Okay, last thing,
35:36
I'm just like getting all my questions out. This one might be made up.
35:42
Is there an ADHD medication that has an unfortunate side effect for young males
35:47
erections or yes or painful ejaculation. Oh yeah, Stimulant medications can have weird
35:55
side effects. Like Historically speaking, we all thought that stimular medicines like made
36:00
you more sexual, which can be true, but not all the time.
36:06
It can make you have more sexuality, less sexuality. It can mess with
36:08
your orgasms. It can make you have random spontaneous orgasms. Those are all
36:13
pretty rare side effects, but they can happen. All right, I knew
36:19
some stuff. Okay, let's hop into the other discussion questions justin what are
36:23
your thoughts influencers, how have they muddied, muddled whatever word we want to
36:28
use the waters around ADHD. Yeah. One thing I've noticed with like influencers
36:35
and ADHD is they'll talk about themselves and speak as if it is ADHD for
36:39
everyone to be like, oh, I'm like this, this is what living
36:43
with ADHD is like. And then they'll say something that's very specific to them
36:47
or not really associated with ADHD. And then so kids watching that who don't
36:52
know about it, they're like, oh, I do that too, and
36:55
I must have ADHD, but it's not really a part of ADHD. So
37:00
that bothers me with what influencers are doing. But it gets a lot of
37:04
cliques. I've seen this one guy who will constantly call out ADHD coaches.
37:12
Yeah, so people who are like not trained professionals, they're just like people
37:15
who like live with ADHD and like that's like super not good, Like I
37:21
know, like access to care is like not the greatest. And also like,
37:24
don't pay a quote ADHD coach a bunch of money for them to tell
37:30
you what works for them, because that's really, like you said, like
37:32
that's really what ends up being like they end up just telling people what works
37:36
for them, and then people who are struggling pay them all this money and
37:39
then they don't actually get anything helpful. So yeah, social media is kind
37:45
of like fucked up a lot. That's that's like the side point for today.
37:49
Yeah, social media has messed up a lot of stuff. And are
37:52
there any other things that you can think of that you think might be contributing
37:55
to ADHD other than media social media? Yeah, I know you have two
38:00
things that you want to talk about, so I'll let you talk about though.
38:04
So I'm just gonna riff these off the top of my head. Yeah,
38:07
you know, in terms of like attention, maybe just like if you
38:09
think about increasing class sizes, kids are dealing with class sizes that feel like
38:15
they're getting bigger and bigger, the idea that they're living in a always negative
38:23
world, so you're always on edge, you're always thinking about something else.
38:27
Those are two things that come to mind for me of like what can be
38:30
impacting our kids, like silently that they're not talking about. There's so much
38:34
going on and there could be a lot of things looking like ADHD. Like
38:37
depression and anxiety are up. We know that, so that makes sense that
38:40
it just looks like kids are struggling with focus and inattention from that, like
38:45
if you're constantly worrying which is ada or which is anxiety? Yeah, it
38:50
looks a lot like ADHD because you can't focus on anything, And I also
38:54
think that it is likely that diet and less activity is probably contributing to this
39:01
too. One thing I've noticed with my ADHD kids is that if family is
39:06
really focused on wearing those kids out physically, getting them involved in sports,
39:12
making sure they're on the move, like running like that, it gets a
39:15
lot better. And overall we are much less active as a society than we
39:22
have been in the past, so I think that might be contributing. Just
39:25
all the junk food that we eat. More studies are coming out that says
39:30
about sixty percent of the food that children eat is highly processed foods. So
39:36
we have no idea what that is doing to us. But I think all
39:38
that processed refined sugars is giving people more energy and the big bursts and surges
39:45
of sugar and their blood sugar spikes which can lead to changes in behavior,
39:49
more hyperactivity. So I think all of this stuff might be all contributing,
39:52
all factoring in. You know, those families that really focus on the activity.
39:57
It's like you're not coming in the house till you're war Now, I
40:00
know, all right, but I mean it's good for the kids. Yeah,
40:06
When I was a kid, my dad used to make me like run
40:07
to the fire hydrant. Like if I was too hyper, he'd be like,
40:10
all right, just enough time, and you go run to the fire
40:13
hydrant and back and I had to go now and touch it. And I'm
40:15
like, man, I should start suggesting that to all my patience. All
40:20
right, let's go outside, let's race do well. As always, Thanks
40:28
guys, thanks for listening. If you made it this far, we appreciate
40:30
you. If you stop somewhere in the middle, we still appreciate you.
40:34
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41:01
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41:07
Thank you, my friend, just for being you and as always take care
41:09
of all mentors