Berner Phone - Dr. Sasha Hamdani: ADHD Specialist & Chaotic Energy Expert

Episode Date: February 11, 2022

Dr. Sasha Hamdani is my favorite ADHD doctor on social media and I brought her to hell to figure out if I have ADHD. She discusses her wild journey of discovering that she has ADHD and how she almost failed out of med school. She explains why women are the hardest to diagnose and the symptoms of ADHD that you wouldn't expect. She also gets to the root of the science behind ADHD and how anxiety and depression factor into diagnoses. We get to the bottom of whether ADHD is just a fad or an explanation for why your brain is the way it is.--- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/appSupport this podcast: https://anchor.fm/berninginhell/support Hosted on Acast. See acast.com/privacy for more information.

School for me previously, apparently when I was medicated, really wasn't difficult for me. It was like, I show up, I do my stuff, I get out there, randomly get lost in the afternoon. But morning was cool. I just like envision you just aimlessly walking through streets in the second hour. Just a vagrant in the street. Yeah, that was me. And that still kind of is me. That's why, like, my friends don't want to go out with me at night time.

I will disappear. Welcome to Burning Hell What's up? I'm your host Hannah-Berner and we are an ADHD hell today, which is just a day in the life. And we have an actual expert on. It's not just a sad comedian per usual.

We have Dr. Sasha Hamdani, board-certified psychiatrist and ADHD specialist, expert, smart-ass-bitch. Dr. Sasha, welcome. That intro was very generous, but try to keep up. Literally pulled it from your bio. I had a couple adjectives I added, but I am so happy to have you on because I have a lot of questions.

And my friend told me that I 100% have ADHD the other month. And I was like, does everyone think that about me? So we're just going to delve into it. You've been on my algorithm on TikTok. I've been on yours. And I want to understand why does it seem like everyone is being diagnosed with ADHD right now? Is it just because of my corner of the internet? Or is there kind of a fad happening?

Or are people just getting educated for the first time about ADHD and women? All? Oh. So, you know, you go down these weird TikTok algorithm holes and, like, you naturally kind of lean towards more things that you relate to. So it's totally possible. You were seeing a lot of ADHD content because you're like, oh, yeah, that's me. As a whole, I think that pandemic was weird for everybody, right? I mean, we've been at home. We've been remote. We've been like, and you've just had a lot more time with yourself, which is good. and also terrible. With your thoughts. I think, yeah, no one wants to do that. So I think that it's one of those things that it's almost like we as a nation went through this like collective trauma and we got to like see how we were in a setting

that was away from other things that could dissuade you from having this diagnosis. So now that you're actually looking at stuff and you're sitting down with your work and no other like safety mechanisms to lean on, you're starting to realize like, hey, this is a lot. harder than what I remember. And people have started to look into it. Plus, I mean, honestly, there's nothing to do. So you go on to social media and you're like, oh, yeah, this sounds like me. I do think that for the first time ever on this podcast, is it possible for you to talk me through what it's like to see if someone is getting diagnosed with ADHD? A thousand million percent. Because I feel like a lot of the little devils, that's my listeners, relate to me in certain ways.

And I feel like a lot of them might be wondering similar things to me. But before we do that, I want to know more about your journey with ADHD because you're diagnosed with ADHD. Oh, yeah. Oh, yeah. And you have a wild story. Wild. Chaotic. Chaotic energy.

My whole life is chaotic energy. So my story. So fourth grade, I started a coup in my classroom. I legit started a riot. I'm like, substance. teacher. I love that. It got all the kids to stand on their desk, started chanting. Like, it was weird. Like, I was a weird kid. That sounds like a typical Friday night for me, but yes. Right. Just up to start shit. And so, like, that was kind of me at my baseline and my, and the teacher was like, you got to do something.

And so, like, addresses to my parents. And my mom's a pediatrician. And so she, luckily, like, we had those resources. And she got me see. And they were like, oh, yeah, for sure, this is ADHD. And I've known since she was bored. But see, how are you not just like a powerful female in the room that wanted to, you know, change the world? Yeah. Yeah. I mean, I think, I think some of the stuff that they were seeing is they were like, I know I'd like to think that she's smart. But home girl can't get her stuff together.

You're like, the rebellion was unnecessary, a completely unnecessary. Totally unnecessary. And like, and it was just like other things that they saw. Like, yeah. My desk was a disaster. And it wasn't even like normal messiness of a kid. Like I would have like old lunches in there and crumpled notes and like my backpack was a disaster.

I would like I would get lost on the way from my parents dropping me off like to school. And then I would get distracted. end up in a different part of the school. And they're like, where the hell were you? You had to walk like 20 steps. And I'm like, oh, I saw this thing. And then I started going there and I'm to walk past a library. And they're like, okay. I'm relating to you so much because when I was little, my parents still make fun of me that it was the first day of after school in first grade. And everyone went to this auditorium and you had to go with your group. And my group was supposed to go to just a classroom in the school. I ended up with a different group that left the

school and went to like a whole different building and I was the and they called all the kids and I was just standing in this building and everyone's like why are you here you don't even go here and my parents laugh so hard they're like how the fuck when you were supposed to just go to a class right in your school end up at a whole different school like and then I've also had to just walk like four blocks to middle school like I walked to school and I was so lost even though I was just took like one wrong turn and I thought I was in Europe. So anyway, I'm just relating to you. Continue. Continue. Yes. Okay. So they saw a lot of things. And they were like, okay, I think ADHD is probably like spot on. And so my parents were like, okay, let's do this. And so my parents are beautiful, wonderful souls, but also super immigrants.

And they're just like, you know, very culturally. And their mindset is just, or was. I don't think they're like that now. But at that time, ADHD wasn't really talked about. about and they, you know, from a cultural perspective, mental health isn't really talked about either. And so I was kind of at that young growing up time, they were just like, okay, we don't want to stigmatize you. So they just didn't tell me. And they were like, check it out. Here's your vitamin. Every day I take my vitamin. Okay. Question. Do you think it was impressive that they were able to diagnose you as a girl that young as having ADHD? No, because I think I presented like a boy.

Oh, because you were like hyperactive and a mess. So hyperactive. I was in everybody's business. I was like touching everything. So it was like in everyone's space. And like it didn't come up before like, hey, she can't really focus. And also she's real annoying. Like it's funny because I could focus, but I was super annoying as in I raised my hand

for everything like I would I wouldn't even have an answer and I'd raise my hand and she would pick on me and I guess that's why like I'm good at improv as a comic but like at nine years old I was like if this bitch doesn't pick on me and she'd pick on me and I'd be like come up with something just come up with something that was like fun for me and the other kids must have been like

can we just go to lunch stop raising your hand yeah I mean I totally I'm a thousand percent the same way and to some degree like that annoying kid I'm kind of an annoying adult morphed into that. A lot of those characteristics are still very like hardwired into my DNA. And so I noticed myself doing that still. But so I'm taking this vitamin.

And actually like things changed for me. And I didn't recognize it right now because I didn't know about that unknown variable that was sprinkled into my life. But I like all of a sudden school became way easier for me. Like I wasn't getting in trouble as much and things became easy. And I actually did pretty well. So then I'm going through all this stuff and, like, high school happens. And, like, in high school, I realized, like, I want to do medicine. And so then I start researching how to get into medical school at a high school.

And then I'd get into medical school at a high school. And so I did this combined program, which... So you become, like, very high performing. I don't know. I'm saying I was high performing. Well, you weren't shedding the bed in school, it sounds like. No, I was not. But, you know, I was just, like, at a spot where,

because my dose never changed my dose never changed from fourth grade okay so I think I did well in school and I was like motivated and I could keep up but now in retrospect when I look at my symptoms like the tail half of the day I wasn't able to like focus or pay attention or do anything because I was like clearly done with my medication what was the medication and what was the dosage oh I don't remember I know I know it was Ritalin and I don't remember the dosage, but it was appropriate for a fourth grader and probably not appropriate for a 16-year-olds. So, like, my parents were like, why the second half of the day? Why are you a nightmare? Why are we, like, so like it would be stuff like once we got more freedom in high school, we could like leave

campus. So sometimes my parents would come home and I'd be like at home already. And they're like, what? We don't think people were in class. And I'm like, oh, yeah. Sorry. But they knew you had ADHD. So do you think they were more understanding? I mean, yes. They definitely were. And especially as I got older. So I got to medical school, started doing my classes and I sucked. Like, I actively thought, like, I remember Googling signs of a stroke. Did I have a stroke? What is wrong with me? So I'm like, all of these people are like already smarter than me. And they were just like so organized, so organized. I cannot even figure out how to feed myself for the day and get to class and do all of

these things. So then my parents were like, okay, are you taking your vitamin? I'm like, yeah, obviously, no, I'm not taking my vitamin. Like, I got bigger problems here. And they're like, okay, well, your vitamin is Ritalin. And so, like, it came out. And like, I can so clearly remember this conversation because I was like, what? Well, it's like your life was a lie. Totally. I felt so betrayed. I felt so, so betrayed. I was like, so, like, I've been drugged into performing my whole life. There's no way that I have this. Like, that's for boys.

No, no, no. So then I'm, like, rebelling against that. And then, like, I was like, okay, I'm just going to try my hardest because now I need to prove my parents wrong. And so I, like, busted my ass and I got a 62% of my desk. And I was like, okay. I've worked like 18 hours a day, and that's what I'm pulling up. And it was so, like, so different from what I accepted. The school for me previously, apparently when I was medicated, really wasn't difficult

for me. It was like, I show up, I do my stuff, I get out there, randomly get lost in the afternoon, but morning was cool. I just like envision you just aimlessly walking through streets in the second half. Just a vagrant in the day. the street. Yeah, that was me. And that still kind of is me. That's why, like, my friends don't want to go out with me at night. I will disappear. Um, so I just, like, it was, so then I, you know, I got to the point where it was like so difficult, so rigorous that I was just like, I don't think I can do this. Like, this is so hard. And I, like, there's, I hated, hated everybody at my, in my class because I was with them all the time. And we're all doing. better than me. And I was like, I cannot look at your faces anymore. Um, and so I told my parents, I'm like, I'm just coming home. I don't even care anymore. So I came home over a break and my parents

were like, okay, well, if you're pretty set on quitting, then don't worry about studying for your exams. Just focus on studying about ADHD. Like, see if you have it. So I did this huge deep dive into ADHD, into symptoms. And I remember my dad. So my dad's an engineer, like not in the medical field. But I feel like the poor guy has helped my mom through medical school and then later helped me through medical school. So he basically is a doctor. Anyway, he was like going through like the DSM and like going through criteria. And he's like, does this sound like you? Because you were like, I don't think I have it. You still were like, I think I just can't do med school. I wasn't sure. At that point, I wasn't sure. I was like there's something definitely different

from high school and now. And if you're saying that it's all due to a pill and having a hard time understanding and conceptualizing yeah because you wanted to figure it out for you it sounds like like you want to be like you guys figure this out in fourth grade but like can we experience this together of this current person and my mental status like I was doing badly in school and so to cope with that I was just super social so I just went out all the time yeah and like I was like that's way more fun so I'm going to do that and so then I was like I don't know if it's ADHD or if I have just really bad habits or if this is stemming like I don't know where this is is coming from yeah so then um i was like okay i think i do have it and then i did my own kind of

um and then i met with my own physician i tried my own medications we try and like i tried the riddle in again and it was a disaster like i just didn't do well on it i was so mean uh yeah and then i tried another one and i like stopped eating and then i tried another one and i couldn't sleep so it was like a trial and error kind of process and then finally Finally, I ended up on a medication and then things just kind of felt, and it took a while. Like, I was like four years in and I was like limping by the whole time. But then two things happened. I found a medication I liked and I went into clinicals where it's like not, I'm studying,

like I'm not just reading, reading, reading books. I'm in a clinical setting. I'm doing, so I guess I wasn't four years. I was two years in. I'm doing like, I'm seeing patients, I'm doing stuff that I enjoy and it's social and it's like I'm multitasking and this is more of a natural medium for me. And then I think things started to pivot and change. And then after that I was like, okay, like my brain is for sure working differently.

I think I have ADHD. And then I went into psychiatry. Wow. What are you currently on right now? Nothing. If you can't tell. No, not at all. I was like, oh, so like this is what she's like, wait.

So how did you go from being on something to then. being on nothing um so yeah that's that is possibly what i'm proudest of so what well and it wasn't even me so i was on this medication did did relatively well throughout the tail end i mean not relatively well i caught up yeah yeah i like managed to get through i managed to match into the residency that i wanted that my heart was set on um and it was this small program in scottesdale in Phoenix, which was amazing. And so I got there, and for the first time ever, like my whole six years, seven years, because I extended my program, like, I got my ass kicked every single day in that school

with academics. And then, like, even my academic advisors were like, maybe this isn't it for you. Wow. So there were doubters. There were haters. Oh, the whole time. I never remember, like, there was one time where it was like so. bad and I hadn't figured out the medication yet. And I talked to my educational team coordinator and I was like, you know, I haven't told you this. But part of the reason I'm struggling so much is because I have ADHD and I'm trying to figure out this medication. And I don't know if I'll be able to do it. And like, you'd think like this guy is supposed to help you and get you through it. And he was like, I've been waiting for this day. I think that's a really wise decision. Let me help you pack up your office. Walk to me to my office was like,

putting stuff in there and I'm like, oh, I hate you. And also, I feel like they're not used to maybe dealing with someone with ADHD where like people just started with the whole like dyslexia thing where so many people have and they just learn differently. But I feel like ADHD is it a, it's a spectrum and people have it in different ways and people don't know exactly. And then people joke about it so much. Like, oh, everyone has ADHD.

How does that affect kind of the general view? view of someone who has it. Well, I think it's so, like, it just further pushes this narrative and stigma that this isn't like, that it's something super trivial. Like, what I tell people is, like, if you could spend, I'm not even kidding, like, if someone could spend an hour in my brain when I was in medical school, they would be like, no, thank you. This is very real because it was like absolute chaos like it was difficult for me to do very functional basic things and i felt like i was fully drowning every single day it was just impossible to keep up so you asked me about how i was able to get off medication yes so i was able to get off medication because the first time

in my life i had i was surrounded by literal psychiatrists because that's what i wanted to do yeah so i'm surrounded by psychiatrists they actually understand ADHD and they were like okay that you don't learn like this you weren't like this and I was like oh yeah I do and they're like you like and so they taught me from a very fundamental way of thinking and and believing and do and all of that how to behave how to act how to think and it changed how I did certain things so then I was taking this medication and eventually like I started having side effects to it and I was just like oh maybe it's in Phoenix and I'm not drinking enough water so maybe I'm dehydrated or you know it's like my heart rate would just, like, shoot up or, like, I would just get so dehydrated.

But then I was like, oh, that's not it. I'm having horrible headaches. I'm clenching a lot. Like, I don't understand. So I worked down and down and down. And finally, I got off of it. And I realized that I, it was okay. Like, for the first time, my brain was quiet and okay.

And it's because for those three years that I was in Phoenix, every single day, they pounded into me, like, good habits. good routines, and they, like, build up my self-esteem. So when I had these kind of episodes where I was like, oh, okay, I don't like, I'm, this is so overwhelming and I don't know where to start. I actually knew where to start. And then I could like recognize that within myself and move on from there. That's why I'm like such a huge fan of like behavioral modification instead of just doing. Wow. Because on Instagram, I'm getting all these ads of pills I should take for ADHD. Yeah. And I thought that was like,

the answer. But I mean, I knew that I could survive how I survived, but I also know that like every like 10 minutes, there's a different cool millennial pill that we can take and someone could diagnose you really quickly online. You don't have to leave your bed. Yeah. Yeah. So I mean, some people, I'm not, I'm not downplaying medication because like literally it's the only thing that got me through medical school. But if I, it was a combination of both. You know, that helped me get to a spot where I didn't need medication. So it sounds like you almost underwent like intensive, like life therapy with these psychiatrists, where they kind of held your hand a little at first and then you like were able

to walk on your own. They, they, they, they, what I, what I say about that residency program is that they rebuilt me as a person, like from the ground up. They, they just took, I was so broken from medical school. I was tired. I was burnt out. I thought I was just a piece of shit. I was just like, I can't do anything.

That's interesting how self-esteem factors into it, like that you almost didn't believe that you could not have ADHD, that just believing in yourself can help in a way. It's almost like a manifestation. Big. It's so big. I was totally setting myself up for failure and they recognize that and they completely rebuilt that.

But one of the things that they explained to me is they were like how this presents differently in women, and especially in adult women, is that for a significant portion of your life, you do what you, you might have had symptoms when you were younger, but then you are understanding societal cues and you change. You change because that is what is societally appropriate. You're not going to be hyperactive anymore. You're not going to, like, you learn how to participate in conversation. And so by the time you feel like you really would benefit from behavioral intervention, everyone else in the room and everyone else around you, it's like, you don't need that. Like, you're fine. But it's because you've spent

your whole life masking your symptoms. Ooh, masking. Masking, which is a for real thing. And like, women have it extra hard because not only are we like coming from a place where we are, you know, diagnosed less. People just aren't aware of ADHD symptoms in women. or you know you present exactly textbook how you're supposed to present and instead people are like I think you have anxiety I think you're about to say the whole like your brain never shutting up especially when it's negative thoughts you're like this is anxiety yeah and it could be yeah totally could be yeah but ADHD also causes anxiety 80C also causes depression 80s she causes so there's such a high comorbidity between those things that it could it could easily be it could easily be

one of those uh it could be ADHD that's kind of mimicking the symptoms of the other stuff so your videos you're amazing on instagram and ticot and i was recently watching one so my dad always makes fun to me because it'll always be like oh is your hair in a bun or is it down is it up is it down i'm always putting my hair up in a bun and down and i don't know why and i'm also like very sensitive to like if there is a little you know tag in the back of my shirt my day's ruined like I can't deal with that or if my sock line is like a little off like we're done for the day um and I know I like am always my leg is always going always and I know it's genetic because like my grandpa was like that but my leg is always going and people will literally be like can you please stop and I'm like oh my god sorry that was just feeling really good when I was doing that and then you also I'm like I like to touch my eyelashes a lot and like there's all these little habits that you address as possible symptoms of ADHD that, but they also could not be symptoms of ADHD. So the thing about ADHD that I think is important to note is that it does, I think there's

real benefit to seeing a practitioner who can diagnose you because you get, and not just leaning on a diagnosis from like, oh, this is what I researched online, this looks like me. Not that I had huge problems with self-diagnosis because I think it's important to be able to look inwardly and kind of put words to what you're feeling because I think that's really validating. But I think it's important to see someone professionally because they can look at all of those confounding things that could possibly be from two or three different things and put together the pieces and be like, okay, this is why I think it's this and not that. So all of those things like the hair twirling and the sensory issues and the, you know, anything else that

kind of the restlessness and things like that could be anxiety, but it totally could be ADHD. And it's funny you also had a video saying this is what people will call people with ADHD. And you wrote lazy, disrespectful and flaky. And I thought it was so interesting because I'm a very high performing individual in terms of like if you looked at stuff I've done in my life, you would never call me lazy. But I have, I definitely have had times where people have called me lazy because I like can't get off the couch because I'm like frozen. And it's not it's like not a conscious thing. Like I'm just so overwhelmed by things. And then this also stick out to me.

You said people with ADHD will almost interrupt you with a story about themselves, which especially with podcasting, I've had, I mean, there's trolls, but they'll be like, Hannah interrupts her guests and she's always talking about her fucking stupid tennis stories. And I became aware of it and then I like tried to stop doing it. But then when I saw you mention it as just a symptom of ADHD, I'm like, oh my God, is that why I would do that? it easily could be you could be a dick i don't know but it's like i'm trying i do it to be like hey me and you have the same thing why would people with ADHD do that though so it it stems from a concept so what what that style of storytelling is is that it is you are

revealing part of your own self-history in the form of a story to show that you understand the content that's coming at you. Yes. So sometimes what happens is that, you know, the thing that's unfortunate is that a lot of people when they are in an interaction and you're telling them a story that is like, yeah, the same thing happened to me. When I was blah, blah, blah, blah.

Yeah. They're just like, this person only wants to talk about themselves and this is so egotistical. Yeah. But this is how we are kind of, I don't want to say like, this is kind of our safety net because we're trying to provide a narrative so that we can ensure that we have listened and so that

you can listen to the story and be like, oh, okay, they understood. So it's something kind of to instead of being like, is that correct? Am I understanding you correctly? And asking questions and doing that. Instead, you show that you've had understanding because a lot of times it's stemming from two things. One, a lot of times you've grown up and you know, I guarantee you've been in this situation where you're like, you still don't really understand or you didn't follow or you weren't really paying attention. You're like, I don't want to ask another question. I'm just going to nod and be okay with it. It's kind of stemming from something like that where you don't want to ask those kind of questions. And some of it is

absolutely unintentional. Like because your brain is moving so fast, you've picked up one little piece of information that relates to the thing. And then you want to indicate that you show understanding so you barf out this story well even earlier in this pod like you talked about your experience as a kid and then i want to be like i did the same thing i got lost as a kid and that's like that's what i'll do but i also feel like sometimes someone will be talking and i'll take that grain of information and if i don't say it my response right then and there i will forget it so people would be like whoa you just completely interrupted me but me i'm like i won't ever get that thought again if i don't yell at you right now i know and that's the kind of

concept of verbal impulsivity. It's that your brain is moving fast and because your brain doesn't have an organized way of like, think about it like filing cabinets. Your brain doesn't have a good filing mechanism for these things. So you finally come across the file you need and you're like, I'm never going to see this again. But it's so funny, I've never heard the term verbal impulsivity because I will joke like, what's it like to just not have to spew out every thought that enters your but that verbal impulsivity has made me a podcaster and a stand-up comic where when I'm doing stand-up, I'm commanding the room and I will have like four side conversations going on with each person. I can turn, be like squirrel and then continue the joke. And that's just like my brain is

loving that environment where I can just be impulsively verbal and people think it's hilarious. But it's also not ideal for a normal social setting. Like you even said group settings. I joke with my front page. I'm like, how are you supposed to? to be in group settings? Because I could be on. I could take over and lead it or I can be quiet, but it feels weird like everyone's going to hate me that I don't care to join the conversation. Like, it's hard. It's weird because with ADHD, you're working with, you just really feel like you can't trust your brain. Because you, you overthink absolutely everything. And then, you know, and then the things that you're supposed to think about just a little bit more.

you're just impulsive on and it just like flows out of you so it's just like okay cool yeah i really know where to go and it's it's interesting how you said in your certain environment your brain was just rejecting it like you couldn't handle it and as an athlete you know the term dumb jock where like you thrive when your brain is quiet and i was a high performing tennis player but i would suffer from like the yips a lot or i would have like serious um like mental blocks with stuff because my brain so chaotic when I would play I would know everything that was going on on the court that I shouldn't know or be thinking about but then in like comedy that me having so many thoughts is like considered like witty and quick where with tennis they were like you're a mental case and I actually

went on um antidepressants and it helped me with some of the yips I was having with my serve because it quieted my brain down but I had a lot of self-hate where I was just like why can't you perform like everyone else yeah and you know what's hard is that i think that just not just ADHD but like mental health in general i think that we get so in our heads literally about like stigma and things like that and you're like i should be able to function like a normal human being. Yeah. But like, what is a normal human being?

Like, I will tell you from being a psychiatrist, normal human being does not exist. Everybody in the world should have a psychiatrist and a therapist. And I said it and I mean it. Like, I don't understand what a normal brain is. And at this point, I think that everybody is just wired differently. So if you're kind of lusting after like, like, I remember telling my dad when I was in medical school, I was just like, I wish that you could take my brain out.

and replace it with my classmates' brain because I'm so tired of this. Yeah. I just want to function like they are. And he's like, in what university do you think what they're going through could possibly be better than yours? What if they're suffering from severe depression? What if they have a chronic medical illness? What if they're like, you have no idea what's going on because you're only seeing what's

happening on the surface. Yes. So I, you know, I don't, there's, I don't know, it's probably because this is what I do all day long. I just feel so bad when people get into that hole of like, why can't I do what everyone else is doing? Because who knows what everyone else is doing? Well, they also have all these stats of people who like have are diagnosed like bipolar, dyslexia. And a lot of them are like insane creative freaks where like they're winning Nobel Peace Prizes and like poetry like they just they apparently like tons of singers have just the most creative people in the world. They're

brain works differently even like autism it's it's just almost beautiful how you learn different ways or you express yourself in different ways i also notice you talk about social battery a little bit do you find social battery is an ADHD thing um it definitely is for me because i am so like that like i will crush a social gathering and need four days alone with my cats And I know you're cat lady, and I'm obsessed with that. Is ADHD connected to cats? Let's, this is the real question. I need to know.

Look at them. Oh, my God. They're so cute. I do think that my cat helps my ADHD. I mean, my, so I tell people that, so I went through a breakup with someone, like my tail end of medical school, who then later I married. So it was like this whole complicated thing. But like, I was so like, we had only dated.

for a month and I was just like I found the person I was meant to be with I just and like that's another thing with ADHD I just like you get you get very hyper fixated on things and I for I got I mean I fell in love like 4,000 times so I just got hyper fixated on people but for him I felt like I just was like absolutely sure I was supposed to be with him so then he stopped talking to me because I was a nightmare. And I was like, I don't need you. And I got them. And they've been hanging out with me for 12 years.

And so I, but like I felt like it helps my ADHD helped and helps my ADHD so much because they provided me structure. Yeah. They gave me like there was, I had to come home and feed them. I had to come. Like I just wanted to be with them more.

And it provided me like this quiet, gentle place where I could decompress. And I never had that before. Yeah. And just be. in the moment with them and just the simple like purring helps you fall asleep type thing and those responsibilities where you can get out of your own head so here's here's what I tell people from someone I think this comes from the experience also that I'm so hyper aware of that

because I've experienced that certain ADHD medications I felt I was awful on it was so mean or my personality or I was a zombie like I wasn't like interacting in the way that I should be but I was so dialed in on what I was doing. But the right ADC medication doesn't change your personality. It doesn't change anything. It just makes you feel like how you would feel if you were focusing on your best day. Wow. Yeah.

Well, that's like with anxiety meds. It made me feel more myself because it just quieted the clutter that actually wasn't really me. And I'm going to give you an example of. So people joke like that I'm a dumb blonde and stuff. But I'm realizing it's those 88s. HD qualities where just I'm like people will be like oh she's space cadet airhead where I went on a full-fledged West Coast comedy tour the last two weeks where I I'm very organized with my work like my room is a fucking disaster but when it comes to my work like my stand-up set is tight it's beautiful every

email's been gone through like certain things I'm really good at and then other things it overwhelming I joke I can't handle admin like if you're like book these flights and these hotels I'm like but if you're like create a new idea for a hilarious you know joke I'm like all in and feel great about it but so I go on this tour and it is chaotic I'm going to Ohio Pittsburgh Seattle San Francisco San Diego L.A. come home during that time I left my laptop at security because they they checked a bag they were like hey whose bag is this and I went and then I never got my laptop and And then I'm pretty sure I left my podcast gear in a hotel room, couldn't tell you which one. So I lost not only my laptop, but my podcast gear.

The only two things I needed my life by the time I got home on this trip. Right now, I'm using my fiancés and I have another laptop that I'll use. But what the fuck? So people will be like, you're just stupid. Like, you're so stupid. But I know I'm not stupid. I just, I feel like I have so many things going on in my brain that I was trying. to handle and I was super overwhelmed and I also have bad luck well can I tell you what I think it

is I think you operate like a lot of people with ADHD where you excel in things that you're naturally interested in yes so if you are interested in something and if it if it is fulfilling to you and if it is because like let's break it down like ADHD at its base so what it is is it's a dysregulation in dopamine in the brain and dopamine is that happy feel-good chemical. So what people with ADHD are doing is they are looking and seeking for things that provides stimulation and dopamine, right? If coming up with a hilarious joke and new angle provides dopamine.

So much dopamine. So much dopamine. In a hotel room? No, never. Like, no, yeah. And so, like, with, that's why with, like, even within this realm of, like, you know, like, what's psychiatry? psychiatry is really fun. It's kind of like stand-up. Like every day. It's like a new thing.

And I'm dealing with like processing information and new like kind of it's less interesting than improv, but it's interesting. No, it's fascinating. It's, well, there's a lot of psychology in stand-up and even like crowd work. It's me just being nosy and be like how long you guys been together and then like joking about it and making people think differently about things and questioning it. Like it's actually it is quite similar. Yes. So there's so there's there's a lot. of kind of social benefit that comes out of that and it's dopamine releasing but like social media and things like that where I get to use creativity and stuff like that I have to actively be like okay I cannot do like I have to set that stupid TikTok timer because I can't be on here anymore

so it's it's stuff that I am interested in or naturally good at or things like that which I do well at because I'm getting that dopamine release. If you ask me, I don't think I have, I'm not even kidding. Like I, like, if left in my own design, I would probably live amongst just like filth. Like, because I don't like, I do not like cleaning. Well, that's me. And unfortunately, my fiance is messy too. So like my room right now. And it gives me anxiety, but I can't, I can't conceptually even know where to begin and it's like I'm stunted but no one's ever adjusted with me because I was a straight A student I was put into tennis because apparently I was really hyper as a kid and they put me in all these sports and then I got to obsess with tennis and getting better and my

ranking improving but so I've always been high performing like I never was like failing at anything so my parents were never like oh we should check on her but I've always been like for example I joke that I'm bad at admin my fiance set up like this whole trip to Europe and I had to move just my flight and I ended up accidentally deleting both our flights and canceling it like just because I was you know when you panic you're just like delete like I just I couldn't stop and like think and it was we ended up fixing it but like I do that shit all the time I'll like book a flight for PM instead of AM like it's just that's just my life and I thought that was just me I know. I know. Because this is like my whole life. This is what I've dealt with my whole life. It's just like, you know, my parents would get so upset with me like with tests and things like that. They were like, you, you literally told me this this morning in the car, but I would just not read the word, which one of these is it not? I wouldn't read the not. And then just like, okay. So I just, you know, I feel like there, it is all a function of your brain moving.

quickly and then you know just just well my dad would always be like I also would spill a lot like I would spill drinks all the time like because I talk with my hands and I'd be pouring something I'd spill and my dad would always be like slow down slow down and I'll be like I don't care

about this stuff like it's like if I'm not interested in it I just want to do it as fast as possible first of all you probably should get evaluated yeah yeah yeah but like not not necessarily because you functioned this whole time and you've been doing fine like whatever like there's something to be said about like skating by doing what you need to do and and have it not impact your life in a way that's absolutely debilitating yeah but here's my spiel about people who have ADHD like this

even if you are doing well externally and everybody else is validating that you're doing fine yeah it doesn't change what is happening internally and if internal and if internally you're uncomfortable or if internally you're like, this is so much to keep up with this and it's so difficult and it's so taxing, then that is the reason I would get it valued because it just makes life a little bit easier. And I always, always, always love to just understand what's happening with my brain a little bit better. So scientifically, from a board certified psychiatrist, I love saying board certified. I think I'm just going to put that in front of like anything I do. I'm a board certified podcaster. And,

What? I don't even know what bird certified is. But anyway, what is actual ADHD? Because you were saying it's like just things moving really quickly. Like does my brain just move really speedy compared to other people if I have it? So ADHD at its. So the actual, well like I guess what we're talking about is what is it versus cause and stuff because that's totally different. And symptoms and stuff. Yeah. Yeah. So it is a neurobiological disorder. So it's. something that typically you know always you're born with this kind of was comes as a fetus um and you um it causes a dysregulation in certain neurochemicals and so what i mean by that is that everybody has certain amounts and areas of the brain that are utilizing certain chemicals like norepinephrine dopamine serotonin which are all chemicals that transmit certain messages with ADHD noropinephrine and dopamine. are the ones that are not even necessarily that there's not enough of them. It's just that it's improperly used in the right places.

So what happens is that if you don't have enough in the spot where it's supposed to be or they're being eaten up too quickly. And so there's just not enough in that synapse or where they're supposed to be. It's kind of like your brain is working over time to accommodate. So your brain just feels like it is going super fast. And so everything is on overdrive. So everything is potentially simulating or just certain things are under-simulating because your levels are a teeny bit off. Yeah.

Wow. That's incredible. And I mean, low-key selfishly during this conversation, I was like, I want to reflect on what's going on in my head, they got it all. But I also love that you've gotten to the point where you've learned how to navigate it without medication. And I also think that if I have ADHD, it does make my brain work in like a unique way that I think has made me who I am. Yeah. And so I feel really strongly about like understanding your neurobiology, which is why I think growing through a practitioner of some sort is helpful. But, you know, I do.

I'm glad that we talked about medication versus not medication. And now that I'm off of medication, also it's kind of shown me. and I get it. I'm a psychiatrist. I'm supposed to like push pills and people like, okay, whatever, I made my peace with that. But I love the concept of being able to like take and work with people and help them build in structures and routines that actually tangibly help their lives with ADHD. Like that break down things like, how do you clean? How do you eat? How do you do time management? And like, so last, what year is it? Okay, it's 22.

Yeah. So like December of this year, I just finished writing a book. Congrats. Yeah. Thank you. But, I mean, it's not like, so, yeah, it should be released with Simon and Schuster next year, which is awesome. That is so exciting.

Yeah, it's so exciting. It should have been released in the fall, but then they had supply chain issues and now I just. No, I've heard a lot of nightmare stories like that because then they also don't like releasing books. in February and you have to like wait for the whole thing. I don't know. People have dealt with one thing happens and then they like have to do it the whole following year. I don't know if it's February or November.

I don't fucking know. But yeah. You never know when you have to like, oh, you have to wait seven years. And you're like, oh, cool. It's okay. Wasn't in a rush. I feel so bad because I'm like, I'm sitting on like. I feel like and you know, hopefully I'll do more on the social media stuff.

But like I feel like if you're scared, you. you in particular if you're scared about medication or like you feel like that could potentially if you want to try other things first like talk to somebody work with a therapist about behavioral stuff you can do because like honestly just building like my attendings when I was in residency I'm not kidding you when I said they like they like they should have been helping with just academics but instead they took me on as like a rehab project and so they like taught me how to eat They taught me how to, like, this is how you get ready in the morning. So you're not 35 minutes late to a rotation.

This is how you prep at night. And so, like, they were helping me with all these little things where I'm like, oh, duh, like, do people. And it makes me so upset because I'm like, people do this normally and they don't have to put thought into this. It's so obnoxious. Well, and then we're living our life where I'm like, oh, people do things not so reckless is this?

I know. I know. But then people will laugh and be like, Hannah can get ready and pack all her luggage in five minutes. And it's like, yeah, because I actually cannot imagine preparing like the day before for a trip. Oh, my God. But then do I forget stuff? Obviously. But is it fast?

Yes. Have I learned to do my makeup extremely fast and well? Yes. Two minutes. Two minutes. It's all I need. So if people are listening and they're like, oh, my God, I think I want to talk to, you know, a psychiatrist, practitioner. What is that process like? Is it scary? Is an invasive? What is it like? So, yeah,

a lot of people, it's weird because this is what I do. So I forget that people, like our system, first and foremost is so broken and so stupid. And it's like, it's impossible to get care. And it's like, you know, for people who really need to advocate for themselves and they need care the most, I feel like they have to jump through all these idiotic poops to get there. But in, terms of actual like say you go through and you get through those hoops and you you finally make your way to someone who can diagnose you potentially treat you at the same time basically what they're going to do like for as a psychiatrist it's basically we we don't do a lot of assessments what we're doing is we're trying to amalgamate all of the different psychiatric kind of things psychiatric and

medical things that could be playing a role so we go through an entire medical history we're trying to figure out is there anything from there that could be playing a role then we go through a psychological kind of evaluation where we're trying to figure out are there any like dynamics in your life or things like that or external stressors that could be causing it and then we dive into the psychiatric stuff where we talk about like anxiety versus depression versus bipolar versus anything else like personality disorders and then we kind of amalgamated all together and we're like oh okay so based on all of that stuff here's kind of where we stand in terms of ADHD. Yes, I think it's ADHD or it looks like ADHD, but it's actually probably a combination

of this, this and this. And this is all from asking personal questions, not from like scanning the brain or anything. Yeah. Okay. Yeah. And if people are, people are probably, there's like a new phenomenon that's on the rise that people are talking about getting pet scans. That is not a thing. It's like crazy expensive. It's putting you through undue things. And it's not scientifically proving because we don't. actually know. Good to know. Yeah, don't do that. So it is, yeah, you're just getting it from assessment and you're trying. And so that's a part of why you need a skilled practitioner who's done this and who's comfortable with this. And I also think lastly, there's been this like kind of abusive

Adderall where like everyone wants Adderall, everyone wants to be diagnosed it with ADHD. It seems like it's so easy. And then you wonder like, oh no, are they just going to diagnose me even though I'm not ADHD. Like these are the inner fears that I have go, or they think I'm like faking it, like just to get out of drugs seeking. Yeah, I know. These are all these fears around just treating ADHD. And maybe that's because I have ADHD.

I don't know. That doesn't like, yeah, like you think about it. But what people don't know, what people don't know is that there's a federal database. So anytime someone takes a controlled medication, whether it's like something for anxiety or something for ADHD or something like that, we know about it. Yeah. We know about it.

Yeah. So if you're drug seeking, I know before you even open your mouth. Oh, yeah. If you've gone to four different doctors in the past month and you've asked for the same thing, I don't think so. Get out of here. Like, so it is one of those things that it is like there's just a very clear line. And I think for people struggling with ADHD, um, it, you, you, you, you,

can learn a lot about what the intrinsic motivation is because if people truly want to learn about ADHD and truly are open to kind of their treatment modalities with that they're not going to be necessarily pushing for one medication they'll be like oh okay let's talk about kind of all the options and what they work best if someone is totally dialed in on that for no really good reason or if the reason was I took one of my friends and it worked beautifully okay well okay you could have taken meth I don't know what you actually took. Like maybe you did a line of Coke. Like I have no idea.

So I, they're really pushing for one thing. That's when I get kind of hesitant. But honestly, I think that this whole process, it's really not scary. I swear. And it's super collaborative. You work with your practitioner and you talk about things and you ask questions and they ask questions. And you guys work together to synthesize.

kind of a diagnosis and a plan that would work for you. And I think that it's super validating. You should leave the experience like with a sense of relief. Like, oh, that, it makes sense. And should I have any, should I have any fear of getting addicted? Of? To what? To Adderall.

Because, you know, you hear those horror stories of like people, but I feel like they're overdosing it or what are they addicted to do feeling it gets like you get hype the fuck up like it's cocaine. So with Adderall. I'm also really stupid when it comes to drugs. I don't let you know. That's probably a wonderful thing. So the thing about Adderall is that for people with ADHD and they've done lots of studies because for a long time, there's a higher risk of substance abuse with people with ADHD, but not because they're drug seeking because they have poor judgment. Like it is a result of the ADHD, not a result of the medication. It actually gets better with medication. So with ADHD, with Adderall in particular, the risk of addiction can be there

in that it is a medication where you build a tolerance and after a certain amount of time, you do need more. But it's a slower process. And the thing about people with ADHD is they're being adequately managed, you're not getting this huge rush or this huge high. Instead, what's happening is your brain slows down. And so you're able to focus on one thing at a time. And It feels calm. And that's great. That's great. But it's not really what people are chasing.

Like people are chasing behind. But no one's chasing like the, oh, it just makes me feel normal. Yes. You know? So I don't. So for people with ADHD that are using it appropriately, I don't really worry about that. Now, I have had patients that are overusing it and are like slamming through their medication. Yeah.

In which case, I'm like, that's a problem. we're not going to do that medication or like they're using it as a party drug like at night to stay up later or to drink more yeah yeah so it's like so if you're not using it appropriately or if you're using too much of it there's no way i'm under prescribe it to you like there's no way that's dangerous and but there's tons of other stuff besides adderall and there are tons of other things that aren't stimulants that help with ADHD other medication classes other things there are even antidepressants that help with depression and anxiety and ADHD at the same time. Wow. Oh my God. Dr. Sasha, you are so incredible. This has been so fucking informative for

myself selfishly and the little devils. And we love hearing your story. I have a final question I'm going to ask you. What advice would you give to people on how to cope with their hell? When it's dark, when their brain's not making sense, they don't trust themselves. What advice do you have to cope with your hell? um the best advice i have um and it's probably because it's coming from a personal place is to just be patient with yourself because i think that's that's one of the things that i never really learned how to do and i'm still working on because i think that you get so wound up and and you get like why am i unable to do that and sometimes when you just have patience and are like

I recognize that this is probably burnout. This will pass. This will pass. I will pop out of this. A hundred percent of the time I popped out of this before. So it's going to happen. I'm going to pop out of this. So I just need to be patient with myself and I need to utilize my time in another way and

maybe do a little bit more self-care in this moment because then I'll get out of it a little bit faster instead of focusing on the 100 million things I have to do, just focusing on kind of calming deal on because you actually end up organizing. your thoughts better when you're not hyper fixating on like circular thought when you're not hyperfixating on things you've already thought about 10 billion times when you separate yourself from it a little bit better you can or your brain naturally organizes it better when you're not actively in the moment wow that is i could talk to you for fucking hours i knew i could you're incredible and i am now like have to reassess my entire life in a good way um where can people find

you, like watch you. Give me all the goods of all the information. Yeah. Um, so on social media. So I'm on Instagram and I'm on TikTok and I'm the psych doctor MD and Dr. D-O-C-T-O-R. Um, I have a website, but it's stupid. And I, your like name is the ADHD doctor, which really kind of got me. But it's, I also followed you because she's very funny and just seems like your smarter friend that can like give you funny advice which we love that energy um literally never heard that before but i will take it and you do an amazing cat eye which i have to respect everyone thank you so much for coming to hell today dr sasha we love you come back to hell anytime and i'll talk to you guys later bye