Good Life Project - Is ADHD a Silent (or not-so-silent) Factor in Your Life? | Dr. Sasha Hamdani

Episode Date: November 13, 2023

Have you ever felt like your brain just operates differently? Like no matter how hard you try, you're perpetually distracted or struggling to focus? You're not alone. Psychiatrist Dr. Sasha Hamdani shares her personal ADHD journey and provides research-backed techniques to better understand and thrive with your uniquely wired brain. We dive into practical self-care tools from her book, Self-Care for People with ADHD: 100+ Ways to Recharge, De-Stress, and Prioritize You! to help manage symptoms, prioritize yourself, and embrace your neurodiversity. Dr. Hamdani aims to empower those with ADHD and neurodiverse brains to navigate the world with more clarity, ease and success.You can find Sasha at: Focus Genie App | Instagram | Episode TranscriptIf you LOVED this episode you’ll also love the conversations we had with Dr. Jill Bolte Taylor about whole brain living. Check out our offerings & partners: My New Book SparkedMy New Podcast SPARKEDVisit Our Sponsor Page For Great Resources & Discount Codes Hosted on Acast. See acast.com/privacy for more information.

I love the term neurodiverse because it's indicating that there's unique wiring. But I also think that we also need to encapsulate and not shy away from the word disorder because I think that's an important term. A disorder is indicating that it causes you substantial dysfunction and distress. And I feel like that's something that it needs to be included in that name because it does. Otherwise, without that, people just minimize ADHD and think everybody has it. It's not that big of a deal. Everybody can't focus. It's our phones. So it gets diminished and the severity gets taken away.

So have you ever felt like your brain just operates differently than those around you? No matter how hard you try to focus or sit still, you seem perpetually distracted or pulled in different directions, struggling to manage emotions or cope with stress or noise or input, no matter how hard you try. If this sounds familiar, you are not alone. And like so many adults who just quote dealt with these experiences for much of their lives, so many are now starting to wonder what's really going on and is there something to do about it? Well, my guest today, Dr. Sasha Hamdani, knows firsthand how a uniquely wired brain can present daily challenges. Diagnosed with ADHD herself back in childhood, she struggled to manage her symptoms through much of her life,

including the often head-spinning experience of medical school. And it was only after deep exploration and work with mentors that Sasha eventually embraced her unique wiring and has now, as a mental health care professional, become a powerful advocate for the neurodiverse community. As a board-certified psychiatrist and ADHD specialist, she's really uniquely qualified to provide both clinical experience and personal insight. And in her book, Self-Care for People with ADHD, 100 Plus Ways to Recharge, De-Stress, and Prioritize You. And through her robust social media presence, she is on a mission to empower those with neurodiverse brains. And Sasha aims to provide accessible tools to thrive, to better understand how to navigate the world with more clarity and ease and success. And we also do some myth busting in this conversation and take on some of the

benefit washing or almost toxic positivity that she sometimes sees around neurodiversity. In her book, Sasha offers over 100 research-backed techniques to better understand and navigate a brain that is different. And we dive into a number of these different strategies and practices and techniques. She also shares her own ADHD journey, along with actionable ways that we can care for our mental health. And we explore how to better understand the difference between more neurotypical distracted state and ADHD and how and when to seek help. I walked away with a truly greater understanding and tools that I know will benefit so many too. So excited to share this conversation with you.

I'm Jonathan Fields, and this is Good Life Project. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you 8 hours of charge in just 15 minutes.

The Apple Watch Series X. Available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time in glossy jet black aluminum. Compared to previous generations, iPhone XS or later required. Charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun.

On January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're going to die. Don't shoot him, we need him. Y'all need a pilot. Flight risk.

It's so curious about you, about your work and this topic, because I think you're just hearing about it over and over and over from more and more people. And I think from older and older people too. So I want to dive into all of it, you know, but I think it's helpful to take a little bit of a step back in time. Your psychiatrist focus, not just on ADHD, but a substantial focus on that in your practice. So much of what you've been sharing in a very public way, all over the internet, on social media, your new book, really does focus in on diversity and ADHD. And I'm always fascinated because when somebody goes that deep into it and then turns around and says, I need to be of service to the world in this context too,

often it's personal. And for you, this is personal too. Yes, very much so. I think that's an astute observation. I think that as I was going through medical school and really for the first time struggling academically and socially and everything, because when I was younger, school wasn't as difficult for me. But when I was in medical school, it was exceedingly difficult. I think in order for me to understand my own brain, I had to deep dive into that. And then once I did that, once I kind of got into psychiatry and continued that work with psychiatrists and therapists and everybody around me that was helping me with that kind of like educational arc, it seemed like too good of

information to gatekeep. And so I wanted to share it. Were you aware of the fact that you sort of experienced the world differently from others at a young age, or was this something where it really started to come together when you were older academically? So I think that's an interesting question because I was originally diagnosed in fourth grade after I just presented as a very disruptive kid. I was getting in trouble a lot and I was hyperactive. Like I was smart in school, but it was very selective. It would only be in things that I was naturally inclined towards or interested in.

And so when it became problematic in classroom, it was brought up to my parents. My parents got me assessed and actually I was started on medication at that time. But I think because of that heavy stigma around ADHD, it wasn't talked about openly. And so I wasn't, I didn't know I had ADHD. I was given medication, but like, I didn't really know what it was. It was like, this is going to help you focus.

But I didn't know, hey, this is a pharmaceutical medication that's going to help you focus. I feel like I had two diagnoses. I had that one. And then in medical school, when things were difficult for me, and I actually started seeking out knowledge about this, that was my second diagnosis. So I think at a young age, I knew that my brain operated differently. And it was very much, I felt like it was a worse than thing. Like I was getting in trouble a lot and I felt like my brain was, I remember very distinctly telling my mom in fourth grade that I was like, there's something wrong. I don't work like the other kids do. And it's not that I'm not trying. It's just like, I will go to school every day to try and it just everything gets derailed. And then I remember in, in medical school, I remember feeling like, okay, I remember

all of this stuff about feeling different. And I remember all this stuff about like, comparing myself to my neurotypical peers and looking at that vast and stark difference and actually feeling validated that, oh, there's an explanation and there is a reason. And it's just that I'm wired a little bit differently. And if I just tweak some things, maybe I can optimize what I'm doing. I mean, it's interesting you bring up the stigma, you know, when you're in fourth grade, go to your mom and you're like, there's something that's just like not right here. That's different. They bring you, you get diagnosed, but it's like at that age, the diagnosis largely kept from you, but the medical intervention isn't. It's sort of like, okay, the parents know what's going on. Like here's a medication that we think will help the kid takes it. But I'm curious,

do you have any recollection of kind of feeling like something was said about what's going on with me that I don't really know or understand and I'm being given something to help with it. And maybe it's even helping, but I still really don't understand what's happening here. Every morning I would wake up and I would have my breakfast and my breakfast would be like eggs and a piece of toast. And then sitting next to my piece of toast would be a little white plate with my Ritalin on it. And I didn't know it was Ritalin at the time. And I remember like my parents just explaining it to me, that's your vitamin. It's going to help you with school. And like, that was the extent of my

knowledge about that. And like for a long time in my adulthood, when I was trying to deal with this and cope with this, I felt very betrayed by that, that, you know, I wasn't given that understanding of what it was. And because I was like, this is my brain, how could you keep that information from me? It would have explained so much and helped me. But I also think that as a whole, a collective whole, a generational whole, we were in a far different spot. And I think it was a difficult subject to broach, especially since I was a really sensitive kid as well. I mean, I think that it was tricky then, and it probably would have been tricky now. It's just, it's a hard thing to

talk about with a brain that's developing and doesn't have a full understanding. Yeah. Do you feel that that has changed in any meaningful way? I mean, essentially you use the word neurodiverse, which is a word that I hear pretty much on a regular basis now, but that word wasn't really around. Even 10, 15 years ago, there wasn't sort of like this category of saying like, no, this is not like a better or worse than category. This is just a different category. And we have a word for it too. And it's completely acceptable. There definitely wasn't around the time of my diagnosis or not a widely used one. I think it was for a long time, better or worse. Like your brain was just not operating the way that

historically every brain should have operated. And I think to some degree, like I love the term neurodiverse because it's indicating that there's unique wiring. But I also think that we also need to encapsulate and not shy away from the word disorder, because I think that's an important term in that it's not just, and again, why it's a disorder. Some people argue that it's a systemic thing and it's, you know, it wouldn't be a disorder if systems had changed. But I think a disorder is indicating that it causes you substantial dysfunction and distress. And I feel like that's something that it needs to be included in that name because it does. Otherwise, without that, I think that people just minimize ADHD and think everybody has it. It's not that big of a deal. Everybody can't focus. It's our phones.

So it gets diminished and the severity gets taken away. Yeah. So it's almost like what you're saying is maybe it disincentivizes actually doing something that might be really helpful because you just kind of accept it as this is just the way I am and it's okay. Rather than saying there are some things that it's like leading to challenges and there's some things I can do about it. And if I actually look at it that way, maybe that'll help me mobilize into action and to doing things. Totally. I guess a big question for me also is when we're talking about something like ADHD, what are we actually talking about? So ADHD is a neurodevelopmental condition, and it is categorized by three different things.

It's categorized by inattention, hyperactivity, and impulsivity. And you don't necessarily need to have all of those things, but you'll see that there's varied presentations of those within each presentation. So the typical three presentations is an inattentive type, a hyperactive type, and then a combined type, which is obviously the grouping of both. And so this is something that typically, typically presents even at birth and it's genetically passed down. And as you grow and evolve, there's a chance that it could get better. There's a chance it could continue into adulthood. There's a chance it could evolve and adapt, and you could just hide it better. So it's something that's not generally

something that just presents out of nowhere. You're seeing it pervasively before age 12. And generally, if you look back into family lineage, there's signs of it as well. Oh, that's so interesting. Do we have an understanding of what's actually happening in the brain that would lead to these symptoms? There's a lot of good hypotheses about that. I think that brain is always a very difficult thing to study like in actuality, because the best way to study the brain is when it's out of your head. Which nobody wants. No. So it makes it a difficult thing to study. I mean, there are some people ascribed to using

scans and things like that to assess like PET scans and fMRIs to kind of assess for glucose uptake and how active certain areas of the brain are. But the fact is that just the science hasn't caught up with that. And we're not there yet. It doesn't actually, it's a really pretty picture, but it doesn't actually give us the information we need. So when you're looking at the ADHD, like from a neurobiological perspective, there's a couple of areas that we do know are impacted. Number one is just that frontal lobe. So directly under your forehead is that big part of your brain in charge of personality and decision making and impulsivity. And so when you're actually looking at anatomical changes,

that's actually a little bit smaller and it develops a little bit later. So if you're thinking about just kind of changes as we progress into our preteen and teen and adult years, you know, everybody talks about how difficult teenage years are, but you know, with ADHD, you can have this like even delayed onset from that where you have like this delayed social maturity. So you're having prolonged problems even throughout teenage years and it kind of escalates from there. You can have changes in the amygdala, which is that emotional cortex of your brain where it's a little bit bigger and a little bit more hyperactive. You can see that in a lot of different areas of the brain, but that's another area that can be impacted. You can have difficulty in areas like the reticular activating system, which is kind of like this post office where all that chemical messaging happens through.

So there's lots of different things, but it's still kind of incompletely understood. I mean, that makes sense to me. So if we don't diagnose it that way, how does it get diagnosed these days? It really is diagnosed clinically. You base it on your history and symptoms. And what I tell people is even though you're doing this clinical assessment and you're asking the right questions, it really hinges on a complete understanding of everything else as well. So you have to have a good understanding of what is this person's underlying medical condition? What is this person's underlying psychiatric condition? Because those things can look a lot like ADHD because, you know, if someone is coming in and they're presenting with focus as the main problem, that tells me nothing. That tells me nothing.

That could be depression. That could be depression. That could be anxiety. That could be a thyroid disorder. That could be ADHD. That could be a brain tumor. That could be, you know, it could be so many, so many, so many different things. And so it's just a very non-specific thing. You have to look at everything in its entirety and tie together that picture, which is why going to a trained mental health professional that can like piece together all those things is really important. Yeah. I mean, that makes a lot of sense. I wonder then because it can show up as different things, because it can potentially show up as anxiety or some like overlap with symptoms of depression is, do you feel like ADHD is often either underdiagnosed or misdiagnosed often?

It's a complicated question. And the reason for that is it really depends on like the patient population. Because I think there are certain populations where it is grossly underdiagnosed. I think women get diagnosed later. I think they're more likely to get misdiagnosed. I think usually they're coming in like the difference between diagnostic rates for men versus women. Boys get diagnosed around six or seven. Women typically median age or mean age of diagnosis is like in their thirties. So there's such a huge discrepancy based on age and gender and, and things like that. I think they're socioeconomic kind of things. There's a huge, huge discrepancy when you look at certain patient populations that are completely flying under the radar and being diagnosed with like

conduct disorder or oppositional defiant disorder or different behavioral issues are more likely to be diagnosed with bipolar or schizophrenia when really it's ADHD and in, you know, more affluent societies where they have more access to care and, you know, they're not going in kind of emergently, they're getting diagnosed and getting that frontline treatment. Yeah. That makes a lot of sense to me. So it's really, it's complicated at the end of the day. Very complicated. What would be some signs? So if you're either, if you're a parent or a caregiver and you're looking at a kid or a teacher and you're looking at a student, or if it's you, if you've just been, you're in your 30s or 40s or 50s, and there's just been this stuff that's been going on for literally for as long as you can remember.

And you've never been diagnosed. You never saw a diagnosis. What are some sort of common signs that would let you know, like, maybe I should actually talk to somebody about this and see if there's something else going on? So typically what you're looking for, like, for example, with the inattentive type, you're looking for difficulty initiating tests. You're having a hard time initiating tests. You're having a hard time initiating tasks. You're having a hard time sustaining focus for tasks. You're having a hard time organizing things. You're having a hard time looking forward into goal-oriented tasks. Like if there's something

really big coming up, it's hard to plan for that. And so you like avoid it or you push it off or you dread it. You look for things like you lose things frequently, being forgetful in daily routine, like walking out of the house and being like, did I brush my teeth? Did I not? So things like that are more of this inattentive picture. And if you were to like, just kind of group that and look at something just like a trope that you were thinking about, it's your daydreamer, right? Someone who's just like kind of spacing out, right? And then you have this hyperactive type, which is stuff where you think more about like this verbal and physical impulsivity. So they're blurting out answers, they're interrupting, they're hyper talkative. They're also very fidgety, hard to stay in their seat, difficult to keeping their hands to themselves, you see kind of a blending of

those two pictures with the combined type. So if you are later in life and you're just hearing like, oh, I just thought I was forgetful, or I just thought I was always a little anxious, or I just thought I was like, I'm a fidgeter. And then you're hearing like, well, but all these come together. I mean, I guess it's interesting because to a certain extent, especially if it's somebody who's later in life who feels like, you know what, all these things are going on, but I feel like I've developed mechanisms, practices, coping things where I'm pretty much okay. Is that the type of person where it still makes sense to say like, well, should I go and see if like, this is actually what's going on and get a diagnosis? Or at that point, is it just kind of like, I've gotten to a place where whatever's going on with me, I'm actually, I feel like I'm good. I'm comfortable. I'm living a good life. And that there wouldn't really be a whole lot of purpose behind saying, let's go down the path of like going through whatever the diagnostic process is.

So I think therein lies that, that hinging word of the disorder, right? If you're getting through this and you're like, I'm actually okay. It doesn't actually disrupt my life. I'm a little spacey. I look like I kind of meet criteria, but it's not bothering me. It's not bothering anybody else. I'm like, fine. I don't think that's a disorder. You're a little spacey, whatever. That's not causing significant dysfunction. And so I think there's that. Now, what I would say is if you do feel, if you're in a situation where you're hearing these symptoms and you're like, that sounds like me, that does cause dysfunction. People often ask me like, what's the point of getting diagnosed? If I'm functioning to some degree, I've developed the things that I need to. I'm in my 50s.

I'm in my 60s. Like, is it too late? I don't know. The way that ADHD made sense to me is once I understood my brain and then it was like the world opened up. I started to understand the motives behind what I had done. I gave myself grace in these kind of things. So I think from just an understanding standpoint, I don't think

that's ever, you're ever too late for that. But keep in mind that that's also having that mindset is a privilege, right? I mean, access to care is such a problem and it's not widely available for many, many people. So I think it depends on a multitude of factors. That makes a lot of sense to me. And what you bring up about, maybe it actually helps you with self-compassion and really just understanding yourself better and self-forgiveness, you know, like in addition to that for like just certain things, the way you move through the world, that alone probably, it really makes a difference just in the way that you experience each day. I wonder also, because we live in a world where there's a lot going on and there are a lot of stressors. How does stress interact with ADHD

with any of the ways that it presents? So I think that stress is a unique thing because there's a certain level of stress that kind of motivates you and accelerates kind of action because there's a sense of urgency behind it. So for an ADHD brain, you might need a with ADHD have, because of this dysregulation with focus and attention and emotional stuff, I think stress can be really destabilizing and it can be hard to get on top of adequately. I think we're ill-equipped for stress, but we also need a little stress to function. So it's just, it's finding a good balance and a workable balance. And I think that's something that I know that I struggle with on a pretty solidly daily basis.

Yeah. And so it sounds like what you're saying is for most people, there's a sweet spot, whether you're experiencing ADHD or not. And maybe it just makes more sense to really try and understand if this is the way that you're wired, like where does your sweet spot lie? So you can be a little bit more intentional about trying to sort of like operate within it rather than push the extremes on each end. Does that make sense? Yeah. The Apple Watch Series 10 is here. It has the biggest display ever.

It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X. Available for the first time in glossy jet black aluminum. Compared to previous generations,

iPhone Xs are later required. Charge time and actual jet black aluminum. Compared to previous generations, iPhone XS or later required, charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun. On January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're going to die.

Don't shoot him, we need him. Y'all need a pilot. Flight risk. The other thing that I'm curious about, and maybe it's almost like the extension of stress, is that we also live in a world where stress rises to the level of trauma. Sometimes it's trauma bundled with grief. Does this affect somebody with ADHD in a meaningful way that's different than somebody who'd be more neurotypical? I think that it does. And I'll tell you, I'll tell you my specific reasoning for that. I think trauma is a really complicating factor in anybody's life. I mean, it adds so

many new dimensions and so many new variables. With ADHD, I think one, you are already at high risk of getting overwhelmed. And then two, the part that people don't talk about with ADHD, rarely, if ever, is the emotional component that comes with it. It's not part of the DSM. So people never really lump it in with ADHD, which is part of the reason why it gets misdiagnosed as mood disorders. But the emotional dysregulation is a huge part of ADHD reason why it gets misdiagnosed as mood disorders. But the emotional dysregulation is a huge part of ADHD. You get a lot of mood fluctuation. So if you're having these sizable triggers with trauma, I think you can get caught in these big spikes of emotional activity, big highs, big lows, which can be really destabilizing to everything else. So if you're

already having a hard time getting your things done and focusing and managing your day-to-day life, and then you're being just absolutely rocked by this trauma at the same time, I think you're going to have a much harder time coping. Yeah, no, that makes a lot of sense. The other thing that really I'm curious about is we all tend to have a certain social wiring, introvert, extrovert, ambivert, and whether that's changeable or not, I know the research is mixed and it depends who you ask in any given moment in time. But I think a lot of us would probably identify if you kind of described, well, this is what it feels like to be an introvert. This is what it feels like to be.

A lot of us would probably say, oh yeah, that's me, or that's me. I happen to be fairly strongly on the introverted side. I'm wondering if that also plays into it, because to me, my introversion, and I would also probably qualify as an HSP, a highly sensitive person, and that shows up in my interactions, or it shows up in how interactions affect me. So I'm wondering whether social orientation also plays into the experience of ADHD. There is this really interesting called rejection sensitive dysphoria. And what that is, is it is this intense, emotional, sometimes physical sensation in response to real or perceived criticism or rejection. So if you're thinking about that within an interpersonal context, you're thinking about that within a conversation with somebody, all of a sudden, if you have this added layer of like, God, if this person breaks

up with me, I'm having this stabbing chest pain, or I'm so worried my, I'll give you an example that I had earlier this week. I came into work four minutes late, which is like, frankly, a miracle because I'm always running kind of late. But I walked in and I saw my peer as I was walking through the hallway. And I convinced myself within that two-second interaction that they rolled their eyes that I was late. It devastated me for the rest of the day. It was hard for me to get my stuff done. I felt nauseous. I didn't want to eat.

I felt like I was having chest pain. I kept checking my Apple Watch to see if my heart rate was up. And then at the end of the day, I walked up and I was just like, oh my God, like Kevin, I'm so sorry I was late. I know that was so embarrassing. And he's like, when were you late? And I was like, oh, this morning when you rolled your eyes. And he's like, I literally did not even see you walk in.

And so I had like convinced myself. Right. It was just in your head the whole time. The entire time that like he was looking for like the cabinet, behind me, and like, didn't even clock me coming in. And also, why would he care if I was not like, my supervisor, and I was devastated for a whole six hour span. That's what I was thinking about. So I mean, there is a very real example. And I think when I vocalize stuff like that, people are like, are you joking? But that's to me like a tricky line to walk. And I think that's something I had a lot of difficulty with initially when I started posting on social media, because I was getting to the point where I was like, what is the point of putting this out? If I read one bad comment that I'm fixated on that, and it ruins my home life. I take it out on the people I'm around at home, has nothing to do with them. And I'm just exposing myself to stuff that clearly,

like, I know in my heart, I am too sensitive for to handle that. And maybe it was never the poster's intention. But that's, that's how my body is responding to it. And to be totally honest with you, my new posting routine is I post it and then I leave it alone. I just close the app and I run away. Just drop what I need to drop and then I run away. That's a form of self-care in my book. I was at a panel recently and someone called it the post then ghost. And I was like, yes. It's like if it works, it works.

It works, it works. Yeah. I mean, it is so interesting. For you, I know you described when you were a young woman, fourth grade was the first time where, okay, so now there's a pill. And back then it was Ritalin. And I know you've written about in the book and talked about how when you're in med school, this was another window where you're in med school, this was another window where you're like, okay, I need to actually revisit what's going into my body to try and manage this because it's a completely different environment, different stressors, different workload.

And you ended up moving through a series of like, will this help? Will this help? Will this help? I think it was like, I think you described seven different medications or something like that before. I think in my entirety, I probably did 12. It was a lot. Wow. Thankfully, there are certain medications that are out there that do help with a lot of people. So it's interesting to me that you're sort of saying now, okay,

yes, and. These can be really helpful, but they're not always helpful for everybody. Sometimes it takes a long time to figure out what works and what doesn't. And just because it helps at one moment or season or age, doesn't mean you're going to be good for life. There are other things that we can do that we are in control of for the rest of our lives that we can start to explore that might really help. And it sounds like for you, that was one of the realizations that really led you to focus on self-care. Oh my gosh. I think that the entire journey of medication was so frustrating, but necessary.

At that point in my life in medical school, I wouldn't have graduated if it hadn't been for medication. There's no way I would have gotten through that rigorous academic program. There's no way. So I know that I needed it, but I can tell you going through that, I hated it. I felt like I lost my personality. I felt like I'd have to pick and choose.

If I want to be myself, what time do I have to take off the medication for it to wear out? And that's not every medication. I've been on medications that didn't have that impact and they have been effective for me and didn't blunt my personality at all. But I felt like at that spot in my life where I was studying for like 13, 14 hours a day, I needed something that was prolonged and that I could like metabolize slowly that wouldn't tank my appetite.

I felt like I was having to pick and choose between being medicated and being myself. And I think that that's where it became really problematic for me because I was like, I don't feel like people should have to choose that. And I haven't felt that way before going through that process of like finding medications. I just was desperate to find anything else that could help me so that I wouldn't need to rely on medication. And again, this isn't an anti medication, I am very pro medication. I'm a psychiatrist, this is my whole job. And it was so necessary for me in big portions of my life. I just feel like in order to get the best possible outcome, you need to do either a combination or at least focus pretty heavily on ways that you can sustain

yourself and optimize your brain so that medications have a chance to work. Like a compliment in a lot of different ways. When you talk about other practices or we use the phrase self-care, because I think self-care is one of these catch-all phrases that these days a lot of people roll their eyes at. They have all sorts of associations of new agey type of this and that. And when you talk about it specifically, how you distinguish between a lot of those associations and what you're actually talking about? I don't know when self-care got this luxurious, just absolutely self-indulgent name about it, because I think self-care is things that you need to do to take care of yourself. And so for me, self-care became more about how do I recognize my own internal

patterns? How do I start to take care of myself in ways that are like, how do I ensure that I have adequate hydration so that my neurotransmitters are firing when they should be? How do I make sure that if it's a chore to eat, that I eat and I'm making sure I'm getting the right nutritional value? How do I make sure that I'm exercising to some degree in a way that my body can tolerate and sustain because I hate it. Like, how am I going to do all of those things and focus on? I think a really important part of self-care is also learning how to educate the people around you because that helps me. That's self-care for me. It's how I broach my surrounding circle. So all of those,

I think people don't think about it as self-care, but that is self-care. You're taking care of yourself through those mechanisms. Yeah. That makes a lot of sense. And it's almost like reclaiming the phrase. It's like, it's been out in pop culture in a lot of different ways, but this is what it means, bare bones, just to like, how do we actually literally take care of ourselves that we're okay in the world, no matter what's going on with us. In your book, it's interesting, you break self-care into sort of like a series of different types of categories and offer a hundred plus different ways and kind of split into these different categories. ADHD is not something that is a part of my experience, but going through

like the different categories and going through different things, I'm like, these are just really good things to think about. No matter who you are, no matter how your brain is wired, no matter what your life looks like, these just make sense. with emotional self-care. And one of the things that you explore is managing intense emotions through gratitude, which I think is really interesting because that is not something that would immediately occur to me as like, oh, this is one thing that affects that, that could help me manage this. It's a wild sensation because I think when you, especially like in my own situation, when I'm stressed about something, I feel resentful, I feel angry, I feel isolated. Gratitude is like something that I was actively having to access and practice. But when you do that, you're inherently doing a couple of interesting things. Number one, you're pulling away from that negative focus and focusing on what is positive.

And in that, just that simple act of shifting your focus into something more positive, you're actually pulling yourself out of this deep hole that you're in and allowing your brain to kind of build up the steps towards the other. So it ensures that you're preventing yourself from falling too deep into this hole that's going to make it impossible to climb out of. And so I think that when you start to and so this is something that I'm actively trying to not only me, but like instill in my children that focus on you know, when everybody is like, count your blessings. And I like that phrase is stuck in my ears, but I don't think I ever did it. I think now,

as a parent, what I am trying to instill is when something difficult happens, try to focus on what is positive in your life around that, and then kind of utilize that to pull yourself up. Yeah, that makes a lot of sense when you sort of like string them together that way. Something else you talk about that I thought was interesting is poetry. Yeah. I'm a writer also, and I'm not a poet, but once every five years, maybe something channels through me that remotely resembles something that would feel like poetry. And I remember those moments because maybe it takes an hour for me to just really get it out of me, but the world doesn't exist when it's happening. And I write a lot of different things

and it's different. There's something different about it. And I'm curious, what was your experience with poetry and how you came to think, well, this is actually a really interesting potential form of self-care in this context? I love that question because no one ever asked about that. I feel like from a very young age, I kind of gravitated towards poetry. And I think it's because of exactly what you said. The world doesn't exist. I was using it almost as like a form of escape. And so I would use like, if I was in a difficult emotional situation, I wouldn't understand it at

the time. I'd be overstimulated. I'd be overwhelmed. And then maybe like two or three days later, I would go into my grandma's closet. And like there were all these blankets and I would write a poem in there. And so my parents were like totally aware of like this weird little quirk that I was doing. It was like, after little bits of like, and it wasn't even necessarily bad things happening. It would be like really great things happen. I remember writing a poem after like I had a third grade birthday and all of my friends came over and it was just so overstimulating that I started crying in the birthday party because it was so much. So it's stuff like that. I think that it is just a very powerful way of transmitting a lot of that emotional and chaotic energy into a safe,

serene spot on a page. And I think there is incredible healing value in that. Yeah. I mean, that makes a lot of sense to me. One of the other things that you talk about under this sort of bucket is also the notion of leaving the ADHD superpower rhetoric behind. And as I'm watching you, people who can't see the video right now, I just saw what you did with your eyes. That was a legitimate eye roll. So clearly this is a thing for you. Oh my God, I hate it so much. I think why I'm so averse to that trope is that number one, I've never experienced that. There's some things that I think my ADHD has helped me with, but overwhelmingly I would rather not have ADHD. That is just the hard and fast of it. I would just rather not

have it. I think my life would be easier. That being said, I value that people are trying to celebrate their brain and bring about, showcase the positive. There is value in that for sure. I just feel like when you move so far into this, like almost like delusional toxic positivity, that it's so marginalizing to the other people that struggle and actually squashes their, the validity of their claims. So like, I remember when I was hearing that for the first time and like when my dad and I were kind of re-exploring ADHD when I was in medical school, he was trying, he initially was the first culprit who was trying to like pull this on me. And I was like, no, man, we both know that's not true. And so I think that I remember telling him, when you tell me that, you make me feel like it's my fault for not being able to

harness this. And that, I think that's where it boils down to. This isn't a volitional thing. Like there are times where people can hyper fixate and hyper focus. And it's amazing. You can get a lot of work done. You can get a high quality of work done. You could do all of these incredible things in a time span that people couldn't dream of.

Is it the right stuff you're doing? I don't know. Is it stuff that can be replicated in're doing? I don't know. Is it stuff that can be replicated in the future? I don't know. It's just very erratic and it's hard to rely on that as a superpower. Yeah. And it's almost like you described, if you're telling everyone, well, it is, and your personal, your lived experiences for me, or at least at this moment, it is absolutely not, then you're effectively invalidating their experience, which is almost like a form, it almost becomes a form

of gaslighting in a weird way. It truly feels like that. And I have the same visceral reaction as I did when I was 19. It still bothers me. And I think I see that it's become so, so pushed on the internet as kind of like this thing where it's like, I've seen it on a shirt before. And I was like, Oh, my God, what? There are positives of ADHD. There are things that actually, I think are really incredible that ADHD you have. And there are certain successes of mine that I've had that are solely due to my ADHD,

but it's not a superpower at all, at all. I think there's things that you can enjoy and cultivate and work on and celebrate, but I don't think that's enough to hinge your entire lifestyle on. And I don't think it's enough so that you can say it as a blanket statement and kind of crush everybody else. No, that rings really true. One of the other buckets, you talk about physical self-care and you've kind of referenced some of what you've talked about, like the importance of sleep and the importance of hydration. Probably intuitive to a lot of people that what you put into your body is going to have

some sort of effect, especially if it's in any way related to your neurochemistry, caffeine, alcohol, sugar, these things are all going to affect you. Exercise. It's interesting because I've increasingly had conversations with people about exercise and its effect on anxiety, on depression. And there's some really fascinating research on it. But it sounds like exercise is an interesting intervention or self-care methodology for ADHD as well. So exercise, if you're thinking about it from just a basic fundamental thing, what is it doing? It's circulating oxygen to other parts of your body. You are utilizing your body to effectively pump and shoot things around. The reason this is so great for ADHD brains is that number one, from a actually utilizing and getting nutrients and things circulating up into your brain. Great exercise is great for that. Number two, if you're dealing with this hyperactivity and restlessness and impulsivity, using exercise to get out that excess energy can be a really effective tool at calming all of that down.

Number three, sleep. Sleep is such an issue for people with ADHD. We actually have people with ADHD have delayed melatonin onset. So their sleep, instead of sleeping, like feeling sleepy at 10, you feel sleepy at one and you're just kind of like forcing yourself to go to sleep early because you have stuff to do in the morning. And so I feel like exercise is a really useful tool in fatiguing your body and trying to shunt yourself into a more normal sleep schedule, normal for society sleep schedule. That makes so much sense. So another thing that you talked about, you actually

recently posted a video about this. I thought it was really fascinating, was an auditory experience, bilateral stimulation. I think it doesn't also have to be auditory because I've seen bilateral stimulation also used in terms of alternating body movements and stuff like that. That was kind of discovered, honestly, by accident. I heard an audio on social media or something like that. And I was like, oh, like, I feel like, calm and even and level. And I think that there is some therapeutic value in it. I don't know if people can just loop those all day long, which would be lovely. But I don't know if that's what people are actually doing. But I think that there is some intrinsic value and kind of recognizing, hey,

there's other sensory inputs that you can utilize and start to train your body on that you can use to your advantage. So for me, with some of those bilateral sounds where I was getting that kind of muscle relaxation and things like that, I feel like they're really helpful in times where I'm getting overstimulated and things like that. So people have always told me like, put on like a nice suit, like take a bath, listen to some soothing music, things like that. And I'm like, okay, but I think it was finding the right type of auditory sound, like something that truly did relax me instead of like finding a spa playlist on Spotify. Like there are sounds that actually can rewire and cause this neural slowness that causes you to calm down.

I've become a little bit fascinated with the world of ASMR. Whereas online, for those who don't know, it's basically, I can't remember what the letters stand for, but it's basically sensory stimulation through sound. And you can go on YouTube and see probably millions of videos where sure, there's people on video, but effectively what they're doing is just they're creating all these different sounds from brushing your hair with a close microphone to just tapping things and whispering. And when you talk to it, many people say that they listen to those and their body starts to tingle. They see auras. It has a profound physiological and psychological effect on them simply through a particular type of sonic sensation, auditory sensation. So clearly for certain people, it does something very real to the brain.

Yeah, I would agree. And I think that that's something that, again, as you start to recognize your patterns, that's something that you can, once you know that, you can start using it as a tool to kind of help self-soothe. You can use that as one of the tools for your self-care arsenal. And it's the fastest-charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X, available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary.

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Don't shoot him, we need him. Y'all need a pilot. Flight risk. One of the other buckets you talk about is mental self-care. There's kind of a distinction between emotional and mental. And I think a lot of the ideas that you offer here are along the lines of what we talked about self-compassion earlier. A lot of people have heard about breathing and therapy, of course. I would imagine things like guided relaxations

or meditation would probably fall under this bucket. And interestingly, and again, this is a little different. You talk about your own experience with art as really making a difference, which I thought, well, a lot of people wouldn't really look at art as self-care or as having a meaningful effect on the way that your brain is functioning at any given moment in time. But your experience is different. I think that for a huge proportion of my life, I would get in trouble so frequently for doodling and doing things like that. I mean, I don't think I've ever had a homework assignment or something that hasn't had some sort of doodling or accent art on it in some capacity. And I realized after a while that this doodling wasn't so much a sign of inattentiveness. I was using it as a form of like stimulating myself while I'm listening and while I'm trying to process something. So like if I was taking notes, I'm listening and trying to like do this at the same time as like a form. Eventually that kind of morphed into like

taking more meticulous notes and things like that. But I found that there was a certain calming mechanism that came with the doodling with things like that. And so when, again, kind of like with the music, as I found myself in situations where I would get overstimulated, and I think like, for me, the early days of being a parent were really, really overstimulating for me, I think it was really difficult to just with the sleep deprivation and things like that, that was really hard for me to figure out how to maneuver because now like my focus had completely shifted in from like taking care of myself to taking care of a baby. And so I, which you've seen both of them at this point. So I think that I had a hard time figuring out what is a way that I can kind of utilize and calm myself down, and potentially

do it in a way that I could instill that in my children and help them self-soothe that way. And so I rediscovered art that way where I really got into it again. And I was using it more like, this is a lot for me. Why don't we draw about it? Why don't we paint? Why don't we color? Why don't we do this? And it's been a really nice thing in our house.

I love that. As you're describing it too, I'm smiling because you're bringing me back to, there was literally never a notebook that I had where the entire border of the page wasn't filled with this sort of like different geometric patterns and doodles. And like I was starting the ads and work my way and work it. And every once in a while, a teacher would be walking around and catch me doing it. And they kind of like raise an eyebrow. And once or twice, I was probably told to stop also, like to pay, quote, pay attention. For me, that was what let me actually pay attention. Like there was something about it that let me just drop in and it wasn't actually distracting me.

It was allowing me to be there. And that was a huge lesson for me early on that to this day sustains. If I'm in a lecture or if I'm in a webinar or a workshop, and I can literally take out a physical notebook or a piece of paper and just start just doodling or doing anything on it, I drop in in a very different way. And it's helpful for me. It's actually doesn't detract at all. I would imagine a lot of people probably do that without realizing that there's a function to it, that it's actually helping them in some meaningful way. We should talk about that more. I mean, right after this podcast, I'm going to go and research

that. There has to be something. I wonder if people have studied that. Yeah, I wonder. Because I think that's something that for so long people have looked at as like, you need to pay attention, you need to stop. And I think maybe that's just like, for the longest time, it's just been a self-regulation tool. Yeah, I wouldn't be surprised at all. You talk about also social self-care, which I think is really interesting. And you explore things like community support. You mentioned earlier an awareness of interrupting and oversharing time with pets. I think a lot of people that would make sense. There's one other category that I do want to drop into, which is career or professional self-care. Because I think for a lot of adults, this is probably

where it gets dicey. This is because on the one hand, you want to take care of yourself, but you want to do it in a way where you feel like you're not going to be stigmatized or ostracized or labeled within the team setting or the office culture, whatever it may be. But you sort of offer the notion that a helpful act of self-care to disclose ADHD appropriately and ask for the accommodations that you need. And I think that part of this entire self-discovery process with ADHD and how to navigate that within a work or school place is understanding, number one, and starting with what you're comfortable with. Because if you're

at a spot where you're like, I don't know, man, I don't want to disclose this to my work, but I really need some help with this. You don't have to tell them that you have ADHD. You can do things like, I mean, it is covered as a disability. And if you wanted to go that road, it should be taken care of. And there's ways that you can make sure that and ensure that that's covered. But if you didn't want to, for whatever reason, whatever personal reason you had, or whatever workplace reason you had, you didn't want to disclose you had ADHD, but also plenty of like pretty nondescript accommodations that you could make, like,

for example, that could paint you in a good light that you're a hard worker, that you're here to kind of contribute to the team and you want to build an environment that's conducive to that. So an example that I give is if you're getting really overstimulated by a lot of people, or you're like, a lot of times people are like where they're sitting, like cubicles are like right in the middle. And there's just like a lot of stimulation and people passing by and interrupting them. You could say something like, you know, I find that being right in the center of the office is really difficult in that there's just a lot of interruption and it's hard for me to continue and keep up my workflow.

And I feel like I do my best work when I'm uninterrupted. So can I move away from the center of the floor or can I come in a little bit earlier and can I leave a little bit, you know, things like that. So if you're phrasing it in a way, like, this is how I can do my best work. I think bosses overwhelmingly are pretty receptive to it. And you're doing that without having to disclose. Yeah. I mean, that makes a lot of sense because you're positioning it as this is going to benefit both of us. So why wouldn't, at least give it a try? And if it's working, then it's working. In this context, in sort of like the work context, you also talk about other ideas around planning and building habits, delegating, which, and I think probably these

are the things that people start to try and do naturally like as, okay, so like these are the things I kind of have to do and that are really going to help and make a difference for me. There's also a reset in expectations that you sort of explore, which is certainly whether you experience ADHD or not, the prevalence of perfectionism, so many people have talked about it and how a really devastating effect. But then if you're holding yourselves to a standard of perfectionism that you feel like is being almost superimposed on you in a particular office culture or setting or team culture, I would imagine that just creates this compounding effect where it just makes things harder than they even really need to be.

Totally. I think that a lot of that stems from yourself creating that structure, right? If within you, you have the standard of work that you hold yourself to a certain standard, and you are unwilling to budge from that, well, there's a huge problem in that. Because if you're already struggling with productivity, you're going to potentially be dealing with some difficulty with completing and having that executive function to sustain a task. So I think that if you're, you know, what is that? What do people always say about perfection? Like the greatest enemy of, what is it? Now I'm blanking on what the phrase is. There's something and it's very profound.

Good is the enemy of great or something like that. Yeah, something like that. It's just like, you know, what I've told myself and what I've told my patients, if you're holding your standard to something being absolutely perfect, I think you're losing track of what the greater scheme of things should be. Like you want net progress. There's going to be ups, there's going to be downs. And with a neurodivergent brain, you're also working against like an architecture that wasn't built for your brain. So you're pushing against a lot of different constraints. And so at the end of the day, you might just be shooting yourself in the foot and the only

one you're impacting is you. So being able to kind of understand like, what's the end game here? If I want to get done with if my end goal is this, and there's 10 steps to there, maybe I just need to get done with the steps. And then that'll get me there. And obviously, our energy should be put towards making a great product and doing what we're supposed to be doing. But getting stuck in these obsessive, perfectionistic, and then subsequently shame spirals with it is just not productive. Yeah. And talking about architecture not being really what it is or what it needs to be for your brain, that really sort of like drops you into the final category of the practical self-care where a lot of it is like some of the ideas around creating routines, budgeting, planning, like lists as appropriate if it works for you, things like this. I mean, you have a whole bunch of recommendations there as well. And these are the things that were, again, I think a lot of people would probably start to do these things just because they almost feel like the low-hanging

fruit. Well, these are the kinds of things that I can start to do just to keep things straight because it helps me get through the day, but maybe also not realizing the effect that it has and maybe the way that it lets you kind of exhale a little bit along the way. So it's not just about being able to accomplish what you're being charged with accomplishing in a work context or a personal context, but maybe just giving yourself a little bit of grace and feeling a little bit better along the way too, which I think is just so important. At the end of the day, like if we zoom the lens out and the hundred plus ideas and the work that you do and your private practice and everything that you offer publicly, it really feels like so much of what you're doing is you're turning out to the

world and saying, hey, listen, your brain may be wired in a very particular way, which may have certain benefits, but also may make it really challenging in certain moments or entire seasons of your life. Anything you can do to bring a little bit more grace into the experience of each day, let's try and do that. And here are just a ton of different ideas. Try them on. I don't know what's going to work for you, but maybe some of these will help and you can put together your own practice and then just keep trying and running experiments over time. I mean, that's so much of what it feels like, the way that you're showing up and offering yourself and your ideas and your insight and your experience. At the end of the day, I think that's my hope. And finding that, you know, for some people that, you know, don't like having to go through information through a book form. I mean, that's kind of

why Focus Genie, that app was created so that people could access that information in a mobile app form and they could get those educational tidbits. They could work on productivity. So, I mean, I think as I just learn a lot from the community on social media. And it's been just like this eyeopening experience learning from that group of people and not only what their unique needs are, but what their unique like solutions are. I think it's, it's felt very collaborative. Yeah, no, that's super cool. So it feels like a good place for us to come full circle as well. So in this container of good life project, if I offer up the phrase to live a good life, what comes up? To live a good life is to serve others. I think that's probably my dad speaking

out of my mouth, but I feel like when my life has been really chaotic and difficult, and I've had a hard time managing my own internal environment, being able to step away out of that and kind of work on helping others or doing things, it's built me up as well. And it raises my self-esteem and it helps me feel more whole and it helps me. And with those experiences, I think it just helps keep society moving. So I think that's a good life. Thank you. Hey, before you leave, if you love this episode, safe bet you'll also love the conversation we had with Dr. Jill Bolte-Teller about whole brain living. You'll find a link to Jill's episode in the show notes.

This episode of Good Life Project was produced by executive producers, Lindsay Fox and me, Jonathan Fields, editing help by Alejandro Ramirez, Christopher Carter crafted our theme music and special thanks to Shelley Adele for her research on this episode. And of course, if you haven't already done so, please go ahead and follow Good Life Project in your favorite listening app. And if you found this conversation interesting or inspiring or valuable, and chances are you did since you're still listening here, would you do me a personal favor, a seven second favor and share it? Maybe on social or by text or by email, even just with one person. Just copy the link from the app you're using and tell those you know, those you love, those you want to help navigate this thing called life a little better so we can all do it better together with more ease and more joy. Tell them to listen. Then even

invite them to talk about what you've both discovered because when podcasts become conversations and conversations become action, that's how we all come alive together. Until next time, I'm Jonathan Fields, signing off for Good Life Project. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest charging Apple Watch, getting you eight hours of charge in just 15 minutes. The Apple Watch Series X, available for the first time in glossy jet black aluminum.

Compared to previous generations, iPhone Xs are later required. Charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were gonna be fun. January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're gonna die. Don't shoot him, we need him! Y'all need a pilot.

Flight Risk.