Science Vs - ADHD: Do We All Have It?

Episode Date: April 3, 2025

ADHD is all over the internet, with people saying that it’s way different than we thought it was — and that tons of us might have it without even knowing it. Influencers are telling us that ADHD can cause all sorts of things, like hyperfocused states, serious emotional dysregulation, even something called rejection sensitivity dysphoria. So — is all this true? Plus, when you do have ADHD — what’s going on inside your brain? And what are the best ways to cope with it? We talk to Prof. Maggie Sibley, Prof. Philip Shaw, and Dr. J. Russell Ramsay.  This episode does mention depression. Here are some crisis hotlines:  United States: US National Suicide Prevention Lifeline Dial 988 (Online chat available); US Crisis Text Line Text “HOME” to 741741 Australia: Lifeline 13 11 14 (Online chat available) Canada: Canadian Association for Suicide Prevention (See link for phone numbers listed by province) United Kingdom: Samaritans 116 123 (UK and ROI) Full list of international hotlines here  Find our transcript here: https://bit.ly/ScienceVsADHD  Chapters:  In this episode, we cover: (00:00) Is ADHD everywhere?? (02:45) How do you really know if you have ADHD? (09:05) Is hyperfocus legit? (12:50) What’s up with ADHD and emotional issues? (18:05) ADHD in women and people who menstruate (20:07) So do is ADHD really everywhere?  (21:34) ADHD in the brain (26:21) Meds, Therapy, Body Doubling?! This episode was produced by Rose Rimler, with help from Wendy Zukerman, along with Meryl Horn, Michelle Dang, and Ekedi Fausther-Keeys. We’re edited by Blythe Terrell. Mix and sound design by Bobby Lord. Fact checking by Erica Akiko Howard and Marlowe Starling. Music written by Peter Leonard, Emma Munger, So Wylie, Bumi Hidaka, and Bobby Lord.Thanks to all the researchers we spoke to for this episode, including Dr. Robert Rosenthal, Dr. Miguel Garcia Pimenta, Prof. Michelle Martel, Dr. Maedbhe King, Dr. Edward Modestino, Prof. Edmund Sonuga-Barke, and Dr. Ashley Halkett. Again, big special thanks to all the listeners who called in and told us about their ADHD experiences! Science Vs is a Spotify Studios Original. Listen for free on Spotify or wherever you get your podcasts. Follow us and tap the bell for episode notifications.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman and you're listening to Science Versus. Today we're pitting facts against focus as we look at ADHD. Lately, it seems like more and more people are saying, I've got ADHD. And if you're pondering your ADHD status, there are plenty of TikTok listicles out there to help you out. Top 10 signs of ADHD. Five things that are ADHD that I had no idea were ADHD. The six surprising signs that could be signs that you, too, have adult ADHD.

Six signs? Ten signs? According to the internet, ADHD goes way beyond those classic symptoms of having trouble paying attention or being fidgety. We're hearing that it includes stuff like... Hyperfocus. You get so engrossed that you sort of lose track of time. You might forget to eat or sleep or go to the bathroom. I have trouble regulating emotions. Mood swings 24-7.

Having ADHD feels like you're on an emotional rollercoaster. Either everything is great or everything is absolutely terrible. But some aren't so sure about all these new so-called ADHD symptoms. They're worried that this ballooning definition of ADHD is making a bunch of people think that they have this condition when they don't. There are all these headlines screaming that we're over-diagnosing ADHD, medicating people for ADHD when we shouldn't be. One British politician called it a fashionable disorder and said a lot of people who have it aren't actually sick at all. You hear this

kind of thing a lot. There's a lot of people who are self-diagnosing and I'm like, no, she's just late and she's a pain and when I arrange to have a coffee with her, she needs to turn up and not tell me, oh, it's my ADHD. No, you're late, mate. So today we're asking, when it comes to ADHD, what's real and what's just hype? We'll also find out what is going on in the ADHD brain. There's all these videos online saying that if you've got ADHD, you can blame your dopamine levels. But is that really true?

The cutting edge neuroscience on ADHD will give it to you. Plus, for people who have this condition, we'll find out some tips and tricks that can help you out. When it comes to ADHD, there's a lot of... No, you're late, mate. But then there's science. Science vs. ADHD is coming up just after the break. Join the high-volume trend with YSL Love Shine Plumping Lip Oil Gloss.

Formulated for maximized volume and 24-hour hydration, this gloss delivers a non-sticky, ultra-thin, glass-like additive texture in every shade, from bold berry reds and pinks to breathtaking nudes. Shine on with YSL Love Shine Plumping Lip Oil Gloss. Visit YSLBeauty.ca to elevate your lip game now. This episode is brought to you by FX's Dying for Sex on Disney+. Based on the podcast of the same name, Dying for Sex tells the story of Molly, who is diagnosed with stage 4 breast cancer. Determined to feel everything she can before

she can't feel anything, she decides to leave her unhappy marriage to explore her sexuality with some encouragement from her best friend, Nikki. FX is Dying for Sex, streaming April 4th only on Disney+. Sign up now at DisneyPlus.com. Welcome back. Today on the show, ADHD. Tell us all about it. It's Rose Rimler, senior producer here at Science Versus. Hi, Rose.

Hi, Wendy. Do you think you have ADHD? No, I don't think so. No. Do you ever suspect that? Oh, whether you have ADHD? Don't answer that. Not me personally, but I have had quite a few friends who have recently been diagnosed with ADHD. It definitely feels like it's everywhere right now.

Yeah, I talked about that idea, that it feels like it's everywhere right now with a professor and ADHD researcher. She's named Maggie Sibley. She's at the University of Washington. And she says there's a lot of reasons for this. One thing we talked about was these online quizzes about ADHD that have popped up. Oh yeah.

The worst for me are the ones that say things like, experiencing indecision, you might have ADHD. Having trouble keeping up at work, you might have ADHD. Come take this five minute quiz to see if you do. What'd you think when you saw that? Well, as somebody who has spent decades doing research, trying to show that you cannot diagnose ADHD with a five-minute quiz,

it definitely activated me a little bit. Yes, I've totally seen so many of these quizzes and been tempted to do them, but haven't. So what are the symptoms for sure of ADHD? Well, to find out, I thought you and I could take a brief quiz, actually. Roz! Which sounds bad, but really what I have for you is this is a valid science-backed questionnaire. It doesn't diagnose you with ADHD.

It's more of a checklist to see if you're at risk of having it. And this questionnaire has man's blessing. Uh-huh. And it basically maps onto the main symptoms of ADHD. Oh, okay. Great. So I'll send you the link. Wow. Here we go. Yeah, put an X if it's never, rarely, sometimes, often, or very often.

Okay. For all these symptoms. All right. So... often or very often for all these symptoms. Alright, so... How often do you have trouble wrapping up the final details of a project once the challenging parts have been done? Um... sometimes. How often do you have difficulty getting things in order when you have to do a task that requires organization?

I'm going to say sometimes. I'm going to say never. Almost to the point sometimes. I'm gonna say never. Almost to the point where I don't understand the question. Ha ha ha. How often do you have problems remembering appointments or obligations? Mmm, I never do. I would say never.

What about you? Rarely. I will often forget that I've arranged to meet with my mom. That one specifically? That one specifically. Let's not look too deeply into that. Thank you. Love you, mom.

How often do you feel overly active and compelled to do things like you were driven by a motor? How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly? What? Ha ha ha, just kidding. How often do you find yourself talking too much when you are in social situations?

When you're in a conversation, how often do you find yourself finishing the... Sentences of the people you're talking to? How often do you have difficulty waiting your turn in situations when turn-taking is required? Never. I don't like waiting in line, that's for sure. And do you have difficulty waiting your turn in situations when turn taking is required? Never. I don't like waiting in line, that's for sure. So Rose, how'd you do? How'd you do?

All right, okay. I'm ready. What'd you get, Wendy? Okay, I got five. Okay. What'd you get? I got two. Uh-huh.

So what does this mean? Well a few years ago, researchers gave this checklist to a sample from the US population, and they found that the average person got about a two. Oh! And five or more is like, maybe you should get evaluated for ADHD. Really?

Yeah, yeah. Whoa! That's so funny. Yeah, I mean, so if you get this higher score, that's when you would probably wanna go to the doctor and get checked out. But what we can see from this questionnaire is that the symptoms that we're looking for with ADHD,

it's still basically this classic picture that we probably have in our heads. So for some people, it's largely about having a hard time staying focused. For other people, it's largely about having a hard time staying focused. For other people, and especially when they're younger, it's more about being hyperactive. There are people who have both. These core symptoms, they really haven't changed recently.

Okay. Okay. It is stuff that a lot of us might experience from time to time. Yeah. But when doctors are trying to figure out if someone has ADHD or not, what matters is how severe it is. How much does it impair your life? Does it get in your way? Yeah.

So I said I, you know, I often have trouble waiting my turn. Right. And if you had so much trouble that you were like cutting in line at the pharmacy that the pharmacy banned you from the store, like that's the kind of, that's the kind of problem. Yeah, right. I just find it frustrating to wait. But you can, and you do. Yes.

Or thinking about that question about missing appointments, we all forget appointments now and then. But Nagi told me this example of a patient of hers that kept forgetting to pick her kid up from school over and over. That's a bigger problem, right? Yes. Yeah, that's a totally different level. And we actually asked listeners with ADHD to call in and tell us about their experiences.

And a lot of what they talked about was pretty hard stuff. This listener. Just trying so hard not to mess up and not trying to forget things or miss things. I've been fired from jobs because of it. It's impacted friendships. I forgot phone calls. I've lost fired from jobs because of it. It's impacted friendships. I forgot phone calls. I've lost important documents. I mean, it feels like it's trying to hold water in a strainer kind of situation.

Right. Okay. So then those are the kind of classic symptoms of ADHD still around. But then more and more, we're hearing people saying that their experience of ADHD still around, but then more and more we're hearing people saying that their experience of ADHD, it's manifesting in all of these different ways. Yeah. Like that they experience hyperfocus or that they can't control their emotions.

So what's going on here? Okay, so let's start with hyperfocus. So this is the idea that for some people with ADHD, when they are able to focus, they can do it really intensely, and they can work on something for hours and hours. People tell stories about forgetting to eat or go to the bathroom. Do you know, I... this is something I absolutely relate to. You know, I thought of you, actually. Because I remember back when we worked in the office together, you would just like power

through, like for hours. It was crazy. I would have never thought of this as a symptom, though. I love it. I love this part of my personality. Yeah, a lot of people who experience hyperfocus say they really like it. Some people who called in said that this is their superpower. Like, one listener told us that when they're in this hyper-focused state,

they can do something in a few hours that it would take other people days to do. It's sort of funny because it feels so counterintuitive to the other symptoms of ADHD, that you're fidgety and you can't pay attention, but then you can pay attention on one particular task that you've been sucked into. Yeah, exactly. It seems like a paradox. The going hypothesis that I've been hearing from scientists is that maybe what's going on with ADHD is they have problems with the control of their attention. So not just like problems with attention,

but problems with how to control it. So to Maggie, it wouldn't be a paradox at all. It does make intuitive sense that if ADHD is a disorder of dysregulated attention, you're going to experience both sides of that coin. So the distract ability, you know, it means that you're unable to focus on something usually that's not holding your interest. And then the other side of that coin is that you can focus well when things are holding your interest

So the same thing that makes it hard for someone to stay on task Might make it hard for them to move on to other things that should be now taking their attention Like, you know, I was saying earlier people forget to go to the bathroom. You should be aware like I have a full bladder I should go to the bathroom. Ah Do you oh my god God. Oh my God, Rose. Yeah. Oh my God. Are you having yet another Ratatouille moment?

Yes. I just had this memory of when I was at uni and I was studying in the library and I really wanted to finish studying. And I paid myself. Ah! I paid, yeah. I just really wanted to finish it and it was the upstairs library, like you had to go down a bunch of stairs to get to the toilet

and I was like, I just really wanted to finish it. I paid myself. Oh my God. I know, I know. You know, it makes me think that some people do say that hyperfocus is a problem. It's not necessarily a superpower. It can mean that you get way too focused on the wrong thing or at the wrong time. So, is this really an ADHD thing?

Well, it's not in the DSM, which is, you know, the psychological Bible. It's not. Yeah, it's not part of the diagnosis of ADHD. So officially no, but there has been a little bit of research on this, and it has given us some clues. We have a couple studies that have found that people who score higher on that questionnaire that we just took, they were more likely to experience hyperfocus.

Right. So, what do you make of it? Like, that's not the strongest evidence that this is definitely part of ADHD. No, but it just, it really hasn't been studied very much at all. So right now it seems like it's plausible that people with ADHD experience a state of hyperfocus more often and maybe differently than people without ADHD. We just don't have a lot of research one way or the other on it. That's interesting. All right, so the next one can we look at is the emotional stuff that people were talking about, that it's really hard to control your emotions when you have ADHD.

This is something I had never really associated with ADHD before. Yeah, it doesn't sound like it has anything to do with that profile we were talking about earlier, like the typical ADHD set of symptoms, which are all about, you know, attention and focus. But a lot of people are sharing stories about being emotionally overwhelmed, dysregulated, very reactive, very sensitive. Here's one listener who called in. That Pixar Disney movie Inside Out, imagine if all the emotions took steroids. That's basically what I experienced.

I have extreme highs, extreme lows. I don't like to admit this, but I often freak out or just kind of have meltdowns over small things when I end up feeling a little dumb, just because I'm like, why did I overreact so much? So is this a part of ADHD or something else? This is tricky. I looked into it.

It's like it's almost in the diagnosis. The DSM does say that low frustration tolerance, irritability, and moodlability, that's basically moodiness. It says that all of those are associated with ADHD. And there is a study that found that people who scored higher on that test that we just took, they also scored higher on a test that measures emotional dysregulation, which suggests there might be some connection here. Do we know why?

I talked about this with Maggie and other scientists, and they think it might be tied to impulsivity, which we know is common in people with ADHD. We know that some people with ADHD. So we know that some people with ADHD have trouble regulating their behavior. Maybe this also applies to emotions, like they could have a tough time regulating emotions like they have a tough time regulating behavior. So it's not the emotions themselves that are unstable, but your cognitive ability to put

the brakes on the emotion, maybe? Mm-hmm. Okay. Right. But some people are taking this a step further, and they're saying that people with ADHD have this particular emotional problem where they are really sensitive to criticism. Like, their mood totally plummets if they feel like they're being rejected or criticized. And some doctors have even named this. They call it rejection sensitivity dysphoria. This is an idea that the internet has really caught hold of. But I looked into it, there's hardly any evidence for it.

There's really just one paper, which is about four patients. And when I talk to academics about this rejection sensitivity thing or the emotional dysregulation thing. They said it might be a part of ADHD, but for some people, something different might explain what's going on. So maybe they have ADHD, but they also have another condition on top of that. That's very common. We know a lot of people with ADHD also have

a mental health diagnosis or they're neurodivergent in some other way like they have autism. Studies pin it at at least 60 percent of people who have ADHD have another diagnosis. And anxiety and depression are some of the most common ones, which could also be associated with being really sensitive to being criticized or perceived rejection. And so what's the concern here? to being criticized or perceived rejection. Mm-hmm. And so what's the concern here?

I guess the problem would be that if you're putting all of these new symptoms into an ADHD bucket, emotional dysregularity, trouble with rejection, and you start saying, oh, everything's ADHD, and then you could miss a diagnosis of depression or anxiety, is that the fear? Pretty much, and the point of getting a diagnosis of depression or anxiety? Is that the fear? Pretty much. The point of getting a diagnosis, ideally, is to get treatment and help for what's wrong.

If you get the wrong diagnosis, you might get the wrong treatment. It's important to get the right diagnosis. Maggie gave me an example of this. She told me about a teenager that she was evaluating. This kid had got referred to her by a school because he had a lot of problems paying attention in class. But as Maggie was talking. This kid had got referred to her by a school because he had a lot of problems paying attention in class.

But as Maggie was talking to this kid, she realized there was other stuff going on here. — You know, he grew up in a neighborhood with a lot of violence and he had a lot of home instability. And as you like just unpeeled the layers of everything this boy had experienced in his life, and you open the DSM to the PTSD criteria, and you understand a little bit about how that can also

manifest, and you also ask questions about that. And you see that that story just fits this kid. Maggie said that trauma can affect how your brain works and affect your coping skills in a way that can affect how you pay attention. And she realized that that was explaining his symptoms. So she diagnosed him with post-traumatic stress disorder. I didn't give him an ADHD diagnosis,

even though at a quick glance somebody definitely would have. And that matters because you don't treat PTSD the same way you treat ADHD. So you don't just give someone stimulants to help them process their trauma, right? Right. Uh-huh. So what do you think? Do you think emotional dysregulation is part of ADHD?

I don't know. It could be. But I think the takeaway is that if you really struggle with this, don't assume it's just your ADHD. Something else could be going on for you. That makes sense. There's another thing that's all over the internet that's worth talking about.

It's this idea that women and girls aren't getting diagnosed properly. Yes, saying a lot on this. They get missed as children. And they only figure out that they have ADHD if they ever do much later in life as adults. And this does seem to be true to some extent. So data from the CDC found that 61% of women with ADHD were diagnosed as adults compared to 40% of men. Okay. Do we know why?

So one hypothesis to explain this is maybe girls hide, push down their symptoms in order to fit in socially because there's a lot of pressure to do that. That's also a possible explanation for why autism is diagnosed later in life in females. We also know that women with ADHD are more likely to get diagnosed with depression and anxiety than men are. And so maybe they're getting treated for that, and then their ADHD gets missed. [♪ music playing, sound effects of a radio playing in background.

Rose, while we're on this topic of how vaginas and penises experience ADHD, I have seen stuff about how periods can affect ADHD. Have you looked into this? Yeah, we're just starting to get some research on this. It looks like ADHD symptoms might actually fluctuate throughout the course of your cycle if you get a menstrual cycle. So there's one study that found that mid-cycle, people's impulsivity symptoms

seemed to get worse, and at the end of their cycle they got sadder and they were less able to cope with stuff. And we also have research that found that women with ADHD suffer more postpartum and during perimenopause. So there might be something going on with estrogen levels changing in the brain, combined with ADHD in the brain, that's basically like a double whammy. That's actually how some of these researchers put it. Okay, so that's really news you can use. If you menstruate and you have ADHD, that's something to be aware of. Your symptoms really might be fluctuating.

And Wendy, just to cap off this part of the episode, we started out by saying, gee, doesn't it feel like ADHD is everywhere? really might be fluctuating. And Wendy, just to cap off this part of the episode, we started out by saying, gee, doesn't it feel like ADHD is everywhere? And it does. I have some stats I have not yet told you, and yeah, I have kind of a reveal here. It's really not that wild. It's not everywhere. Oh. So if you look at about 20 years ago, in 2003, the CDC put out data finding that among adults, 4.4% of

people said they'd been diagnosed with ADHD. Okay, so 20 years ago, 4.4% had ADHD. Fast forward to 2023, that number had gone up to 6%. Wow! Oh, it's not that. It really feels like it's gone from 1% to like 50%. Right. But, you know, when you look at some friendship groups. But it's not that extreme. It's really not.

It's not that extreme. It has been going up, but that could easily be explained by more awareness from both doctors and patients. Yeah. After the break, what is an ADHD brain? Yep, it's your brain on ADHD and what you can do about it. Welcome back to the show. Rose is telling us all about the science of ADHD. Hey, Wendy. So I'm ready to talk to you about ADHD in the brain.

Yeah. Tell me about dopamine. What's it doing? Yeah. I mean, that's what you hear online, that ADHD is caused by a dopamine deficiency. And this comes from the fact that dopamine is a chemical in the brain that helps us pay attention and feel motivated to do things. And we know that stimulants like Adderall work by increasing the availability of dopamine and other neurotransmitters in the brain.

Okay, so ADHD brain, dopamine is out of whack? No, not so fast. Wendy, there's more here. Scientists are pretty sure now. There's a lot more going on. Oh, if it was as simple as dopamine, we'd probably have figured it out by now. I talked about this with Philip Shaw. He's a professor of developmental psychiatry at the King's-Modsley Partnership. You know, it really is so incredibly complicated. It's breathtaking. Like, it's magnificent and it's a challenge.

Like, I think there's no way it's all just one big thing. Wow. Philip's like dopamine, more like nopamine. The British don't talk like that, but yes. Um... Isn't he Irish? Yeah, but my point still stands. So there are other things going on in the brain that could help explain ADHD. And Philip and I talked about some of his favorite explanations.

Yeah, there's two that I'm particularly taken by. Tell me about this dalliance with two other theories around the ADHD brain. So the first one has to do with the default mode network. Have you heard of this? I have. I think you have. It's come up before.

Yes, it's the part of your brain when you are sort of day dreaming, when you're not particularly thinking about a thing, but it's just like what's going on in there on the default. Exactly. Just the mind drifting, that sort of feeling, you know? If you're a bit bored, you know, probably after I go on for five minutes, everyone's brain will be in this state. He's being modest.

He's actually very interesting. Mm-hmm. Right? Reminds to be sane. So if your mind is drifting, the default mode network is activated. We can see this in a brain scanner. But if you start thinking about something, like you start making dinner plans in your head or thinking like, oh, I better sit down and do my taxes next week or whatever,

other areas of the brain light up. And in response, the default mode network kind of simmers down. But what we see in people with ADHD, when researchers have gotten them into these scanners, is that the daydreaming network doesn't always simmer down when they're thinking about something else. It might kind of intrude. So every so often, the individual is doing something,

and then the offline brain pops up and turns it off when it shouldn't do. So there's an imbalance between the offline and the online brain. Oh, that's so interesting. And that could totally help explain why it's hard to focus, right? Yeah.

There's another explanation that has to do with another network in the brain. Okay. So basically there are these pathways where different parts of the brain talk to one another. There are these fantastic information processing loops in the brain. They go deep in the brain, and then they go to the surface of the brain, the cortex, and then they go back.

These information processing loops are what controls attention, cognition, everything. Some of these loops are really important for what's called executive function, which can help us decide what we pay attention to. And in ADHD, the thought is that they're a bit disrupted, that the flow of information sometimes goes a bit awry. And so how do all of these different ideas, the dopamine brain looping default mode network, are they all happening at once in an ADHD brain? So no, not necessarily. What scientists are starting to figure out is that there are probably a bunch of different kinds

of ADHD caused by a bunch of different brain changes. Gosh, just meet 100 people with ADHD after meeting them. You're not going to think they've all got the same thing going on. It's just not like that. Philip says that some of his colleagues are actually calling it ADHDs, not ADHD. So maybe for some people, dopamine is the main issue. For someone else, the imbalance with the default mode network is the main issue. For someone else, it's these loops that are important for executive function.

Or there could be some combination of these things. And by the way, we should say that while these brain changes are meaningful, they're also small. It's a slight shift in how the brain functions or talks to itself or is connected. Okay, so now can we look at treatments? What can people do if they're really struggling? Yeah, so as we've said in a previous episode,

stimulants help lots of people. So there was a trial of about 400 adults with ADHD gave them Adderall. And they found that 65% of people given Adderall got better. That's compared to 20% of people who took the placebo. So that's why stimulants are kind of the first line medication for people. Yeah.

But obviously that's not everybody. Not everybody got better. And not everybody wants to take them or can take them or can get them, right? There's been a shortage. Yeah, there's also side effects, right? They can mess with your sleep. Yeah, they can mess with your sleep, your appetite. So there are non-stimulant medications that are also fairly effective,

but there's a lot of other things you can try. I mean, online, you hear all these tips and tricks. Everything from body doubling to changing your diet. What is body doubling? It sounds so sci-fi, we'll get to it. I'm gonna leave you in suspense, but I called up a psychologist named Russell Ramsey to talk about this. And he does therapy for adults with ADHD.

And he's like, a lot of his patients come in and they're like, I don't really know how therapy is going to help me, especially with my main problem in life, which is like not getting stuff done that I need to get done, procrastination. They'll say, I know what I need to do, but I just don't do it. So what good is talking with you about it gonna do me? Or that I haven't read already. And my answer to that is,

I think I'm pretty good at helping people understand how they don't do things. Not just, oh, you procrastinated again, try harder next time, not to procrastinate. So that's a lot of what Russ and I talked about. How to help a person with ADHD get motivated and avoid something called procrastivity. Can you guess what that means, Wendy? Sounds sexual.

Are you thinking of the prostate perhaps? I was thinking of like procreation. Oh no, here's how he defines procrastivity. Procrastivity. Procrastivity is avoiding a higher priority, more important task by doing some lower priority task, a chore or whatnot, but that is self-defeating because then the more important task doesn't get done.

So he gave me this example. There is a patient of his who at the time was a graduate student working at a lab. And she had to present a paper to her lab group the next week. Yeah. And so she knew that like this is going to be a drag and she talked about it in advance in therapy with Russ. I think that day or like the day before we said, okay, so how are you going to do this? She said, I got a long day in lab. I'm going to come home. I have the article.

I just need to read through it, do a couple slides. It doesn't have to be anything big. And if I do it right away when I get home, I'm good for the next day. So some time passes, she comes back for her next session. Russ follows up and he asks, so how did it go? Did you read the paper and make the presentation? And she said, you know what? I got home and I thought about doing it.

But my first thought then was, I'm going to bake a cake. No! She didn't know why she liked then was, I'm going to bake a cake. No! She didn't know why she liked cooking shows. I'm going to bake a cake. Don't do it! Read the article! She didn't read the article. She baked a cake. And then she said, and I'm diabetic. I can't eat the cake. I want to make it.

I knew it. But it wasn't like I had a neighbor to give it to or a nephew. I wanted to do it. But it makes no sense that I did that instead of, and probably took longer doing that. OK. Classic proctivity. Procrastivity. Yeah. OK.

So how does Russell get his patients to read the science report? So one thing Russ has noticed is that a lot of people are opting for a task that's sort of broken into steps, like baking the cake, there's a recipe, so it's like do this, then this, then this. And so he has found it can be really helpful for his patients to break their tasks down into kind of a recipe. And he likes to use what he calls if-then statements. So like for the cake baking scientist, he told her like, okay, so next time, tell yourself if I can sit down at my computer

when I get home from work, then I can open the document. If I can open the document, then I can read the abstract. Wow. If I can read the abstract, then I can- Real little instructions one by one. Yes. It's like the first step is like, that wasn't so bad, maybe I can do the next step.

That wasn't so bad, maybe I can do the next thing. Before you know it, you're actually doing it. He also asked his patients to remind themselves of the bigger picture. Why am I doing this annoying task? How does it matter for my life or the goals you want to accomplish? And he finds this is helpful for his patients.

Yeah, he does. So Russ practices a form of therapy that's called CBT. And there are studies on CBT for people with ADHD that find that it can really help. A lot of these studies are looking at CBT plus medication. And so it seems like what works fastest is CBT with medication. People improve the fastest with that combination. OK.

But for some people, CBT on its own maybe could work. So we have one study that found that they eventually caught up to the people who were also taking meds. Wow. That's impressive. Yeah, I mean there is a caveat here. So very recently there was this big meta-analysis of treatments for ADHD and when it came to CBT they said that mostly these results were shown in

clinician reported ratings, so like your doctor says my patient's getting better or not, and it didn't really show up for self-reported ratings. So people were saying like I'm not doing that much better on average, people in CBT. So like the positive results are mostly coming from the doctors saying this is working for my patient. So that's interesting. Get that cake baker into the studio. Let's ask her how she feels. I mean maybe people are improving in their coping skills, but this doesn't That's interesting. Get that cake baker into the studio. Let's ask her how she feels. I mean, maybe people are improving in their coping skills, but this doesn't show up when asked about their core symptoms.

Or maybe the improvement is subtle enough that the people themselves aren't noticing it as much as, like, an outside observer might be noticing it. So let's just say right now you procrastinate four times out of five. And if we can get that four times out of five. And if we can get that to three out of five, you're still procrastinating. But if we invented a medication with those results, we're billionaires. Most people will get better.

You know, some people not as better as they would have hoped to have been. OK, so therapy, medication, some things that can help. What else we got? Well, I promised you I would tell you what the hell body doubling is. Oh yeah! It sounds so weird. It just means having someone else there with you, even virtually. And so what is this person supposed to be doing?

Well, they might... So let's say you are working on... You're a student, you're working on your homework. Having a friend in the room is also working on their homework. It's kind of like keeping you accountable. Okay. But Russ was like, yeah, yeah, sure. That is something I would view as credible.

Now has there been a randomized controlled design saying, hey, we tried this and not? No, but this is one of these, if you will, common sensical that it can help anybody. I think it's probably the basis of personal training at a gym. Oh, I should be able to walk in here and do all the machines. But if Lars over here tells me to get on the treadmill, I do. I love that you use Lars. That's such a personal trainer name. I don't know why. Yeah. Yeah, it just sounds like one. It totally does.

Yeah. Another thing people talk about a lot online is listening to music or white noise. And there are some studies that get people with ADHD to do a task while listening to white noise or music and find that people do better when they have this sort of noise. Oh, that's cool. All right, on to diets and supplements. People love to offer these. Yeah, so people have looked into this somewhat,

mostly in kids. Stuff like taking vitamins and minerals, omega-3s, omega-6s. But it's pretty iffy. Just a couple years ago, there was a big Cochrane review that kind of just poured cold water on the omega supplements, helping kids with ADHD. And I didn't find anything in adults

that would convince me that there are any supplements to take or diets to try or foods to avoid or eat to improve your ADHD. So watch out for those influences online promising the world. Seems like really right now the best supported stuff to try, medicine, therapy, those are the best tools that we have for treating ADHD. And then some of this other stuff, body doubling, listening to white noise or to music, there's no, there's not really any harm to trying that. So if it works for you, that's great.

All right, Rose, we've come to the end of our ADHD episode. Yeah. Hopefully, listeners are able to focus for long enough to get to here. come to the end of our ADHD episode. Yeah, hopefully. Listen, it's Rebels of Focus for long enough to get to here. If you tuned out for a hot minute or two, let me sum up. All right, so when it comes to the symptoms of ADHD, while perhaps ADHD might manifest in emotional stuff or hyper-focus,

we're still kind of working that out, but based on those two symptoms alone, do not be diagnosing yourself with ADHD. The main symptoms are still having difficulty focusing and also being a little bit hyperactive. The ADHD brain is complicated. It's not just dopamine, but it is also a little bit dopamine. And if you are looking for treatments, there's no magic diet or supplement, you can go on. But medication and therapy might help. Yeah.

How'd I do? That sounds good. You might need a little help. You could enlist a really hot muscular guy named Lars to work on this with you. And if you choose to do that, you have our blessing here at Science Versus. Thanks, Rose. Thanks, Wendy.

And Rose, Rose, Rose, Rose, Rose, let's go. I'm still here. How many citations are in this week's episode? 61 this week. 61, and if people want to see them in all of their glory, where should they go? They can click the link to the transcript, and that link is in our show notes. That's right. So if you want to read more about any of the studies that Rose told us about,

just head to the show notes. Also, if you want to come say hello and let us know what you thought about this episode, we are on Instagram, science underscore VS. I am on TikTok at Wendy Zuckerman. Yeah, and I just wanted to call out here. We had so many listeners call in, leave voicemails, send us voice memos, email, comment on Instagram, and tell us about their experiences with ADHD.

And I listened to every one of those voice memos and read all those comments. So even if you didn't hear yourself in the episode, it was really important for me to hear from everybody. And I thank everyone for sending all that stuff in. It was super helpful. Yeah, thank you so much. We do love, love, love, love hearing from you.

Also, as a little thing, Emma Munger, who used to sound engineer our show, has a new album out. Did you know this, Rose? No, I didn't know that. She doesn't just score podcasts. She also makes beautiful, beautiful music. And I was listening to the album last night. It's really lovely. So you can find her on Spotify. The album is called Patten. Her name is Emma Munger. It's M-U-N-G-E-R.

Because not M-U-N-G-A. Because you're right. No. No. Thanks, Rose. Thanks, Wendy. This episode was produced by Rose Rivler with help from me, Wendy Zuckerman, along with Meryl Horn, Michelle Dang and Kenny Foster-Keys.

We're edited by Blythe Turrell, mix and sound designed by Bobby Lord, fact checking by Erica Akiko Howard and Marlo Starling, music written by Peter Leonard, Emma Munger, So Wiley, Bumi Hidaka and Bobby Lord. Thanks to all of the researchers that we spoke to for this episode, including Dr. Robert Rosenthal, Dr. Miguel Garcia Pimenta, Professor Michelle Martel, Dr. Maeve King, Dr. Edward Modestino, Professor Edmund Senaga-Bark and Dr. Ashley Hawket. Again, a huge thanks to all of our listeners who called in

and told us about your ADHD experience. Thank you. Science Versus is a Spotify Studios original. Listen to us for free on Spotify or wherever you get your podcasts. And if you want to know when new episodes come out, if you're listening on Spotify, you can follow us and tap the bell icon. I'm Wendy Zuckerman.

Back to you next time.