Stuff You Should Know - ADHD pt 1

Episode Date: November 5, 2024

Today, Josh and Chuck dive into part one of their two-part suite on ADHD.See omnystudio.com/listener for privacy information.

From the Scopes Monkey Trial to O.J. Simpson, trials have always made us reflect on the world we live in. I'm Mira Hayward, and my podcast, History on Trial, will explore fascinating trials from American history. Join me in revealing the true story behind the headlines, and discover how the legal battles of the past have shaped our present? Listen and subscribe to History on Trial, now on the iHeart Radio app, Apple podcasts, or wherever you listen to your favorite shows. Hey everybody, in today's episode and in part two, we talk very frankly about ADHD and all that that means over the lifetime of a person who has it. So, if you're a parent with a kiddo who has ADHD, maybe consider listening by yourself first before you share it with them. Just a thought. Hope you enjoy these episodes.

Welcome to Stuff You Should Know, a production of iHeartRadio. Hey and welcome to the podcast. I'm Josh Clark and there's Charles W. Chuck Bryant and there's Jerry Jerome Rowland. You put the three of us together and you got yourself a podcast called Stuff You Should Know. That's right. And this is the sort of long simmering. We've had it on the back burner down to as low as it can simmer for many, many months.

The ADHD, what is now gonna be a two-part episode because we've had, I mean, that's not why we're splitting it up, but we have had a lot of requests for this over the years. And it's big. There could certainly be more than two episodes. And as much as I wanted to try and split this up into AD and HD for fun, it just kind of doesn't work that way.

So we're just gonna split it up into two parts. I think you're more thinking of ACDC. Oh, okay. That's what I think it is. I gotcha. No, Chuck, instead today we're talking about ADHD, which stands for Attention Deficit Hyperactivity Disorder. Kind of wordy, but it really does get the point across because with ADHD, I'm

sure a lot of people are familiar with it, especially the people who requested it, it's a, I'm not exactly sure exactly what kind of disorder it is, whether it's a mental disorder, a personality disorder, an externalizing disorder, there's actually a lot of debate about it. But essentially, it's where people have a lot of trouble paying attention, sitting still, focusing, and a bunch of other stuff that we'll talk about.

And you put it all together and it can make life kinda hard to navigate. And at first, we'll talk about it a lot more, but kids, it used to be like little boys fidgeting essentially was what ADHD or ADD at the time was considered. But over time, it's really kind of expanded. We've realized way more girls have it than we thought before.

And we've also come to realize that adults have it too. And that's a, I mean, it's a really big, huge disorder and a lot of people just kind of use it as shorthand, like, you know, oh, I forgot my keys, it's my ADHD or something like that. But the more you know about it, the more you realize it's a genuinely debilitating disorder that people have.

Yeah, and sometimes you may lose your keys. It's true, that is a big part of it. I mean, they're not wrong about that one. For sure. So, you know, when it comes to something like this that is only in, I mean, honestly, in the last like 25-ish years, really come more into focus

as far as our understanding of it. When you look back through medical and, you know, psychiatric literature, you're gonna see it pop up. They just didn't know what it was at the time. And in this case, you can probably go back all the way to the 18th century with a Scottish physician named Sir Alexander Crichton, who in his 1789 book

talked about children who were unable to focus on one thing at a time. And it's one of those clear cases, kind of like, oh, well, it was probably somebody with ADHD. It is not just a modern condition because kids eat too much sugar and they have screens in their lives. Screens can, we'll talk about that,

it can certainly make things worse. But it's not like, oh, because people are so busy and there's too many distractions these days. And back in the olden times, when there were no distractions, people didn't suffer from something like this. It's just not true when you hear about some of these old descriptions. Yeah, no, not at all. And our understanding of it has progressed like over the centuries. But it is interesting that it started in the 18th century, because I mean, Crichton nailed it on the head. Like, he's like, there's definitely something here.

And I guess it just kind of stayed there for a little while until 1902, when a pediatrician from the UK named Sir George Frederick Still. Ironically. Yeah, I thought that too. He described children who had a defect of moral control, which is essentially saying that these are kids who have trouble

delaying gratification, not thinking about negative consequences when they carry out actions. And that's impulsivity. That's what we call it today is impulsivity. And that's what Still was essentially describing at the time. Yeah, in the 30s, some more descriptors came along from the courtesy of some German physicians named Franz Kramer and Hans Polno.

In this case, talking about more of the hyperactivity side of things. And then about five years after that, still in the 1930s, in 1937, a big, I guess, breakthrough came along when a doctor for the Rhode Island facility for children with neurological problems named Charles Bradley was doing an experiment where he was doing an imaging test on the brain.

And specifically in this case with kids, he was draining some fluid around the brain, rather, gave the kids headaches. He treated them with benzadrine, which is an amphetamine, and what he found out was, wow, this doesn't seem to make any intuitive sense, but giving these children amphetamines is, or at least for about half of them, made them less fidgety and more focused,

and all of a sudden you are onto a pharmaceutical, potential pharmaceutical treatment. Yeah, I mean, what a way to accidentally stumble into that less fidgety and more focused and all of a sudden you are onto a pharmaceutical, potential pharmaceutical treatment. Yeah. I mean, what a way to accidentally stumble into that because even today we're not exactly sure how stimulants like take care of ADHD symptoms. We just know they really, really work. Luckily, this doctor was like, quit complaining, take some benzadrine and shut up little kids.

And back then the kids obeyed. So there was a, so that was actually kind of a diversion. 1937, when, when Charles Bradley discovered this, that amphetamines treat ADHD, um, it didn't like take off like wildfire because there was an interim period between then and like the fifties where psychiatrists and psychologists were like all this stuff needs to be talked out through psychoanalysis That's how you treat, you know mental disorders and in the 50s Finally people were like no, let's let's start prescribing drugs and one of the first companies was Siba Geige Pharmaceutical company. Yeah, I mean you're definitely gonna go out of business if that's the name of your pharmaceutical company? Yeah. I mean, you're definitely gonna go out of business

if that's the name of your pharmaceutical company, but they're the first ones who developed Ritalin, and it turns out that the guy who developed the drug, Leandro Panazzoni, Panazone? His wife was named Rita, and he named it after her. That's right. Lovely Rita. So it was the first half of the 20th century

when things started to change, you know, not, I guess I could say begin in earnest as far as researching this kind of thing. A lot of like research into brain injuries were happening at the time and they thought that, well, hey, this is what's going on. With any kind of developmental issue, it's almost certainly a brain injury. That can be the case for sure with all kinds of developmental issues, including ADHD in this case. But in the 1960s, that started to go out of favor a little bit, and they started to realize that, hey, a lot of this stuff, there are a lot of actually distinct conditions and you can't just lump them all in there and say it's because a kid hit his head when they were young. No. So in the late 60s, the DSM-2, the sequel, introduced a diagnosis called hyperkinetic

reaction of childhood. And it's essentially ADHD that they were talking about. And this is the first time it showed up in psychiatry. It's like, this is actually a thing. We just aren't clear what to name it yet clearly, because we're calling it hyperkinetic reaction of childhood. And within a decade and a half, we finally had it nailed down to attention deficit disorder, ADD, which people of our age, that was what the name we were first

exposed to it as. It was not ADHD, this newfangled version. It was ADD and that's the way it was and you liked it. Right. That's right. ADD had a couple of subtypes depending on whether there was hyperactivity involved, but it wasn't like a part of the actual definition at this point. I think seven years later, it finally landed upon,

I guess this would be 1987, I was but a junior, I'm sorry, a sophomore in high school. I was 11. Oh, you were just a cute little 11 year old. How was, well, I didn't get pimples, luckily, but a would-be pimply-faced teenager when ADHD finally rolls through the door. And I think if you had no hyperactivity attached

at that time, it was called undifferentiated ADD. Right. Am I saying all this right? I think so. Yeah, yeah, you totally are. And then in the 90s, another big breakthrough came through when they found out, hey, there's a genetic component to all this, and there

are actually a lot of adults that have this. We thought kids just grew out of this kind of thing, but now adults are saying, like when they're diagnosing, like Gen Xers basically diagnosing their kids, they're saying, wait a minute, that sounds a lot like me. Maybe I have it, and oh my goodness, I do do and that may be also why my kid has it. Yeah. One of the reasons why they used to think it was just a childhood disorder that you grew out of was because the first batch of kids with ADHD or ADD, they weren't

followed into adulthood, they stopped studying them after they were kids. So they just didn't think about it. And then also, and this is really sad if you think about this, as an adult as you grow up you get so good at masking your symptoms in order to blend into society that researchers were unaware that there was a whole group of people with a disorder that was just unrecognized because they were good at disguising it, which is a huge part of ADHD. And it turns out just being neurodiverse in general.

Yeah, for sure. And we'll get to masking more in a little bit. But another revision in 94 in the DSM finally divided ADHD up into three types, the inotentive type, hyperactive impulsive type, and then the combined type, which is both. Yeah, and that's where we are today, right? That's where we are today, but you know, the more we learn, I feel like every 10 years that there's another change, so who knows where it's gonna stop.

Yeah, they're just gonna keep adding letters. Maybe. So I say we take a break and come back and talk about how this whole thing kind of works in the brain as far as we know. Let's do it. In July 1881, a man walked into a train station, pulled out a gun, and shot the president of the United States. James Garfield's assassination horrified the American people, and they wanted his killer,

Charles Gatteau, punished. But Gatteau, many experts believed, was insane. What had seemed like a black and white case was now much grayer. Could the justice system truly deliver justice in a situation like this? Guiteau's trial was extraordinary, but not unique. Important trials have always raised questions and made us reflect on the world we live in. I'm Mira Hayward, and I'm exploring the stories of these trials in my new podcast, History on Trial.

Every episode will cover a different trial from American history and reveal how the legal battles of the past have shaped our present. Listen and subscribe to History on Trial, now on the iHeartRadio app, Apple podcasts, or wherever you listen to your favorite shows. It's Charles and Joshua. It's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff,

it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's stuff, it's too, it turns out. And this is the most amazing part of this. Jerry and I were diagnosed within like a week of each other, and we both told you on the same day, and you found out that you were the only third of stuff you should know that doesn't have ADHD.

I know, I know. It's like, oh, this is great to know here, 15 years into our career. Yeah, I know. It's like, oh, this is great to know here, 15 years into our career. Yeah, I'm surrounded. I'm surrounded, but you guys are both wonderful and understanding this stuff helps everybody understand things because as you'll see throughout this episode, ADHD affects you and it affects your parents, your loved ones, your partners, your business partners. And I think the more people understand all this stuff,

the more empathy we can all have for each other. That sounded like a really wordy children's book about ADHD. Not a kids' book writer, even though we have a kids' book. Exactly. That still holds true. So, Chuck, there's, like, it's clear, like you said, they have a genetic, or they found a genetic component to this whole thing. They've also found that there are definite differences in brain structure with people

who have ADHD. The brains are just simply physically different. One of the things is that they're smaller in places, like they have less volume, maybe some parts are thinner, some parts may be thicker. And it's really important to point out that brain size is not relative to intelligence. So if you're very smaller, it doesn't mean like you aren't intelligent. And maybe here's a really good place to point out that one of the things that I

think is kind of overlooked about people with ADHD is they have the same thoughts and feelings and emotions that anybody else does. It's just that they have trouble regulating those emotions and regulating those behaviors that the same impulses that everybody else gets can slip through with a person with ADHD. That damper that's like, well, I can't do that because it's socially unacceptable, that neurotypical people have is kind of absent for the most part in people with ADHD unless they're really paying attention and trying to hold it back. Yes, absolutely. And what's fascinating is that they can detect some of these differences, like with brain scans, physical differences as early as age four, which, you

know, it suggests at least that, like, this is innate, like, you were probably born with this if you can be, you know, four years old and detect differences in brain scans. Another big one, and this is kind of the real crux of the whole thing is if you were a person with ADHD, then that means that you have a deficit of two things that really make a big difference in your life, dopamine and norepinephrine, two things that we've talked about quite a lot over the years. But you know, we know what dopamine does and part of the challenge of ADHD is if you're not getting a dopamine hit, and this is just a sort of a big generalization, but I think if you have

ADHD you can probably relate. If you're not getting that hit of a dopamine, which is a, you know, part of the reward center, like hey, you did a great job cleaning that room and making that bed, and just look at it. My dopamine is hitting, and I feel great about that. If you're not getting that, or that's, you know, dampered in some way, then you're not gonna be as interested in cleaning that room or making that bed. It's not that your kid doesn't care, or is lazy,

or loves a mess, it's because they literally don't get that same reward or adults, that same reward that someone who doesn't have that neurodiversity does. And so they're not going to be incentivized to do that thing. Yeah. And as we talked about in the dopamine episode, it's not like dopamine gives you that hit of feeling good. It's the thing that comes along with whatever makes you feel good and says, this is important.

Learn this and remember this so that the next time you're faced with cleaning a room, you can remember, oh, there's some good feeling at the end of this. And if you don't have that, yeah, there's no reason whatsoever for you to get up and clean a room, especially, there's like, as we'll see, there's actual like brain function that's missing or impaired

in people with ADHD that allows them to self arouse and be like, I should really do this, I'm gonna get up and do this. Yeah, and fatigue is another sort of, I guess, co-symptom of ADHD sometimes, cause maybe you don't sleep as well, maybe the hyperactivity is just wearing you out or your anxiety which can also come along.

So not only are you not getting that dopamine hit and your body isn't learning and your brain isn't learning like, hey, here's the reward that comes with making that bed. If you're fatigued at the same time and let let's say you're an adult, and it's not just like make your bed, small child. If you have a huge amount of things on your plate, and you're fatigued, and you're not getting that dopamine hit, it can, I'm sure, feel like the weight of the world is coming down on you, and you could go into shutdown mode.

Yeah. So one thing I saw is that they don't think that people with ADHD produce less dopamine. The current understanding is that people with ADHD have more dopamine transporters, so that dopamine gets moved out of the brain faster, so you have less of it at any given point in time, not that you make less of it. The other one you mentioned is norepinephrine and that's usually the thing that allows you to kind of arouse yourself and it helps you also very importantly regulate emotion, regulate self-control, regulate attention. And so those are the neurotransmitters, the big ones that

definitely in some way shape or form affect ADHD. We just don't fully understand it. But one of the other big things that has to do with the brain is the, um, typically the frontal lobe or the, um, frontal cortex contains like our higher thinking or higher behaviors. And that's usually put together in something called executive function, which is a suite of behaviors and cognitive abilities that essentially let us just be, you know, functioning people in society as far as the terms of society require. how you handle distractions that come your way, how you control what impulses that come your way that may or may not distract you from those tasks. And we're gonna talk about, I guess,

like six broad executive functioning components. And if you have ADHD, one or all of these are gonna be dinged in some way. Doesn't mean you can't, you have zero executive functioning by any means, but it just means with these six things, some of them may be worse than others because ADHD, like most things, sort of exists on the spectrum, as far as how severe it might be for each individual. The first part of that executive functioning is working memory.

Of course, that's just your, you know, that's your working memory. It's just like thoughts at any given moment about what you're doing and what you are remembering to do. Right. You usually think of working memory with like remembering a phone number while you're going to write it down, you know, but it also involves everything from like engaging in a conversation, planning a vacation, like anything where you're having to hold a bunch of thoughts like in the front of your mind

while you're kind of working it all out. That's working memory and it's really important and it's very frequently impaired in people with ADHD. Another classic executive function that is essentially universal as far as ADHD symptoms go is self-restraint or inhibition control. And not just physically, but also emotionally and intentionally too. Like staying in a conversation,

not blurting out something offensive about someone's hairstyle, even though you don't mean to hurt their feelings. Another one too. Being on a diet and then just being like, I'm just gonna eat a bunch of cookies too, who cares? A lot of, all of those things have to do with inhibition control and that's just a big part of it.

Yeah, and you can still say like, geez, who wears a mullet these days? Just say it very quietly to your friend. Or just think it. And that's another thing too. I think that's why a lot of people who don't have ADHD recognize that it, because they were thinking the same thing, but they know not to say it.

This person says it. You know what I'm saying? That's the difference. Yeah. Like if you've ever heard anybody say something like, oh, I got no filter. That person has no filter. That person may have ADHD. It's a good chance.

You know? Or they're just irresponsible, one of the two. Yeah, that's true. You they're just irresponsible, one of the two. Yeah, that's true. You can also just be a jerk. Planning, organizing, and problem solving is another big one. If you have a goal for work or life or whatever, school, what you usually do when you're executive and... when you're an executive...

No, when you're functioning executively, is you take that goal, you look at it, you break it down into steps and smaller parts, you do an evaluation of like what's the best way to tackle this thing, and that's a big, big part of problem solving. If that is impaired with ADHD and you're thrown a big task or a big work or school project, you may kind of just freeze for a while. And, you know, this sounds bad, but you might just sit there

and think about something entirely different for a little while. Yeah, you might go to great lengths to avoid that task. And also not just procrastinating, but like really genuinely having trouble focusing because you don't know what to do. You don't know where to start Yeah, like you can't do it. It's not a disinterest or anything like that, right?

Another one's decision-making which kind of ties into that where you know, you you can't just say yes to everything That's not how life works So you have to take into like account future consequences and you have to figure out do I have time to do all of these things? And if not, which one's more important? Like all that goes into decision making and that can be largely impaired too. Not just, not like necessarily all the time, but you were just kind of mentioning something

called ADHD paralysis. That where like things can get so overwhelming, you cannot know where to start your, you know, like your boss is coming down the hall to get this report you haven't even started on, and like you just shut down. You can't decide anything, you can't really focus on anything.

That's called ADHD paralysis, and that can come from having to make decisions. Yeah, and that's where as a parent, or as a partner, a business partner, or life partner to someone, if you don't have that challenge, that's when you can really step up and sit down with your kid or your friend or partner and say, all right, let's sit down and look at this.

Let's talk about the steps, like maybe what a good first step might be, maybe get a little help organizing something. Those are like, to be a really active, involved parent or partner is key to everyone, you know, doing the best they can in life. Yeah, totally. And we'll talk more about like what parents and like family members and spouses and all that can do later on down the road. But that's great. It's a great thing to hit multiple times, you know? Yeah. Time management is another big one that kind of ties into a

little bit of the planning and organization and stuff like that, but just being able to allocate your time, keep track of the deadlines. It may seem counterintuitive, but if you are a person with ADHD, you might do much better with a deadline instead of some just amorphous task this handed to you. So like knowing the deadline may be really good for you or the deadline may just come and go sometimes as well. Yeah, and it's not necessarily because they're like, I don't care about this deadline. They may have literally forgotten about it.

I read a horror story, Chuck, about a guy with ADHD, an adult whose boss came to him and said, hey, you know, why don't you run Monday's meeting? I'm not going to be there. And the guy was like, I knew that this was like a step toward like getting me ready for like the next level for a promotion into management. So he was really excited about it.

And then over the weekend, he totally forgot about it. When the Monday meeting came around, he sat down with everybody else waiting for the boss, wondering where the boss was. And they all just left the meeting and went back to work. And his boss came and asked him how the meeting went, and he's like, what are you talking about? And it finally sunk into him, like, what had just happened. And think about that. Like, he just probably totally scuttled any chance of that promotion because he just forgot about it.

And that's just something that can happen with it. That's a frequent reason people with ADHD miss deadlines. They just forget that they have one. You should have saved that for Halloween. That horror story? Yeah. Where's the knocker? Didn't that just turn your stomach?

It really does. Like just imagining that guy. For sure. And then the last part of executive functioning that can be impaired is another big one. It's called task shifting. And it leads into a couple of things we're going to talk about. That means you get out of your default mode, which we'll expand on here in a second. And doing something called set shifting, which is being able know, being able to switch from task to task,

being flexible as you're doing that. Maybe realizing like different tasks and different situations require different rules. And if you don't have that, if that's impaired, you might be really rigid in how you think something has to be done, a very black-and-white thinking that can come across to others as stubborn. But in the ADHD mind, you just have a hard time task shifting. Right, exactly. And that's a huge classic one too, like you just focus on one thing or you can't start another thing too.

And if you put all that together, in life, people with ADHD, they have trouble remembering to pay bills, they forget that they have homework, they say trouble remembering to pay bills, they forget that they have homework, they say or do inappropriate things like not waiting for their turn to speak, they have trouble self-motivating, staying on task, they misplace things, they have false memories, which is a really big one that we'll talk about,

they can't remember important dates or that they're supposed to run a meeting. And another big one too is that they'll very frequently, ADHD causes you to walk into a room and you have no idea what you went in there for. You knew you went in there for something. That happens to me sometimes too. But imagine every time. Yeah, no I can't because it's frustrating and it can also be alarming.

Yes, that's another thing too, is especially as you age with ADHD, you can start to be like, okay, is this ADHD or am I developing early onset dementia? Like they bear, there's a lot of overlap and it can be very scary. But you also learn tricks like you just leave the room and go back out to where you just were

and you're gonna see like a clue that will prompt you to remember and then you just leave the room and go back out to where you just were and you're gonna see like a clue that that will prompt you to remember and then you just think about it while you're going into the room and then You remember it's usually just amounts to an extra trip back out of the room and then back into it But it is just frustrating for sure You know they call that in the old film biz. Do you remember a MacGuffin? No, you go back to one Okay. Yeah, that's right. That's right, I remember Chad saying that. He would always pinch the bridge of his nose while he was saying it.

Yeah, back to one just means first position of that scene. Like if the scene starts and you're in the doorway, go back to one, you go back to that doorway. So maybe that's a fun way to remember that kind of thing. Yeah, I love that, Chuck. Way to go. No, let's not take a break yet, because I think we should talk. I mentioned default mode. Default mode network is a very big part of this, at least understanding of this.

The brain regions collectively that function when you're just hanging out, when you're hanging out on the couch, you don't have anything to do in the moment. I mean, people with no children can identify with this maybe. I can't. But the times of the day where you can just sit around and introspect and daydream and zone out a little bit, that's called default mode. And when you're doing that, there are parts of your brain that become

really active and light up during default mode. And if you're a neurotypical person, going between default mode, because once you have to kick into action mode, that default mode turns off. Switching between those, if you're neurotypical, is, you know, it works as it should. If you have ADHD and the problem

is that default mode stays on sometimes. They've like shown this in brain imaging studies. So if you're doing a task that requires focus, your default mode still may be on and that's active at the same time. And those two things are not simpatico. No, and by sometimes it's pretty much all the time. Like it just does not shut off. So that amounts to, there's a psychiatrist named Ned Hollowell, MD, who put it as a persistent

magnetic pull away from the task at hand into distraction. So because your brain is like, no, no, no, we're over here, we're going to daydream because your default mode network is on, you can't focus for long periods on the task at hand. Or if you can, it's a constant struggle to resist letting your mind wander. You have to actively keep it focused

on the thing you're doing because you're, like you said, the action network didn't take over in the default mode network go down, you know, proportionately to one another. Now they're just both on. Default network go down. It turned into tuk-tuk for a minute. Yeah, that's how tuk-tuk's is. So, and we'll talk about medication in, you know, I guess probably in part two.

But aside from medication, if you are trying to help turn that default mode network down or off, breathing techniques are a big part of that. Like trying to stay in the present, bring yourself back to the present through breathing techniques and mindfulness exercises, those can go a long way. Yeah, for sure. Do you wanna take a break and then come back and talk some more about ADHD?

Yeah, sure. Since we're here. In July 1881, a man walked into a train station, pulled out a gun, and shot the President of the United States. James Garfield's assassination horrified the American people, and they wanted his killer, Charles Giteau, punished. But Guiteau, many experts believed, was insane. What had seemed like a black and white case was now much grayer.

Could the justice system truly deliver justice in a situation like this? Guiteau's trial was extraordinary, but not unique. Important trials have always raised questions and made us reflect on the world we live in. I'm Mira Hayward, and I'm exploring the stories of these trials in my new podcast, History on Trial. Every episode will cover a different trial from American history and reveal how the legal battles of the past have shaped our present. Listen and subscribe to History on Trial now on the iHeart Radio app,

Apple podcasts, or wherever you listen to your favorite shows. Borderline disorder better yet for quarter Alright so this is a big one maybe one of the biggest sort of downsides to ADHD. And don't worry, there are some upsides too, because there are some quote ADHD superpowers here and there that we're going to talk about, so take heart. But one of the biggest drawbacks is called Rejection Sensitive Dysphoria or RSD. It's a very destructive thing if you have it. It's very destructive to people around you. It's basically when any kind of rejection

or even appearance of rejection, even if it's not rejection, will trigger a very, very intense flood of emotion that is, it almost has and can feel like it's having and can have an actual physical effect that is so strong, not just a fear of rejection, just a, because no one likes rejection, but if you have ADHD and RSD, anything like that can bring a real flood of negativity around you. Yeah, it can be actual rejection, but it can also be something like constructive criticism, which is important to be able to take a perceived slight, maybe a made up slight, somebody's

fleeting facial expression and offhand comment, your own false beliefs, and then there's two ways generally that a person with RSD, or we should just say ADHD, will respond to that, to that perceived rejection. They can internalize where they'll just emotionally curl up into a ball and just shut down, or they may also lash out, and they'll have a meltdown or an outburst or they'll become angry. That's called externalization. And so to really kind of put it in perspective,

imagine either one of those being the response that you get when you ask someone to not leave their dirty dishes in the sink. Like that's RSD. That's what it's like living with RSD, that's what it's like having with RSD. And the big problem is the whole thing is instantaneous. It's not like, I'm gonna have an outburst,

I'm gonna melt down, I'm gonna emotionally ball up. It just, it goes from trigger to response with nothing in between. Yeah, and then the person in your life may end up, even if they're understanding of what's going on, may end up walking on eggshells, may not wanna criticize or constructively or otherwise anything about that person in fear of like a meltdown

or an emotional outburst or something like that because it can really disrupt like a relationship. So you've got one side where someone can't help something and you've got the other side where even if that person can't help it, it's destructive to the relationship. So I'm just gonna do everything I can to avoid any sort of confrontation.

Yeah, it makes it really hard to have a connection with somebody who might just melt down at you at the slightest provocation, right? Yeah. And you said something, the person can't help it. The person with RSC cannot help this. They're not being a jerk. Like they can't not do this.

And one of the problems with it is that it's really fleeting. It's like a tidal wave or getting punched in the stomach. That's what it feels like, the overwhelming emotion, like you said, but that's fairly fleeting. And then that gets replaced by regret and then feelings of shame every time because you're just so ashamed, you can't control yourself, right? So some people who have RSD will become people pleasers

where they don't share their thoughts, their true emotions, their true opinions. they don't share their thoughts, their true emotions, their true opinions. They don't share themselves because what they're doing is cutting off as much risk as possible of being rejected and thus triggering a bout of RSD. Yeah. Yeah. That's a vicious cycle. It is. And so initially they used to think that it was comorbid with ADHD, that it was a separate thing. And it's not even recognized in the DSM yet.

That recently recognized. But apparently studies have found that essentially 100% of people with ADHD also have RSD. So they're just basically coming to the conclusion that it's a terrible symptom of ADHD. Yeah, exactly. We mentioned some benefits and positive things. Hyperfocus is one of them. It's sometimes called the superpower of ADHD. And I've seen this with all kinds of people in my life that have ADHD. If it's something they're into and they're interested in and they can zero in on that thing, it is like, I mean, hyperfocus doesn't even begin to describe it. They can tune out everything and sometimes to their own detriment, you know, if it's like other things in their life that need attention, hyper focus can distract away from those. But it can also be a great thing.

If you are someone with ADHD, you may have a real skill for zoning in on something. Maybe a particular kind of job might be really, really good for you. Or particular tasks may be really, really great for you. And you can get a lot done sometimes that way. Yeah, it's like the exact opposite of your inability to self-motivate, right? I saw a corporate study bandied about the statistic all over the place, but essentially this one company found that a person, a neurodiverse person, who is locked into something that interests them in their work,

will essentially do the job of two people. They produce between 90 and 140 percent more work than their peers in the same, say, department, and that their work is consistent and error-free typically, because they're just totally laser-focused on that thing. So if you can find a job that holds your interests like that, you're very much in luck because unfortunately, one of the things that is a huge challenge for people with ADHD is finding a job when you have to find a job that doesn't hold your interests. It's very difficult to arouse yourself to do that, even though you know you have to do this

and you should be doing it and you feel terrible. For not doing it, it's really hard to do sometimes. Yeah, which is why understanding yourself and your challenges is really key when you go out into the world and join the workforce. It's important for anyone to go into the job search thinking like, all right, what am I really good at and what are my challenges?

But I just think it's probably times a million if you have ADHD. Yeah, for sure. Another kind of something related to this is you can become laser focused on just everyday tasks that end up catching your interest somehow, surprisingly. And so people with ADHD, if they're doing a task and they're in hyper-focus, it'll take them way longer to do it frequently, but that's because they're doing a perfect job of it.

So like, say vacuuming the car. You just go to vacuum the car and you're like, huh, this caught my interest and now I'm totally focused on making this car immaculately clean in every way, shape, or form. So of course it's gonna go from taking 15 minutes to taking an hour and a half, you know? But when you're done, the car looks awesome. Yeah, so maybe there are probably CEOs all over the place

now trying to staff up certain departments. Yeah, that's actually a thing. And there are probably people that should be auto detailers and start up your own small business that way. Yeah. Well, one of the things I saw, I read a DelWatt or Del... How do you say that consulting firm? I don't know.

It doesn't matter. I read one of the reports and they were saying that, traditionally people think like, okay, there's gotta be a good job for a neurodiverse person, like maybe programming or coding or something like that, just let them go off and be themselves by themselves. And they're starting to recognize like, no, like you can put somebody that's neurodiverse in any job

and if they find something interesting in it, they're going to excel at it. It's not necessarily a specific field that applies to neurodiverse people. Yeah, yeah, for sure. And kind of tagging onto what we were just talking about, viewing yourself as not having some sort of defect or deficit and like, hey, this is who I am.

This is how I, like I have no choice but to operate this way and try and work within that framework, not the framework of somebody who doesn't have ADHD. Like it's the world and jobs a lot of times are kind of structured around, I mean, yeah, the entire world is structured around people who aren't neurodiverse, so fitting into that world can be a real challenge no matter what your neurodiversity is.

So kind of working with who you are and understanding that is a real key to moving forward in life. Yeah, and there are a lot of positives, upsides to having ADHD that kind of give you talents that other people don't necessarily have. Like one of them is, I saw it described as, you're getting so much noise at any given time, you're inevitably going to also get more data points than other people at any given time. And people with ADHD have typically an ability

to connect dots that other people, make connections that other people can't see. That's a big one. Another one is like, if you are multitasking and you actually get those projects done, that kind of boundless energy that's synonymous with the hyperactive part of ADHD, you're gonna get a ton of stuff done in any given day,

way more than like a neurotypical person who poops out halfway through the day. Yeah, for sure. Another potential positive is earlier when we were talking about some of the impaired executive functions and being super just sort of black and white and rigid, when you apply that to a moral code,

you may have a very strong moral compass, whereas somebody who's a little more, sees like the gray instead of the black and white, might be like, well, you know, it's really not so bad if you do this kind of thing. Whereas if you have a very strict sort of view of right and wrong, and a black and white sense of that, you may be like, no, that's just wrong.

Chuck, there was this one time where I tried to fight two guys who I thought were throwing rocks at a manatee. And I was seeing red, Yumi was even like, it's not a manatee, stop, and I didn't even hear. And those guys were like, it's a rock, we're not throwing rocks at manatees. I was like, oh, all right. And luckily they were cool with it,

but I was ready to fight two dudes for throwing rocks at a manatee. Like my sense of justice was just that stricken. I wish I would have been there. We might have fought him anyway, Josh. Just because I've never been in a fight. So like, I don't know, it'd be fun to get in a fight with you. Right, sure. Oh yeah, back to back.

Yeah, yeah, exactly. The two musketeers. Another one, Chuck, is if a person with ADHD gets excited, it's infectious typically. If they're in a place where they feel safe and comfortable, like just showing their excitement and just letting it hang out, you're probably going to get excited along with them

because it just spills over. It can be really nice to be around. For sure. One more thing, if you have ADHD, you very typically catastrophize as far as thinking goes. You're just constantly expecting the worst, just because over and over and over again in your life, the worst has come around

because you forgot to do something or whatever. So that catastrophic thinking can actually be an asset in that you can look at something that everybody's about to do and be like, well, we're all going to die if we do this, that no one else saw, and you can find a safer option in that way. It's actually a huge benefit of having ADHD, even though you have to suffer with catastrophic thinking in order for that to be an asset too, you know? Yeah. Chuck, I say that we end part one here. Yeah, just getting cooking too. And then we're going to pick up part two and we're going to talk some more about ADHD in

part two. And then while we're talking about ADHD, we'll eventually finish part two and then that will complete part one and two of ADHD. What do you think about that for a plan? I think that sounds great and as is custom here we don't do listener mail or anything for these two-parters so I guess we'll just say see you Thursday? Yeah and finish on that dramatic pause like the very special episode of Different Strokes. groups. Stuff You Should Know is a production of iHeartRadio. For more podcasts, my heart radio, visit the iHeartRadio app, Apple podcasts, or wherever

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