The Agenda with Steve Paikin (Audio) - What are the Myths and Facts Behind ADHD?

Episode Date: October 17, 2024

Attention-deficit/hyperactivity disorder, or ADHD, is a commonly diagnosed neurodevelopmental disorder in children and adults, but advocates argue, very misunderstood. Here to provide us with a better understanding of what it is, or isn't, we welcome: Dr. Doron Almagor, Child, Adolescent and Adult Psychiatrist at The Possibilities Clinic; Heidi Bernhardt, Founder of the Centre for ADHD Awareness Canada and a former psychiatric nurse;, and Katelyn Weinstein, Psychology student at the University of Guelph who was diagnosed with ADHD at age 7. See omnystudio.com/listener for privacy information.

Attention Deficit Hyperactivity Disorder, or ADHD, is a commonly diagnosed neurodevelopmental disorder in children and adults, but advocates argue very misunderstood. Here to provide us with a better understanding of what it is or isn't, we welcome Dr. Doran Almagor, child, adolescent, and adult psychiatrist at the Possibilities Clinic and the chair of the CADRA Advisory Council. Heidi Bernhardt, founder of the Center for ADHD Awareness, Canada and a former psychiatric nurse. And Caitlin Weinstein, psychology student at the University of Guelph, who was herself diagnosed with ADHD at age seven. And it's great to have you three with us

around our table here tonight at TVO. We're gonna put some stats on the record here. I'm gonna ask our director Sheldon Osmond to bring this graphic up. We'll go through some stats and then come back and chat. Here we go, ADHD, Attention Deficit Hyperactivity Disorder is a chronic neurodevelopmental disorder. It affects about 5% to 9% of children

and 3% to 5% of adults. It's the most common neurodevelopmental disorder in children. 80% of adults and 44% of children with ADHD have at least one additional mental health condition. 46% of women are misdiagnosed with another mental health condition disorder before being diagnosed with ADHD. Hmm.

So, we get all that on the record to start with. Dr. Almagor, let's start with you. The main causes behind ADHD are what? That's a question I get asked a lot. It's a complex question. I can't answer it simply, and it's still something that scientists are working on. But it's called a neurodevelopmental disorder for a reason. The neuro part means it's brain based, it's genetic, it's biological.

The developmental part means it's something that evolves throughout the lifespan. So it's something that is also affected like most genes by the environment and things for instance maternal smoking, drinking, maybe stress in the environment. And things, for instance, maternal smoking, drinking, maybe stress in the environment, things like lack of sleep can actually express the genes more fully. Now when you said genetic, I thought, oh, you inherited from your parents or grandparents. Is that the case?

Yes, often that is the case. In fact, if a mother has ADHD, their child has a 50% chance of having ADHD. That's pretty high. When I started in a mother has ADHD, their child has a 50% chance of having ADHD. That's pretty high. When I started in the field of ADHD, I started off as a child psychiatrist, seeing kids with ADHD only. And mothers would come to me and say, you know, I've had the same type of symptoms like

when my kid, when I was a child. And at that time, this is talking about the 90s, the early 2000s, we didn't even know adult ADHD existed at that time. So that's how, really, that's how the consciousness around adult ADHD started then. One more quick follow-up here. We noted that it often accompanies one more mental health condition as well.

Why is that? Oh, that's something that I see daily and something that people don't realize about ADHD. They see it as maybe even something that's not even that serious, right? Like a little kid running around. ADHD has a huge burden for the person and society and part of that is the development of other disorders that happen with ADHD like anxiety or depression, things like substance abuse. A lot of that is about the kind of burden

of untreated ADHD and there's a lot of emotional dysregulation around ADHD and that can end up just being after a lifetime of not being successful, a lifetime of failing at school or having marriages break up or not kind of go go on to education as much as somebody could. people feel demoralized, end up feeling depressed, maybe turn to substances. So we see that all the time, and it's quite disheartening.

Heidi, I want to get a better understanding of how your understanding of this has changed over the years. For example, when we were kids and we were in class, and we saw that and we were in class and we saw that one kid over in the corner, quote unquote, bouncing off the walls, we didn't know it was ADHD, but that's what he had.

I think we now understand that that kind of hyperactivity and just constantly on the go, that's how we diagnosed it back then, even though we didn't know what it was called. How do you diagnose it today? Oh, so it's a very lengthy process. Actually we have Canadian practice guidelines on diagnosing ADHD. So it is as much ruling in the symptoms of ADHD and you know looking at it as ADHD as ruling out any other disorders that

could be causing those symptoms called a differential diagnosis. So process of elimination in some respects. Yeah so it's looking at the medical history of the child or adult. If you're an adult you also want to get a lot of information on their childhood because again it's a lifelong disorder it doesn't just show up in If you're an adult, do you also want to get a lot of information on their childhood? Because again, it's a lifelong disorder. It doesn't just show up in adulthood. So it is. It's medical history, mental health history.

What symptoms are you looking for? OK, so are we talking children or adults? We'll start with kids. So that hyperactive little boy you talked about, that's one presentation of ADHD, which is the combined presentation. So it's dysregulation of attention is what we're really looking for.

And these kids and adults can over-focus as much as they under-focus. So that's a fallacy about ADHD, that people can't pay attention. If something really grabs their attention as in stimulating, you can't't pay attention. If something really grabs their attention isn't stimulating, you can't break their attention, right? So they can focus for hours and time passes and they don't realize it's passing, right? So it's that dysregulation. Some people have hyperactivity or impulsivity and

others do not. And it's very often the presentation without the hyperactivity and impulsivity that we miss. We miss diagnosing girls more often than boys because they most often have what we call the primarily inattentive presentation. You're looking for different symptoms in adults than in children. Yeah so sorry, so often during adolescence the hyperactivity decreases. We don't often see high school kids running around the back of a classroom right, like we do five and six year olds. But a lot of adults I talked to talk about the hyperactivity internalizing it so they're constantly feeling this

restlessness right and their their hyperactivity may be more subtle. You know, shaking the leg, twirling the hair, kind of thing. But in adults, we often see disorganization, forgetfulness, being late for everything, you know, having issues at work, social issues as well as organizational issues, getting things done. And a lot of people, unfortunately,

who don't understand ADHD see those symptoms as the person just being lazy or not trying harder. Which is not the case. Exactly. Caitlin, you do get to speak on this program. Here we go. How old were you when you were diagnosed? Yeah, that's a funny question because I was diagnosed

as a kid, very young age, which as a girl, that's a little bit less usual. but I was first diagnosed with anxiety. So you mentioned that a lot of women are diagnosed with another mental health condition first and that was absolutely my experience. I exhibited a lot of the symptoms that you see with the self-regulation, not just with my attention but also emotions, impulse control, but that combined presentation of ADHD. So I had the tantrums, the meltdowns, the irritability if I was having a sensory overload that day.

And that presented as a lot of like, just conflict with the people around me, conflict at home and reactiveness. And so- How early in the game? Age six or seven. Six or seven, I don't know. And so then that ended up with me

accessing some mental health resources, getting a diagnosis with anxiety. And it wasn't until a few months after that where I was doing some follow-up on that with the anxiety meds when my doctor said, you're bouncing off the walls. Do you think maybe there's something else happening here? And so then I got the diagnosis. Closer to age eight, but still seven.

Did you think there was something off about you? As a kid? Yeah. Absolutely. You did. You could feel that you were different from the other kids. Yeah. And I think some of that might have been my own anxiety.

But I definitely internalized this feeling that I was a bad kid. It was really hard to regulate my emotions, so I would say things that I didn't mean. I would make decisions that I didn't want to make. And no amount of telling myself not to do that again would change it, and as a kid that's really frustrating. But you don't have the language at age seven, eight, nine

to articulate that, so I think a lot of the therapy that I went through as a kid was just unlearning that. Before I was able to manage the ADHD, I had to just be able to regulate enough and change my narrative about myself. This has surely got to be one of the worst aspects of ADHD, is that a young child thinks of themselves as being bad. Not as being, you know, having some issues to deal with,

but being bad. What's the consequence of feeling that way? I think that's one of the myths that we see around ADHD is that the kid is just being bad and that's one of the reasons some of those people don't seek out a diagnosis. They feel, oh that'll label my kid. But I think the labeling, you know, being called it's ADHD actually gives people a roadmap. It gives them something to do. It tells them hey the kid isn't bad. They have a condition. It can be treated.

There's something you can do about it. So I think not knowing what it is, just seeing the behavior often gets people labeled as being bad. Teachers will often say hey your kid is bad. They're disrupting the class. While getting help, you know, help helps that quite a bit. How many kids you got? Three boys. Three boys. Any of them have this?

All three. All three. And my husband. And your husband. Yes. So do you assume the boys got it from the husband? Yes, although I can probably see traces of it in some sides of my background as well, from different people in the family.

So these stories of kids going to school and being called bad kids, you experienced with that? Yes and no. More so with my grandson. My three boys were all gifted, so they weren't failing school. So they were doing OK. But the interesting thing was they had enough inhibitory qualities that they saved it all

for us at home. So they would be OK at school, and then they'd come home, and I'll have a word break loose. You can imagine three boys with ADHD in a household with one of the parents with ADHD. So when I present to parents, I always say, I really, really wish I knew then what I know now. Life would have been so much easier for everybody

and so much better for the kids. Tell us what that means. If you'd known then what you know now, how would things have been different? It would have been advocating in the school system to get them the help they needed. They weren't failing, but they also weren't diagnosed and got support as being gifted right so they did fine till they got the post-secondary and then it was

kind of like a two-by-four between the eyes right because all the organizational difficulties like time management all of that stuff really hit them hard because they didn't have to do a whole lot of studying until then, right? So, and yeah, the emotional dysregulation that Caitlin talked about, and that was, yeah, a lot of our family life's experience, different kids dysregulating, and a lot of fighting.

But all boys fight. So that's not necessarily a tellt a lot of fighting. But all boys fight. So that's not necessarily a telltale sign of anything. And interestingly enough, that is what the early doctors told us, right? They're not wrong about that. Yes. And they just said, oh, they're very active boys and they're very bright and they're right, which they were, right? But it really became difficult that, you know. You are a university student now.

So you've clearly figured out how to deal with this. Is that fair to say? Yeah, I mean, I think I learned how to deal with it at a pretty young age. And I sort of went from this pipeline of the experience I described before, at age seven, eight, nine, thinking I'm bad, to very quickly unlearning that and the anxiety kicking in

about how I was gonna be perceived by those around me. I really didn't want the world to see me as bad, so I worked really hard. And I think I had the privilege of being able to mask some of those symptoms, and I also had the privilege of having a really supportive environment throughout elementary school and high school.

And I learned self-advocacy skills. So between all of that, I was able to apply to the University of Guelph, and I've been pretty successful. So I'm in my fourth year, planning to graduate soon. But I will say that my success isn't attributed to just me learning to manage it. I have developed skills. I can self-advocate.

But I'm learning to live with the ADHD. It's not skills. I can self-advocate, but I'm learning to live with the ADHD. It's not something that I overcame, and I've also learned to adapt my environment to better support my needs and surround myself with people who can hold space for that. So you tell me you don't think you've been cured of this. Is that fair to say? Absolutely not. I still very much have ADHD. You do. But you manage it both by self-regulating and meds, too, I assume? I do take medication. I think that's one facet of the treatment plan that I have.

I do see a counselor and have been in therapy for a really long time. And that's been huge for the emotional regulation and self-management piece. But again, I think a lot of the success, success, I say success because there's not one definition of success, and that's another issue within the ADHD community.

But I think my own success and the pathway that I've taken is largely attributed to having access to the support resources that I needed from a very young age in a way that was able to help me get to the point where I am now. So she's never going to grow out of this. Is that right? When you've got ADHD, you've got it for life? Well, that's the definition of ADHD.

But I also want to say, you know, Kaitlyn's success, I think it's because you're able to get treatment and be identified from an early age. And you've been also sticking to your treatment. So good for you for that. And I can see the results now. You're in university and doing well and that's often we see people with ADHD can do amazingly well throughout their life if they get treatment, if they're identified.

So yes, it's not something that's going to go away. It's a, you can call it a neurological difference and Someone will have it from birth to life, but they can do very well if they can get the right treatments and the supports. The treatments can be medications, they can be psychotherapies, and the supports need to be around education and at work. When we really see a lot of success, when we get all four things going together. We treat the biological, we treat the psychological, we treat the environment and we also look at things like work and the school environment as well. What kind of diagnostics are you using in order to get there?

In terms of diagnostic, in terms of getting the well. In terms of diagnosis in the first place? Well, Heidi went over some of the diagnostics We don't have a blood test We don't have a brain scan and so we do have to go over a very careful kind of diagnostic Process and interview trying to understand what's going on for the person what the symptoms are and Could anything else account for the symptoms as well anybody working on a blood test? People are working on a blood test.

People are working on brain scans. Now, right now, we can show brain scan differences between populations of people without ADHD and people with ADHD. But it's not sensitive enough to work in terms of one person, per se. That would be great. But I think with any complex behavioral type of kind of problem,

it's going to be more complicated than that and nothing really beats kind of talking to somebody and understanding what they're going through. That's going to probably remain the gold standard for a long time, I think. I can just add to that. Yeah, I think also, you know, I'm going to challenge you on your questions a little bit here. Please, of course. I think it's important to talk about treatment and I really like that you talk about that multifaceted approach that addresses your intrinsic needs as well as your environment. And I think that's kind of what I was getting at as well with the supports that I received growing up.

I tend to avoid language around things like fixing ADHD or a cure because again, like you said, it's a difference. It very much is a disability as well and you need that label, especially for advocacy, to recognize the validity of it and the need for accommodation. But you can also examine disability through a social model and lens to view the way that circumstance and environment play a role

in how somebody is able to thrive. And so as much as it's good to talk about treatment that's most effective and do research on things like blood tests and understand what's important, ADHD Awareness Month is also about being aware of how to make the world more ADHD friendly rather than just making ADHDers more adaptable to the world. Understood. You are a psychology major.

Yeah. Can you tell? I mean, presumably you are interested in this subject because of your own personal history. Yeah, that's definitely driven me kind of toward this path. I mean, presumably you are interested in this subject because of your own personal history. Yeah, that's definitely driven me kind of toward this path. But I think I've always wanted to be a clinical psychologist. And being an undergrad has sort of shifted my thinking.

I think I want to go more into advocacy for both neurodiverse communities and also other issues as well. This is a good thing. You're a great communicator and a great advocate too. Thank you. And I'm sure you're gonna hear from people who are watching this who are saying they want you on their team by the time we're all said and done here.

Okay, let's move on here. Women we've noted are often misdiagnosed. Yes. Why is that the case? Women very often present differently. Girls present differently. Not so often with the hyperactivity. Women tend sometimes to have more of the emotional dysregulation, especially in adolescence and going through hormonal periods, per se. And I think family doctors are very good at diagnosing anxiety and depression.

And as Dr. Elmagar said, when you don't treat ADHD, you get anxiety and depression. So those two things are diagnosed. And we did a survey a number of years ago. And we had women who, for decades, were being treated for anxiety and depression unsuccessfully because their underlying ADHD was not diagnosed. So we need to work on that.

Yes, very much. Can I add to that? Please. And often with women, and Heidi was saying that people present often with hyperactivity when they're children, but inattention when they're adults. But women tend to have more inattention on balance than men when they're kids. And inattention tends to be more silent. It's more internal.

And if a girl is smart, she's trying hard, she's in the back of the class, that inattention might not be noticed by teachers. Teachers often look only at grades. And people with ADHD can be, you know, they can be very high, have very high IQs, do very well in school. So they may never be noted by anyone. Inside though, they're not feeling that. They're feeling anxious. They're trying harder.

They're trying to master ADHD. That puts stress on them. They can continue in the system for a while, not be identified. But usually there's some breaking point that can happen maybe in later high school when demands get greater, maybe in university, maybe when their mothers and have to take care of a family or maybe even during menopause when hormonal changes can exacerbate ADHD. So what we see is that women tend to be diagnosed later than men and because of that they actually have a higher burden of ADHD than men and surprisingly of that they actually have a higher burden of ADHD

than men and surprisingly and this is something that everybody has been shocked by in the past few years studies have been showing that women have higher death rates from ADHD higher accident rates higher substance use rates than men in ADHD. Okay, come on in here. Again, people of my generation, their exposure to ADHD came before we even knew what to call it. So lots of myths have developed over the decades. What's something that ought to be dispelled?

I think what upsets a lot of families dealing with ADHD is the blame the parents get. And a lot of families dealing with ADHD is the blame the parents get. And a lot of people who don't understand it think the parents are not trying hard enough. They're lazy. They haven't disciplined these kids. These kids just need to learn right from wrong, all this kind of stuff. Actually, I can tell you from personal experience and talking to thousands and thousands of parents over the last 30 years, parenting a child with ADHD is hard work, if you're going to do it right.

And the parenting is much, much more difficult than if you have kids without ADHD. And I wish people understood that and did not judge parents with ADHD. And for some reason, people who have very little knowledge about ADHD feel they have the right to tell parents to medicate or not parent, medicate their kid, give their kid more exercise, less TV. You know what? I have been pondering that for like 40 years. I don't know why. I mean if a child has some other medical disorder, you know, they wouldn't tell them to take the kid off insulin. It makes no sense, but for some reason it still happens.

When you met the man who would become your husband, they didn't call it ADHD back then, did they? No. No. So you found out after the fact I guess. Well after the kids were diagnosed and that's very very common that the adult gets diagnosed after the child is born. I see. Okay. What else? What else should be on this list of myths that we need to get over? Well we've got a hundred myths around ADHD and things have been getting better. There's been more education around but there's quite a few around there. I'm going to come back to one you kind of mentioned, Steve.

You said to Heidi, don't all boys fight. And that's something that goes on a lot. And people often will say, around that, they'll say, they'll just grow out of it. Just wait. Don't do anything. They'll just grow out of it. Boys fight.

People, they're not old enough to focus. But that is true, isn't it, Dr. Almofra? I mean, some't just grow out of it. Boys fight. Be bold. They're not old enough to focus. But that is true, isn't it, Dr. Almofra? I mean, some of them grow out of it. Some of them eventually stop fighting. So if it's kind of regular fighting, sure. But what we see with ADHD is beyond that. It's something that it's not just something that you would see just kind of the regular fighting

on the playground. You see kind of chronic dysregulation around their emotions, around their activity. So it's more than just that. And just letting it kind of, waiting until people grow out of it doesn't work. What we see is that you really need early intervention for ADHD. Early meaning what age? The early age would be below the age of eight is when you really can see good results later

on. If you can treat before the age of eight, you can prevent a lot of the complications that happen later in life. After age eight, you can treat after the age of eight. I tell people who are even at age, you know, later adults, senior citizens, it's never too late to start treatment, never too late to actually get the right treatment for yourself. But if you can treat at a very early age, you can actually do much more for later life.

So earlier is better and often, unfortunately, people say, no, let's wait. We want really to wait until treatment is our last resort. But that actually doesn't do the child any service. And then you start seeing a lot more complications as people get into adulthood. Got it. You got siblings? I do.

What do you got? I have a brother and a sister. How fractious a household was it when you three were growing up? It was lively. There was definitely a lot going on. And I think also, like, the whole idea of like boys fight, that dysregulation may present as fighting. It can also be like that internalized spiral.

It can be overthinking. It can be meltdowns. It can be conflict. It takes a lot of different forms. So I think narrowing it down to one form and saying, well, like this can be explained by something else, really does not reduce ADHD, or like the complexity of that experience.

All right, given that you've lived this, are there any other myths that you've run into along the way that you think need dispelling? Yeah, I think the myth that like, you can't be smart and have ADHD. ADHD really has nothing to do with your capability to, you know, achieve cool things and do something that you are passionate about.

And I see so many people in my life who are neurodivergent and successful in their own way and fantastic. And I think some people have the experience of being told that because they have ADHD, they can't achieve things. I found, especially like around high school age, that because I was achieving things,

I couldn't have ADHD. And that was an interesting one because there's kind of this like conflict of feeling like, I found, especially around high school age, that because I was achieving things, I couldn't have ADHD. And that was an interesting one because there's kind of this conflict of feeling like, okay, so if I do well, then all of a sudden, my disability will no longer be recognized. And that's a myth that I've been trying to challenge for a while. Interesting. Can I just add something about treatment?

The difficulty with assessment and treatment for ADHD is long, long wait lists. A lot of what we call, you know, multimodal treatments for ADHD are not covered by provincial healthcare plans. So sometimes even getting an assessment you have to pay over a WIP cost per se, especially for adults. It can be very, very very pricey thousands of dollars. Actually finding physicians to prescribe medication can be difficult. A lot of family doctors don't want to do it but then you've also got the cost of

the medication but at least getting the prescription is most often covered by health care plans. Psychotherapy, coaching, a lot of the things that we do have research that shows it's very helpful are not covered. So a lot of people are not getting all the treatments they should be getting. Also in the school system we talk about you know recognizing ADHD, getting supports in family life in the school, a lot of that is not being done in Ontario. We do not recognize, unfortunately, the Ministry of Education does not officially recognize ADHD as a disability. So these kids don't automatically get the right to special education resources

and I spent a lot of my time advocating. You think it should be recognized as a disability? Well, yeah, we recognize autism. We recognize learning disabilities that are both neurodevelopmental disorders. And those kids have the right, they're what we call IPRC'd or recognized as a child with special needs. I used to know what that stood for. Independent Placement Review Committee? Yeah, Individual Placement Review.

Individual, okay. Yeah. So, you know, but we, these kids with ADHD, and very often the symptoms in the presentations overlap with how kids with autism present as well, right? So why should one neurodevelopmental disorder be recognized and another one not? Right. Can I get you on that? How well do you think the school system does at dealing with all these issues? I think it's hit or miss and it depends on like the funding and resources available within a certain community.

And I can really only speak to my own experience. Heidi knows a lot more about the province-wide landscape. My experience was that I got a lot of support in high school and in elementary school. Where'd you go? I was in private school and elementary school, and then I went to a public Catholic school in Burlington. And it was OK? I had a good experience. I know, though, that not everyone does.

And I saw firsthand what my privilege granted me. And I think being articulate about my experience, knowing my needs, and having self-advocacy skills, you know, helped me succeed and get the help that I needed. But I also saw other students, especially black and racialized students, not being treated with necessarily as much respect or like belief in their experience as I was. And so, you know, people would listen to me

when I could advocate for my needs in a civil and articulate way. But, you know, having that ability should not be a requirement to, like, having human rights. So that's my take. Got it. Do you have a theory as to why this is not recognized by the school system as being something worthy of additional help, whereas other neurodivergent situations are? When I tell parents ADHD doesn't count as an exceptionality in the school system and they can't get an IP just on the basis of ADHD, they don't believe me. I have to explain it over and over again. So it

doesn't make any sense. It's a historical kind of circumstance. It doesn't actually make any sense today. I don't know this, I'm just guessing here, but is the ministry concerned that if it did recognize this it would be absolutely flooded? I don't know what the ministry's thinking is. I think it was part of the educational act when it was formulated. It wasn't considered to be an educational exceptionality at that time. And I know that organizations like Heidi's have been trying to get it on the radar but they've been not successful doing so. Often I'll try to advocate personally by writing letters to the school

but that's been harder and harder to do and schools have been very resistant to kind of formulating IEPs for students with ADHD. So often parents have to resort to private schools, which is not doable for a lot of parents. Sometimes when we have an added exception and exceptionality and added diagnoses like autism because as we've said before ADHD doesn't travel alone it often goes together other things. Sometimes it's actually a relief and helps to actually add a learning disability to ADHD. They can at least get the help at the school. It's a bit ironic, but that's how it works. Follow-up with the health care system. How well is it doing right now at

accommodating the needs of people who require medication or whatever? I'm not aware we have a health care system when it comes to mental health in Ontario. To be blunt about it, I've never seen one in my ears. What do we have? Mental health industrial complex. I'm not sure I would call that. It seems to not even be as organized as such. It just seems to be a number of different kind of, a lot of well-meaning practitioners,

great hospitals, you know, great people, but there is no kind of central kind of organizing principle behind it. So we are stuck with a lot of waiting lists everywhere in trying to get ADHD treatment diagnoses. There's very little in the healthcare system for the kind of allied health professionals that do ADHD coaching or psychotherapy. So it's very hard to get that kind of integrated treatment that you really need. So that's something that we see. What was the situation with your boys in terms of

treatment of the health care system? The oldest was diagnosed at 14 and a half and it took two and a half years and five medical professionals to do it. So I mean it took persistence. It really took and five medical professionals to do it. So I mean, it took persistence. It really took a lot of persistence. And then the other two within two years were also diagnosed. But understanding the system or lack of system as to where to go where to get the sports I and really to be honest that is why I founded Kodak because when I went through it There was none of that. There was no training for parents. There was no support. There was no information. There was no supports for

youth Digging into your pocket. How much have you got to guess it, how much it has cost extra over the years? Oh, I don't know, a hundred thousand, a hundred and fifty thousand, a lot. If you're going to, you know, pay for, you know, psychology. Is that all together or each kid? Okay. You know what, I don't even want to think about it. I don't blame you.

You know, what I said to my kids was the one nice thing they did for me, it was almost like they took turns having crises. They didn't all do it at the same time. But I mean, I'm talking from, you know, early age through university years, you know, into young adulthood. So a lot of ups and downs. And yeah. So the reason I use the industrial complex language,

and some people might call this a radical take, but I think the amount of money that you need to have to get that help in the first place is the reason why my outlook has changed. Because as much as I've had really good supports, I have family members who could afford therapy, who could afford a school that I felt really safe and welcome in. And so not everybody has access to that.

And as a result, the people who are wealthier, people who are a higher class, are going to get better access to more support. And the people who might need it the most have the least access. And so there's that gap. And the health care system that we have doesn't account for that either. We're down to our last minute here. There's that gap and the healthcare system that we have

doesn't like account for that either. We're down to our last minute here. If you had Sylvia Jones is here for a minute, what would you tell the health minister about what we need? I've told her three things. Reduce waiting lists, reduce waiting lists, reduce waiting lists. And I think you can do that by training more people

to diagnose and treat ADHD. I think that would be a really good first step. There's organizations that the ministry can support that are set up that can help with that like Heidi's Kodak. So I think that would be my main message to the minister. Have you given that message in the past? We have. We've lobbied. I've lobbied with Heidi in Queens Park. What's the reception? The reception is polite but other priorities are there and we'll call us back next week. That's been the reception over the years.

I don't want to say we've made no headway. We have, but it's been very, very slow progress. How about for you? If you had 30 seconds to bend the ear of the Minister of Health or Education, what would you say? I think both ministries need to take ADHD more seriously. I think they think it's just a throwaway kind of disorder. They don't take it as seriously as they do autism and learning disabilities.

And it's a shame, because it costs our society a lot when we don't recognize it. You get the last word. Yeah, that's an honor. I think there should be more of a priority in funding mental health services for everybody who needs it. The privatization of it makes it really difficult for people to get the help they need, not just with ADHD,

but any mental health experience, and having that available helps everyone. Awesome. Great discussion, everybody. Thank you very much to Heidi Bernhardt, founder for the Center of ADHD Awareness Canada, CADAC for short, and on the other side of the table, Dr. Duran Almagor, psychiatrist, and Caitlin Weinstein, psychology major, University

of Guelph. Thanks so much, everybody. Thank you. Thank you.