The Jefferson Fisher Podcast - ADHD Expert: Why You Feel Motivated But Can't Do Anything

Episode Date: September 25, 2026

If you’ve ever wondered why a simple conversation can feel so overwhelming with ADHD, this episode is for you. Dr. Sasha Hamdani joins me to explain what’s really happening inside the ADHD brain��and how it impacts emotions, rejection, relationships, and communication. We talk about why everything can feel “louder,” why feedback can hit so hard, and practical ways to communicate without shutting down, spiraling, or becoming overwhelmed. Buy Dr. Hamdani’s new book: Too Sensitive – Rejection, Resilience, and the Science of Feeling Deeply – http://us.macmillan.com/books/9781250423764/toosensitive/  Join me on Supercast for ad-free episodes, bonus content, and AMAs: https://jefferson.supercast.com/ Leave me a voicemail to be featured on the show! https://www.jeffersonfisher.com/ask-jefferson  Order The Next Conversation Workbook: https://www.jeffersonfisher.com/workbook Thank you to our sponsors: David. Subscribe and save 10% on every order’ at https://davidprotein.com/jefferson  Cozy Earth. Upgrade Your Every Day. Get 20% off at cozyearth.com/jefferson or use code JEFFERSON at check out. BetterHelp. Click https://betterhelp.com/jeffersonfisher for a discount on your first month of therapy. Order my book, The Next Conversation, or listen to the full audiobook today. Like what you hear? Don’t forget to subscribe and leave a 5-star review! Suggest a topic or ask a question for me to answer on the show!  Want a FREE communication tip each week? Click here to join my newsletter.  Join My School of Communication Watch my podcast on YouTube  Follow me on Instagram  Follow me on TikTok Follow me on LinkedIn Learn more about your ad choices. Visit megaphone.fm/adchoices

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If I were to compare a non-ADHD brain with somebody who has ADHD, what would be the difference? It's louder in there. You're taking in all of this information all at once, and you don't have that grade of a filtering system to tell you, this is important, this is not important. So you have much higher likelihood of things raising threat levels than the average person. So ADHD is truly a regulation disorder as it pertains to emotion, motivation, energy, sleep, appetite. So people can be extremely motivated, and it's still hard for them to get to. of what they need to get to because of that dysregulation. I've treated so many people with ADHD that have ADHD and I've experienced it.

I was diagnosed in fourth grade because I presented atypically for a girl. I was hyperactive, really loud, truly disruptive. I started a coup in my classroom. Teacher called my mom and I was in the doctor's office the next day. Did not know I was being treated. What is not helpful to do in communication with those who have ADHD? Why is it that simple feedback to an ADHD can feel like a personal attack? Do you have any advice for people who have ADHD to improve their communications?

I have a couple of things. Number one. It feels like, to me, at least a third of my audience, either has ADHD or loves in relationship with know somebody close who has ADHD. And so in terms of definition setting, what is, I want to know what's the clinical definition of ADHD. It can kind of, maybe from your perspective, what is the urban dictionary kind of definition of ADHD? Okay, I'm going to answer that. But, no, I'll answer that first, but then I'm going to give you like a caveat and like my hot take from that. So the clinical

definition of ADHD is it is a neurodevelopmental condition that impacts inattentiveness, hyperactivity, and executive function. So it is a brain-based kind of, of functioning that historically definition has kind of focused a lot on attention. So it stands for attention deficit hyperactivity disorder. I'm going to get more into that. Yeah. I'm ready. You know, and everybody, like if you're looking at the urban dictionary definition, ADHD is for people that can't focus. Right. Right. That's what you kind of think of. Now here's my hot take. Right. I think ADHD, I agree that it's a neurodevelopmental condition.

It's something that generally speaking you are born with and you grow and develop over time. I believe it's so much more than attention. I think ADHD is truly a regulation disorder. It has to do with, yes, a regulation issue when it comes to attention, but also as it pertains to emotion, as it pertains to motivation, as it pertains to energy, as it pertains to sleep, as it pertains to appetite. just a regulation disorder across the board. If we're saying that ADHD is not so much leaning towards attention. Yeah. And instead is more leaning towards regulation.

Or not solely towards attention, but yes, I think at its base it's a regulation disorder. Okay, well, let's just put it on the spectrum. Yeah. And we have, you know, the needle in the middle. And we're going to be super umbrella over this and say, you feel like it's not all, just attention. It's also other things, including regulation. What would that mean? So if we accept your definition of it, what's the implication of that? The implication is that we, when we talk about ADHD comprehensively, historically, we've always been taught to just look at focus, inability to focus,

inability to complete tasks, inability to stay organized. I am countering that with, especially since, as my career has like specialized in ADHD, as my research has been in ADHD, as I've treated so many people with ADHD and as I have ADHD and I've experienced it. Yeah, you have it. I have it. Yeah. Okay. So this is like a very lived experience as I'm going through this as well. I think when you look at it in its totality, I think, yes, attention is definitely impacted. but I also think a dysregulation when it comes to emotional stuff is a huge, huge part of it. And just to put things in a perspective, I'm not the only person who believes that. In Europe, they changed the criteria in 2019 to reflect emotional regulation as part of ADHD.

Okay. The U.S. is just kind of behind. Yeah. Go figure. So I want to take what you're saying, and I want to take it one step further. And that is when I ask, what's the implication of that? What I imagine is if we're saying, hey, I'm going to take it. hey, this is now a regulation thing on top of it. Yes.

That means there is hope of X. There is a solution for X. There should be a more focus on X. Oh my God. Yes. Okay. Okay. So I think if we reframe this as more of a regulation condition.

Number one, I'd like to talk about what we're going to fix. And then I'll talk about what I hope it will see in the future. I think if we're talking about, okay, ADHD also has this emotional component, then we're going to avoid. misdiagnosing people who show any sort of emotional spectrum with their ADHD with anxiety and depression. Because that's what's happening right now. We don't really have a framework for talking about emotion when it comes to ADHD. So whenever someone is swinging one way or the other, whether they're getting more anxious or they're getting more depressed, then it's just like,

you need an antidepressant. And I'm not against antidepressants. As a psychiatrist, I mean, we utilize them. It's a good tool. But if it's not actually treating the underlying cause, then you're just giving medication for the sake of giving medication. It's not actually addressing the root cause. Yeah. So I feel like it'll help counter a lot of misdiagnosis. I also feel like my hope for this in reframing this as a regulation condition is that earlier intervention, we'll be able to kind of talk about this more comprehensively. So we'll be able to see things a little bit earlier. We'll be able to educate people from a younger age with behavioral techniques that can kind of help them regulate a little bit better and just better management overall.

Is ADHD an epidemic? Well, define what you mean by that. Something that is growing in both dissemination, like of more people now saying they have it. Okay. Okay. and now becoming almost more of a, I'll even go so far as saying, it feels like a lot of people I know have it more than the people I know who don't. Really?

Yes. Because, and it might be truly suspicious that the field that I'm in, every, I feels like every other Q&A that I have, the person begins with, hey, Jefferson, I have ADHD and I battle with depression, or I have ADHD and I am neurodivergent, I have like, Yeah. And friends, I have two of my best friends, both, take, you know, ADHD medication. Yeah.

Okay. One has done it since, like, junior high. Right. Okay. The other has kind of, I don't know, kind of self-diagnosed. I mean, he went and saw a clinician to talk about it of now he's an adult and has, oh, I've had ADHD this whole time. And so what I mean is it feels like I know a lot of people that have it, and it's more in discussion of conversation more than it's ever been. I would agree with that.

I think it's part of the cultural conversation more than it has been. I don't think there's necessarily an increase in just like general population ADHD. It's kind of like, but I think we're getting better at picking it up. And I think we're getting better at talking about it because a lot of people are now, especially since it's so. prevalent on social media, or at least on my algorithm. I mean, right? It would make sense for you, truly. I know.

But I feel like because of that, people feel more comfortable talking about it with their providers, talking about it with their peers, talking about it with their family members. And so now we are, you know, discovering and more. Is there actually more of it in the public? I don't know. Maybe we're just better. It's like saying, you know, we got a super, like a better, like a better, uh, better telescope and now we're discovering more stars. Well, the stars are probably there in the first place, right? We just can see them better now. So I don't know if there's more of it. And I would say that this overdiagnosis kind of thing is really population dependent. Like it's, there's some racial and socioeconomic groups that get it picked up a lot more often. And there are other groups that are wildly underdiagnosed. So it just kind of depends on where that trickles down. Because I don't think it's across the

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that's my bias of where I come from. You have ADHD, so that's your bias of where you come from. So we have two different perspectives. Sometimes I feel that there are those that, this is probably the exception to the rule, that it's like an answer. that's looking for a problem. Like some finding their whole life is dysregulated.

So they're looking for some way to blame it on something. Okay. And so I like that you include regulation in this because it makes it much more holistic in my mind that we're taking it not just from I can't pay attention. Right. Because this guy, I have trouble paying attention. It's part of the human condition. Exactly.

Yeah, I definitely have trouble paying attention to anything. but I like that what you're saying is if we add in the regulation component which is something that I go okay that's something we can talk about that's something we can help a lot of people with do you find that the people you talk to and the people that you've treated

have had ADHD let me just ask you this way is ADHD something you're born with it or something that you can find out that has arisen when you're in your 40s? A lot of the time you're born with it. Really? Yes. Now, what I will tell you is that, you know, for a long period of time, ADHD wasn't really talked about.

So a lot of people weren't getting diagnosed in their childhood because it wasn't part of the conversation. Or because of their presentation, especially for girls and women, when they were going through their schooling, when typically it would have been. picked up, they weren't outwardly facing with behavioral issues. They weren't being impulsive. They weren't being, they weren't causing issues in the classroom. And so they weren't picked up. And then it kept, they kept getting passed from classroom to classroom. And then, you know, when they got into situations where they just could not cope, that's when things started to fall apart. And then at that point, it was, you're hormonal. Or this is depression or this is anxiety or this is mommy brain. And it just kind of gets kicked down the line. And then what happens is, you know,

happens usually what I'm, or at least what I'm seeing within my own patients, it's a lot of times people come to me and they're like, we actually got our kid assessed. And then when I was sitting in the evaluation, I'm like, this sounds like me. And then I got assessed. And so it was kind of like this, we've seen this huge rise in people that actually are coming in after their kids are getting assessed. Do you think there's a certain time or age that a parent should consider getting their Get assessed? No. I mean, like, I...

Are there any, like, indicators or markers? Well, I think... So, the difficult thing about psychiatry in the childhood population is just, sometimes it's really hard to tell, like, what's normal childhood development in your kid being a kid? Right. And what's ADHD and what's not? I always tell patients and parents, like, you know. your child the best. So if there's something in you that is like, I think there's something going on,

I think there's a focus issue, I think there's an emotional regulation issue. If you're concerned about it, or if it's come up like at school where other people are concerned about it, if it's accessible to you and if it's affordable to you, I don't think there's any harm in getting evaluated, like talking to someone who from a medical professional standpoint can evaluate your child. But at that point, even if they say, yes, this child has ADHD, I think there's so many different treatments that you could do. You don't necessarily have to jump to medication. That's another important thing.

I do want to talk about that because I know you have an opinion on that. And I want to make sure we get into it. I want to know what you think my opinion is. It's going to be a good one. I think your opinion is a good one. Are we saying fundamentally is ADHD a spectrum where you can be full on, you know, is it something you can have more of or something you can have less of than others? Um, I think, I mean, yeah, I think everything, right? Everything is probably somewhere on a spectrum. The way you, how we, how our diagnosis sits right now is 80s, broken into three types. There's inattentive type, which is, you know, the classic daydreamer presentation, difficulty focusing, difficulty completing tasks, difficulty organizing tasks, forgetful, losing things. There is hyperactive, which is physically and verbal.

impulsive. These people can't stay in their seat. They're interrupting others. They're impulsive and or hyperactive. And then the third one is combined type, which is a combination of both. Okay. So you can present at different ends of the spectrum on all of those kind of things. And the thing that becomes hard is that there's outward behavior where you can see it and you're like, okay, this person cannot stay still and they can't stay in their seat and they are like, physically touching everybody else. And then there's other people who I would argue their ADHD is just as disruptive. They're staying in their seat. They just can't focus.

Focus. So it's hard to compare those two. So I guess you can, I guess you could put it onto a spectrum in terms of like functionality, like how much people can do. But it just, it presents to differently. Well, in my mind, it's like if you get the chicken box, you know you got the chicken box. You know what I mean? Yeah. There's, you got it.

And where ADHD is concerned, you know, is it just, you tell me something? I go, huh? And they're like, ADHD. Or is it just that you were thinking about something else? So that's what I'm saying of like the spectrum mentality of it. I do have a question of, in your opinion, is ADHD overdiagnosed? I think it depends on the population, right? I think it's over diagnosed in some.

groups and I think it's under diagnosed in some groups. Well then let's talk about some groups like in you mean in demographics in terms of men women kids are you talking about U.S. versus other countries? I'm talking about like if you look at the U.S. population and demographics of that and ADHD diagnosis there is a significant difference in white upper class American children that are getting diagnosed with ADHD versus people in a lower socioeconomic class that might be black or Hispanic. These kids aren't getting diagnosed with ADHD. They're getting diagnosed with behavioral disorders, oppositional defiant disorder. These are kids that are going through instead of actually looking and assessing, they're going through like behavioral plans. They're being given antipsychotics.

They're giving medication that doesn't actually apply to them to try and tamper down behavior. behavioral things that are happening, which are actually a result of impulsivity from ADHD. So it really does depend on where. And again, that's not a hard and fast rule, but if you look at trends within the U.S., that's what you see. I want to make sure I congratulate you. This book is fantastic. Too sensitive, rejection, resilience, and the science of feeling deeply. Yeah. Dr. Sasha, Hamdani. I love this.

For those that aren't familiar with RSD, and I encourage anybody who's listening to this episode, if you can go, I love, I think I really like Dr. Hamdani. You're going to love her book. Or if you've ever really been told you're too sensitive. How about that? If you've ever been told you're too sensitive, this is the book for you. What is RSD? Yeah.

RSD is an incredibly robust emotional response to real or perceived rejection, criticism, possibly disappointing someone else. It's a neurological phenomenon that happens as like your body's defense mechanism to threat. What is RSE-Stain for? Oh, yeah, that would have helped. Rejection, sensitive, dysphoria. Rejection? Sensitive.

Sensitive. Dysphoria. Dysphoria. In plain language, that means... That rejection is exceedingly hard to bear. Overwhelmingly. Overwhelming. Shut down hard to bear.

Okay. And the tools you provide in here, what I love about it, is that it really does. It turns this. from feeling of am I to a feeling of strength. And what I'm excited about to talk about with you now is if we take some of the principles of this book and we say, okay, what you already talk about in your background in ADHD.

And my group, my community, whom I love, that we talk about communication. Yes. Is, all right, let's put some of this stuff in words. You want to help me? We're going to help a lot of people, which I'm very excited about. First, what do you need to be,

thinking about, what's the number one thing you need to consider when you are speaking to somebody, communicating to somebody that you know has ADHD? I do love that question. Yeah. I think, well, first, let's back up. I think people with ADHD, they, again, like what we talked about, everybody can present a little bit differently. So are you asking me about ADHD? Are you asking me about, like, someone who's extremely emotionally sensitive and has RSD? I'll see both. So first let's do, and that's a great differentiator. So let's go just ADHD and let's talk about that and then we're going to move into the RSD of it. So ADHD, I think if you're communicating with someone with ADHD, it really depends on how they present and what's going on. But for the most part, it would be normally you present. I don't think you have to communicate any differently. Now, if there is,

this person is getting really overwhelmed or if I'm giving them too much information, it might be something like, okay, you know, I sped up. Let's slow this down. Like, especially, you know, when I am seeing patients, which, again, it's a little bit different of a conversation. And I'm, you know, this patient might have ADHD. Sometimes I'm like, I just gave you a lot of information. Right. And I'm sorry, let's break this down and let's talk about, I'm going to write this down for you so you can have it and you can look at it later. But these are the three most important things we're going to talk about today.

And I kind of go over them and I list them so it's easy to kind of go through and follow. From the emotional side of things, and I guess I'm starting to answer the RSD question, for people that are emotionally sensitive, I think phrasing things in a way, so part of the issue with RSD and for people that are emotionally sensitive

is that even if what you're saying is neutral, and I don't know, Jefferson, if you've experienced this, but like sometimes if I'm already kind of in that place where I'm, I feel anxious about our relationship or something, and then someone tells me something neutral, my brain will attach a negative thing to it, and I'll just start spinning about that. Or if there's a delayed text, I'll just fill in that space with, they're mad at me, something went wrong. Right. There's a problem, and then I'll spin, spin, spin. So I think for someone who, does that, and I know I do that. I'm emotionally sensitive. I know for my son, he's kind of wired the same way. Yeah. It's doing, it's understanding that communication style. So now within our house, you know, if like I have a tone shift, which I'm tired, man, I can't regulate my tone all

the time. But sometimes I'll do that and then I'll, I'll recognize what I'm doing. I see in his face that something is kind of shifted and that he feels like, oh, God, is she upset? And I'll say, you know what? I'm so sorry. I don't know why it came out that way. Let me try again. Or I will, you know, if I'm, if he looks or like even when my husband is talking to me and there's something that we, him or I just kind of crossed wires on in terms of

communication. Do you know how we communicate now? You're probably going to be like, this is. Let's hear it. Well, because I, okay, I feel like I'm talking to someone who's so good at communication and this is like a weird swerve. This is a no judgment zone. Okay, thank you.

Sometimes when we beef, I feel like that conflict that happens, it is on both of our parts, it's difficult to experience in that moment. Me, because I'm looking at everything his face is doing. Like if he's sighing, if he's turning away, like my body and my brain is reading all of that. Sure. And I feel so incredibly overwhelmed. And like then two things happen. Either one, shut down, can't have this conversation.

Or two, more likely. I want this conflict to resolve immediately and I will chase him around the house. I'll be like, hit another thing. Yeah, yeah. The anxious attachment type of like, yeah, we need it now. Just hunt him down and he's like, oh my God. Yeah. And he wants to avoid it.

He wants to be quiet and process what I'm saying without watching me crumble. Yeah. So now what we've found has been most effective is that when we get into that, I have to write because I feel like I'm most eloquent when I do that. And I get to, I'm able to hone down my thoughts instead of just this rapid, like, otherwise you let me go. I'll bring up everything I've ever felt bad about in my entire life in one conversation. Yeah, that's true. I think it's very healthy, though. I know, like for my wife, when we have our beef, like I said,

we have definitely found that she will at times go into, she has like a notes in her phone that she'll just start working away on. But it's a process of filtering things, getting it out, rather than creating kind of a snowball. Yeah, new beefs, a snowball effect. You've been, how long? ago were you diagnosed with ADHD? So first or second

time. You can be done twice? You can double ADHD? So I'm double ADHD. I was diagnosed in fourth grade. And I was diagnosed because I presented very atypically for a girl. I was hyperactive. I was in everyone's face. I was really loud.

I was disruptive. Truly disruptive. I started a coup in my classroom. Oh, nice. I was a substitute teacher. I respect that. Okay. And the substitute teacher told my teacher, the teacher called my mom and I was in the doctor's office the next day. Like it was so fast. Diagnosed, started treatment at that time. Yeah.

Did not know I was being treated because it was so like it just wasn't talked about. My parents didn't know how to bring this up with me. So they're like, these are vitamins that are going to help you focus or that'll help you, you know, that'll help you. I don't even think it was like focus. These will help you. And I was like, all right. And it was medication. Okay.

Which, yes, that face was appropriate. It wasn't the best move. They made up for it. But that's kind of where like the conversation just wasn't there yet. And they didn't know how to have it with me. Also, keep in mind, exceedingly sensitive kid who already felt kind of othered. Like I grew up in a like as the only ethnicity in my. school. And so I was already like, this is, yeah, I just, I feel very different already. So I go through,

I did really well on this vitamin. It well enough that I get out of high school and I got admitted into this combined undergrad medical school program. So I started medical school at 18. Okay. And then the wheels fell off. I was like my, I was by myself for the first time. I had moved away from home. I, you know, was it started like a very rigorous courts load. Also, I wasn't in sports, which was like a big difference for me because I think that really, yeah, that really regulated me. And this was the first time I wasn't doing anything physical. And so my parents were like, what's up, man? Yeah.

And they're like, have you been taking your vitamin? And I was like, I don't even know where that is. So no. So they were like, okay, it's actually ADHD medication. And I took that so poorly. I just felt very angry and betrayed by the whole thing. And I dug my heels in. I was like, there's no way.

There was no way. There was one other kid in my elementary school who had ADHD. I did not present at all like him. So I was like, no. And then as I started going through, I'm like, this is actually very hard trying to like study and do all these things. And then at one point, my dad was like, just come home. Like, you don't need to do this.

Just come home. Let's learn about your brain. If you have ADHD, you have ADHD. If you don't have ADHD, you don't have ADHD. What a good dad. He's a great. Solid moves. So we were like sitting and this is like before like, you know, there was so much stuff on the

internet. So we're sitting in the library like going through it. And he's like, this sounds like you. And I was like, this does sound like me. And so we were going through this. I'm like, yes, we do have that. And then I started. And then I went again to a physician, started talking about medication and really just like

kind of took more ownership of my like, okay, this actually does explain my brain. Can you explain to me? how this medication works. Can you explain to me on this medicate? And so then I feel like that was a second diagnosis. I'm with you. And you chose not to, you're not all medication currently. Not now, but I, through med school, I absolutely was. It took me a long time to find one that worked, though, because I tried so many. And some of them, like, frankly made me real weird. Like, I just wouldn't eat. Even more weird. Even more weird than my baseline. So, like, it was, like, I was shooting myself in the foot. And then eventually I found, like,

right regimen and truly I would say that being on medication helped me get through medical school. I don't think I could have done it. Otherwise. Before we keep going, I want to take a moment to tell you about David. I don't know about you, but I have a lifestyle that is fast-paced. I'm always in transition, always working, always doing something else, doing something with the kids. And I always feel like I may not be getting all the nutrition than any, especially when it comes to protein.

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Davidprotein.com slash Jefferson and when you buy four cartons you will get the fifth free right now you can also go look and find their store locator to find a David protein bar near you and now let's keep going all right I want to I want to bring us back to communicating with those who specifically on the ADHD side all right now have you found I want to do it two different perspectives because I have people in my community who have ADHD and they say Jefferson, I have a really hard time communicating with people because I tend to interrupt a lot or I tend to go off on tangents or I tend to get wrapped up into the fear of things that aren't even in the conversation. And then on the other end of the table, I have people

who are married to somebody who has presents with ADHD and they have a hard time communicating with them. So I want to start with those that are, don't have ADHD and are with somebody who does. All right. I want to give them some tools. I want us to give them some tools on what may be able to help in communication. So we can rely on the things that you know help you as a case study. Yeah. I can tell you what information I've received from people is, Like bullet points are very helpful. Very helpful. So bullet points are helpful.

What else is helpful for somebody to communicate to someone who has ADHD? Written. I think like, write it down. So for me, within having a conversation, there's so many other things that go into a conversation that I am now, after my medical training, realizing not everyone has. And I think this is part of like being married to someone who absolutely does not have ADHD. I'm like, you don't have that. Yeah, yeah.

And so, like, within a conversation, I'm not only thinking about what I'm saying and what you're saying. I'm also thinking about you moving your foot and, like, you're positioning and your tone. And then I'm thinking about, like, how am I going to respond to that? Should I be mirroring? Should I be doing the same thing? Like, that's where my brain is going simultaneously. As a result, sometimes it's hard to remember everything that's going on. the conversation or keep a logical flow. And I think that's when people get fragmentation in

communication because so many other things are happening in their brain at the same time. So when you write it down, it's a lot easier to kind of keep on track because you have those visual cues. Like, we already talk about this. Remember talking about this. Let's go to this next one. So I think bullet points helpful. Writing it down is helpful. The other thing that I think is helpful is understanding their communication style ahead of time. So I think for some people, it is, When you are, there's some people that really need that kind of gentle or neutral framing of things, you know, because they tend to get emotionally triggered by certain things, even like neutral. So, like, if you are phrasing some information, and I'll give you a work example, if you were a boss and you were talking to somebody and you were telling them. you know, I think I, we need to postpone this project because I, I think we need to redo this one part.

You say that to someone who's emotionally sensitive or who has ADHD and is already so, like, worked up about their own performance and they're, they're, they already have a feeling of a lack of self-trust because they're like, I've already messed this up before. This is a direct reflection of my worth. if you say we need to postpone this because we need to redo this part, it can feel devastating. Instead, how you might rephrase that is like you understand kind of that underlying emotional component to it. And so you're like, you know what? I think what you have here is actually pretty good. What let's try. Is there a fly here?

I don't know. I think that's fuzz. But it did look very, it was a fly-like looking fuzz, I will say. Fly-looking fuzz. All right. Ignore. You're good. Back up.

Yay. I think how you could reframe it is if you were saying, there's some really good stuff here. Why don't we spend a little bit more time and expand on this? Because I think we're almost there. Those two things feel so different. So that would be my recommendation. Understand kind of that emotional component to it as well. Okay.

So I want to nail it. I'm going to talk about it even more. We're going to keep just rolling and out. So I hear bullet points because it's good to get things in little chunks. Yep. Rather than, is it, is it just for a matter of curiosity, is it, for somebody who has ADHD, is it, would it be easier to read like bullet points on a page or the whole page just being all text? Bullet points, but I feel like everybody would find it easier to read bullet points.

Well, I find in particular that bullet points, when I say the, When I say bullet points, I mean, give it a sentence and then get some interaction back rather than beginning. I mean verbally. I'd say like if I'm giving you a verbal bullet point, something short, concise right to the point. Okay. Verses me going through a very long paragraph of words that give a lot of opportunity for distraction, the inattentiveness, whatever else that could be kind of being pulled in to the conversation. So I hear bullet points being one of them.

Shorter communication is better, if you can. Short and sweet. Knowing how they communicate ahead of time, I hear that. Sometimes you don't know. Yeah. Sometimes you don't know. And it might also be very good. And we can talk about this on the other side.

For the person who has ADHD, say this is how I best communicate. I have started doing that. It's very helpful. Tell me. Like, for example, sometimes when I feel like, you know, I moved into my own practice about a year and a half ago. And so I, when patients message me, which in general I love is like updates and things like that, sometimes I will have patients who message me and they leave me big, long chunks of message, numerous, numerous pages worth broken up. into men and like my my box is this big so I'm like and so you know there was for some patients I'm like I have to tell you how I can mean I get lost with it first of all I can't scroll right second

of all I get lost in this message I need like if if if this is like a long lengthy thing where we need to expand then I need to do it within an appointment so I can ask questions in real time because I can't absorb information like that I'm trying to help but I can't like this this feels like too much to grab hold of, I really have questions in between. So if it's not like in bullet point form that I can answer and go through, that's going to be difficult for me to answer. Or we need to have it where we're talking in real time about it because that's too much for me. I'm trying to find something in like, if I could distill it down into like two sentences of when I'm communicating with somebody who has ADHD, what's really going on?

in their head. Like what, if I were to compare a non-ADHD brain with somebody who has ADHD, what would be the difference? It's louder in there. Okay, louder. There's just a lot more going on. So with ADHD, like, if you think about what's actually happening from a neurological perspective, it's not, there's not a lot of good filtering that happens.

So you're taking in a lot of input at once. You're measuring visual stimuli, auditory stimuli, hearing, like processing what's happening in real time within a conversation. So you're processing all of that stuff. And it's difficult in that moment to prioritize like, this is what I should be focusing on because you're like, okay, their head is turning this way or they're clearing their throat. That means they're not interested. Instead of being like, well, let me listen to what they're saying because that's what's important. So you're taking in all of this information all at once, and you don't have that grade of a filtering system to tell you this is important, this is not important. So you have much higher likelihood of things raising threat levels than the average person because you're taking a lot of info.

Okay. I like this. Let's keep going here because this is making sense to me. Okay. If I were to have a soundboard, a mixing board, and one of those says, my five senses, right? Okay. It sounds like that ADHD, it has a way of increasing and raising, you know, at least the bar of how much you are feeling at a given time. So everything feels really loud, like just a big traffic jam, that it's really every, whatever you feel is magnified,

amplified. And in turn, that means your thoughts are amplified as well. So your thoughts get really loud or your attention to little movements get very, very busy. And so that means it's very hard to just have a straight line from A to B. Is that, is it, am I there? No, no, no, you are there. The thing that's a little bit, not different, but I mean, if we're talking about everything kind of on a specter base, Because you talk a lot about this as neurodivergence as a whole.

Like you talk about this with autism where they have poor filtration as well. With ADHD, I think it depends on the person and it depends on what's going on in their brains and in their lives. Like for example, certain hormonal shifts will make this even louder. Like there are certain times where if estrogen drops, dopamine, which is a great regulator in the brain, drops as well. and then everything just gets louder, more overwhelming. Everything kind of peaks up that way. So it's not necessarily a constant that their brain is always going to feel like that. There are times where your brain is more quiet and you're able to attend.

And there are times where it feels very loud, very busy. Okay. But I think it's in the baseline. Yeah, this is helping me. Because I really do try when I give advice on communicating. Yeah. That I ask other people who I know who have ADHD of like what's helpful, what's helpful to you, what's not helpful. So I want to ask both from your opinion and those of your patients, what is not helpful to do in communication with those who have ADHD?

Like what really gets under their skin and makes things like much, much harder. Do you know what I feel is very annoying? And I think my patients reflect this is when, like, for example, if someone were to talk to me about getting something done or something like that, and their response starts with adjust. Just do it. Just calm down. Just get it over with. I think that implies that there is a volitional component to it. And sometimes quite literally, like all my effort is there, I want.

I want to do something. I want to get things done. And it is so much harder for me to get over that initial momentum, whether that's because of executive function paralysis, like it's really hard for me to organize and figure out what the next step is or whether that's because of emotionally I'm just kind of paralyzed in that moment. It's difficult for me to get to that next step. So when people are saying, just do it.

Just buckle down. Just make a list. You shut up right now. I can't. And I think it really became obvious because part of why I wrote this book is because two years ago, my dad passed about two years ago. But even prior to that, we'd been dealing with him being on and off kind of sick and then really ramping up with sickness. And in that time was, and I can't believe it took me that long, but it was during that period where I'm like, this is the first time I'm actually seeing this connection between. my emotional status and my functional status.

Because if my emotional status is like chaotic or wrecked because of something like as big as a loss or something where my brain is just completely preoccupied with emotion. Yeah. I cannot be productive. And it's like all my scaffolding falls apart. And I can't even figure out what the first step is, which made it really hard for me to, you know, get my job done and to parent my young kids and to do all those things. And so it was when I saw that, I was like, there's something more to this. This isn't just like ADHD in relation to just attention. There is an emotional component because when that's not addressed, I mean, the functionality just goes.

Sure. Did I get off tangent? I think I did. No. Okay. No, I mean, it's, it reminds me of, you can have, let's just say if you have an argument with your spouse in the evening and it doesn't get resolved that next morning at work. is wrecked. Yeah. Because you can't, you can't concentrate. I mean, I can remember at the law firm, I'd have maybe another associate or a partner or something, and maybe they're going through a divorce, and like, everybody kind of has to know, like, they're not going to be nearly as productive because they're just going to be that, like you said, that a scaffolding is gone. The emotion's not there. So I definitely believe, and even in my own life, of the emotional function versus the actual

task function. Productivity function, I know. What are the top things that those who have ADHD, instead of seeing it as the condition, instead of pointed towards some other type of thing? What's the misdirection there? I think a lot of people miss that this is a neurological condition, an underlying neurological wiring and neuroanatomical difference in the brain. So it doesn't, using techniques like, I don't even know if it's a technique, just try harder doesn't work because there's sometimes where these people with ADHD, they are applying all of their effort, but it is just neurologically, things aren't totally lining out for them. Like energy isn't regulated and focus isn't regulated, and motivation isn't regulated

and emotions aren't regulated and it's hard for them to put together all those pieces to make that kind of process move forward. But it's not effort-based. They want this to happen and they're trying, but their brain has blockages kind of getting them to that point. And there are ways around it. There's medications for it. But like in that moment being told, just do it or just write it down doesn't help. Do you have any advice for people who have ADHD to improve their communications? Is there anything that you've learned yourself of what they can do to better communicate?

It's taken me a long time to answer that question. I have a couple of things. Number one, and we talked about this before, is I think writing has been very helpful for me because in those episodes, like, when I'm having difficult conversations with my husband. But the thing that I end up sending him is usually like the fourth revision. I've gone through so many different iterations. of it and I've distilled it down to what I really truly want to say without a lot of unnecessary barbs or like just a lot of things that don't actually pertain to the situation in hand.

So I think it's a much clearer communication style. That's one. The other thing that I think a lot of people with ADHD, because there is that lack of self-trust in, you know, in your. ability to emotionally regulate and just your ability to kind of function, I think a lot of people take the backseat in communication. And so a lot of communication happens to them. And it's difficult, either in real time or to muster the courage to figure out and say the right response. So a lot of people stay silent. And I think I've done that for a great majority of my life, that instead of

having difficult conversations. I just, I'll just take what you say and then, yeah. Or not even avoid, but just like, that's fine. Like, I'll agree with you. I'll placate. I'll, you know, I'll be the people pleaser in that moment because I'm trying to avoid conflict in that moment because I know that in conflict I'm going to get emotionally dysregulated.

I'm going to become, I won't be articulate. I won't be able to express what I'm trying to say. And then I'll just make the situation worse. So my defense mechanism up until, like fairly recently, it's a long time to get here, would be just to kind of let conversations happen to me. If people are trying to have difficult conversations either, all people please, I'll get through that moment. I literally, I'm like, my heart rate is up. I feel so dysregulated that I just need to get through this conversation. What do you do now?

now now I'll just like straight up tell them what's happening yeah this is so stressful to me I can't have this conversation right now I can't have this conversation while I'm waiting to pick up my kids I can't like this is not the right time nor the right place let me or I'll take a break from the conversation like any time to think about this like I just need to step away from a moment because I don't want to say something I don't mean and I want to be thoughtful about my response. So I've learned to back up and take some time so I can process it on my own. And when I feel less of that happening, then I can come back and continue the conversation. Or sometimes I'm like, I know for a fact that I'm fully scared of this person. And I will never be able to kind of

communicate as efficiently as I want to, in which case I'll be like, you're getting an email. I'm not talking to you. I found that at least some of the advice that I've given in this kind of communication is often when I can get them to, when they're talking to somebody who has ADHD, to eliminate the worst case scenario right out of the bat. Because otherwise, the person who has ADHD is thinking worst case scenario nine times out of ten. And so as soon as that conversation starts, it's, hey, I still love you.

We're still together. You know, or everything's totally okay. You're not getting fired. Exactly. Yeah, yeah, yeah. Whatever that the hammer, the worst case scenario is, get that out of the way really quickly. You're not in trouble. Yeah.

That's really smart. To be able to, and then that way you kind of have a little bit more room. I've also heard, don't tell it to me, show it to me. Like it's, it helps if you follow up with text or maybe after a phone call, you follow up with an email. They'll just talk about what we talked about. I'm also curious what you think about this for those who say, Jefferson, I have ADHD. By the way, I'm going to ask a question. Is ADHD considered neurodivergent?

Okay, it's safely within, okay, gosh. That people will ask how to communicate in that way, and I usually will say, or they'll ask how can they improve their communication. And I will tell them to narrate out their thoughts. In other words, to be able to say, like, my brain says this, or what my mind is telling me is this, to be able to at least get those thoughts out rather than internalizing them

and probably making it worse. Is that helpful advice? To yourself or in front of somebody else? Out loud. Yes, out loud. So in other words, if you were to talk to me and ask me a question, and maybe my brain's going somewhere else, I might say, my brain is telling me that you're upset about this in this moment.

Like getting that out rather than worrying about, oh my gosh, is she upset with me the whole time? So I would love to do that. But sometimes my brain is telling me that if I say it out loud, it will make it true. Or that you will now start fixating on, why do you think that you're mad at me? And I feel like it would open up. Like there is a huge fear, and I think this comes from being rejection sensitive or criticism sensitive, that if I point out the thing I'm already anxious about, you'll be like, oh yeah, that is a good idea. I am a little mad at you. Let's explain and get more into that.

And then I'll have to sit in that discomfort more. So like, and I'm not saying that's healthy. I'm saying that that's a fear that I have especially experienced as we've gone through. So I have always air, as a pattern, I would tend to hide that away. I don't want you to think that you're, like, I don't want you to know that I feel upset. And so I just kind of mask it and then I blow up somewhere else. Is there something your husband does that he has learned, say this is, at least throughout y'all's relationship, something that he can do to help community? with you?

Yeah. I think we've gotten, so our relationship was interesting because we met and then immediately had to do long distance because I went for residency in Phoenix and he was in Kansas City. And in that time, a lot of our communication was via text and like not even phone call all that much because I'd be working or he'd be worried. So a lot of it was like we'd communicate via words, which was like actually kind of a beautiful way because I couldn't like I wouldn't get so wrapped up in my head about certain things but also with that you don't get those tone cues you don't get those context cues so it's a little bit harder to

so early on in the game I would do things like you know I'd show my friends I'm like does this sound like he's mad? Is this like what? And they were like no and I was like okay okay eventually over time as we got more comfortable I got to the point where I'm like, I would like screenshot what he said and I would be like, when you said this, I got really anxious about this. Is this true? And then he would say, no, that's not true.

That's not what I was saying. I'm sorry if I made you feel that way. I think it was just gaining that comfort with him to be able to kind of say, here's the thing that made me anxious about how you said it and him saying, I understand why you felt that way, let me rephrase it, or that's not what I meant, and him addressing it right away. I think that made the conversation a little bit easier when we were able to, because it took me a long time to get to that spot where I could like point out that. Because before that, I was just showing it to my friends, or literally anybody who would see my phone. So what I'm hearing

is call. Yeah, if instead of text, if there's really a very important conversation to be had, pick up the phone and call. Mm-hmm. I mean, it does, if there is miscommunication that's happening that way, now what I will tell you is sometimes I'm too scared and sometimes I'll send that text out. I don't want to talk to you. I want you to respond by text and tell me because I'm already feeling anxious and scared and stuff like that. I know for people that aren't emotionally sensitive, me explaining this really sounds like it's you're handling this very fragile, delicate, creature. I think the way that I explain emotional sensitivity to people is that they're people,

if you look at emotional sensitivity as a spectrum, and they're in the middle of the spectrum is people who feel emotions up and down that are situationally appropriate. And on one side, it's like apathy where they don't feel much. The other side, which is where I live, is that neurologically, the way certain people process emotions is that emotions, they feel like. things very quickly, very deeply, and for a long time. So things can feel very big. And that can be, that can be up and down. I can feel small things and feel elated by them. And I could feel small things and I could feel like this is difficult for me to deal with and process. And so I think as we've gotten more comfortable with each other, he's, he's been able to recognize like my cues as like,

Okay, I can see that you're kind of spinning one way versus the other. I have a good. My brains, to hear that, my brain's on me. One thing that I find is common for those who have ADHD is they have trouble answering questions sometimes. Is that what I was doing? No, not at all. Okay. No, no, no, no, no, no, not at all.

No, this is, I like, I like the answers. And I want to hear everything that you have to say because it parses it out and there's, it's, um, there's a lot in them. What I find is that the people who ask me questions will say, I have a hard time either staying on topic. Yeah. Or getting to the point. Or I tend to over talk. And what could be just a simple yes or no, I have a very difficult time with that. And so they find that they just continue to just start.

talking. What's happening in their brain when that's happening? Again, if you go back to filtration and regulation, it's hard for people sometimes to figure out what's the most important thing that I need to give. What's the answer that I need to give? And instead, they're like, well, the answer is yes. I know the answer is yes, but I need to give them this context so they know why the answer is yes. And then once they start going on this tangent of why the answer is yes, then there's another side quest story that they need to get into. Right. So is that a must? Like in there is the brain saying, no, you must get this context out?

Because in my, Jefferson's brain goes, how can I help them go, you don't only need all the context? I need you to pull up that yes or no right to the top. Is that like a trained learn thing or is that like, no, Jefferson, they, they have to talk out the context first. Not a must, but sometimes without having a firm parameter, they think that that's, you know, that's how to justify the answer. Like, for example, when I'm doing psychiatric screening, and you're going through some of these questions, and with everything in psychiatry, there's so much nuance, and there's so many things that, well, it could be this, and dependent on this, and

dependent on this. Sometimes I'm like, I just need a yes or no answer because this is talking about, like, pattern recognition. Right. And so I just tell them right off the bat, I'm like, I don't need any other answer. I just need a yes or no. And then we're going to dive into it later. Knowing that you can park this stuff and talk about it later, sometimes that removes that need to give context. So just like giving them that avenue, like we will talk about this later. Let's just get through. I just want a yes or no. And then we'll go through it in more detail next. I hear you. So and for the person who, that to me, if we say, hey, and see, I'm putting this in all the emails and the DMs or the people that I talk to and ask questions and they say, I have ADHD. I have such a trouble with over talking, talking too much.

And I have a hard time. I really have a hard time of going, okay, well, shorten your answer, take out the context and I'll say, give them the headline. Don't give them the bottom of the page. Give them the headline first. Yeah. But that's very still difficult. It's like I'm saying that advice, but that doesn't mean that it's helpful if their brain is not going to fire that way. Sometimes it is hard to find the headline. And, you know, because there's so many things that could be the headline and something like that. But I think also just phrasing that within the conversation of like, you know, we're having

an interview. You know, maybe you already know that this person overshares. I'm one of those people. It's hard for me to kind of filter what's important, what's not. And so having someone say, you know, like we're having an interview questions or answers should be around 30 seconds, like stuff like that, giving them like kind of rough estimate, it helps to some degree. Would it be helpful if your partner has ADHD or a coworker has ADHD to say, hey,

what's the best way for me to communicate with you? What would be like come up with a plan together to involve them in it, right? rather than treating them differently. Yeah, I love that. I wish everybody did that. But I think also, Jefferson, I think a lot of times when we're trying to drill down and figure out, like, I've had a lot of discussions

about this in terms of, like, accessibility just as a general conversation. I think a lot of the techniques that we use to, like, better address for people with ADHD, I think that's stuff that a lot of times would be great for everybody. Yeah. Like, you know, like bullet points, great.

Having things follow up when written, great. So I think there's a lot. Be more patient, great. Great. Be aware of their emotional climate ahead of time. Great. So I think there's a lot of stuff that I think is just kind of universal. I think that people should just be more gentle with each other and gentle.

General, gentle. Gentrificial. Yeah, any of them. What's the number one thing that people get. wrong with someone who has ADHD? There's so many. Give me a category. I want you to talk about that it's lack of effort.

Okay. That is laziness. I think that people don't consider that this is a neurobiological phenomenon. Like it's underlying neurochemistry, neuroanatomy, different wiring. And it doesn't have to do with. your intrinsic desire to do something. So people can be extremely motivated and it's still hard for them to get to what they need to get to because of that dysregulation, whether it's attention, whether it's emotion, whether it's motivation,

whether it's energy. So it, but that's because of their wiring, not because they're not trying hard enough. So it doesn't have to do with laziness. How does a partner make sure that they are not, that they can talk about the wiring without making it a problem about the person. I think, like, for example, you know, when you're looking at how households run and, like, the distribution of labor and things like that, I think sometimes it's hard because occasionally what you'll see with ADHD is you fall into, in relationships, you fall into this pattern of almost like a parentified. child relationship instead of partners. Like, you know, one partner is kind of a caretaker and the other one is just kind of

along for the ride, which is not always the case. But that's kind of in the most trope kind of scenario, something that could potentially happen. And a lot of that stems from poor communication, right? It's just that, you know, well, one partner doesn't know how to address these needs that the other partner has had. The other partner is not taking accountability for what they need to do and pull their own share. And so there's just this like miscommunication that's happening. And then it's almost like these separate pathways that they're on. So I think that talking about

one of the greatest things that's happened in our home is that, you know, my husband and I, when we're just like trying to get anything done, he's, he's. he's if he sees me like struggling with certain things and I'll tell you anything with paperwork I struggle with it's just it's just too boring I can't do it it's so hard and so I'll you know it'll be hard for me to stay on top of deadlines and things like that and he's an attorney so he's like very driven by deadlines and like he just really understands all of that stuff and it's great yeah so you know when when it's stuff like that he'll be like like, how can I support you in this?

Which is such a different question than why didn't you get that done? And sometimes I don't even need his support. Just knowing, like, how can I support you in this? My answer is, no, I'll get it done. And then I'll just sit down and kind of start doing it. But I know that he's not upset with me. I know that he's not trying to come at me. He's willing to help me with this.

And then I'm like, okay, I'll just knock it out. And so it's just a difference in how you approach the problem. I love that. Instead of saying, why hasn't this been done already? Ask the question, how can I support you in this? And he does that all the time. We have it here in your book, Plain as Day, how to respond to constructive criticism. How do you make sure that, and I'm going to pose it as a question, so you can talk about the tool that you have, which I think is perfect. Why is it that simple feedback to an ADHD bring can feel, like a personal attack. Yeah. I think it's because of that level of uncertainty. You know, people are reading into that feedback and they're like, okay, what are the

next steps from here? Clearly, this person hates me. I'm going to get fired. It's like, this doesn't, this doesn't bode well for me. I can't fix this. It's over for me. And so already from that constructive criticism, it's not like, what can I take positive so I can improve my performance?

It's, this has been a devastating blow. how do I get out of the situation unscathed? So it's, it is the way that it's hitting your ear already is so incredibly threatening. You've dumped out alarm chemicals that are telling your body to respond in fight or flight or freeze. And so you're responding to it as if, you know, there has been like a critical threat that's happened in the moment. So that's why it's truly neurological. Like your body is being flooded with, with chemicals that are telling you something is seriously wrong. So when you're experiencing that big robust response, it's not just you.

It's not just a personality quirk. Like your body is sending you signals that are telling you this is a big deal. So when you get that email from that employer who's asking you about what you did and everything in your, you know, why you did X, Y, and Z in this proposal and everything in your brain is screaming, I'm a failure and this is so terrible and I should just quit and leave. Yeah. What you should do instead is... Okay. What did I say in there? Yeah, yeah, yeah. So this is what I'm going to put it like this and then I'll have you comment on it. What you should do instead, okay, in your book, too sensitive, you're going to have your feet on the floor, you're going to take your breath, which I'm a big fan of.

Say to yourself, I'm safe. This is feedback, not a personal attack. If you need to excuse yourself for a few minutes, collect your thoughts, let your body calm, which is that regulation piece. Yeah. And ask yourself questions, like, is there at least one useful piece of information that I can grow from? And what would it look like if I view this as actual feedback that is not personally threatening? So here's a deal that I love about how this book is kind of structured because it starts with, you know, this is like what's happening, a example, a real world example, which I've gone through hundreds of billions of times, all of these. And then it talks about the tool to use. And then it talks, well, actually, first, it goes through. the example, then it talks about what's happening in the brain. Like, this is why you feel so

dysregulated. Then it talks about what tool to use, and then it talks about how to apply it. All of the tools in that book, you've heard before. You've heard about deep breathing. You've heard about taking a walk. You've heard about delaying the reaction and about moving your body. You've heard about all of that stuff. But what is different is what to apply and when to apply and how to practice it when you're not in that moment. Because I think that's so important, because when you are right in the throes of things, you don't remember any of that stuff. So being able to practice it when you're not, it goes into your brain so that at least, you know, over time, you start to get more comfortable.

You start practicing stuff when you're not dysregulated. So it'll start to become more second nature to you as you're going through. And so with this, you know, when you're taking seconds to, okay, let me, let me breathe. Let me process what's happening. and let me, if I need to, I need to take a break. What you're doing, quite literally, is when your emotional center of your brain is spinning out of control, by taking a break, you're allowing that area to calm down a little bit so your prefrontal cortex, that very smartest part of your brain can come back online and be like, this actually isn't that big of a deal.

You're fine. So you're physiologically giving yourself time for resources to ship from one area to the brain to the other. I love it. And what's so good about the book is that you really go into the why for people that are wondering, why has this happening to me? Well, you explain exactly. This is why it's happening. Yeah.

There is a neurological reason this is happening. And having that knowledge and that information, I think it would be a big comfort of people. Dr. Amdani, thank you so much for coming on. Thank you for having out and talking with us and everything. So thank you so much. Yeah, thanks. Calculating route to avoid seeing poverty. Turn left to bypass the unhoused youth sleeping on the street.

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