Well with Arielle Lorre - 482: Hormones, Anxiety, Rejection Sensitivity: Root Cause + What Actually Helps with Dr. Sasha Hamdani

Episode Date: September 16, 2026

Dr. Sasha Hamdani is a board-certified psychiatrist specializing in ADHD, rejection sensitivity and emotional regulation, and the author of the new book Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply. She also happens to have ADHD herself, giving her the perspective of both doctor and patient. In this episode, Sasha and I get into a question that feels impossible to avoid right now: does everyone have ADHD—or have we just gotten better at recognizing it? We talk about what ADHD actually looks like beyond the stereotypes, why women are so often diagnosed later in life, and how to tell the difference between normal distraction, stress and anxiety versus something clinical. We also get into hormones and ADHD, why symptoms can change throughout a woman’s life, non-stimulant medication options, and the lifestyle changes that can actually help with focus and energy.Then we get into the part of this conversation I found especially fascinating: rejection sensitivity and feeling everything so intensely. Sasha explains why a text, a change in someone’s tone or perceived criticism can send some of us into a complete spiral—and how to stop burning so much energy on fear, anxiety and perceived rejection. Plus, we talk about her new book Too Sensitive and the tools she uses to regulate emotions without trying to become a person who simply feels less.You can find Sasha at @thepsychdoctormd on InstagramThanks to my sponsors:Go to boncharge.com and use coupon code BLONDE to save 15%.Head to hungryroot.com/blonde and use code blonde to get 40% off your first box and a free item of your choice for life.Visit Prolon.Life.com/BLONDE to claim your 15% discount and your bonus gift. Nutrafol is offering our listeners $10 off your first month’s subscription and free shipping when you visit Nutrafol.com and enter promo code BLONDEVisit WACOAL.com and use code WELL at checkout for 10% off your first purchase.Try QUO for free PLUS get 20% off your first 6 months when you go to Quo.com/blonde.Head to ladder.fit/WELL and take a quiz to find your perfect ladder plan. Use my link and get a free 7-day trial with NO credit card, and $10 off your first month if you join.Head to DrinkNello.com/WELL and use code WELL at checkout for 20% off which stacks on top of subscriptions for up to 40% off.This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a dear media production. This is Well, a podcast about wellness in all its forms. I'm Ariel Laurie, and each week I'm sharing unfiltered conversations with people shaping how we feel, live, and look. Come for the substance, stay for the honesty, and leave with the tools to be well, inside and out. I loved this episode and this guest so much because she's a doctor, but I feel like she's not a regular doctor.

she's a cool doctor, to quote, mean girls. And I say that because my guest, Dr. Sasha Hamdani, is one of those people who can explain what's happening in your brain without making you feel like you are sitting through a medical school lecture. So a little background on her. She is a board certified psychiatrist. She specializes in ADHD, rejection sensitivity, and emotional regulation. She also has ADHD herself. So she approaches this from both the clinical and And the lived experience side, she has built an audience of more than 2 million people by making really complicated mental health concepts incredibly accessible. And she's also the author of the new book, Too Sensitive, which is all about rejection sensitivity and why some of us seem to feel

everything at A 10. So this conversation was so good because I basically asked her all of the questions that I think we are collectively wondering right now, like does everyone have ADHD? Are we over pathologizing normal human behavior? Why are so many women getting diagnosed in their 30s and 40s? What happens when hormones enter the chat? And why can one weird text message completely derail your day? We also talk about medication, including non-stimulent options. We talk energy, focus, anxiety, rejection sensitivity,

and the things that you can actually do in your daily life to work with your brain instead of against it. So this one is so informative. It's very relatable and also just really fun. So please enjoy Dr. Sasha Hamdani. Welcome. Thank you so much. Cannot wait to talk to you. Yay.

For personal reasons. Okay. I'm kidding. Lay it on me. As we were just saying, selfish reasons. Where was I even? Okay. I'm on my third one today.

Sorry. I'm on my fourth. I get it. We're going to be talking about a lot of things today, mostly revolving around ADHD. Yeah. And I think it's probably natural. for people to listen to something about like a diagnosis, whether it's ADHD, whether it's anxiety, whether it's an attachment style, whatever, and find themselves in that. But I have to say that in

doing the prep for this episode, it's the first time, I think, in seven and a half years that I've been recording this podcast where I've really felt like, okay, I think that this truly encompasses like everything that's going on here. Oh, let's get into it. Yeah. But to say, start. I actually do want to do a quick round of ADHD or not ADHD. Okay, you're not going to like my answers, but all right. Okay. Well, I'm going to give you scenarios and then you tell me, and obviously there's nuance. So, I'll just put that disclaimer. I can spend three hours researching the perfect coffee maker, but I can't send a two-minute email. Okay. Obviously, that alone, not necessarily diagnostic, but you can't. You know, but you can't send a two-minute email. Okay. Okay. Obviously,

that alone, not necessarily diagnostic, but you see it a lot in ADHD just because with ADHD, the way that I describe it is you have an interest-based nervous system. So if there's something that feels urgent or feels interesting to you, like for whatever reason, right, coffee makers aren't that interesting. But if that's what piques your interest and you're obsessed with it, that hour or day, it's that will trump kind of anything else. And you can just get a lot of and you lose sight of how much time you've spent, whereas you're like, I have to send this email and I have to cancel my cable bill. I mean, it's never going to happen.

I'll pay for cable till I die, I guess. This was not on my list, but now that you say that and I'm thinking of it, do you ever see these videos or do you ever find yourself on a day where you have nothing until three o'clock. And you sit around your house in different places. Waiting, your entire day is waiting for that three o'clock appointment. And then you're late. Like, this is me. And so my whole feed is these videos. And I'm like, is that ADHD or not ADHD? So for me, I think a lot. So that is me. Like to a T. I think a lot of that does stem from ADHD. And it's partially because I don't trust my relationship with time. Like, I really don't. Like, I can't, I can't tell you how long something is

going to take. I, like, I will notoriously, like, as I'm leaving the house, I'm like, you know what, I'm just going to switch the laundry real quick. And then all of a sudden, like, 45 minutes go by. And I was like, what happened here? How did, how did this happen? And so I feel like if there's an important thing, like, doctor's appointment or something, as a point of like, this is important. I have to do this. I will limit myself from doing other things. I'm like, I'm just going to sit here, which is why I try to do all my appointments in the morning. Because if I have a three o'clock appointment, my day is trash. That's smart. Yeah. Sometimes I have like a three o'clock podcast and I'm like, I can't. To like today.

No, today I've been going since 11. I need TV or a podcast to fold laundry. That could be a lot of things. That's not necessarily ADHD. But if you are experiencing that with ADHD, sometimes if you think about that, like with really boring tasks, like, I mean, maybe laundry is interesting. It's, but for a lot of people, it's just like an, like, just a task of daily living that's really boring. Sometimes you need, like, that extra stimulation. And so using something like listening to stimulating music or listening to a podcast or watching a TV show that's, like, enough stimulation to get done with that annoying, boring task that you don't want to do. This one is also me.

Okay. Sorry, everyone. I think it's probably a lot of people listening. I procrastinate until the panic kicks in, then somehow do my best work. And urgency-based nervous system. So if it's urgent, everything starts clicking on firing. You can actually get done with a tremendous amount of work at a small amount of time because you are driven by that urgency and that deadline. How does one get an urgency-based nervous system? You bored with that. Genetic came around from birth. Okay, I'm going to do a couple more. Some of the You've already answered. Okay. I walk into Target for toothpaste and leave with $300 worth of things I didn't know I needed.

I don't know. That might be Target. I feel like, you know, sometimes with ADHD, prioritization of things is a little bit difficult and secondarily, like, distraction is a huge problem. So prioritization, you're like walking through the aisles and you're like, this is important, this I need right now. So you're putting all of these things into a cart.

at grocery stores. I do this all the time, too. And then distraction, you're walking down an aisle that you have no business going down, but you're like, I probably, like, hair stuff. Okay, great, I have hair. And then you're just down there and, like, spending all this money that you don't necessarily need to. It could be an ADHD thing. I feel like that's probably all of it.

It could be. That's what I was saying. I was like, you're not going to like these answers. No, it's okay. I expected it. Okay. I get exhausted after a day of socializing. You can get that with ADHD.

you can get that with anxiety, you can get that with trauma. Could be a lot of things. Okay. I'm curious. Maybe I miss this, but you're very open about the fact that you have ADHD. At what point in your life were you diagnosed? So I was first diagnosed when I was in fourth grade. And I was just like very disruptive as a kid.

So I presented more like a boy. It was picked up really quickly because I was a menace. And then, you know, luckily the teachers passed this on to my parents. My parents took it seriously. I was put, like, managed then and there. But I didn't know I was on medication. Like, it was just like explained to me, like, this is going to help you focus. And so I was like, oh, this is like some vitamin I'm taking.

And it worked. So I was like, great. And then I went through. I did well enough that I got into medical school after high school. So I started all those. And it was the first time I was out of the house. It was by myself. And like the wheels fell off.

I just like did so badly. And so my parents were like, what is happening? What are you taking your vitamin? And I was like, no, I like, I literally don't even know where it is. And they were like, okay, it's ADHD medicine. And I was like, what do you mean? And so then I was like very angry about it. And I like, rebelled against it.

And I was like, I can do this on my own. And I got and I really tried. And I was like trying to do all of these things while also trying to manage being myself. and trying to like navigate, you know, just like tasks of, like laundry and other stuff and just trying to like do everything at once. And, you know, I saw all my peers doing really well and me still continuously struggling. And it wasn't until I took this to exam in school that I studied for, like stayed up, studied, knew that stuff inside out. And I like walked out of that test, convinced, like, that I was going to shove it in everyone's face because I got a perfect score.

Like, yeah, I felt so good about it. And then when I got the great back, I got a 32 percent. And I was like, that's very bad. Like, not a rounding error. Cause I didn't flip over the page. And so, like, I went to the instructors and I was like, please, like, let me do it orally. Like, just test me on this. Like, I clearly know this stuff. And they're like, no, I got 100% on the first page. And I didn't flip over. And so they're like, you need to learn from this. And I was like, I don't think I do. do. But after that, I was like, I think there is something going on. My dad brings me home back to California and we just like researched and looked into ADHD and I was like, this very much

is me. And then it became like a journey of like what actually worked, like what behavioral stuff work, what medications work, how does this work? So I feel like I got diagnosed twice. And there are three different types of ADHD, right? What are those? Because I think that, you know, you talk about this a lot, but a lot of people have that stereotype in their mind. of the hyper young boy. And they think, well, I'm not off the walls and disruptive. And so that's not me. That's not me.

So there are three different types. There's inattentive. There's hyperactive. And there's a combined type. Inattentive is like the daydreamer. Difficulty with initiating tasks, difficulty with completing tasks, difficulty with organizing things,

difficulty with forgetfulness. Just so there is, you know, you think about that kid who's just like sitting in class and twirling your hair. And like, most of the time she's like a pleasure to have in class and gets passed along. And then something happens and things get too hard. And then like the wheels fall. Then you have hyperactive. And that you really think about more as a, it's not always because I present with a lot of hyperactivity too. But there's typically how males present where it's more physically and verbally impulsive. there's like difficulty staying in your seat and fidgeting and interrupting and blurting out things.

I think combined type is usually a combination of both. Mm-hmm. And that's what I am. Yeah, I feel like I identify with that daydreamer. But I also, I did well in school. Yeah. I was always really smart. I didn't try that hard.

So I was a good, decent student. Mm-hmm. But I could not bring myself to do the one. I couldn't try. Like, I don't know why. I guess that's maybe potentially like ADHD and that I just could not sit there and focus. There were a million things that I would rather have been doing. And so I just kind of coasted.

And I did well enough because I was, I say this like humbly, like inherently smart enough to like do well. Yeah. I just always thought, oh, I just don't have a good work ethic. And that's what everybody thinks. Yeah. That's what everybody thinks. And I think a lot of that trap is that people get into this like mindset that if I had ADHD, if that could possibly be an explanation, my whole, like I can't do well. Like I won't, I won't progress through. But like I was getting through medical school and I was doing, becoming a doctor and all of these other things that I think that if I wasn't already kind of in the system, there's a possibility that I could have gone to. a physician and they would have been like, no, you've done so well, like, you don't have ADHD. And ADHD, like, it's something that that's the problem with looking at a observable behavioral

data, right? Because so much of this is internal. If the physician can't see it, then they're, they can't diagnose you. Like, that's insane. Yeah. I actually went to a physician and I got the testing done and I knew how to answer in a way that I would get prescribed medication. Not because I thought I had ADHD because I loved the medication. It was the beginning. of my descent into addiction, I would say. I just remember I was snorting concerta in high school. Blue. How?

Concerta. I don't know. Conserta doesn't crush very well. No. Chunks of blue. Oh, God. But I do remember, I think my brother maybe had ADHD and so he was actually prescribed it and I think I took it orally like recreationally and I was like,

this is amazing. I am locked the fuck in. And I wasn't hungry and, you know, all that was happening at that age. So I don't know why I decided to snort it instead. I could have just taken it. Here we are. Yeah. But that didn't last very long.

I mean, it did help me concentrate for sure. And when I was in college for the semester before I dropped out, I remember taking like recreationally so that I could stay up and write a paper like the classic thing. Red Light is one of those wellness things that I'm actually very consistent about because there is so much. much research behind it. And Bonchard makes one of my favorite at-home devices, their red light face mask. I also have the chest one. And I also have the red light wand, which I love for travel. So it uses both red and near infrared light to support collagen and elastin production, which is obviously what I care about the most when we're talking about skin, just keeping it firm, smooth, and healthy looking as we age. It's also incredibly easy to actually use consistently. So you can wear

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Nutrafol for years, this update means that you can now get their most advanced support yet. You can see thicker, stronger, faster-growing hair, and less shedding in just three to six months. I am back on Nutrafall because I have a lot of thinning. I don't know why. And it has worked for me in the past. So I'll keep you guys posted on that. And right now, Nutrafall is offering my listeners $10 off your first month's subscription and free shipping when you visit Nutrafall.com. and enter the code blonde. That's neutrofoil.com, N-U-T-R-A-F-O-L-com, Code Blonde. I want to talk about some ways that it shows up maybe later in life because we have that stereotype, right? And if anybody is listening and they're like, well, I don't have any of that.

Yeah. I can focus. I can get it done. You know, I don't lose track of things, whatever they're thinking. They don't identify not to convince people that they have it. But what are some of the more subtle ways that it can manifest. Because I've heard you talk about how it can be kind of like a regulation issue. And that really resonated. So I think that a lot of times when people have ADHD and you're discovering it later in life, it's not that you just got ADHD or it's manifesting later in life. It's like you've had it this whole time.

It's a longitudinal pattern. I think where we really drop the ball in terms of diagnosis and how we're, we talk about things is when we talk about attention deficit hyperactivity disorder. For so many people, they're like, that doesn't sound like me. I don't really have a deficit of attention and I'm not hyperactive. Like, who is this for? And then you look at the word disorder and you're like, well, I guess it hasn't like negatively impacted my life enough.

But then if you start looking at it like a regulation issue, you're looking at, okay, my attention is dysregulated, my motivation. is dysregulated, my energy is dysregulated, my emotions are dysregulated, my appetite is dysregulated, all of that in general. You're looking at, okay, ADHD as like, it just kind of makes you reassess what is your baseline. And you've worked with probably thousands of women at this point, right? So are there patterns that you started seeing in behavior when you were like, maybe there is this other thing and it's not just the attention deficit thing. Oh, my God. So a lot of times, you know, it's sad because like for boys, the typical age of diagnosis is between six and eight.

For females, the typical age of diagnosis is 35 years old. What? Yeah. Is there an interaction with hormones? Like a, okay. Okay. And a lot of times you're going through life and like when it first kind of peaks up. And it might be like you had this all along, but, you know, you were smart. You got through school and it wasn't a big deal. Like you're getting passed along elementary school. And then junior high happens. And everyone's like, it's your hormones. You're just a little pitchy around that time or you're, you know, or focus becomes

harder and it's just like you need to apply yourself. You don't have good work ethic. You're too focused on being a social butterfly. I heard that a lot. I mean, and so like you just everything, it becomes absolutely everything else before people start looking at ADHD. And then you get into a spot where you like, you know, life gets harder, college gets harder and work gets harder and relationships get real. And it's just like it starts compounding. But a lot of times what happens is that women aren't being assessed until they have kids.

And then the kids have ADHD. And they're like, what? This is me. You're evaluating is literally me. They're filling out a form for their kid and they're like, if I answer all of these for myself, it's the same. And so I think it's interesting when you get to that spot because the women that would sit across for me, they're coming in and these are people that, you know, are either like

postpartum or they're in paramedopause or, you know, whatever other part of their life and their primary complaint is my emotions are out of control, out of control. And so that's when you really start thinking about that linkage between the emotional regulation and ADHD. At what point can you make the distinction between something that is like the normal human experience versus something that's clinical? Because, I mean, to your point, in that game that we just played, you're like, you're not going to like the answers because a lot of that is just normal human experience, right? So at what point does that cross the threshold into like, okay, this is pathological. Patterns. Okay.

Patterns in time. So if you're looking at this and you have like these little blips that happen, human experience, hormones, it could be any of those things. This is a consistent, long lasting kind of pattern that you've seen in many different environments and formats and things like that. Then that's when you start looking at it more seriously. Like, is there an underlying thread that connects this? I feel like that is kind of the light bulb that I had when I was listening to this because I just turned forward. I've been talking for the last two years how I feel like my hormones are so crazy out of control. I'm a different person every day of the month and I feel everything so intensely.

And I go and get my hormones checked. And my doctor's like, I have women that would fight me for your hormones. Like hormones are all good. They're perfect. Yeah. Perfect. And then I'm like, huh, okay. Well, now I can rewind, right?

I had that experience when I was younger. I was super, super sensitive. Yes. Always when I was younger. I could not. self-regulate. So I turned to drugs and alcohol because then I could regulate. That's what that was. It was like I overshot the mark at trying to regulate my emotions, like plain and simple. I heard someone say a misguided attempt at self-care. And I look at relationships and I'm like,

anxious attachment. And I want to talk about that piece as well. But I'm like, wait a second, patterns. Patterns. The pattern. Yeah. Yeah. It's kind of crazy. because I had never considered ADHD or anything until I started researching this episode. It's wild. And like, again, I don't think with ADHD and things like that, like, it's not my job. Like a lot of people come in and they're like, especially since my area of clinical specialty is ADHD, they're coming in and they're convinced we're going to talk about ADHD. You're going to say I have it. We're going to start a medication.

Here's what. And then by the end of the interview, it's like, no, like, I totally understand that attention is fragmented and maybe there's an emotional component, but this is anxiety. You were dealing with anxiety, man. It looks very similar. So, you know, with getting a good diagnosis of ADHD, part of it is ruling in the ADHD. Part of it and equally, if not more importantly, is ruling everything else out. Because I think that there's a lot of things that can look like ADHD, but you're looking for specific patterns. You're looking for. that intersection at different times. So it's tricky. It's tricky trying to figure it out. But for a lot of people, you hear that story about I was trying to regulate. And I had this underlying dysregulation. And drugs and alcohol made me feel quiet. They made me feel calm. They made me feel numb. And so in this book, I talk about, because like when I was writing this book, it was right after my dad died. And I was like, okay. well, I was 38 years old at the time.

I was like, I'm 38 years old. This is the first time I'm putting together the piece that if I am emotionally feeling out of control, I can't do anything else. My productivity goes away. Like, I can't. All consuming. No, yeah, I can't do anything. And I was like, okay, there has to be something more than this. And so that actually got me looking at like emotional sensitivity as like a neurological phenomenon.

and then got me to the question of like, okay, if that's where we're starting and that's our assumption, like, how do you know if you're too sensitive or not? Like, what's normal? And so then you start to look at emotions like on a spectrum. And if you're looking in like middle of the road

or what you would say is typical, you're thinking like something situational happens. Your emotions rise appropriately. They go down appropriately. But then they kind of get back to that neutral baseline. If you're looking on one end of things, you get into apathy where it's like, something emotional happens and you're like,

meh, and you're not really up or down. You go into the opposite end of the spectrum, which is, you know, where I hang out. That's where you process emotions very differently. You feel things very quickly and deeply and for a long time. And it's in that area because you feel emotions that are so big and so overwhelming and sometimes so scary, you are looking for like anything to calm that down.

And so if you don't know that that's what you're doing and that's what you're looking for, it's really easy to go down that pipeline of, you know, using substances to calm that. How much is nature versus how much is nurture? Because I look at my own experience and I look at my brother. Same nature. Same-ish nurture. Yeah. I mean, same genes, right?

Like, but he's completely different. Yeah. Actually, I would say he's pretty sensitive. But, like, I was on that end of this factor. where feeling everything so deeply and cannot function. I remember I always say this. And when I talk about like my story and how I kind of started with drugs and alcohol, I talk about like my first breakup.

And I would see my friends break up with their boyfriends in high school. We're not talking like divorce or anything. Yeah. And they would cry and be upset, but they would still function. Then they'd move on with their lives. And it was paralyzing for me. paralyzing. Looking back after writing this book, I was like, wait, when else has this come up?

And I thought back about my first breakup. And I remember telling my roommate at the time, I was like, I get what they're talking about, a heartbreak because it physically feels like my heart is breaking. Like, I feel chest pain. And I was like, don't she feel that way? And she's like, no. I was like, oh. Yeah.

Okay. Just me. All right. great. Because I feel like with, especially when it, you know, revolves around rejection or criticism, which is like almost always in relationships and things like that, I would feel those emotions so deeply, but I would also feel them so physically, which was like terrifying to me at times because I'm like, I can't like go into a situation where I'm, you know, we're talking about how to navigate through this relationship. And I like, I feel like I'm going to throw up and my stomach is in

and I'm like, like, you're talking to me and I'm like literally grabbing my stomach because it hurts so badly. And it makes it like it's quite literally that dumping of alarm chemicals. Your body is responding because it thinks it's in danger. I'm just like, fun tip. Yeah. I mean, it's so interesting because there is such an overlap. I would just imagine that it's so difficult to discern what is anxiety. What is ADHD? What is ADHD? what is just being sensitive and wired in a certain way? What is an attachment issue? I feel like when it comes to these diagnoses too, and we can talk a little bit about the DSM,

because I've heard you talking about this, and it's really interesting. It's kind of subjective, right? I mean, yeah, there's testing and everything, but it's not like you can measure the blood, and that's the diagnosis, and it's black and way. I wish, yeah. There's a lot of nuance. So, like, what is the criteria? There's patterns, and then there's criteria.

right, according to like the DSM. So what is it right now as it stands for ADHD? So we talked a little bit about this when we were talking about the different types of ADHD with the inattentive and the hyperactive and the combined. But I think what is really important is that this was based on observable behavioral traits of hyper young voice. And so it doesn't talk about emotional regulation, which is, by the way, a huge oversight. In Europe, they just changed their criteria in 2019 to include emotional regulation as part of a core component of ADHD.

So like everywhere else is kind of catching up. I think without having emotional dysregulation in the ADHD criteria, we're going to consistently get into a spot where we're dealing with that confusion. Like, what is this? Is this ADHD? Is this anxiety? Is this depression? And because it's not in the criteria and we can't really explain it in that capacity because of the limitations there. people just get diagnosed with anxiety and depression and they get put on antidepressants, which might not be appropriate for the situation. I've met with so many people who are like, I did not feel like my symptoms were adequately managed at all. I've tried so many different antidepressants until I started ADHD medication. And then things started to click. I was able to regulate a little bit better than I could move on from things. Yeah. And you've talked about how

medication is not always the answer. And I think that there are people, who are nervous about that. And if you're dealing with somebody who has attempted to self-regulate and has dealt with addiction for a long time, it's kind of a tricky space with some of the stimulant drugs. I know that there are a lot of other things that people can try and use. So there are, but not many people know about that. So because a lot of people, they'll vocalize to me like, so like what? If I go through this process and like get diagnosed and evaluated for ADC, like what's the outcome I start at all? It's like, no. I mean, there's, first of all, like understanding, getting evaluated, you're going to understand your brain so much better.

Second thing is that if you do decide to treat it or manage it, you can treat it behaviorally, you can treat it with medication. If you choose the medication road, there are a lot of people. And I will tell you, as someone who has taken stimulants and medications that are not stimulants, I far prefer non-stimulants. And stimulants, life-changing for some people. But for me, and I think it's because of that emotional dysregulation component to it, like if you're looking at baseline, a stimulant would give me like this incredible, like long, skinny peak of action. Like I feel like I took a limitless medication at times. Sometimes it wouldn't work like that. But there would be things where I'm like, I have this. functional window, but truly it's like an hour, maybe two hours. And then the rest of the day,

I'd be crashing off and I'd be, I feel like I'd be even a little bit below baseline just with that contrast of how I felt. To me, when I started a non-stimulate medication, especially there's some medications that actually deal with that emotional dysregulation component, I felt like my baseline kind of moved up. And then I was like, oh, but I felt like that 24 hours a day. And I was like, that I would way rather be there than just have two hours. I just want everything to be a little bit easier for me to feel a little bit more level. And so I far vastly prefer those if that's kind of how their presentation is. Yeah, I feel like some people, myself included, try a stimulant medication and feel that way and think, oh, I don't have ADHD then because it made me too like wired or

whatever it is, whereas it's supposed to kind of make you more even, right? It's so common in colleges that you try medication or you do something like that. So, you know, they have like a total of three days of experience and they're like, I've never felt better. Does that mean you have ADHD? No, I mean, it's not a long enough trial. It's, it's releasing chemicals into your brain where you don't know what the rest of that day look like. You don't know what the caffeine content was that day. You don't know what was clicking. there are, you know, what I tell people are like stimulants and things at the class of medications. It's not just working on your brain. It's working on everywhere in your body. So you have to make sure,

like, this is a safe medication to take that you can handle it over time. The other thing is stimulants, they work in two very specific ways. Number one is to fight off sleepiness skews. And two is to point towards motivation. So if there are some people that are, like, I've never felt better. This is amazing. Sometimes it could be like, well, baseline, are you just like constantly running on empty because you've been partying and you've been out? Like, you're tired. And now a stimulant has removed those sleepiness cues. And now you're like, oh, this is amazing. So it's hard to tell. That's not necessarily diagnostic. What are some of the other medications out of curiosity that are not stimulant?

So there's some medications that are, you know, a lot of them are 24-hour acting agents. Some of them are antidepressants. Some of them are blood pressure medications. Some of them are just... Like Guantacin? I'm obsessed with Guantfacin. Why do you know about guamphazine? I'm prescribed it, but I was nervous to take it.

I prescribed it for symptoms related to mastal activation syndrome. Okay. Like adrenaline, crazy, like, when I have a flare. What I've seen is like my favorite thing. That's what I ended up using. And I was like, oh, my God. Because Guamphazine is one of the few medications that actually helps with the emotional regulation component and the rejection-sensitive dysphoria, like when you have that intense

emotional response to rejection or criticism, it is one of two agents that works on that. But in addition, it also helps with sleep. It also helps with anxiety. It also helps with focus. It just, it seems it's like a great regulator. The biggest problem with it is it's a low dose of blood pressure medication. So sometimes people can feel a little bit like. I have low blood pressure, low itch.

Yeah. So and sometimes people can feel a little bit dizzy or if they're not great about hydration. Things get weird. Sounds pretty good to me. Yeah. And then let's talk about lifestyle a little bit because you also hear people that are like, oh, it's like your diet and exercise. And I'm sure that those things help as well.

Of course. So what are some of the lifestyle things that can. help manage some symptoms and maybe conversely things that we're doing that are not helping because I'm sure to some degree, and I've heard you talk about this, like we all have very short attention spans now. We have, I'm sure, trouble concentrating. Like, I can't remember the last time that I've, like, watched a movie, not picked up my phone, you know, even like a TikTok video. I'm like, fast forward, like get to the point and it's like a minute long. Like, I can't even. Or the record movies are too long. Very long. Yeah. Why? Yeah. I know.

No. Unless I'm in a movie theater, I don't, I don't remember the last time I watched a movie successfully. No. No. Number one, in terms of behavioral modification, most important, sleep. Sleep. Because sleep is literally the only thing that actually gives your body energy. You allow your body and your brain to reset and restore and kind of like clear out toxic material overnight. Like you're allowing your body to have a chance to recharge to function to function. better for you the next day. And that's really annoying to me because I hate sleeping. Like, it's just, it's too hard. I'm not sleepy at night. I don't like have that. Like, I'm fatigued. Let me go to sleep. I'm always like, I, my husband says I have the zoomies because I'm like, legit hyper at nighttime. And it's hard for me to settle down. And then it's, you know, sometimes when I do lie down, it's just like my brain won't shut off. I'm just like, like, like thinking about stuff. coming up with great ideas. And then I want to execute them right. Like, I don't want to go to

sleep. It's boring. I want to execute them right now. I saw something or I listened to something where you were talking about how you had to go to bed early for a flight. And your husband's like, okay. And he like, close his eyes. He's asleep. Same with my boyfriend. I'm like, what? And you woke him up, right? Yes. Yeah. I woke him up. And I was like, how do you do that? Yeah. And then when I asked him that, like, he was like, I was like, what do you see when you close your eyes? Like when you go to sleep, what's happening? And he's like, literally nothing. Yeah. And I was like, what? I know. I know. What do you mean nothing? You're not like worrying about every single interaction you've had over the day or thinking about what you need to do. Like, that's crazy. My boyfriend is the same way. He can sleep anywhere, anytime he doesn't need blankets. He doesn't need to be laying down. He can be like literally, I'm like, I need perfect conditions. But I'm not diagnosing him. But I'm not diagnosing him. I think he's pretty ADHD. And I think he would say that too.

I think maybe he like is, but he doesn't take medication. But when it comes to sleep, he's just like, perfect. Like I don't think he's ever, I don't think he even knows what anxiety is truly. I don't think he's ever experienced anxiety about anything ever. So that's interesting, right? Because you can have some of it and then not have other parts of it, which again makes it so tricky, I'm sure, because there is so much. But again, sometimes what I see with sleep is sometimes it's not even. Disregulation where it's really hard to fall asleep, sometimes people who are really good at sleeping and they want to sleep all the time. And it's like a deep, like they wake up and they never feel like fully rested. So it could go either way. Yeah, that's not him either. He wakes up. He's like happy alert. He doesn't drink caffeine or anything. Very bizarre. Who is this person? Yeah. I always say, I'm like, we need to switch bodies for like a day. You would be in the hospital. If you lived a day in this body.

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Criticism, rejection. Yeah. In relationships and work and in what kind of scenarios, anything? Literally anything where you could potentially feel that rejection or criticism. It is a neurological phenomenon that happens where your body and your brain tell you, based on that like fear of I'm going to be rejected, I'm going to be criticized, I'm going to disappoint someone. Body just starts dumping alarm chemicals. And now your body is telling you. you, your brain is telling you, you're in danger, something bad is happening. And so it's just a matter

of, like, how you work through that moment. And so for a lot of people, they feel that, like, from the mental perspective, like, this person hates me. I don't know what's going to happen. Our relationship is over. This is, and it's not just relationships. Like, this could happen with, like, talking to a boss. This could happen with, even with yourself. Like, you, the example that I gave a little bit earlier today is like on this book tour. I had a podcast that canceled two days before. And I was like, they hate me. Like, I'm not a big enough deal. They don't want to talk about this. Whatever I'm writing about is stupid. And it took me a second to kind of work my way out of that. But it's interesting because if you don't know that this is occurring and if you don't know that you're

emotionally sensitive or you don't know that this is rejection sensitive dysphoria. You may just be like, I, like, this is just me. I like this, this has, my body is responding so strongly. It has to be true. It's a matter of kind of self-trust. And for a huge majority of my life, like with relationships in particular, I would get into situations where I would just get so enamored so quickly, fall into this situation where I was like blissfully happy. But then when I started to like that haze kind of wore off and

things started to like level out. I was like, ooh, what? And then I would get into situations where, you know, I realized my pattern was just like I would get into those relationships and I would kind of like morph into whatever that person needed me to be. And then as soon as I started acting like myself and they were like, what is this? This is not like the person you presented. I would take it as they're rejecting me. And it would cause so much conflict that I would just, like, instead of rectifying and fixing the relationship, I'd be like, I'm out. So it, you know, I look back on that. And, like, this book kind of helped me do that because I didn't actually critically look at my patterns with, like, how I handled emotions until I wrote this.

It's been a pattern. I would imagine that it would be very cathartic. It was. It was so healing. Yeah. Are there differences in the brain? Like, as you're talking, I'm just thinking, I feel like we hear about this a lot, especially when it comes to like attachment style and anxiety.

And we attribute it to something that happened in early life, right? Something environmental, something in that nurture. And I would imagine we must misattribute things sometimes because, like, is this a chemical thing? Yeah. And you're just born with that? Or is your brain structure different? Is your amygdala, like, bigger? Sometimes.

Okay. Sometimes and more hyper responsive. I think, first of all, like with the misattributing things, like, I am a psychiatrist. I have spent so many years of my schooling literally doing this. And there are times where I'm like, I truly don't know what emotion I'm feeling in this moment. Like, I don't know if I'm sad. I don't know if I'm anxious. I don't know if I'm.

if I'm scared. I don't know if I'm jealous. I don't like, what am I feeling? It's confusing and it's scary and it's bad. But I don't, I can't pinpoint. And that's like one of the skills in the book that I think is really important because when you can't figure out what you're feeling, it feels very overwhelming. If you can pinpoint and be like, no, no, no, this is, this is stemming from, I am very anxious about this or I feel very guilty about this. Like, once you can start to peel it apart and give it a name, it already loses some of that, like, fear because you're like, I know this, I've recognized this, I've gotten through this in the past. So it regulates your nervous system just being able to put a name and label an emotion.

I think that's probably refreshing for people to hear. Because I think that there's just like a misconception that some people have it all figured out and that we need to have it all figured out and that we need to be able to, I mean, name emotions. And I remember even being in rehab. They really dumbed it down. You know, there was like a wheel on the wall. Do you know that wheel that I'm talking about? I love the feelings wheel.

Yeah. Yeah. You know, they make it into pillows. I'll get you on for this. I didn't know that. But it is really hard, especially when you're in it and when you are sensitive or you are feeling something. And oftentimes, I would imagine it's multiple things at once. Yeah.

Right? It can be. And for me, like, I did this exercise and I continue to do it. and this was more of a recovery thing, but if I'm feeling triggered or I'm feeling, it can all be traced back to fear for me, all of it. And I can see how a lot of my behavior, even including like the regulation stuff, like it was all fear, you know. Fear of what?

Well, that's the tricky part. It's peeling back the layers of the onion. It kind of depends on the scenario. But I remember, and I talk about this a lot. Like when I was, I was a disaster when I was potentially going to get divorced. Yeah. I knew it was the right thing to do. But it was so hard.

Of course. Because he was a good person. Yeah. I loved each other, but it just wasn't right. Yeah. I call it the good person dilemma. Good dilemma. And when I started talking about it, I was like, whoa, lots of people know this dilemma where you feel stuck, but you can't.

It's like, and somebody said to me, sometimes you have to like put a good person back on the shelf for someone else to enjoy. And I was like, what? Yeah. I don't want someone else to enjoy them. But anyway, I did this exercise with like a mentor of mine. And I wrote down all my fears. And it was all like, what if I never meet somebody? What if this is the last good person? What if I don't like where I move? What if this? What if that? And it was like it all came down to like the potential of feeling discomfort. And then I look back at those patterns too. And I'm like, the drugs. and the alcohol were to like not feel discomfort and not feel you know so it's just I don't know I feel like for me like the fear thing is really everyone has a different thing and I feel like with this book talking about rejection sensitive dysphoria for me that was that fear that fear of being rejected the fear of being criticized and like the lengths I would go yeah avoid that like I will be in a relationship and

I will be the person that you kind of want in that relationship because I don't don't want to be rejected. I don't want to deal with whatever that happens next. Like, this is, this is, like, the price I'm willing to pay for that emotional safety. And so I, when I was actually writing about that as a concept, you start to look back and, you know, peel back where it shows up anywhere else. And I'm like, oh, my God. Like, in work, I'm the person who, like, overprepairs. And, and like goes through something 50 million times, I'll rehearse conversations in my head before I have them because I don't want that person to think of stupid.

I don't want that person to think, like, I didn't prepare or didn't care about this. I don't want that person to point out a mistake and it devastate me. And so it's stuff like that where I was like, all of those things where I am burning so much emotional energy. And honestly, like time, I'm doing it. because of the fear of rejection, because of the fear of criticism, because the fear of disappointing someone is so strong. And that pushes all my decisions. I feel like some of that is probably like biological evolutionary, right? I know you did armchair expert. I feel like Dax always talks about this. Like the fear of like being pushed out of the group. Yeah. Right. Yeah. So we all probably have a little bit of that wire. And we want to fit in. We want to be liked and not criticized and not reject.

and all about, but this is like to the endth degree. So, yeah, I don't think, like, as an evolutionary advantage, I think we still have that software that has been running that whole time. But now in this world, sometimes you don't need that level of hesitation and sensitivity. Yeah. Or maybe you do, because, like, it is objectively a hard world, but then it becomes, like, how do you manage, like, how do you feel those feels, but you feel them safely instead of drowning in them. You have millions of followers. How do you deal with? I know you must get assholes and trolls. How do you deal with that? I literally just posted a thing today because someone was like, you look like you're 40. Like you're a doctor. You should like stop looking old. And I was like, I am 40. Leave me alone. But I mean,

it's stuff like that where I recognize within myself. I'm like, first of all, I'm not that person who like, like every single. And there's so many positive comments. But like I can't run the risk of seeing a bad one. I will not do it. Post and ghost. I schedule my posts and I'm just like not on there. Every once in a while I'll stick around like for the first couple of things

just to make sure it actually posted. And then if comments come in, usually the first ones are pretty cool. It's like as you like if you hit more viral videos, you're just like, oh my God. What? I feel like certain platforms too. Yeah. Like YouTube, I don't look at YouTube. Sorry everyone watching on YouTube.

I generally don't look at YouTube comments. Occasionally, I will just to kind of like gauge how people are responding to. Yes. And so if I've responded to it, that's me. That's not somebody else. Sometimes I'm like, thanks. But for the most part, I don't. I will never Google myself.

No. I know that there are pages. out there that exist talking shit about me. I will never. I've never seen him. I saw it once. I saw it once years ago and I was like, that's enough for me. People have crazy crazy theories. But yeah, it can be difficult. It can be really difficult. Existing in a space online and being emotionally sensitive, they don't go together super well. No. It's like even being on this book tour, I'm like, I don't know. But I think that It's, you know, after writing this book and, like, actually utilizing skills from this book and, like, looking at that behavior and what actually helps in the moment and over time, I've had opportunity to utilize it and help in that, in this process to kind of keep things moving along in a positive trajectory, which is, I've been grateful for.

I mean, I feel like you're the best person to do this work because you don't just talk the talk. You walk the walk. I'm going to cry the cries. You live it. Yeah, you cry the cries. You're like in it. You're in the trenches. Those are the best people to help. I hope so. Well, thank you so much for coming and tell everybody where they can find you and comment only nice things. Yeah. And get your book and all of that. I am on pretty much all social media. I'm the psych doctor MD. There is an account with like straight up my name. I saw that. Not me. And I was like, that's weird. Not me.

Have you tried to report it? I don't know. Maybe. They won't take it down. They won't. Because I have an impersonator too. And they're like, this does not violate our community standards. Sorry.

My name. But they're not verified. Look for the verified one. Yeah. We'll link everything for you. The psych doctor MD. And then, yeah, link the right one. And then this book comes out on August 25th, but it's available for pre-order

before then. And I hope people, it truly was, like, it was healing to write it. I think it was so helpful to write it. I think it was so helpful from the perspective of, like, someone going through it that to have, like, that second half of the book is literally just real world examples. And then it goes through like, your step one, your step two. And I was like, where I, like, I wish I had had that going through my early relationships and, like, work and academics and parents.

like all of those things. So I hope that it's helpful and digestible and easy for people to go through. Amazing. Well, thank you so much. Thank you. I hope you enjoyed that episode. If you liked the episode, and if you like the show in general, please take a second to rate, review, and subscribe. It goes such a long way in supporting the show. Follow the show over on Instagram at well.pod. You can also follow my personal Instagram at area. Lori, I'm always sharing great clips from the episodes, and we also have full episodes on YouTube as well if you want to watch in entirety. Thanks for listening. What's up, everyone?

I'm Shea Shea. You may know me from nine seasons of Bravo's Vanderpump Rules, but I'm here to tell you about my podcast called Shananagan's. We talk about everything from reality TV, pop culture, relationships, parenting, and invite you to join the conversations with Q&A sessions where nothing is off the table. There's so much more I want to share with you. Thanks for listening and make sure to subscribe to Shananagan's to stay up to date with new episodes every Friday. Please note that this episode may contain paid endorsements and advertisements for products and

services. Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.