← ADHD for Smart Ass Women with Tracy Otsuka
ADHD for Smart Ass Women with Tracy Otsuka
EP. 360: What Women with ADHD Are Really Feeling (Dr. Dr. Gilly Kahn Explains)
01:36:55
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- [00:02]
A
This podcast has no sponsors, just free content for ADHD brains like yours. But if you want more, here's how. If your ADHD brain feels like an enemy right now, that's because no one ever taught you how to work with it. But that changes today. Join my you, ADHD Brain is AOK Academy and start making ADHD your advantage. Or for more information, find the link in the first line of this episode's description. Now, let's get on with the show. Richard Branson, Michael Phelps, Justin Timberlake, James Carville. Wait a minute. Where are the women? Greta Gerwig, Lisa Ling, Audra McDonald, Simone Biles. That sounds like a list of highly successful titans in a variety of industries. They all have adhd, but you don't hear much about that, now, do you? You know what else you don't hear about are the 43% of people with ADHD who are in excellent mental health. Why aren't we talking about them and what they are doing right? I'm your host, Traci Ed, and that's exactly what we do here. I'm a lawyer, not a doctor, a lifelong student, and now the author of my new book, ADHD for Smartass Women. I'm also a certified ADHD coach. And the creator of youf ADHD Brain is aok, a patented system that helps ADHD women just like you get unstuck and fall in love with their brilliant brains. Here we embrace our too muchness, and we focus on our strengths. My guests and I credit our ADHD for some of our greatest gifts. And to those who still think they're too much, too impulsive, too scattered, too disorganized, I say no one ever made a difference by being too little. Hello, I am your host, Tracy Otsuka. Thank you so much for being here for another episode of ADHD for Smartass Women. You know my mission. I show you who you are, and then I dare you to become it. And after meeting thousands of ADHD women, I can say without blinking that I've never met one who wasn't truly brilliant at something. Not a single one. Which is why I am so excited to introduce you to Dr. Gilly Khan. Dr. Khan is a clinical psychologist based in Atlanta who specializes in neurodiversity and emotional regulation. When she's not seeing clients or mommying, you'll usually find her writing probably about something psychological. It's no surprise that before earning a master's degree in experimental psychology and a separate PhD in clinical psychology, Dr. Kahn studied psychology and creative writing in a college. Today, she blogs for Psychology Today and is the author. Allow me to interrupt. A psychologist reveals the emotional truth of behind women's adhd. First of all, can I call you Gilly?
- [03:32]
B
Yes, I prefer that, actually.
- [03:34]
A
You earned that PhD. Welcome, Gilly. Did I get all of that right?
- [03:39]
B
Yes, you did. Thank you so much for inviting me on your show. I'm so excited to be here today.
- [03:44]
A
I'm thrilled. Before we talk about your brilliant new book, though, where we always start is with our guests ADHD diagnosis. It just helps our listeners to connect. So can we talk about that first?
- [03:59]
B
Yeah, sure.
- [04:00]
A
So let's start with the circumstances around your diagnosis, because I know it was a later in life diagnosis.
- [04:08]
B
Yes, that's right. Yeah. So I was about 33 when I got diagnosed. And to me, it wasn't a surprise because I went in and I sought out the diagnosis because I wanted to start getting help for my adhd. And it was just kind of an ongoing question in my mind for several years. I was first exposed to psychological diagnoses in late high school when I took an AP psychology class. And during that time, I noticed that some things were really challenging for me, and I was trying to understand myself more. And you can't help but when you're starting to study psychology to identify with some of the diagnoses or to kind of diagnose yourself. And it was confusing to me because I felt like I couldn't. I didn't really fit in any of the boxes that were available at the time or even now. And so, you know, some potential diagnoses that kind of were considerations in my head were generalized anxiety disorder, because GAD is about having a busy brain, but what's your brain busy with? Worries. And so that didn't seem to kind of line up for me because I wasn't a very worried person per se. It was just that my brain was active. And because of that, it was hard for me to fall asleep. The other thing I really struggled with was regulating my emotions. And so, like many women who are late diagnosed, I was first diagnosed with depression, if I were to describe, because I saw a therapist, but she never told me what my diagnosis is. And that's frustrating to me when therapists don't tell and there are therapists like that. But I think if I were to kind of categorize like, the type of depression that I struggled with, it was more persistent depressive disorder, which is it could show up as, like this kind of low level of consistent depression that lasts like one or two years, and you could have bouts of more intense symptoms, but for the most part, it's kind of more dys, which is a less severe but still clinically significant. And I think that after a while, maybe it became more of pmdd. It was probably more persistent Depressive disorder with PMDD hidden in there. PMDD is premenstrual dysphoric disorder. Depressive disorder. Sorry, that's relevant here because a lot of women with ADHD end up also getting diagnosed with pmdd, and they also experience a lot of hormonal conditions. Like, I have a history of pcos, polycystic ovarian syndrome. And if you've read anything recent about ADHD in women, then you'll see front and center that estrogen is associated with dopamine. And so during periods when you experience, pun intended, during moments when you experience lower levels of estrogen, then your dopamine levels will also decrease. And we know dopamine is tied to ADHD symptoms and also to depression and mood issues. So, you know, I think women are complicated, and I think adding to that is the way that the criteria are written right now. And that just complicates things even further for women, because the current criteria really don't accurately grasp or characterize women with adhd.
- [07:52]
A
Absolutely. So did you go in for the diagnoses, having done basically all the research on your own and knowing it was adhd? And how long was that from the first time you went to go see a therapist or a psychologist or a psychiatrist? Because it sounds like, and I know this from your book, that no one ever suggested adhd, and you had even gone through school at that point, and still there was no red flag for, oh, maybe I should consider adhd.
- [08:28]
B
Yes. I think that's another shortcoming of the criteria, because they rely on observations, and a criterion is that someone else would need to. Also, the symptoms need to be present in more than one context. But what clinicians understand is that a different person would have to rate the client as significant in ADHD symptoms. But I was a master masker and.
- [08:56]
A
A good student, too.
- [08:58]
B
Yes. And I worked really hard to make sure that no one saw I was struggling, but I knew I was. And that doesn't detract from how much women with ADHD really do struggle. And that explains why many of us are diagnosed with depression and. Or anxiety beforehand and why suicide attempts are so much higher in this population.
- [09:24]
A
Was there a one thing for you or even two for me, it was two things. My son was diagnosed. I never identified with his diagnoses, but I was researching for him. Eight months later, I found one sentence that drivenness is a form of hyperactivity. And I was like, what? Oh, my gosh, he got his ADHD from me. And then the second one was interpersonal intuition, that sense that most of us have where you can walk into a room and you can feel the energy. You can just feel. You might not even know the people, but, you know, you know, you have the sense of what's going on. And so in life, then you may question it, and people are like, oh, no, no, no, no, that's not true. And either it's. They don't want to see it in themselves, or they really, really don't see it in themselves, but you see it. So I'm curious for you. Was there something or a few things that just always didn't sit with you, and then when you discovered that, oh, wow, that's connected to adhd, that there was a light bulb?
- [10:35]
B
From my reading, I think the two biggest things I didn't know that were more convincing, that convinced me even more, you know, to consider ADHD as possibly, you know, the answer for me was my other, you know, health conditions. Migraines. I had no clue. A lot of women don't know. Anytime I make a post about ADHD and migraine and the overlap there is about 35%. It's pretty high. And, you know, they're all surprised. No one really tells you that. And there's a lack of communication between different types of medical providers. So, like, I went to see a neurologist, and my neurologist never said anything. So one was migraines and the other one was pcos. You know, I. And both of those have to do with, you know, the symptoms. There's. I mean, there's so much overlap because there's a sensory component, too. But, yeah, at the root, the commonality really is dysregulated hormones.
- [11:37]
A
Yeah, I had migraines, too. You do talk about migraines in your book, but you don't talk really about the extent of your migraines. Were they. Was this something you struggled with every week?
- [11:48]
B
Oh, yeah. Probably sometimes more than once a week. Yeah, it was highly debilitating. That was actually the first time I went in for therapy. When they start with, what brings you in today? And for me, it was migraines. I'm here, you know, in therapy because of my history of migraine attacks, and I can't take it anymore. It's making me depressed. And I was a new mom. I had a newborn, and it was all way Too much for me, on top of undiagnosed adhd.
- [12:15]
A
And people who don't. Who've never had a migraine, they don't understand how debilitating it is. I mean, for me, the pain was so severe, I would throw out me, too. And I remember thinking, like, if I had to, like, let's say this was my wedding day, I literally could not show up. I was just in bed with all the windows, you know, the window covers down. Well, I don't really have window covers, but covering my face with, you know, with the blanket because I couldn't take the intensity of the light or, oh, my gosh, if someone started cooking in the house, that would just send me over the edge. So I think people who have not experienced a migraine don't realize how bad it is. And I was so lucky that I would get them every. Like, I'd maybe get two, maybe three a year, but it wasn't every week. I don't even. And with a child. Oh, my gosh. So have they gotten better?
- [13:10]
B
Yes. The solution for me was a different class of medication that has only become available in the past, maybe it's been five years. They're called gypants, G, E, P A N T S. And so. And the. The brand name is Nertech odt. And so people will find kind of different, you know, solutions to their migraines. The most common type of medication that's prescribed for migraines that I used to take, they're. They're triptans, so. And I hope you tried those.
- [13:46]
A
Yeah, didn't work for me.
- [13:48]
B
Not like it didn't relieve your symptoms at all.
- [13:51]
A
None of them did. I just kind of. And it was almost like when I took medication, it prolonged them. So I just learned to. I never had two days of migraines in a row, though. Do you know what worked for me? Gilly? He walked in to my appointment and he said, how are you doing? And I said, I'm doing pretty good. It's just this residual migraine. And he looked at me and he said, it started yesterday. And I said, yes. You know, the migraines would be so bad that the next day I'd feel 5,000 times better, but I still would have this weird pressure in my head. And he said to me, did it start at about 3:15? And I looked at him and I'm like, yes. And he said, I would look into barometric pressure migraines, but I think it was a combination of hormones and. And barometric pressure. And so I just Started to Google. This was probably 15 years ago and all these people were talking about Advil, cold and sinus. And I am telling you, and it works for my entire family because both my kids who have ADHD struggle with migraines. But it's kind of like me, you know, it's not an everyday or an every week thing. And if you take Advil, cold and sinus right when you feel the migraine coming on. So for me, I get this weird swallowing kind of. And so I know what the symptoms are. You know that it's coming. If I take it right away, I can still feel that there's something there. But it's. I can function, I can work, I can talk. I am not, you know, debilitated in bed. And honestly, and I think again, it's hormones. As I've gotten older, once I got to 50, they literally, or maybe even 45, they literally just went away. So that was a long answer. But I think it goes to. Again, we are individuals, right. What works for you may not work for me. And what works for us may not work for them. So it's kind of this guinea pig thing.
- [15:54]
B
Yeah, yeah. I think the, the biggest problem though, with migraines when you also have ADHD is that it's, it's just this, you know, spiral men and they just, you know, they feed off of each other. Because if you have migraine attacks, and I try not to say migraines, I don't know if it's like a nitpicky thing because you know, there's a movement more in the direction of saying like, you know, migraine attacks, because it's not just a headache. And people tend to minimize. Yeah. Like when you have a headache, you don't vomit, you don't spend three days in bed. Then when you have ADHD and you already struggle with paying attention and with regulating your emotions and with getting stuff done on time, especially when I was in college, I would be out like out of commission for at least a day. And then that puts you behind on your work and then you don't have time for self care. There's always this fear of when is the next one going to hit. And so then that makes you anxious and it is the worst combination, especially when you don't have the right type of treatment. And so that brings me to. So the other medication that is often, typically that's what's covered first in the United States by insurance. It makes you. And there's some research also showing that. And this is so unfair and so common for different studies in health care. But the research on medication for migraine, although women are more likely to struggle with it and to be diagnosed with migraine, the research is lacking on focusing on women.
- [17:42]
A
Wait, wait, are you kidding? Even there, the research is fairly non existent for women.
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B
And what's ridiculous too is that let's say there's a sample with men and women and maybe it's 50, 50 or close to being equal. They don't compare the groups. Like they won't do like, you know, a sex difference analysis and then what's the point? And so anyway, so I took the triptans and they made me feel. Sarah Shayet on the ADHD experts podcast, she used this word and I was like, oh my God, she's not the only one too. Like, I've listened to books on migraine and they've used it and it makes you feel loopy. That's just the best way to describe it. Like you just feel like out of it and dumb. Like it's hard to produce language times 100. You know, it's already hard with ADHD and it's hard with migraine. But then you add this medication on top of it, and then that would make me feel depressed. I'm sorry, this episode sounds so depressing, but ADHD is hard.
- [18:48]
A
The medication that you're just talking about, what is that? Do you remember the name?
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B
Yeah, that was. So it was a triptan. Elitryptan.
- [18:56]
A
Yeah, and that's exactly what it is. I just didn't feel good on the medication. Okay, so let's go back to you get diagnosed and it wasn't even so much the diagnoses, it was you discovering on your own that all these things are connected. Oh my gosh. This is adhd. This explains everything. Was that your experience?
- [19:16]
B
Yes, but it was similar to your experience, I think. I don't know, maybe there's a pattern. It just like clicked in my head. But I think a lot of late diagnosed women notice it in their kid and with me. So. Yeah, so my, my daughter, you know, was born. That's when I started therapy when she was a newborn. And she was just a very difficult baby. And she continued to be a challenge, like just with regulating her emotions and while she's. She's a sweetheart, you know, I mean, she's a lot, like, she talks a lot and she just requires a lot of attention. But I think, you know, you grow up at some point, but at that age, I think ADHD is like in a kid is really, really really difficult. And you can't tack it onto their age because when you see other kids their age, they're not like that. You can compare one 3 year old to a bunch of other 3 year olds and then see a difference. And I think that that's true, you know, for kids with adhd, because it's a brain based in a disorder, so it's going to be visible at a young age. And so I remember when she was really young, you know, two, three, like my husband and I would say, like, she's got to have adhd. And then he would say, like, I wonder where she gets it from? And I would say me, because it's almost like, you know, I would say, I think I have adhd. No one really believed me or took me seriously.
- [20:43]
A
When you were going to school to get your degree, you obviously knew what ADHD looked like. But it sounds like maybe your daughter exhibited the traits that were pretty common versus you did not. Or were you like her as a child too?
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B
I was probably like her as a child. I don't remember myself as a 2 year old. And the other thing is my mom passed away when I was 4. And I think if anyone's gonna give like a, you know, an accurate description of what I was like when I was young, it would be her. Sometimes my dad will say, he'll. He'll say that I was a difficult child early on, but some of his stories are just not fully accurate. And so I, I'm just honestly, like, I'm not sure. But I do know that I did struggle with a lot of the more well known symptoms. And it was more in retrospect, like when I thought back on my life, that I realized that it was adhd. Like, for example, I used to get grounded for forgetting books at school. And it's like when the first time I got grounded it was, we had a fourth grade dance, I think. Oh yeah. Someone in my class was having a dance party and it was boys and girls. And I had a crush on someone and I really wanted to go. And it was crushing, like so crushing that I forgot my book. I got grounded for it. And then I really tried really, really hard not to forget another book. And that's where I kind of sadly learned my workarounds. And I still use some of those skills today because they are helpful and I teach them to, to my clients.
- [22:28]
A
I want to talk about this brilliant book. And Gilly, we kind of went back and forth for a little bit and I was like, oh, gosh, I don't Want to read another ADHD book? I mean, there are so many, right? But I have to tell you, I just loved your book. You were so honest about your experiences and compassionate. But I think what I loved the most was through all the honesty and all the compassion and all the difficulty of your experience with adhd, what I loved most and what shone through was the hope and optimism that you brought. You were so clear that no matter the situation, things can change and they can get so much better once you have a better understanding of how your brain works. And I'm going to be honest with you. Sure, I have RSD at times. I cannot go on Reddit because it's just so mean. Just can't. So I don't. But I don't have RSD to the level that you share here, but your words literally gave RISD life for me. Like, I really understood what I thought I understood before reading your book. And I think what I loved as well is you gave me. I mean, I've been doing this for a while now, but you gave me awareness about things that I'm not sure that I had. And you know how that happens, where someone gives you a puzzle piece and you can slot it in and then it's like. Like it just completes that part of the puzzle. And so I'm so grateful for that. And so I have gone through the book, as you can see. When I love a book, this is what I do. And I just have some questions, some comments, some. I just want to hear your reaction.
- [24:24]
B
Of course. Yes, I came prepared, too.
- [24:30]
A
These are easy questions, though, I think, for you. So I'm starting at the beginning. And this literally is what locked me in, Raising the volume on their voices. Crazy, selfish, psycho. These are all probably terms that many of us with ADHD have heard at one time or another. Too much, too emotional, too talkative, Bitch, snob, hard ass, cold, prickly. The one that got me, that you can see is highlighted, is snob. I had never thought about that. But I believe that people with adhd, women with adhd, because that's who I, you know, am around and work with. We are such creatures of specificity, and so many of us have this quality of excellence. Nothing is good enough. And we kind of know where it comes from, right? But I also think aesthetics. And I have always, from the time I was little, if someone didn't say it, I could feel it that they thought that, oh, my gosh, she's such a pain in the whatever. Because everything needs to be a certain way. And so I Just have adopted this idea that, oh, I'm a snob. Like, I just appreciate, you know, things done in a certain way. And I appreciate. Appreciate when people really take time with aesthetics. And so that means I tend to like nice things. And I've never seen that connected to adhd. And so I kind of wanted to know from you, where did snob come from? And just the appreciation of, like, you know, you're talking about things like Shakespeare and that, and I'm going to ask you about Shakespeare, but those sorts of, you know, things that we tend to appreciate, if that's our area of interest.
- [26:19]
B
Yeah, I think what you just said is really what I think. So I use these words because I really pulled them from the introduction of the book, which leads into the first chapter. I interviewed 12 women with ADHD. I just pulled words and phrases that they told me, and that's what I plugged into that list. Snob is not a word I used. I can relate to it. But another woman said that she's been called a snob. When I think of snob, though, I definitely tie it to special or heightened interests, which I think a lot of people with adhd, even if they don't qualify for a separate diagnosis of autism, we probably have hints of autism, or there's a lot of similarities. I have never been diagnosed with autism. I don't think I have autism. But I also can deeply relate to a lot of aspects of people who are autistic. And I think there are characteristics definitely that I have, and I think that's where the special interests are, because over the years, I have been definitely obsessed with very niche areas, and then I learn everything about them. And I think that can come off as snobby because we're impulsive and so, like a specific example. And, you know, in graduate school, I remember this one moment when the professor was lecturing and she said something that was just so blatantly wrong and misleading. I couldn't help myself. I was just like, it's interesting that you say that, because I read this other article, and I named the. I was crazy. I named the authors the year, the title and the results and why they opposed what she said. When we had our break for class, she walked by me and she goes, gilly, can you please stop by my office after class so we can have a conversation? And that's the moment where my heart sank. I walked to the back bathroom and cried in a stall, and it was like I was transported back to middle school. The same moments that I experienced and I Think that's a common experience for people who have women who have ADHD and. Or autism. The correcting an authority figure, impulsively knowing all of this information, and then you immediately are viewed as a snob.
- [29:08]
A
Or even in a group. Right. A group of, let's say, other women, where you will challenge someone because you know it's not true or you see a different side to it. So I'm curious with that professor. She wasn't calling you on the carpet for challenging her, was she, when you.
- [29:27]
B
Met her in her.
- [29:28]
A
Her office, or was she. I want you to work on a research project for me.
- [29:32]
B
No. Yeah, she criticized me. I mean, it was very. One thing she said to me was because I at the time was doing research on friendship, on peer relationships. And I did that for many years. And I could go into more detail. I'm just not going to. But she basically said to me, you know, it's interesting for someone who's so interested in friendship, you know, that you could struggle so much in interpersonal interactions.
- [29:59]
A
Oh, my gosh, that is insane to me. Isn't that what a professor is there for, is learning? And I'm sorry that happened. That's bullshit word for word.
- [30:09]
B
It's like, you can't forget something like that.
- [30:11]
A
Right. And that's more about her than you. But when you're younger, right now we can laugh at it. But when you're younger, it's just like, oh, my gosh.
- [30:19]
B
Definitely. Yeah. It's scarring. And then, you know, in that moment, it's like I could respond impulsively, but I feel like it's like you kind of shut down. You know, I'm just. So I say one thing and then think something else. So I think, thank you for your feedback. You know, and in my head, I'm just like, I've had. You know, at the time I was married, but I was with my husband for years, you know, best friends. I was just like, who are you to tell me what my relationships are like?
- [30:49]
A
Well, and it was such a backward jab.
- [30:52]
B
Yeah, it was like passive aggressive. That's exactly what it is.
- [30:55]
A
Totally. I mean, that was so all about her. Obviously, there was insecurity there, but of course, we turn it on ourselves first. Right?
- [31:03]
B
Yeah. I think that fits with snob.
- [31:06]
A
Okay, that makes perfect sense. But I'd never seen that word associated with adhd. So, again, puzzle piece. Okay. The other thing that you said earlier on is sensitivity to rejection. So we have a sensitivity to rejection, but we also have a sensitivity to praise and coming From a family. I had a tiger mom and a tiger dad. It was all about modesty. You never bragged. And I married an Italian, my husband Rich, who. Their family bragged about everything. Like, he would walk into the room, and all they would be doing is bragging about him, you know, But I wasn't used to that, and my family wasn't used to that. But I also think this sensitivity to praise is so key, and I really believe that that, in part explains my driveness, because you kind of feel like, oh, if I just keep doing, at some point, someone's gonna. They're gonna notice.
- [32:07]
B
Yeah, yeah, yeah. And I. You're right. And I think that could lead to a lot of burnout, because we're. We're seeking out praise and, you know, good feelings from the environment instead of just being content for, you know, just having that intrinsic motivation and just feeling happy, you know, with. With what we have. But I think it. It's easier said than done. It. It's hard to. To get to that state when you have adhd because you are so sensitive to praise. So you get a dopamine hit anytime you get the praise. And so I have mixed feelings about it, you know, because on the one hand, because it's helpful, I think it is helpful to hold on. Like, when you sent me that email that made me feel so happy, and then I feel awkward. I'm like, how do I respond in a way that shows that, like, I love what she said, but it doesn't seem like I'm cuckoo.
- [33:07]
A
Oh, my gosh. But the beauty of us, people like us, is we get it right? So you appreciate it, and whatever you send back, it doesn't matter how cuckoo I'm be like, I'd probably love it, because I can relate.
- [33:22]
B
Yeah, yeah, yeah, yeah. So I think it is helpful to hang on to messages like that. Like, if someone sends you an email or a text and makes you feel really good, like, hold on to it. You know, look at it. Because I think we don't have the best memory, and we have selective memory, and we remember what our professor told us, you know, years ago, but we might forget what Tracy told us or what someone else that you really look up to or respect wrote to you. I think those are good reminders, but then also trying to dig deep and find the value in what you're doing rather than just doing it for the praise and for the end result.
- [34:09]
A
Absolutely. Okay, page 32. This was all about Shakespeare, and, oh, my God, was this an aha for me? So your Love of Shakespeare. And it was interesting because my daughter's boyfriend, we were in New York City at the time that I started this book, actually, and we were in New York City. And her boyfriend's father was a Shakespearean actor, and he had struggled with Parkinson's for 20 something years, and he literally never had a job other than as actor his entire life. So he made a living, a good living as an actor. He was in a bunch of movies as well, you know, that we know, and was on Broadway. But really his love was Shakespeare. And he. He had three services and the third one was at the Shakespeare Theater in Brooklyn. And it just me picking up your book and starting your book right after that, because I just. The service was like a. It was like going, well, there was a playbill for it. You know, it was like going to, you know, the theater, all the, you know, the different kinds of people that were there. It was hosted by some famous.
- [35:32]
B
Something that's so synchronous. Like, you just went to the show.
- [35:35]
A
I know. And I never got to meet this man, but literally up until he passed away, I think it was at the beginning of September, and even through August with Parkinson's. Advanced Parkinson's, he was still working as an actor. He was amazing. And I heard all of these people get up and they all had those beautiful voices, you know, and talk about him. And I just. I could feel the love. And it really made me think, oh, my God, Tracy, are you doing enough with your life? Look at all the people that he's touching. And so Shakespeare, right? And I remembered, oh, I really liked Shakespeare, but why did I like Shakespeare? And then when I got on the plane the next day, that's when I started your book. And I was reading what you said about Shakespeare, and I remembered how much I had loved as a high school student, Shakespeare. And I remember being surprised. Why would I love Shakespeare? I mean, it's hard to read and, you know, but what you pointed out puzzle piece for me was that what I loved was the strong female characters who broke gender norms, like the challenging the status quo. But I didn't even really realize that while I was reading it until I read what you. What you were saying about it. And that's when it connected for me. So now I'm going to go all the way back to Shakespeare. So I just. I wanted to thank you. But also, I am curious how many women with ADHD love Shakespeare and maybe they don't know why.
- [37:13]
B
Yeah, yeah. No, it is interesting. And I think, you know that the professor for that class, actually. I think what really could make a difference also in whether you like a subject or not is the teacher. And I think she really made it for me because she was so knowledgeable. I still look back on my notes sometimes, like, I did definitely, for that chapter, and I sent her the book to read, too. So. Yeah, and she had this, like, you know, this call ADHD for smartass women. And she has, like, badass quality about her. And I think we can, you know, think back on probably people we've even met in real life and appreciate, you know, when there's a strong woman, you know, or just like a badass role model. And. And that's why I like Catherine, you know, from the Taming of the Shrew. She's different, she's misunderstood, but she says it as it is.
- [38:19]
A
I didn't even get that name, and then when I put it all together and I'm like, taming of the shrew. Like, no wonder, right?
- [38:30]
B
Yeah, we can add shrew to the list.
- [38:34]
A
So in your experience, the ADHD women that you've had, I'm going to say, the privilege of meeting, would you say that most of them are like that in terms of, you know, challenging and opinionated and, I don't know, maybe feminist and, you know, against breaking the gender norms?
- [38:54]
B
Yes. Yeah. And it's interesting because, you know, going back to my confusion and not understanding, you know, diagnosis would fit me, if anything at all. I like the way girls. This is how it was taught to me, too, in graduate school, the way girls with ADHD are described as, like, they're described as space cadets or they're kind of meek or shy or introverted. And it wasn't me. You know, it was like there was some aspect of me, but. And. And I think that's true for a lot of women with adhd, that they just speak their mind and that's what gets them in trouble. But a lot of times what they say is true. I feel that way about people who are. Who are autistic, too. Like, I just. I love when they say something, and I'm just like. I love that you just said that. You know, like, I wish the world was just more honest and blunt. So, yeah, I think so.
- [39:56]
A
I say all the time. I mean, obviously I'm not. Well, not obviously, but I have not been diagnosed with autism. But I'm very confident that my father is autistic and one of my nephews and my sister, and I think I'm somewhere on that spectrum. And it is exactly what you're saying where I think nothing of shooting my mouth off. And I'm not worried about. I know that what I'm saying is pushing the envelope. I don't care. And I think some people know that, too, or they don't know that. Right. They don't know how they fit. Just socially, I feel like I know it very well. I feel like I'm very clear on social dynamics. In fact, it's probably one of the things I'm very good at, but I don't care. And it's almost like. And maybe that's boredom, right. That you say these things to get a rise out of people, to realize who are your people? Because it's just so important for me to be around those kind of people.
- [40:56]
B
Yeah. I think it's a value system, too. I think we just hold certain values where maybe we have clear ideas of what's right and what's wrong. And, I mean, you can see, like, the gray, I think, in situations. But if I feel like something is wrong, it's hard for me to shut up.
- [41:19]
A
Yes. Well, that. Justice, sensitivity and the authenticity.
- [41:23]
B
Right.
- [41:23]
A
We just. It's almost like we have to let people know who we are and where we stand, which in this climate, gets us into trouble a lot.
- [41:33]
B
Yeah. Yeah. Especially as a woman, you know, which is also relevant to the Taming of the Shrew. And I think masking plays a big part there, too. Right. By the end of the play, Catherine is, like, assimilated, or she's tamed, so called. Right. By Petruchio. Okay, so she's tamed, but she's also not, because she's still kind of herself. But I think that the, you know, the masking places a lot of pressure on women not to be honest and authentic. And then that can confuse, you know, diagnosis and other people. And I've written about that, too, where I feel like sometimes with masking, I'm like, all or nothing. It's hard for me to just lower the volume on what I'm feeling. So if I feel like it's not safe for me to be myself, then you might get a very dry version of me.
- [42:32]
A
Do you think that adhd, I mean, the fact that, you know, you talked about suicide, and we know that women with ADHD will attempt suicide at a rate three times higher than men with adhd. So how much of this do you think is primarily because of sexism, gender role, stereotypes? I mean, we don't even have the studies for women, so how would we even really know how women behave differently than men? Or girls or boys.
- [43:04]
B
Yeah. Like, why are suicide rates higher for women compared to men?
- [43:11]
A
Well, do you think that so much of it is these expectations that we put on women, you know, social roles and what women are? I mean, we're supposed to have our career kind of right, as long as it doesn't infringe on the other roles we're supposed to do. But then once we have kids, we're supposed to be completely responsible for the kids, dealing with all the schools, the homework, and then we're supposed to take care of the house. And often, you know, even with our partners, I do not have this. I will be honest about that. But, you know, we're supposed to be the social, I mean, the emotional support of our partners. You know, I mean, that's too much for any human being. But then you put ADHD on top of that, that we're just set up to fail.
- [43:57]
B
Yeah, yeah. I think with the suicide, that's where I would throw in more of the rsd, the rejection sensitivity dysphoria. Probably because we've had real life experiences that have really hurt us and maybe we're not provided with appropriate supports or we just, you know, I think people who end up in that position, they just maybe didn't have the right coping skills. They couldn't manage it. And not being diagnosed properly with ADHD contributes. But yeah, I think it's partly environmental. It's because of the negative feedback that we often get from the environment. But it's internal to, and I think a lot of primary care practices, they'll give phq of the phq 9, which is a depression screener, but they don't really give an ADHD screener and that's a problem because people just assume that if you're depressed, then you're at risk for suicide. But when you really think about it, what leads someone to actually kill themselves? There's a level of impulsivity there too. And, you know, that would explain why people with adhd, and particularly women, would be more likely to, you know, attempt and complete suicide.
- [45:39]
A
You don't need another planner or productivity hack. You need a system that works for your brain. One that helps you stop second guessing and start trusting yourself. My patented six step program, your ADHD Brain is a. Ok. Gives you the tools to work with your brain, not against it, so you can finally follow through on what truly matters to you. Click the link in the first line of this episode's description to learn more or book a discovery call. Now let's get back to the show. Absolutely I still question, though, don't the roots of all of this go back to sexism, gender roles and stereotypes, the fact that we don't have the information? Although, wait a minute, you did say this was interesting. I'd never heard this before on page 51. Okay. This is likely ramped up for women with ADHD whose amygdala, the fear or emotion center of the brain, is less developed compared to boys with adhd. Conversely, the areas of the brain involved in controlling behavior, learning and memory are larger in girls with ADHD than boys with adhd, which is why we can be so much better in school often. And then you put the people pleasing in there. Right. Where we just tend to be people pleasers or more likely to be people pleasers than boys. And so if a teacher sees that, oh, well, she actually can do it. I'm never even going to consider that there's something going on.
- [47:21]
B
Yeah, I think, you know, and this is something I remember that we used to talk about when we were learning about peer relationships and child development, that teachers generally love having girls in their classrooms because at baseline, you know, ADHD or not, they're just better behaved and they're. And it all boils down to, you know, what they're capable of physically. And because those parts of the brain that regulate hyperactivity are. They develop more quickly in girls, then it makes sense that girls are more of a delight to have in class. In fact, like in classrooms where you have just boys, and you compare that to classrooms where there's boys and girls, the boys tend to be better behaved when they're with the girls, because the girls tame them or, you know, calm them down, which is ironic with the Taming of the Shrew. But now that I'm thinking about it, but yeah, because girls are better able, I think, to regulate their behavior, but that doesn't mean that they're not like, crumbling on the inside.
- [48:28]
A
Yes, but if what you see is a girl who's totally controlling her behavior, she's doing well in school. I think teachers don't even have the time to consider that maybe there's something going on inside. Right.
- [48:40]
B
Yeah, exactly.
- [48:40]
A
That she's not holding up.
- [48:42]
B
I think what really frustrates me is that in. This is wild in the ADHD criteria, when you look at. Compare that to other diagnoses, most other diagnoses are ended with that the disorder or the symptoms cause clinically significant impairment in daily functioning and. Or distress. Right. But then for adhd, it's only functioning. Doesn't even mention distress. And that's wild, because how do ADHD symptoms not produce distress if you can't pay attention? It should be relevant and an option there too. But that just shows how focused the criteria are on behavior and how much they really do avoid the emotional.
- [49:36]
A
But they used to have it in there. Right. And there's other countries that consider emotion as well. And then what you hear all the time, or at least what I hear all the time, is how when I speak to women, that emotion is actually the hardest part for them, you know, in their ADHD puzzle.
- [49:57]
B
Yes. Yeah. Yep. That's definitely true for me too. And I think a lot of people don't even realize that emotional dysregulation is one manifestation of ADHD. And Dr. Russell Barkley has been arguing for over 10 years that it should be included in the criteria as a core symptom. But when, because people don't know about it, particularly, you know, professionals, then a lot of people with ADHD end up getting misdiagnosed with things like bipolar disorder, borderline personality disorder, disruptive mood dysregulation disorder, because those symptoms can't be explained by ADHD, as the criteria are now.
- [50:41]
A
Absolutely. Okay, page 68. This is about adult onset ADHD. You talk about a research that indicates that individuals classified as having adult onset ADHD tend to have above average IQs, which makes sense because they were able to get through school, probably. But then you also say, and I think this is so true, adult onset ADHDers, they had more supportive and accommodating home and school environments in childhood than child onset ADHDers. Mm.
- [51:21]
B
Can you talk about that? Yeah. So think about what would lead to flying under the radar, A cushion. Right. So, like having being in an environment where you need support, like, for example, sometimes, you know, I wonder why did it take so long for a family to bring a teen, you know, as old as 17, 16, 17, to get diagnosed with autism or ADHD. And a lot of times the reason is because they're in a school that was already accommodating, or they were in a home environment that was accepting. And so they didn't really need the evaluation or the label because they were getting all of the help that they needed. But maybe then they're going to go to college and they're in a situation where they would benefit from having the label and evaluation and to just learn from. Learn about their brain, and it becomes beneficial at that point.
- [52:19]
A
Yeah, I hear that over and over again. And that was my story, too, where I had so much scaffolding and so much structure at home. And then I went to a Catholic high school where, you know, they just had so many rules. And, yeah, I hated them. And I tried to distance myself, but I. I'm kind of a rule follower. So unless it's something, you know, there's something about education where I will break rules right and left. But if I know that I need that degree in order to get to the next spot, right, I'm gonna follow the rules. But I went to college and oh, my gosh, first of all, I was in a major I had no business being in. Cause I thought, well, my dad's a dentist. I'm gonna be a dentist. You know, they'll call me Dr. Otsuka. You know, I had no interest in being a dentist, no interest in the actual practice of dentistry, but it sounded good. And I almost flunked out of college. I had none of the scaffolding, you know, and then you have all these other responsibilities that you've never had to do before. You know, my father would still in college, in high school, he would, you know, bang on the doors in the morning, okay, it's time to get up. And it was bad.
- [53:30]
B
Yeah, yeah, exactly. So, like, you know, even now, I. I'm not really, you know, responsible for our finances. There are things in life where, you know, my husband helps me, and I'm scared one day, you know, if I don't have him, like, what the hell I would do.
- [53:49]
A
We need.
- [53:49]
B
Yeah, we need a lot of help, like support. And I think there's nothing wrong with admitting that that's what. What's baked into adhd. But as a kid, too, I was. My dad was pretty overprotective. Not in, like, all the good ways, but because of that, all I really had to focus on was school. I didn't have anything else, really. I mean, there were peer issues, you know, but I didn't have to worry about having food on the table. You know, like, he took care of us, you know, financially. There was just. There were no nothing. There was nothing else. You know, that was a stressor. Whereas, you know, for a kid who is in a home environment that's a bit more chaotic. Maybe the parents are struggling with mental health issues or they're, you know, come from a low socioeconomic background. Like, I mean, it wasn't easy for us, but we had. We had like a basic stable household. And I think that helped me and being able to be okay. My grades were not amazing, but I didn't fail out of high school. I got into A good school for college. I was also with my dad's help with networking, and he would talk to guidance counselors and whatever. And some kids don't have that. The supports are important and then also the high iq, because people who have a high IQ also tend to have better social skills, which is ironic.
- [55:21]
A
How many people do you meet that are. And are we talking about really high? Q. I'm just thinking of someone like.
- [55:26]
B
Well, I mean, like, you need to have, like, at least an average iq, but, like, you know. Average. Yeah. And I'm saying, like, when you get.
- [55:32]
A
To a point, the higher it gets, the less your social skills are.
- [55:37]
B
That's actually an interesting point. I don't know how to answer that question, but I do know there's a correlation and that you would need to have, like, at least average, because if, you know, if you're below average in iq, that it would make sense. It'd be harder for you to, like, pick up on social cues and, like, know what to do and to navigate social situations because they're complicated. Um, but, yeah, so I think, you know, if you have better social skill. Social skills, then you're probably better at masking, too. And. Yeah, and so that would help you be sneakier, you know, and. And less likely to get diagnosed. And I don't think the. The goal while you're doing that, like, when you're young and you're masking the goal isn't like, I want to not get a diagnosis. Like, that's not what's happening. It's more, I don't want to feel shame. I don't want to be rejected. You know, I don't want to get in trouble. And that's what really, I think motivates the masking 100%.
- [56:33]
A
Okay, page 92. This was another puzzle piece or an Aha. Poor working memory is often associated with difficulties with math.
- [56:44]
B
Yeah.
- [56:45]
A
I was like, what? Word problems? And this consistent inconsistency that I felt where literally up until word problems, I was, like, probably top in the class in math. Then we brought word problems in. I could not do them. And I now realize, oh, it's because I couldn't hold all those numbers in my head, and we weren't allowed to use a pencil and paper to write anything down. But then my senior year, I took a trigonometry class, and I got the highest grade in the class. And so I've always been. And then a couple of years ago, I took a full battery neuropsych testing, which they normally only do for kids. Which was so helpful. I mean, privilege. Yeah. That I had the opportunity to do that. But it really made me understand, Like, I used to walk around like Barbie. You know, I'm. I'm bad at math. I'm bad at math. But in the back of my head, I was like, but there were those times where I was so good at math. And so then getting that testing and realizing that actually you're very strong in math, but it's that one section of word problems or anything where you have to keep stuff in your head that then I really struggled with math. And so I just adopted this attitude that I suck at math and it wasn't true. And so I thought, too, well, you're bad with finances because you suck at math. I don't suck at math at all.
- [58:08]
B
It's not. Yeah. I mean, it's also a question of, like. Yeah, there's a lot of, I think, aspects to it. Like, is it overwhelming to you? Is it, I guess, interest, Right. Yes, that's exactly. That's what I was thinking. Yeah. Is it boring? I think math is just not interesting to me. And so I'm just not interested. Yeah. In numbers. But, yeah, I can totally relate to what you're saying. It's hard for me to manipulate information in my head. And, you know, if there's one workaround that I have really leaned into and used in my life, it's writing things down generally. So just memory in general. Because a lot of times my brain will tell me, like, you don't have to write that down. You're going to remember it. And then I've learned to talk back and. And say, no, you won't remember it. Write it down right now. And that has helped me tremendously understanding that it's really hard for me, even though sometimes my brain could be optimistic. You know, I'm. I. That's a weakness of mine is remembering specific details or information or names or a location or even an appointment. I have to write everything down.
- [59:23]
A
Or when you stop someone on the street and you say, how do I get here? And they start giving you all this stuff and I just start laughing. Can't do it. I just keep walking. Thanks. Can you talk a little bit about the cerebellum and balance? And the reason I'm going to say that is I read this a lot. And you have it in your book, too, that people with ADHD tend to be less coordinated. I am incredibly coordinated. But I attribute it to starting at six or seven years old, I dance ballet six days a week up until probably 15 or 16 years old. And so my balance is so good. But I also attribute that to. Because you say that cerebellum doesn't just affect the physical balance, it also affects our emotional balance. And I'm pretty good with the emotional stuff. I'm very kind of even. You know, sure, there are times like Reddit, where, yeah, I just get so anxious I can't even go there. But in general, I think that I don't struggle as much with those issues because of ballet. So can you talk about the cerebellum imbalance?
- [60:40]
B
Yes. First of all, every time you mention Reddit, I laugh because it's like a panic attack, you know, And I feel like I have to sometimes post an article on there because it gets a lot of exposure. But it's. I've lost hair over it. Over Reddit.
- [60:58]
A
It is the meanest social media site, and it's. And you can't really respond back, which is hard for us.
- [61:05]
B
Yeah, like, you can, but you shouldn't, right?
- [61:09]
A
Yeah, absolutely. And somewhere along the line, someone on Reddit decided that I am against medication, which is so far from the truth. Are you kidding me? If I could find a medication that worked and those certain times that I need to do those things, you know, like memorize a speech, I would use it in a heartbeat. But somewhere along the lines, I don't believe in medication, and I. I can't even go there. Like, even my daughter's like, mom, I went to Reddit. They are so mean.
- [61:35]
B
That's funny.
- [61:36]
A
I can't even go. Okay, go on. I'm sorry. I'm just yapping away.
- [61:39]
B
Yeah, yeah. So in their book ADHD 2.0, Ned Hallowell and John Ratey write about the cerebellum and about how doing exercises can improve coordination. Certain types of activities, like yoga or karate. You said dance. That's exactly why I have my daughter in dance since a young age. As a result, your ADHD symptoms could also improve. It's not a replacement for all other types of treatment, but if you're going to be. If you're going to do something that's behavioral to try to improve your ADHD symptoms, improve concentration and decrease that internal restlessness, then doing activities that focus on practicing balance is something that could be really helpful.
- [62:38]
A
And so the key is not just balance, but also that you're using your brain. Right. So there's some sort of routine that you have to memorize.
- [62:49]
B
Yes. Yeah, I think it's more the. Yeah, I think obviously with everything that you do there's what you do and then the brain functioning right. That occurs while you're doing it. So when, when you do something, it could also influence development in your brain and can strengthen those networks the more you do it. That's really, I think, the underlying mechanism. If you ride bikes a lot, or if you walk on a balance beam or, I don't know, you do gymnastics, then that could potentially help improve your, you know, your challenges related to ADHD symptoms, because there's this relationship there.
- [63:38]
A
Okay.
- [63:39]
B
Okay.
- [63:41]
A
One of my favorite books, too, is Dopamine Nation. I just think it's a brilliant book and you clearly love it. I had no idea about video game addiction. And honestly, even shopping addiction, kind of. I sort of understand that one. But the video games, I just, after I read that, I felt like, oh, my gosh, I've never heard anybody. I've heard a mention of it, of course, and we've seen a few studies, but I've never heard anyone talk about it to the level that you did. You devoted almost two chapters, Right. To addiction, and you talk about video games, so I assume you're a gamer.
- [64:22]
B
I am not, actually, no. And the reason I chose to. So I, I. So the, the first chapter that leads into the addiction chapter is about reinforcement, and that has a lot to do with addiction. Right. Like what. What's rewarding to you? And then, then that leads into the behavioral addiction chapter. And I started it with a gaming addiction case because it was very eye opening to me, and when I had that client and it just felt like such a perfect example of a case where it could easily be minimized or normalized and say, like, he's a teenage boy. You know, he loves to play video games. It went over everyone's heads, even my head. We kept it until the last thing that we addressed.
- [65:12]
A
Tell the story because it was fascinating.
- [65:16]
B
Yeah. So the case I describe is a teenage boy who was struggling in school, and he was missing a lot of school. There were a few different confusing elements to this case. One, he was not sleeping well. He was previously being treated for a sleep disorder, but he was still not sleeping well when I saw him. He also had a history of severe anxiety and panic attacks, and he was already diagnosed with adhd. The parents were. They brought him in because he was struggling with anxiety. Again, he wasn't sleeping well and he was missing a lot of school. And that was the key concern. And so initially, when I started working with him, it was more to address the anxiety and every other piece we were trying.
- [66:20]
A
And he would Start and stop a lot. Right. Like, he'd get better, and then he'd get worse again.
- [66:25]
B
Yeah, yeah, yeah, that's right. Yeah. Yeah. Okay. Yeah. So he would. One of the things that we knew already was that video games were very motivating to him. And so the parents were kind of leaning on that as a crutch, trying to use the video games as a form of reinforcement for his homework completion and for school attendance. And that's very normal and helpful for a lot of teens to use some kind of reinforcer. Good job. Now you deserve TV time. But in the case of someone who's addicted to that behavior, it's not so helpful because then they, you know, they tie the reward with. The reward is something that is. That can only bring them downhill. It's like, once they get started, it's hard for them to stop. And so that's what we would find in the beginning. He would lose his video games as a consequence. Sometimes the parents took it away, and then his behavior would improve. Like, he would go to school, he would do his homework, you know, and so at a certain point, he would say, mom, can I have my video games back? And then they would give it back, and we would see, like, a downward slope where you would get it back, and then would end up being eight hours on his video, and they would.
- [67:55]
A
Be, like, literally banging the door down, trying to. He was just, like, out of it, Right?
- [68:02]
B
Yeah. So it, you know, got to an unhelpful point. There were several times where I tried to find a different reinforcer or something else that he could do that would be as rewarding as video games. But it's hard to work with family. Sometimes you give advice, and the parents don't take it. Yeah. Yeah. And I also think, like, I understand from the perspective of a parent, like, you want your child to be happy, and they knew that video games made him happy, and so they would still give them. Give him the games. But some of the behaviors that were highly reflective of addiction was, like, he. You know, he would miss school, and if he was allowed to have the games, he would just play on his video games for, like, an entire day and. And just never get off. The other thing is that it would lead to a lot of sometimes physical conflict at home. Like, you know, he would hold the door shut so his parents couldn't come in. And so there was one point where we took the door down, and, you know, there's just, like, you just kind of tried to address everything. And there was also a situation where he Stole, like, a family member's credit card. Because now in games, you know, and I learned this through teens that I've worked with, they're like, that's the chapter on reinforcement, right, where I write about this. But there are in game purchases, and then that could become like, a separate, like, or a related addiction within the video game. And then you end up spending a lot of money. And then they rationalize it in their heads as, like, this is an investment, you know, because then they could win the game or, like, sell. They're called skins. Like, they buy skins in video games, which is, like, different costumes or different, like, tools. Like, they could buy gear and then sell it for a lot of money. But, you know, you end up, like, not really making the money back.
- [70:18]
A
And so what. Ultimately, what happened with him? How were they able to address the problem and resolve it? I can't remember. Did he have to go away to. You know. He did, yeah.
- [70:32]
B
So I think, you know, there are some clients I see where I could end it with a happy ending with, like, because they were successful, you know, in finishing therapy, things were really good for them. With this type of case, I think it's harder to end up with a positive outcome. And so, yeah, in the end, they were looking more for an inpatient type of situation because they just couldn't. It was hard for them to manage, I think. And to not give him the addiction object. It's like, if you're addicted for. For some people, you know, it's like.
- [71:12]
A
They'Re giving him alcohol, right? Or cigarettes.
- [71:15]
B
Yeah, yeah, exactly. Yeah. You need to just not give them that. And. And if you're not able to do that, then it becomes more helpful for, you know, the kid to get more intensive help and then maybe for. For the parents to be involved in that. You know, there's only so many times you can try the same thing, and it doesn't work. And so sometimes you need to pivot and try something different in therapy.
- [71:42]
A
And so ultimately, is he okay now? Did it work?
- [71:45]
B
I don't know.
- [71:47]
A
Okay.
- [71:48]
B
Yeah, that's okay. Sometimes, you know, like, your clients move on, and then they're not your clients anymore.
- [71:54]
A
Right, right, right. And honestly, I'd be scared to know. I just want to imagine him, you know, I have actually a client of mine who had the same struggle with her son, and they ended up sending him away. And he is doing fabulously. So it did work, at least for that particular young man. And he was older, too. He was, like, 17, 18. Failure to launch because of these video Games. And it just, it made me realize how. Well, first of all, I didn't realize how bad this could be until. Cause I didn't deal with. Yeah, I didn't work with the son. I didn't realize how bad this could be until I read, you know, that chapter in your book. But it really made me feel like that I basically dodged a bullet, you know, with my son who video games were a big deal and all his friend group, you know, they were into video games too. And so they'd wear those headsets. And so I rationalized it by, oh, well, he's socializing. Because they were his in real life friends too, but that's how they would socialize often when they couldn't get together. But the one thing I will say is, yeah, it was probably too much video games. And I loved how you were talking about, well, if you don't feel successful in all other areas of your life, but you're a really good gamer that, you know, that builds confidence in that particular skill and you're not getting it from anyone else or anywhere else you want to do more of it. It makes perfect sense. But my son, if we said, okay, it's enough, he would, you know, begrudgingly, but he would turn them off and sometimes we would take them, then he would find them, but. And he still today, you know, he plays some video games. I loved that you talked about. Okay, this is page 145. Low estrogen and low dopamine can be majorly debilitating for females because dopamine increases motivation and positive emotions. And what you talk about is PCOS and hrt. You talk about menopause, low estrogen and hrt. And I have this idea that I wanted to ask you about. So I'm on the other end and I am so sensitive. I couldn't take supplements until I figured out, oh, they have to be chelated. So now I can take supplements. I couldn't take regular estrogen unless it was like the bioidentical whatever. But we find. Finally found something that actually works. But my premise is that for brains with adhd, we need more estrogen. And the reason I say this, and there was an article in Attitude News and Research and when I was pregnant, and I know this is not everybody with adhd, but I've spoken to enough women. It's totally anecdotal, of course, but I've spoken to enough women who have shared this with me. I have never been more on fire than when I was pregnant. Oh, my God. If I could have Pregnancy brain. You know how neurotypicals talk about pregnancy brain and they're like, ah, you know, they couldn't do anything. They were tired. I was. My brain just worked like it has never worked in my. Well, it worked like that. Before puberty, I could memorize anything. You were like that too. Memorize anything.
- [75:29]
B
I don't know if I can memorize anything, but I was really happy. Like I was just happier. I was a happier human being.
- [75:35]
A
Yeah, no, everything was so easy. So I saw this one line and it said, for some in this article, this was research, though for some, the high estrogen of pregnancy may ameliorate certain ADHD symptoms. And for me that was so true. And so I've been fighting with my clinicians, but nobody knows anything about this. Nobody knows about anything about ADHD and estrogen. And I've been searching far and wide trying to find an expert, but I don't think there is one because I really believe so the estrogen. I didn't have any of the perimenopause kind of symptoms that most people have. Literally none of them. But the brain fog has just been. I think that's what caused anxiety in me is all of a sudden I couldn't rely on my brain. All the things I could do before, I could no longer do now. And so I really believe I need more estrogen. I can't have the same amount of estrogen that everybody else has. And look at when I was pregnant. So I saw my numbers of what my estrogen levels were when I was pregnant. It was insane. But nobody seems to know anything about this. And so I'm just wondering what are your thoughts based on your struggle with pcos? And so are you on HRT for that and has it really made a difference?
- [77:05]
B
No. So I'm not on HRT right now. I'm just taking birth control continuously. Yeah. This has been an area of, I guess, like frustration for me, you know, because I think, think OB GYNs generally are just not knowledgeable about ADHD. And I don't think they understand. Like when I go to them and I tell them, you know, like, I feel like I can't concentrate on this birth control pill or I feel like, you know, my. Maybe I can concentrate. Like I can't concentrate, but my mood is low or when my, you know, when I feel good, then I can't concentrate. I think it's because this is my understanding. But again, I think it's just very unclear. Based on my conversations with professionals and from my readings, I Think women with ADHD are probably particular in the type of estrogen that would. Like you said before, that was true for me too. I didn't even realize there were different types of estrogen.
- [78:14]
A
Yeah.
- [78:15]
B
Yeah.
- [78:15]
A
Like I just learned that recently too know that.
- [78:17]
B
Yeah. Released by certain types of pills. And I. There was a paragraph or there was a section in. So Sandra Cooey or Cooey. Yeah.
- [78:29]
A
So she.
- [78:29]
B
She recently in the Netherlands. Yes. So she published an article that was about. It was like a review with a lot of other authors about the most recent knowledge on the association between like hormones and adhd. And there were. There was a section in there that was interesting to me and that seemed to resonate with what we're discussing right now. Where mentioned something. I don't remember the exact details, but it. It mentioned that like women with ADHD may respond better to certain types of. Of birth control and that it has something to do, I think with the type of estrogen. It talked a little bit about progesterone as well. And I think that in general, like, they don't respond as well to. Was it. I think it was higher levels of progesterone. But yeah, that was a recently published article and I don't think it's well understood because it's confusing to me and I think this is all pretty new.
- [79:38]
A
Yeah. I couldn't take birth control pills either and I think it was. So I always had the sense I can't handle estrogen. And I'm just starting to do the research into this, but apparently there's some sort of a. It's called a dry urine test where they can actually test the different kinds of estrogen. Oh. But yeah. And so I've been thinking. Okay, I think I'm going to try that but I need to do more research into. Okay, what exactly does this mean? Is it legitimate? You know, all of that?
- [80:05]
B
The piece of me is I don't want to have to be an OB gyn. Like, that's not. Not what I went to school for. But I also feel this pressure of having to. You know, the thing is, you know, my cousin is an OB gyn, so sometimes I'll ask him questions and, you know, kind of swap ideas. I know. Yeah. Nobody. He's the best. He's.
- [80:26]
A
Oh, well, I love to hear that.
- [80:28]
B
Writer. Yeah. And he's very sensitive, which is strange because the OB GYNs are spoken to like, as my providers, they're women and they could be, I think, invalidating. Yeah.
- [80:41]
A
Yeah. It's just insane to me. How little we know about how women's bodies work, and then on top of it, how women with ADHD's bodies work. We know nothing. You know, it's just. That's my issue. If there is no research, then all I've got to go on is anecdotes, right? And talking to hundreds and probably thousands of women and seeing, well, what's your experience? And then trying to cobble it together from there. But it's really frustrating.
- [81:13]
B
Yeah, that's exactly what it feels like, cobbling it together.
- [81:17]
A
This was hilarious, the idea that we can be overly ambitious. And I'm going to read this because. Oh, my God, I couldn't write to this. You know what I'm going to read. I remember this one time being a teen at the mall in Miami. I was with a friend going down one escalator. Right at that moment, a boy who had a crush on me passed us on the adjacent ascending escalator. I saw him blush and wave at me as my friend, and I cruised down the escalator and hopped onto the tile. At the time, I was flirting with that boy and a different older boy who later became my boyfriend. My friend turned to me and asked what I would do about this situation. As if having two boys liking anyone was a problem. When one relationship falls through, I thought, I'll have the other one. I just. I absolutely love that my thing was too. Then I'd be really interested in someone, and then once they were interested, I was no longer interested. And I literally would think, oh, my gosh, this was too easy. And I remember when I met my husband, I was so mad at him for the first two weeks because I was. And I was 25. And I remember just thinking, crap, this is it. I don't want this to be it. There's so many more fish in the sea. And this means I can't ever date anyone else. So I could completely relate to your story that. More, more, more, right?
- [82:49]
B
More, more, more. That's exactly what I was getting at. Yeah, yeah, yeah.
- [82:54]
A
So cute. This is probably the last one. And then I'm going to stop torturing you. You wrote about. When you were talking about. It was the chapter about your mom. And you said, my greatest fear as a kid was being left alone and forgotten. And my greatest fear as a kid was that I was gonna. My mother was gonna die. And I would. I would pretend I had a stomachache so that I could go to the school nurse, and then the school nurse would call my mom and my mom would come pick me up and she would take me out for lunch and then we'd go watch reruns of Perry Mason or, you know, one of these crime shows, which is why I ended up as a lawyer. And I lost my mom two years ago unexpectedly. I thought she had at least 15 years left. And Gilly, I could be your mom, so I cannot imagine what it must be like. And I thought in your book, did you say you were four or. Okay, I cannot imagine what it was like to lose your mom at 4. And so. And I just felt like my mom was my rock. She was my person. Right. And I was so much older and it was still really difficult. And I just wanted to say to you, do you realize how well you've done and how. And are you really proud of yourself for all that you've been able to not just achieve, but who you are as a person?
- [84:44]
B
You're going to make me cry.
- [84:50]
A
So I went to your website and I saw those little pictures. Little pictures. I saw those pictures of you and you've got a bow in your hair and you're smiling and you're silly. And I could literally see 4 year old Gilly in those photos. And so I hope that that Gilly that you were at 4, you've truly been able to become more of her. And I think I see that in those photos.
- [85:25]
B
She's a good photographer. No, she was just like, do whatever you want. I was like, can I get on the desk? And she was like, yeah.
- [85:31]
A
Like, oh my God, they're so adorable and they show your personality. And I do get that people in our life do the best they can, but that doesn't really necessarily make it much easier. Right. And so you had to navigate a lot of that. Granted, you had structures around you, thank God. But a lot of it, based on my reading of the book was a lot of it was figuring this out for Gilly. And I just hope that I know that your mother is looking down and she's just so proud. It's such a beautiful book and I just know that she would be so proud that you wrote this book. And I want you to know that it is my favorite book on ADHD and emotion. And we're going to put it. It is. And we're going to put it on our book list.
- [86:25]
B
Thank you so much. I really appreciate that. Yeah.
- [86:31]
A
I have this promise that people with adhd because I'm sorry, but what you went through, that was big trauma. And so my premise is, you know, those of us and you kind of alluded to it as well as, you know, in the late diagnoses. But my son had an early diagnoses, but. Sorry. I mean, he's privileged and he had a lot of structure, and he was constantly, you know, with this expert and this clinician, and, you know, he had two parents that were doing all the research, and he still struggled, but he didn't have. None of us can get through life without trauma.
- [87:14]
B
Right.
- [87:15]
A
There's always something that, you know, but those kinds of big traumas, he didn't have to deal with that. And so.
- [87:21]
B
Thank God.
- [87:23]
A
Yeah. And however, I also believe that what you went through is part of why you're so good at what you do. Right. And as much as I can read your story and just be so taken by it and so impacted by it, I will never be as successful with someone who has experienced what you've experienced. For example, if I ever had to work with them or be their friend or you just, you know, you've got this reserve now, and I've been talking a lot, but I really want you to hear how impactful it was. And I'm not even the best end user of what you wrote here, but how impactful it would be to someone. To a woman, especially a younger woman and actually any woman. Right. Who has experienced trauma and also has ADHD and is trying to put all the pieces together.
- [88:25]
B
Yeah, Yeah. I think probably, like, the. The hardest piece in relation to the ADHD diagnosis is that a lot of people were influenced by someone's book and they basically assume that trauma creates adhd. And that is very insulting to me. And I don't think people. They're not intending to insult anyone. You know, I think that's just the way that they understand it. But it's.
- [88:58]
A
And the symptoms look similar. Right.
- [89:00]
B
Exactly. Yeah. And I write. I write about that in the book, and I think trauma will make anything worse. Yeah. But to say that, you know, me going through my mom passing away, you know, and, you know, struggling in an environment where, like, my dad was an immigrant and a single parent and, you know, and it's still a struggle in the family, it just. It ruptures, you know, but to say that that's the reason that I'm struggling with everything in life is not correct.
- [89:38]
A
Well, and the terrible thing is most therapists still think that, you know, if they don't understand what ADHD looks like, they will attribute everything to trauma.
- [89:52]
B
And what I appreciate about your work is the optimism and the pride. That's like even seeing that squirrel behind you makes me Happy.
- [90:05]
A
I feel so guilty about that. Friend bought it. I did not buy that.
- [90:08]
B
I think it's adorable, you know, and it just. It fits your personality so perfectly, even if you don't like it. I'm sorry. It just made me happy. Like in your email signature, there's a tiny little squirrel. Who else has that? And so to say that your ADHD symptoms are the result of trauma is ignoring the full picture, because there are amazing things about having adhd, too. And I've had people ask me, if you could get rid of your adhd, would you do it? And I say no without any hesitation, because I think that without my adhd, and yes, I think that my experiences have definitely helped to maybe drive me and push me in this direction. And child psychologist, for sure, you know, and with writing, too. But I also think that, you know, people with adhd, they tend to think creatively, and there's research on that. And I think that we have a lot of empathy, and the fact that we're very blunt and transparent can also help, you know, if you're a writer. So, no, I wouldn't. I wouldn't trade it. I think that anything that's amazing is going to be a struggle at times. Just like if you're a savant, that's really cool, because savants are experts in certain areas or they know a lot of information that most people don't, but then their social skills are lacking. You can't. It's inhuman to be incredible at everything.
- [92:01]
A
Yeah, absolutely. Well, I just loved your book. And again, I was literally, oh, my gosh, another ADHD book. But from the first page, I was just drawn in. And I don't think there is a better book that really explores emotion, ADHD and women. So thank you so much for writing it, and again, I just hope you're so proud of the work that you've created.
- [92:29]
B
Thank you. Thank you so much, Tracy. That means a lot.
- [92:32]
A
Okay, so we're going to end on it on a different note. Give me one ADHD workaround, and then you're going to tell us where people can find you, your book, all the stuff.
- [92:42]
B
The first ADHD workaround that I mentioned before was writing everything down, right? Like, if your brain tells you so, don't worry, you'll remember this later. Just write it down anyway. And another one. Making things that seem dry or boring, fun. And a quick, easy way to do that is to be your own cheerleader. And this might make some people feel weird, but I say there's a team Gilly. And so Sometimes I feel like something's a dragon where I can't really get myself started on an assignment. I'll just be like, all right, team Gilly. It's time to get the cheerleaders together, and we're just gonna raise the standing desk and open the documents. You know, like, talk to yourself. Talk yourself through the steps and pump yourself up, because sometimes we really need to fake it till we become it, and at least it will get the document open, if anything.
- [93:44]
A
Yeah. And I find that when I do stuff like that, and then I laugh at myself. Right. That then amps up the energy, and that's positive emotion, which is dopamine, and so it works so much better. Okay, Gilly, tell us where we can find you. Where do we find your book? Anything that you want to. I don't know, something you're working on, whatever.
- [94:06]
B
Okay. Yeah. So you can find me on my website, drgailycon.com my social media is on there, but the social media account that I'm most active on is Instagram, and the handle for that is at Dr. Gillicon. And my book, I think, will probably be linked, but if you. You look it up online, you can find it pretty much anywhere. You could also find it through my website. Again, the title is. Allow me to interrupt. A Psychologist Reveals the Emotional Truth behind Women's adhd. And, yeah, I'm constantly working on something, so right now I'm just working on articles, actually, for an autism magazine. So that's next on the agenda. But, yeah.
- [94:55]
A
Dr. Gillikahn, thank you so much for spending time with us here today. You are a delight, and I just. I just want to see everybody reading this book.
- [95:06]
B
I would love that, too. Yeah.
- [95:08]
A
Yeah, I bet. Okay, so that's what I have for you for this week. If you like this episode with Dr. Gilly Kahn, please let us know by leaving a review. Our goal is to change the conversation around adhd, helping as many women as we possibly can learn how their ADHD brains work so that they, too, may discover their amazing strengths. Thank you so much for listening, and I'll see you here next week. You've been listening to the ADHD for Smartass Women podcast. I'm your host, Tracy Outsuka. Join us at ADHD for smartwomen.com, where you can find more information on my new book, ADHD for Smartass Women. And my patented you'd ADHD ADHD brain is a okay system to help you get unstuck and fall in love with your brilliant brain. Your ADHD brain is not broken. You just don't have the right tools. If you're sick of feeling behind overwhelmed or like you're always playing catch up, my patented program, your ADHD brain, is a OK Academy will give you the system that you need to finally take control and move forward. It's designed specifically for how our ADHD brains actually work. No forcing, no shame, just a real blueprint that shows you exactly who you are, what truly matters to you, and what you should do next with your life. For more information, find the link in the first line of this episode's description. Look, you already have everything you need. Let me show you how to use it.