Podcast Summary: ADHD for Smart Ass Women with Tracy Otsuka

Episode 362: From RSD to Seeking Rejection: A Young Nurse’s ADHD Playbook
Date: December 10, 2025
Host: Tracy Otsuka
Guest: Nina Padilla, ER nurse

Episode Overview

This episode features a candid, insightful conversation between host Tracy Otsuka and Nina Padilla, a 23-year-old emergency room nurse from rural New York. Nina shares her journey from struggling for years to obtain an ADHD diagnosis, navigating emotional challenges like Rejection Sensitivity Dysphoria (RSD), and ultimately transforming her unique brain into a professional and personal superpower. Together, they discuss the misunderstood faces of ADHD in women, the realities of working in high-pressure environments as an ADHD woman, and how embracing difference and even seeking rejection can foster confidence.

Key Discussion Points & Insights

1. ADHD Diagnosis Journey & Early Struggles

• Persistent Advocacy: Nina began suspecting ADHD at 13 but was dismissed by her pediatrician repeatedly because her symptoms didn’t fit the “textbook” hyperactive boy.
  • “I brought it up every single year until I stopped seeing my pediatrician when I was 21.” [03:49]
• Symptoms Overlooked in Girls: Despite doing well in school and being the “perfect kid” in class, Nina struggled with focus, daydreaming, impulsivity, and emotional intensity.
  • "I can't focus for the life of me, I'm always daydreaming... But they thought girls who did well in school can't have ADHD.” [05:42]
• Panic Attack Catalyst: A multi-day panic attack during her last semester of nursing school led to therapy and, finally, an accurate ADHD diagnosis at 23.
  • “My focus was getting really bad... couldn’t sit in my chair... My doctor said, ‘No, you’re having a really bad panic attack... Let’s revisit ADHD.’” [03:49–05:13]

2. Navigating Emotional Dysregulation & Family Dynamics

• Emotional Intensity: Nina describes being highly emotional as a child, especially at home.
  • “If I was frustrated, I’d instantly start yelling and crying. If I was sad, I broke into tears.” [09:51]
• Family Context: With two older brothers and a father she describes as the “picture perfect ADHD boy,” Nina believes her ADHD is inherited. Yet acknowledging and addressing it took time, especially as her father denied the possibility in her.
  • “My dad... forgetful, impulsive, hyperactive... He’d say, ‘My kid with ADHD could not be you.’” [10:46–11:18]

3. Post-Diagnosis Transformation & Embracing Medication

• Visible Change: Starting Adderall made an immediate and positive difference.
  • “My coworkers... said, ‘You're very different. And not different in a bad way…Far more focused, not running around like a crazy person. I wouldn’t forget things.’” [11:27–12:04]
• No Longer “Losing Sparkle”: Nina’s initial fear that meds would dull her personality was unfounded.

4. Being Different & Finding Community

• Confidence in Difference: Nina never tried to “fit in”—an attitude that both isolated her and led her to find her “people” early on.
  • “I’m Nina, and that’s who I’m always going to be. I don’t care to be anybody else.” [13:37]
• Resilience Developed Young: The pushback from parents and society only made her more dedicated to her true self.
  • “They were definitely like, ‘Nina, can you just be a little bit more like everybody else?’ And that just made me want to even more be myself.” [14:13]

5. The Emergency Room: ADHD Superpower in Action

• Why the ER?: The fast, unpredictable, and high-stimulation ER environment perfectly matches Nina’s ADHD-driven need for novelty and activity.
  • “I fell in love with the chaos…Overstimulating, but so stimulating at the same time. I never had a chance to sit.” [17:57–18:21]
• ADHD as a Strength: Nina’s quick thinking, energy, and need for stimulation thrive in the ER. Even colleagues and doctors recognize it.
  • “Somebody needed something done... I said, ‘It’s already done.’ She looked at me... and goes, 'Nina, don’t fix whatever’s going on up there.' That was the moment I was like, this is my ADHD superpower.” [25:16–25:44]
• Feeling Understood in the ER: She jokes that the ER is full of undiagnosed and diagnosed ADHD professionals.
  • “I always joke that part of the interview... should be ‘Do you have ADHD?’ Because all of us found each other.” [24:29]

6. From Rejection Sensitivity to Seeking Rejection

• Past RSD (Rejection Sensitivity Dysphoria): Nina shares that fear of critique and rejection once hindered her, even leading her to leave sports.
• Actively Seeking Rejection: In a transformative pivot, she now deliberately courts rejection to build resilience.
  • “I seek a no, I seek a rejection letter... It’s the reason we’re having this conversation today.” [27:15–28:24]
• Impact of Rejection Therapy: Seeking rejection has cured much of her RSD and boosted her confidence.
  • “I no longer have a fear of hearing no, or getting rejected... It’s definitely been some exposure therapy for it.” [29:42–29:49]

7. ADHD and Early Adulthood

• Dating Struggles: Object permanence issues and distractibility make relationships tricky.
  • “If you don’t text me very often, I forget you’re there sometimes.” [30:08–30:34]
• Flexibility & Adventure: The upsides—spontaneity, impulsivity, and openness—make her 20s exciting and full of possibility.
  • “If I wanted to get up and go, I could... It gives me a lot of flexibility.” [32:33]

8. Misconceptions About ADHD Professionals

• Breaking Stereotypes: ADHD nurses are not the “textbook boy with ADHD who doesn’t do well in school.”
  • “We are smart ass women with ADHD. I work with so many incredible smart women with ADHD in the ER.” [33:53]
• Unique, Valuable Thinking: ADHD enables unconventional, holistic problem-solving—often critical in emergency medicine.
  • “We think really weirdly sometimes, and that saves our butt a lot of the time in the ER.” [35:14]

9. Advice for ADHD Women and 20-Somethings

• Don’t Force “Productivity”: Nina has removed “productive” from her vocabulary, noting it’s toxic for many with ADHD.
  • “We say the P word. We don’t say productive... So harmful to be stuck in this world of productivity.” [39:13–39:18]
• Interest Over Everything: Personal interest should drive choices in career and life.
  • “It’s interest, interest, interest, and then double down on interest again.” [39:04]
• Try Anything & Work With Your Brain: Don't be limited by conventional expectations—test passions, take risks, ignore the need for a formal “platform.”
  • “Go with what you’re good at…Find what works for you and what interests you and is going to keep you interested.” [38:16]
• Role Models & Wisdom: Learning from others’ mistakes—especially family—can inspire pursuing true interests.
  • “I learned a lot from [my brother’s] mistakes…He is not working with his brain.” [40:14]

Notable Quotes & Memorable Moments

• On not fitting the ADHD stereotype:
  “They thought girls who did well in school can't have ADHD.” – Nina [06:11]

• On medication’s impact:
  “I was just far more focused, not running around like a crazy person. I wouldn’t forget things.” – Nina [12:04]

• On finding her people:
  “All my friends are also different... So I felt normal in a different way.” – Nina [12:35]

• On ER as ADHD heaven:
  “I fell in love with the chaos. I never had a chance to sit...It was so overstimulating, but so stimulating at the same time.” – Nina [18:21]

• On seeking rejection:
  “I seek a no, I seek a rejection letter...I got really tired of people pleasing.” – Nina [27:15]

• On productivity as a “P-word”:
  “We say the P word...so harmful to be stuck in this world of productivity.” – Nina [39:18]

Timestamps for Major Segments

• [03:49] – Nina’s decade-long journey to ADHD diagnosis
• [09:51] – Emotional dysregulation and childhood experience
• [11:27] – Life-changing effects of starting Adderall
• [13:37] – “I never tried to fit in.”
• [17:57] – Why Nina fell in love with the chaos of the ER
• [25:16] – “Don’t fix whatever’s going on up there”—ADHD as a superpower
• [27:15] – From RSD to actively seeking rejection
• [30:08] – Dating and object permanence challenges
• [33:53] – ADHD nurses defy stereotypes
• [39:13] – Banning the word “productive”
• [38:16] – Advice for finding your ADHD path

Tone & Language

The episode is warm, affirming, and conversational. Tracy expresses admiration and delight at Nina’s self-acceptance and unique strengths, while Nina balances humor and wisdom as she shares her journey. Both reject pathologizing ADHD, focusing instead on adaptation, resilience, and leveraging difference for success.

Takeaways

• ADHD in women is often missed—especially when they’re high-achieving or internalize symptoms.
• Medication and understanding can be life-transforming.
• Choosing environments that fit your brain—especially high-stimulation, fast-paced ones—can make ADHD a superpower, not a liability.
• Actively seeking out challenges and potential rejection builds resilience against RSD.
• Embracing, not fighting, your natural tendencies (even if they’re unconventional) is the pathway to thriving.
• Redefining productivity and focusing on interest/passion sets the foundation for a satisfying career and life.

For more on Tracy’s program and book, visit adhdforsmartwomen.com. To reach Nina, find her on Instagram: @nina.isabella.