Podcast Summary
Podcast: ADHD reWired
Episode: 540 | Hormones, Migraines, Social Skills with Gilly Kahn Ph.D
Release Date: June 29, 2024
Host: Eric Tivers, LCSW, ADHD-CCSP
Guest: Dr. Gilly Kahn, Licensed Psychologist
1. Episode Overview
This episode dives deep into the intersection of ADHD with hormones, migraines, and social skills, particularly for women and girls. Host Eric Tivers talks with Dr. Gilly Kahn, a psychologist specializing in ADHD, anxiety, and depression in children, teens, and young adults. The conversation covers Dr. Kahn’s late ADHD diagnosis, symptom management, how hormonal fluctuations and migraines tie into ADHD, challenges in emotional regulation, and practical strategies for improving social skills and making friendships as both a child and adult with ADHD.
2. Key Discussion Points & Insights
Dr. Gilly Kahn’s ADHD Diagnosis Journey
- Late Diagnosis & Female Presentation:
- Dr. Kahn was diagnosed at age 33, a pattern common among women due to ADHD being misunderstood in females.
- Her daughter’s behavioral signs and connecting with open colleagues motivated her own diagnosis.
- "It's so important to practice what you preach." — Dr. Kahn [05:17]
- Stigma & Self-Acceptance:
- Owning the diagnosis openly, displaying a neurodiversity sticker, and discussing the importance of modeling pride in neurodiversity for clients.
Medication & Experiential Shift
- Dr. Kahn describes a significant positive change since starting medication, despite challenges with stimulant shortages.
- Beyond Attention:
- "Medication helps so much more than just allowing you to pay attention. It regulates your mood... Without it, I feel like there's bugs scraping beneath my skin." — Dr. Kahn [06:43]
- Medication is also beneficial for mood and physiological regulation.
Hormones, Migraines, and ADHD
- Personal Health Background:
- Dr. Kahn shares her long history with severe migraines starting at college age and later being diagnosed with PCOS.
- The Estrogen Connection:
- Migraines and certain “female” health problems are tied to hormonal fluctuations, particularly estrogen, impacting ADHD symptoms.
- Changes in estrogen can also influence dopamine, acetylcholine, serotonin, and norepinephrine — not just dopamine.
- "It’s not just dopamine. It’s everything." — Eric Tivers [13:29]
- Clinical Implications:
- Mental health practitioners should be alert for puberty, period onset, or headaches as key moments to assess for ADHD in girls.
- Discussion on lack of concrete research on dosing ADHD medications according to the menstrual cycle.
- Migraines & Stimulants:
- Anecdotal reports (including Dr. Kahn’s experience) suggest stimulants can briefly alleviate migraine symptoms; headaches often return when the medication wears off.
Emotional Regulation Strategies for Youth with ADHD
- Realistic Approaches:
- Standard advice like "take a deep breath" during meltdowns often fails for those with ADHD due to performance deficits.
- “You're not you when you have ADHD and you're mad.” — Dr. Kahn [25:17]
- Effective Strategies:
- Medication is helpful, but skills also matter:
- Teach teens to take a time-out (with parent involvement), communicate needs, then employ coping skills (like deep breathing) once calm.
- Including parents and simulating real-life practice is crucial.
- Medication is helpful, but skills also matter:
Impact of Diagnosis on Practice
- Dr. Kahn finds that being open about her diagnosis validates and encourages neurodivergent teens struggling with shame.
- "So many teens have said to me, 'it means I'm stupid.' And I would point to my doctoral diploma... I have ADHD. I'm not stupid." — Dr. Kahn [27:55]
Social Skills Development: Kids, Teens, and Adults
- Social Skills Groups:
- Structured group practice is helpful mainly for kids with a knowledge gap, including some autistic and ADHD youth.
- Application and real-life simulation, plus parent involvement, are vital for transferring skills outside therapy.
- Groups can be powerfully validating:
- “It’s like, I’m not the only one! For some reason, we get each other.” — Dr. Kahn [31:47]
- Adults & Friendship:
- Making friends as an adult is hard—more so with ADHD ("out of sight, out of mind").
- Actionable tips:
- Pursue genuine interests (hobbies, classes, community groups) to find friendship opportunities.
- "Plan your social life in the same way you plan your professional life." — Dr. Kahn [42:22]
- Use a planner to remember social commitments, and practical hacks (e.g., taking a selfie with new contacts to remember names).
- Both host and guest admit that remembering names is a major social hurdle for many with ADHD, sharing humorous and relatable anecdotes.
Systemic Gaps & Advocacy
- The need to advocate for oneself with healthcare providers is highlighted, as awareness of ADHD, especially in nuanced or female presentations, is low in many fields (primary care, neurology, psychiatry, psychology).
- Bringing notes to appointments and being prepared to offer more context is key.
3. Notable Quotes & Memorable Moments
- “Medication helps so much more than just allowing you to pay attention. It regulates your mood... Without it, I feel like there's bugs scraping beneath my skin.” — Gilly Kahn [06:43]
- “You're not you when you have ADHD and you're mad.” — Gilly Kahn [25:17]
- “So many teens have said to me, 'it means I'm stupid.' And I would point to my doctoral diploma... I have ADHD. I'm not stupid.” — Gilly Kahn [27:55]
- “Plan your social life in the same way that you plan your professional life.” — Gilly Kahn [42:22]
- “I think that the part of my brain that is responsible for names... I just got a defective model because it is literally someone will tell me, and in two seconds I've forgotten it.” — Eric Tivers [42:42]
- “Allow me to interrupt. Nice, right? Because I'd rather be an interrupter than stay silent.” (on her upcoming book) — Gilly Kahn [49:13]
4. Timestamps for Key Segments
- 03:14: Dr. Kahn’s ADHD diagnosis, motivation, and stigma in women.
- 06:00: Positive effects, and challenges, of ADHD medication.
- 08:20: Hormones, migraines, and how they relate to ADHD in women.
- 13:00: Neurotransmitters beyond dopamine, and their roles.
- 14:58: Lack of research on adjusting ADHD med dosage by menstrual cycle phase.
- 16:13: Stimulants sometimes alleviating migraines.
- 24:09: Emotional regulation with ADHD teens—practical strategies.
- 27:37: How Dr. Kahn’s diagnosis influences her work and modeling for clients.
- 29:32: Methods for teaching social skills to neurodivergent youth.
- 39:50: Challenges and strategies for adults making and maintaining friendships.
- 42:22: Using planners and hacks to manage social connections.
- 47:01: Advocacy advice for navigating dismissiveness from healthcare providers.
- 49:11: Dr. Kahn’s forthcoming book on emotion dysregulation in ADHD women.
5. Additional Resources & Contact
- Dr. Gilly Kahn's Website: drgillykahn.com
- Instagram: @drgillykahn
- Upcoming Book: Allow Me to Interrupt (expected 2026)
This summary provides a deep overview and actionable insights for adults with ADHD, clinicians, and anyone interested in the nuanced intersection of ADHD, hormones, migraines, and social skills—especially as experienced by women and girls.