Podcast Summary

Podcast: Hacking Your ADHD
Host: William Curb
Guest: Rae Jacobson (journalist, ADHD expert, host of Hyperfocus at Understood.org)
Episode: The Over-Pathologizing of ADHD
Date: November 24, 2025

Episode Overview

In this insightful and candid conversation, William Curb and Rae Jacobson explore the tendency—particularly within ADHD communities—to over-pathologize everyday human experiences as ADHD symptoms. They discuss the challenges and consequences of assigning every quirk or inconvenience to ADHD, the complexities of comorbid conditions, and the value (and potential pitfalls) of online self-diagnosis and communities. The episode also delves into personal anecdotes around organization, shame, memory, and the emotional rollercoaster of living with ADHD.

Main Topics & Insights

1. Setting the Stage: Who Is Rae Jacobson?

• [03:17] Rae introduces herself as a journalist and host of Hyperfocus, dedicated to making ADHD research accessible and relatable.
• Shares the struggle of managing podcasting and life with ADHD, especially when sick:
  “...when I have a cold on top of my ADHD, it makes me feel...like I'm calling up from the bottom of a well.” – Rae Jacobson [03:17]

2. What is Over-Pathologizing ADHD?

• [05:01] Discussion about people attributing all sorts of everyday experiences (losing keys, getting songs stuck in your head, clutter, scrolling on phones) directly to ADHD.

• Rae on the "symptom of a symptom":
  “Misplacing your keys every now and again, not ADHD... but if the locksmith knows your name, that might be something different.” – Rae Jacobson [06:57]

• Both hosts emphasize the difference between quirks and impairing, chronic issues:

  • “...is this small issue something that's so repetitive that it's caused me genuine difficulty?” – William Curb [08:23]

3. The ADHD Shame Spiral

• [08:39] William recounts searching for lost documents and the ensuing shame spiral:
  “I can't believe I did this to myself again...that is that ADHD shame there.” – William Curb

• Rae on the universality of this feeling for ADHDers:
  “As much as I understand why it happens, ...it's still the first mental move after something happens.” – Rae Jacobson [09:04]

• They compare this reaction to how non-ADHD individuals might experience setbacks, wondering if the emotional weight is unique to ADHDers.

4. Organization, Clutter, and Sentimental Items

• The hosts discuss the fantasy of being “chronically organized” and the reality of cycling between order and chaos.
  “I get into periods of organization where I'm like, everything is great... and then, you know, it starts with the misplaced sock and it all comes tumbling down.” – Rae Jacobson [12:59]

• On keeping objects for memory (Rae):
  “They’re like talisman...if I look at something that jogs my memory, then I have the memory.” [15:01]

• William shares his practice of using a “one line a day” journal to help recall key events [17:48].

5. Overlapping Symptoms, Comorbidities, and the Online Community

• [24:03] William highlights how ADHD online communities (like Reddit) foster both validation and confusion, as people crowdsource experiences without recognizing overlapping conditions such as autism or depression.

• Rae describes clinical wisdom around comorbidities:
  “One of the questions ...around comorbidities is...do you treat the ADHD first...or the depression first? Clinicians will say: you treat the depression first.” [24:47]

• The “Who’s Driving the Bus?” metaphor:
  “Is the clutter coming from the ADHD side...or depression?...You need to know who's driving the symptoms.” – William Curb [26:14]

6. The Nuance of Self-Diagnosis

• They explore the accessibility and risks of self-diagnosis via the internet, noting barriers to professional diagnosis in some countries [28:13].

• Rae:
  “Self and community diagnosis is not a panacea...It's not as simple as just saying you should get an accurate diagnosis.” [28:33]

• William emphasizes a functional approach:
  “Is what you're doing helping?...Can I do things that will help my brain regardless of what's going on?” [29:26]

7. Comorbidities and Unexpected Connections

• Discussion of surprising, lesser-known ADHD comorbidities like hypermobility and heart disease in women [32:15].

• “It's nice to know what I need to be aware of for the future. These comorbidities that are invisible and genuinely dangerous.” – Rae Jacobson [33:47]

8. Real Impact: The “Disorder” Debate

• Rae expresses her frustration with trivializing ADHD and relates it to significant life impairments: job loss, depression, and personal struggles [35:43].

  “For me, that's what it has been like...This has been, for me, job loss, challenges with family and friends...” – Rae Jacobson

• Both touch on the pressure to focus on ADHD’s strengths—creativity, “thinking outside the box”—while acknowledging the hardship it inflicts [41:30].

9. Would You Get Rid of Your ADHD If You Could?

• [38:50] Rae asks William the recurring “Hyperfocus” question:
  “If you could get rid of your ADHD, would you do it?”

• William’s reply:
  “I don't know...How much of my personality is based around this?” [39:14]

• Rae sums up the existential dilemma:
  “I don't know how much of me is ADHD and how much of me is just me or if there is no difference between the two... Sometimes it feels like the symptom of a symptom of a symptom stuff is a way for us to kind of dance around the center, which is this thing that is really serious...” [41:30]

• William’s metaphor:
  “Like climbing a mountain while I'm tied to someone else...and that someone else is my ADHD...we have to find a path up the mountain together.” [43:15]

10. Building Supportive Systems & Accepting Complexity

• Final advice focuses on building workable systems, seeking help when needed, and accepting that the path to well-being is neither clear nor linear [45:19].

  “Finding a way to acknowledge what's hard—and the things that might require a little more investigation—is always going to have value.” – Rae Jacobson [45:19]

Notable Quotes & Moments

• “Not everything annoying is an ADHD trait. Sometimes it's just being a human in a busy, overstimulating world.” – William Curb [47:49]

• “We all have different challenges...so it does kind of make it feel, if you're unacquainted with it or ...on the fence, that almost anything that's causing you trouble could maybe be ADHD. And that is where I think we get into a much stickier side to this.” – Rae Jacobson [22:43]

• “Who's driving the bus?” – referenced multiple times as a key metaphor for understanding symptoms and comorbidities [26:14]

• “ADHD does not exist in a vacuum. It is a constellation of symptoms which can make it hard to pin down. And it also...brings friends.” – Rae Jacobson [32:15]

Key Timestamps for Segments

• 03:17 Rae's background and the origins of the Hyperfocus podcast
• 05:01 Introduction to over-pathologizing symptoms
• 08:39 The ADHD shame spiral and self-blame
• 12:53 The fantasy (and realities) of chronic organization
• 15:01 Sentimental objects as memory aids
• 17:48 Journaling as a workaround for memory issues
• 24:03 Online ADHD communities: support vs. confusion
• 26:14 The comorbidity conundrum and “who's driving the bus?” metaphor
• 28:13 Nuances and pitfalls of self-diagnosis
• 32:15 Overlooked comorbidities: hypermobility, heart issues in women with ADHD
• 35:43 The reality of ADHD as a disorder versus a set of mere “quirks”
• 38:50 The “would you get rid of your ADHD?” existential question
• 43:15 Climbing the mountain: working with your ADHD rather than against it
• 45:19 Closing thoughts on acceptance, help-seeking, and the convoluted journey of ADHD

Final Thoughts

• Rae: Acknowledging and investigating what’s hard for you is always worthwhile—whether through journaling, seeking community, or reaching out for professional help. The path with ADHD isn’t straight or clear, but it can be meaningful and at times enjoyable.
• William: Build systems that actually help you day-to-day, focus on what’s truly impairing, and don’t attribute every inconvenience to ADHD.

Episode in a Nutshell

This episode stands out for its humor, empathy, and deep reflection on the realities of living with ADHD. Rather than viewing ADHD as the explanation for every struggle, William and Rae urge listeners to ask deeper questions, disentangle overlapping symptoms, and seek support when impairment is real. The conversation models curiosity, self-compassion, and a refusal to oversimplify a condition that is both challenging and, at times, weirdly wonderful.

For full notes and transcript, visit: hackingyouradhd.com/258