303 Boredom Feels Like PAIN?! The ADHD Brain Explained with Dr. Marcy Caldwell

Summary

Podcast Episode Summary

Podcast: I Have ADHD Podcast

Host: Kristen Carder
Episode: 303 – "Boredom Feels Like PAIN?! The ADHD Brain Explained with Dr. Marcy Caldwell"
Guest: Dr. Marcy Caldwell, Clinical Psychologist and ADHD Expert
Date: February 18, 2025

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Overview

This engaging episode revisits the fundamentals of ADHD, with a focus on how the ADHD brain differs from neurotypical brains, the challenges with self-regulation and boredom, and the unique experiences of adults—especially women—with ADHD. Dr. Marcy Caldwell, a prominent psychologist specializing in ADHD, joins host Kristen Carder to debunk myths, validate the lived experience of ADHD, and provide clear analogies to help listeners understand their brains better.

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Key Discussion Points and Insights

Dr. Marcy Caldwell’s Background (02:21–05:03)

• Professional and Personal Life
  • Clinical psychologist with over 20 years’ experience; passionate about neurodiversity advocacy.
  • Traveler and mother of two boys in a family full of ADHD.
  • Founded and directs The Center for ADHD in Philadelphia.
• ADHD in Her Personal Circles
  • While undiagnosed herself (due to her professional familiarity with assessment tools), she relates strongly to many ADHD traits:

    “I am definitely not neurotypical. We'll just go with that. And I am somewhere in the middle, in the messiness of it all.” (05:01)

  • Acceptance of her “messy middle” rather than striving for a distinct diagnosis.

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Foundational Analogy: The Mixing Board (09:59–13:01)

• Dr. Caldwell uses a powerful analogy:
  • Neurotypical brains: Like a sound studio mixing board with dimmer switches—capable of subtle adjustments for optimal energy, attention, and engagement.
  • ADHD brains: Same number of switches, but only ON/OFF toggles—regulation swings sharply from one extreme to the other.
  • This difference requires substantial energy, often resulting in all-in or all-out experiences.
  • Kristen enthusiastically endorses this analogy:

    “I don't think I've ever heard it explained better.” (13:01)

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Regulation and Its Adult Manifestations (15:02–21:13)

• Self-Regulation as Core Issue
  • Regulation challenges can show up as procrastination, lateness, messy living environments, and difficulty with transitions or task initiation.
  • Dr. Caldwell identifies motivation drivers for ADHD brains: “Novelty, competition, interest, and pressure.” (15:32)
  • Classic task initiation difficulty:

    “That initiation hurdle is a hurdle that requires more energy to get over than it would to just kind of walk through it if it weren't there.” (20:10)

  • Kristen relates personally:

    “I struggle to even take my stuff out of the car when I get home....It is such a herculean effort for me to just even grab my work bag, my lunchbox, just to bring it back into the house, let alone put it away.” (19:40)

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Core ADHD Symptoms: Known and Lesser-Known (21:13–26:46)

• Symptoms highlighted by Kristen:
  • Impulsivity, distractibility, restlessness, dopamine-seeking, working memory issues (including time blindness), emotional regulation struggles, poor self-reflection, problems with prioritization/organization/planning, task initiation and completion.
• Dr. Caldwell Adds:
  1. Masking: Pretending to be neurotypical is a key and draining part of daily life with ADHD:

     “Masking...is a huge part of what drains that regulatory battery and is part of what makes it so much harder in the afternoon and evening because it's a pretending throughout your day.” (22:49)

  2. Narrow Optimal Stimulation: ADHDers require a high, but very narrow band of stimulation for best function—too little and it’s painful, too much leads swiftly to overwhelm.
  3. Sensory Overload and Attenuation: Difficulty filtering stimuli often leads to sensory overload, which can trigger emotional dysregulation and fight-or-flight responses.

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“Boredom Feels Like Pain” (27:43–29:10)

• Dr. Caldwell describes the neurobiological basis for extreme boredom:

  “FMRI scans show that lack of stimulation actually does initiate the same sort of brain activity...it is actually painful for an ADHD brain to be bored.” (28:02)

• Kristen is deeply validated:

  “I always say it feels like death...I feel physical pain with boredom.” (28:34)

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Sensory Processing and Overwhelm (29:11–32:30)

• ADHDers often lack the “mute button” for sensory input:

  “It just feels like everything is a lot.” (32:30)

• Everyday sensations (a watch, tags, noise) can remain intrusive and signal the nervous system to go into fight-or-flight.

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Gendered Differences and the Diagnostic Journey (32:30–42:22)

• ADHD in Women:
  • More likely to have inattentive type, internalize symptoms, and mask through people-pleasing and perfectionism.
  • Later diagnosis leads to increased shame, anxiety, depression, and grief for ‘what could have been’.

  “The longer you go without understanding what makes you different...you then assume that you’re wrong and that you’re bad.” (33:38)

• Stages of Diagnosis Acceptance:
  • Moving from “I’m just like everyone else” → “There’s something wrong with me” → depression and frustration → community and positivity → balanced acceptance.

  “At some point, people tend to move out of that, and often it's because of community.” (40:39)

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Memorable Quotes and Moments

• Perfect Soundboard Analogy:

  "A neurotypical brain has that with all these dimmer switches. ADHD brain has just as many switches, but they're on off switches… It's much harder to kind of balance somewhere in the middle." – Dr. Caldwell (10:29)

• On Masking:

  "Pretending to be neurotypical ... that's so true. Pretending to have it together." – Kristen & Dr. Caldwell (23:46–23:51)

• On Female Experience:

  "We have this very high expectation for women...when executive functionally, that is extra challenging. It really creates this like, well, who am I? What good am I?" – Dr. Caldwell (35:39)

• On Acceptance:

  "I am a full person...there are great things and terrible things about me, just like there are with every other person on the planet." – Kristen (42:51)

• Boredom as Physical Pain:

  "FMRI scans show that lack of stimulation actually does initiate the same sort of brain activity...that it is actually painful for an ADHD brain to be bored." – Dr. Caldwell (28:02)

• Kristen’s Validation:

  "That is so validating...I did not know that. I'm so appreciative of that information." – Kristen (29:10)

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Debunking ADHD Myths (43:04–48:55)

• Most Annoying Myths (43:53):
  1. “Everyone is a little ADHD.”

     "No, we're not." – Dr. Caldwell (44:08)

  2. "ADHD is a new phenomenon; it's being overdiagnosed.”
     • Increases in diagnosis stem from greater awareness, reduced stigma, and pandemic-era stressors.
     • Still, underdiagnosis persists in women and minority populations.
• Research Note:
  • ADHD often intensifies during major life changes (pandemic as a collective event increased diagnoses).

    "Normally our major life events are all happening at different times...But in 2020, everybody had the exact same thing happen." (48:12)

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Resource Links & Closing (51:32–52:36)

• Connect with Dr. Marcy Caldwell:
  • Clinical practice: centerforadhd.com
  • Writing/blog: adept.org
  • Digital course on emotional regulation, upcoming book, and availability for speaking.
• Kristen invites listeners to join her FOCUSED membership for further ADHD coaching and support.

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Useful Timestamps

• Dr. Caldwell's background: 02:21–05:03
• Mixing board analogy explained: 09:59–13:01
• Regulation in everyday life: 15:02–21:13
• Masking and symptom review: 21:13–26:46
• Boredom and pain centers: 27:43–29:10
• Sensory processing overload: 29:11–32:30
• Female ADHD experience: 32:30–42:22
• Diagnosis journey stages: 39:10–42:22
• ADHD myths debunked: 43:04–48:55
• Research on ADHD over lifespan: 47:18–48:55
• Closing, resources: 51:32–52:36

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Tone and Language

This episode is rich, warm, and validating—mixing humor, expertise, and deep empathy. Dr. Caldwell and Kristen empower listeners by naming experiences, breaking down stigma, and providing actionable analogies and information for self-understanding. The language is clear and jargon-free, with moments of self-deprecating humor and authenticity.

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Transcript

[A]

Welcome to the I have ADHD podcast where it's all about education, encouragement, and coaching for adults with adhd. I'm your host, Kristen Carter, and I have adhd. Let's chat about the frustrations, humor and challenges of adulting relationships, working and achieving with this neurodevelopmental disorder. I'll help you understand your unique brain, unlock your potential, and move from point point A to point B. Hey, what's up? This is Kristen Carter and you've tuned in to the I have ADHD podcast. I am medicated, caffeinated, regulated, and so ready to roll. Thanks for being here with me today. This is going to be a great conversation. We are getting back to the basics of adhd. What does it mean to have adhd? What should we be looking out for? Whether you are a seasoned ADHD vet and you know all of the things, or you're just kind of exploring the concept of, like, what you. What is this ADHD thing that I keep hearing about? Because I kind of have been seeing TikToks that I really resonate with and it makes me a little bit uncomfortable. This episode is for you. With me today is Dr. Marcie Caldwell. She's a psychologist, a writer, illustrator, and proud wife and mother in a family full of ADHD with over 20 years of experience. She's a passionate advocate for those with neurodiverse brains for focusing on helping craft systems and environments that nurture unique strengths. As the founder and the director of the center for adhd, one of the nation's leading ADHD clinics, which, by the way, is right here in Philadelphia. Dr. Marcy is committed to making a difference in the lives of those impacted by neurodiversity. A nationally recognized speaker, consultant, and educator, Dr. Marcy shares her insights with Fortune 500 companies and Prestige publications like the New York Times and HuffPost, championing awareness and advocacy for the ADHD community. She is the perfect guest for us to be talking about all of the fundamental aspects of adhd. You are going to learn so much from this conversation. I can't wait to get started. Marcie, thank you so much for being here.

[B]

Thank you for having me. It's a pleasure to be here.

[A]

So you live in the area. Tell us a little bit about yourself.

[B]

Yeah, so I'm a clinical psychologist. I'm also the mom of two, two little boys, ages 8 and 11. And let's see, what else. Love to travel. We spend our summers abroad, which is super fun.

[A]

Where are some of the places that you've been in recent years?

[B]

Recent years? We spent two summers in Switzerland, and last summer we were primarily in France. And we send our kids to camp, and we. We work while we're abroad, but we send our kids to day camps, and so they now have friends all over the world. We rent our house out, so it kind of pays for the whole experience. It's great.

[A]

That is so awesome. Wow. That is total ADHD vibes, by the way.

[B]

Well, yeah.

[A]

Right. You in. In your intro, I read that you are from a family full of ADHD years. Would you mind telling us a little bit about your ADHD experience for yourself?

[B]

Yeah. So I started out as a psychologist thinking. I don't even know what I was thinking in terms of what I wanted to do exactly. I just wanted to help people. And I was working in college counseling at the time. I also had a small practice where I was doing assessments. So I was kind of testing adults, and in that practice, I was testing a lot of folks with adhd. That's one of the things that people want to get tested. Right. And I would often recommend that they go on for therapy. And the thing about that kind of testing, back then, it was super extensive. Right. It would take 10 to 12 hours. They would tell me their whole life story over and over again. And oftentimes folks would say, I don't want to have to go through that again. Like, you now know all of me. Can I just stay here? And eventually, I kind of started to develop this practice that was full of folks with ADHD the time I then met my husband who has adhd, and I was like, my whole world is about ADHD all of a sudden. And so I went out and looked for some more training, and I, you know, went to some conferences. I approached Ari Tuckman to supervise me.

[A]

This is prior to your own diagnosis.

[B]

So I have not been diagnosed, actually.

[A]

I am so sorry.

[B]

That's fine.

[A]

Okay. So your family.

[B]

My family, adhd. I, personally, I call myself in the messy middle. I am. And I. So it's tricky when you're a psychologist and this is what you do. I can't really be tested. I know all of the measures. Right. There's kind of no way to objectively assess me. There are things that I very much relate to, and there are things that I don't relate to, which, you know, it's true of anybody with adhd. And I am definitely not neurotypical. We'll just go with that. Okay. And I am somewhere in the middle, in the messiness of it all. And that used to be really uncomfortable for Me. And the truth is, I've kind of. I'm okay with it now. Right. Like, I know how my personal brain works. I know what works for me. I know what I need. I know how to create the systems that work for me. And that's kind of the important part. That's often what we're getting to with the diagnosis. Right. The diagnosis is just a step on the path to that, so that I can't get an answer as to, like, where do I fit? Which box do I fit into? It's kind of okay with me now.

[A]

I so appreciate you sharing that. And again, I apologize. I made an assumption. But hearing you say that you're in the messy middle, that there's really not a place where you would be able to be objectively assessed because of all of your knowledge. I mean, all of that makes so much sense. And I completely agree with you that most of the time, the diagnosis is a means to an end. The end being, I want to understand myself. I want to know what works for me. I want to make sure that I'm setting myself up for success, that I'm understanding my brain and knowing, like, how to proceed in ways that work with my brain and not against it. And so that makes so much sense to me.

[B]

Yeah. Yeah. It's been a journey.

[A]

Yeah.

[B]

As it is for everyone, Right?

[A]

Yeah, absolutely. So you've spent how long working with people with adhd? You have years and years experience.

[B]

I've been working with folks with adhd basically since 2008. Okay. And in a more focused way since about 2012. And I love it.

[A]

Why do you love it?

[B]

I. I mean, that I'm married to a man with ADHD might indicate I. I love ADHD brains. I love the energy that often comes with an ADHD brain. I love kind of the spontaneity, the creative problem solving, and I just find it fun. I also find the process of kind of system engineering really fun. And I know that this is often really frustrating for folks, the fact that we have to kind of rebuild systems over and over again. But I also find that kind of fun. And realizing what we've learned in the process and putting together new systems and iterating, I just think it's a blast. And there is something that works really well with. Whatever it is, the way that my brain works works really well with folks with adhd.

[A]

That's so great. So we have done several episodes, as I've mentioned already, we've done several episodes on the fundamentals of adhd. But about every hundred episodes. And we're at, I don't know, three and change right now. It's so important, I believe, for us to revisit just the fundamentals. Like, there are a ton of podcast listeners that kind of come in and out and are listening to different episodes, and some of our listeners are starting at the very beginning, like, oh, I'm just kind of waking up to this, and I'm seeing, like, Reels or TikToks that I'm relating to, and that makes me feel a little bit uncomfortable, and I don't really know what to do. And for better or worse, ADHD is kind of trending right now. And I think there are good things about that and really obnoxious things about that, too. But let's kind of get to some fundamental aspects of adhd. So I think it's pretty widely known that, like, distractibility, impulsivity are typical traits of someone with adhd. What other kinds of things? If we're talking in terms of adults, what other kinds of symptoms do we need to be aware of when it relates to adhd?

[B]

Yeah, and I'm so glad that you're doing this, because I think oftentimes in the ADHD world, we can kind of talk about so many of the far reaches of adhd, and we often miss that basic stuff that is so foundational. And so I really think of ADHD and kind of the core difference of an ADHD brain being regulation based within regulation. Right. And so if. And the way I often describe this to folks is that if you think of a neurotypical brain as being like a mixing board in, like, a fancy sound studio. Okay, Right. So you have tons of different switches, but they're all dimmer switches. And so we can get the just right level of everything. Right. Just enough attention, just enough energy, just enough motivation. So we still have some left for later, but we have just enough to kind of get this task done. And all of our brains operating is on this board. So there's a lot of things on there, including, like, the volume of our voice. Right. And so a neurotypical brain has that with all these dimmer switches. ADHD brain has just as many switches, but they're on off switches. Right. And so they go all in and they go all out. And it's much harder to kind of balance somewhere in the middle. It's possible, but it takes a lot of energy, which is why oftentimes that regulation is easier earlier in the day when you have some energy to kind of try to balance it somewhere in the Middle. Then later on the day when we've spent all that energy and it's like, sorry, I'm all in or I'm all out. That's. That's where you're gonna get me. So this creates these kind of all in, all out experiences across the board. And so that can be with emotion. Yes, it can be attention and energy level, but it can also be, as I said, the volume of your voice. Right. Like, this is a. A typical one that we get a lot with kids, that kids with ADHD get in trouble in class because they're like, they're whispering, but they can't whisper. I actually had this with my husband just this morning. I was like, yeah, we were talking about something with my son. And I was like, can you keep your voice down?

[A]

He's like, what?

[B]

He's like, around. So, you know, everything that our brain does needs to be regulated. Um, and so that's really the core difference. Yes, we see it the most with attention. We see it the most with hyperactivity. But it's gonna be all the things and. And it's gonna be this kind of all in, all out sensation.

[A]

I don't think I've ever heard it explained better.

[B]

Thanks.

[A]

Which is a huge compliment because I've heard it explained a hundred thousand times. And so kudos to you for that analogy because that makes complete. I fully understand the concept of a neurotypical having the ability to kind of. And I can see the sound mixing board in my brain and having the ability to kind of amp up a little bit and then pull back a little bit. Whereas for an ADHDer, it's on or off. And that is the experience of my life. I'm either on. And when I'm on, it is like.

[B]

Feels good, I'm on, but I can.

[A]

Immediately feel the switch off. And there is a very distinct difference between Kristin Carter sitting in this podcast studio being on and Kristin Carter sitting on the couch with the messy bun and the, like, the hood over my head. My husband calls it a cone head. Cause I have like the big huge bun of hair and then I have the hood over top. I like pull it over my head and I'm just like, nobody talk to me. I'm off. Like, it's just like, I've spent it for the day. I have nothing left. So, sorry, no more to give.

[B]

Yep. Yeah. Dang.

[A]

So how does regulation, how does the inability to regulate affect a human? So Barclay says Dr. Russell Barkley often refers or referred to ADHD as a disorder of self Regulation. And I agree with you. I think that this is just the primary aspect of adhd because it's not necessarily just all attention, it's not all impulsivity. It's like the fact that we struggle to regulate that dimmer, switch that up and down and moving it appropriately for the appropriate settings. How does that affect an adult? Just like a basic adult. What does that look like for us?

[B]

So it's gonna show up in the world in lots of different ways. And it's part of, I think, what's so confusing about ADHD for so many people and is that it can be all in and it can be all out, and sometimes it can be somewhere in the middle. And so it is going to show up in different ways in different settings, in different circumstances for different people. Right. Because some things are going to activate the brain and draw the brain into that kind of all in setting, and some things aren't. And if there's enough energy in the system, enough regulatory energy in the system, that's okay, we can kind of force it. But if there's not, then too bad, it's not going to happen. And so it's going to show up as things like procrastination. Right. Because ADHD brains tend to be motivated by four things. Novelty, competition, interest, and pressure. And if something isn't providing one of those things, it's not going to kind of turn that brain on. Right. And so we're going to have to just wait until time passes and pressure builds up, and then that pressure builds up, and all of a sudden it kind of flips the switch from off to on, from off to on. And now I can go. Yeah, and now I'm going to go hard and I'm going to be all in. Right. And it's going to look like a tornado, but I'm probably going to get way more done than I could have that whole time beforehand when my switch was off. Right. So that's one of the things. Lateness kind of happens in the same sort of way. Right. That enough time passes and then it's like, oh, switch turned on. And now I have to go. And now I will go. But I have. But it took a while for that switch to turn on.

[A]

So now I couldn't get myself to move right before that moment where I realized, if I don't get my ass up off the couch right now, I'm gonna get in trouble.

[B]

Exactly.

[A]

Yeah. There's gonna be hell to pay in some way.

[B]

Yep, yep. Messy houses.

[A]

Yeah.

[B]

Right. Because nothing is there to kind of so if you think about what's needed to kind of keep a house in order, right, you have to put the bag where the bag's supposed to go. You have to put the keys where the keys are supposed to go, right? And in order to do that, I have to have just a little bit of attention running that whole time of like, what do I have on my body? Where is it supposed to go as I walk in the house? And so it's just a little bit of attention, just a little bit of memory, right? And when I'm saying just a little, we're talking about regulation, we're talking about that, that knob being somewhere in between in and all out. And so that's not going to happen usually, and particularly not with a lot of queuing and a lot of effort. And usually when the messes are created, it's usually in the afternoon and evening, right, as we're coming in and we're just like throwing our stuff all over the house. That's when the mess gets created.

[A]

After a long day of work or a long day of school or long day of self regulating and keeping things in order. And in places where there's more accountability, maybe like, there's more, there's more eyes on you at work. So maybe you're working a little bit harder because you feel the eyes on you or there's like actual consequences if you don't, you know, do it. Right.

[B]

Yep.

[A]

And then you get home and it's your safe place and you're just like, ugh.

[B]

Yeah.

[A]

I struggle to even take my stuff out of the car when I get home. I pull into the garage. If I don't get stuck in the garage, which I usually do right on my phone or just like trying to get myself to transition from the car to the home. Because now I'm switching off like work mom, work person mode, professional person mode, into what I call second shift, which is my mom mode. Right now I'm the Uber and I'm the cook and the chef and the clean, whatever. So I get stuck in my car. But then I even struggle. It is such a herculean effort for me to just even grab my work bag, my lunchbox, just to bring it back, back into the house, let alone put it away. Like when I get home. Please don't make me do it. Yeah, I just want to plop it.

[B]

Yeah, yeah.

[A]

Yes. I feel it. I feel it. Because by that time my switch is off.

[B]

Yeah. And the other thing that's coming into play there too is an initiation hurdle yes. Right. Because you stopped. You got in the car and you stopped moving. If you walked from the studio to your house and walked in the house, you probably wouldn't feel as much struggle with it. Right.

[A]

That's so true.

[B]

Because you didn't stop the stopping.

[A]

I'm immobile. I'm sitting in my car.

[B]

And then you have to go again. And that initiation hurdle is a hurdle that requires more energy to get over than it would to just kind of walk through it if it weren't there. Right. And this is another one of those things that's so frustrating to folks because it's like, why is this so hard? Why is it so hard for me to get out of the car? Like, it's just getting out of the car. Because. Because there's initiate. There's a hurdle in front of you, and that hurdle is hard to get over. Particularly the longer the day goes on and the more that you had to expend your energy resources during the day and so forth.

[A]

And also for me, like, when my kids were younger, like, what I anticipate the chaos being, like, inside of my home.

[B]

Yeah.

[A]

Like, I would rather just sit.

[B]

Well, there's that too.

[A]

And not go into the chaos that I know is about to ensue.

[B]

Yeah.

[A]

Task initiation is one of those symptoms of ADHD that I think is not very well known. I'm going to read some of what I believe to be like the most well known symptoms of adhd, and then I'm going to ask you to add anything to that. So obviously, and this is from my website, I have ADHD.com, i compiled it from a bunch of different psychologists that I talked to about the ADHD symptoms. So impulsivity, distractibility, restlessness, like this internal chugga, chugga, chugga, Whether it is externalized hyperactively or not. Maybe I'm just keeping it to an internal thing. The chase for dopamine. So, like, wanting the novel, the new, the exciting working memory issues that include, like, time blindness. Like time blindness, I think, is just a huge one and a huge way that people who maybe don't identify as being ADHD can kind of clock. Like, maybe there's something more going on here. Emotional regulation, poor working memory, struggle with self reflection. And so, like making the same mistakes over and over and over. Difficulty with priors and prioritization and organization and planning, like that cluster group. And then what you just talked about, like initiation, task initiation. And then on the other end of that completion, what would you add to that? Are there any that are Kind of like either missing or like little known symptoms that maybe the layperson wouldn't even know about.

[B]

So that's a pretty comprehensive list. I think one thing that I might add in there is this masking and maybe that's not quite a symptom, but if we're talking about kind of the ADHD experience, I think we always have to be kind of be talking about masking for those that don't know is really just this, this feeling and often need, like very real need to pretend as if. And the reason why I'm noting it is that I think that is a huge part of what drains that regulatory battery and is part of what makes it so much harder in the afternoon and evening because it's a pretending throughout your day.

[A]

Can you describe that a little bit? Pretending to what?

[B]

Pretending to be neurotypical.

[A]

Yes, that's exactly it. That's so true. Pretending to, Pretending to have it together.

[B]

Yeah. Pretending to not want to interrupt all the time. Pretending to, you know, be able to see time. Pretending to show up places where you're, you know, when and how you're supposed to show up.

[A]

As if it's not hard.

[B]

Yeah, exactly.

[A]

Like, as if, like I'm just, I'm just like you just walked in here. It's fine. I'm on a health kick right now and my kids are so annoyed at me. I've changed the type of rice and pasta and bread that we eat at home. I've even eliminated all breakfast cereals from the house. No more Captain Crunch or Cinnamon Toast Crunch to be found in the Carter home. It's a true ADHD hyper focus for me right now. But one thing that I've stuck with, and I don't think I'll ever stop taking is AG1. I, Kristin Carter, an adult with ADHD, have been able to be consistent with taking AG1 every single day for a long time. It's the first thing I do when I wake up in the morning, before coffee, before anything. It literally takes me about 60 to 90 seconds to just scoop it into some cold water, shake it up and drink it. It really is so easy. And I'm traveling with my family to Indiana for the holidays. We'll be staying in a hotel, eating out for a lot of our meals, and generally partaking in lots of non healthy activities, which is fine because balance, you know what I'm saying? And I know that I can stay consistent with AG1 thanks to their travel packs. I'm just gonna pop six travel packs into my shaker slip that Baby into my travel bag. And done. It's so simple, I don't even have to think about it. So I encourage you this New year, if you want to do one thing to improve your health as an adult with ADHD, try AG1 for yourself. It's the perfect time to start a new healthy habit. And that's why I've been partnering with AG1 for so long. And listen to this. AG1 is offering new subscribers a free $76 gift. When you sign up, you'll get a welcome kit, a bottle of D3K2, and five free travel packs, just like I'm going to be using over the holidays. You'll get all of that in your first bottle, so make sure to check out drinkag1.com Ihaveadhd to get this offer. That's drinkag1.com IhaveadHD to start your new year on a healthier note. For me, one of the most draining things is like, pretending to be interested in something that I'm not interested in. So, like, smiling and nodding. I was in a meeting the other day for my company, and there was, like, a couple people involved, and this woman was doing a presentation. I was just like, I do not. I don't care. I do not care. And it drained by the end of that meeting. I was, like, not able to function. I had a meeting right after and I canceled it. I was like, I'm out. My brain is no longer available.

[B]

Yeah, yeah, yeah. And I think that actually gets to another important one, is that for folks with adhd, there's a very narrow band of what I call optimal stimulation. So all. As Ari always says. Right. Like, ADHD doesn't invent any new problems. This is true for all folks. That, that we have a band of optimal stimulation where we work our best. Right. Where there's enough going on. We're interested and engaged, but not so much that we're overwhelmed. So everyone has that band. It kind of looks like a normal curve, like a little hump for ADHD brains. It tends to be much more narrow. So that still a hump, but it's like a very narrow hump. And it tends to happen a little higher up on. On the scale. Right. So it tends to require more stimulation. And. But it's a very narrow thing before it flips over into too much stimulation.

[A]

And you never know.

[B]

Yeah.

[A]

When that's just gonna go a little bit too far.

[B]

Yeah. So that. That tendency to feel really bored and that boredom to actually be painful. And when we see. We see FMRI scans that boredom actually does light up pain centers for ADHD brains.

[A]

Wait, say it again. That's so important.

[B]

Yeah. So FMRI scans show that lack of stimulation actually does initiate the same sort of brain. And, you know, and we have to be careful because just because we see something on a brain scan doesn't mean that it functions in the exact same way that we think it does. But we are presuming that because it's lighting up the same kind of pain centers, that it is actually painful for an ADHD brain to be bored.

[A]

Okay, can we pause just for a second?

[B]

Yeah.

[A]

That is so validating. I lead a very large community of people with adhd and we talk about boredom a lot. And we talk about. I always say, and this is maybe taking it too far, but I always say it feels like death. It feels like death in my body. Like, I have got to get out of the situation or I am going to die. Like, I feel physical pain with boredom. And so the fact that that is seen on FMRI imaging is so validating because actually, I did not know that. I'm so appreciative of that information.

[B]

Yeah.

[A]

Wow.

[B]

And then on the flip side of that is overstimulation. Right. And that's one thing that wasn't on that list, is that ADHD brains tend to have this kind of filterless sensory processing that doesn't kind of keep out extraneous information. I often like to think of it as like, the difference between, like, a VIP dance club and like Coachella. It's like all the things are coming in. Some of that's fantastic and can lead to a really cool vibe. And it also means that it can get rained out and, you know, be a mudfest. Right. And so people with ADHD tend to get very overstimulated by certain things. Like really loud, sudden noises can be really, really painful. My husband responds really viscerally and negatively to the dog barking and a baby crying. Like, all those kinds of noises can be really painful. Tags. Right. Any kind of sensory information for a neurotypical brain, often it'll experience that for sure, but it'll attenuate to it and it'll kind of normalize.

[A]

What does attenuate mean?

[B]

So it'll. So, for example, wearing a watch, Right. When you put a watch on, you feel it at first, and then a couple minutes later you stop feeling it. Yeah. First of all, for some folks with adhd, they never stop feeling it.

[A]

Right. And so it's like your body is saying to you constantly, you're Wearing a watch. You're wearing a watch. You're wearing a watch. And then multiply that by everything you're wearing, everything you're hearing, everything you're seeing, everything you're touching, everything you're experiencing. Your body's like, this is happening. This is happening. Instead of kind of blocking out, it's almost like a mute button that's missing.

[B]

Yep, exactly. And that then puts our sensory system into overdrive. Right. And why is our sensory system there to protect us. So a sensory system that goes into overdrive kicks off that fight or flight response. And so an ADHD brain is much more likely to kind of kick over into that kind of extreme fight or flight because it's often already almost there. Wow. Right. And it doesn't take very much, and this is part of what happens with emotional regulation for folks is it doesn't take much to flip that over. Right. When you're already kind of at your max because you're just being bombarded by all the sensory information. And it's not getting muted, it's not kind of getting pushed away, then what else are you going to do?

[A]

Wow. Gosh, that is fascinating. And again, it feels really validating to hear you saying it because it puts language, it puts words to the experience, to my own personal experience of like, it just feels like everything is a lot.

[B]

Yeah.

[A]

Just feels like everything is a lot. Yeah. So let's transition a little bit here, and I would just love for you to take a minute or two to talk about, is there any difference in the way that women display ADHD symptoms? We know that women are typically diagnosed later in life. The last stat that I heard, and maybe you have some updates on this, but the last stat that I heard was the median age for women being diagnosed female diagnosis is 38, which is pretty late. Yeah. I was lucky enough to be diagnosed early at 21. So, like, that's really early for a woman. And I'm so grateful for that. But what are some of the key characteristics or qualities of ADHD symptoms displaying in women?

[B]

So, yeah, so women and girls do tend to manifest ADHD differently. That doesn't mean they always.

[A]

Not all the time. Yeah.

[B]

Not every person, they tend to be more likely to be have an attentive type, less likely to have impulsivity and hyperactivity. They tend to internalize symptoms more. And so what that means is tend to a. Try to mask them, which tends to show up as a lot of people pleasing perfectionism and also leads to a lot of shame. Right. Um, and, and, and that is then amplified by the later diagnosis. Because the longer you go without understanding what makes you different, just the way our psychology is built as humans, when we are different because that is not optimal for kind of survival and evolution, we then assume that we're wrong and that we're bad, right? And so the longer you go without knowing why you're different and how you're different, the longer you go with this internal belief of I'm wrong, I'm bad, and the longer you go, the harder it is to shake. So we see more symptoms of anxiety, depression, eating disorders and self mutilation, self harm. All kinds of things happen for women in part because of this later diagnosis and this kind of internalized shame. Also have to think that what do we expect for women? We expect them to show up. We expect them to handle social situations gracefully, right? We expect them to, you know, make phone calls and, and bring over quiches. Maybe not quiches.

[A]

Yes, it's so true.

[B]

And think about birthdays and, you know, and keep a clean house and stay organized and send in the permission slips and like do all these things that are all executive functioning nightmares. And so we have this very high expectation for women, and that's hard for any woman to maintain. But then when executive functionally, that is extra challenging. It really kind of creates this like, well, who am I? What good am I? And how, you know, how do I relate to this label of woman, even let alone woman with adhd? So it creates this very tricky identity issue. And the other thing that I see with kind of a late diagnosis is a lot of grief comes along with it, right? Of kind of like, what could have been if only I had known. And you know, almost all of the women in my practice that have a late diagnosis, this is a big part of what we work on. It's like, what could have been, you know, what degrees could I have gotten? What pursuits could I have followed? You know, who would I have been if I. I didn't have to feel like I was broken this whole time.

[A]

It makes me think of like our mothers, our grandmothers, our great grandmothers who were never privy to a diagnosis. I mean, it obviously runs in families. I am positive that it's in my family. And just thinking of the generations of women, excuse me, that came before me, that just never had the luxury, the privilege of a diagnosis. And when I talk about diagnosis on this platform, I'm always so adamant that being diagnosed is such a privilege. Like, yes, there's a lot that can come with that and it can be hard to kind of grapple with, but to even have that information is like, gosh, we're so lucky. Like, I feel so lucky to know this about myself, because prior to this understanding, I just thought I was a bad person. I just thought. I just. Like, I just couldn't get it right. And even, to be honest with you, the diagnosis didn't change that because my doctor didn't tell me anything about adhd, really. So it took me learning about ADHD and the symptoms and then being like, excuse me. Everything that I hate about myself is actually related somehow to adhd, so maybe it's not me. Maybe if I get a handle on these symptoms, I can. I can stop hating myself. And that. Like, to speak about the journey of the female ADHD experience, it is so. It is a roller coaster, but it can be so healing to just know that about yourself.

[B]

Yeah. Yeah. I have, in recent years, been kind of tracking the progression of folks kind of through their diagnosis and kind of their identity in relationship to the diagnosis. And we've been doing this in the practice, and we have kind of developed a model of how people kind of go through that journey. And of course, it's adhd, so it's not. It's not linear, and people kind of move in and out of the processes. But that oftentimes we come to a diagnosis not knowing. Right. And kind of thinking, like, I'm just like everybody else. The things that are different about me are bad. Right. And are about who I am as a person. And then a diagnosis kind of pops that bubble. It's kind of hard to go back to that stage, though. We can do all kinds of crazy things in our heads, so we can. And then it kind of becomes a like, oh, there's something wrong with me. There's like, a problem. Right. It's been identified. Let's fix it. And there's a lot of energy in that. And this is when people tend to come into treatment and they're kind of like, come on.

[A]

Yeah, do it. Yeah.

[B]

Which is great. And, like, harnessing that energy is fantastic, but within that is also, like, there's something wrong with me. Right. And then there tends to be a stage where people go into kind of a depression. Right. Of a. Like, there's something wrong with me, and it's not going away. Like, I tried a whole bunch of things, and this hurts. And I've did all the things all the experts told me to do, and I'm still. Didn't fix me screwing up.

[A]

Yeah, yeah, yeah.

[B]

I'm still showing up in the world in the same way. And. And people tend to get really low at that point, and at some point, people tend to move out of that, and often it's because of community, and they start to kind of learn more. People that have adhd, they maybe do a lot, even more education. They get involved in a community like yours, or they go to an ADHD conference or something like that, and then they're like, oh, ADHD's really cool. Yes.

[A]

Right?

[B]

I like these people. This is my tribe, right? And they can get very excited. And. And this is where some, like, toxic positivity can come in, too. And. But it's kind of a. Like, ADHD is amazing, right? And. And there's a lot of great stuff in that. In that stage as well. And then we see kind of people move into this, like, yes, I have adhd. It gives some real challenges. There are also some things that I really love about it. And everybody on the street also has things that are challenging and that are wonderful. And how can we work together? How can I help you with your challenge? How can you help me with my challenge? People tend to be more willing to kind of walk into places and say, this is what I need. Here's what I have to offer. Right. With equal confidence in both of those things. And so we've seen people kind of make this progression. I got us off on a tangent.

[A]

I absolutely love it, and I think that's so helpful to the listener to hear, like, where do you find yourself in that progression? I think would be a really interesting question to ask. Like, are you at the very beginning where you're like, oh, my gosh, there's a problem? Are you at the kind of the toxic positivity where you're like. Like, adhd is my superpower. Like, where. Where do you find yourself? Hopefully, no matter how long it takes, it ends with some sort of, like, acceptance. Like, I am a full person.

[B]

Exactly.

[A]

I am flawed, and I'm amazing. There are great things and terrible things about me, just like there are with every other person on the planet. And this is the challenge that I am facing. So what are the tools that I.

[B]

Use exactly to help?

[A]

Yeah, that's so good. So we can't have a podcast about, like, the fundamentals of ADHD without talking about some of the myths. And I love to ask this question, like, what are the most annoying myths to you? Like, what are the ones that just like, grind your gears, that you roll your eyes at, that you're just like, oh, my gosh, these people are so annoying. Maybe you don't identify as someone who loves to call people annoying, but as someone with adhd, my on switch turns on and I get annoyed immediately. And so I'm like, scrolling on social media or I'm reading the latest ADHD news, and sometimes it's great, and sometimes I'm just like, oh, my word. So what are some of the myths that annoy you the most?

[B]

So everybody has a. She is a big one.

[A]

I mean, everyone's a little adhd, right?

[B]

Yeah, that's Marcy.

[A]

Like, we all are a little bit adhd.

[B]

No, we're not.

[A]

We're not.

[B]

I get where, you know, every myth has an origin story. Right. Like, I get where that comes from. And it comes from, as I was saying, what Ariel says. Right. ADHD doesn't invent new problems. So, yes, we all have problems with the things that folks with ADHD have bigger problems with. It's the extent of the problem and the larger constellation of the problem. Right. And the universality of the problem. So that's a big one. I think also the, like, it's taken on a new tone lately, which is the like, well, everyone has ADHD now.

[A]

Oh, right. Like, it's a new phenomenon that's overly diagnosed.

[B]

Right.

[A]

Yeah.

[B]

Which I think is particularly pernicious because it calls into question anybody who has adhd. And. And again, that has a real origin story. There has been an increase in diagnosis because there's an increase in awareness. Right. There is still statistically an under diagnosis, particularly in populations like women and girls and African American populations. And there are lots of kind of pockets where it is still very much under diagnosed. Are there pockets of the world where it might be over diagnosed? Probably, yeah. But the thing is that the more we talk about it, the more people are like, huh, that sounds a little like me. Maybe I'll go see if this fits. It is a spectrum, right. And human beings exist on a spectrum. Where we draw the line is a somewhat arbitrary and be a little muddy. And so that's where that possible over diagnosis might happen, is in that kind of muddy, messy middle. And that's okay. That's part of life. That's part of diagnosis. That's just kind of what happens. But we don't want to have all the people that are being under diagnosed not be able to access that, just because there might be a couple people that are in that messy middle that maybe are on one side of the line, but we're calling on the other. Right. And so all of that talk just kind of leads into an under diagnosis and a stigma. I think that really is unfair for a lot of people. The other thing that I'll say about that is that. So Margaret Sibley's research out of University of Washington, that looked at ADHD across a lifespan. Right. And this was really new, really exciting research because it looked at folks from birth, maybe not quite birth, like five or six.

[A]

Sure.

[B]

Early childhood. And they're still following them. And it's been. Don't quote me on this, like 30 years. They're adults now. And so we have this kind of research, this longitudinal research. Usually we do test them once at the beginning and once at the end. This time, they tested all along the way, and what they found was that ADHD persists through life, but that it persists in this kind of waxing and waning sort of way. And it tends to. The symptoms tend to increase around major life changes. Well, guess what happened five years ago. Every single person had a major life event. Right. So that we have this huge surge in diagnosis is also in part due to that.

[A]

Yes.

[B]

That normally our major life events are all happening at different times. Right. And so, you know, somebody's having kind of a surge in symptoms and being like, oh, this is really hard. I need to go figure out what's going on at a different time than somebody else. But in 2020, everybody had the exact same thing happen that caused everyone to go into crisis and everyone to come get diagnosed. So I do think that that needs to kind of be factored in when we're talking about this increase in diagnosis, because it's a very real thing that happened, and it did result in a whole bunch more diagnoses.

[A]

Absolutely. I'm so glad you brought that up. And I want to add to that, for the first time, maybe ever, we had that big life event happening for everyone at the same time. And we also had so much access to information, access to medical care via Zoom or Skype that we never had had previously. So all of these new technology that we have access to, I think made it easier for people to access care and get the diagnosis that they needed. I love that you brought that up. And yet there's still a segment of the population walking around thinking that there's bad people because they just can't function the way that everyone else does. And that's why we record episodes like this, because we want to make sure, first of all, that people with ADHD have a really solid understanding of what it means to have adhd. So many of us, myself included, were diagnosed Given a prescription and sent on our way. I had no idea what it meant to have adhd. I believe. I mean, it was a long time ago and my memory sucks, but I believe it was something like, yup, you have adhd. And this was before the Internet. This was before so what year? And then like, not before the Internet, but before we were googling everything. Do you know what I'm saying? So it was like late 90s, early 2000s. And so I didn't just go do a Google. It was like, Dr. Ned Hallowell's book is what my dad read. And then he was like, oh my gosh, I have adhd. And then he was like, kristen, you definitely have adhd. And I was like, whatever, dad. You don't know anything. But I didn't read the book. I didn't know what it meant. My doctor didn't tell me anything. So I spent a decade or more being medicated for adhd. Still struggling, of course, because pills don't teach skills and they don't fix everything. Thinking like, I was so flawed. My character was flawed. I was a selfish person. I guess I don't really care about my friends. Cause I don't remember their birthdays. So that must mean that I don't care. I guess I'm really narcissistic because I arrive late everywhere and like, no matter how hard I try, I'm just always late. So I guess that I'm super. Like, all I can think about is myself. You know, things like that that I would accuse myself of because I just didn't know what it meant. And so recording an episode like this is so important. I'm so, so grateful to you, really. Thank you for being here, truly.

[B]

Of course. It's been a pleasure.

[A]

Tell me about the work that you do and how people can get in touch with you. So if anyone is listening and they're like, this Dr. Marcy woman sounds fantastic. I need more of her in my life. How can people find you?

[B]

Sure. So I have a group practice called The center for ADHD. You can find [e-mail] and if you want to work with us clinically, that's the spot to go. If you're looking for kind of more of my writing and kind of thinking on things, I have a blog called adapt.org that's a D, D E P T.org and I have a digital course as well for emotional regulation for adhd. And yeah, and then I'm around speaking and so forth and have a book coming out sometime, hopefully.

[A]

Sometime, hopefully.

[B]

Oh my gosh.

[A]

That is so real. I love it. We'll link all of that in the show notes, so anybody listening or watching on YouTube all of that will be there in the show notes. I so appreciate you. Thanks for being here. This is great.

[B]

Thanks for having me. It's been fun.

[A]

If you're being treated for your adhd, but you still don't feel like you're reaching your potential, you've got to join Focused. It's my monthly coaching membership where I teach you how to tame your wild thoughts and create the life that you've always wanted. No matter what season of life you're in or where you are in the world, Focused is for you. All materials and call recordings are stored in the site for you to access at your convenience. Go to ihaveadhd.com focused for all the info.