Kristin Carter (3:34)
Hey, what's up? This is Kristen Carter and you are listening to the I have ADHD podcast. I am medicated, caffeinated, regulated and ready to roll. Happy 2026 y'. All. Happy New Year. Happy, happy, happy New Year. I hope you had a wonderful holiday season with your friends, your family, your loved ones, whatever that looked like. Over the last couple weeks I have taken a lot of time to rest and that's really important to me. It allows me to then show up and do my job, but the rest time over, especially like the winter holidays are really cozy and important to me and I hope that you've been able to connect with the people that you want to and just take in some time for yourself as well. I used to hate it when my kids were off of school when they were little, little, little because it was just so chaotic in the home and we had no structure and all of that. But now that they're older, like they're so old, my kids are so old and I absolutely love Having them home, I love the time off. I like. It's clear that they need the time off and they really deserve it. They work hard at school and their sports and band and all the things, and I just love it. We did some special, to me, things. We did some fun, like forced family fun activities. That's what we call it, forced family fun. No teenage boy, like, really wants to hang out with his family. I have three teenage boys or two and a half teenage boys. I have 17, 15, and 11. So, like, basically three teenage boys. And, you know, none of them really want to hang out with their family. But we call it forced family fun. We try to do fun things with them. We. We took them to the Kalahari Water park, which is like an hour and a half away from us in the Poconos, and that was just like, you know, an experience. It's just. It's fun to be able to do those things. We tried to think of, like, what are things that they would enjoy doing. I don't know if you grew up in a family where you had parents that, like, thought about what you wanted and planned activities around, like, the things that you wanted. I didn't. So being able to do that for my kids is. I don't know. I just enjoy it. We are also trying to teach my youngest son, or let me just rephrase that, he wants to learn how to snowboard. So that's something that we tried to do over the break. It was comical. I didn't grow up skiing. I grew up on a tropical island. As you know, I lived in Guam for eight years. And then, like, my family never had money, so skiing is a rich people thing. But we were like, he's a little skater kid. He wanted to learn how to skateboard, which he's been doing. We go to the skate park and then he wanted to learn how to snowboard. So that's something that we're all just like, okay, I guess we're gonna try it. And that was a lot of fun too. I'm wondering what your thoughts are about 2026. We don't do a great job of self reflecting often. It's just not our default. And I'm just wondering what you're wanting to get out of the next year. I know that, like, economically it's just really weird right now. Really difficult for a lot of folks. And I'm wondering if you're feeling like there's hope this year, but self development in a lot of ways is just available to you. And I'm wondering what you want to get out of the next year. For me, personally, my word for the year, which I've never done, but, like, the theme that I'm thinking through for my life and I'm also bringing into my focused community, is connection. We are so disconnected in so many different ways. And I personally am feeling the void of disconnection in my own life. And what I mean by that is that I do have some really wonderful relationships. But as I shared last week, I've gone through five years of self development and relational pruning. And what happens, like, if you think about a plant, what happens when you prune the plant is like, it's kind of a little bit stubby. I'm feeling a little stubby right now. And so I'm trying to think of ways that I can bring connection into my own life. And one of the ways that I'm doing that is I'm going to be hosting monthly girls nights at my home. And I, you know, I'm committing just for the winter. So January, February, March, April, you know, just to once a month have people. It's just women from my church have them over. We're gonna do puzzles. We're gonna sit around. If anybody wants to have a cocktail, they may do that. We're gonna just, like, be together. And I hope that that adds to our connectedness. And I hope for me, what that does is prove to me that there are really wonderful people in my real life that I can connect with. And so that's just something personally that I'm doing, like a step that I'm making toward what I want. It's easy to be like, oh, I'm lonely. I don't, like, I don't really see anybody. But to do something about that costs you, right? So, like, for me, it's like setting up a date, making sure that my family is taken care of, or like, out of the house or somewhere else in the house, inviting people over. The possibility of, like, opening my home and not really anybody coming. But I'm looking forward to what that might, you know, look like for us. And I'm just wondering what for you, you're looking forward to this year, or you want to make changes in this year. I want to remind you that I'm hosting a webinar this week, and I do know for certain this time that it is this week. It's on Thursday. And it's called Rejection Sensitivity 101. Understanding it, soothing it, healing it. I would love for you to join me. You can go to ihaveadhd.com rejection to sign up for that. And just know that in focus my coaching program, we are going to be using connection as the overarching theme of our community for the entire year. So if you are feeling disconnected, if you are feeling lonely, if you are just feeling like you don't have a spot for you, if there's not a group of people that understand you, who know you, who you feel safe to be yourself around, come and join us. Would you do it? Would you come and join us in January? Starting next week, we're going to be studying rejection sensitivity. Because if we want connection in our lives, rejection sensitivity is one of the biggest barriers to us finding connection, establishing connection, really seeing connection clearly. And so we're going to be studying for four weeks in a row how to understand, soothe, heal our own rejection sensitivity. But again, if you want to come to my free webinar, you can do that. It's actually absolutely free. Free to you. And if you're listening to this after the fact, the replay will be at this website. I have adhd.com rejection and so you can either sign up there or go and watch the replay. Today we're going to be talking about something that I find very interesting. I hope you find it interesting as well. We're going to talk about five concerning facts about ADHD that I think everybody should know. As you know, I went to the Children and Adults with ADHD conference a couple weeks ago, the Chad conference. And by by now it's a couple months ago and one of the speakers that I listened to was Dr. William Dodson. And I have mentioned him on the podcast many times actually in reference, in conjunction with rejection sensitivity. And I will say if you're a longtime listener, you've heard me criticize some of his takes on RSD rejection sensitive dysphoria. However, he really won me over in his presentation that he spoke at the Chad conference. And just as a person like he's obviously so knowledgeable. So he's just been around the block a million times regarding ADHD and the ADHD community. He's such a well respected person and I really, really appreciated his talk. So I want you to know that many of the facts that we're talking about today are things that I learned from him or was reminded of from his talk. You can look up Dr. William Dodson, he has a lot to offer the ADHD community. But what I want to communicate today is that there are some things that we need to bring to the forefront. There are some things about ADHD and its treatment and its understand that like I just really want us to fully, fully understand because ADHD is widely misunderstood even, or maybe even especially among professionals and clinicians. And these misunderstandings directly impact the diagnosis, the treatment, the outcomes and like how we treat ADHD as a society. And so I want this episode to be very educational for you and just really help you to understand more about adhd. So we're going to be talking about five concerning research backed facts that everyone with ADHD should know, or everyone who loves someone with ADHD or just everyone in the world should know. Number one, most people stop taking ADHD medication within a year. I was floored when I learned this. There was a systematic review by this person, whose name I cannot pronounce, of 147 studies. So a systematic review is a review that looks at a bunch of studies at one time and it gathers the information and the findings from the various studies. So there was 147 studies that were looked at across 29 years. And what that found is that within the first year, 80% of people discontinue their medications across all ages and all genders. There's an 80% first year discontinuation rate. What? This is wild to me. When I learned this, I like almost fell off of my chair because this is extremely concerning and very important for us to know. In the first year, 80% of people who start taking medication stop. Okay? So what this tells us is that even the people who are accessing care, who do the work of like finally going to get a diagnosis and finding the right clinician, finding someone who will prescribe them medication, even the people who are doing all of that work, they don't stay in treatment. Okay? And when you think about the research that tells us how effective ADHD treatment is and how dangerous it is to live with ADHD untreated, which, you know, it raises the rate of incarceration, of substance use abuse, it raises the divorce rate, car accident rate, unemployment and underemployment rate. Like there are so many issues that those of us who are untreated face. It's extremely concerning to know that for like only 20% of us who start medication continue to take it. That's wild. Now what are the reasons for this? Why are people stopping? And what's interesting is that like I'm talking to you, like I wonder if you fall into this statistic Dodson listed or like from the studies, but he listed reasons including the side effects. People didn't like, the side effects suboptimal Response usually meaning the dose is too low, too low. Social stigma, like there's just still a stigma around taking ADHD medication. It's kind of lumped in with other psychiatric medications obviously. And I mean, I scroll Instagram and TikTok just like you do. And there is so much social stigma around like, oh, everybody has adhd, you're weak, you like, it's over treated. It's basically meth, like all of the myths out there about the medication. So of course there's resistance then socially to taking medication and then also which is so huge, like inconvenience around acquiring medication. You've heard me rant on this before, but it is absolutely infuriating and it, it boils my blood that it is so difficult for those of us who are actually diagnosed and prescribed medication from a medical doctor. It's so difficult for us to access the medication that we have a diagnosis and a prescription for. It's absolutely ridiculous that it is so difficult that it is such a controlled substance that we have to make 17 phone calls and go to 42 different pharmacies to get the medication that we need. Not to mention then there are supply chain issues and all kinds of restrictions around it. So yeah, those of us who struggle with executive dysfunction, my hand is in the air. Those of us who struggle with executive dysfunction are going to have an even harder time accessing these medications that are different, difficult to acquire. So yeah, I, I understand. And actually I fell into that statistic in some ways when I moved out of my parents house and I was on my own and I was like, what's the cost benefit analysis here? Do I actually really need this medication? And I stopped taking it for quite a while because I was like, this is too hard, it's too hard to get. And there weren't even supply chain issues at the time, but it was just like really hard to remember to refill my prescription. And I didn't know how to ask for help from my husband and I was just like, yeah, it's probably not a big deal. I'm not in school anymore, so I probably don't need it. Right, Wrong. So instead I laid on my couch and watched daytime tv. Okay, when, when we say like when the statistic says that about 80% of people discontinue their medication, it doesn't mean that it didn't work. It often means that the system didn't work. So there was something going on with the system either. Maybe the clinician wasn't helping them to understand how long it takes to find A medication that works well, maybe the dosage was incorrect and there was no education around, like what it's going to feel like if the dosage is too high or what it's going to feel like if the dosage is too low. And like how to track that and figure it out. And there's just so little follow up. Like a clinician will write a prescription to be like, okay, bye. And you're just like, bye. And then you're left to your own devices. And we know how that goes. So I think it's very important for us to understand that within a year, 80% of first timers are going to discontinue their medication. And if you don't want to fall into the statistic. Statistic, that word is very difficult to say. So don't judge me if you don't want to fall into this statistic. I'm curious what you might be able to do to support yourself so that it is not so hard for you. Can you ask someone to help? Can you rely on your clinician a little bit more? Can you actually find a clinician who is more empathetic and helpful, Et cetera, et cetera, et cetera. Okay, so that was concerning fact number one. Number two, concerning fact about adhd. I don't know if you know this, but the diagnostic criteria falls shockingly short. Meaning that we do not have correct diagnostic criteria for adults. Did you know this? We don't have adult specific diagnostic criteria. All of the diagnostic criteria that is still being used in 2026 was originally established for individuals 16 years or younger. That's some bullshit. That's absolutely crazy. Now this is really interesting. When the diagnostic criteria was originally established, it was established for children because ADHD was thought to be a childhood diagnosis. And I have previously said on this podcast that adult ADHD wasn't recognized as an adult disorder until 1994. That is still what the Google says. However, in his presentation, Dodson said that it was in 1980 in the DSM 3 that was the first to acknowledge that ADHD persists into adulthood. So I'm a little fuzzy on those numbers whether it was 1980 or 1994. Either way, it is newly thought of as an adult disorder. ADHD as an adult condition is pretty new. Pretty new, but not that new. Like we still should absolutely by this time have AD specific diagnostic criteria. We also don't have female specific diagnostic criteria, which is wild because ADHD often presents differently in females than it does in typical males. We also don't have therapeutic guidance for the elderly, which is concerning because a lot of doctors erroneously recommend that older adults discontinue their medication for fear that it may interact with, you know, their heart or just because they're older. So they don't need it. I'm using air quotes for the listening audience. You don't need it. Like, eh, you're 70. You don't need to have a fully functioning brain. Like, that is absolutely ridiculous. So we should have some guidance for the elderly, of course, taking into consideration blood pressure and heart condition, et cetera, et cetera. But it is not okay to just look at someone's age and say, oh, you're done, what, performing for your life. So you don't need to have full access, access to your frontal lobe. That is not true. That's not true. And people are living so much longer now. So 70 is not old. Right? Like 80. Like if, if I'm going to live to 100, which I plan to do, you best believe that I'd be taking those medications until that age because I want to have full access to my entire frontal lobe for the entire day of my life, thank you very much. Okay, so the diagnostic criteria focuses on children, but ADHD presents in adults and it can shift dramatically throughout the different phases of adulthood. So we really should have some established criteria for, of course, for children, for adolescents, for young adults, for adults in midlife, especially, especially women who are going through the transition hormonally of menopause. Etc. Okay, so we need to understand ADHD across the lifespan. And I hope if there is ever another iteration of the dsm, that it will include these different criteria. We should absolutely have diagnostic criteria for women specifically, and elderly individuals should. We should have therapeutic guidelines for elderly individuals because what's happening is they're withdrawing from treatment because clinicians are uncomfy about it, because there's no clear guidelines about it. And so if we had the guidelines, then the clinicians would be able to follow the guidelines and the people who are in their senior years would be able to access medication if it is, you know, warranted and healthy enough for them, which I think they deserve. And I will be demanding it in my older years as well. Okay, Number three, I think this is really important and I had not considered this as an issue prior to Dodson's talk. Here it is. Many people are seeking ADHD diagnosis because they. Someone else wants them to. Many people are seeking ADHD diagnosis and treatment because someone else wants them to. It's not their own motivation. Now, why is this a concerning fact? About adhd? Well, this is concerning because a lot of people who initiate treatment, initiate diagnosis and treatment are not internally motivated to continue. Like kids don't bring themselves to the pediatrician, right? Parents do. Parents are like, something's up with my kid, we need to get them assessed. And parents are leading the charge in that that's appropriate, of course. But if the parent and the pediatrician are not educating their child on how this is going to be helpful to them, what the differences are in their ability to function, how much hope that medication and treatment and coaching and all of the different things that can give to somebody with adhd, if you're not educating the child about that, then as soon as they're out of the parent's home, they're going to discontinue treatment. Right? And when we think about adults, this is so fascinating. A lot of adults seek help, seek a diagnosis and treatment because it's the other people in their life that are pressuring them to do so. Right? A spouse is like, I can't deal with you anymore, you have to go do something about this. A boss is like, you're going to lose your job if you don't figure this out. A therapist is like, hey, I think this is an issue. I think this is an issue. It is often outside forces that are kind of influencing the ADHD to seek treatment. And sometimes that means that they're not internally motivated. And that's a problem because. Because in order to like have success and move forward and continue with like the hard road of self development when it comes to adhd, there has to be some sort of internal motivation is ADHD obviously affects our relationships, right? So the people around us, ADHDers, they often feel the impact, maybe even more than we do. It just depends on the scenario. But there are times when like the ADHD is kind of like blissfully ignorant to the impact that they are causing in their own home or at work or in their relationships in the community. And so it may be pressure from other people. There has to be like an education and an internal self reflection of like, oh, this is something that I actually want to change myself. Obviously some of us ADHDers do have low internal motivation, so we might not be ready to engage in long term treatment. And that, that's concerning. That's concerning. Obviously this means that it's like a major contributor to dropping out of care and discontinuing treatment. External motivation can get people in the door, right? Like if your spouse is like, you need to take care of this or if your Boss is like, you're about to be fired or you're going to be put on performance improvement program. Like, external motivation can get the patient in the door, but the internal motivation is what keeps someone in treatment. And this is really important that if you're listening to this, you consider like, am I being externally motivated or am I internally motivated? Am I trying to make other people happy? Or do I see the benefit for myself in my own life, in my day to day, in my. My ability to thrive and function and show up as myself? Like, this is what I want for us. I want us to be able to see the benefits of treatment. Now, whatever treatment may look like, maybe medication is not the right fit for you, but is it rigorous exercise? Is it a rigid diet? Is it making sure that you are, like vigilant about your sleep? Is it some sort of supplement regimen? Like, what is it for you? Therapy, coaching, et cetera, et cetera? Like, it takes a whole village, right, to help, to help us, to really be able to have access to our frontal lobe and to be able to show up the way we want to in life, right? And so I want you to be thinking through pause, am I internally motivated or am I externally motivated? Because the external motivation is only going to get me so far. Really. It's the internal drive. Do I have it? It's the internal drive for desire for change, for desire for wholeness, for desire for self development, for desire for making progress. Like I talked about at the beginning, like, what do you want out of your 2026? What might be possible for you? What do you see as being like, you know, if I could change this one thing, this is what I would change. If I could make improvement in this one area, that's what I would want to work on this year. Like, what is that for you? For me, it's connection. For me, I'm going to be making some, like, very specific and intentional steps to becoming more connected with people. In my real life. I have a lot of connections virtually, and I love them and I appreciate them, but I need humans in my real life. And so that is my, like, internal motivation. I have a drive for it. I'm going to be making some changes there. I wonder for you, are you internally motivated? Do you, do you feel that drive for, like, I want to make a change, I want to do something differently. I think a lot of times the barrier for this is that we have failed a lot and we don't believe that we're going to follow through. And so I'm not even going to bother set an intention. I'm not even going to bother make an effort because I don't trust myself to follow through. Now that's another podcast topic for another day. And I am positive that I have talked about this before on the podcast, but just know that self trust is available to you. Okay? Self trust is available to you. And I would really question, like, am I just afraid to try and fail? Because failing feels so terrible. Okay? Being internally motivated is huge.