Rejection Sensitivity & ADHD with Dr. Sasha Hamdani

Summary

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Laugh Lines with Kim & Penn Holderness

Episode: Rejection Sensitivity & ADHD with Dr. Sasha Hamdani

Release date: August 4, 2026

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Episode Overview

This episode delves into Rejection Sensitive Dysphoria (RSD) and its tight connection with ADHD, through a lively and heartfelt conversation with psychiatrist, author, and ADHD expert Dr. Sasha Hamdani. Kim and Penn share personal stories and challenges from their own lives and careers, while Dr. Hamdani offers expert insight, practical strategies, and warmth. The discussion covers the mechanics and lived experience of RSD, the impact of hormones (especially for women), emotional regulation, and what it truly means to feel things deeply. The episode is rich with optimism: embracing sensitivities, seeking understanding, building practical toolkits, and supporting loved ones—especially kids—on similar journeys.

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Main Discussion Points & Insights

1. What is Rejection Sensitive Dysphoria (RSD)?

[13:29] Dr. Sasha Hamdani:

• RSD is "an intense emotional, sometimes physical pain to real or perceived rejection, criticism, or feeling that you disappointed someone."
• It produces a neurological response—not just an emotional one.

Kim: Describes physical sensations: “It felt like I've been stabbed in the chest. And I grew up thinking this was just normal.” [06:30]

Dr. Hamdani: Clarifies distinction between “sensitive” and RSD:

“Emotional sensitivity is a spectrum... RSD is on that end where you feel things incredibly robustly.” [15:11]

2. RSD & ADHD: The Connection

• RSD is not included in the official ADHD diagnosis despite being present in many, especially women and adults.
• Original ADHD criteria were designed around hyperactive young boys, not capturing broader experiences including emotional regulation issues.
  [16:34] Dr. Hamdani:

  “The DSM definition is so stupid and narrow… it doesn’t have emotional regulation, which is a huge part of ADHD.”

• Emotional regulation is critical in understanding and treating ADHD.
• ADHD and RSD often co-occur, but RSD can exist outside ADHD too.

3. What Does RSD Feel Like?

Physical and emotional symptoms include:

• Chest pressure, tightness, panic-attack-like feelings
• Stomach dropping, nausea, migraines
• Emotional “flooding,” tears, a sense of being overwhelmed Different triggers (family, work, friends) can produce variations of these symptoms. [19:22] Dr. Hamdani:

“If it’s a loved one, I feel this intense chest pressure… if it’s work, my stomach is tied in knots. Sometimes I even get migraines from stress.”

4. Hormones, Perimenopause, and Women’s Mental Health

• Hormonal dips (perimenopause, before periods, postpartum) lower estrogen AND dopamine, making RSD and ADHD symptoms worse. [36:17] Dr. Hamdani:

“Estrogen drops, dopamine drops ... If you already are at a deficit... RSD feels so overwhelming.”

• Increased dialogue around perimenopause is helping, but emotional regulation is a primary reason women seek help in midlife.

5. Misdiagnosis & Retrospective Insight

• RSD-related reactions are often misdiagnosed as anxiety or OCD.
• Reflecting on past patterns—over-preparing, perfectionism, withdrawal from tasks—can shed light on undiagnosed RSD or ADHD. [27:38] Kim:

“I did so well in school... But my reactions, my panic attacks, they all lined up with rejection or failing. The anxiety diagnosis never quite fit.”

6. Practical Tools & The CALM Toolkit

[39:14] Dr. Hamdani: introduces her “CALM Your Mind Toolkit” (from her new book):

• Challenge negative thinking
• Accept and label emotions
• (Movement) Move your body to process physical energy
• (Delay) Delay reaction to let emotional flooding subside

Real-world example:
When a colleague didn’t reply, Dr. Hamdani drafted “crazy” emails but used the toolkit to delay reaction by 15 minutes—helping her “frontal lobe click in and realize it was no big deal.” [41:33]

Labeling emotions and physical movement are key:

“Just saying, ‘I am feeling very nervous,’ out loud brought me down...” – Kim [44:39]
“Movement forces blood flow to the frontal lobe. You populate the resources your brain needs to process emotions.” – Dr. Hamdani [45:34]

7. The Double-edged Sword: Emotional Sensitivity as a Gift

• Emotional sensitivity, when harnessed appropriately, is a wellspring of empathy, connection, and awareness.

“Emotional sensitivity, if you navigate it, can be emotional intelligence.” – Dr. Hamdani [57:21]

• Highs are felt as deeply as lows (emotional euphoria).

“I can experience life very fully. All I want is to be a little bit more in control.” – Dr. Hamdani [48:24]
“Positivity sensitivity, euphoria... same wiring!” – Penn & Dr. Hamdani [48:07–48:24]

8. Chronic Apologizing

• People with RSD often apologize excessively to preempt potential conflict—sometimes 60+ times a day!

“It’s their most immediate defense at repairing conflict, even if it’s not happening.” – Dr. Hamdani [53:29]

Memorable comedic riff:

Penn: “Maybe we need a new word for sorry. Like, ‘Hey.’ That’s the new sorry.” [55:14]

9. Supporting Kids and Families With RSD/ADHD

• RSD and ADHD are highly genetic—handling them as a family provides opportunity for cohesion and understanding, not just for “the identified” person.

“A child with an ADHD parent is so lucky… There is that unique understanding. It’s like, ‘I know what this is like.’” – Dr. Hamdani [60:10]

• Emotional dysregulation in kids—often mistaken for misbehavior—may actually be early signs of ADHD/RSD, especially when emotional outbursts or “selfish” actions mask hurt or shame.

10. Relationship Hacks

• When fighting, delay communications. Dr. Hamdani drafts emails to her husband, redrafting until the emotional flood subsides, then sends a clear message.

“I can’t respond in real time… any emotion he’s displaying, my body is already in fight or flight.” – Dr. Hamdani [71:10]

• Both partners should respect each other’s process and allow space.

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Timestamps for Key Segments

• 03:07-03:21 – “Emotional sensitivity, if you navigate it appropriately, can be emotional intelligence.” (Dr. Hamdani, opening hook)
• 13:29-15:10 – What is RSD, and how is it different from “just being sensitive”?
• 16:31-17:18 – Critique of ADHD diagnostics and emotional regulation
• 18:04-20:41 – Lived physical symptoms of RSD and the impact of triggers
• 26:34-28:53 – RSD can exist without ADHD; problems of misdiagnosis
• 36:17-37:39 – Perimenopause, hormones, and worsening of RSD/ADHD
• 39:14-44:39 – CALM Toolkit, practical strategies for management
• 53:29-54:51 – Why people with RSD chronically apologize
• 57:21-58:09 – The upside: Emotional sensitivity as emotional intelligence
• 60:10-63:03 – Parenting ADHD/RSD children; family attunement
• 69:07-71:39 – Relationships: Email drafting hack for emotional honesty

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Notable Quotes

• “Emotional sensitivity, if you navigate it appropriately, can be emotional intelligence.”
  — Dr. Sasha Hamdani [03:07, 57:21]
• “The DSM definition [of ADHD] is so stupid and narrow. It just doesn’t encapsulate much of the population at all… The biggest pitfall is it doesn’t have emotional regulation.”
  — Dr. Sasha Hamdani [16:34]
• “I can experience life very fully. All I want to do is just be a little bit more in control.”
  — Dr. Sasha Hamdani [48:24]
• “Why do we obsess on the one negative comment?”
  — Penn Holderness [31:58]
• “A child with an ADHD parent is so lucky… There is that unique understanding. ‘I know what this is like.’”
  — Dr. Sasha Hamdani [60:10]
• “Knowing about it takes away a lot of guilt and shame… Now you can actually start doing the work.”
  — Dr. Sasha Hamdani [57:57]
• “Emotional sensitivity and emotional intelligence are on that same line. If you navigate it, it can be a superpower.”
  — Dr. Sasha Hamdani [57:21]

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Memorable Moments & Humor

• The hosts joking about who has a better WikiFeet rating and whether it should be a revenue stream.
  [13:45-14:14]
• Dr. Hamdani’s openness about anxiety over the “boring science” section of her book—her sister’s bluntness about it, and the hosts’ encouragement.
  [65:54-68:18]
• Chronic apologizing: Kim’s tally of “sorry” in the grocery store and the idea of replacing it with a drawn-out “Hey…”
  [53:05-55:37]

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Resources, Recommendations, & Where to Find Dr. Hamdani

• New book: "Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply" — out August 25, 2026
• Socials: @thepsychdoctormd (Instagram, TikTok, YouTube)
• App: Focus Genie
• Website: Search "Dr. Hamdani"
• For connection: [e-mail]; leave a voicemail at 323-364-3929

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Takeaways

• RSD is real, common, particularly in ADHD—but also in others.
• Physical and emotional reactions are part of neurological wiring, not personal failings.
• Knowledge and labeling are liberating.
• Tools and support can transform sensitivity into strength and empathy.
• Family and social understanding—especially for kids—are crucial.
• You’re not alone, and you’re not “too sensitive.”

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(This summary skips advertisements, intros, and outros, focusing only on core content.)

Transcript

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[Kim Holderness]

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[Penn Holderness]

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[Kim Holderness]

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[Penn Holderness]

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[Kim Holderness]

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[Penn Holderness]

Yeah.

[Dr. Sasha Hamdani]

Emotional sensitivity, if you navigate it appropriately, can be emotional intelligence.

[Penn Holderness]

At least I'm not in seventh grade and someone's pointing to me, calling me a crybaby.

[Dr. Sasha Hamdani]

I can experience life very fully. All I want to do is just be a little bit more in control. Decent.

[Kim Holderness]

Ooch.

[Penn Holderness]

Fair. That's fair. Yeah, we get older every day. Got more wrinkles.

[Dr. Sasha Hamdani]

That's okay.

[Penn Holderness]

Yeah, we're laughing. When we age, life is like a comedy stage. And that's why we got laugh lines.

[Kim Holderness]

Hey, friends, I'm Kim Holderness.

[Penn Holderness]

And I'm Penn Holderness. Welcome to Laugh Lines. If anyone has ever told you to take a chill pill.

[Kim Holderness]

Oof. Or don't have a cow, man, you're

[Penn Holderness]

in the right place.

[Kim Holderness]

We are your people.

[Penn Holderness]

Yeah, I think I was more of a chill pill. But then, like, after Bart Simpson said, don't have a cow, that became a big thing.

[Kim Holderness]

We really need to bring back those Gen X comebacks. I mean, like, what do they even say now?

[Penn Holderness]

It's a ruthless burn.

[Kim Holderness]

Like, don't have a cow.

[Penn Holderness]

Don't have a. You know how painful it would be to have a cow.

[Kim Holderness]

Also, don't tell me to chill. Don't give me a chill pill. That's deeply offensive.

[Penn Holderness]

Honestly, chill pills are. They're part of life now.

[Kim Holderness]

I do take some chill pills, if we're fair. If I'm honest. I do enjoy a chill pill.

[Penn Holderness]

Yes.

[Kim Holderness]

We are excited to have our guest on today to talk about the emotional side of adhd. She's gonna be with in studio. I'm obsessed. You are going to love this episode. But first, we have some housekeeping.

[Penn Holderness]

Yeah. Our new children's book, get it done and have Fun. ADHD Hacks for awesome Kids is now on pre order. The book's gonna come out in late September, but the pre orders are a big deal for us. It's kids book about how to take those mundane tasks that the ADHD brain absolutely hates and make them not only bearable, but in some cases, enjoyable. And we think it's really gonna help out kids and parents.

[Kim Holderness]

And we have book tour dates coming up for the fall and we' to be in the Midwest, the East Coast. We're going to the South. So go to get it done and have fun to see if we're coming near you. We would love to see you. I know.

[Penn Holderness]

We love. Those tours are so much fun. It's particularly when they're around ADHD books because we meet all kinds of different people, and it's all. It's like our tribe, right?

[Dr. Sasha Hamdani]

It's.

[Penn Holderness]

It's people who are like us.

[Kim Holderness]

And speaking of people like us, if you're listening to this podcast, maybe you have adhd. Maybe somebody you love has adhd. What is I am so thankful for in the new research and what we're talking about is the emotional side of adhd. Our guest has a new book out called Too Sensitive. And how many times in your life have you been called too sensitive as a kid?

[Penn Holderness]

Probably every single day leading into high school, in times when, you know, boys really weren't supposed to be sensitive.

[Kim Holderness]

I remember I have so many stories like this, but I remember one time I was trying to help an adult, a family, family member get ready for a brunch at their house. This is not my mom, by the way, so don't think it's my mom. And the person who was hosting said, I want this to be really nice. Like, this has to be really nice. I'm like, okay, got it. And so I was put in charge of slicing tomatoes, and I was slicing the tomatoes, and then she came over and looked. She was like, oh, thanks. And so I walked away and I looked and she threw them into the trash and was like, I have to start again.

[Unidentified Guest/Interviewer]

Oh, no.

[Kim Holderness]

In hindsight, hers were, like, thinner slices, much better. But I. When I saw that I had failed at slicing tomatoes, by the way, and I disappointed somebody, it felt like physical pain. It felt like I had been stabbed. And I grew up in a dance class where you go to get corrected, you go to learn. And I remember it, I would get stomach aches hearing the most, like, that's why you're there. So I just thought it was a very normal thing to feel physical pain when you were faced with rejection, failure, even the slightest failure. But it turns out it is one of the most common parts of adhd.

[Penn Holderness]

Yeah. And I don't know how we're married to each other, because I, like, I grew up with this as well.

[Kim Holderness]

Yeah.

[Penn Holderness]

I was called a crybaby early on, middle on, late on. I. There were moments in high school or I remember when I emotionally flooded because of something someone said about me, specifically when things were not going my way or there was a comment about my appearance, about my voice. Like, my voice changed, like, really late, so I had, like a. I had a higher voice, which they called a girl's voice until I was in high school. And same thing hurt. And then also the tears would come, and there was no way that I could stop them. And so, Kim, we both had this and still have this, and then decided to start a job where essentially people can say whatever the hell they want directly underneath our work. It would be like. It would be like if Picasso just had like a tell us what you think. Right.

[Kim Holderness]

Comment section.

[Penn Holderness]

Right. If he had a comment. Comment section. We have a comment section. And it really does kind of inflame this sensitivity. But sorry, you were talking about the clinical discovery that we had about this.

[Kim Holderness]

Yeah, well, it's called rsd Rejection Sensitive Dysphoria. Meaning. And our guest has written an entire book on this. And I. I can't. I can't tell you how fast I read this book. It was so helpful to just normalize this. But, yes, working on the Internet is probably the worst job for someone with rsd. I mean, yesterday, an old man. I'm assuming he's an old man. I've put him in. I put him in a basement.

[Penn Holderness]

I know where this is going.

[Kim Holderness]

He told me my skin. My skin was too shiny. And I went to bed thinking about it.

[Penn Holderness]

Yeah. And first of all, I think he's roughly my age, which makes me old, I guess. I guess if you make that kind of comment, you get category categorized into old. So I'm still young, because I haven't said that. But yeah, we were in the middle of a live, like, book event. And. And randomly we got 700 comments during that live event. Most of them were like, we absolutely love you guys. Thank you so much for bringing this to our attention. The one comment that you couldn't let go was about how your face was shiny.

[Unidentified Guest/Interviewer]

Yes.

[Penn Holderness]

Which, by the way, like, that. We call that Dewey as heck. DH like, that's. That's. That's what the kids are actually going for.

[Kim Holderness]

My daughter did remind me that young people have dewy skin. I was like, yeah, it's all my estrogen. Hey. Okay. We have today one of the leading psychiatrists in this space to explain why our brains are the way they are. And I think a lot of you are going to hear some things today, and they're going to make you feel some things for the first time. And hopefully, when you hear her words and hear her research, you're not going to feel like you're crazy. And that's just, that's a good feeling.

[Penn Holderness]

We met her about a year year ago and she's absolutely lovely and we are thrilled that she's going to join us in studio for Laugh Lines. Her name is Dr. Sasha Hamdani. She is a board certified psychiatrist specializing in adhd, RSD and emotional regulation. By the way, like ADHD and rsd, deeply entangled, and that's what we're going to talk about. Dr. Sasha talks openly about ADHD because she has it and understands it deeply. She has over 2 million followers across social media and regularly delivers educational content and speaks at major conferences.

[Kim Holderness]

Dr. Sasha wrote the book Self Care for People with ADHD, developed a mobile app called Focus Genie to provide more support and she has collaborated with the World Health Organization to raise mental health awareness. Her new book, which I'm so excited about too, Rejection, Resilience and the Science of Feeling Deeply, will be out in August of this year. Dr. Hamdami has been featured in a TEDx talk on Focus and it appeared in the Washington Post, the New York Times, which Wall Street Journal, Forbes, and obviously now her next step is the Laugh Lines podcast. Welcome to the attic. Dr. Sasha Hamdani. Oh my gosh. Thank you so much for coming.

[Dr. Sasha Hamdani]

Thank you for having me.

[Kim Holderness]

Oh, this is so exciting. I've been a follower for of you for years. I love everything you're putting out to the universe and the conversations you're starting. We just read a very impressive bio for you. Oh my God. Very impressive. Can you tell me what the bio is not saying? Like, how did you get here with a book about RSD and sensitivity? Like, how did you get here?

[Dr. Sasha Hamdani]

I'm in kind of a, an interesting position because I have ADHD and I treat adhd. So like I, I could see my own personal lived experience and I can also see all the people that I've treated and I, I have like this incredible wealth of information because of that. And I kept seeing this pattern that for a long time I was like, this is just me. I'm just incredibly sensitive. And then after my dad passed a couple of years ago, I was like, well, can't do anything anymore.

[Kim Holderness]

This is, we're done.

[Dr. Sasha Hamdani]

We're like, there's no, like, I have it. And then that was really the point where I got, and I know grief is so difficult for everybody, but I got to a point where I was like, wait a minute, like, this is the first time I'm actually piecing together how strongly my emotions impact my productivity and like My ability to function. And so then I started looking into it more, and that made me just more aware of patterns within my own patients. And that's what started me down this pathway of learning more about rsd, researching more about rsd, and actually trying to put a name to it and give. Well, there was a name to it, but, like, actually gather information all in one place, because right now, it's really scattered, truly hard to find info.

[Kim Holderness]

Yeah.

[Penn Holderness]

Okay. There's rsd. Rejection sensitivity, dysphoria. Can you tell us exactly what it is? And in that definition, I'd love to know what the difference is between, like, the dysphoria and just being sensitive. Right.

[Dr. Sasha Hamdani]

Because I think bazillion percent. Right.

[Penn Holderness]

Everyone's like. Everyone's.

[Kim Holderness]

Nobody likes to suck.

[Penn Holderness]

Yeah.

[Kim Holderness]

I mean, nobody wants to get rejected

[Penn Holderness]

if you like to suck.

[Dr. Sasha Hamdani]

Cool.

[Penn Holderness]

You're probably not watching this podcast because you're like, I'm good. I don't need this.

[Dr. Sasha Hamdani]

Yeah, no, I'm gonna answer that question. I'm also gonna take off my shoes, please.

[Kim Holderness]

Okay.

[Penn Holderness]

Okay.

[Kim Holderness]

Please take off your shoes.

[Dr. Sasha Hamdani]

Okay.

[Kim Holderness]

You know what?

[Penn Holderness]

So you got socks. That's good, because you don't want to be on Wiki Feet.

[Kim Holderness]

If we're gonna sell feet picks, I'm gonna. I'm gonna be the one selling them.

[Penn Holderness]

While we're talking about rejection sensitivity, Kim is very sensitive about the fact that my Wiki Feet rating is higher than hers. So that's.

[Kim Holderness]

I was a dancer, so I have really messed.

[Dr. Sasha Hamdani]

Okay.

[Kim Holderness]

But again, I got bunions. People are into that.

[Penn Holderness]

People are into people like my bunions.

[Dr. Sasha Hamdani]

You guys do know an alarming amount of, like, wikifeet information which is leading me.

[Kim Holderness]

Maybe there were moments where we were like, hey, is this. I think someone said, is this an income stream?

[Dr. Sasha Hamdani]

No, no, no. Judgment work is work.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

All right.

[Penn Holderness]

We're socks.

[Kim Holderness]

We're socks. Socks out. Okay. Rsd.

[Dr. Sasha Hamdani]

Rsd. So the definition of RSD is an intense emotional, sometimes physical pain to real or perceived rejection. Criticism is feeling that you disappointed someone. It is this robust neurological response that happens.

[Kim Holderness]

Okay, and how is that? First of all? Yes to all of it. I feel like if I feel like I've disappointed someone. If I don't succeed at something, I feel like I'm being stabbed in the chest.

[Dr. Sasha Hamdani]

Yes.

[Kim Holderness]

Yeah. And I feel like I want to vomit. How is that different from just like, oh, being sensitive? Like, nobody. Nobody loves to be rejected a million percent.

[Dr. Sasha Hamdani]

No one likes being rejected. No one likes being criticized. Where I would put this? And I've thought A lot about this, because I was. For, like, a majority of my life, I'm like, I am just too sensitive. That's what I thought. When you look at emotional sensitivity as a spectrum and you're looking at, like, if you're right in the middle. Right. That you have emotions that are reciprocal to the response. You have highs, you have lows, but it's situationally appropriate. You have one side of the spectrum where it's, like, almost emotionally blunted. You're not feeling much of anything. It's kind of like numb. You can't really feel a lot of joy. You don't really feel down. You're just.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

Then you have another end of the spectrum where you feel emotions very, very, very intensely. And I think RSD is on that end of the spectrum where you feel things incredibly robustly.

[Penn Holderness]

Right. For things like ADHD and for things like anxiety, there's like a tipping point where you get diagnosed and then there's interventions, there's medication, there's ways to deal with it. In order for that to happen, there has to be, like, a definition in the dsm. There's not one right now for rsd, correct?

[Dr. Sasha Hamdani]

No, there isn't one for rsd. But now that you've got me talking about that, I think that a lot, especially the dsm, when it comes to adhd, we have so much work to do because the definition is so stupid and narrow.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

It just doesn't. It doesn't actually encapsulate much of the population at all because when it first came about, it was quite literally created. Those. Those criteria were created by studying the outward behaviors of hyper young boys.

[Unidentified Guest/Interviewer]

Yeah.

[Dr. Sasha Hamdani]

That does not cover young girls. It does not cover adult females. It doesn't even cover adult males that may mask their behaviors. It's not a great evaluation system for actually looking at adhd. And that becomes very immediately evident if you treat adhd. And the biggest, biggest, biggest, biggest pitfall and problem with the criteria as it stands right now, that it doesn't have emotional regulation.

[Penn Holderness]

ADHD, you mean? Yeah, 100. And that is. That's something that people have been saying for a very long time. So as far as the RSD part, so the emotional kind of flooding or dysregulation.

[Dr. Sasha Hamdani]

Yeah.

[Penn Holderness]

Kim described hers as. Can you say again what it felt like to you? Stabbed.

[Kim Holderness]

It felt like I couldn't breathe. It felt like I'd been stabbed in the chest. And so that's what it feels like to me.

[Penn Holderness]

To her, yeah. For me, it was always just emotional flooding and just Tears that I couldn't control, and that went all the way through high school. And I. I like to think that the tears part I've grown out of, but there still are, like, intense, flooding, emotional moments for me when something doesn't go my way. What does it feel like? What? I think it feels different for everyone. Right? What does it feel like for you?

[Dr. Sasha Hamdani]

So the thing that's weird is I thought about this, and I was like, how would I describe. Because, like, my husband will. My husband does not have ADHD in it, so it's like a very.

[Kim Holderness]

Wow. Weird.

[Dr. Sasha Hamdani]

So it's just like. It's an interesting kind of interplay because, like, sometimes when I'm asking him stuff. The other day, he was. I was getting ready to go on my trip, and I had to wake up to go to the airport super early in the morning. I was like, well, why don't we just go to bed right now? And so he's like, okay, fine. He lies down, like, immediately falls asleep. I wake him up.

[Kim Holderness]

And I was like, no, no, not fair. I'm not.

[Dr. Sasha Hamdani]

I'm like, what? So then I'm like. I'm picking now to be like, what? No, what happens in your brain? And he's like, nothing. My brain is winding down so I can go to sleep. And he's like. And that's what I was doing before you woke me up. And I was like, I. I can't even imagine. I'm like, that's when I have. Literally every. Every night, it is like, this internal struggle because I'm like, I have, like, these great ideas that are just coming to me right now. I don't want to go to sleep anymore. I want to get up and execute them right now. Because apparently right now is when I have energy. My husband is like this. When you get your zoomies.

[Kim Holderness]

Yeah, yeah.

[Dr. Sasha Hamdani]

And so I'm just like, take a magnesium, go to sleep. I was trying to explain RSD to him, and I was saying, you know, when I feel this incredible emotional response, it also depends on who I'm hearing that from or who is triggering that kind of response. Because I feel like if it's. If it's a loved one that triggers that. I. I feel this, like, intense, like, chest pressure. And like. Like, it's almost like. And it feels kind of like a panic attack where I'm like. I'm having tightness of breath, and I feel if it's work or I feel like I'm getting in trouble at work. I feel this drop in my stomach. Like, my stomach Goes up in knots. I feel anxious. I feel, I feel like this, I don't know the best way. It's like this impending doom. I'm like, this isn't great. Something bad's going to happen. I have had times where, within friendship groups where there has been some weird, like miscommunication or weird invite situation and I would get splitting migraines. Like, I would just like it would. I, I would stress myself out enough and my head would start hurting and then I would like fixate on that and then my eyes would start hurting and then I would get a migraine.

[Kim Holderness]

Wow. So you really have paid attention to your body enough to know how in

[Dr. Sasha Hamdani]

retrospect, not at the time, I wasn't piecing it together like when this stuff happened. But like in the past three years, as I've been gathering all of this data, I'm like, what is it? What? Like, can I say that every single time it looks like this? But I think what happens is that like from a neurobiological standpoint, when you are emotionally sensitive and especially if you have, you're on that end of the spectrum and you have rejection sensitive dysphoria, There are two parts of the brain that are really kind of prominent here. The first one is the amygdala, that emotional threat detector. The second one is your frontal cortex, which is that prefrontal cortex, judgment, decision making, processing, like the most logical.

[Penn Holderness]

And that's where people with ADHD have issues.

[Dr. Sasha Hamdani]

Yeah, yeah. Just historically, anyway, your pre, your amygdala, it is a little bit more hyperreactive. So when you get emotional cues that are happening quickly, you're just spinning, spin, spin, spin. And maybe that, by the way, the connection between those two parts is also weak. So you're not communicating with that frontal lobe. So you feel things before you can logically process them. And so sometimes when you feel those things, you're attaching this like negative story to it because that's so habitual for you. And your body just starts dumping alarm chemicals. And that's when you're feeling all of that physical stuff. So it kind of depends. It could depend on sleep, it could depend on hormones. It could depend on so many different things.

[Kim Holderness]

More on this after these words.

[Penn Holderness]

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[Kim Holderness]

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[Kim Holderness]

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[Penn Holderness]

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[Kim Holderness]

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[Kim Holderness]

All right ladies, as you know, Menopause has a prequel, and like many prequels, it doesn't get the same attention as the original.

[Penn Holderness]

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[Kim Holderness]

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[Penn Holderness]

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[Kim Holderness]

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[Kim Holderness]

joinmidi.com okay, so can you have RSD without ADHD?

[Dr. Sasha Hamdani]

Yes.

[Kim Holderness]

Okay, so that is why it's probably important to have some sort of. To have in a dsm.

[Dr. Sasha Hamdani]

Yeah, I think so. And I think that RSD is the reason we talk about it so closely linked with ADHD is that it was discovered when, you know, Dr. William Dodson is the one who coined this term after looking at all of those patients. And he was an ADHD specialist and he was seeing this as part of his work with emotional regulation. And he was like, okay, this is coming up over and over and over again. And this seems to be like one of the most limiting parts. Why don't we talk about this? So that's why we, we generally link those two. But yeah, you, you could experience that. It's, it's a neurological phenomenon that happens.

[Penn Holderness]

The, the naming of ADHD is already a problem. We don't have a deficit of attention. We have an abundance of it. Don't know how to control it. It's half the time it's not hyperactive. And you could think of it as more of a brain difference than a disorder. And then tack on the fact that there is no emotional regulation mention anywhere.

[Kim Holderness]

Yeah.

[Penn Holderness]

In the name or really in the description.

[Monica Reinagle]

Yes.

[Dr. Sasha Hamdani]

And so here's the problem. Without having that emotional dysregulation component to it, what's going to happen is that when people have these episodes of emotional dysregulation, which is all the time, that's when people are, that's when physicians, because this is what their tools are being given to them that's when they're like, this is anxiety, this is depression. And that's when they're getting put on medications or being treated for things that don't actually apply.

[Kim Holderness]

It's so interesting because I was diagnosed with ADHD last year at the age of 49. And it does. Part of the diagnostic process is you're forced to kind of look back and do an archeological dig on your life and how you handled things and talking to people who knew you as a child.

[Dr. Sasha Hamdani]

Yes.

[Kim Holderness]

And my mother, so sweet. And she's like, oh, I'm so sorry I missed it. It wasn't a conversation in the 80s and 90s. But she's like, you did have very outsized reactions. Like, that was the biggest indicator for me because I did so well in school and I was like the overachiever. But even looking back when learning about rsd, reading your book, I thought I suffered from anxiety, panic attacks, because I was having these very physical symptoms. But if I look back to when these things lined up, it is after failing at something or not living up to my own expectations on something, being hearing a comment from a family member or a person who's like, rejected me like that. It is, it so squarely lines up with that in a way that anxiety, the anxiety diagnosis, never did. It's like.

[Dr. Sasha Hamdani]

And you'll see with this, this common thread of being, you know, a perfectionist and being an overachiever, a lot of that is because you're like, if I do so well, I will not get rejected. I will not get criticized. I will be immune from this stuff.

[Penn Holderness]

Or if you don't do it at all.

[Dr. Sasha Hamdani]

Yes, yes. So I'm just going to back away. So this isn't even an option for me.

[Kim Holderness]

So this is where the anxiety diagnosis and the OCD diagnosis, I'm not saying it's totally off base, but it never really squared because my reaction, because I'm so afraid of this physical response and this feeling, I over prepare.

[Dr. Sasha Hamdani]

Yeah.

[Kim Holderness]

For anything. Or I don't do it at all.

[Dr. Sasha Hamdani]

Don't do it.

[Kim Holderness]

I'm not going to participate because then I can't fail if I didn't try. So. Okay, that is how I feel. Like, tell me the RSD piece of that.

[Dr. Sasha Hamdani]

All.

[Kim Holderness]

Everything.

[Penn Holderness]

All.

[Kim Holderness]

Everything, all.

[Dr. Sasha Hamdani]

But like, if you look at those patterns, right, and you are trying to discern that, like, what's anxiety, what's ocd? What's like looking at what, what triggers that and what is happening, what is that neurological response to that? I think that you can, you can clearly say okay, well, I think this is rejection sensitive dysphoria. And now that you've done that kind of retroactive work, and you're like, okay, I know I have adhd, and it's far more likely. I think you can make that extrapolation. Did you ever. And this might be an overshare, so you don't have to. Did you ever try anxiety medication?

[Kim Holderness]

Yes, I have, actually. Only. So I had tried it throughout my adult life.

[Dr. Sasha Hamdani]

Okay.

[Kim Holderness]

Never really. Never really worked. So it didn't stay on it for a long period of time. I found an amazing psychiatrist finally, who was like, let's do some chemistry experiments. And like, so I finally found a combination of medicine that is used to treat adhd. And we didn't know that at the time. And so it's like, all of a sudden I'm like, is this what everybody else feels like?

[Dr. Sasha Hamdani]

It's wild, wild, wild. And so, like, I tell people, you know, if you are. If there's a part of you that is thinking, like, maybe I have adhd and like, you know, I have a lot of people who are like, the algorithm told me I have adhd. And, you know, things like that, I don't care. Like, if there's a part of you that thinks that and you've had a long history of these medication failures where nothing really seems to fit, it's worth an evaluation. And I know access is a problem, but it is worth looking into it to get a better understanding of your brain for sure.

[Kim Holderness]

Yeah.

[Penn Holderness]

So the story of our life is fun. We both clearly have this. We definitely have adhd. It sounds like talking to you that we've got some level of heavy rejection sensitivity. And so we decided to do a job where everything that we do has a really convenient comment box right underneath it and people can say exactly how they feel. Now I should say that I would say that 50 times as many comments are positive.

[Kim Holderness]

Yeah.

[Penn Holderness]

Why do we obsess on the one

[Kim Holderness]

comment that's negative usually about my appearance? Let's be fair.

[Penn Holderness]

Well, I mean, there's stuff about me too, but I. But yeah, for her.

[Dr. Sasha Hamdani]

You know what I got recently? I got a comment on mine where it was like, you look too stressed in your videos, so I can't trust your videos anymore. I was like, friend, right?

[Penn Holderness]

It's. It's two insults wrapped into what I know.

[Dr. Sasha Hamdani]

And I'm like, I mean, it was elegant, for sure.

[Penn Holderness]

Were you more concerned about I don't trust you or more that you look stressed?

[Dr. Sasha Hamdani]

Stress?

[Kim Holderness]

Yeah.

[Penn Holderness]

It's always the appearance Right.

[Dr. Sasha Hamdani]

And I was like, God, I appreciate

[Kim Holderness]

that in your videos. First of all, I don't think you look stressed.

[Dr. Sasha Hamdani]

Thank you.

[Kim Holderness]

But I don't think you look stressed. But I. What I appreciate and why I fell in love with your videos is because you're a passenger on this flight. Like, you are. You're walking the walk. And so you can. I think everybody who's like, trained in doing this work is great, but if you don't have this, which many of the therapists, let's say, like most of the therapists that I've encountered in my adult life through don't, like you can identify with that. So I think it's super cool that you can.

[Dr. Sasha Hamdani]

Well, thank you. I was talking about RSD in a more academic setting, and they said, but you're so outgoing and you're on social media. How could you have that? Like, you're putting yourself out there in a spot where you could get rejected. And I was like, I. First of all, when I'm on social media, most of the time I'm posting and then I'm ghosting. I'm out of here. Like, I'm, I'm not sticking around for comments.

[Unidentified Guest/Interviewer]

I'm.

[Kim Holderness]

I'm.

[Dr. Sasha Hamdani]

No, but the other thing is that I. There is this, like, intrinsic balance where I'm, I'm, you know, I have this fuel for creativity and I like the like, positive reinforcement and the negative isn't quite as bad yet. But I will tell you, I will get a bad comment every once in a while and it will pause what I'm doing. Like, I'll get discouraged and I won't want to post. And so then. And then I forget about it and then I keep go back at it. And I think that's kind of led to my statement I was quite literally forgetting about it.

[Penn Holderness]

I've actually gotten better at the rest of my life by reading comments. It's been kind of like an exposure therapy for me. Like a way to, to, to take it, to process it, to respond to it and, and like to do it all in a safe environment where at least I'm not in seventh grade and someone's pointing to me, calling me a crybaby. And I don't know if that's like something that people could do or if

[Dr. Sasha Hamdani]

probably that's probably something great. I think in general, the average population isn't dealing with that kind of situation.

[Kim Holderness]

Yeah, it's not like it's not a super relatable, but it's. But I don't know. I don't know, there are so many people that don't post, like, they want to post pictures of their kids on vacation, whatever, for fear of that. For fear of a negative comment.

[Dr. Sasha Hamdani]

That's true.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

Or like, post. You know, a lot of people are afraid to post. Yeah. Just the driving fear of rejection or criticism is so strong and so human. And so it's something that I think a lot of people can relate to. I think what makes. What makes this so profound as a neurological phenomenon is when it starts to move into impairment and when it starts to move into, like, I can literally explain, like, what is happening to my nervous system in real time.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

And I think that's. That's worthwhile noting because it's not like you're too sensitive. This isn't like a personality flaw. It's not like, just something quirky about you.

[Dani Pellegrino]

It.

[Dr. Sasha Hamdani]

This is a difference in neurological wiring.

[Kim Holderness]

And to know it.

[Dr. Sasha Hamdani]

Yes.

[Kim Holderness]

Is so freeing. The ADHD diagnosis. Reading all this information, your book, now that I know why it feels like I'm being stabbed in my chest for some reason, that makes me feel like I have control, if that makes sense.

[Dr. Sasha Hamdani]

I feel the same way, which is great.

[Penn Holderness]

Right. So now, like, we're going on this journey together here. We. We know more about rsd. We understand why it's a component of adhd. We understand the amygdala. Like, we're getting there.

[Dr. Sasha Hamdani]

Yeah.

[Penn Holderness]

Enter perimenopause girl.

[Kim Holderness]

Which, like, why does perimenopause and menopause and all the wild things that are happening inside a woman's make RSD feel so much worse?

[Dr. Sasha Hamdani]

So what happens is that as your estrogen drops, which is what happens not only in perimenopause and menopause, it also happens, like, right before your period starts. It also happens right after you give birth, so postpartum. So, like, the. These are hormonal dips that even people outside of per menopause, when you're in these low estrogen states, you also get a drop in dopamine. So estrogen drops, dopamine drops. That's a problem because dopamine is in charge of alertness and attention regulation and mood regulation. So if already you are at a deficit and you're less able to weather the storm, something triggers this rsd. It feels so big, so overwhelming, and a lot of times, I will tell you that my patients will come in, and I'm seeing a lot of patients. I think I'm so grateful for this new movement that we're talking about, perimenopause. So Much more. But they'll come to me to talk about perimenopause and the emotional regulation stuff is the thing that drives them to the physician in the first place.

[Kim Holderness]

I did something I'm learning about ADHD as I'm digging in that pms.

[Dr. Sasha Hamdani]

Yeah.

[Kim Holderness]

Pmdd, postpartum depression. Like, all of those things are exacerbated when you have adhd.

[Dr. Sasha Hamdani]

Yes.

[Kim Holderness]

Slash rsd. I had no idea. And I don't know that. I mean, knowing doesn't decrease the symptoms, but I have to say, we have two kids in my life. I thought I wanted three and four, but the postpartum period was so hard, awful, that I couldn't. Pen was the one. He's like, I can't. You can't go through this again.

[Dr. Sasha Hamdani]

Yeah.

[Kim Holderness]

And I had no idea to get snipped. Yeah. I had no idea that there was, like, what was. What was happening in my brain was also.

[Dr. Sasha Hamdani]

Oh. Because I think what people always think about with postpartum and when you look at that patient population that has ADHD and these kind of hormonal things happening, they think this is hormonal. It's, you know, it's just going to be some mood stuff that happens, but you'll lose it. You'll get through it. It's no big deal. And. Or, like, what happens is like. Like, let's throw an antidepressant at it and it'll get better. Right. The problem is with adhd, because of that drop in dopamine, it's not just that your mood is significantly worse. Your baseline functioning is so incredibly impaired, which is also going to make your mood worse. So now you're like, I. I literally am feel paralyzed. I can't function yet. I have to take care of this small little life that literally needs me to live. Like, that's. That's a lot.

[Penn Holderness]

Let's talk about ways to manage it.

[Kim Holderness]

Yeah.

[Penn Holderness]

Right. And we're talking about RSD or just any sort of emotional dysregulation when it comes to adhd.

[Monica Reinagle]

Yes.

[Penn Holderness]

What are your best practices?

[Kim Holderness]

You have the calm toolkit.

[Dr. Sasha Hamdani]

Yeah.

[Monica Reinagle]

Yeah.

[Dr. Sasha Hamdani]

Calm your mind toolkit. I. So in order to do that again, like, so I'm sitting here, like, mid grief, and I was like, oh, no, I need help. And I was like, there has to be something for this emotional dysregulation piece that I. I need to be able to do. Because it wasn't even just the emotional dysregulation, but, like, someone would look at me wrong.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

And it would just, like, send me spar and, and I'm like okay, well that has just set me back two days. Like I, I can't make forward progress if I'm constantly going behind. And also like trying to take care of kids during that time. It was so hard. So I pulled from every area of psychology trying to find and psychiatry and neurology what works in the moment and what works over time for RSD and that, that I think I haven't found anywhere. So that's what I think was so important about that book. But, but in general, pretty basic principles like challenge negative thinking and movement and delay your reaction. The reason I think these principles are important is in their application. So knowing what to apply and when to apply. So I'll give you an example. Doing this press for this tour has just been like an. I'm like why am I writing a book about rejection sensitivity? Publish like go on a promo tour for this. It's, it's just rife with rejection. I reached out to someone to write a blurb. They were like sure, we'll do it. And then just straight up ghosted me. And I am sending the messages, I'm not getting anything back. And in my brain I create this full on narrative that like they don't respect the work that I'm doing. They don't think I'm credible. They like they previously were into it but they must have researched me and decided against it. I like I had convinced myself of all this. I had drafted like three pretty insane text messages.

[Penn Holderness]

Like just, just, just sitting in your,

[Dr. Sasha Hamdani]

in your you know, draft and erase, draft and then erase and you know, all to the gist of like sorry if I did something that you don't.

[Kim Holderness]

Like, like just so crazy ex girlfriend stuff.

[Dr. Sasha Hamdani]

Just insane like so inappropriate for like this peripheral doctor you've never met to be talking about a piece of like academic work that like why?

[Penn Holderness]

Why? And it starts with I'm sorry, all of them.

[Dr. Sasha Hamdani]

All of them, all of them. Because clearly it's something about me that is true for this right as I'm going through this calm your mind toolkit I land on delay your reaction and I was like, this is the one I need to use right now. So I set an alarm, set alarm for 15 minutes. And I mean by golly like that, that urge to like within 15 minutes my amygdala had stopped spinning enough that I could be like, like that's an objectively insane idea. Don't do that. And but I think what happens is that when you are like I'm just not going to think about that. You allow yourself to get kind of distracted by everyday life. And your. Your frontal lobe has a chance to click on your amygdala, calms down a little bit, and you can see a little bit more logically. And then you do the reality testing. You talk to your husband, and he's like, that would have been insane. I'm really glad you didn't send that. And then a week later, you get a response back from this person, and they're like, I was abroad. I did. I. Like, I didn't get that message.

[Kim Holderness]

Wow.

[Penn Holderness]

The delay, right? Because you're. You're emotionally. In that. You're so flooded at that point. It's really hard to resolve anything when you're like, we know this about when we get in fights together.

[Kim Holderness]

Well, I. I identify with your story in that if something goes wrong, I need to fix now. And sometimes my fix now is not a great idea. It's firing off the email. It's making a phone call. That's not appropriate. Like, the delay would be very hard for me, but I think would work wonders.

[Unidentified Guest/Interviewer]

It's.

[Dr. Sasha Hamdani]

It's so. It's. And I was like, why am I 40 years old? And, like, this is the first time I've conceptualized doing that. I want to save me so much time. I should just delay what I'm doing. But again, it's knowing that application and pra. And, like, the thing that I like about the way this book is laid out is in the real world, examples. At the end, it. It tells you what's happening. It gives you an example of what's happening, tells you what's happening in the brain, what tool to apply, and then how to practice it in real time. And so I think that that's, like. That's what I needed. I was like, just tell me what to do. So this was helpful.

[Kim Holderness]

I went through all the tools, and again, you were saying, like, because I've been in therapy for so long, so I've heard bits and pieces, but to have it laid out, to understand what was happening, one of them was, like, just labeling the emotions in your body and having a name for them. And I've heard that before. But again, like, our. And this wasn't an RSD necessarily. This was a stress response. But our dog had a seizure, and so I had to. I was obviously, I was shaking, and it was like, whatever was happening in my body, I was, like, shaking, which I think is a normal, like, probably appropriate response. But I sat there because I just read your book, and I Was like, I am feeling very nervous. I am feeling like, I was, like, saying out loud, like, this is a very stressful situation. I'm feeling very nervous. And for some reason, just saying that,

[Dr. Sasha Hamdani]

yeah, it brings you down.

[Kim Holderness]

It brought me. It brought me down. I mean, I was still going crazy. But just the labeling of it is kind, I mean, hard in the moment to get your brain to do it. But it was so effective.

[Dr. Sasha Hamdani]

It's so effective because what happens is that now instead of being this, like, like complicated mess that you can't wrap your arms around and, like, you, you can't grab hold of, you're like, okay, I, I know what this is. This is a familiar emotion. I know that this is time limited. And then your brain is like, okay, you've dealt with this. Let's start to move on. And there. It's a neurological thing that happens, that

[Kim Holderness]

decompression and obviously, like, moving your body, Walking, dancing, stretching, like, all of that, but also hard for me in the moment. But I have, I've built the kind of mental muscle that, like, I know what I need now is to kind of, to be able to, like, move and, like, what's happening when you're moving? Like, what's happening when. How does movement help?

[Dr. Sasha Hamdani]

Movement is so effective because when that, like, surge happens, your amygdala, again, completely overloaded. Your frontal lobe is like, I don't know what's going on. I'm somewhere else. When you exercise, you're forcing blood flow, which is taking oxygenated glucose to your frontal lobe. And your frontal lobe is like, okay, I get what we're doing. And so you're, you're literally populating the resources that need oxygenation and resources at that time. The other thing that I like, and this is, like, one of those examples of knowing, because you've heard, like, people have told you, like, move your body, go on a walk. Go on a walk. Like, you've heard it. But I think I know, like, I, I, I'm not gonna do any of that stuff. Thank you. But I think what is helpful is that when, when you're looking at that sometimes with rsd, depending on how it presents, because it can look so different. And depending on what you're experiencing, like, there's sometimes where, if you were to tell me, delay your reaction or, or try mindfulness or deep breathing, I'm like, I can't, because I am overwhelmed by this restless energy. Like, I feel like I'm vibrating at this point. And that's when you move your body. You need to like kind of get some of that out. You're not fighting against your biology, you're working with it. And so I think that this, this is one of. It's just an interesting way to take tools that we've had forever, but actually learn how to apply it based on what's happening in your body.

[Kim Holderness]

I love it.

[Penn Holderness]

So RSD is part of our brains. That's, that's just what it is. It's not something. I mean, I feel like I've outgrown certain reactions, but I think it's still going to be part of my brain. Just like adhd. Like I might learn how to deal with it, but I'm not going to outgrow it. It's who we are. Yeah, right. Having said that and you knowing all the science, I'm going to describe something on the complete opposite end of RSD and you tell me if it's the same chemistry.

[Dr. Sasha Hamdani]

Okay?

[Penn Holderness]

Okay. I have like, when I hang out with my friends, I have these moments and like my buddy Bird has, he's called them. It's like Pen's best night of my life moments. I just get so happy with something that's going on and it's not substance induced. It's like if something, if someone tells a really funny joke or he like. I had a buddy sit with me one time and I was crying when I was looking out of the airplane window because it was the most beautiful sunset I'd ever seen. And it got me thinking about how we are the only people in this perfect planet in this tiny little solar system in this giant universe and how frickin lucky we are to be alive.

[Unidentified Guest/Interviewer]

And.

[Penn Holderness]

And I got overwhelmed with how great it was. It's like a positivity sensitivity, euphoria. So whatever. The exact opposite is.

[Dr. Sasha Hamdani]

Same wiring, but I love that it's the same thing. But that's what we're talking about. Emotional regulation is not just for lows.

[Penn Holderness]

It's for good stuff. Too high.

[Dani Pellegrino]

Yes.

[Dr. Sasha Hamdani]

And that I think is so when, when people are. I was asked a couple of days ago, like, do you want to be less sensitive? And I was like, no, I don't. Like, I like this emotional sensitivity because I think it gives me, it makes my life so expansive. I think it makes me a better parent and a better doctor and a better partner. And you know, I, a person, just like I, I feel like I can experience life very fully. All I want to do is just be a little bit more in control.

[Penn Holderness]

Fair. That's fair. And, and there's ways to do that medicinally, I'm sure. But there's also these, this toolkit that you have with calm. But, but it's good to know that, like, that's part of it.

[Unidentified Guest/Interviewer]

Yeah.

[Penn Holderness]

Right.

[Kim Holderness]

The same.

[Unidentified Guest/Interviewer]

It's.

[Penn Holderness]

And so there is, there are those great, wonderful, like, top line moments that you have.

[Dr. Sasha Hamdani]

I'm the same way you are. Yeah. My husband is like, are you feeling very earnest right now? I'm like, yes. And like, so the, the first time I, I like, I invited myself to a family wedding, like, really early and I like, in front of his whole family, I'm like, like, I'm just. We're in the middle of the mountains and it's so beautiful here and I'm surrounded by really beautiful people. And you've opened your hearts to me and they're like, we don't know you, sir.

[Penn Holderness]

This is a Wendy's. Like, what are we?

[Dr. Sasha Hamdani]

I was just like, so. And it's wild because I see my son in these moments of just like he's experiencing everything.

[Penn Holderness]

It's so beautiful. Right?

[Dr. Sasha Hamdani]

Like, it's so earnest and sweet and

[Kim Holderness]

you would never not want to be like that. No.

[Dr. Sasha Hamdani]

It's so beautiful to see. I hope that never gets stomped out of him.

[Kim Holderness]

Okay. Yeah. Okay. So. Chronic apologizing. More on this after these words.

[Penn Holderness]

This episode is sponsored by Ollie, your wellness partner for Back to school and beyond.

[Kim Holderness]

Back to school season is here. Packed backpacks, packed lunches, and packed schedules are officially back.

[Unidentified Guest/Interviewer]

Yeah.

[Penn Holderness]

And back to school is a rite of passage for kids and a gauntlet for parents as they try to navigate new schedules and more responsibility.

[Kim Holderness]

We only have two more years of this and I'm not really sure if I'm gonna miss it.

[Penn Holderness]

Yeah, it's exciting, but also stressful and nerve wracking, but also joyous.

[Kim Holderness]

Luckily, Ollie offers science backed supplements that are expertly formulated for both parents and kids.

[Penn Holderness]

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[Kim Holderness]

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[Penn Holderness]

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[Kim Holderness]

Because as you know, the morning mayhem comes early.

[Penn Holderness]

Visit ollie.com and stock up on back to school must haves today. That's o l l y.com these statements

[Kim Holderness]

have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treatment, treat, cure or prevent any disease.

[Unidentified Guest/Interviewer]

Back market is the best place to get the tech you need for back to school for less like professionally refurbished smartphones to take those first aid pics.

[Dr. Sasha Hamdani]

Mom, your finger's blocking the camera.

[Unidentified Guest/Interviewer]

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[Dani Pellegrino]

Hi, it's Dani Pellegrino from Everything Iconic. Have you been putting off that annual doctor's appointment because you don't want to make the call? Or maybe you've been meaning to find a new dentist but you have no idea where to start? I find that's especially true when you move. It's hard to find your people. I've been there. Which is why I use ZocDoc now. As a busy podcaster, parent, and someone who's always juggling a million things, I love anything that makes life easier. And ZocDoc lets you search and compare local in network Doctors. With over 250,000 providers across more than 200 specialties, you can read reviews from real patients, find a provider who feels like the right fit, see actual appointment openings, and book instantly. I recently had a last minute health issue pop up and needed to see someone fast. And instead of calling around or sitting on hold, I found a doctor on zocdoc and booked an appointment in just a few minutes. It made the whole process so much less stressful. Now taking care of your health just got easier. Download the zocdoc app today. That's zocdoc Z O C D O C and book that appointment on your to do list.

[Kim Holderness]

I was trying to count the other day how many times I said I'm sorry. Okay, it was. I lost count. It was in the 60s and I had just left the grocery store. I said sorry to every person I passed. Like I don't know, I said. So I was like, I'm gonna stop counting because this is upsetting. Why? Why do people with RSD apologize constantly?

[Dr. Sasha Hamdani]

Because that is their most immediate defense at repairing conflict, even if it's not even happening yet. I think that could be a conflict coming up. I'm just going to say sorry and it becomes very habitual.

[Kim Holderness]

Right?

[Dr. Sasha Hamdani]

And so it's just, I'm concerned that at some point, even if there is nothing going on, I'm concerned that you may interpret this as I'm doing something incorrect. I'm going to apologize just get it out of the way. It means nothing to me. I'm just going to say sorry. But then eventually, over time, the issue with chronic apologizing is that eventually you're telling your brain this narrative that it is your fault. You're doing all of these things over and over. Yeah, that. That these things are your fault. And so it be. When it's like, bigger stakes, things like, oh, I'm sorry. I didn't do this. This was never my thing to carry.

[Kim Holderness]

Right. And I. I realized I'd said sorry three times because a man was sitting on this side of the aisle and he was, like, looking at the shelf. But I. The only way to get by was to go in front of him and to temporarily, for two seconds, disrupt his view. I ducked down. I was like, sorry, sorry, sorry. No, like, he was standing there. I had to pat. That's the only way to pass. It was two seconds. His life was not, like, hurt in any way, but he was actually kind of.

[Penn Holderness]

Should have been moving a little bit.

[Dr. Sasha Hamdani]

Kind of in the way.

[Penn Holderness]

Yeah, he's kind of in the way.

[Kim Holderness]

He was actually kind of in the way.

[Unidentified Guest/Interviewer]

Yeah.

[Kim Holderness]

Yeah. But I took that on, and after that, I was like, I'm going to stop counting because this is insane. You should have just said, excuse me or pardon me.

[Penn Holderness]

Maybe. Like, is there a fun new word we could use? Like, pardon me Might be a little. That might be a little.

[Dr. Sasha Hamdani]

Pardon.

[Kim Holderness]

Pardon.

[Penn Holderness]

Like, that person may think it's their fault. What about, like, hey,

[Dr. Sasha Hamdani]

you.

[Penn Holderness]

I mean, it's like a gentle, like, hey. And like, that's the new sorry. Like, I'm here, here. No judgment.

[Kim Holderness]

We're gonna workshop that.

[Dr. Sasha Hamdani]

Workshop it.

[Kim Holderness]

We're gonna workshop it.

[Penn Holderness]

You did a pretty good one there.

[Kim Holderness]

Me going through the grocery store.

[Dr. Sasha Hamdani]

And like, depending on how sorry you are, the hay gets longer.

[Penn Holderness]

Hey.

[Unidentified Guest/Interviewer]

Oh.

[Penn Holderness]

Oh. Longer.

[Dani Pellegrino]

Yeah.

[Kim Holderness]

And then obviously, it's not a troop apology. No, it's not an actual.

[Dr. Sasha Hamdani]

It's almost like a reflex.

[Unidentified Guest/Interviewer]

Yeah.

[Kim Holderness]

So we've talked about. We have this theory that we wrote this book. ADHD is awesome. The actual definition of awesome is that it's. It's both. It's.

[Dr. Sasha Hamdani]

Yeah.

[Kim Holderness]

Yeah. It could be. It can fill you with just dread, and it could be overwhelming, or it could be like, yeah, you just saw the sunset from an airplane. It could be. It can be both. RSD is both.

[Dr. Sasha Hamdani]

Both.

[Kim Holderness]

Right. Okay, let's just plain talk. I know you just did it a little bit before, but just like, what. What is. What is the advantage of feeling things so deeply?

[Dr. Sasha Hamdani]

I think the advantage of feeling things so deeply is just. You have this incredible capacity for empathy. You can connect to people easily. You are picking up stuff that a lot of people don't read. You know, you can walk in and, like, I. I know a lot of people who can walk in a room, and they're like, something weird has happened here. The air is off. Like, the energy's off. This is weird. You can. I feel like in parenting, like, there are times where I can look at, you know, one of my kids, and I'm like, there. Something is going on with them. And it's just that, you know, that attunement to emotional information. And I think what is so important to note about emotional sensitivity is emotional sensitivity and emotional intelligence are both kind of along that same line. It. Emotional sensitivity, if you navigate it appropriately, can be emotional intelligence.

[Kim Holderness]

So people listening to this podcast, maybe they've not been formally diagnosed with adhd, but really identify themselves with rsd. We use the phrase, you know, free adhd. It's the explanation, not the excuse. Right. So we. It can explain behavior, but it doesn't excuse poor behavior. I have had some outsized reactions. I have not delayed before sending the text message.

[Dr. Sasha Hamdani]

Me neither.

[Kim Holderness]

Right. So, I mean, how should we. Like, how should we be operating in this world that is. That is hard, hard.

[Dr. Sasha Hamdani]

Number one, knowing about it, because I think just like recognizing it in yourself and having that verbiage, I think, number one, it takes away a lot of guilt and shame because you carry so much of that. Number two, I think once you actually have an explanation that agrees with you and that you actually relate to, then you can actually start doing the work to kind of figure out how to fix the problem. Because if you're operating under the thing, I'm just really anxious, or I'm. I'm just too sensitive, and that's who I am. It's not that there's anything going on with my wiring. That's just a personality quirk, and that's just who I am. I'm the. I'm the crybaby of the family.

[Dani Pellegrino]

Right.

[Dr. Sasha Hamdani]

You know, I. I don't think you can do a lot with that. There's not, like, a lot of. Of work that can be done. But I think that what's exciting about this, this entire phenomenon and looking at it like a brain wiring kind of thing, that brain wiring can be adapted and it can be changed, and it can be enhanced, and it can be malleable, and so you can have this underlying neurological and emotional sensitivity, and you can really Navigate that and get a lot of those positives and stop, like, drowning in your own emotions.

[Penn Holderness]

Awesome. So, and, and learning about the science has just in this hour, like, helped me understand my brain, I think.

[Dr. Sasha Hamdani]

It's not been an hour.

[Penn Holderness]

It has been an hour. It. It really has helped, I guess. So here's my next question. When it comes to being someone who supports someone with RSD or with adhd, and let's say it's a kid who may not be able to grasp the science. So we, we do have. We have a parent of an ADHD child who sent in a voicemail. It's Rebecca. And so we're gonna go to the la. You tell us what's on your mind.

[Kim Holderness]

What was it like when you guys were preparing to be parents, especially as

[Dr. Sasha Hamdani]

somebody who has adhd.

[Penn Holderness]

ADHD is highly genetic. If the two of you have adhd, you pretty much prepare for an ADHD family. And if that happens, there's going to be some RSD as well. So how do you navigate a child when maybe they don't have the same understanding of all the science that you just talked about?

[Dr. Sasha Hamdani]

First and foremost, I think a child who has an ADHD parent is so. An ADHD child with an ADHD parent, I think is so lucky. I think an adhd, a non ADHD child with an ADHD parent, there's so much joy and love and emotional expressiveness that comes about with that. But I think an ADHD parent who's dealing with an ADHD child, there is that unique understanding where you, you are able to say, like, from drawn, lived experience. I know what this is like. So you don't need to have all the science for it. Like, as they get older, if that's helpful for them, if that helps their understanding, you can do that. But for the most part, a lot of what kids need is just that supportive environment. I know, I see what you're doing. I feel that same way too. And then just kind of helping. And like within our house, when, like, I am. My husband is really even keel and I am the one whose emotions are very large. But, like, when, when my kids are seeing that kind of stuff, it's like almost like we're all navigating it. So when my daughter is going through stuff, we're all navigating it. When my son is going through stuff, we're all navigating it and looking at it and exploring it and like, what. What would have made you feel better in that moment? What could we have all done? And so it's all Just kind of this, like, it's almost like an opportunity for family cohesion.

[Kim Holderness]

Yeah, I, Yeah, I, I also think that now that I know it's adhd, before it was like anxiety, ocd, I do think I have. I pick up on everything. And I think a lot of ADHD people with a. Thinking, the pattern recognition, all of that stuff, I think it's actually a benefit to be a parent with that.

[Unidentified Guest/Interviewer]

Yeah.

[Kim Holderness]

Because you are. You are sensing everything.

[Dr. Sasha Hamdani]

Everything.

[Kim Holderness]

Yeah. We got an email from Samantha. She says, my son has extreme emotional dysregulation. He often blames others, shows selfish tendencies and becomes very emotional or angry over small things. ADHD runs in our family. Is there a chance he has ADHD and it's presenting more emotionally?

[Dr. Sasha Hamdani]

Yes. Yes. And again, I haven't seen him. But there is always a chance. Especially if there's a genetic component, it's worthwhile getting checked. For boys, it can be really hard because boys are just treated very different. Pen you'll know this. I mean, they're treated very differently. Even in a school setting.

[Penn Holderness]

If you get emotional. Absolutely.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

You're just, you know, like, it's not that big of a deal. What's wrong with you? And so even from a really, really, really young age, boys learn I can't be emotional, so I'm going to be angry or I'm going stunted or.

[Penn Holderness]

Yes.

[Dr. Sasha Hamdani]

Yeah. Or I'm going to shunt this somewhere else. And the sad fact is that a lot of times that's when you get super angry. Adults. Yeah, like these really emotionally sensitive people that don't. That think anger is the only acceptable emotion, and that's what you get. And so it's, It's. That's totally a possibility, but it's one of those things that, like, being able to recognize emotional regulation could. Could be a part of it and addressing it. Like, she's so clearly, this person's so attuned to their child that they're picking up on stuff. Like, could this be a possibility? Like, that's great. Six is so young to be able to catch this stuff.

[Kim Holderness]

And it is. I could talk to you forever about this. The way the boys are socially, it is not. Acceptable is not the word. But there's an expectation if boys act out, if boys are mean and they push and they get so flooded that they. There's an outburst physically, that's almost like, as culturally we. We can expect that. Whereas if girls, you. We can't do that. We just have to like, sit there and cry. I mean, that's and that becomes socially acceptable. Like, women are so emotional.

[Dr. Sasha Hamdani]

This whole concept and. And talking about emotional regulation. I hope that this starts a movement where, like, people are just, like, really, like, starting to look at this as a neurological phenomenon. This is something we need to look at more seriously because, like, get it into schools.

[Kim Holderness]

Yeah.

[Dr. Sasha Hamdani]

Like, start early, start talking about this, because there needs to be just more support and emotional literacy everywhere.

[Kim Holderness]

And I think that even if you are the kid or the family that does not experience life this way, knowing about how your friends are processing is. Is huge. It's huge. Thank you for coming. Anything else? Like, what are. Anything else we should be talking about?

[Penn Holderness]

Yeah, what. First of all, like, where can people find you?

[Dr. Sasha Hamdani]

Yeah.

[Penn Holderness]

What's the. Like, what. What's the best way to just type something into a phone or computer and immediately up, up you pop.

[Dr. Sasha Hamdani]

So if you type in Dr. Hamdani anywhere, you're gonna see my website and my socials. And on my socials, I'm the psych doctor, MD on everything. I'm on Instagram and tick tock and YouTube and other stuff.

[Kim Holderness]

And your new book.

[Dr. Sasha Hamdani]

My new book, and my new book is called too sensitive, and that's coming out on August 25th. And it's broken into the neuroscience of things. Then it has a self assessment to see how sensitive and where you fall on that spectrum. And it has the calm your mind toolkit and then has real world examples. And I think, like, I've experienced all of those examples many times.

[Kim Holderness]

Many times.

[Dr. Sasha Hamdani]

Many times.

[Kim Holderness]

What? I tore through the book. I loved it so much.

[Dr. Sasha Hamdani]

Did you think the beginning was boring?

[Kim Holderness]

No.

[Dr. Sasha Hamdani]

Okay, good.

[Kim Holderness]

Well, no. Well, that's why I. I was.

[Penn Holderness]

What if she had said yes?

[Kim Holderness]

What if I said.

[Penn Holderness]

What if she had said, you know what? I skipped it?

[Unidentified Guest/Interviewer]

Well, that's.

[Kim Holderness]

I mean, you talk about the part where we got to know, like, how you ended up in this and, like, that part. And the science.

[Dr. Sasha Hamdani]

Yeah, the science behind.

[Kim Holderness]

I loved that.

[Dr. Sasha Hamdani]

See, I do too. That's how I learned. Like, if I know what's happening in the brain, it makes more sense to me.

[Unidentified Guest/Interviewer]

Yes.

[Dr. Sasha Hamdani]

But I, like, I agonize over that because I'm like, is that like, maybe I'm the only one who likes that sciencey part?

[Penn Holderness]

No, for most people, knowledge is like. Knowledge is like an anxiety cure.

[Dr. Sasha Hamdani]

But don't you. I agree.

[Dani Pellegrino]

Yeah.

[Dr. Sasha Hamdani]

Well, yeah, I do agree.

[Penn Holderness]

At least for us, I guess. Yeah.

[Kim Holderness]

Well, I also think that without the physical, like, studied research that you. You. You could probably just like. Because it's happening in My body. Right. And I know that there's ADHD deniers, there's RSD deniers, I'm sure, that are like, you just need to get over it. But if I could say this is what's happening biologically, it kind of takes the wind out of that argument.

[Penn Holderness]

And, like, what's the number one question you ask yourself when you're feeling real true, deep shame? It's what's wrong with me, which is intrinsically, I don't know what's going on with me. So this kind of destigmatizes the shame because it explains what's going on. And you can't ask that question anymore because you know the answer.

[Dr. Sasha Hamdani]

Oh, my God, you guys, this makes me feel so good.

[Penn Holderness]

No, it's, like, super important. That's why we love.

[Kim Holderness]

No, I, I, I was, like, like, highlighting parts, sending him to fan, like, to pen, like, make sure you get to this part.

[Dr. Sasha Hamdani]

Like, I'm going to. You know who did this? This is my sister who did this. She was like, it's boring. You might want to cut down on it.

[Kim Holderness]

And I was like, sister? Oh, my God, that is so funny. Leave it to his sister.

[Penn Holderness]

Does she have.

[Dr. Sasha Hamdani]

No, of course she doesn't.

[Penn Holderness]

Well, you'd have to say it like that.

[Dr. Sasha Hamdani]

No, she does it. And, like, she, like, she has always been. She's younger than me, but, like, she is just, like, really analytical and, like, works in data analysis. And, like, she's just like, her brain is like a grid. And so there are times where she's like, you are just, like, off in space right now. Like, I need you to come. And I was like, I don't. I don't want to be where you are.

[Kim Holderness]

Where you are is a lot of spreadsheets.

[Penn Holderness]

I've always wanted to be in a family where they, like, say exactly what's on their mind.

[Unidentified Guest/Interviewer]

Mind.

[Kim Holderness]

Yeah.

[Penn Holderness]

It sounds like you may. Are you in one of those families?

[Kim Holderness]

Maybe. That's a lot.

[Dr. Sasha Hamdani]

It's not great. It's, It's, It's. It is. Like, people typically say what they want to say, and my mom and I are the ones who are like,

[Unidentified Guest/Interviewer]

you

[Dr. Sasha Hamdani]

were nicer about it.

[Kim Holderness]

I think everyone in my family has a. A measure of RSD because we, we kind of tiptoe and because we don't. We. I want to say something, but I don't want to hurt your feelings because I know what that feels like, and that's not good either.

[Penn Holderness]

I mean, you and I have basically.

[Kim Holderness]

Well, he and I are fine.

[Penn Holderness]

Like, we say whatever we say, can

[Dr. Sasha Hamdani]

I tell you, like, my biggest RSD hack for relationships?

[Kim Holderness]

Yes, please.

[Dr. Sasha Hamdani]

Okay, so my husband, again, doesn't have rsd, but. But, like, when we first. We had done long distance for a while when I was in residency, and then we got married, and we were in the same house, and I was like, oh, I don't know how to talk to you. I don't know how to live with another person. And we would get into conflicts, and I, like, I. I would get my feelings hurt all the time. And we lived in this townhouse, which is like, the bottom floor was a garage. Then there was, like, a kitchen and living room, and then there was a bedroom. So I'd beef with him, and then I'd go up to the bedroom, and I'd be like, well, do I jump out the window? Like, how do I get out of here? Right. Truly, like, do I just spider man down this trellis? And so we had to learn. And I was like, listen, when we get into conflict, I. The way that you communicate is that you want to process what you're doing and you want to stay quiet and you want space. I will chase you around the house and, like, be like. And another thing. And another thing, because, like, that's what I want. That immediate repair. I want that reassurance that things are going to be fine. And I don't want to sit in that discomfort any longer. I want to fix it now. I don't have time for you to wait around. So what we decided to do is the best way to kind of handle that and to respect both of our communication styles is I have to write him emails now. I write him an email and I process it, like, four separate times, and I do different drafts, and the first one is always crazy. And then it gets progressively more normal. And then once I find a draft I like, and usually it's taking me a while and I'm calming down every time.

[Penn Holderness]

Right. This is actually implicating the thing you were talking about, about getting a little bit of distance between it. Right? Yeah.

[Dr. Sasha Hamdani]

I send it to him. He's responding to it without seeing me crying or chasing him. So that helps.

[Penn Holderness]

This is important. The hack for you, the RSD person, is take a little time, make your thoughts clear, let it de escalate, and put it into. Into writing.

[Dr. Sasha Hamdani]

Yeah. Because I can't respond in real time. And like, whatever emotion, I have already decided that any emotion he is displaying towards me, my body is already, like, in fight or flight or freeze.

[Penn Holderness]

But his. But he's got a responsibility as well. To. To read it, give it respect, and then. And then save some space for you to. To talk to him about it later.

[Dr. Sasha Hamdani]

Yeah. And then we. We discuss it. And usually by then, food's great. We like. It's. It works.

[Kim Holderness]

I. I have this my entire life. I've always known this about myself. I cannot actually process an emotion. I can't in real time.

[Dr. Sasha Hamdani]

It's too hard.

[Kim Holderness]

It's too hard. And I have to. It takes me another day or two to be like, okay, that I was deeply offended by that person. Like, I knew something was off, but I couldn't name it. So the whole, like, writing things down probably is not going to work with us. But I will say we. We do. By the nature of what we do, if we have conflict, we go to bed angry. Yeah. If we have conflict, we have to jump on a zoom in five minutes together about something we're really excited about. So, like, it naturally delays it and naturally kicks the can and so that by the time we come back, we're like, what were we talking about? Oh, okay. We're fine.

[Penn Holderness]

It's probably still important, but we're able to talk about it in a different way. Because when we get mad that you've delayed.

[Kim Holderness]

Yeah, we've delayed.

[Penn Holderness]

When we get mad, we both go to that place.

[Kim Holderness]

Flood.

[Dr. Sasha Hamdani]

Like a flood.

[Penn Holderness]

Yeah.

[Kim Holderness]

I threw a cell phone one time and I broke a window.

[Dr. Sasha Hamdani]

Okay, that's excellent. Flooding.

[Penn Holderness]

Amazingly, the cell phone was okay.

[Kim Holderness]

The window was not. Important to know I didn't throw it at him. Important, important. I just needed. I needed to.

[Dr. Sasha Hamdani]

I need to just get this physical stuff out of my body.

[Kim Holderness]

I should have gone for a run. Instead, I did some damage to the house.

[Dr. Sasha Hamdani]

You know what we've all done to the house. It's fine.

[Kim Holderness]

It's fine.

[Unidentified Guest/Interviewer]

It's fine.

[Dr. Sasha Hamdani]

It's fine.

[Kim Holderness]

I could talk to you forever. I'm so excited about your book.

[Penn Holderness]

Okay, guys. The book is called Too Sensitive Rejection, Resilience and the Science of feeling deeply by Dr. Sasha Hamdani. It is fantastic. It is going to be on bookshelves on Aug. 29.

[Dr. Sasha Hamdani]

25.

[Kim Holderness]

25.

[Penn Holderness]

25th. But it's available for pre order right now. And we can tell you this. If you pre order it, it super helps.

[Kim Holderness]

It super helps. And then it arrives at your house. Here's a. See a little early about pre ordering. If you pre order it, sometimes it shows up a couple days early.

[Dr. Sasha Hamdani]

Get out of town.

[Kim Holderness]

Yes, yes. So pre order from. Yeah, there's some.

[Dr. Sasha Hamdani]

I didn't know that.

[Penn Holderness]

Yeah, pre Ordering is the way to go.

[Kim Holderness]

Like, there are different bookstores because they

[Penn Holderness]

have to make sure it gets there by like the exact time. So to do that, they like, they front load the, the delivery time and it gets there like three days early. So there'll be people. Yeah.

[Dr. Sasha Hamdani]

Oh, my God.

[Kim Holderness]

I know.

[Penn Holderness]

So we're going to read the credits now. And like you told us that. It's so funny. You have a lovely voice.

[Dr. Sasha Hamdani]

Thank you so much.

[Penn Holderness]

But we asked you why you didn't do a podcast and you said because you don't like the sound of your own voice. But you have a fantastic voice.

[Dr. Sasha Hamdani]

I have listened to it.

[Penn Holderness]

Huh.

[Dr. Sasha Hamdani]

In recordings.

[Penn Holderness]

Well, we're gonna give you a chance to be a co host because you're gonna. You can read the credits for us.

[Dr. Sasha Hamdani]

Laugh Lines is written and produced by Kim Holderness, Pen Holderness and Anne Marie Tapke with original music by Pen Holderness. It is filmed, edited and live produced by Sam Allen and hosted by acast. As always, we love to hear from you. Please write to us at podcastheholdernessfamily.com or leave a voicemail at 323-364-3929.

[Penn Holderness]

We have a landline and we will

[Dr. Sasha Hamdani]

talk to you soon on the Laugh Line.

[Penn Holderness]

You're gonna get a lot of like, you should do a podcast now because that was great.

[Kim Holderness]

It was great. Yeah.

[Dr. Sasha Hamdani]

I will never.

[Penn Holderness]

Because you didn't just say, how can I provide these investments? You'd be, how do I holistically provide everything? How do I bring in the legal, the accounting, all this, and do it at a price point no one else is doing it. Learn more about how we approach wealth [e-mail] Integrated hello, I'm Monica Reinagle, host

[Monica Reinagle]

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[Unidentified Guest/Interviewer]

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