Chrissy Teigen (5:10)

Do you have adhd?

Dr. Alok Kanojia (Dr. K) (5:12)

It's a great question. I don't know. I've never been formally diagnosed, first of all. Secondly, I think if I were to be evaluated by a psychiatrist, I would certainly have been diagnosed with it. But then two really important things changed. The first is that some people grow out of it somewhere between probably 10 and 30%. So as your frontal lobes develop and you get to be like 25, 28, 30, sometimes you kind of can sort of grow out of it. But I think there are two other things that really happened with me. The first is that I learned how to, like, use it. I learned how to compensate for it. And then the other thing is that I spent seven years studying to become a monk, and in doing that, literally trained my brain. So I think after those two things, some amount of getting older, some amount of even harnessing it is kind of what I do now. I lean into it very, very heavily.

Chrissy Teigen (6:07)

I have quite a chaotic mind myself. No doctor has ever diagnosed me with anything. And even though I have brought it up a few times to therapists and psychiatrists, nobody has ever really wanted me to fix that issue of my brain. First it was because it was always something else. I was always, like, addicted to something or we had bigger fish to fry.

Dr. Alok Kanojia (Dr. K) (6:31)

I guess that's really common with adhd, by the way.

Chrissy Teigen (6:35)

Really?

Dr. Alok Kanojia (Dr. K) (6:35)

Yeah. Oh, yeah.

Chrissy Teigen (6:37)

Oh. Addiction is everything. Yeah. Okay.

Dr. Alok Kanojia (Dr. K) (6:40)

So like, if you look at ADHD and I want to hear the rest of what you said.

Chrissy Teigen (6:44)

Go ahead, Go ahead, please.

Dr. Alok Kanojia (Dr. K) (6:45)

So if you think about adhd, it has a very high comorbidity with, like, depression. So children who grow up with ADHD learn that they're different. So if I'm a kid and I'm in school and I can't pay attention, I get yelled at a lot by my parents. Especially if I'm hyperactive, it causes problems. And then as those children go through school, they learn that they're maybe not. They're not able to pay attention. So much of a child's self esteem is about academic achievement. There's a really scary statistic that by the second grade, many children with ADHD aren't invited to a single birthday party.

Chrissy Teigen (7:19)

Wow.

Dr. Alok Kanojia (Dr. K) (7:20)

So when you're like a kid and you have trouble waiting your turn in line for the slide, then other kids don't like you, you don't get invited. So they will grow up with low self esteem. Also, ADHD is a risk factor for things like addiction. So I think it's really common for people with adhd. This is how we get so much misdiagnosis and so much adult diagnos, because there are other things that seem to be more front and center.

Chrissy Teigen (7:44)

So is this something you're born with?

Dr. Alok Kanojia (Dr. K) (7:46)

Yes and no. So I think there's absolutely a genetic component to adhd. We know that brains are different, but what we also know is that usually when we think about something like a mental illness or a diagnosis, it's an intersection of genetics with environment. So what happened in my case and what happens in a lot of cases is that if children, if you can give a child enough individual attention, then there's a chance they won't even be diagnosed with adhd. So if you look at the rates of diagnosis, the ratio of teacher to kids in a class correlates with ADHD diagnosis. So if you've got 30 kids or 20 kids and one teacher, the classroom where these children get more individual attention, they're less likely to be diagnosed with adhd.

Chrissy Teigen (8:31)

Wow. Well, explain what it means to be the H then in the adhd. What does it mean to be hyperactive?

Dr. Alok Kanojia (Dr. K) (8:38)

Yeah, it's a great question. What we know is that ADHD is like a combination of different things. So there's an attentional component. And a lot of people misunderstand this because they think, oh, I have difficulty focusing. That's only half of it. The other half of the attentional component is sometimes people have difficulty shifting away from something. So if you've got ADHD and your kid is like super into something, it's hard to actually distract them, get them to stop. So it's both kind of hyper focus and an inability to focus. Then there's the hyperactivity component, which is like movement. So kids will be fidgety. And this is what's really scary about a lot of girls, is that girls and women are less likely to be hyperactive. And the hyperactivity is what really leads to childhood diagnosis, because that's when you're disruptive. Right. So when you have a kid who doesn't sit still in class, then they will get diagnosed because the teacher's like, oh, they're not sitting still. We need to do something about this thing.

Chrissy Teigen (9:33)

Wait, that's so true. Rarely do I see a hyper girl, and I have two boys that are just completely beyond.

Dr. Alok Kanojia (Dr. K) (9:39)

So here are the words that are used to Describe girls with add Spacey, airheaded. Right. So, like, they're not able to pay attention in class. Oftentimes they'll be, like, wandering in their mind, but they've been socialized and forced to sit still.

Chrissy Teigen (9:56)

Wow. It looks very different in girls daydreaming, basically. Daydreaming?

Dr. Alok Kanojia (Dr. K) (10:01)

Absolutely.

Chrissy Teigen (10:02)

Yeah. Oh, my gosh. Wow. That's really interesting. I never thought about that before, but yeah, boys, it comes out in so much more of a physical way.

Dr. Alok Kanojia (Dr. K) (10:10)

Absolutely.

Chrissy Teigen (10:10)

Yeah. Boys are bananas. Hear more from today's guest by going to audible.com chrissyonaudible that's audible.com Chrissy C H, R I S S Y on audible I remember hearing something. God, in like, my early 20s or something, which was basically that if you take Adderall as a recreational type drug, that it would make you hyper and it would make you crazy. There's been parts of my life, like in my younger 20s where I tried Adderall. And, yeah, it did not calm me at all. It did not make me more focused. I became very extremely, like, cracked out of my mind, basically.

Dr. Alok Kanojia (Dr. K) (10:57)

What does that mean?

Chrissy Teigen (10:58)

And in, like, fits of rage, by the way. Oh, my God. And so I did hear that that's what it does to people that don't have adhd. So that's kind of my reasoning for thinking that I don't have it.

Dr. Alok Kanojia (Dr. K) (11:08)

Yeah, so that's actually like, really good reasoning. Okay, so it's fascinating. There's so much there. So the first thing is that if we look at Adderall as a stimulant, right? So if you give a stimulant to someone, they usually get stimulated. So you'll get. Maybe you'll get a little bit more angry. Sometimes people, like college students will use it to be able to focus for long periods of time. But if we look at the brain of someone with adhd, what it actually stimulates is the brakes. So we have this part of our brain called the frontal lobe or frontal lobes. And the frontal lobes is the part of our brain that keeps the other parts in check. So, like, right now, let's say I'm having a conversation with you, but if my bladder sends me a signal, oh, we need to use the restroom, there's a part of my brain that will say, like, we're not gonna worry about that right now. So the frontal lobes are the part of our brain that suppress other parts. When I'm feeling emotional and I need to calm down, those are my frontal lobes.

Chrissy Teigen (12:04)

Acne.

Dr. Alok Kanojia (Dr. K) (12:04)

So what happens with people with ADHD is Their front frontal lobes are not as good at controlling the emotional regulation parts of their brain, the attentional parts of their brain. So when we give them a stimulant, it strengthens their ability to restrain the other parts of the brain. Now that's if you're kind of neurodiverse, if you have adhd. What's really common with people who have a more neurotypical brain is that when you add the Adderall, remember that it's going into your bloodstream. It's going to every part of your brain.

Chrissy Teigen (12:35)

And by the way, is Adderall doing the same thing as Ritalin or.

Dr. Alok Kanojia (Dr. K) (12:39)

Basically, yes. So those are both stimulant medications. So methylphenidate and then Adderall is an amphetamine. So they're both like stimulants. And roughly they work about the same. But usually people, like some people will be able to tolerate one and not tolerate the other. That's really common. So if you give it to a more neurotypical person, you'll get sometimes what you experienced, which is more anger, more stimulation of the emotional parts of your brain.

Chrissy Teigen (13:04)

I like to microwave out of the wall. I remember that was like my peak. You remember how you felt when I was coming? I was like the next day after. And I remember just being like, listen, I've done different drugs. And this to me was like way, way, way worse than the come down from any other drug I've ever taken in my life. Just judging from what you've seen, would you think that I had adhd?

Dr. Alok Kanojia (Dr. K) (13:33)

I don't know.

Chrissy Teigen (13:34)

Okay.

Dr. Alok Kanojia (Dr. K) (13:35)

So I think the way that we make a diagnosis is not based on what we talked about. Right. So what I hear a lot of, and I think this is confusing for a lot of people. What we're talking about is your human experience, but making a diagnosis of adhd. And this is what's really confusing for people is that you can struggle in certain ways. That doesn't mean you have it or you don't have it. And the other really important thing to remember is that ADHD is a spectrum. So we talk about something called neurodiversity. So it's not binary. And this is what's so confusing for many people. So when we talk about diagnosing someone, let's say they need five out of. They have to check five out of nine boxes. But the number of people in the world who check four out of nine boxes or three out of nine boxes is way higher than people who check five. So there's a ton of people out there who have something called subclinical ADHD where it's not so severe or they don't have every dimension of it, but they have a couple of dimensions, or it's not so severe that it impairs your function, but it still causes you struggles. And so part of the reason that we take this approach to thriving with ADHD is that I would actually say the majority of people out there will struggle with a handful of these things. But you don't need to have ADHD to struggle with concentration difficulties, to struggle with not understanding what you feel for emotions being too intense, for having self esteem issues because you did poorly in academia, struggled to maintain friendships. I mean, the number of women I've worked with who struggle to feel like good moms because they don't remember to pick things up from the grocery store or their kids don't have, oh, I have a birthday party and I forgot to get my kid a gift. I mean, that can have such a profound impact on a woman's self esteem. It's like, it's really terrifying, right? To fail your child is so scary. And so I honestly have no idea.

Chrissy Teigen (15:34)

Yeah. And I love that my very trusted doctors would never trust anybody that were to diagnose anything on a first visit or for an hour long visit. If anybody out there is curious and really is interested in finding out if they maybe are on the ADHD spectrum, then how long should it take to diagnose?

Dr. Alok Kanojia (Dr. K) (15:55)

Oh, I mean, I think if you do a solid clinical interview, you can figure it out in 15 to 30 minutes.

Chrissy Teigen (15:59)

Oh really?

Dr. Alok Kanojia (Dr. K) (16:00)

Oh, yeah. So I think it depends some. Right. So you gotta take that with a grain of salt. But generally speaking, I mean, I did a lot of emergency room psychiatry, the place that I trained, so. Cool. And so, you know, you're seeing like 25 patients overnight and so you can get good at sniffing it out.

Chrissy Teigen (16:20)

Do you feel like ADHD is over diagnosed right now? And also, would you say that there is a difference between just being like a little flighty and someone that likes to have lots of different noises happening and actual adhd? Because I sometimes worry that I'm asking for this diagnosis or something and it might just be a part of my personality. So what's the difference between having ADHD and having just a different type of personality?

Dr. Alok Kanojia (Dr. K) (16:52)

Yeah, so it's a great question. So the first is, I think ADHD is the most over diagnosed, the most underdiagnosed condition today. So I think a lot of people who have difficulty with focus, which is happening more because of the effect of technology on our brain. If you sort of look at content on the Internet, it used to be like video essays on YouTube and now we have shorts, we have reels, we have tiktoks. Right. So our attention span is actually shrinking. And so a lot of people feel like they have adhd. They struggle to study in college because their minds are undisciplined. And so they'll go to a provider and they'll say, like, hey, I have difficulty focusing. Can I get this diagnosis? And we diagnose a lot of people with ADHD who I don't think have it on the flip side, like we were talking about earlier. So girls are chronically under diagnosed because they're not hyperactive. So the fastest way to get diagnosed with ADHD is being disruptive, causing a problem. But there are a lot of people who have difficulty focusing, can't pay attention, but they're not disruptive. They're good little girls. And if they're good little girls or good little boys, then they're not disruptive and they never get diagnosed. So I think it's both over diagnosed and underdiagnosed.

Chrissy Teigen (18:03)

And maybe like with just all of the benefits that you get from listening to somebody like you, maybe it's just over drugged we can say too. And you can do it in a way that isn't.

Dr. Alok Kanojia (Dr. K) (18:13)

Yeah. So I think it's a really great point. So if you look at the data, what we find is that taking stimulant medication on average only improves symptoms by about 30%.

Chrissy Teigen (18:27)

I mean, do people go from like getting an F in class to all of a sudden taking Adderall and now they have an A like some people do.

Dr. Alok Kanojia (Dr. K) (18:33)

But I'd say those people are the minority. Right. So this is why it's cool to have like meta analyses where we have studies that look at like 20,000 patients. And what we find is that it improves symptoms by 30%. That's really what it does. The really interesting thing is that psychotherapy for ADHD improves things by about 60 to 70%.

Chrissy Teigen (18:51)

Wow.

Dr. Alok Kanojia (Dr. K) (18:52)

But it works way slower. So it takes about a year for you to learn these kinds of skills.

Chrissy Teigen (18:56)

Yes.

Dr. Alok Kanojia (Dr. K) (18:57)

So I think that's where it gets kind of tricky because on the one hand, we have sort of the low hanging fruit, and a lot of people do really benefit from stimulants. I've prescribed stimulants before. They really can work.

Chrissy Teigen (19:08)

Well, is ADHD something you could see on a brain scan? When I'm told I have something I need to see, like the numbers for it. Like, that's the only way that I'm like, oh, my gosh. Like, yeah, absolutely. Now I get it. Yes. It's almost not enough. And we've said this in other episodes. It's not enough for me to just feel something since I. So as I brought up earlier, want to be believed. I've always been so curious if it's something that you could actually hold up and be like, look, I have this.

Dr. Alok Kanojia (Dr. K) (19:35)

So you can't see it on a brain scan. So this is where there's a slightly nuanced answer here. You can't see it on a brain scan in the sense that we do not use things like CT scans and MRIs to diagnose ADHD. If you take 100 people with ADHD and 100 people without ADHD, their brains will be different. So there are differences in the brain. What we can do is diagnose you through something called neuropsychological testing. This is a testing of your mental function. So how long can you focus on a particular thing? One aspect of neuropsych testing is we'll give you a set of headphones, and then when you hear a tone, you hit a button. And every time you hear the tone, you hit a button. And if it's boring enough, people may get distracted and they'll miss a tone. So we can absolutely objectively detect it. But I think that still, the majority of diagnosis doesn't require a test. I mean, you can take a good history from someone, ask someone, you know, what was school like for you? What did you have difficulty with? And you can make a test that way. Now, as for, like, your need for proof, I think that is a separate thing.

Chrissy Teigen (20:35)

Absolutely. Yeah. Because, like, in my mind, and this is where my mind goes, my doctor would give me that test, and then in his mind, he would think that I was trying to fail the test so I could get the drugs. Like, that is so ridiculous. I know it isn't.

Dr. Alok Kanojia (Dr. K) (20:48)

Let me say, are you thinking what's in my head right now?

Chrissy Teigen (20:50)

I don't know. I know it's ridiculous.

Dr. Alok Kanojia (Dr. K) (20:53)

How do you jump to that?

Chrissy Teigen (20:54)

Because I'm like, I just. The overthinking of it. I do ketamine therapy, and I'm given a questionnaire before every single treatment that is three pages long. And sometimes I wonder if they think that my answers are 1 instead of a 5 on a scale because I want more ketamine. Like, that's just like a natural thing that I think. I don't trust a test as Much as I would like a scientific scan of my brain that said I had it, that I would be proud of, I wouldn't trust a test quite as much even if I were completely 100% honest with it.

Dr. Alok Kanojia (Dr. K) (21:29)

Where did you learn that you're not believable?

Chrissy Teigen (21:32)

Oh God. Where to begin? Oh God. I mean, since probably I was 12 years old till like now, constantly I just felt very defensive a lot my life, probably. So, yeah.

Dr. Alok Kanojia (Dr. K) (21:45)

So, you know, it's interesting cause like I'm noticing two things. One is that we're having a conversation about ADHD and we keep on getting drawn to your story. And I think that there's a part of this that I feel like is off topic and there's a part of this that I think is really on topic. So this core doubt that you have about being believed, being accepted, being judged sometimes in the harshest light is something that I see a lot in my patients. So if you look at, there's a study on comorbidity, which means when you get diagnosed with ADHD and a mood disorder like major depressive disorder, 3% of people who get diagnosed with major depressive disorder will grow up to have ADHD. 70% of people with ADHD in a co born red population will grow up to have a mood disorder like major depressive disorder. I mean, this is what I think is kind of interesting is like it's not clear to me that you have adhd, but this developmental trajectory of being doubted, this developmental trajectory of not doing well in school, not being invited to birthday parties, being judged as spacey, being hyperactive, being disruptive, being forced to suppress who you are, will form this kernel of self doubt. And then as these kids grow up into adults, they have severe self esteem problems. Because how do you become a good person? You study well, you pay attention, you do your chores. It gets also really devastating, especially for women who get married. So there's a scary statistic about women with adhd who get divorced. 50 to 70% of them, the ADHD is a core reason why they get divorced. Whereas if you look at men who have adhd, their divorce rates due to ADHD are way lower. It's like 10 to 20%. And the reason is because if we look at the fundamental duties and expectations as a society for women, it's like planning for your kid's birthday party. Making sure when my kids go have a birthday party, I drop them off and I will go to my wife and I'll ask, where's the gift that I'm supposed to drop Off. Right. So there's so many organizational things that we take for granted that women are expected to do that make them feel like failures as mothers, failures as, like, the person who takes care of the house. They really struggle with those things, and then they get punished for it when they fail to live up to it.

Chrissy Teigen (24:08)

Do you think I'm bipolar? Do you think I have. No, I think these are just my own personal questions.

Dr. Alok Kanojia (Dr. K) (24:15)

No, no, no. I think this is really common. So I think people are looking for answers from other people.

Chrissy Teigen (24:20)

Well, we're looking for answers from, like, Harvard educated people.

Dr. Alok Kanojia (Dr. K) (24:24)

Yeah. So I think there's two ways I would answer this. One is that what you are really has to come from within you. And I know that sounds cheesy, but what I mean is that if you don't have an internal sense of who you are, you will look for external labels. But the problem is that the external label, if I say you have ADHD or if I say you're bipolar or whatever, those are words. That's not an internal experience. What I'm hearing you do is try to make sense of your internal experience. How do I understand what the hell is going on within me? Because I feel this way and I feel this way and I feel this way. I don't feel this way. I lack these kinds of feelings. I don't know how to make sense of what is going on on the inside. And this is really common when people are judged a lot from the outside. So what you may have noticed is that you said you are modeling in New York, so this is really common over there, is that what you are on the inside gets severed little bit by little bit by little bit because you need to be something on the outside. So you amputate yourself from you as you become more of what the rest of the world needs. And now you're looking for an answer from the outside. There are a couple of other things that are really interesting called transdiagnostic factors. So these are things that are not necessarily. They're not like mental illnesses. They're like almost cognitive characteristics which can manifest as depression or anxiety or whatever. So one of them is something called the intolerance to uncertainty. Some people just need an answer, and that's what their diagnosis is. It's not a diagnosis, but it's just a feature of I need an answer. I can't. I need to know what's going on. Perfectionism is another one. So there may be, like, some of those kinds of things where it's not really like a diagnosis, but it's like a feature of how your mind functions.

Chrissy Teigen (26:20)

That makes me just think that raising kids that are more confident and outspoken and all the things that it's tough to be as a kid, it's tough to allow as a child, all the different elements that make them that way is actually a really good thing. If I had been a more confident child and confident in my own emotions, my abilities, wasn't always second guessing how I felt. I wonder if I would have grown into this person that I am today, which is not a monster by any means, but just uncertain.

Dr. Alok Kanojia (Dr. K) (26:49)

I think about it slightly differently. I take a really karmic perspective. So you think about if things were different, then I wouldn't be this way, right? Yeah, you need to be this way. You shouldn't be different. You need to be this way. Because if you didn't have those struggles, what kind of parent would you be? If you weren't this way, would you have walked the path in life that you walked? I know it's hard because it can be hard to be the product of painful youth. Let's say right now we have all these micro traumas, macro traumas that are layered on top of us or whatever, but you're exactly where you need to be. Because if you weren't this way, then we wouldn't be having this conversation. If we weren't having this conversation, then how would that benefit the people who are listening to us? So everything that you are is exactly what you need to be right now. That's how I think about it.

Chrissy Teigen (27:46)

I'm very okay with being the person I am now that maybe had all of these difficulties. Because I know for a fact it makes me a better mother, a better wife, more empathetic person, a kinder person. I'm okay with it. Yeah. I guess that's like a weird thing that. Right. Cause like, I would have loved to have fixed myself right when I was younger.

Dr. Alok Kanojia (Dr. K) (28:05)

Absolutely. So you're okay with the person that you are, but that doesn't mean that it wasn't painful to get here.

Chrissy Teigen (28:09)

Yeah.

Dr. Alok Kanojia (Dr. K) (28:10)

Right. So we can be happy with the person that we are today, but that doesn't erase the shit show that got us here.

Chrissy Teigen (28:17)

Yeah.

Dr. Alok Kanojia (Dr. K) (28:18)

And the pain that comes with that. The difficulty that comes with that. I mean, I know this is kind of, kind of weird, but the moment that you let go, needing everything to make sense is when you can see it for what it is instead of trying to impose something on top of it. I don't know if that makes any sense.

Chrissy Teigen (28:33)

It does.

Dr. Alok Kanojia (Dr. K) (28:34)

Right. So like, accept it for what it is that things are not. Things are not good or bad. Most things in life are bittersweet. Most things in life are contrary. Most things in life are actually what they are. This is getting even more confusing, but here's what I mean. So bittersweet on the one hand. But on the other hand, it's neither bitter nor sweet. It's just what it is. So I'll give you a simple example. I, like, basically failed out of college, right? That's a bad thing, right?

Chrissy Teigen (29:00)

Look at you now.

Dr. Alok Kanojia (Dr. K) (29:02)

Exactly. So there was a time in my life where I thought there is no circumstance at which a 1.9 GPA is better than a 4.0 GPA. But if we think about, oh, the brand of Dr. K. Dr. K is someone who failed out of college and then wound up training and teaching at Harvard Medical School. This is the one situation where I was surrounded by a bunch of kids with 4.0. That doesn't make you special, right? It's failing out and then becoming exceptional, which is like a huge part of the. I mean, I don't really care about this stuff, but, like, that's part of my story, right? And so this is the thing is, like, is failing out bad? Well, that kind of depends. And that's how everything in life is. Nothing in life is good and nothing in life is bad. Things are just the way they are. It is our mind that imposes a judgment. It is our mind that tries to make sense of it. This object or this chair or the way that we sit, the way I look, the way that you look, the way that people are feeling right now, if they're in a nice car or a crappy car, if they're in a nice home or a crappy home, if they're homeless. It's just what life is. And I'm not saying that all of those things are the same, but I think that there's, like, a difference between saying that something is good or bad or trying to make sense of it, trying to make it fit in our mind, and just accepting it for what it is. You can change it, by all means. And that's where, like, this whole weird relationship that I have with ADHD comes in. Because on the one hand, it's bad and it's an impairment. But I work with a bunch of content creators, influencers and streamers. About 30 to 40% of them have ADHD. And, boy, it makes them exceptional at their job because they can follow chat, they can follow comments, they can do a thousand different things. That would drive a neurotypical person insane. So a big part of this is just accepting what is and then moving forward from that. Now that we say, okay, you've got adhd, is this a disadvantage in some situations? Absolutely. For some people, it's a global disadvantage. Like, I've worked with people who are just really impaired. The whole point behind making a guide like this is because if you understand who you are and how you work, you can take that negativity and you can turn it into a strength. And there are a lot of people with ADHD will take issue with that because they're crippled by it. They're, like, handicapped by it. But the majority of people that I work with are not like that. Their brain is different. And if you understand how it works, what all of the individual principles are and the challenges that you face, you can turn it into an advantage.

Chrissy Teigen (32:01)

And now for the toolkit. Each episode, our guests distill their expertise into practical and actionable insights. Today, Dr. K takes us through an exercise he calls urge surfing.

Dr. Alok Kanojia (Dr. K) (32:13)

I think one of the best things that you can do do is to learn how to take a pause. So I love this technique called urge surfing. With adhd, we have impulsivity, which is a part of it. So we have this idea like, oh, I want to eat a bag of chips, or I want to stop doing this, or I want to start doing that.

Chrissy Teigen (32:29)

Yes.

Dr. Alok Kanojia (Dr. K) (32:30)

So we have all these urges, and we think that we have to conquer an urge. Right. Especially if we want to be done with it forever. I want to conquer it so I never have to deal with it again. The key thing about an urge is you don't need to conquer anything. You don't need to win. You don't need a ton of discipline or willpower or anything like that. All you need to do is wait it out. So if you look at the nature of an urge, it starts small, and then it starts to grow, grow, grow, grow, grow, grow, grow. And if you wait long enough, it'll naturally subside. So if I feel hungry and then I feel hungrier and hungry and hungrier, then eventually the hunger actually goes away, and then it'll, like, come back because your body is generating new signals. That's not the same hunger. It is a new signal entirely. So there's this great technique that I learned when I was working in an addiction rehab called urge surfing, which is just to surf on top of the urge. Notice that it's there, notice that it's growing, and it feels bad, right? It feels like, oh, my God. I have to give in. I have to give in. I have to give in. But you actually don't just watch it and watch it grow. And it's gonna be just like a wave where it comes into the shore, but it doesn't, like, keep going across land and get to the other coast, right? It reaches this peak, and then it starts to come back. So just surf, like, right on top of the urge. Watch it growing, watch it growing. Watch it growing. It won't grow forever, and then naturally, it'll start to subside, and something really beautiful will happen. If you're able to practice this technique, which is really easy, just watch the urge grow, and then watch it shrink, then you will learn an old alternative to conquering the urge or giving in to the urge. You can just sit there, It'll come, it'll go, and then you don't have to respond to it. Actually, the goal is inaction.

Chrissy Teigen (34:13)

Would you say that for someone like me? I almost want you to promise that it'll subside and not hit a peak to where it's just, like, uncontrollable.

Dr. Alok Kanojia (Dr. K) (34:24)

So there's a really, really scary thing that sometimes when you have an addiction that people will do. I had a patient who was addicted to opiates, and when they started craving opiates, they would want the opiate. They want the opiate, they want the opiate, and they resist and resist and resist, right? And then the craving would get so bad, they have to give in. That does something really scary. It trains your brain. Your brain wants opiates, and it says, hey, this dumbass is not giving it to me. This dumbass is not. Let me intensify the craving. Let me intensify the craving. Then your brain will learn this dumbass does not respond to medium or mild cravings. Then what happens is it jumps straight to severe cravings. It learns, hey, this is the signal that I need to send to this person to get them to give me what I want. One thing you can try is with a small urge. So I did something as part of my meditation practice where I gave something up for about 10 years. And it wasn't, like, the hardest thing to give up. I think this is another problem with urge surfing is we try to tackle the biggest things first. So I'd say, take something small.

Chrissy Teigen (35:31)

Can I give you my small urge? Yeah, every night for the past four years. Well, it's not a small urge.

Dr. Alok Kanojia (Dr. K) (35:39)

I was about to say this is not a small urge. This is great. This is really important. You may say it's Small because it's some dark chocolate covered almond or whatever. Right. My little indulgence. It's not a little indulgence. It's a huge indulgence.

Chrissy Teigen (35:52)

Yeah. Okay. I have gotten a postmates order at one o' clock in the morning every day for. For years now.

Dr. Alok Kanojia (Dr. K) (36:03)

Sounds great.

Chrissy Teigen (36:04)

Yeah.

Dr. Alok Kanojia (Dr. K) (36:04)

Don't give that up. Give up something else.

Chrissy Teigen (36:06)

God, you're so right.

Dr. Alok Kanojia (Dr. K) (36:07)

So practice with something that is manageable before.

Chrissy Teigen (36:10)

So what's a small urge then? Give me a small urge.

Dr. Alok Kanojia (Dr. K) (36:13)

Little ones will be like a little bit of salt on your food.

Chrissy Teigen (36:17)

Oh, shit. Okay.

Dr. Alok Kanojia (Dr. K) (36:21)

Yeah.

Chrissy Teigen (36:21)

Okay.

Dr. Alok Kanojia (Dr. K) (36:22)

And by the way, urge surfing is really good. No one ever said it was really easy.

Chrissy Teigen (36:29)

Yeah.

Dr. Alok Kanojia (Dr. K) (36:31)

So remember, the difficulty is the point. What is the difficulty? The difficulty is your frontal lobes trying to restrain. That's like your frontal lobes doing push ups. And we don't really appreciate. What I love about this conversation right now is we don't appreciate is psychiatrists say, oh, do this little practice, little meditation. Oh, give up that little thing. Little. No, it's hard. It's really hard. Every step is blood, sweat and tears. And don't sell yourself anything less than that. But the cool thing is that the harder you work out, the more swole you're gonna be.

Chrissy Teigen (37:05)

This has been really great. Thank you so much. I could talk to you for absolutely ever. Dr. K, thank you so much for being here. Today on self conscious. 30 Days to Thrive with ADHD by Dr. Allop Kanozia is available on Audible. Until then, tune in, turn on and feel better. This is Chrissy Teigen and you've been listening to Self Conscious, an Audible original podcast. This has been an Audible original produced by Audible, Q Code and Huntley Productions, Hosted by Chrissy Teigen Written and executive produced by Jimmy Jelinek Executive producers for Q Code Shen Yan Hu and Alexa Gabrielle Ramirez Executive producer for Huntley Productions Chrissy Teigen, Executive producer for Audible, Stacy Creamer. Recorded and engineered by Ben Milchev Filmed by Bridger Clements Production Coordinator Brian Coulter. Edited, mixed and mastered by Ben Milchev, Head of Creative Development at Audible Kate Navin Chief Content Officer Rachel Giazza Copyright 2024 by Audible Originals, LLC Sound Recording Copyright 202325 by Audible Originals LLC.