ADHD pt 2

Summary

Stuff You Should Know: ADHD pt 2 – A Comprehensive Exploration of ADHD

In the second part of their enlightening double episode on Attention Deficit Hyperactivity Disorder (ADHD), hosts Josh Clark and Chuck Bryant delve deeper into understanding this complex neurodevelopmental condition. They provide listeners with a thorough examination of ADHD’s diagnosis, prevalence, impact on adults, associated comorbidities, challenges in daily life and relationships, and effective treatment strategies. This detailed discussion not only sheds light on the intricacies of ADHD but also offers valuable insights for individuals, parents, and caregivers navigating life with ADHD.

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1. Introduction

Josh and Chuck kick off the episode by addressing their audience directly, ensuring that those tuning in for the second part of the ADHD series are well-oriented. They acknowledge the seriousness and maturity of the topic, setting the stage for an in-depth conversation.

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2. Understanding ADHD Diagnosis

Diagnosis Complexity

Diagnosing ADHD is a multifaceted process that extends beyond a simple test. Josh emphasizes, “There’s not one like, here’s our ADHD test... you’re pulling all these disparate info together to put together, like, okay, this kid has ADHD and it’s this kind” ([07:16]). The evaluation involves gathering information from multiple sources, including parents, teachers, and educational records, to ensure a comprehensive understanding of the individual’s behavior across different settings.

Criteria for Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines specific criteria for ADHD diagnosis. For children, the presence of at least six out of nine symptoms from either the inattentive or hyperactive-impulsive categories is necessary. Adults follow a similar framework but with adjustments to account for age-related behavior differences, such as restlessness during meetings instead of physical hyperactivity.

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3. Hereditary Factors and Environmental Influences

Genetic Predisposition

A significant discussion point is the hereditary nature of ADHD. Chuck states, “If you have kids and you have ADHD as a parent, your kid has about a 50% chance of having it as well” ([02:33]). This underscores the strong genetic component, highlighting that ADHD often runs in families.

Environmental Factors

Beyond genetics, several environmental factors contribute to the development of ADHD:

• Prenatal Exposure: Exposure to alcohol or tobacco during pregnancy increases the risk.
• Birth Complications: Premature delivery or low birth weight can be contributing factors.
• Toxin Exposure: Childhood exposure to lead or experiencing a brain injury are also linked to higher ADHD incidence.

These factors interact with genetic predispositions, making ADHD’s etiology multifactorial.

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4. ADHD and Screen Time

Relationship Between ADHD and Screen Exposure

The hosts explore the correlation between screen time and ADHD symptoms. Chuck reveals, “A large study of five year olds... the kids who watch the most TV had almost an eight times more of a chance of meeting the ADHD diagnosis criteria” ([04:56]). While excessive screen time doesn't cause ADHD, children with ADHD may be more attracted to screens due to the constant stimulation and dopamine release they provide, potentially exacerbating attention difficulties.

Managing Screen Time

Given this link, parents of children with ADHD are advised to monitor and limit screen time more closely, recognizing that the allure of screens can intensify ADHD symptoms.

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5. Prevalence and Demographics

ADHD Rates in the United States

In the U.S., approximately 10% of school-age children have been diagnosed with ADHD. This figure escalates with age, as older children are more likely to have been diagnosed due to increased awareness and access to diagnostic resources.

Gender and Racial Disparities

• Gender: Boys are more frequently diagnosed than girls, with rates around 13% compared to 6% for girls ([12:30]). This disparity is partially due to behavioral expectations; boys’ hyperactive behaviors are more readily noticed, while girls may mask symptoms more effectively.

• Race: Diagnostic rates vary significantly among racial groups:

  • Black children: 12%
  • White children: 10%
  • Hispanic children: 8%
  • Asian children: 3%

These discrepancies highlight potential biases in diagnostic practices and access to healthcare resources.

Global Prevalence

Internationally, ADHD prevalence rates in children hover around 5%, with slight variations across countries:

• UK (NHS): 5%
• Australia: 6-10%
• Canada: 5-7%
• Germany: 4.33%

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6. ADHD in Adults

Undiagnosed ADHD

Many adults with ADHD were undiagnosed during childhood. As adults, their symptoms manifest differently, often impacting professional environments and personal relationships. Chuck notes, “Adults don’t get up in meetings and run around the table... instead they’re just going to sit there and just use all of their energy to not do that and then also to try to focus on what’s being said” ([22:43]).

Challenges for Women

Women with ADHD are particularly underdiagnosed due to societal expectations of being quiet and composed. They often mask symptoms effectively during their youth but may face significant challenges later in life, leading to misdiagnoses such as depression or anxiety.

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7. Comorbid Conditions

High Rates of Comorbidity

ADHD frequently coexists with other psychological conditions, complicating diagnosis and treatment:

• Autism Spectrum Disorder (ASD): 30-80% of individuals with ASD are also diagnosed with ADHD, and 20-50% of those with ADHD have ASD ([23:30]).

• Depression: Individuals with ADHD are up to five times more likely to experience depression compared to neurotypical peers ([25:08]).

• Anxiety: About 40% of children with ADHD also suffer from anxiety disorders ([25:50]).

• Oppositional Defiant Disorder and Conduct Disorder: Found in 30-50% of children with ADHD ([25:16]).

These overlapping conditions necessitate a nuanced approach to treatment, addressing all co-occurring disorders for effective management.

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8. Challenges in Empathy, Relationships, and Daily Life

Emotional and Social Difficulties

Individuals with ADHD often struggle with emotional empathy, leading to misunderstandings and strained relationships. Josh explains, “If somebody’s telling you something and they’ve just inserted that pop, like, the end of it... you're losing the emotional component” ([29:01]). This can result in accidental gaslighting, where individuals may unintentionally dismiss others’ feelings or perspectives due to difficulties in empathizing.

False Memories and Trust Issues

ADHD can impact memory accuracy, leading to false memories where individuals recall events inaccurately. This poses challenges in personal relationships, as discrepancies between memories can lead to conflicts and trust issues.

Physical Challenges

The concept of “ADHD sway” refers to a postural imbalance associated with ADHD, potentially causing unintentional physical disturbances in social settings.

Family Dynamics and Divorce Rates

ADHD significantly affects family relationships. The stress and challenges of managing ADHD can lead to increased parental stress, lower parental warmth, and higher divorce rates among couples where one or both partners have ADHD ([42:07]).

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9. Treatment and Management

Comprehensive Treatment Approaches

ADHD is highly treatable with a combination of medication, therapy, and coaching:

• Medication: Central nervous system stimulants like Adderall, Vyvanse, and Strattera are commonly prescribed. Josh notes, “Study after study has shown that kids on stimulants for ADHD treatment do not get addicted to those stimulants” ([46:52]). These medications are effective in managing symptoms by increasing dopamine levels, which aid in focus and impulse control.

• Therapy and Coaching: Cognitive-behavioral therapy and ADHD coaching help individuals develop practical strategies for time management, organization, and executive functioning.

• Exercise and Nutrition: Regular physical activity boosts dopamine levels, enhances executive functioning, and helps manage hyperactivity. Proper nutrition also supports overall brain health.

Family Training and Structured Parenting

Implementing structured, authoritative parenting styles characterized by high control, warmth, and support is crucial. Family training teaches parents how to establish clear rules and consequences, fostering a supportive environment for children with ADHD.

Long-term Outcomes

Effective treatment can significantly improve quality of life. A 2012 meta-analysis reported that 72% of treated individuals with ADHD experienced improved outcomes, including better self-esteem, fewer accidents, lower addiction rates, enhanced employment prospects, and greater academic success ([53:24]).

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10. Resources and Support

Expert Recommendations

The hosts recommend several resources for further understanding and managing ADHD:

• Melissa Orlov: Offers marriage seminars tailored to neurodiverse couples.
• Gina Perla: Provides a balanced perspective on ADHD.
• Russell Barkley: An esteemed author and former president of the American Psychological Association, known for his extensive work on ADHD.

Caution Against Misinformation

Josh and Chuck caution listeners to be wary of misinformation on social media, urging them to consult credible, professional sources for accurate information and support.

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Conclusion

Josh and Chuck conclude by emphasizing the importance of empathy, understanding, and utilizing available resources to support individuals with ADHD. They encourage listeners to explore the recommended resources, lead with compassion, and foster supportive environments both personally and within their communities.

Notable Quotes:

• Chuck Bryant [02:33]: "If you have kids and you have ADHD as a parent, your kid has about a 50% chance of having it as well."

• Chuck Bryant [04:56]: "A large study of five year olds... the kids who watch the most TV had almost an eight times more of a chance of meeting the ADHD diagnosis criteria."

• Josh Clark [07:16]: "There's not one like, here's our ADHD test... you're pulling all these disparate info together to put together, like, okay, this kid has ADHD and it's this kind."

• Josh Clark [25:08]: "Kids with ADHD are five times likelier to have depression than neurotypical peers."

• Chuck Bryant [23:30]: "30 to 80% of people with Autism Spectrum Disorder are also diagnosed with ADHD."

• Josh Clark [46:52]: "Study after study has shown that kids on stimulants for ADHD treatment do not get addicted to those stimulants."

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This episode of Stuff You Should Know offers a thorough and balanced perspective on ADHD, blending statistical insights with personal anecdotes to create a relatable and informative narrative. Whether you’re seeking to understand ADHD better yourself or support someone you care about, Josh and Chuck provide valuable guidance and resources to navigate the challenges and embrace the strengths associated with ADHD.

Transcript

[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

Hello everyone. In case you're listening to these episodes out of order, we gave a heads up in episode one that we have a kind of a grown up talk about ADHD in these two episodes. So we wanted to say if you're a parent with a kid who has adhd, maybe listen to it yourself first before you share it with them on with the show.

[Chuck Bryant]

Welcome to Stuff youf Should Know, a production of iHeartRadio.

[Josh Clark]

Hey, and welcome to the podcast. I'm Josh and there's Chuck. And Jer's here again. And we're starting up part two of our double episode on adhd.

[Chuck Bryant]

That's right. And if you remember, in part one, we discussed adhd, some people have it, some people don't. And we're gonna talk right now about how you can figure that out. And that's called diagnosis. Right now, where we are scientifically is that the biggest factor on whether or not you have ADHD or not is hereditary. If you have kids and you have ADHD as a parent, your kid has about a 50% chance of having it as well. And like we mentioned in the first part, a lot of adults from especially our generation, Gen Xers, are now getting diagnosed in their 30s, 40s, 50s, because they found out that their kid has ADHD. And they were like, wow, little Chucky Jr looks a lot like big Chucky.

[Josh Clark]

Yeah, that's a symptom. I thought that was charming.

[Chuck Bryant]

Exactly. I thought it was a bug.

[Josh Clark]

And even if they don't recognize it in them. There's a 100% chance that their spouse will be like, I really think you have this too.

[Chuck Bryant]

Yeah. But there are some other factors, right?

[Josh Clark]

Yes. There's issues during pregnancy. That's a big one, usually exposure to alcohol or tobacco, premature delivery if you didn't weigh very much when you were born, if you were exposed to lead as a kid, if you had a brain injury as a kid. There's a lot of concern about some other stuff. I think you said at the very outset of part one. There isn't any research that suggests watching too much TV or living in a go, go, go world. There is some research that suggests that blue number one and blue number two, food dyes may actually at least exacerbate ADHD symptoms. But for the most part they think it's a combination of genetics, the environment you were raised in, and then possibly like actual environmental factors like being exposed to lead or your moment, you know, smoking when she was pregnant with you.

[Chuck Bryant]

Yeah. And just to kind of clear up the TV and the screen thing. Watching TV or being on screens too much or too much tv, quote unquote, isn't going to help give you adhd. But there is a connection there. If you are a kid with adhd, the pull toward a screen is going to be way stronger than a kid who doesn't have it. That short attention span is going to really crave the flashy graphics that video games or cartoons can deliver you. It'll deliver that steady dose of dopamine. They've done studies. I found one, a large study of five year olds that compared attention span of kids who watched less than 30 minutes per day of TV with those who spent more than two hours in front of a TV. And of course we mean, you know, screens basically. Right. And pretty dramatic results. The kids who watch the most TV had almost an eight times more of a chance of meeting the ADHD diagnosis criteria. And it even outranked other things that cause attention problems like, you know, lack of sleep or parent stress, economic stress, stuff like that.

[Josh Clark]

Wow.

[Chuck Bryant]

So there's a link. It's not going to give you adhd, but if you have a kid with adhd, then you should probably just monitor screens even more. You know, you should be doing that anyway, but maybe even more so.

[Josh Clark]

Yeah. Because those sites are designed to release dopamine and train you to come back and do it again and again and again. And so kids with ADHD who don't normally have a flood of dopamine when they get it, they really Learn to do that thing that gives them that dopamine, which again, doesn't give you like a feel good rush. It just comes along with that and tells your brain this is a really important thing to do. So do it again and again and again.

[Chuck Bryant]

Yeah, for sure. It's also like the age of your kid is really important when you're trying to diagnose if you're preschool aged or younger, or I guess that counts as all ages younger than preschool, but you know what I mean, that can be a lot tougher because there are other developmental delays that may look like ADHD that change. And you may not be able to get a really good diagnosis until they're, you know, six, seven, eight years old. And even when they're older, like, you know, teenagers, you gotta rule out a lot of stuff like learning disabilities, mood disorders. If you have like vision or hearing problems or a sleep disorder, a lot of that stuff can fool you into thinking you have adhd. So it can be tricky.

[Josh Clark]

It can be. So there's two lists. There's an inattentive list and then there's a hyperactive list.

[Chuck Bryant]

Yeah.

[Josh Clark]

And each one has, I think, nine, like, criteria. Things like, you know, you lose things frequently, you appear to zone out while people are talking to you, stuff like that. And if you have six out of the nine on the inattentive list, you have inattentive type adhd. If you have six out of nine on the hyperactive list, you have hyperactive type adhd. And if you are really running up the numbers and you've got six of nine on inattentive and six of nine on hyperactive, you've got the combined version of adhd. Adults, it's the same thing. Although the criteria is adjusted a little bit for, you know, runs around rambunctiously in class, you don't do that. But say you feel restless at during meetings, like it's really hard to sit still.

[Chuck Bryant]

You may be mentally doing that.

[Josh Clark]

Exactly.

[Chuck Bryant]

I would love to jump up and spin in a circle.

[Josh Clark]

Right, right.

[Chuck Bryant]

But a kid will actually do that, whereas the adult in the meeting will just struggle through that.

[Josh Clark]

Exactly. So the criteria is essentially the same. It's just kind of adjusted for adults. And then for adults it's five of nine for either list. And then also with kids, when you're diagnosing kids, you look at their educational records, you talk to their parents, you talk to their guidance counselors, you get as much information as you possibly can to properly diagnose somebody with adhd. Because there's not one like, here's our ADHD test. Whether it's a blood test or a written test, you're basically pulling all these disparate info together to put together, like, okay, this kid has ADHD and it's this kind.

[Chuck Bryant]

Yeah. And that's why parent teacher conferences are super valuable. I think when you first start to have to do that stuff, you're just like, oh, God, kill me. I gotta. Seriously, like. Cause your experiences from when you were a kid, like, what a waste of time. But it's not at all. When you go in there as a parent, you know how your kid is at home. You don't know how they are at school because you don't have a little camera in their classroom where you can just sit around and watch what they're like.

[Josh Clark]

So rich parents do, right?

[Chuck Bryant]

Yeah, maybe so. But you can really glean, like, I think when you have challenges with a kid at home, as a parent, you're dying to know if it's just you or if it's just the way it is at home. In other words, obviously not just the parents fault, but you're wondering. So you're like, when we get in there with Ruby's teachers, we're always just like, so what's going on? What's she like? Does she have trouble with this or that? And sometimes it's like, yeah, she has the same trouble with this or that at home. And sometimes it's like, no, it's not at all at school. And so it's really super enlightening.

[Josh Clark]

Yeah, that is super enlightening. Does it make you feel better or is it more just like. It just answers the question that you have?

[Chuck Bryant]

Yeah, just I think, you know, knowledge is power. So just knowing that stuff, that. Dude, we should start doing that with you and Jerry. They need to be adult versions of parent teacher conferences.

[Josh Clark]

Oh, that's a great idea. You know, I would be so anxious.

[Chuck Bryant]

Oh, no, it'd be good. We do it over drinks.

[Josh Clark]

Okay. One other thing. You can find a lot of really great accurate diagnostic tests on sites like TikTok, which have lots of misspelled words in the title. So those are always really great to test whether you have ADHD or not.

[Chuck Bryant]

Be aware of the. I mean, social media stuff can help. There's some good resources. But what was that study? Like? Half of the stuff on TikTok was just wrong.

[Josh Clark]

Yeah, I think 52%.

[Chuck Bryant]

Yeah. When it came to this. Yeah. More than half.

[Josh Clark]

Yeah. So one of the big questions that we're still answering today, and if you haven't picked up that we don't have a full grasp of ADHD in any way, shape or form yet. That's correct. But one of the factors that we're trying to figure out is the prevalence of ADHD among kids and among adults. And it's kind of all over the map. It does seem like we're starting to kind of zero in a little bit. We're figuring out like the, the criteria to really diagnose adhd. And it seems like the numbers are starting to get a little smaller as time goes on and we get a little better with recognizing adhd.

[Chuck Bryant]

Yeah. And correct me if I'm wrong, because I know that you found some other numbers, but we'll just go through them and you can just say.

[Josh Clark]

If I'm off wrong.

[Chuck Bryant]

Between ages of 3 and 17. So school age kids in the U.S. united States of America, around 10% have been diagnosed with ADHD. That number does get bigger with age because a lot of times you won't get tested until a little later. And some, you know, diagnostic testing requires money and sometimes a lot of money. I mean, you can do like a, just a sort of a psychiatric evaluation maybe if your kids go into a therapist or something. And they may just look at criteria and ask a few questions. But if you want like a real deal diagnostic, diagnostic evaluation, like, those aren't cheap. And that sucks because like these numbers are kids who have been diagnosed because they were able to be diagnosed. So I'm sure there are a lot of situations where that's not possible.

[Josh Clark]

There's also a shortage of psychiatrists in the United States. So it's often there's a long wait list to even be seen from that psychiatrist you have to pay a lot of money to. Not all psychiatrists specialize in adhd. So you really need to find from an even like, smaller pool to choose from of psychiatrists. And then also once they diagnose you that the, the outlay of money is not over there, like you have to keep seeing them and they charge you every time for that. And psychiatrists are medical doctors, so their fees are not on the par or on the order of a psychologist or a therapist. They're four or five times more on average, probably I'm pulling that out of thin air, but it's very clear that you're going to pay more for your psychiatrist than you would for a therapist.

[Chuck Bryant]

Yeah, for sure. Generally. Still, boys are more likely to get that diagnosis than girls, about 13% to 6%. There's also variations by race. I believe the Highest percentage is black kids are at 12%, 10% for white kids, 8% for Hispanic kids, and 3% for Asian children, which is just super interesting.

[Josh Clark]

It is interesting for sure. And there's gotta be some clue in there somewhere like that seems like that's weird that there's a difference. Cause I think all of those numbers were for kids in the United States.

[Chuck Bryant]

Yeah, it was.

[Josh Clark]

I think globally, they've come up with, in a 2017 study across the world that 5, almost 5.3% of kids have ADHD. And there's a question like, okay, is this over diagnosed? Because I said that the prevalence rates seem to be kind of getting a little smaller as we zero in. Better and better. But the diagnostic or the rates of diagnosis have really picked up, or they really did. At the Beginning of the 21st century, between 2005 and 2014, diagnoses of kids with ADHD doubled. Doubled? That's crazy. That's a huge increase. Doubled. It's almost like 100% more.

[Chuck Bryant]

Yeah. And there's just no scientific consensus right now on whether it's an over diagnosis or whether it's just. We know more now and there's less stigma, there's more kids getting tested now. The Criteria changed in 2013 from the DSM 4 to the DSM 5 as far as that threshold. So all of those things probably factor in to the doubling, I would think.

[Josh Clark]

Yeah. One thing, though, if you are taking your kid in to be tested, make sure that it's. Since they kind of evaluate the kid against the expectations of their grade level. If they're young for their grade, that needs to be taken into account. Because they can easily be misdiagnosed because they're actually not at that grade level yet. Because they're not of that age quite yet, even though they're in that grade.

[Chuck Bryant]

Yeah. And with COVID kids potentially missing out on, depending on what happened where you were on a lot of valuable schooling. So, yeah, it's important to look at because Ruby is young for her grade. So in some cases she's like eight or nine months younger than some of her classmates. And then when you throw. Even though she did Covid kindergarten, which was a real boon, they did their best. It wasn't like regular school still. So teachers and educators are having to sort and parents are having to sort through all of that still.

[Josh Clark]

Chuck, just to kind of give a hat tip to some of our listeners in other countries, I saw that the NHS says in the UK 5% of kids have ADHD. In Australia, they estimate 6 to 10% of kids have ADHD. Canada 5 to 7%.

[Chuck Bryant]

Not bad, eh?

[Josh Clark]

And then our friends in Germany can expect a percentage of 4.33 for the number or for the percentage of kids that have ADHD in that country. So what about adults? Because as we now realize, adults have ADHD too, or they probably had it in childhood and it was just undiagnosed and they just didn't get diagnosed until later in life. That's typically what happens.

[Chuck Bryant]

Well, my friend, let's take a break and find out those results right after this.

[Josh Clark]

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[C]

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

Lately, I've been learning some stuff about insomnia or aluminia. How about the one on borderline disorder? Better yet, birth order. Heard that one before, but it was so nice, I learned it twice. Everybody, listen up. Oh, it's Charles and Joshua.

[Josh Clark]

It.

[Chuck Bryant]

Stop it, stop it. Stop. You should know. All right. What a cliffhanger that was. Are adult listeners on the edges of their collective seat? Seats. Seat. Collective seat.

[Josh Clark]

Yeah, collective seat.

[Chuck Bryant]

Because it's collective.

[Josh Clark]

Collective soul.

[Chuck Bryant]

Collective soul. Oh, that's a good one. The rate of the condition into adulthood is all over the map. You might look at one thing that says about 5%, because that's kind of what it is for kids. Ish. And then you might read something else that said, no, like 75% adults have it. It's really, really startling when you start looking into this as an adult. There was a study from 2021 that found that it can fluctuate over time. And that's kind of what I was talking about being on the spectrum. But about 9% of those diagnosed as kids, they said, had, quote, unquote, fully recovered in young adulthood. So I don't know what that means, though. Are systems in place such that they've learned to manage it?

[Josh Clark]

Yeah, that's the weird thing is there's no known cure for adhd. All of the stuff that we use for is just managing it. But I think one of the reasons also that they were like, it's just a childhood disorder that you outgrow is because some people actually do some.

[Chuck Bryant]

So you actually can. Okay, so that may be the 9% or part of that 9%, I guess.

[Josh Clark]

But to pull one of your old, old school words, and it seems hinky to me, like, I don't understand how. Yeah, I don't understand how you could outgrow something that arises from your brain being literally different than other people's brains. Yeah, I don't get it, but maybe we just don't, don't understand it quite yet. But it is true. I'm not a hundred percent sure, but for the most part it does seem like if you have ADHD as a kid, you have it as an adult as well.

[Chuck Bryant]

Yeah. And if you're an adult with adhd, you're probably seeing it play out with organization and focus. You know, a lot of times with your job, but just in your life as well, because it's always there. You might have some pretty severe mood swings. You might be a procrastinator. A lot of times you're misdiagnosed because it might make you really anxious. So there's like, no, you have anxiety or it might really bum you out with these mood swings. And they might say, oh, you're just depressed. All of that could just be ADHD or a comorbidity.

[Josh Clark]

Yeah. And we'll talk about comorbidities in a second. Oh, I got it. But with adults, you know, again, adults don't get up in meetings and run around the table and they're like, just go ahead, I'm listening. You know, instead they're just going to sit there and just, you know, use all of their energy to not do that and then also to try to focus on what's being said. And then girls with adhd, Chuck, tend to fall through the cracks much more frequently for a couple of reasons. But the main one that I saw is that girls are so expected to be like demure and quiet and self possessed that girls learn to mask their symptoms earlier than boys do, who can get away with being more rambunctious than girls can. So it goes undetected. And then finally when they, you know, grow up and have a family, there is like, I can't. There's too many plates. I can't do this. I'm just exhausted and I'm not doing any of this the way that I'm supposed to be. And they'll usually get diagnosed with depression and then anxiety or something like that, but if they find the right doctor, they'll be properly diagnosed as ADHD for sure.

[Chuck Bryant]

You mentioned comorbidities. Autism is a very interesting one. 30 to 80% of people with Autism Spectrum Disorder are also diagnosed with ADHD. And about 20 to 50% of people with ADHD also have Autism Spectrum Disorder.

[Josh Clark]

You're just like, why aren't they the same percentages? But it turns out that ADHD is actually more common than autism. So that brain buster is solved for sure.

[Chuck Bryant]

And there is a lot of Overlap there. I think before 2013, with the updated criteria in the DSM 5, they thought that was like a mutually exclusive thing. And some people. This is much the minority for sure, but there are some researchers that do think it's just sort of a single condition manifesting in a couple of different ways. But most researchers don't think that. They think it's like two separate things that live alongside one another a lot of times.

[Josh Clark]

Right. And, Chuck, I just. I just realized. I don't know if we've shouted out Livia this whole time yet for helping us out with this one, but she did a great job.

[Chuck Bryant]

She did a great job. And before I forget, the other thing, as far as ADHD and autism spectrum disorder is you're more likely to just do better if you have one or the other than if you have both. That may feel intuitive, but I think it was bare saying, did I interrupt.

[Josh Clark]

And interject that Livia thing?

[Chuck Bryant]

No, it's fine.

[Josh Clark]

Depression's another one, Chuck. I think kids with or people with ADHD are five times likelier to have depression than neurotypical peers. And they're not exactly sure why. A lot of people are like, well, it's obvious. I mean, like, it can be a really hard life to have adhd, especially when it's undiagnosed and untreated. So of course people have depression. Other people are like, no, we're talking about actually, like clinical, like, brain based depression.

[Chuck Bryant]

Right.

[Josh Clark]

It's possible that there's actually. They share similar roots in the structure of the brain and that might account for it. That there's a lot of overlap physically between depression and ADHD.

[Chuck Bryant]

Yeah, for sure. And about 40% of kids, and I think we touched on this a little bit in part one, also have anxiety, which just makes it all tougher to deal with because it kind of feeds on itself. 30 to 50% of kids with ADHD fit the criteria for a couple of other conditions, one called oppositional defiant disorder and conduct disorder, which we should maybe cover. We could probably cover both of those in one episode. At some point we should.

[Josh Clark]

Man. One of the most heartbreaking things I've ever seen in my life was on a plane and this kid was just kicking the back of my chair non stop hard. And I turned around to look like, what the heck's going on?

[Chuck Bryant]

You said, don't, Josh. No.

[Josh Clark]

Right. And the parents were there with them, and they just gave me a look like, what? What do you want us to do? We can't do anything. And I've never seen Two people look more tired and more defeated in my life, and their kid was probably only three or four. And it was just like, I still. Today, I just feel so bad for those people because that's your kid. And, like, there's not a lot of understanding or treatment with that, and certainly not out in the general public who turns around like, you know, what are you doing? Why is your kid doing that? Yeah.

[Chuck Bryant]

And in the old days, like, you would tie your kid to a plane seat or something barbaric like that.

[Josh Clark]

Yeah. Which I'm sure helps a lot.

[Chuck Bryant]

All right, so if you don't have ADHD like me, it helps to grow older because you do get a little wiser and you do gain empathy. Hopefully. At least I have. So it's hard to put yourself in someone's shoes until you are close to someone with adhd. And then, like I said, it really benefits everyone if you can lead with empathy and understanding, like in your case, with that kid even. And that's coming from someone with ADHD recognizing maybe this behavior in a kid. But it can be hard if you don't have it to understand this stuff.

[Josh Clark]

Yeah. So low empathy, generally with people walking around who know about autism are probably like, yeah, that has to do with autism. It turns out it's a huge symptom with adhd, too. And probably the exact same stuff applies to people with autism, but with adhd, it's not that you don't care. You couldn't care less or whatever. You do care. You just either lack the ability to, like you said, put yourself in that person's situation so your empathy can be triggered, or you lack emotional empathy, which is where you're like, oh, man, that's terrible that that happened to you. But I'm not feeling empathy. Like, I don't feel it. That's. That's the difference. They're not sure how many people with ADHD have low empathy and exactly how it works, but it is a huge problem because, again, like, they're. If you can't. If you can't empathize with people, that's a basic human thing.

[Chuck Bryant]

Yeah.

[Josh Clark]

And that will really cut down on the number of connections you have with people. Because if somebody's telling you something and they've just, you know, inserted that pop, like, the end of it, and, like, this is what happened, and you're like, oh. Like, you're just taking their words at face value and you're losing the emotional component. It's missing. It's not landing on you. And they're just like, well, what is wrong with you? But, like, you. Did you not hear what I just said?

[Chuck Bryant]

Yeah.

[Josh Clark]

And you can stop and think about it and be like, oh, yeah, that's crazy. But, like, in the moment, it's not. It's not there.

[Chuck Bryant]

Yeah. Yeah, totally. And this is something I never knew anything about until we started researching this, but false memory or faulty memory can be an issue if you have adhd. And it's not just, well, I just don't remember things as they really were. It can literally be, like a false memory. They've done tests with kids, and they showed that kids with ADHD are much more likely to remember things that weren't on list. And this is sort of the key here. Not only that, but be really emphatic that those memories were correct and trying to defend those memories. And that can be not only a frustration, but a real challenge, especially as you get into adulthood, to sort of be able to construct your autobiography of who you are. Because that's all based on your memories.

[Josh Clark]

Yeah. Because if you can accept that you have false memories and that you embellish stuff that you don't remember inadvertently, you don't know that you're doing this, you start to question all of your memories, like, which ones are true, which ones are made up. That's a huge problem individually. But also, as far as relationships go, you're accidentally, inadvertently gaslighting the people that you're like, no, that totally didn't happen. Or, you said this. I didn't say that. And to get to a point where you can trust the other person's version of events, what you're doing, you're having to disavow your own version of reality.

[Chuck Bryant]

Yeah.

[Josh Clark]

And rely on somebody else's version of reality. And that's probably the hardest mental thing a person can do in their life, is abandon, like, just not, like, not trust their view of reality and be like, okay, I trust your version instead. It's one of the hardest things you could possibly ever do. And that's what it requires to not accidentally gaslight people and not get in arguments all the time. Because your memories are false.

[Chuck Bryant]

Yeah. And I imagine, you know, you keep kind of going back to this, how so much of this can lead to a lack of ability to connect with people in different ways. I imagine when you find your person or your persons in your life, it may be maybe a smaller number than it would have been otherwise, but I would think that maybe some of those connections, because so much trust is involved, can be even deeper sometimes.

[Josh Clark]

Yeah. Oh, for sure. If you can find somebody that you feel like you can be yourself around and just let your guard down and they accept you as you actually are, you hang on to those people. For sure. And that's true whether you have ADHD or autism or whatever.

[Chuck Bryant]

Oh, for sure.

[Josh Clark]

Like, if that's whenever you find those people. But it's like you said, they're going to be much fewer and farther between because you're lacking that initial easiness of, like, oh, I like you. Oh, I like you too. Let's start hanging out more and cultivate a friendship naturally, without even thinking about it. Each relationship is a lot of work for people with adhd. So, yeah, of course you're gonna have fewer of them.

[Chuck Bryant]

Yeah, for sure. And these are, you know, we're kind of going through just sort of like, what it's like to live with it. So some of these are downers. But you are more, I believe, twice as likely to be injured in life if you have adhd, which sounds kind of weird, but it makes sense, you know, if you're distractive or distracted or if you're impulsive, if you take more risks, that's going to lead to more injury in life. There's also this very, very strange thing called the ADHD sway, where it's a literal physical imbalance, a postural imbalance that's associated with adhd, which could be a short stuff on its own, maybe, I think.

[Josh Clark]

So. Yumi found this hilarious video, I think, on Instagram of somebody saying, like, what? It's like walking next to somebody with adhd. And because the ADHD person will accidentally walk in front of you or walk, like, kind of sway too close to you or something like that, you end up the guy who was, like, walking along next to this girl who's talking to him, and, like, he ends up having to, like, climb over, like, a jungle gym and ends up having to walk through a bush and, like, all this. All this stuff. And the person with ADHD is totally oblivious that all this is going on. But it's because of that, that ADHD sway. They don't. As far as I know. No one knows exactly what it is, but they think it could have something to do with the differences in brain structure, has something to do with the balance as well, because that's in the brain as well as in the ears.

[Chuck Bryant]

Fascinating. All right, we're in the act. 1, 2, 3, 4, 5. We're headed toward the act 6.

[Josh Clark]

Wow. Is this the one where the guns go off?

[Chuck Bryant]

Oh, I hope not. So we're headed toward Act 6 and we will talk more about the destruction of masking behaviors right after this.

[Josh Clark]

Congratulations to Easterseals Southern California on their first place win for innovation in Customer service at this year's Unconventional Awards by T Mobile for Business. Easterseals has used T Mobile 5G to create immersive VR development tools that aid people with autism in addressing transportation barriers. These tools are shaping the way safe and personalized skill building is delivered and for that, T Mobile congratulates Easterseals Southern California for their unconventional thinking.

[C]

Black Friday is coming. And for the adults in your life who love the coolest toys, well, there's something for them this year too. Bartisian is the premier craft cocktail maker that automatically makes more than 60 seasonal and classic cocktails each in under 30 seconds at the push of a button. And right now, Bartisian is having a huge site wide sale. You can get $100 off any cocktail maker or cocktail maker bundle when you spend $400 or more. So if the cocktail lover in your life has been good this year or the right kind of bad, get them Bartesian at the push of a button. Make bar quality Cosmopolitans, Mark Martinis, Manhattans and more. All in just 30 seconds. All for 100 off. Amazing toys aren't just for kids. Get 100 off a cocktail maker when you spend 400 through Cyber Monday. Visit bartesian.com cocktail that's B A R T E S I A N dot com cocktail.

[Chuck Bryant]

Attention parents and grandparents. Are you searching for the perfect gift for your kids this holiday season? Well, give the gift of adventure that will last all year long. A Guardian Bike the easiest, safest and quickest bikes for kids to learn on. Kids are learning to ride a bike in just one day. No training wheels needed.

[Josh Clark]

Very nice. But what sets Guardian bikes apart? Well, they're designed especially for stability. They're low to the ground with a wide wheelbase and ultra lightweight frames. They offer superior control and balance. And this particular design gives young riders the ability to learn. And again, just one day without any tears or frustration.

[Chuck Bryant]

That's right. They're assembled here in the United States of America. And I gotta say, Guardian Bikes was kind enough to send my daughter a Guardian bike. And she loves this thing. It's her first big girl bike. I put it together with great ease and this thing is a great bike.

[Josh Clark]

So join the hundreds of thousands of happy families, including Chucks, by getting a Guardian Bike. Today. Their holiday sales have begun offering the biggest deal of the year. You can save up to 33% on bikes, no discount code needed. Plus, get free shipping and a free bike lock and pump with your first purchase. After signing up for their newsletter, just visit guardianbikes.com and Happy Riding.

[Chuck Bryant]

Yeah, I've been learning some stuff about insomnia or aluminia. How about the one on borderline disorder? Better yet, birth order. Heard that one before, but it was so nice, I learned it twice. Everybody, listen up. Oh, it's Charles Joshua. It. Stop it. Stop it. Stop. You should know.

[Josh Clark]

So, Chuck, you promised that we're going to talk about masking. So I feel like my back's against the wall. I have to start talking about masking, which I will right now. Okay.

[Chuck Bryant]

Okay. Are you masking right now?

[Josh Clark]

Sure. Yeah. I think at all times, people with ADHD mask to varying degrees. For sure. I feel very comfortable on the episode, but, you know.

[Chuck Bryant]

Yeah, I didn't mean to put you on the spot. I was kind of just joking. What is masking? Let me ask you that.

[Josh Clark]

Masking is camouflaging your symptoms to blend in better.

[Chuck Bryant]

How bad can that get? And how bad is that for somebody?

[Josh Clark]

In some ways, it's necessary and needed just to navigate the world just to blend in. And not to blend in, like, don't look at me. But to seem. But to be able to interact with people in levels that they're not, like, huh? What's wrong with you? They're paying attention instead to what you're saying or, you know, the value that you have. Yeah, you have to. If you have ADHD and autism, a lot of neurotypical disorders, if not all of them, require you to mask, to be able to just kind of live in the world. Right. So in that sense, it stinks. And there's a lot of. I think you kind of mentioned it either earlier in part one, some employers are starting to create more neurodiverse inclusive workplaces where it's just like, just be yourself. But traditionally, if you want to just make it in the world, you have to mask to some degree. Right. And so in that sense, that's okay. Or at the very least, that's not the most insidious version of masking. The problem with it is that starts to carry over throughout other parts of your life, and you find that you eventually develop a version of yourself that you assume other people would prefer to be around. And in a lot of cases, you're probably correct. And so in addition to, you know, all of the exhausting this. That it keeps from not, you know, getting up and running around the conference table during a Meeting and being like, no, go ahead, I'm just keep going, I'm listening. You, you also, your self esteem takes a real nosedive because what you're training yourself is that you're you is not good enough. You have to hide yourself for people to accept you or value you. And that's the most insidious part of masking.

[Chuck Bryant]

Yeah, I can't imagine that even it can get so bad where you lose your sense of self because you're masking so much. Obviously something like this can manifest in bad ways. Mood swings, anger, those are symptoms that can be associated with adhd. Because of the masking and regulating those mood swings, being unable to be generally in a stable emotional state can be very, very challenging. And that takes a lot of energy. And that's part of the fatigue that can come along with adhd. If you're always on or playing a role that you think you should play to fit into work or life or the world, it's gotta be exhausting.

[Josh Clark]

It is. So you're more irritable, so you're more prone to like get mad at somebody who cut you off in traffic. Whereas like a neurotypical person might be like, huh, that guy's having a bad day or what a jerk or something like that, you know? Yeah. You add all this stuff together and research consistently shows that people with ADHD have lower self esteem and lower self compassion too, than neurotypical people. And that's. Yeah, again, like I said, it's a really insidious part of ADHD and just being neurodiverse in general. Again, it's not just adhd. People who have to mask. Anybody who isn't neurotypical will feel like they have to mask, at least in some situations, unless they make a conscious decision not to do that. It's almost like resisting an impulse and just being like, I am going to be me in every situation. And to tell you the truth, I'm not even sure that that's possible.

[Chuck Bryant]

Yeah. And resisting impulse is one of the challenges anyway.

[Josh Clark]

Right? Yeah, exactly. Good point.

[Chuck Bryant]

So as far as families go, we already mentioned that family members may be on eggshells. There have been studies that have shown that you may have a lower parental warmth and especially maternal warmth toward a kid with adhd, which is super sad. More stress, more depression, they found among mothers especially. And if you have like one neurodiverse child, one kid with ADHD and two or three other kids, or just one other kid who is neurotypical, that can be really challenging for everybody, including the neurotypical kid. And they have found adults with ADHD have about twice as likely chance of getting divorced as a neurotypical couple.

[Josh Clark]

Right. So, yeah, and there's a lot of challenges just in living everyday life at home, even not even just at work or at the mall or something like that. There's some other real bummer downsides to having adhd. As a population, you're very susceptible to addiction because again, like, these things flood your brain with dopamine, so you learn to do those over and over and over again. So it's really easy to get addicted to just about anything if you have adhd. There's a study of people who were in treatment in the U.S. i can't remember when it was conducted, but they found a quarter of them had ADHD and another quarter, between 24% and 62% of homeless people in the US were found to have ADHD, despite again, only maybe 3.1% of adults globally having the disorder. So they're disproportionately represented in those populations.

[Chuck Bryant]

So here's the good news, everybody. We've been through five acts and a third of some good things, some bad things, and real challenges.

[Josh Clark]

We laughed, we cried, we laughed, we cried for sure.

[Chuck Bryant]

It's a very, in fact, one of the most highly treatable conditions or disorder. I don't even like saying disorder, but I guess that's how they list it that you can have. There are a few things you can do treatment wise. There is coaching, there's therapy, and there's medication. You may try one of these things. You might try two. You might try all three as an individual or a parent. If you're helping your kid through this.

[Josh Clark]

Situation, well, that's the most effective, usually is. All three of those.

[Chuck Bryant]

Yeah. I mean, medication can be very effective. As of 2016, 62% of kids in the US that are diagnosed were on medication. 30% of those were only on medication, 32% were on medication and behavioral treatment and 15% shunned the medication and just did behavioral treatment.

[Josh Clark]

And that's kind of understandable for a parent to make a decision and that many parents to make the decision, like, I don't want to put my kid on speed because again, like central nervous system stimulants are the go to drug for treating adhd because it really, really works. It's like flipping a light switch. I understand where like, just even from the first dose, you're like, oh, this is what it feels like to be neurotypical. Right. And one of those stimulants that is prescribed one type Adderall, Vyvanse, Strattera. They are literal amphetamines. So the idea of putting your kid on amphetamines really does not sit right with a lot of parents. Even though the state of understanding the consensus in the professional ADHD community, despite a lot of non professionals giving contrary advice. Yeah, usually, yeah. Study after study has shown that kids on stimulants for ADHD treatment do not get addicted to those stimulants. Like it just doesn't happen and then it also doesn't set them up for increased addictions later in life and it may actually decrease. Some studies have shown the proneness to addiction of other stuff later in life even too. And I don't want to be just like a lackey for psychostimulants as ADHD treatment. There's a lot of different info out there but from what I could tell when I, when I researched it for this, the professional community generally agrees they are not harmful to be on even long term.

[Chuck Bryant]

Yeah, there are a couple of kinds. There's immediate release medicines that's sort of as needed, like maybe up to four hour effective time window. You may crash really hard after that or get really tired or depressed after that. There are extended release medications that's sort of the morning pill that can last all day sometimes. Sometimes it's six hours, sometimes it's up to 16. Sometimes people tag team those take that pill in the morning and then either as needed or in the afternoon or evening. One of the immediate release medicines and you have to get screened for something like this. They're going to do a cardiovascular screen for health risks and stuff like that. But it's sort of, I believe they haven't found link to cardiovascular disease. Right, but didn't they, there was something about the heart you found that was contrary to that. Right?

[Josh Clark]

Yeah. There's a study in the Journal of the American Medical association that I think from like 2023 that was like actually we studied some dudes in Sweden and it seems like they're, they were at an increased risk of cardiovascular disease from long term psychostimulant use from adhd. So again it's possible that we just don't know enough or people haven't been on it long enough. But again these things were developed in the 50s and kids have been on them since the 70s, 80s at the latest when they started putting them on well effectively speed to treat this stuff. And there doesn't seem to be a lot of research that suggests they are harmful.

[Chuck Bryant]

Right. If you don't respond well to those, if the side effects are no good, there are other medicines that you can take that are not stimulants. Alpha antagonists, sometimes. Sometimes, like, they found that some medications to treat high blood pressure, like clonidine, have, you know, improved ADHD symptoms. So, you know, talk to your doctor if this is something you're interested in. And, you know, just, we're not medical professionals, so, you know, speak.

[Josh Clark]

Good point.

[Chuck Bryant]

Speak to your doctor and, like, really do some research and dig in. It's, you know, putting your kid or your adult self on a. On any kind of medication. It's not something to take lightly. So just, you know, really, really dig in there and ask questions, for sure.

[Josh Clark]

And no, no shade on you. If you're a parent, that's like, I don't care what you say. I'm not putting my kid on speed. For sure. Totally, totally get that. Like, I respect anybody's decision about that, because it doesn't mean that you don't care about your kid. I respect anybody's decision about stuff like that, of course. So I said that the most effective, I guess, approach to treating ADHD is not just medication, but also different types of therapy and then also some other interventions like exercise and nutrition. And when you put all that together, it's much easier to treat ADHD symptoms. One of the first things, especially with kids with adhd, is family training, where you teach the family how to. Teach the kid how to act and behave like, what's expected of them, what the consequences are, and not just the kid. The whole family is supposed to fully understand and be very clear on all of the house rules and the structure of the family. And I guess so the younger kids can effectively tell on the kid with ADHD when he misbehaves or she does. Right. And I saw that authoritative parenting type is the most effective, which was described as high control with high warmth and high support.

[Chuck Bryant]

Oh, interesting.

[Josh Clark]

But also, that means. Okay, so high warmth, right? Does that mean that some parents make a decision to not be warm to their kids? Like, they think that that's the best way to raise kids?

[Chuck Bryant]

Well, I mean, sadly, sure, there are all kinds of parents, but I feel like that probably. High warmth probably means extra warmth, like being really attuned to.

[Josh Clark]

Gotcha.

[Chuck Bryant]

Providing that extra warmth would be, my.

[Josh Clark]

Guess, on fire, like a furnace of a parent.

[Chuck Bryant]

You mentioned exercise. Of course, that's good for everybody when it comes to mood regulation and your brain functioning at its highest. But for sure, if you have adhd, it can Increase dopamine. It can improve your executive functioning. If you have a lot of pent up energy, especially if you're a kid with hyperactivity, exercise can really help for sure.

[Josh Clark]

Coaching is another one too. There's therapy, obviously, but coaching is huge in the ADHD community because you're not like, okay, what's wrong with you? Let's figure out all your traumas and stuff like that. It's like, okay, you're having trouble with time management. Let's figure out what works for you for getting better at time management. And it's a legitimate way to approach ADHD symptoms. So are productive strategies where that will probably also come out of coaching sessions. And one thing that you'll learn very early on is phone calendars that are easily accessed that you can put reminders on all the time alarms on your phone. Anything that can remind you can become like second nature to use to really help you navigate ADHD symptoms and remember important stuff. Stuff.

[Chuck Bryant]

Systems, baby. That's the key.

[Josh Clark]

That's right.

[Chuck Bryant]

Getting systems in place. ADHD or not. Systems are just the older I get, the more I realize that if you don't have a system in place, then you're just flailing. You got to get a system. Outcomes are pretty good. There was a survey, this is a little bit old, but I think it's probably still pretty pretty on par. But 2012 survey of 351 English language studies. So I guess this is like a meta analysis of long term outcomes of people with ADHD found that 72% of people treated had improved outcomes when it comes to everything from self esteem to fewer accidents behind the wheel, less rates of addiction, antisocial behavior, increased employment, increased academic success. So 72% if you are treated. That's great. That's really successful.

[Josh Clark]

Yeah. There's a lot of good resources too for adhd. There's a researcher named Melissa Orlov. She holds marriage seminars that really kind of paint ADHD in an almost exclusively positive light. And if you were a couple that's tried traditional marriage counseling, you've been like, this isn't working. It's because that stuff's geared toward neurotypical typical people. Hers is geared toward neurodiverse people. Melissa Orlov is very frequently criticized as being overly positive about adhd. There's a researcher named Gina Perla who came out with a much more balanced look. It seems like ADHD called is it you me or adult adhd? Which is a. Yeah. And then Russell Barkley has written a lot of books too for kids. And parents and adults. And he was the president of the American Psychological association for a while.

[Chuck Bryant]

So he's no slouch.

[Josh Clark]

No. And again, be very wary of who you're listening to on social media. But there are psychiatrists who specialize in ADHD who post a lot on social media and can be really helpful on Instagram, too. That I wanted to shout out are Perry, Nichols, Mandanis. It's great. And then the psych doctor, M.D. sasha Hamdani. She has ADHD herself and she wrote a book called Self Care for People with adhd.

[Chuck Bryant]

All great resources. And you know what? Let's skip listener mail altogether and just encourage people to support one another. Dig into those resources, try and lead with empathy and understanding. You get much further in life and rate and review our show.

[Josh Clark]

Well put, Chuck. Very nice. In the meantime, if you want to get in touch with us, you can email us. You can send us that email to stuffpodcastiheartradio.com Stuff youf Should Know is a production of iHeartRadio.

[Chuck Bryant]

For more podcasts iHeartRadio, visit the iHeartRadio.

[C]

App, Apple Podcasts, or wherever you listen.

[Chuck Bryant]

To your favorite shows. Hey, what's up, guys?

[Josh Clark]

I'm Nick Chubb, running back for the Cleveland Browns.

[Chuck Bryant]

The holidays get really busy for me.

[Josh Clark]

But I still want to pull up to events. Looking nice. Abercrombie's latest job of party looks is taking me through the season for dinner with the fam, drinks with the guys, and even New Year's Eve.

[Chuck Bryant]

They have outfits for every occasion.

[Josh Clark]

I'm mainly a jeans and T shirt guy, but Abercrombie has the dressier fits that keep me comfortable. Shop Abercrombie for every night out. Gifting is hard, but here's a hint. Give the gift of connection from US Cellular. Not sure what that means.

[Chuck Bryant]

Here's a slightly more specific hint.

[Josh Clark]

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[Chuck Bryant]

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[Josh Clark]

Your family wants new phones.

[Chuck Bryant]

How do we know?

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[Chuck Bryant]

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[Josh Clark]

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[Chuck Bryant]

You drive your teenager around a lot.

[Josh Clark]

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[Chuck Bryant]

Uh, mom, this is Jake's house, not Jacobs.

[Josh Clark]

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[Chuck Bryant]

See app for details.

[Josh Clark]

Bye, Mom.