Wellness Unmasked: ADHD, Autism & the Culture of Diagnosis: Dr. Sami Timimi Challenges Modern Psychiatry

Summary

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Podcast Summary: “Wellness Unmasked: ADHD, Autism & the Culture of Diagnosis: Dr. Sami Timimi Challenges Modern Psychiatry”

Podcast: The Clay Travis and Buck Sexton Show
Host: iHeartPodcasts
Guest Host: Dr. Nicole Saphier
Guest: Dr. Sami Timimi, Consultant Child & Adolescent Psychiatrist (Ret.)
Date: January 27, 2026
Episode Length (Content): ~34 min

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Main Theme & Purpose

This episode of "Wellness Unmasked" dives into the dramatic rise in psychiatric diagnoses—particularly ADHD and autism—in children and adults, questioning the scientific validity and cultural drivers behind these trends. Dr. Sami Timimi, a longtime critic of mainstream psychiatric labels, shares his views on how shifting definitions, subjective criteria, and societal pressures have created what he calls a "mental health industrial complex." The conversation explores whether these labels help or hinder individuals, the impact of commercial interests, and how families can navigate this complex landscape with caution, skepticism, and compassion.

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Key Discussion Points & Insights

1. Challenging Mainstream Psychiatric Diagnoses (03:53–11:34)

• Controversial Yet Evidence-based: Dr. Timimi notes that questioning the evidence behind psychiatric labels like ADHD or autism can earn a psychiatrist the label of "charlatan" in mainstream discourse, especially in America. He insists, “As the scientist in me is quite confused about why looking at the evidence… turns you into somebody who is considered controversial” (04:37).
• “Upside Down Science”: He defines "upside down science" as the process of creating a hypothesis (e.g., ADHD as a biological disorder) and then demanding others disprove it, rather than seeking evidence before accepting it as real.
• Lack of Biological Anchor: Despite decades of research, Timimi argues that ADHD lacks a clear biological basis—it's “a description of behaviors like hyperactivity and impulsivity,” not a verified, distinct condition (05:15).

Notable Quote

• “What I’ve seen happening is… when you develop a concept that has no… empirical anchor… these concepts are very vulnerable to being expanded.”
  — Dr. Sami Timimi [07:23]

2. The Evolution—and Expansion—of ADHD (04:37–11:34)

• Historical Trajectory: ADHD began as a rare “hyperkinetic disorder”; then the scope was broadened to include attention issues, mild symptoms, and eventually adult ADHD.
• Expansion Through Ambiguity: Diagnostic criteria (“often squirms with their hands or feet”) are subjective, resulting in an expanding umbrella. “How often is often? What’s a unit of squirm?... The whole thing is subjective” (09:10).
• Masked Symptoms Create New Diagnoses: The recent idea of ‘masking’ (where individuals hide their symptoms) has enabled further expansion, especially among adult women—“your customer base, you’ve got an enormous market to expand into” (11:19).

3. The “Mental Health Industrial Complex” and Commercial Drivers (15:15–21:16)

• Profits from Distress: Dr. Timimi identifies a “mental health industrial complex” wherein emotional distress becomes a lucrative market, driven by pharmaceutical companies, influencers, and even clinical assessment providers.
• Diagnosis as Branding: Psychiatric labels have become “brands,” facilitating ongoing consumption of therapies, drugs, content, and self-identification but often not delivering real, lasting help.
• Comorbidity and Medicalization: It’s not rare for young people to accumulate multiple labels—OCD, PTSD, anxiety—seeking ever more diagnoses and medications.

Notable Quote

• “Psychiatric diagnoses are not really diagnoses because they describe things, they actually don’t point to causes, they have no explanatory power within them. But what they’ve become is brands.”
  — Dr. Sami Timimi [17:30]

4. Autism: Rise in Diagnosis and Dilution of Meaning (21:16–25:28)

• No Single Cause—It’s Cultural: Dr. Timimi emphasizes that the main driver of increased autism rates is a “culture of diagnosis”—psychiatry expanding the label’s bounds (22:06).
• From Rare to “Full Spectrum”: Autism began as a rare disorder with significant impairment; now it covers everyone from those in care homes to “the richest man in the world, Elon Musk” (23:29).
• Impact of Social Shifts: Changes from industrial to service economies may have boosted sensitivity to “people skills,” but the diagnosis has lost empirical clarity.
• Overdiagnosis vs. Underdiagnosis Is a False Debate: “No, it’s the culture of diagnosis. These are not diagnoses” (25:11).

5. Searching for “Normal” & Societal and Individual Impacts (28:26–33:59)

• What Is Normal?: Dr. Timimi’s book “Searching for Normal” explores how ideas of normal have “been shrinking,” but human diversity is the baseline (29:30).
• Identity and Diagnosis: Diagnosis has merged with identity-politics, conferring social currency—but potentially also “capturing” or “enslaving” people in fixed identities (30:39).
• Advice for Parents: Timimi urges parents to see labels as temporary and non-definitive—“hold it lightly, do not see it as lifelong, because it isn’t” (31:52).
• Focus on Relationships, Not Labels: Avoid mystifying clinical language and remember that core parental relationships, love, and guidance are more important than professional interventions unless truly needed.

Notable Quote

• “Trying to boil us down into single dimension identities... is highly problematic because we’re made up of multiple different things that define us… Identity is not something... that you get from a fixed label.”
  — Dr. Sami Timimi [29:57]

• “If you do find yourself going down the path of… getting a label like that for your child, then hold it lightly. Do not see it as lifelong, because it isn’t.”
  — Dr. Sami Timimi [32:11]

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Memorable Moments & Quotes

• On Commodification:
  “Our consumption of psychopharmaceuticals, of diagnoses, of therapies... that idea of mental health is just going up and up and up.”
  — Dr. Sami Timimi [20:54]

• On Armor and Communication:
  “Go back to ordinary language, because when you start using these mystifying languages, it might disempower you as a parent.”
  — Dr. Sami Timimi [33:11]

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Important Segment Timestamps

• Introduction & Framing: 02:51–04:00
• Critique of Scientific Evidence for ADHD: 04:37–11:34
• Diagnosis as Brand, Commercial Influences: 16:07–21:16
• Rise and Dilution of Autism Diagnoses: 22:06–25:28
• Moving Forward & Re-examining “Normal”: 28:26–33:59
• Advice to Parents: 31:34–33:59

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Takeaways for Listeners

• Diagnoses Should Not Be Life Sentences: View psychiatric labels as tools, not identities; don’t accept them unquestioningly or as permanent.
• Watch for “Concept Creep”: Beware of clinical terms leaking into everyday life, which may obscure more direct, human ways of relating and problem-solving.
• Cultural and Economic Factors Matter: The rise of diagnoses is as much about changing societies and economic incentives as it is about true increases in disease.
• Parental Wisdom Counts: Ultimately, personal insight and relationships matter most; “nobody knows their children better than their parents.”

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Episode Tone & Language

• Intelligent, Nuanced, and Critical: Both Dr. Saphire and Dr. Timimi maintain a curiosity-driven, critical tone, probing for scientific rigor while emphasizing compassion.
• Accessible but Unafraid of Complexity: The episode doesn’t shy from challenging ideas or uncomfortable truths about diagnosis, science, and society.

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Conclusion

Through thoughtful critique and candid reflection, this episode challenges conventional wisdom about ADHD, autism, and mental health—urging listeners to question labels, stay alert to cultural trends, and prioritize relationships over psychiatric branding. Dr. Timimi’s call is not to deny suffering, but to resist over-medicalization and rediscover the complexity and fluidity of human experience.

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For a deeper exploration, check out Dr. Sami Timimi’s book, "Searching for Normal," and keep the conversation open—whether you agree or not, this is a discussion worth having.

Transcript

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[Dr. Nicole Safire]

Welcome to Wellness Unmasked. In the US nearly one in nine children have been diagnosed with some form of ADH, a number that has steadily risen over the past two decades. Is this better recognition and access to care or are we medicalizing normal human behavior? Joining me is Dr. Sami Tamimi, a child and adolescent psychiatrist known for challenging the mainstream media psychiatric models. Dr. Tamimi questions whether labels like ADHD truly reflect underlying biology or whether culture, environment and expectations play a much larger role than we're willing to admit. Now, this is a very, very thoughtful, nuanced conversation. It's not about denying anyone's suffering, but about asking better questions. So let's get into it. With us today on Wellness Unmasked, we have British consultant, child and adolescent psychiatrist and psychotherapist in the UK National Health Service. Dr. Sami Tamimi. Thank you so much for joining us today. Man, I have so many questions for you.

[Dr. Sami Tamimi]

Thank you so much for inviting me, although just a little correction. I've recently retired from the National Health.

[Dr. Nicole Safire]

Service, so then formally of the National Health Service. But it's still a pretty, pretty big title that you once carried.

[Dr. Sami Tamimi]

Yes, yes. And more than three decades worth of working in public services.

[Dr. Nicole Safire]

So can we dive right in? Because some of the things that you've critiqued, you know, if you were here in the United States, you would be branded almost like a charlatan because you're pushing against kind of what the mainstream media narrative is regarding the traditional psychiatric diagnoses, especially ADHD and autism. Can you talk a little bit about that?

[Dr. Sami Tamimi]

As the scientist in me is quite confused about why looking at the evidence and analyzing the evidence turns you into somebody who is considered controversial. To me, the controversy is the other way around. When we create concepts and we practice what I think is upside down science. In upside down science, while in proper science, what you do is you come up with a hypothesis. You assume your hypothesis isn't true until you can show with verifiable data that your hypothesis is true. You don't start by assuming your hypothesis is true and then expect other people to come and show data that the hypothesis isn't true. That's what I mean by upside down science. So I've looked at all the evidence and I've been following this for a while, ever since my time as a trainee child and adolescent psychiatrist When I was asked to join a consultant in a project looking at the prevalence of adhd, this for us, a new concept. This was in the mid-1990s, coming into the UK to look at the prevalence for this, and I went and did this big literature review of the existing literature at the time and had this horrible feeling that the more I read, the less I came to think about, well, what the hell is this thing being called adhd? Surely you're not telling me ADHD is simply the behaviors that you're describing, but all these papers seem to be assuming that adhd, which is basically a description of behaviors like hyperactivity and impulsivity, and the assumption was this was a verified, identifiable condition, that these behaviors point to some sort of neurodevelopmental, in other words, something to do with the development of the nervous system, that it was primarily genetic and that it could be diagnosed, and that it is likely to link to some sort of brain difference or abnormality. So I could see from the start of this new concept that there was something missing in terms of the scientific basis for that. So I've been following that literature and the research ever since then. Over the last three decades, I've been writing about it, and I write about it again in my latest book, Searching for Normal. Because what I've seen happening is what I predicted many decades ago, which is when you develop a concept that has no, what I would consider empirical anchor. In other words, it doesn't start with some sort of objective, verifiable basis in our biology, then. And if the definition of these conditions are simply descriptions, and all descriptions are subjective in nature, then one of the things that's going to happen, particularly if society goes through phases where there is more distress around, more insecurity, alienation and so on, then what's going to happen, or what's likely to happen, is these concepts are very vulnerable to being expanded. And what we've seen happen with concepts like adhd, autism, depression, anxiety, is the bound. Not only the boundaries have expanded, but the whole parameters. So they've gone through what I call a mutation of constructs. So if you look at adhd, for example, it starts off as a very rare condition, and originally it was called something like hyperkinetic disorder, and it focused on levels of activity. It was considered largely developmental in nature. In other words, the expectation was most children would grow out of most of the behaviors that define it. And what we see then happen is it expands, firstly horizontally, so it starts to include different behaviors, so attention comes into the picture. So the idea of attention deficit becomes quite important. So it expands into new behaviors. It further expands in terms of the severity of these behaviors because remember the types of behaviors that we're talking about. If you look at a list of behaviors for the diagnosis of something like adhd, you'll see statements like often squirms with their hands or their feet. Well, how often is often? What's a unit of squirm? How much movement do you need to have a unit of squirm? How many units of squirm? And so on. The whole thing is subjective. So this expansion goes from a rare condition to about considered to about 3 to 5% of children. Then it expands vertically by going into the concept of adult adhd. So at some point the idea that most children grow out of it starts to disappear and it starts to be talked about as a lifelong condition. Again, these changes are not coming about because there's been new evidence about the biology, but it's still being called genetic, even though those evidence about genetics are missing. It's still being called neurodevelopmental, even though nobody can find what that neurodevelopmental bit is. So it expands into adulthood and then it takes another mutation in the last five to ten years in particular, a new concept comes in, again without any biological evidence to back this. And this concept is masking so the idea that you have the symptoms, but because you're good at hiding them in public, people don't see it. And it's just when you get home and you know you can relax that all of these so called symptoms come out. And the concept of masking enables ADHD to make another expansion beyond its traditionally mainly male based diagnosis towards more women getting the diagnosis. So this becomes the biggest growth area and for all sorts of reasons, and I go into some of them in my latest book, Women have been the when it comes to adulthood, women have been the main psychiatric customer base. Now you can think about all sorts of sociological reasons why that might be and what sort of social pressures women find themselves under. But if you can get into the market of where women are, your customer base, you've got an enormous market to expand into.

[Dr. Nicole Safire]

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[Dr. Nicole Safire]

You know, in the United States, about 12% of children are being diagnosed with ADHD. That number goes up to 15% in kids. Now. You kind of laid out for us the expanded diagnostic criteria and other confounding factors that may have contributed to this increase. But we're now also kind of getting into the weeds of potentially. I mean, obviously the mothers are the ones who are most often seeking treatment for said children when there is suspicion of adhd. And so do you think that there is some sort of manipulative marketing or even a level of deception? What do you think is the impetus behind some of this rise? Not necessarily the broadened diagnostic criteria, but do you think that there's more of a nefarious something behind it in terms of whether it's the pharmaceutical companies or something else?

[Dr. Sami Tamimi]

So in the west, we live in economies that are based around markets and the selling of things. What's happened is what I have termed the growth of what I think of as now a mental health industrial complex. Because it turns out that particularly when society becomes more insecure and there's a greater level of distress, that distress can become a source of profit. And it's kind of not a conspiracy theory, but, but more just the machinery of our economics means that once you find certain conditions seem to attract a lot of attention from the population, a lot of people are going to make money. So I think if I was to point the fingers at the culprits, my starting point would be certain strands of academic psychiatry who've created this concept using upside down science. And this is where the controversy should be, shouldn't be with people like me who are pointing these things out. It should be with the people who've promoted concepts out of thin air, essentially, without the backing of a solid scientific evidence base, and continue to perpetuate these. These are the modern snake oil sellers. And the pharmaceutical industry is probably the best known bit that saw great profits to be made from, if you like, turning emotional distress into a source of profit. But as these concepts grow, what seems to happen is that psychiatric diagnoses are not really diagnoses because they describe things, they actually don't point to causes, they have no explanatory power within them. But what they've become is brands. So I think of psychiatric diagnoses these days as brands, and with these brands come all sorts of sources of profit, from very expensive assessments to pharmaceutical to therapies, to influencers, podcasts, magazines, books, you name it, you see a whole range of products grow around these concepts. The danger is if we don't recognize what's going on here and we fall into the fantasy that these psychiatric brands are actually diagnoses. In other words, they offer explanations what tends to happen because they are better thought of as commodities. What tends to happen with most commodities is that they give you a temporary feeling of my life's improved. But after a while, a lot of commodities, you want the next one or you want a better one, or they're not quite working. So what I've seen is a process whereby people, once they enter into this way of thinking about what's going on in their life, thinking in psychiatric terms, is they might start out with a diagnosis of, for example, adhd. Few years down the line, they start wondering about, well, that doesn't explain everything. And they find themselves getting another diagnosis, say autism. A few years later there might be another one, say obsessive compulsive disorder. And along the way they're accumulating other associated things, they're consuming books, podcasts. But they might also have started on medication. And that medication tends again, according to the evidence, it doesn't lead to long lasting improvements. So they might have got more medication, another one, higher doses, and so on and so forth. So we've got a whole system that seems to be geared to creating patients rather than helping people move on in their lives. I've seen, I mean, in this country it's not quite as bad, but it's still getting that way. I've seen 16 year olds come to clinic who've already got a diagnosis of adhd, autism, ocd, ptsd, anxiety disorder, and they're coming to the clinic because now they and their parents are convinced that there's actually something more going on. They're wondering that there's something that has been missed all these years. And so now they're wondering, does this person have a bipolar disorder? And so they're already on multiple medications and they're thinking they need another one. This is where it leads us. So our consumption of psychopharmaceuticals, of diagnoses, of. Of therapies, of all sorts of things that related to this idea of mental health is just going up and up and up.

[Dr. Nicole Safire]

What do you make of. I'm sure it's hard to miss some of the conversation with the United States HHS Secretary RFK Jr. And a lot of the talk about the rise in autism spectrum disorder diagnoses, specifically within the United States, he's attributing to in California. I think I've heard him say numbers as high as 1 in 30 kids have some form of autism. And there's been a lot of conversation as to a singular cause for that. My personal belief is there's not a singular cause for that. But as we've kind of discussed a broadened diagnostic criteria, but also largely influenced by our environment, the foods we're eating, the microplastics being consumed, the pollution in our air, so much and so forth. What do you make of the purported rise in.

[Dr. Sami Tamimi]

The biggest cause of the rise in autism is the culture of diagnosis. It is caused by psychiatry and certain branches of academic psychiatry promoting a broader idea of autism. So autism is interesting in some ways because it starts its life towards the end of the Second World War as a very rare condition. So the original condition was thought to affect about 0.01 to 0.04% of children. You're talking about very rare condition. And they nearly all had significant learning difficulties. So these were the type of individuals who were unlikely to be able to live an independent life. They were always likely to require considerable amounts of care and support educationally, clinically, and socially throughout their lives. But the concept has expanded so much that we've gone from this type of group who are likely to end up as residents in support homes, right up to the richest man in the world, Elon Musk. I mean, that is the full spectrum of human functioning, if you like. So the concept itself, I think, has now become so diluted that it doesn't really tell us anything about the persons who are getting the diagnoses. And therefore it's impossible to start disentangling potential causes, because the biggest driver of this rise has nothing to do with our environments, has nothing to do with our genesis and has a lot to do with an expansion of a concept. It does interact with changes in the types of social roles that people are expecting, particularly as we moved from a more industrial society where people worked in factories to the more service sector and consumer facing where the demands are on people to have certain types of people skills. So you could put an argument together that it reflects that type of shift in our economic, in the types of economic activities that are desirable. That makes it more likely that people who have, you know, the diversity of quirks in the way we interact socially that might make it harder for some people to get on. But at the same time, as we've seen with a whole host of people who are considered to be at the top of their game in sports, in culture, in industry, who are coming out and saying a whole load of celebrities have come out and said that they have or they're considered to have a autistic spectrum disorder. So even that doesn't seem to. So I think we've ended up with a whole narrative that lacks any empirical basis. It's like floating in some abstract space where we're talking about are we over diagnosing? Are we under diagnosing? No, it's the culture of diagnosis. These are not diagnoses.

[Dr. Nicole Safire]

More coming up on Wellness unmasked with Dr. Nicole Safire.

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[Dr. Nicole Safire]

So in your book Searching for Normal, you know, that is obviously a very complex term. You know what, how do we get to that, that level of normal? How do we move from here? I find myself, myself living in a very polarized society where if you say anything other than if you, if you make the claim that autism has increased because of an expanded diagnostic criteria, which from my opinion is the most ob. Same with ADHD and same with anxiety and same with the majority of our mental illness, you know, I am immediately ostracized by one half of the population saying that that's not true. It's, you know, specifically you have to say that vaccines cause it all or else this one group will be very upset with you. But on the other hand, you know, I do, I do look around our environment and I wonder if there is some more than just the expanded diagnostic criteria. And I find sometimes it's very difficult to move forward in this conversation. Like how do we get to that level of normal and move forward from where we are?

[Dr. Sami Tamimi]

So the key word I think in the title of my book is searching. Because in some ways I'm unpacking all the assumptions that we have behind the idea that there is a normal. Where do we get our ideas for a normal? Our ideas for what we consider to be normal have been shrinking, but maybe the whole concept of normal, because by definition we're all pretty unique. Diversity is the nature of the human condition. Trying to boil us down into single dimension identities to me is highly problematic because we're made up of multiple different things that define us from our background, from our family, from our nationality, our, our religion, our politics, our profession. Identity is not something. So one of the things that I've seen happening is that the mental health industrial complex has kind of merged with the whole identity politics movement. So people have started to identify and see it as a important part of who they are when they get a psychiatric diagnosis. So it's kind of social status shifted. And this is partly the reason why people get so upset. If you're saying, do you know what? These are not diagnoses. They don't explain anything. They are labels. And labels come with potential harms that if you're not aware of them, what you think might be liberating to you might in a few years time start a process of capturing you, of enslaving you. And I think it's up to us to point this out because our culture is kind of running away with concepts that I think are potentially disabling and harmful to us as individuals, but also to us at a population level.

[Dr. Nicole Safire]

So from the individual. So I'm a mother of three boys from the individual listening to this podcast. Like a mother who either has a child who has maybe been labeled neurodivergent or they're grappling with does my child have adhd? What's your advice to that mom listening?

[Dr. Sami Tamimi]

Well, everybody has to try and figure things out for themselves. And sadly, unfortunately, sometimes if you're going to, if your child needs extra help and if you're going to going to get extra help, you sometimes need to go down these paths. That's just a sad reality. But if you do find yourself going down the path of labeling or getting a label like that for your child, then hold it lightly. Do not see it as lifelong, because it isn't. I know plenty of People, one of the truths about growing up is that change is inevitable. All sorts of things about you, from your body to the way you experience your emotions, to your friendships, to your ambitions and so on, they will change. So don't get drawn into this idea that you've got some fixed lifelong problems. And the other thing I would really caution against is getting drawn into what I call concept creep. Whereas the language and concepts that came out of the clinical setting have sort of leaked out and people now talk about things like masking, they talk about meltdowns, they talk about dysregulated emotions. And all of these sorts of things go back to ordinary language, because when you start using these mystifying languages, it might disempower you as a parent. You might start to think that knowing how to help your kids grow up is an incredibly complicated thing and it needs multiple experts to tell you this or that. And all of these things might get in the way of the more important things, which is a relationship, your relationship with your children. Just that basic thing of, you know, loving them, them, knowing you love them, not being afraid of conflict, not being afraid of guiding them. All those things might become a lot more harder to do if you've sort of farmed out your capacity to influence your children as they grow up to a professional class.

[Dr. Nicole Safire]

Well, I love that advice. And Dr. Tamimi, I'm so glad that you came on Wellness Unmask Anybody who found this whole conversation as interesting as I do, you have to pick up a copy of Searching for a New Approach to Understanding Mental Health, Distress and Neurodiversity. It just came out this last year. It is very informative and it just allows you to change the way you think about something.

[Dr. Sami Tamimi]

Well, thank you very much for inviting me. I've enjoyed our chat and I do think these are very important topics for us to be engaging with.

[Dr. Nicole Safire]

This conversation is exactly why wellness en masse exists. Whether you agree with Dr. Tamimi or not, not his work and opinions, forces us to pause and ask, are we helping patients or are we just simply labeling them? Are we treating root causes or are we just managing symptoms? And is there a level of deception when it comes to the pharmaceutical market? Mental health is real. Suffering is absolutely real. But how we define, diagnose and treat that suffering matters. And it's especially true for our children. My hope is that today's discussion encourages curiosity, critical thinking, and just better overall conversations between patients, parents, doctors, whoever's involved in that conversation. You've heard me say it once. You're going to hear me say it a million times. I don't think anybody knows their children better than their parents. And so while it's important to get other people's opinions, at the end of the day, all you can do is take the information that you're given and you make the decision that's right for your child. If this episode made you think, please be sure to share it with other people. If it challenged you, Even better. I'm Dr. Nicole Safire. This is Wellness on Mass. Thank you so much for listening to Wellness unmass with Dr. Nicole Safire on iHeartRadio. You can also find us on Apple Podcasts. Wherever you get your podcasts, I'll see you next time.

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