Sasha Hamdani (on ADHD)

I'm Dan Chaper, and I'm joined by Monica Mouse. - Hi. - Today we have Sasha Hamdonny on a long time coming. We've been talking about ADHD AdNazim.

“I think we've maybe lost listeners over it,”

but we finally have brought in an expert

to either correct confirm who knows. It just explore this topic that we are obsessed with. - That's the fun thing about the show. We get to talk about something that we know very little about, and then get real answers.

- It is awesome. Sasha is an MD, she's a board certified psychiatrist, specializing in ADHD, RSD, and emotional regulation. Her books include self care for people with ADHD. And an upcoming book, it comes out in October,

look forward to when people start serving pumpkin a lot of spice lattes and dressing and Halloween costumes. - T-S-L. - Too sensitive, rejection, resilience, and the science of feeling deeply.

Oh, I love this. This is a great episode. - Yeah. - Please enjoy Sasha Hamdonny. - Yes, episode of Armchair Expert is presented by Apple TV,

the new US Home of Formula One, starting March 7th. You can watch complete all-axis live coverage of every Grand Prix, including practice, qualifying, and sprints all in one place. Watch every race live, only on Apple TV.

♪ He's in our chance for him ♪ ♪ He's in our chance for him ♪ ♪ He's in our chance for him ♪ ♪ He's in our chance for him ♪ ♪ He's in our chance for him ♪

- I'm nervous to be too optimistic, but we had a microbiome expert on who has a probiotic that actually is real, and I've been on it for like, I think, two weeks. - I'm probably not even, probably like on a week or something.

- And I was in Detroit and I cheated on my diet. - Sure. - And I had gluten and sugar, and I didn't have any rash, and my joints didn't hurt, and I'm like, "Did it fix my leaky gut and mizzle?"

- That fast. Maybe, I mean, it's also, it's like maybe that with that exclusionary diet. - Yes. - 'Cause I've been gluten-free for five years

because of this. - You have sorry, I'm gonna go through it? - Yeah. - Oh, do you think it's the sexiest autoimmune movement? - Oh, it's so good.

- Like I've walked around, I mean, I could feel like it's cold outside, and that's been like, "No, no, no, no!" - How long have you had it, or been diagnosed with it? - So I was diagnosed with psoriasis in Biff, the grade.

- Oh, well, long time, but it didn't affect my joints until I got out of medical school, and I was like, "What is this? "Why am I elderly? "I did my residency in Phoenix,

"and it was warm and nice and I didn't really notice things "and then I moved back to Kansas City where it was cold, "and I was like, something is wrong with me." It was horrific, and then I was like, "Okay, well, let me just apply these,

"or something else that's gonna help me." - Must be my fault. - Yeah. - And I was like, "I need to do more." - Okay, and then I went, I got the full work up,

and I also have horrible rashes all over my actual joints. - Oh. - And then they were like, "Well, I'm just like, "Okay." - Yeah. - I have to point out, we're all wearing blue.

- Yeah. - So that's really nice.

A we're wearing basically the same outfit.

Black pants in a blue top thing. - And you also both have the most beautiful skin tone and hair tone. - What does that mean? - Well, wow.

Oh my God, long last twins. - You could bridge the divide between Pakistan and India. - That's what I'm doing. - That's what we're here to do. - What do you do here, that'll be solved.

- Yeah.

“- But I am curious, because you must experience”

this bit of dissonance, right, where you've gone to medical school, and then things are happening to you, but you're somehow not using the same criteria, or it's hard to apply to yourself what you already know, right?

- And also, I'm a psychiatrist. So anything with the body of my soul? (laughing) - He'll be fine. - He'll be fine. - Okay, you're from Santa Barbara.

I once lived there. And what part of Santa Barbara did you live in? - Monocido. - Monocido. - Okay, so what do mom and dad do? You feel guilty right if you're eating it.

We just had to guess who currently lives in Monocido and he said, Santa Barbara, and I said, Monocido, and he said, "Yeah."

- Do you go to that amazing bookstore?

Godmother's, do you know about it? - No. - What maybe it's after you're gone for a while. - I mean, gone for a while. - I mean, it's fine for like 18 years.

- Okay, moved out. So it changed a lot, but my mom still lives there. So we're, and I was able to come to the podcast, and then we have a sleepover last night.

“- That's what I was hoping to get to Santa Barbara.”

- And there's a huge ice-traum in Kansas City. My flight has already been canceled. - Oh, no. - Oh, no. - Okay, I guess I'll have to go be in Mother's Theatre for a couple of days. - Oh, my God, we'll go to Godmother's.

It's very, very cute. - Wait, how do I not? Where is it?

- There's only one main thing. - There's only one main thing.

- A parallel to the train restaurant. - There's state street. - State street. - It's not there. - It's on Lily Avenue. - Lily. - It's on Lily? - Ding-di-di. - I know. - Lily. - It's her middle name. - I know.

- It's just close to Summerland Beach. - That doesn't count. - It doesn't want to see it. - Okay. - I think it is because, because we went to lunch in Monocito and it was like 10 minutes away or nine. - Ten minutes away could be carpenter Rhea.

- Oh, why could I be? - You guys are Monocito's sleigh. - Three blocks long. - Yeah, it's a small team. - You guys are so picky. - We can live there,

“I think this is what it is. - I guess I think I know.”

- Okay, that's fine. - So drive the 10 minutes. - We'll see. - What did Mom and Dad do in Santa Barbara? - It's a funny story, because my mom and Dad got married. And they were from Paxlan. My dad applies all over the US for a job.

Doesn't get anywhere. The first job that gave him an opening as an engineer was in Santa Barbara. It was like sweet. - Yeah. - And so we go there. My mom's in training because she is a pediatrician. So she's still going through a residency and then I came out.

- Yeah. - And then we just kind of lived and grew up there. - You didn't grow up there. - Nope. - It's a weird vortex. - Oh, it was weird when I got there from Detroit. I was like this is a very weird. - It's a weird microphone. - Please pinpoint the things

that you thought were right, because I have my own specific. - So growing up there, it is this weird mix of people

that have been there for a million generations

and are just trickled down and they're on level a thousand of their trust fund. - Yeah. - They're not really engaged. - Yes, and humanity or no concept of work or motivation to like some people in my high school currently right now, they have the same jobs that they had

in high school, but they're just working until their parent dies and that they can warm up stairs. - Yeah, I'm delighted that we have the same observation. 'Cause I got there and I started meeting and I remember I met this girl at a coffee shop and she was shooting math

and she was also very interesting and pretty. And I went to her house and it was this very nice house I'm on a seat of and there are other children of rich kids that were just completely neglected. There's like this whole cadre of rich neglected kids there

that I thought was so freaky and weird. - It's weird. - I'm so curious, hold your. - I'm 30 now. - I'm not coming up. - Okay, 30 now. - We're very close in age. - Yeah, very very close. - We're the same.

- Basically, the same, but I am 30. I just, I'm sorry, don't you think about it?

“- You have to be on it. - I have to be on it.”

- I have to be on it. - I am, I am. - You have had a very similar trajectory in that you two were trying to very much hide from your culture. I have a lot of this approach of yours. - I had purple contacts for a while.

- Oh, I wanted them. - I wanted them. - I wanted them. - I wanted them. - Yes, I wanted them. - Yes, I wanted them. - The irony, you guys are both such babes.

It's incredible that you would be trying to become.

- You're going through that in your formative years and you're already feeling other guests. And so you really do whatever. And when I'm saying other from a physical, like an ninth grade, I show up to public school coming from private schools.

So I didn't really know anybody. I'm a Riley context. I've had gear during the day. - Oh boy, not even nocturnal. We could have taken a fucking break for six hours.

- Oh, I did. - Two periods into that school. I was like, this goes. - You're a third fiber, if you went to school there.

“- No, you can't. - You don't make it out.”

- You don't make it out and I was like wrong. Let me deal with the palate issues and overnight I'll deal with it. - Yeah, yeah. - At a different time. - Yeah, yeah. - That's right. - Okay, but you're kind of a wonderkin.

- And you get diagnosed with ADHD at nine years old, which that's the beginning of these diagnoses. Yeah, maybe the uptick in these. - That's early. - Well, it depends. - Where you're wrapped probably.

- Also gender for boys. Typical age of diagnosis is between five and seven. Or women, do you know what it is? - Four, three, three, three, five years old. - Thirty-five years old. - Thirty-five years old.

- Thirty-five years old, age. Usually, they've had their own kids. They're like, this is weird. They go to the doctor. The kid gets diagnosed and then the bomb gets diagnosed.

- Yeah, okay. - I'm saying. - Okay, so you do get a diagnosis and then that's immediately helpful, yeah. In that you get medication that starts working. - Yes, I'm hesitating because it's a weird story.

- Okay, great. - Okay, so fourth grade. I was pretty boisterous as a kid. Substitute teacher comes along. - I create an insurrection in the classroom. I got everyone to stand up on their desk, start chanting it.

And like, that's horrifying, I have kids. I can't imagine treating a teacher, or a substitute teacher like that ever. But I was just the person who did that within an hour of that happening.

The substitute teacher calls my teacher my teacher calls. From a doctor's appointment, she calls my parents, and she's like, do something. And so then my parents got me, my mom was a pediatrician. So I got in with a physician, I got diagnosed,

and I got treated. But it was so stigmatized at that time. They didn't tell me my diagnosis.

I feel like I was diagnosed twice,

“because it was on medication hugely helpful.”

My parents were like, okay, take this vitamin. And I was like, whoa, this vitamin is working. - Yeah, yeah. - No, much. - It beats the shit out of Flintstones. - It's like, well, it's like those two.

- Oh, my god. - Oh, my god. - So chalky and disgusting. - Yeah, I know, but the sun is stouting. - So I got sit through class. I could pay attention, I wasn't getting in trouble.

And school wasn't painful for me.

It was never hard for me before, but I was so bored.

And I was like, I can't sit here and do this. And so it became very manageable. And that kind of propelled me through. This stupid vitamin. And then I did well enough throughout my schooling

through high school that I got into a combined undergrad graduate program. So I started medical school at 18. - It's like I condensed to a six-year program. - Yeah. - At university in Missouri, Kansas City. - I was like, yeah, dad went there.

- Did you? - You shut up right now. - Yes, he did. - He really did. - Sorry, it's okay. - We went to tech. - As jokes in the mix here. - Really? - Yeah, his exam is in the mix.

- Oh, yeah, okay. - It's very proud of us. - Yeah, he is. So I went there and that was the first time I'd been away from my parents. That was the first time I'd been by myself.

I'm like, there's so much stuff in freedom and also laundry and all of this other stuff

that I've never had to worry about.

Because my mom would do it. I don't know how to feed myself. - No. - Oh, sorry. - Oh, sorry. - You're my way and on your hands. - I did my laundry starting from age eight.

- Okay, okay. - My mom tried. - Could you stream me from milkshake

“from the bottom of the stairs and she would make you one?”

- No, that's nowadays. Now, you're thinking of a wrong story. I was making a milkshake in the basically the middle of the night. - Okay. - And she was like,

calling from her and like, stop. There was a blender going and her was asleep. And she was like, what do you do? I'm like, I'm like, I'm not joking. - So I was making. - Okay, okay.

She also says something. - Sorry, sorry, sorry. Sorry, I don't probably could yell. - Did my mom be like, yeah. (laughing) Amazing. (laughing) She did try to instill skills

and I just was uninterested in high school. I was playing sports and I was doing all this other stuff. And if you had told me, your laundry's not gonna get done. I'd be like, okay, I'll just wear my part gun to school. It's fine. - I don't care about that stuff.

I still kind of don't care about that stuff. - There was a lot going on. And I went from being one of the smart kids in my school to all of a sudden being quite literally the bottom of my class. When I realized something was wrong

and I brought it up to my parents' is, I did this neurotest. So neuro anatomy, when I stayed up, really tried to focus on, I was like, I know this brain inside out. It was really interesting to me and I was visual that I was like, I got this.

This is so easy.

Going to the test, I'm like, this is amazing.

I'm getting all of them. This is perfect. I'm the first one out of the test. And then they had this thing where they would post your grades with your ID number. It's like the next day, I'm like showing up.

I'm still looking for my ID number. And you're looking at all of these grades and you're like 90, 80, whatever. And I was like, there is some loser who got a third or two. And I was like, well, that's me.

- You want that? - Yeah, what a disconnect. I didn't flip over. - Oh, oh, oh. - Oh, oh. - You just did half of the test. - I got 100% I didn't flip it over. - Okay, you think the perfect.

- Oh, you would think, I went and I was like, please. - This is going to break myself a stream. - And I was like, I'll be on the outside of the room. You can give it to me, orally. Just read me the questions.

I will tell you the answers. The guy was like, you're either going to learn from this or you're not. And I was like, okay, well, I guess I'm not. So I remember telling my parents, like, well, are you taking your vitamin?

I was like, especially, I don't even know where that is. - I don't know what you're talking about. - I knew you still thought it was a vitamin and right up college. - It was a vitamin. - Okay, so I have a little bit of a little bit of your parents.

- Me too. - There's an ongoing beef. You also could have been told that nine years old. That this notion that there's all these things we can't tell kids is so silly. I don't understand. - It was a different time, though. - It's a terribly different,

I mean, because pretty young. - No, no, no, even like when my brother was little, which is eight years below me, 80D was if you have that year problematic. - Sure, but there's no reason that the child couldn't understand that they have ADHD

and explain what limitations and what other things are going to be coming their way. So they have an expectation and some tolerance. They can understand that. - I think that could have happened.

But I also think, I don't thought about this a ton.

“Since I've been parent now, how would I handle that differently?”

In that time, it was so stigmatized. There was a kid who had ADHD a couple grades above me in that private school, and that kid got expelled for putting fireworks in a toilet. - And they were like, this kid is nothing.

- And he's grown up. - He's grown up. - We don't know what to do with him. - He can't be at school anymore. And all the room parents were talking about it.

And then I was also the only brown kid in this sea of white children. I already felt weird.

“So I think my parents probably were doing at that point.”

What they thought was the best. They were trying to intervene. - They think they're protecting you. - Yes. - But I don't think lack of information is ever protection, personally. - Not wrong.

They redeem themselves big, because I'll tell you what they did that was correct. So after that, so I'm like, yeah, I don't know where my document is. - Next topic. - And they're like, okay, that's up.

- This vitamin is actually ADHD medication. You know, ADHD, I was like, no, I don't. I've been medicating against my well. I feel really angry about deceived. - Yes. - And so I was like, let's just start over.

So then I really tried to apply myself in school. I would wake up at 5.30 in the morning. I would start studying. I would study for like 12 hours a day. I'd be so into it that I would get into it.

Periods where I was like, I should probably go eat. And I was like, no, no, no, no, I got to finish this chapter. I was just trashing my body to get those results. And I took another exam. And it half turned my best efforts.

I still got a 60% why?

“Because I was so tired the day before this has to”

had so run down that I was foggy. And I couldn't think at that time. And I was like, previously, when I was on this vitamin,

I never had those problems.

I don't understand what's happening. And so then my dad was like, listen, you might. (laughs) Make it through medical school. - Yeah. - Just come home, who cares?

Let's learn about your brain. He brings me back to California. And we go to library, straight up old school library, pulling out textbooks, both of us were just sitting on the floor. He is reading textbooks about ADHD and he's like,

this sounds like you're like, that does sound like me. - And so we learned so much. And I thought it was handled in such a curious and open way. A him and my mom both were like, we wish that we had that verbiage to tell you.

We didn't know. And you were under our care for so long. We didn't know what a fracturing there would be when you left and you were out of that environment. - So then, truly, I had to like scrape and clawed

to get out of that hole. But eventually, I tried a bunch of different medications. Some of them wouldn't let me eat and some of them wouldn't let me sleep. They were some, they were a disaster. But then it was a combination of finding a good medication

and finding the right therapeutic things. And I don't think I truly figured it out until I got into residency. So after a medical school, I was just surrounded by psychiatrists

and therapists. This is my happy place. - Yeah. - There's a great, 'cause med school, it was so hard. The entirety of med school.

It was like all of my attendings. I don't know whether I was already pegged as a problem. But I had an episode where there was an attending who came into my office. I didn't do very well in the test.

And he had been kind of rough on me the whole time. But he's like, don't worry about it. You know what we're gonna do? - Yeah, and we have these little cubicle offices. And it just brings like a box to them.

And he starts packing up my office. He's like, you could just go home. You came here for a reason. Maybe you'll meet your husband here and I was like, oh my gosh.

- So, especially now, as a mom of a girl, I was like, if anyone spoke to my girl like that, I would be ferole. - In that moment, you're so embarrassed and you're so confused.

Like, why is someone who's supposed to be helping me through my educational steps doing this? You just don't do anything. And so I just carried that. - Yeah.

- And so, but then, I feel like residency just reversed all of that, 'cause I felt traumatized in med school. And then in residency, all those pieces got rebuilt. And they were like, this is what you're good at. Lead with that and then we'll work on the back end.

- Okay, so you've become specialized in ADHD. - I'm taking up my shoes. - Oh, please. - Yeah, do it. - You can dump the socks too, whatever you want. - No one's ready for that.

- Okay. - I would love to know the historical understanding of ADHD as a condition. I'd love to start with one maybe.

First enters the DSM or one does it appear.

And what do we think it was then? And how would we now define it today? So the problem with that is it has had such an evolving course. And it has had so many different names. When it was first noticed, it was in the 1700s.

We had a patient who is extremely restless.

“And that's what we're describing now as fidgeting”

or a sign of like that physical impulsivity. And then as it moved on, it got the name a hyper kinetic condition. That was an interesting kind of segue because it really dialed down on the hyperactive component.

Then as we progressed, we didn't get into formal ADD territory, which is not called anymore until the '80s I believe. - That's when I was introduced to this concept. It was ADD. - Yeah, ADD.

And that's what I was diagnosed with initially. That came later. And then just recently in the DSM five, I got beef with the DSM five. - There's a lot of beef to be happy with the DSM in general.

- So now what our standard diagnosis is ADHD is attention deficit hyperactiveity disorder. It's broken into three sub-type.

So if you have ADHD, it's always called ADHD,

You can have the hyperactive presentation or you can have the combined type, which is kind of like a combination of both. A huge problem is people sometimes are like, I can't have ADHD because I'm not hyperactive.

- 'Cause it's in the name. - Right, right, right, right, right. - It's too wide of an umbrella, we would say, maybe. - It's too wide, but it's also too narrow. It focuses so, so, so, so, so, strangely on just the focus components.

And it doesn't touch at all on other areas of regulation. 'Cause I think ADHD at its base, it's a dopamine dysregulation error. So you have dopamine dysregulation when it comes to attention. You have dopamine dysregulation when it comes to the impulsivity.

You have dopamine dysregulation. It's sleep with appetite with emotions. All of that is so huge,

but we never really touch on it.

With the emotional side of things in particular, if we don't change that with ADHD, this is why people are gonna get misdiagnosed with anxiety and depression for a million billion years. - Yeah, I guess currently, though,

it is diagnosed through symptoms, yeah? You're reporting symptoms, yeah? If a fills enough criteria, we would say you have it. My curiosity is, are we approaching, or do you believe we'll get to a point

where there will be different diagnostic tools, DNA markers where we'll go, oh, we see this clumping of this here. Would it be FMRI brain scam where we would see something that would let us know, is there going to be a day where we can read the actual percentages of neurotransmitters

and say, oh, you have this exact cocktail that ends up to this like, are we approaching any kind of diagnostic tool that's not just symptom related? - No, okay, let me tell you why on all of those fronts,

I think about that all the time.

If there was something tangible, we could grab onto and check a level of something that would be amazing. So with the levels of dopamine, dopamine, serotonin, you can usually check those.

There are a lot of things floating around with a urine test where you pee and then they check your levels. The reason why those are incredibly unreliable is because sometimes it's not truly that you don't have enough dopamine, it's just not present in the spot

where you need it to be at the right time. - Right, it's a dysregulation. - So what happens if I come to you and I'm like, okay, I think I have it, what do you ask? So there's a couple of things.

The thing that makes a good ADHD diagnostic interview is that not only are you checking for symptoms, but you are simultaneously ruling out other things.

“And I think that's what makes it such a complicated thing”

to do because I have patients who have come in and they're like,

I went online for an assessment and it says, I definitely have it and I'm like, what? And I understand the thing about ADHD that I know because I have it when you are right in the middle

of trying to navigate a brain that feels so overly chaotic for you. You are willing to point yourself in any direction to fix it. - Yes, that's right.

- Your desperate. - That population is a vulnerable population because they are the people desperate to want help. So I understand why people are taking tests online. It's just not a super valid test

because it's capturing you in a very subjective manner. It's not giving good timelines. It's not ruling out any other things. So it's giving this very skewed kind of thing with ADHD. When you're looking at the criteria,

you're screening for both the inattentive symptoms, the hyperactive symptoms. And then obviously you'll get if it's combined from both those, you want to check timelines, see if these symptoms presented before 12.

When you're assessing for an adult, that can get tricky because if you're asking them to recall retroactive data, that's hard. A lot of people don't remember and a lot of people have spent so much time during their childhood

where their parents have masked, covered up, fix kind of symptomology that it's hard to assess. So that's difficult.

“You have to really dig back to get good criteria.”

And then when you're asking questions, like for example, with the inattentiveness you're asking, is it hard to stay engaged with a task? Do you feel like it's difficult to eat or organize things? Do you feel like you get distracted halfway

through the conversation? You're asking things about focus and focus adjacent topics, but you also have to ask, is this present during a depressive episode? Is this present when their substances involved?

Did you notice this before or after you got on thyroid medication? You're asking all of these things while you're doing a simultaneous screening for other things. So it becomes pretty complicated.

It's so dynamic. You're doing a comprehensive medical rule out. It's confusing from a psychiatric perspective. Like is this bipolar? Is this ADHD?

Is this depression? Is this anxiety? Is this trauma? There are all things that overlap really beautifully and can mimic it.

“So you need to be able to kind of pull from the diagnosis,”

what the patient is saying, ask the right questions to get to where you're going. And I'll tell you, a lot of people come to me, 100% dead said, I have ADHD. And by the time we're done with the interview,

it's like, no, you didn't.

This is what was causing it.

Yeah. And so it takes someone who's been trained to be able to discern that. Over a protracted period of time as well, I would imagine. And this isn't something you're doing in five minutes.

You really need to learn quite a bit before you're doing that. We're not. And then we probably get into the other issue, which is I'm sure it is a spectrum condition. So what do we say that 79% of these symptoms

equals it or 71% or whatever, you know, when is it a disorder? When are you one deviation below a disorder? You could still be suffering a lot of the symptoms before you're chronic or in a formally or pathologically

in this condition. And it doesn't mean that's irrelevant that you're just a step before it.

“So my great curiosity is, so what are the inattentive symptoms?”

And I also want to talk about how it manifests differently in men and women and boys and girls. To your point, my hunch is the DSM was originally just assembled with the boy symptoms. And so I imagine they really present differently

and males and females. So how do they? And what are those symptoms? And so with the inattentive, you're looking at difficulty with starting a task,

staying engaged in a task, completing tasks, having difficulty with disorganization. You're looking at issues with executive function, the skills that are required for processing and getting a goal done, goal or into behaviors done.

Those are kind of more the inattentive symptomology. Hyperactive, you're thinking more like physical and verbal and inclusivity. These are the kids and adults who have difficulty staying in their chair. They're constantly fidgeting, they're flirting out things.

They're interrupting. - Interrupting. - Ding, ding, ding, ding, ding, ding, ding, ding. - Also we should say, "Dax is looking for a diagnosis, right, the end of this." - What?

- Can I just say you one second,

how I got interested? He must know Gabor, Mante. - Yeah. - I'm walking him to his car and he says to me, "Have you ever been diagnosed with PTSD?" And I just went, that's a weird thing for him to say,

and he's an expert on it. So I just went like, "Oh, that's really interesting." He said that. And then I, too, my algorithm became like everyone else. And I start seeing these different things.

I interview a friend who's been diagnosed and see who's a kid and he tells me that ADHD folks have an outsized sense of justice and if that, in fact, is one, I definitely suffer. So, you know, I'm just not oblivious

to a lot of these things do sound a lot like me. - Here's the deal, I'm not gonna diagnose you. - Yeah, I don't want you to know. I'm actually not looking for that. I don't care if I do or I don't have it.

- Well, you should.

“I think that there is nothing more liberating”

than understanding your brain.

You deserve to have a good diagnosis and to know how your brain works. When I went from not knowing what was going on and then I sat with my dad and then we actually went back to a physician

and he explained, like, these are the things that are going on in your brain. And this is why you might have difficulty with this. I gave myself so much number one grace about things that I beat myself up

about for years and years. - Right, right. The self-flagellation went to the game as I understand one of the conditions. - Emotional regulation needs to be as part of that.

For example, so my dad asked last year in April of 2016. - I'm sorry. - We found out he had lung cancer. We found out he had the spot

and they were like, it's annoying, but we'll get a treated whatever. So we go, we get a treated, he goes through the chemo, he goes through the radiation. He calls me one day and he's like,

I just don't feel great. So I have word of light. I go over, I'm like, you look awful. I take me to the hospital. Everyone's like, no, we can't do a PET scan.

It's too soon. I was like, do it. We don't care if insurance doesn't cover it. Something's wrong. It was everywhere and he died 13 days later.

- What? - 13 days. - Oh my God. - 13 days.

“But what I noticed, I think this is probably why”

it feels so passionately about the emotional regulation part is that the colliding of brief and ADHD was so destabilizing for me. It was like my brain exploded. The brain fog was so bad.

Grief, horrific for everybody. But I think for someone with ADHD who's experiencing that emotional dysregulation already, I had no idea how I was ever going to get through coping with those big emotions.

I was like, this is too much for my brain. I can't parent. I can't get through a work day and see these patients without just losing it. So when I was going through all of that

and I had a really tough time with that, because I knew I had ADHD. I mean, it was hard because I was like, this is tremendous. I felt like I was completely broken down and starting from scratch.

I was like, because I know how my brain works, I need to create systems that are very low-lift for me right now and find a way to rebuild that way. If I didn't have a diagnosis or an understanding of my brain, like this actually makes sense to be

or this is what I believe is going on, I think I would have just kept trying to do whatever one else told me to do, which didn't work. - Yeah. (upbeat music)

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with real time updates in iOS app. (upbeat music) - I'll tell you after he passed. I don't drink. I don't really do anything super interesting.

- I was just like, my brain is so loud. I wanted to be quiet right now. - Yeah. - It's not perfect. - Yeah.

- And I was just like, what can I do? I knew at that point, it was my emotional regulation. And I was looking for a way to medicate this. - Yes. - You needed relief.

- Yeah, and I was like, that isn't something that I can medicate. My brain is having a really hard time with things that are really big. And so I need to find safety to get through

these kind of moments. And my husband, his mom passed because of brain cancer years before.

So he was really well first and supported all of us through it.

He kind of saw what I needed and helped me through that moment.

“But I think if I didn't know about ADHD,”

I would have ended up in a really weird spot. - Yeah, I believe that makes a lot of sense. Okay, now back to the male female differences. And my hunch was that the original criteria was probably just addressing the boy issues.

And you thought you agreed. So how do they express differently? - Going back to boys getting diagnosed way earlier, then females typically boys present with more of the hyperactive symptomology.

So they're the ones who are causing problems in the classroom. They are disruptive. They're getting up in the class. They're bothering others.

- Which is probably why you got diagnosed early 'cause you were behaving like that. - Yeah, yeah, yeah, yeah. - Absolutely. And I think about that a lot and I'm like,

I'm actually pretty grateful for that presentation. Because I got picked up. But girls on the other hand are mostly in attentive. They're like the daydreamers that are spacing out in class and they're doodling.

So those girls are pleasures to have in class. They're not bothering anybody. They're getting passed along. And then what happens is as the external pressures rise and as they're doing harder things,

as they're doing more adult things, like getting into relationships,

Your needs exponentially increase and what is demanded of you increases

“and you just aren't able to cope anymore.”

And then it feels very much like a breaking point. Two other reasons that people assign female at birth don't get diagnosed. Number one is a hormonal part of all of this. When women are going through hormonal shifts,

when your estrogen is dropping, your dopamine drops also your symptoms get worse. Now, these women or girls

who are going through their first periods or things like that,

their ADHD symptoms are 10 out of 10. Horrible and they're going through all of these intentional issues. They're also going through emotional dysregulation 'cause they're like, what do I do?

My dopamine's all off. And that's when they're like, she's bitchy because they're per period. Right. You want your period?

Yeah, I saw post of years that was like 30% PMS symptoms for ADHD girls versus 10% for the general pop. It's significant.

“Wait, when you feel at 30% more, is that what you're saying?”

It's more common. PMDD is significantly more common in the ADHD population. It sucks because you're in a situation where you're like,

okay, well, my mood is already garbage around that time

before my period. But now I can't focus and I can't do the things I want to do and it's even harder for me to emotionally deal with it. Like it doesn't seem fair. So that's another huge one.

And then the last one is quite literally just, I'm not trying to get political here or it's not even political. But there is a societal difference in expectations for females. The females are expected to kind of tow the line and mask. So what is acceptable for a boy to be doing class

is very unacceptable for a girl. So the girl now learns to hide that behavior. So then what happens is that this high achieving, very capable student or child goes through life. They are now getting applauded for masking their stuff.

And so when at times it becomes overwhelming and they can't, people are like, what's wrong with you? Why are you so emotional? What's happening?

Why are things falling apart?

Why are you breaking down a word? It feels like such a huge shift in their baseline functioning. But really, they're just busting their ass trying to feel and look normal. Yeah.

OK, I want to ask if these things I've heard anecdotally are around the digital campfire are, in fact, people to ADHD over indexing. So there's a rejection. That's sort of dysphoria?

Yeah, tell me about that. I would love to tell you about that. So I've become obsessed with that. Since my dad was sick, I mean, I was just like, what's happening?

Why am I so sensitive to certain things? So rejection sensitive dysphoria is the very, very real emotional sometimes physical pain that comes from real or perceived rejection or criticism. So someone criticizes you or you think

that that's happening. And all of a sudden, you can't stop thinking about it. You're beating yourself up about it. No one likes getting rejected. That's not it.

I have told my husband, it is like someone sucked the air out of my lungs. It feels that's negative to me, rejection sensitive dysphoria.

“I think it's so important to recognize and to know about”

because it's so hard for the person who's experiencing. It's also so hard for the people around that person. Oh, yeah. The relationship to around them. Oh, my God.

So when my husband and I get into fights, I'm so sensitive that if I know we're kind of beefing with each other, he'll look at me and I will just start crying and then I will chase them around the house. And I'm like, and another thing is show out.

Because I feel like this urgency that I have to resolve this so that this feeling goes away. This is the email, right? Yes. So what do we do?

I'm not an effective communicator when I'm in that state. I'm emotional and I'm angry and I'm scared and I'm sad. And all of the things all it wants. And it's too much right in that moment. So what I do is I literally write an email and I draft it

and I draft it and usually take three or four passes because I'm like, that's not what I want to say. So already by the end of it, I've come down pretty significantly. You've regulated a bit. Yeah, because I've had this like, safe place.

The safety of my laptop, I'm like, this is my happy place. I can write this down and I can take as many tries as I want to make it sound the way I want. Then I send it off to him and we have a whole folder of this. Usually I'll send him a text message and I said,

do something, he'll read it and then he will think about it and process it and usually by that time I'm like, I'm going to just go somewhere else. I also go sit in the closet or I'll go sit in the car or I'll go and hang out with the kids.

I don't want to be around him because I'm looking for as he's reading at what it's face is doing. And so then what he'll do is he'll respond to it and he'll make pizza rolls and then he'll put it out. And then we'll have like a fun snack and we'll talk about it

and then we'll be done and it's the best system we've ever had.

This exists in my relationship and my need jerk is we are good

enough communicators and we are smart enough and we've all done enough work that we can sit down and talk about this. That's where I come from it feels like a failure that we would have to be texting each other or emailing. But then here in you say that I was like, I also must admit,

it does go smoother if those couple steps happen before we can front something verbally. I'm happy to be relieved of the shame of us failing and being great at talking immediately, I guess. I don't know how people do talk immediately.

“Whether it's ADHD or not, I think time is kind of important.”

Time and giving yourself that space to regulate before you come into and like try to resolve the situation because otherwise this is so messed up, but I think I'm realizing now that if I come off of an argument and I want to address it right away, I want to show him how hurt I feel and how badly that hurt and it's not

about resolving it exactly. It's about wallowing it and then I get angry or it matters.

I mean, it's possible to agitate it.

It's the whole thing. Yeah. How about this inflated sense of justice or this inflated discomfort within justice? So it's not a clinical term.

You see it a lot in autism as well. But it has to do with like rigidity being very rigid and having a set expectation in your brain and then having it not come to fruition in the way that you planned. I think that's kind of where it stems from and so they're looking at

like a huge gamut of presentations of ADHD. So there's some people who in order to maintain their ADHD, they have become very rigid about things. They have built these structures for themselves where it's like, this is how it has to be because this is how I can function.

Right. That's where I can have compassion for it is you're very easily dysregulated. You somehow learn this about yourself. Whether you're conscious of it or not.

And yes, the more things that you can map out and plan out and control the less chance you'll have at dysregulation. So I'm sympathetic to it. My thing is like the airport. All my character defects come out at the airport because I mean

“I ask to cooperate with the TSA to do things that I think are”

illogical or make no sense. I'm powerless. People are taking photos of us. I don't like that. They might be taking pictures of my kids.

Just speak storm of things. And I do a pretty effective job of controlling my day. You know, normally. And so yes, I have learned that before we leave to the airport for the best outcome, I have to have that expectation that helps

me enormously just go like, okay, we're going to get there and some guys going to tell you to hold your pants up and also hold your hands over your head at the same time, what you know is impossible. People are going to take pictures.

They're curious. Get over that. But if I walk in ill prepared or unprepared for what's going to happen, that's when some massive dysregulation happens pretty quickly.

Yeah, we're all trying to get by. There's some brains that are just more sensitive to these things than others. Do you ever spend any of your time or focus thinking about the evolutionary aspect of it?

I do wonder if this would even be a quote, condition without

the incredible amount of stimulation.

What do you think about that? There's been some thought about if we're looking at ADG, just from evolutionary perspective. And we're looking at hunters versus gathers. ADG, see people are the people who are going off and they're

hunting and they're doing these things that involve risk and adaptation and impulsivity to some degree. Novelty seeking. Yeah, and they're great at that. And now we're putting that same group of people that would thrive

in that environment in a new environment. And I don't necessarily think it is, well, maybe it is due to all the stimulation.

“But I think it is just society, adapts and evolves based on”

what its needs are. And the needs are there is just a much larger neurotypical population. And so the world is built for a neurotypical. Now you're expecting this population of people whose brains are

wired differently to occupy space in a world that just wasn't built for them. And a really easy example of that is for ADGs. A lot of people have delayed militant and onset. So their brains don't feel a normal.

I feel sleepy at 10. And then I'm going to wake up at 7. Theirs are like, I want to go to sleep at 1. And I would love to wake up at 10 a.m. But that's not where society runs.

You've missed three hours of meetings already. Yeah, you're right. There was a lot of different outlets for a lot of different types of brains before. But we have really homogenized the work experience, which is you go to a box.

You sit in a chair. You do this thing. There's not like, oh, yeah, why don't you go explore it over that other peak? Will weave the baskets where more app to sit here and weave these baskets?

You know, everyone has a bit of an outlet. Now it's like, no, no, everyone's supposed to wake up at 6. Everyone's supposed to do this in that. So you had fun only in this all into the same thing. There's going to be a lot of tension there.

I think it's tough because you are expecting people as you're growing up

So you're already kind of starting off at a deficit. And then, you know, you hit a delta and they're like, okay, Ben, for yourself. You haven't really had time to build good skills. Unless you've actually really dialed down under 280 HD, learn how to make accommodations for yourself.

It's kind of like, you're going through this environment that you never

really figured out with schooling. You never really grabbed hold of it.

“And then now you're an adult and you have to figure out what to do with it.”

But you don't have any of those foundational skill sets. What do you think about the fact that so many people, especially from social media and stuff are self-diagnosing? I have a problem with that. And this comes up a lot on the show.

That's partly what we were so excited to have you. But I think it's a problem that so many people are walking around saying, I have ADHD when they don't know if they have it or they think they have it based on what they've seen because for me, I'm like, well, what about the people who really have it?

To me that takes away from it is something happening in your brain. A neurodevelopmental condition. Right.

What are your thoughts on that?

So I kind of have a hot take on that. And my hot take is that I think self-diagnosis is actually good to a point. And the reason for that, and I'll tell you what the point is, too. I think that it is incredibly valid to have someone learn about what is happening in their brain, find things out on social media or in books or in literature or research that looks

like them and grab hold that and start learning, verbage of how to describe their own internal environment. I think that's a wonderful thing. And I think that that can be a wonderful stepping stone to accessing care. And I know that's not an accessible step for a lot of people, but that next step.

I have problems with it when it moves from self-diagnosis to the medication standpoint. That's really where I start to draw the line because when you start trying to treat yourself, you haven't done the exclusionary kind of thing to figure out what else is going on. And medications of any type, they're not without risk. You're doing things that could potentially impact other things in big ways.

So if you think you have ADHD and you want to learn behavioral strategies that help

an ADHD brain, go for it, man, my hunch on Akka is that your issue is much more.

The person who says, I have ADHD so deal with this using it as an excuse. I don't think you would ever have a problem with someone going, I think I have ADHD. So wow, I should explore these tools that have been shown to work really well with ADHD. Let me try them. Great.

These are helping.

“I think your fear is probably more like, I proclaimed I'm this and you have to lower your expectations”

of me now. Yeah. Exactly. Obviously if someone's like, oh, I think I have it. I'm going to do research and learn about it and figure out how to help myself.

That's amazing. That's what I would want for everyone. But that to me is not what's happening. I think people are saying, I have it. And so I'm late.

And I think the reason I don't have an issue with it is I come from a background where alcohol itself diagnosed. That is the full premise. No one can tell you you're an alcoholic, you have to tell yourself you're an alcoholic. And then you have these steps that you're disposed of if you want to try this.

And no one's declaring, I'm an alcoholic. So deal with the fact that it didn't come to work. So for me, the association with the self diagnosis is very positive. I think you're right. If you're using ADHD as an excuse and if you're saying, I can't do this and you don't

have a formal diagnosis for someone who does have ADHD, that can be extremely irritating. Yeah. And I've been guilty about where people have said that and I'm like, you don't want to smoke. You can't possibly know like I do at the end of the day, I have no way of knowing that.

I have no way of knowing what's going on in the feeling. Yeah. You don't know. What their dysfunction is, I don't know. So I've tried to peel that back and figure out and look at what is this bothering me so

much, but using self diagnosis as a tool to get steps to get a formal diagnosis or get more access to knowledge about things and research about things so you can learn about your internal environment. I think that there is a huge space for lived experience of talking about that. Yeah.

You're here for someone to be like, I have ADHD, I have time, blindness, don't ever expect me to be on time. Yeah. And that happens. And it's like, guys, I don't want to be on time either.

But I think it should be more like, I have ADHD. Yeah. I think I relate to this time blindness thing. What are the two three best tools? Yes.

Because I know I do have to be on time places. We all have stuff and we have to figure out how to live in this world. You know, we're not islands.

“That's why I'm going to just quickly say neurotypical bullshit as well.”

It's the same reason the ESM has fucked up because it has some premise of normal, which simply doesn't exist. There may be people who don't have something going on. There's a lot of people. We're all very above.

And I think the neurodivergent terminology, it was like a psychological turn that came out in the 90s. And it was really this umbrella term to talk about autism and ADHD and all of these other

That's why our typical was just kind of like a byproduct. What's the opposite of this? You do some as problems. Yeah. Yeah.

How do stimulants work? Why is that an effective medication? This is a weird area of medicine because it's not this cut and dried mechanism. So basically, where a majority of that deficit happens is that frontal lobes, so directly underneath your forehead, that's where all that executive function judgment processing happens.

So what a stimulant does from just like a very rudimentary perspective, if your brain

has a million different things going on, going different times, because of that underlying

dopamine and orp and effort and dysregulation. So everything is just floating pad in an incredible space. You can take a stimulant, a riddle and derivative, something in that family. And it actually works a little bit counterintuitively because it slows things down. And really, it's not that it's slowing things down.

It just speeds everything up to match what's going on with your brain. It like synchronizes it almost. Yeah, it is very counterintuitive. I very much feel like I would benefit, but I also know I can't be on that. Oh my god, there's so many better things than being on a stimulant.

Yeah. Oh, okay. So here's the deal. If you're trading ADHD, you could do it behaviorally or you could do it medicinally.

And with medicine for ADHD, they're stimulants and they're non-stimulants.

And so the stimulants are whatever one thinks of and they're our gold standard right now because they work well, they work reliably and you could tell pretty quickly, is this going to work or is this not going to work? Those are things like Adrold derivatives, riddle and derivatives. Those are all part of that class.

But for a lot of people with ADHD, stimulants, even the long acting ones, they'll give you like a six to eight hour coverage. But ADHD exists outside of that six to eight hours.

“So then it's like, what are we doing for the rest of that?”

So non-stimulants, a lot of them give you a 24 hour coverage for the great majority. They're either fall under the category of an antidepressant or a blood pressure medication or some other class. Interesting. And you are getting additional benefits.

So for those people who have ADHD who are also anxious, there's a medication that's helping to eat ADHD, well, it is a blood pressure medication. So there's long acting formulations of blood pressure medications that can help with anxiety and ADHD. Or you do an antidepressant which is going to help with depression and anxiety and ADHD.

Or you can do something long acting that people take for shift work disorder. So it really depends on what you need and what you're looking for and what else is happening at the same time. But for a lot of people, when they're coming to the doctor, they're assuming, if I have ADHD, I need to be on a stimulant.

I need to be on five ants, I need to be on AdRoll, I need to be on Briblin, and 90% of the time.

That's not the direction we're starting at because I always tell people, we need to build

skills. So we need to work on that. If that's not possible because your ADHD is dysregulating everything, we need to give a medication that's going to give 24 hour coverage as much as possible so that you have a chance to kind of see and build.

For some people who just that diagnosis immediately lifts them, it gives them the permission to study and make changes and do those things that they don't need to be on medication.

“So it's not like an absolute, you have to be on medication to treat your ADHD.”

But there are a lot of people that in order to build and cement those habits, they need to be on medication and that's also incredibly valid, it just depends on how your brain is wired. Your first book, SelfCare, for people with ADHD, you have over a hundred tips. It's fast moving.

It's for an ADHD brain to read this book. Just a little page long place. I can tell you my favorite one in that book and it's due a headstand. That's not the one that's going to work the best or anything. It's just the weirdest one.

But there is something about that change. What you're doing something weird, how I figured this out is when I was in medical school when I was studying for organic chemistry, it was just so boring to me. I was like, I can't do this anymore. My mom would be like, just do something to change your position or just do something to

distract yourself a little bit and it was that inversion of a headstand. That's hilarious, not necessarily the most impactful, but that's one.

“If you're bored in the middle of stuff, another one, I think that is important.”

So the book is broken up into separate areas and it breaks it down in terms of emotional self-care, physical, self-care, professional, self-care, all of those other things. I think if I were to pick from those, because some of that book is also things like giving yourself permission to grieve if you haven't gotten a diagnosis, because a lot of these people are coming to a diagnosis late in life.

I'm done with the career portion of my life. I'm done with the child-rearing portion. I missed on so much and now I'm having to grieve this diagnosis. I bet there's a feeling of, oh, man, I could have blank, which is heartbreaking. It's hard, but you know what I tell patients who are in that position is that this whole time,

this whole time and so now it's what you do with it and it's what you make of it with this new opportunity and so you wouldn't have built those skills that you needed if things were different potentially.

“Another very, very important one is just making time for physical activity.”

I feel like such a hypocrite because I hate exercise. I think it sucks. It's so boring and it's so hard for me to motivate myself, but it truly does make my brain work better. Let's talk about the forthcoming book that will be out.

That's called "Correctative," two sensitive rejection resilience and the science of feeling deeply. I like this. So it's exclusively ADHD because this feels like this could encompass more than just ADHD. No, it's not.

It's exclusively, but you know, the thing about like we were talking about rejection says it was for you, almost 100% of people with ADHD have projections. I feel like I am ADHD now. [laughter] I have that pipe of contract.

[laughter] I really have all this. I know that I don't know. I don't know. I don't know.

I don't know. But I do have that. So the concept of rejection since it was for you. I started writing this book when I was all dysregulated with my dad. It came about during that time and I was like, this is the word.

My first part of my ADHD.

My emotional dysregulation. This is the thing that will bring me to my knees every time. If I can't focus or if I can't do things, I'll make a hack around it or I'll delegate. I can't delegate someone to take care of my emotions. Yeah.

I thought I'm like, there has to be a better way to think about this and learn about it and talk about it.

“And I think that's why I have so much beef with the DSM.”

By the way, you're upchanged their criteria in 2019 to include emotional dysregulation as part of a core component. We haven't. And so I look at it like say your diabetes. So bad that you started to lose your vision.

Now instead of someone being like, oh, okay, well let's fix your diabetes. They're like, no, no, okay, let's just give you glasses. Let's treat anxiety and depression instead of treating the underlying diabetes. The underlying diabetes is ADHD and the anxiety and the depression and the rejection sensitivity and the emotional dysregulation.

That's what's causing the vision loss. Right. It's a symptom. Not the cause. Yes.

It's a core part of it. It's not a separate diagnosis. And so if we don't get on top of this, what happens and I've seen it so many times is that for women in particular, I'm seeing women who are on antidepressant number six or seven.

They're coming to me and they're like, I don't know what to do anymore. I think I've ADHD. Did you talk to someone about this? Yes. I've talked to my doctor for years.

What did they say?

The first thing that they're going to hear is they're going to say, well, you're doing

too well. There's no way you could have ADHD. The second thing they're going to hear is, no, it's anxiety and depression. Let's treat that first. The third thing they're going to hear is after their six or seven antidepressants in,

then they're going to say, listen, these antidepressants aren't working, can I please look into ADHD? They're going to be like, we can't treat ADHD until you're anxiety and depression are clear. These people aren't getting help and it's because emotional dysregulation isn't in

the criteria. They haven't loved one who has come to this late in life and it's so fucking impressive because they've done it without any help on their own, but they said to me, I finally realized that I'm processing everything different than everyone else around me. And I'm realizing that these really crazed states I am going through are that thing.

Yeah. It's not fixed, but it has helped me go, oh, that things happening and no one else around you is really experiencing it. So if I pop off now at work or try to let everyone know, hey, they don't care because they're not experiencing it.

And this is without any help from anybody, just as ability to go, oh, that things happening is incredibly powerful. It really, I feel like it takes a lot of the heft of it away. It probably gives you a little bit more agency.

The way that this book is set up, the first part of it is truly just the science behind.

And a lot of the evolutionary perspective and just like the history of it, how it came about, the neurobiology, what is actually happening, what areas of the brain are being triggered that amygdala is being hyperactive because it's assessing threats all the time, even though it's not appropriate. And then the second part of the book is how deeply do you feel, so it's actually an assessment

where you can actually walk through and be like, is this me? Where do I fall? It's broken down into like, you're probably in a spot where emotional sensitivity isn't a huge issue.

“You should read this if it applies to other people who love, so you have better understanding.”

Or this probably does apply to you, maybe it's not all the time. Or this is probably you. This is probably something that's pretty significant, but you haven't had really all that much of a verbage for it because we don't talk about it. And then it goes into the tools you use.

There's just 12 tools that you use. And then the last part of the book, which is my favorite, are real world examples of how

So it's a quote, and then it is what's happening in your brain, and then how you get out

of that moment.

“So when I was researching, I was pulling all these different psychological principles and”

like, what actually does work, so this is just an amalgamation of all of those principles together to actually help with the select thing. Yeah, I mean, I can immediately think of several people I can't wait to buy it for, which will be triggering, but then, I can't decide on the covers. It goes, can help me with that.

Oh. When you see it on your and I stand, don't be triggered. Well, Sasha, this has been a blast. You have a very popular Instagram account that would be very fun for people to go through because I think a lot of stuff would feel quite familiar as you describe it.

Oh, there was one last thing selfishly I wanted you to talk about, and that is parenting with ADHD. What can you tell me about that? It's hard. It's hard.

Parenting with ADHD is a huge expansion of what your needs are, because not only are you

having to manage your own brain, you're having to manage and guide little people's brains as well. Tell them, regulate. That's really your job. Yes.

If you're from the logistical standpoint, it feels like it's just a lot to do. My kids are in two separate classes, which is two different class party schedules, two different field trip schedules, and two different teachers, and end of school things, and parent teacher conferences. And that probably doesn't sound super overwhelming, but that's so hard for me to keep

“track of it, which one is this, which one is this, and you have to really create good systems”

around that. And I think the most, most vital thing that I could tell anybody who is parenting with an ADHD brain, give yourself grace, let yourself mess up and have a hard time, because when I got pregnant, I had numerous Pinterest boards of the kind of parent I wanted to

be, like what I wanted their nursery to look like.

Immediately, you had this kid, you're sleep deprived, you have breast milk everywhere. This is not what you thought it was. And that goes out the window, and you're just like, this is probably going to be harder than what I thought. And one of the best things that we've done as a family is work through moments that are

hard and difficult to kind of together as a team and problem solving. So there are times this literally happened two days ago, where I was just like, this is hard. Oh, good, there is so much, so when you give me a show and tell bag, and you're like, I have to do this by tomorrow, and it's 8.30 at night right before you're going to

bed, you run downstairs, and you're like, I forgot to do this, and I have to bring it in the morning. That's hard for me. And I'll do that, but this is why I snapped at that, or this is why I had a hard time here. And then when I tell my kids, when we have conversations like that, like, any ideas

is a good idea, come up with solutions, and let's talk about it, and so they were wrongs solving. They're like, well, he could have turned in his bags you earlier today, well, he could have figured out what he wanted to put in there. And siblings are great at coming up with ideas for the other siblings.

I don't know when he put that, I don't know how many good ideas. I'm great at figuring out what they should have done, and why they can see right through the problem in their sister.

“Yeah, I think it's just giving yourself grace when you mess up, use it as a learning”

opportunity for everybody. I think I was so focused on hiding parts of myself from them, where I'm like, what am I doing? I don't know what their brain is like. Well, when you're a symmetric rejection reaction, you can feel rejected from your

family. You can feel right there. Yeah, yeah. Getting burned by my five-year-olds, yes, I feel like it's that here we are. Okay.

Well, this was lovely. Cannot wait for the new book. Currently, though, you could start with self-care for people with ADHD, and then look forward to sensitive rejection resilience and the science of feeling deeply, I hope you come back.

This was a blast. Yay. Stay tuned for more armchair experts if you dare. We hope you enjoyed this episode, unfortunately, they made some mistakes. I have to say I'm only three days into no dairy and I'm already noticing.

I hate it. Well, that's good. Well, saying last night, I almost would rather have a runny nose all the time. You have to, yeah, decide, I guess. Ah.

The worst one you know, it's better to live in English. That's true. That's true. Just go. I'm just someone with a runny nose.

I know. Ah. Well, then you can pick, like, if there's something you really want with cheese and you just know what you're getting yourself into. You just go, okay, I'm going to cough for a day.

Yeah, exactly. I'm going to blow my nose a lot. Exactly. And that's going to be that. Yeah.

Well, but also, good, if you know you don't want to be coughing, if you have a big

a living. Yeah. Yeah, yeah, yeah.

“Someone's got to edit around your coughing and to explain you.”

Sure. Sure. That. That's good to know. Never.

I mean, never say never.

If I had to, I guess I would, but I could never give up cheese and see, it's my favorite

food. It's so good. And it makes, it can make something that's virtually tasteless. Like a macaroni noodle on its own in a box of crap. Not saying cheese.

Not saying cheese. You're not going to eat that. You add that cheese to it. Now you've got one of nature's greatest experience. That's best.

Best. Best. And to tell you that in a very fun way, Lincoln has now kind of joined a little bit into our sim talk in so far as we were laying in bed a couple nights ago, and she was telling a story about a girl in class had a caterpillar on her shoulder.

Okay. And apparently there's like a season for this. And there's caterpillars all over the trees at school and they're dripping down on people. Oh, okay.

That just made me feel gross.

And then we were just talking about caterpillars. And not all of a sudden, I just had this thought and I said, you know, Lincoln, when we die and we wake up in like a medical room and they go, you were in a simulation.

“I think one of the things they're going to say is, and by the way, you thought that there”

was a tiny little sleeve of mayonnaise and that that little sleeve of mayonnaise went into a dark cloth and came out as a butterfly. And you bought it. You don't buy it. Oh, God.

That's what it is. A caterpillar is just a little tube of mayonnaise and we have bought into the idea that that thing runs into a bug. Somehow goes into a dark cloth and comes out as a butterfly is preposterous. Well, we're talking about like the bus maybe is proof of the sim.

I now think the caterpillar butterfly metamorphosis story we've been told is insane. How would it go from mayonnaise to a butterfly? Well, how would a seed this small turn into you? Oh, the like the embryo?

Yeah, it starts as a a sesame seed size.

I know that's crazy. That is crazy. But I don't think is nuts is like a little tube of goo goes into a cloth and is now a flying, most beautiful colorful structure. Where's it all coming from, man?

And we don't call it that is so nasty. Oh, my God.

“Then we're having a lot of fun with what else they are going to say to us like,”

you guys, he's not an octopus could swim over an environment and immediately become that environment without even looking their eyes are looking up at the surface of the water and then they just hover over some coral and then they're whole body immediately is the color of the coral. So camouflage, real, real, beings are very impressive.

Is there anyone you want to add to this one? So right now it's like leading the charge is like butterflies. We're going to feel so stupid that we bought into that and then for us the octopi, camouflage, amazing. If you watched it recently, it's in Monica, it could swim over your face and it would

just be your face. Really talking about. Really? Yeah, the camouflage. Is that the bioluminescence or whatever the thing? It's called, it's identical to whatever it's swimming over.

No way. It's not LCD, TV. It is. It is. They're telling us it is.

Also, TV. I mean, all of it. It's all. It's. TV.

I'm fine with it. No. TV. It's a prehistoric globagu. Globagu.

Well. Okay, you're fine with it. Well, I mean, I just think humans is, that's a bigger, to me that's a bigger leap from going from a sesame seed to you is bigger to me than the man A is God. But at least the thing is cell dividing and it's taking on building blocks through nutrition

to create the new cells and you can just see the course of action. It's like it's doubling every time it divides. It's very crackable. This sesame seed will know I, nothing. It's a human.

Yeah. It's wild. It's wild. But again, this gooey slug enters a cloth and then it flies away. Okay.

Okay. You're not as perplexed by it, but I just think it's one of the, it's a miracle. It's one of the hardest to believe things that happens in nature. Yeah. I mean, there's some things like lady bugs that I don't like, but have grown to like

a little more. Okay. What are they doing then? So it started to lead really just the way they look. It's like, wow, or like same with fruits or like the pineapple.

on it and the sweeten it like, I know, but I'm struggling with it.

You know, okay. You're not letting me. The gap between these two organisms. If you were to like, you just look at all in nature and we didn't know that those were the same things.

They'd be two of the last things you ever even put in a category, a caterpillar and a butterfly. It's like an elephant going under a cloth and coming out as a rattlesnake. Yeah. Okay. You don't like my examples or not my examples are just things that I find like wild about

the world. Yeah. You're really blown away with growth. Yeah.

“And like the lady bug doesn't grow, it just is very, it's just, how is it?”

Red with polka. It like nature made polka dots like perfect polka dots like on top, like on an, on an insect, like what that doesn't even make sense. It is crazy. And then if it turned into a screwdriver at some point, sure, you feel like hold, hold on.

I guess, yeah. I don't have that. I'm not that, I'll be wildered by Metamorphosis. Yeah, because because of the seed turning into you, like I'm primed with that and that. Yeah.

My distinction is like it was one thing and now it's another, at least the seed was

always a human, you know?

Well, the butterfly was always a caterpillar at, it just, it's what they're trying to tell us. That's what they want us to believe. Yeah. I mean, yes.

The Sim is crazy. It is. I mean, what about magic? We're going to feel foolish. You're going to feel foolish because you're going to be like, they're going to be like,

no, that was magic. Like those tricks that David Blended aren't tricks. That's magic. And like, you spent so much time trying to figure out what, what were the tricks and there are no tricks.

Yeah.

“I mean, as you know, I spent no time trying to figure it out because I know why can't”

figure it out. And I know it's not magic. Yeah, but you're going to find out it's magic. Oh, we were playing 32 questions last night at dinner. Oh, no.

And Delta really stumbled upon one.

Now, it was, I would argue that she was wrong on both fronts.

But one of the questions was, oh, is it man made? Oh, okay. Or is it from nature? Okay. I like that.

Yeah. And so it wasn't man made. We figured that out early. And then later on the line, there's not from nature. And so I kind of bailed out of the game.

So I'm, well, if it's not man, it's not from nature, then it can't be anything. Okay. Right. There's nothing. Nothing.

Let me think. Not man made. It didn't happen. It didn't happen. Nature.

Did she mean like, caught in or something, that is nature. But like, I could see her think like, well, what it was was weirdly. It was both nature and main, which is maybe why she didn't think it was either. An eyelash. Oh.

So that's both nature and man made. That feels like she stumbled upon her riddle. Oh. That is a good riddle. Yeah.

What's man made? Man made and. Nate from nature. Man from nature. And eyelash.

Although she said it was neither. Yeah. She meant it. Yeah. But I can understand why she said neither.

Is it man made? No. At that moment. She was like, no, no. The body made it.

Nature made it. Right. And then is it from nature and is like, no, it's human made. Sure. Sure.

Well, yeah. Yeah, interesting. That's a fun game. Yeah. It was. It's fun for a while.

I bail out pretty early. My, my, my, my attrition for 30 questions is. Is brief. Okay. Once we, like, I guess I just, I lose.

I lose. Hope. Again, when I heard it's not man made and it's not from nature. I'm like, well, then, I can't continue to get. I'm doing running the fool's errand now.

Oh, wow. Because there's nothing that is not either one of those things. Okay. Okay. Yeah.

Comment if you can think of something that's neither. That's a riddle. Well, it's not really a riddle. It's just a hard question. Would we say, like, thoughts or man made?

Well, I guess it depends on how we're, how we're saying man made. If we're saying, if we can't exist without a, a, a human. Mm. Okay.

Like, a wrench doesn't exist in nature. Yeah. Exactly. And that's, but a man didn't, can, like, guess, construct thoughts. But it's more abstract than that.

They didn't invent thoughts.

“I think it's an example of it's both in that case, because it is the human thought.”

Like, what's, is, is human thought man made or nature made? Yeah. And it's both. Or neither. [laughs]

Or I'll play with Delta. Stay tuned for more armchair experts.

[music] Let's play. Play. Are you two questions?

Why don't you want to play?

Okay. You have something? No. You have to do it. No.

Oh. Okay. Think of something. Okay. Is it man made?

Yes. Would it be sold at Walmart? Yes. Is it smaller than a microwave? Yes.

Is it for personal hygiene? No. Do you plug it in? No. Okay.

It's smaller than a microwave. You don't plug it in. They sell it at Walmart. This is where you give up.

“We're getting clothes to where I would give up.”

Okay. Rob, do you have any questions? Is it food related? No. No.

Okay. So we're not eating it smaller than a microwave. Is it bigger than an iPhone? No. Wow.

Okay. Great. We just really got.

So it's kind of microscopic.

No. They sell it. It's smaller than an iPhone. It's not personal hygiene and it's not electric. Is it a pen?

No. Is it home improvement related? No. Would it be in your living room? Um.

I would say no. Like would it be in your kitchen? Um. Not traditionally. Would it be in your bathroom?

No. But to be in your closet. Could be in your closet. Could be in your closet. Your nightstand?

It. You. Yeah. I'd probably put it in my nightstand. Wow.

Not electric. Well, don't plugged in. Is it battery powered? Um. I think.

It's not plugged in. And. But it's. It has an electronic. It's electronic.

Is it electronic? Yeah. Is it a vibrator? No. We were led there.

Yeah. Nightstand. Yeah. It has a battery. Smaller than an iPhone.

“These days you do plug in your vibrator.”

For a period. Yeah. They're not tethered. Right. Correct.

If you've got one that's tethered, my tip my hat to you. What? What? You're running out of voltage. Yeah.

Um. Um. No. It's not a remote. But you're kind of in.

They're in the right zone. And in the nightstand. Not a remote. Not a vibrator. Is electric.

I mean, I don't know if it's a lot. God. I don't know if it's a lot. I don't know if it's a lot. Okay.

Can be. It can be. Oh, wow. Now I'm picturing a nightstand drawer. I mean, don't get so stuck in the nightstand.

It just, it could be there. Okay. And you said it is a original electric. It can't be. Battery.

Let's say it has battery. Does it tell time? Um. Is it a watch? Close.

Very, very close. And some would say it's a kind of. An apple watch? No.

“Like one of those fucking rings you wear, like a or health monitoring.”

I think a little more archaic. Stop. Yes. Stopwatch. Good job.

A stopwatch. Yeah. Do you have a stopwatch? I have one in my nightstand. You see.

Okay. You have a stopwatch. Oh. Oh. No.

Stopwatch. Um. Let me just think of a stopwatch. Uh. Because there's a stopwatch where.

Uh, using in. At the saddle. Uh. Top of mind. That's okay.

Okay. I mean, I feel like I keep it in the nightstand. Or I keep it. Um. You know.

Yeah. And the garage toolbox. I'm going to meditate and why the game for me. Get frustrating. Okay.

Probably just because I don't know. And I don't like not knowing. Sure. Probably. Calvin likes and it's frustrating for me too.

Yeah. It's hard, right? Especially when you.

I'm not sure he's always answering correctly.

Yeah. I have the same an as a male thing. I'm like suspicious that either they forgot or. Yeah. Like, Vinnie, we can't play with because he's.

He'll just change it. Yeah. Yeah. That's the other thing. You catch these kids change in it.

Like, if you guess it too quick, they don't like that. Yeah. Sure. And it's. What should happen is it should be written down on a piece of paper to keep everything

above board. Well, I mean, playing with kids is different than playing with adults. Like, I think if you play with kids. Sure. It could be a little like, are they switching it?

Yeah. Do they remember? I mean, a lot of the time, like, this is a long game. Yeah. And I'm sure if they remember.

Sure. But if you're playing with an adult and you don't trust it.

That's on you. Uh-huh. Okay. Adults know what they're doing. Yeah.

Whether or not they would change it as another thing. There is some legion of people that would change it. Sure. But if they don't know the answers, like, that's like a little like, you know. It was very easy when they were tiny children.

Yeah. Because you knew or something they could see in the room. Of course. Yeah. Yeah.

Yeah. You could narrow it down pretty quick. Yeah. Is it a light switch? Yeah.

It's because they look at it immediately, too. Wow. Every time you ask. Is it brown? No.

Yeah. I know. So cute. See the little caterpillars turning into butterflies. Mm.

All over the place. All right. Shall we do some facts? Okay. I didn't bring it up in the interview, although I was tempted to.

What? You know Sasha holds a very dear. Oh. It's a very important name to me. It is.

That's a U.S. It's a light wind. Oh yeah.

That's your first girlfriend.

It's definitely not. Say that to Sasha.

“Was that that was your first girlfriend or the first you had a crush on?”

We're getting close. It's so relevant to my therapist remembered her name. Is this because she had the sauna? No. That was Randy.

That was later. Okay. So your elementary school could not. No, no girls like me. And I like so many girls.

I just don't doubt that it's the other day. Yeah. I like so many girls. None of them like me. I got a sixth grade with my new look.

No, my brother. Right, right, right, right. And that most popular girl in the whole junior high. Yeah. Sasha Crossed.

Okay. Was an eighth grader. Yeah. I knew she was an eighth grader. Came up and gave me a note in the hallway.

In the sixth grade hall. Okay. I took it into my science class and I opened it up and it said, will you go with me? So you dated? Yeah.

Yeah.

Did you get your first girlfriend?

I had it. I got to be careful. This is I'm going to call her Frank. Frank. I had it.

I got like a hang on time once. It was. Oh. Let's just wait. What happened?

I had a, I don't know if you'd call her a girlfriend. I had a girl who I think. You're talking to her. Yeah, a little bit. And I think I think on Valentine's Day.

Maybe I gave her something. Maybe she gave. I think I want to say she gave me some. Some fudge or something. But I, yeah.

I do remember her name.

“And the reason it's so important is it is a transition from no girls like me to the most popular”

girl in the world. I know. This was a humongous. The biggest one, 80 of my wife. That's huge.

I also think I was kind of right and saying your first girlfriend. Because I'm not counting this fudge girl. That's fine. That's fine. Yeah.

We made out. We made out. We would make out. And from the process. Did you, you didn't make out with fudge?

No. No. Yeah.

He was your first girlfriend.

Yes. Yes. And I guess I'm impressed. You didn't bring it up because. It's really important.

We have an interview to Sasha. No, we have it. No. I have only met one Sasha since then. Sasha Baron Cohen.

I guess, too. Thank you for pointing that out. Yeah. The other was a Russian dude. I knew.

Oh, sure. I know. All right. Well, Godmother's bookstore. You know, I was like, "It's in Monocido."

And then you guys were like, "Oh, son, I'm onocido. We're from there." Yeah. And then-- And then--

And then-- Okay.

“Which I think Rob said, "Summerland, Summerland."”

Oh, okay. And everyone was like, "Yeah, that's not Monocido." Okay. Which is fine. But then when I googled, I said, "Where is Godmother's bookstore?"

It said, "Godmother's bookstore is located." Two, two, eight, zero. Lillie Ave. I think Rob had said that. Because you said, "Lillie, that's her middle name."

Um, Summerland, California, founded by Jennifer Rudolf Lash and Victoria Jackson in 2024. Oh, it's pretty new. Oh, I see. It is situated in a restored 19,000. Also on his bar.

Victoria Jackson, the performer from Serena Life, Victoria Jackson. Who's that? A beautiful blonde cast mate in the late '80s. Oh, I don't know. I see her SNL.

Oh, no. It's a different Victoria Jackson. It's a cosmetics mogul. Cosmetics mogul. Okay, great.

With the renowned literary agent. Oh, well, it's situated in a restored 1920s bar. And often described as a cozy curated space near Monoceto. It says that. Near Monoceto, it does.

Open daily. You're having a hard time with this one. Yeah. You're having a hard time with this one. Yeah, a hard time with this one.

You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one.

You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one. You're having a hard time with this one.

It's such a cute book store. Oh, my God. I could live there. Oh, brand new too. Disappointing in here.

It feels old. Yeah. Timeless. I love it. Okay.

Now, you know how I was on D? Hmm. Suit up a different. Thank you, which is math. Um, precursor.

Does math eat alcohol? Just said he used to make it like a pack man. And it was like the math would eat the alcohol.

Does it? It doesn't eat alcohol.

But it gets you high, which offsets the inebriated effects of alcohol.

Okay. Because alcohol's such a depressing. So if you imagine you took a Xanx and then you took an Adderall. The Adderall would lift you out of the Xanx channel. Interesting.

And this is why people do speed balls, coke and heroin. They're opposites. So you're kind of leveling off both sides, both down sides of the drug. Okay. But I have a heroine does your nodding off.

It's not ideal. Coke your two edgy, uh, annoying on your face. You know. So I think that's what he means. Is it right sized as inebriation?

I don't think it metabolizes the alcohol in faster. Okay. So a cocaine is the same thing. Got it. All right.

“Um, what was the most popular Flynn Stone's vitamin flavor?”

Based on nostalgic discussions. The orange Flynn Stone's vitamin was widely considered. That's what I think of. Really, I'm, I was a red. I'm a red.

She liked great. I think they made orange really front and center in the ads. She says purple and in some cases the iron fortified versions were less popular due to taste. With some users describing purple as yuck.

Wow. Purple was my favorite. Oh. But you and Sasha could have shared vitamin. Oh, Valentine's.

That's cute. God, I loved him. Hmm. It says nothing about red. Um, I'm going to give you credit for something.

So you've been saying for a while that. God, more, my day is a expert in ADHD.

And I've never told you say it.

I've stopped myself from saying, is that true? I don't remember that. I know he is like a trauma expert. But I don't remember ADHD. So I thought this was my in.

Yeah, to correct. Yes. God or my day is a Canadian physician and author. He has worked in family practices and specializes in child development and trauma, including long term effects on physical and mental health, such as autoimmune diseases, cancer, ADHD, and addiction.

So it's in there. Yeah. It is circuitous path is if you remember when we interviewed them. Started working with the addicts and skid row there. Yes.

That wasn't his thing. But that became his thing. Yeah, exactly.

“I don't like Sapolsky being a fucking prime ental just as a hobby, you know?”

I think his addiction trauma stuff some more was his hobby. Right. But not always really known for that. Yeah, yeah. Yeah.

He's written five books, exploring topics such as ADHD, stress, developmental psychology, and addiction. Now, if you guys miss that episode, you really should go back. Yes. That is such a great episode we did with him. Oh, I guess I'd like to say one thing to Eric died, my friend.

Oh, yes. And he was such a beautiful dude. And I think it would Eric gain. Yeah, I think it would be a lovely episode to listen to. Yeah.

It's very serious about what kind of spirit Eric had. Yeah. I'm sorry. How are you doing? Well, I was talking to Lincoln about it.

And I said, I, well, first I go straight to like gratitude.

Right. Like I had a lot of, I was, when you hear someone as ALS, my worst nightmare of that would be. I have lock-in syndrome. Right. And although he was very, very diminished physically at the end, he couldn't move much of his body, if at all.

He could talk. Yeah. So he avoided that phase. So I just immediately, in the same way when my dad died, I felt grateful. Like it didn't get gruesome.

Yeah. So I was grateful for that. I know how many people around that made me grateful.

“And then the sadness, I think, for me, takes a minute.”

And I was talking last night to Lincoln. I said, I don't know. Imagine you came over from school today. Mom said, Dad died today. Don't.

Could you comprehend that? And she's like, no. I'm like, yeah, wouldn't it take you a long time? You be like, no, that's not true. That's not right.

And then months later, you were like, oh, wow, that really is true. That's, so I think I'm in that phase, which is it? Yeah. Is it now? Yeah.

I mean, intellectually, I know, but also. Yeah. No. I think that's totally normal. I think that's something.

Yeah. How most people processing is it takes it. I feel guilty about that. Like I see people in real life and in movies. They hear bad news.

And then they are immediately devastated. And I'm so protective, I think. I have so much like well-worn neural pathways that I'm like, I have so much shit that just engages right away to prevent me from feeling terrible. Yeah.

And I think it takes a while for me to be willing to let that in. Yeah. I think you shouldn't feel guilty about that. I think it's totally normal. And what's the problem?

But there's nothing wrong with this. No. Other than I think, well, my fear would be like, let's say I've been standing at

And then all of his friends were then they start crying and I don't.

“And now I appear to be sociable, you know, the sociable.”

That's like the fear probably. Right. Or that's on there. I watch these fucking date lines and the cop show up and I've witnessed something terrible and I'm kind of stable and they interpret that as guilt.

Right. Like these are the crazy thoughts I have about like, yes. But you're supposed to act. People expect you to act a certain way.

And if you don't, they start filling in explanations as to why you're not reacting

the way they do. I know. Other people that's on those people who are deciding that everyone should be reacting the way they react. Yeah.

“I think it takes a long time to process all of these things.”

Yeah. And yeah. And I'm sorry. It's really sad. Laws is hard.

Yeah.

When I saw two weeks ago, there was lots of laughing.

Yeah. That's good. Yeah. Okay. So I interrupted that fact check for that.

And then I wanted to say, yeah. Yeah. Well, let's just send on that. Do you have another one? Well, I'll just just about PMDD.

What's PMDD? Really bad, PMS. All right.

“People, people, ADHD get PMS sometimes worse.”

Yeah. And I have, I'm pretty sure I'm PMDD. Okay. And so then I was PMW. [laughs]

Are you, are you complaining things? [laughs] Oh, I don't know. [laughs] I do think I have it.

And then I was like, I also have that rejection thing. Maybe I have ADHD. Yay! [laughs] Why are you talking about a 180?

[laughs] [laughs] No, I don't. I don't think I do. [laughs]

But it's all spectrum, you know? It is. So that's-- All right. Love you.

Love you. [music playing]