The ADHD Doctor: How to Focus, Stop Procrastinating, Manage Your Emotions, & Feel in Control

I just finished a conversation that every person deserves to hear.

“Have you ever been told that your anxious depressed hormonal to sensitive, disorganized, not trying hard enough?”

This conversation may just change how you understand yourself or someone you love. I mean, I'm still in just complete shock at how new this information was even for someone like me who has been digging deep into the topic of ADHD with medical experts for 10 years. For 47 years, I struggled with my focus, my emotions, don't even get me started on my emotions.

I was diagnosed with anxiety, I struggled with depression, I never made a deadline, I had trouble starting projects, I know I needed to do, and then I was diagnosed with ADHD.

“And suddenly, I could see all these patterns that I'd been blaming myself for for my entire life.”

Today, we're talking about ADHD with one of the most renowned medical doctors and psychiatrists who has been studying ADHD and is here with new information, at least this was brand new for me, about the way that ADHD impacts you. Because if you think ADHD is just about attention, let me tell you, Dr. Sasha Hamdani is going to tell you, that's only a third of the picture. She's going to explain why ADHD is usually missed, especially in women and girls, just like me, and how it overlaps with emotional struggles, like anxiety, depression, OCD hormones, emotional sensitivity, and burnout.

This is not about diagnosing you, this is not about being sensational, I'm so excited for this episode to get out and to be out there for you as a free resource and spread around the world.

Because when you hear her explain this huge cluster of symptoms that ADHD patients and her clinical practice all struggle with, you will see yourself, and you will finally stop saying, "What's wrong with me?" And start getting the support you deserve. Hey, it's your friend, Mel, and welcome to the Mel Robbins podcast. I am thrilled that you are here.

“Thank you for taking the time to listen to this, because what you're about to experience is extremely important, and I'm proud that you're going to have this as a free resource.”

It's an honor to be together, it's an honor to spend this time with you, and if you're a new listener, or you're here because somebody shared this with you. I just want to take a moment and personally welcome you to the Mel Robbins podcast family. Today's conversation is an extremely important one, because we have a world-renowned psychiatrist who is here to give you and the people that you love a comprehensive guide to ADHD. My guest is Dr. Sasha Hamdani, a board-certified psychiatrist who is an expert in ADHD. Dr. Hamdani is the best-selling author of two books on the topic of ADHD and the science of feeling deeply and emotional sensitivity.

The millions of people follow her online where she is known as the Psych Dr. MD. What I love about Dr. Hamdani is her empathetic and tactical advice on ADHD, anxiety, high-functioning depression and emotional sensitivity, which is exactly why I wanted her here to talk with you and me today. One of the most trusted voices online for people trying to understand what ADHD looks like in real life, because Dr. Hamdani, in addition to being in clinical practice, treating patients with ADHD, has ADHD herself.

Today you're getting the ADHD appointment you wish you could get, and most importantly, this really mattered to me. I wanted to make sure that by the time you were done listening, you had the exact steps and there are four of them that you should take. If any of the information that she's about to share with you today resonates with you or feels like it pertains to somebody that you love. So please help me welcome Dr. Hamdani to the Mel Robbins podcast. Thank you for having me. I am beyond excited that you're here. I have been wanting to do a comprehensive and eye opening and helpful episode about the topic of ADHD with a medical doctor for over two years.

This is a topic that impacts me at a deeply personal level. It impacts my children. It impacts my husband because he has to live with me. Where I want to start is, if we take everything to hurt that you're about to teach to us about what ADHD is, what it isn't, and more importantly, what to do if this is something that sounds like you or someone that you love, what's going to change about my life.

I think this is going to give you the clarity to see that number one, your brain isn't broken. This is just a different wiring.

Number two, it's going to give you the language and the tools and the steps of where to go next, so that you can actually start navigating this condition. Use it's something that just struck me because I think when you talk about the topic of ADHD, you immediately think about attention, and you think about focus, and maybe you think about the little kid who can't sit still, but you said overwhelm and beating yourself up.

“Yeah, could you speak a little bit to the emotional side of what we're going to talk about and what might change based on what you're about to teach us?”

How much time you got? Because I feel like that is a huge overlooked part of ADHD. I think ADHD at its base. First of all, I hate the name ADHD. I think it's stupid. So Dr. Humbani, what is ADHD? Yeah.

So ADHD is a neurodevelopmental condition, which stands for attention, deficit, hyperactivity disorder. I think ADHD at its base is a regulation issue.

“Yes, attention is part of it, difficulty regulating attention, but also difficulty regulating motivation, difficulty regulating energy, difficulty regulating emotion, that's a huge one.”

Difficulty regulating sleep, difficulty regulating appetite, and anybody with ADHD has felt this, and if I'm speaking to you, these are things that you've probably experienced too, because it's not as simple as, well, I don't, you know, it's hard to stay on task today. Okay, I am so overwhelmed, and I've beaten myself up about this, and now I feel paralyzed with this guilt and shame and this overlay of this emotional component, and I think, unless we really, really get on top of this, and start looking at the emotional regulation part of ADHD, we're never going to fully encapsulate the full picture.

I'm looking at our executive producer, Tracy, who I've worked with for 10 years, and I'm smiling at you, Tracy, because I canceled two days of taping last week, because I found myself in this state where the word I was using as I am so overwhelmed right now, and I feel so flooded with emotion, I don't even feel like myself, I can't. But I didn't think that was related to ADHD, it feels very affirming to hear that, well, actually, the wild swing of emotion, is a core part of how ADHD can present, because it's not just an issue of your ability to direct your attention.

It's also your inability to process emotion in a way that is somewhat modulated, it goes in wild swings, and because if you truly are somebody that has this condition, you have always lived with wild swings. I don't even know what it's like to regulate your emotions. What is that even mean in your world, Dr. Hamdani, what does regulate mean? Because if you do have ADHD, or you love somebody who does, we're having a completely different experience of life than somebody who goes through life without an ADHD brain and body.

“For sure, for sure, and I think when you drill down and actually look at what regulation is right, like for mood, right, if this is kind of normal baseline, and this is down in the depths of depression, and this is like so happy and elevated, right?”

People generally, they have a normal Ebb and flow that can happen situationally. With ADHD, it can feel like ups and downs and ups and downs, and it's usually coupled with anxiety and productivity issues and all of this mash together. It's like you feel like a hurricane. You feel like a hurricane. Like I can start cleaning the closet, but then all of a sudden I crash and I've got clothes off hangers everywhere, and now I'm like, what did I do again? I think a lot of people can argue, you know, well, sometimes people have emotional dysregulation or emotional swings, because you're not getting enough done. I'll tell you, even in my own case, I can feel these kind of emotional swings, and I can feel extremely overwhelmed.

I can't do anything right now. I just want to hide. That is emotional dysregulation where it's like, I have the logical part of my brain that's like, you don't have anything to worry about, you're fine, things are going well, you're okay, but still you're having these big ups and downs that you're dealing with at the same time, and I think that's so vital to talk about, because that's what gets missed diagnosed.

“Well, my greatest wish for this episode other than the person listening, really feeling empowered and seen and having your expertise to really help you take the next step to get the support that you deserve and to better understand yourself.”

Second bigger mission, okay, is that this sparks a change in the way that ADHD is defined, because you can see that if society thinks ADHD is jitteriness and, you know, kind of the typical little boy like our son was bouncing around in a classroom that can't sit still and can't focus and if that's all that we think it is. Then doctors and pediatricians don't have the right definition for it, so of course, they're going to continue to go, well, only if your jittery does it look like this, but anything in the realm of dealing with emotions must be something related to anxiety or depression, we're going to keep seeing this problem.

“Originally, the ADHD criteria was developed looking at hyper young boys are criteria is not even built to look at everyone else is not built to look at girls is not built to look at adults.”

I think part of the biggest flaw in this is that when you just moving on from like the hyper young boys part of the issue is they're looking at these highly observable behaviors, like these are the kids that are disrupting classes and these are the kids that are can't stay in their seat. But what about all those other presentations where the only people they're disrupting are themselves and they're just getting past from class to class to class and then later mel those are the people that are getting diagnosed with anxiety and depression because by the way, you're too old to have it now.

“That was me. Yeah, I've also never heard anyone say that the way that you can present there's the external disruption, but.”

I hadn't ever heard anybody say, or you could be somebody that's internally disrupting yourself. Yes, with your thoughts, with your inability to stay on task with your emotions, that's exactly how I felt all the time. And that's what I hear day in and day out when I'm hearing from women over and over and over again that my whole life I have felt like something was off there was something missing and they have never put together those pieces and then their child gets evaluated and that's when the pieces kind of come together.

I'd be curious who you're thoughts about something ADHD in kind of culture and society. Yeah, kind of feels like an I rule.

Because people have thrown the world around so much and live in a world where everybody has fragmented their attention by being online. And at the same time, we have a neurological condition which here in the United States is classified as a protected disability. Yes, we have all of this research around it. And so the term is kind of in popular culture and thrown around. You know what I mean? No, about the I roll. Yeah, you got ADHD. It's not even that they get those I rolls from their doctors. I have heard from another physician.

I have been doing some advocacy work online talking about ADHD and he made the comment. Oh, so you can give Adderall to all the housewives who need it. And I was like, you're gross. I got to get out of here. That is kind of what this feels like. It feels like that's just kind of the like medication is the easy way out and like everybody has it and it's easy to qualify. You talk to anybody who is trying to get a good ADHD diagnosis. So many hoops in place. It is hard to get a diagnosis because people are turned away from or discouraged, just openly discouraged or hostile. The thing that I experienced as a parent is, well, oh, you're just trying to get your kid extra time on a test. So you can get him into a good school.

And why do I have to cry in front of a bunch of administrators to get him properly assessed? And so I also feel because of parents pushing their kids and trying to gain the system. There's also a little bit of like, oh, do you really have ADHD or you know, your parents just push for this so that you get the extra time and accommodations that way.

“And it's really hurt people and hurt our ability, I think, to get hurt and to be diagnosed. And I think that's part of it for sure.”

People ask me a lot. Is this underdiagnoser over diagnosed ADHD? And my answer to that is it's both, right? It's over diagnosed in some populations and it's wildly underdiagnosed in some like there's some racial and socioeconomic populations,

where ADHD is so far down the list of what it could be. And it's just immediately this is oppositional defiant disorder. This is a behavioral issue. This is some other kind of weird attachment thing.

So these kids aren't getting help. And then there are other people where it's almost like they're entering like a pill mill situation where like I know this one doctor and he's really loose with lateral. There's a wide range and I think that truly, I think that if we had better criteria that properly nail down what we're looking at more comprehensively, then people wouldn't give these eyebrows. They wouldn't get like because we would be treating what we're looking at.

“I agree with you. Yeah. What exactly is happening in the ADHD brain? So this is going to be extremely oversimplified, but I think it's important. The way that I describe it is there's a couple of areas of the brain that you really need to know about.”

And the first one is the frontal lobe. So directly under your forehead. Think of that as like the very smartest part of your brain decision making judgment processing. That's your frontal lobe. Then you have this amygdala, which is this little almond-shaped central area of the brain.

And that's in charge of all of that emotional data. So with ADHD, you're dealing with a couple of things happening.

Number one, you're dealing with a prefrontal cortex, smartest brother brain. It's a little bit thinner and a little bit less responsive. Oh, really? Yes. And then you're dealing with an amygdala that's a little bit more hyper-reactive. And then you're dealing with the connection between the two, which isn't as strong. So what you're going to get is you feel things strongly because that amygdala is like, alarm chemicals, like something is happening. And then prefrontal cortex is sometimes slow to filter and figure out exactly what to do with it.

“The other thing that's happening in the brain alongside all of that is you have to talk about dopamine. And again, when you think about ADHD in general, that's very oversimplified.”

But dopamine is that neurochemical, that's in charge of alertness and attention and emotional regulation and mood. So it's present and doing many different things at once. And a lot of people think that it's a lack of dopamine. You have low dopamine and that's what's causing all this. It's really that the dopamine you have present isn't in the right place at the right time. And so that can change with hormones, that can change with age, that can change with stress. That can just be an underlying deficit or dysregulation. So when you have those kind of factors, all at once, you're dealing with just a tremendous amount of input that you're getting and a kind of weak filtering system.

And so you're just doing the best you can. When you talked about the prefrontal cortex and being kind of the thinking and like the secretary of the brain, the processor. And then you talked about the amygdala, the little almond, it made a lot of sense when you were like the input is overloaded and the connection between those two things is weak. Yeah, which is why it is hard for somebody that has this neurological condition called ADHD to actually regulate the signals coming into here and all the sensory crap coming into here.

Correct. So that makes perfect sense why it would be hard if the connections week for us to take all the input into the thinking part of the brain and process it. And at the same time, take all the input into the sensory part, the amygdala, and also appropriately regulate and process that to and send signals to your body and your mind.

Now, when you use the word regulation, let's just say the person that's listening is never really heard that term or doesn't quite know what you mean.

Fully intending on studying Dr. Hamdani. Okay. I go to sit down. Now all I can do is hear my stomach. Now all I can do is hear the people in the corner over there. Now I'm looking at the person and an hour or two goes by and then I start to think what why can't I just do what everybody else is doing what is wrong with me.

“And I have example after example after example and the emotional side of this and the wreckage that it caused internally for me and the self hatred that it causes.”

When you finally get a diagnosis, there's almost like relief and grief at the same time because you start to understand how much unnecessary suffering.

You inflicted upon yourself because you didn't know what you were dealing with. Oh, and it's the same story you hear over and over again. I have had people who have come to me and they knew something was off. They have felt this guilt, this shame and so they go to their doctor. The doctor is like, this is anxiety. Your anxious about something or your, you know, depressed about how things are they're started on medication medication doesn't work.

“Okay, go back to the doctor. This is working. Try another medication. Go back to the doctor. I've had people that have been on 10 different medications. They have never found relief or they found very partial relief.”

And then you actually evaluate them for ADHD and you get to the bottom of like, oh, okay, you're having this emotional dysregulation that's happening.

All right, let's treat the ADHD and all of this gets significantly better better than any other medication. The way that I describe it is for people who have diabetes and they start to lose their vision. Now all of a sudden, they go to their doctor and they're like, oh, I'm losing my vision. And then this would be like if the doctor was like, all right, cool. Let's get you some glasses. No, the correct answer is let's work on the diabetes. Let's fix this underlying problem. And then underlying problem is that ADHD that's causing all of these things.

You just describe my life story. So undiagnosed ADHD. Yeah, super hard of myself. Studios hardworking and had no idea what was going on, but had lots of anxiety. Yeah, and the anxiety started growing from middle school through high school got worse and worse and worse. And I got put on Zoloft at the age of 22. Yeah, I took Zoloft until my mid 40s because I was diagnosed with anxiety. Yeah, and while the Zoloft for me at least kind of turned down the volume of the chronic like state of alarm that I lived in.

It never really solved solved anything. And it wasn't until our son Oakley was diagnosed with ADHD that I'm like, wait a minute.

I went. I got a neuropsych evaluation. I got a clinical diagnosis. I stopped taking anxiety medication. I haven't had a panic attack since I haven't had anxiety problems since because the entire time we were treating the wrong thing correct. So this is one of those conversations where I keep forgetting that I'm supposed to ask you a question because I'm so dumbfounded by what you're sharing. Like I feel on one hand completely validated and on the other hand, I am somewhat devastated by the fact that I'm just kind of learning about this whole world of the emotional dysregulation and the ways in which ADHD is really impacting our lives that

most of us don't even know about. I am absolutely sending this to both of my daughters while we're on break, but don't go anywhere.

“There's so much more that we are going to dig into and I really want you to stick around for the end because Dr. Hundani is going to walk you through the specific four things that you need to do.”

If you feel like this is resonating with you and how to start thinking about getting the support that you deserve. So you're going to want to hear that. Stay with me. You know, after hosting this podcast from us four years, there's one topic that every single health expert agrees on the importance of protein for your health longevity, feeling your best, but here's the problem. Who the hell has time to cook all this chicken breast and beef and eggs? That's exactly why I became a co-founder of Pure Genius Protein.

Welcome back, it's your friend Mel Robbins and today you and I are getting a comprehensive guide to ADHD with Dr. Sasha Hundani.

And so Dr. Hundani, I read in your work that there are three different types of ADHD.

“I didn't know that. What are the different types of ADHD?”

Okay, let me show you. Okay, first one, in a tentative ADHD and we touched on this briefly, in a tentative ADHD typically are the daydreamers. They tend to be forgetful difficulty with organizing things difficulty with remembering where you play something difficulty with initiating tasks difficulty with, you know, if there's a big task coming up in front of you, you tend to avoid that.

Typically, this is how females assigned a birth present.

Okay, in a tentative ADHD, in a tentative check.

“Hyperactive or a pulse of ADHD, this is the second form of ADHD. And this is, well, one of the ways that males can present.”

And this is both physically and verbally impulse. These are the kids that are having difficulty kids and adults difficulty staying in their seat. They're fidgeters. They are impulsive in speech in that they're interrupting. They are blurting out answers in conversation. They have difficulty participating in conversation. So this is, this is that hyperactive type.

And then the third type is the combined type picture.

And combined type picture is just a combination of both of those features. So you can have in a tentative features and you can also have the hyperactivity component. Fun fact, this is what I am. How do you know? You know what I'm saying? Because it feels like it's a little general like all of it. So you can kind of find situations for yourself, but how do you know what you are and why is it important to understand which of the three you might be? So, I mean, you really are going to know once you get a good solid evaluation.

Because I think that part of getting a great evaluation, a very sound evaluation is equal parts, yes, ruling in ADC, but also ruling out everything else. I want to make sure that this isn't anxiety, that this isn't depression, that this isn't bipolar, that this isn't some thyroid issue or some medical issue underlying it. So there's within the evaluation where you're talking about ADC, you go from childhood and you kind of look at longitudinal patterns, because again, with women specifically, it's hard because every month we look different, hormonally.

So catching you at one spot in your cycle versus another spot, you might look different and you might present a little bit differently.

“So you're looking for longitudinal patterns. Can you break apart how does the emotional side impact girls?”

So when you're looking at females, they typically fall into this pattern of more the inattentive presentation. So these are the daydreamers. They're forgetful. They have difficulty organizing things. They have difficulty with routines and motivation to get tasks done. And so these are the people that in general can be a pleasure to have in class. They're getting passed along and they're doing well, but internally they're working so hard, so hard. You know what, that doesn't get better. You get through your elementary school years, you get to puberty, then all of a sudden you get smoked by hormones. Now hormones immediately change things. Now instead of physicians and again, not the fault of physicians, right, this is a fault of criteria.

But now instead of physicians looking at this child and saying, "Whoa, we miss something. You're having like all these mood swings and school is hard for you and friendships are hard for you and all of that." They're saying, "You're a teenager. These are hormones. Get used to it." This is what you hear as like a 13 year old girl and then they have to get through it. So you just kind of bear it and then you get into college and your demands get harder. You start getting into more serious relationships and then maybe you get into a situation where you're trying to start your own family.

Now you're getting hit with another wave of hormones and actually during pregnancy, estrogen levels are a little bit higher, dopamine levels are a little bit higher, so you might do okay, but then postpartum comes and rocks your world.

And so that gets missed again. Then you get through all of that and you get through your reproductive years and now you're in perimenopause and things are chaotic because your estrogen drops again and you're like, "Something is wrong." And now it's, well, your hormonal, like, give it 10 years. We'll see you later in perimenopause. Yeah. There you go. This happens during perimenopause. You've described my whole life. I know. I had postpartum depression crashed. I started having severe brain fog and other symptoms during perimenopause, so you get hormones which help it didn't help the brain fog. Yeah. And again, like, it was just diagnosed with anxiety, living with anxiety, struggling, struggling,

pushing through postpartum depression. Oh, my God, the sobbing is your breastfeeding. Like, just, I don't feel like myself, oh, my just, and then perimenopause, then the creams, and then all of a sudden 80 HD diagnosis and it's like, "We what?" And it felt as soon as I was not only diagnosed but found the medication that worked for me, it's like all of a sudden after 47 years.

I felt like it was in my body. Yeah. Yeah. And that gets missed and it gets missed over and over and over again because our criteria doesn't catch that.

Is it common in women that if you have undiagnosed ADHD that it can cause anxiety and depression? Yes. Why? A lot of times, like, when you look at ADHD, there can be anxiety and depression that is a separate thing that travels along with it. That that can happen. But for a lot of people because, again, circling back to that emotional regulation part of ADHD that everyone seems to miss and that is so critically important to getting a comprehensive picture of ADHD. Number one, if you've gone through your whole life and you've thought that there's something wrong with you and you're less than and you're broken, that's going to make you anxious. If you can't do the things that you know perfectly well that you are capable of.

That's going to make you anxious and you know what, it's probably going to make you pretty depressed too.

If you're going through these huge moments of this energy dysregulation where you are getting tons done and then it's like you've hit your max and then you crash. You have this huge crash and then you feel like, okay, I have literally nothing left in my tank. That looks like depression.

“But these are all emotional dysregulation issues that are happening and so that's why you see that with ADHD.”

Is there a connection between undiagnosed ADHD and eating disorders? Yes, there is, but I think that again, that stems from dysregulation and it stems from a lot of ADHD.

You're not able to be mindful about certain things. So sometimes it's not actually, you know, when people think about eating disorders, they think about, you know, on one extreme that you're not eating enough from the other extreme, you're eating too much. Like for the extreme where you're not eating enough, a lot of times with ADHD, sometimes it can be like, you don't really have hunger cues. And this is outside of the medication. It's just your body isn't communicating telling you your hungry. And I know personally, if I get invested in a task that I'm truly interested in, I can go eight hours.

And I'm not eating. I'm not trying to say I'm not getting up on the flip side with like binge eating disorder and things like that.

“There can be a time where you're trying to stimulate your own dopamine. You're trying to like get things going without even knowing that's what you're doing.”

And you're grabbing for things and you're eating and you don't even know and you can look down and you're like, okay, that was a whole sleep of Girl Scout cookies. Like, so there's like, you can be on either end. So yes, there are linkages with disorder to eating on both ends. And what's interesting is again, this kind of distinction that you're seeing Dr. Hamdani of the external presentation versus the internal turmoil. How I describe it is, it's like the outside of your house is on fire versus the inside of your house is on fire.

Like it just feels like both are on fire. Both are literally inflames. The way we look at it now is we only care if we can see the flames. Flames are going on inside the house.

“What would you say to somebody who has received this episode from someone that cares about them?”

Yeah, because the person who cares about them sees these patterns and has sent this episode, you know, in a text saying, hey, you know, I'd love for you to listen to this because this sounds a little bit like what you might be dealing with.

I think if you are listening to this episode,

I don't want this episode to push you one way or the other. This is not meant to convince you that you have ADHD. This is not meant to push you in one direction.

“It's meant to ask you questions about your own internal environment so that you can start digging deeper and figuring out is there something here or is there something that needs to be addressed?”

And what I want to reiterate about all of this is that I think good compassionate care and diagnosis stems from a very nonjudgmental and shame-free place. And so just being able to look at this episode and whatever other research you do in a very compassionate and self-compassionate way, I think you'll be able to receive information and actually start to put together patterns about your own behavior a little bit better. And that might be ADHD or might not be. What do you think the biggest misconception is about ADHD that keeps people, especially women, from getting help?

That you have to treat with medication. I don't think you have to. There are some people that are on medication and it is life-changing for them.

And so I'm never going to, and even when I was hurt, my nature depresses before.

Same thing, that can be life-changing for some people. So I'm never going to go back on that because medication is a tool and can be wonderful. But also being able to actually commit time and figure out therapeutic tools that might work. It is also so critically important and some people don't need medication. They get through with doing cognitive restructuring and work through therapy that can be extremely beneficial.

I so appreciate your answer. What I find reassuring about what you're saying is there are other ways you can support yourself.

We're going to get into that very specifically about what to do and how to get a diagnosis and what are the things that you can do and what are the medications.

Yeah, you know, I remember when I got my diagnosis. It was both an extraordinary relief.

“Yeah, and I had a lot of grief and anger. Yeah, is that common to feel a sense of grief like when you finally understand what's been there the whole time?”

Yes. When I evaluate people, I actually tell them about that. Like, I don't know what this evaluation is going to show or if it's ADHD, if it's not ADHD. But depending on what we go through, this is just a deeper exploration of what's going on in your body. You might feel like this is an answer.

This is what I've been looking for and I might feel like I wasted so much time and I'm grieving that loss of time and potential and all of that stuff. And to them, I say, that is normal. Like, you are allowed to feel those things. That's perfectly normal and there should be space for that because that is a very valid expression of what's happening. But I also tell them that in that time, it wasn't wasted because what you're doing the hard work, you were building routines, you were building structures, you were building work around that eventually as you have the right tools and scaffolding.

Those are going to come in handy for you. Those are going to make this process a little bit easier because I've also seen on the flip side of things. When people are started on medication and they don't have that scaffolding in place and then when they're off medication, it's like they're floundering again.

“So I think this multi-factorial approach of doing lifestyle and behavioral modification with medication, if that's appropriate, can be extremely helpful.”

It was life-changing for me. I'd love to talk about the connection between being high achieving. Yeah. And how that, especially in women, can hide ADHD, especially for themselves. Yes. So I'm going to introduce you to the concept of masking. Have you heard of that? Not in the context of ADHD.

So masking is when it can be conscious or unconscious, camouflaging of your symptoms. And this is something that women do exceptionally well because I think from a young age we're sensitized to do this because we don't want to be in trouble. We don't want to stick out of a crowd. We don't want to bring a lot of attention to us. I'll give you an example with me. Like I was a combined type presentation, so I was very hyperactive. Like I couldn't stay in my seat, a big visitor, but I learned. I can't get up all the time in class. I'm getting in trouble constantly.

So I would squish my thighs down on the seat.

Now from a productivity and a masking perspective, you also see things like perfectionism.

I don't want to get in trouble. You see things like overcompensating. Like I'm going to stay at work extra long and I'm going to overprepare and I'm going to get things ready because I don't want to get in trouble. I know I'm going to miss something. So I'm going to prevent that from happening. You see things like within relationships and knowing that there's like that emotional regulation. You see a lot of women just kind of accepting stuff that they might not think is appropriate for any of their peers.

But they're like, I was probably in the wrong. I was a little bit too emotional. I chased them away. And so in order to protect that emotional sensitivity, they don't want to get into conflict. They don't want to fight. They don't want to do things like that. So I mean, there's lots of different ways that are directly impacting and harmful to someone who is continuing this mask for a long time. Eventually that mask gets too heavy to hold. Dr. Hamdadi, thank you for sharing this with us in a little bit.

“We're going to get to the steps of what you should do next, but we still have a little bit more to unpack.”

And so I got to take a quick break so we can hear a word from our sponsors. And I want to give you a chance to just digest this for a second.

Don't go anywhere because I promised a little later in the show we are going to be getting to the step by step. There are four of them that you need to do this. What Dr. Hamdadi's recommendation is if this is resonating about you or with the person you love, four steps to getting the exact support you need when we return. Stay with us. [ Music ] Welcome back to friend Mel Robbins. Today we are here with psychiatrists Dr. Sasha Hamdadi.

And she is giving you a comprehensive guide for free to ADHD that you can use as a resource for yourself and the people that you love. You can send it to your doctor, you can send it to your friends.

“So Dr. Hamdadi, let's keep going. Is ADHD a superpower?”

No. Everyone asked me that. I am so jealous of the people who say that it is. I'm jealous of the people who say that it is and the reason for that is I feel like there are some things that ADHD has brought me that I wouldn't have otherwise. Like being on social media, going to the White House, getting book deals. Like that is because of my ADHD. That's because of that hyper focus. That's because I was interested in something and it bled into this area. But there's also things on a day-to-day scale that I feel so limited by.

And I feel like the analogy that I give is it's like a superpower that I have very little agency over her because it's like you can fly now. And that's your superpower. But you can't choose when or where. So you're just going to blast off into space that I give time. So it's I feel like I love the concept of a positive reframe. And I think there is some beautiful, beautiful, beautiful, beautiful things about ADHD. I really do.

But I think there's also some things that are really difficult to deal with. And I think when people continuously focus on that superpower trope, for me it diminishes the struggle.

“And so I feel like the best way to approach ADHD is just realistically.”

They're good. They're just like anything else. There's good stuff. There's bad stuff. And it's how you deal with it.

I appreciate you saying that because I always thought that it sounded like toxic positivity.

Yeah, by somebody who doesn't have ADHD. And when you also consider Dr. Hamdani, what you're teaching us, which is for decades. Medical professional society, the DSM has not included the full scope of ADHD, especially the emotional dysregulation. There is no superpower to feeling constantly overwhelmed in your life. And yes, there are some small benefits. And I love the analogy that you said it's like having a superpower you can't be in control of. Like I would love to be able to throw fire from my palms, but I don't want it going off at the wrong time.

And there's a lot of anxiety that comes with going through life thinking you can't trust yourself. Yeah, you can't trust yourself to follow through. You can't trust yourself to be on time. You can't trust yourself to remember. You can't trust yourself to not screw this up yet again.

Yes. So we've talked a lot about the emotional regulation side of things.

There is a neurological phenomenon that you see in almost 100% of people with ADHD, they experience some component of rejection sensitive dysphoria. Rejection sensitive dysphoria. What does that even mean? That's a big thing. It's a big thing. It's mouthful. Rejection sensitive dysphoria.

Is this incredibly robust emotional response? Sometimes physical, but mostly emotional response to real or perceived rejection or criticism or this fear of disappointing.

“And when it is this internal emotional response flooding of neurochemicals, that happens. How do you define this? What this is? It is a neurological phenomenon when you look at emotional sensitivity, right?”

And you have what you have if you are somebody struggling with ADHD. I'm saying just part of the human condition, right? Emotional sensitivity in general. You have if you're saying this is kind of normal emotional sensitivity. You have emotions down emotions up, situationally appropriate, you're right in the middle.

You have lack of emotional sensitivity where people really aren't responding in the way that they should be. They don't feel big highs. It don't feel big lows. Maybe not situationally appropriate.

Then you have people that are highly emotionally sensitive and they are the people who feel things quickly and deeply and for a long time. And I would put rejection sensitive dysphoria as like the the ending point of that as most emotionally sensitive because when they feel something, even if it's not actually happening, if they perceive that there is a risk that I'm disappointing you or that there's some rejection or the person doesn't like me. They're world caves in. They start turning inwards and it becomes this flooding of neurochemicals and alarm chemicals that are happening that literally paralyzed other areas of the brain.

Wow.

“Holy cow. You have a brand new bestselling book to sensitive. I love the title. Thank you. Why is this rejection sensitive dysphoria important to dedicate an entire book to this?”

Because no one talks about it. So we don't have the tools and the language to treat it appropriately. Can you show us what this may look like in day-to-day life? Yes, I can. I can show you with text messages from you. Oh God. Okay. So the team is screenshot my phone. Okay. Go ahead or actually screenshot their phone and something that I've said. Okay. So if we're looking at just this screenshot with you responding to something that I'm saying and all it says is no worries. Okay. For me, what is happening in my brain is, is she mad at me? Is she unhappy with me? Does she want me on the podcast still?

I am spinning because in my brain, I've attached a level of uncertainty because I'm afraid that there is rejection and criticism underlying this. That to me is a direct reflection of my own self-worth. So I'm going to spin on this. I'm going to ask other people about it. I'm going to show my phone to other people and be like, what do you think about this message? And I am going to waste a tremendous amount of emotional energy on this.

“Now the things that I could do with this is that I could chew on it for hours and hours, which is what I love doing and that's what I usually do.”

Alternatively, I could do things like I could overcome it. I could send you a text message back and be like, okay. I'm just making sure that we're cool or okay. I want to reiterate our plans and you're like, I am busy. So there's a lot of emotional handholding I would need in that moment. I might do things like, I get that text message. I'm already decided that you're mad at me. I'm done now. That's that had been my trajectory in my 20s with relationships. I would read into neutral interactions. I would read them as threatening in some capacity and I would be like, I don't need this. I'm studying. I don't need this and I would end the relationship because you're not going to push me away. I'm going to leave first.

You see different patterns and it is truly when you take a neurologically emotionally sensitive person, which is something you see a lot of in ADHD.

And if you think about that, this is the stuff that keeps me up. This is the stuff I worry about. This is the stuff I I reality test with people and they get so annoyed because I'm constantly going and asking them like, is this normal? Is this not there? There's so much.

“I don't want to say life loss, but that's what it feels like. I'm just spending so much time doing that.”

I have spent a lifetime doing this and yet at the same time, I'm just doing the best I can to manage all the inbound anyway. If you relate and you read messages like this.

What do you do? Yeah, and for the record, it's not just messages. Like it can be things like for me, I'm so sensitive to tone, to shifts in tone. I'm sensitive to body language. I can pick up an energy in a room before I go in saying, you know, it's like so this is one of those things about being emotionally sensitive. And then simultaneously being emotionally dysregulated is that those things hit hard. Yes. So recognizing it is huge. That's a big thing that I think is really important.

The other thing that we see is important are things that work in the moment to reduce activation.

You see, once things like movement, and it doesn't have to be like do heavy cardio or or lift weights do some sort of movement that's going to increase that oxygenated glucose to get to that frontal lobe. So you see the text message now like, yes, I do squats, you can you can be because think about what you're doing, like once you understand neurologically what's happening, you're dealing with this overactive of Medila and this underperforming frontal lobe. Oh, I see, oh my god, I just got it. So in that moment, the input from just a simple text message is like, yes.

And that floods your brain. Yes. And your thinker, your prefrontal cortex is like, I don't know what to do. I can't come online, something's going on like ha ha.

And so neurologically, even though a text message seems stupid and inconsequential, yes neurologically, your brain is screwed. You are responding to a threat like you have seen a mover when you are actually assessing threat, like whether it's a social threat, whether it's a physical threat, your brain doesn't know the difference in that moment.

“Your body is responding in the same way. So you're having this flooding of neurochemicals. And so what you need to do now is understanding, okay, my emotional center is overwhelmed.”

My frontal lobe is not working as well as it should. And then you look at that situation and whether it's like, okay, I can utilize movement and that's going to get some oxygenate glucose to my frontal lobe where it's supposed to be. And hopefully we can get that thinking back on board. The other thing you could do delay the reaction and this is something that it took me so long. I understand neurologically, I am flooded right now. I know that I want to respond to this K. I know that in 10 to 15 minutes, I'm going to feel different. And so in 10 to 15 minutes, I will reassess this and I will even do things like I'll set an alarm.

I'll set an alarm 10 to 15 minutes, I'll come back and gosh darn it. I do feel different. But I think what's important is that like with this book to sensitive, I don't want to make you less sensitive. I want to help you be more in control. I love that. I don't want to make you less sensitive. I want to help you be more in control. That is the perfect statement for us to then talk about how you feel more in control. Because I'm sure as you've been listening or watching and you're really taking in everything that Dr. Hamdani is teaching you in me today, you are thinking of like 13 people in your life or you are thinking, wow.

“Sounds like me. So what are the steps you should take if you think you or someone that you love may be dealing with ADHD that's not diagnosed?”

Yeah. Let's go through this because I think a visual will help. So I'm going to pull up a visual. Great. So if you think you have ADHD, let's start with the first step. So first step, track your symptoms. It's so important to number one, know your baseline. Number two, it's also needed to understand how your treatment is progressing if that's kind of what it would, whether that's therapy or whether that's medication or those holes being fixed.

Distractability during a task. Like are you getting pulled out of the task? Completion of tasks. So I would lump that all into one, but I think it's important to make those distinctions like where is a problem is it's starting. Is it staying in the task? Is it actually getting it done? That's important. I think that is vitally important. Sleep. Sleep track what you're doing with sleep. I want to know how long you slept. I want to know if your sleep was fragmented. Are you waking up at the middle of night? Is it hard to follow sleep? So get me as much data as you can. This can be notes on your phone. Like this doesn't need to be something super formal.

“And the third thing that I want you to track that I think is really important is mood. I actually don't give a lot of guidance on this because it's almost an interesting diagnostic fact to see how you track mood.”

However, you want to track your mood. Just give me some sort of mood data point. Okay, because I want to see number one. How that pattern progresses over time. And then especially for women. If you cross poorly that with your hormonal cycle. Want to see that too. Got it. There's a strong hormonal component. We need to look at that as well. Got it. So if I were to do this for a couple of weeks, you'd get some good day it because then you could go and has it been like this in the past.

Obviously, ideally, I don't want a couple of weeks. I want like enough for two hormonal cycles.

I want two months. I want two months. Okay. Great. You can have two months. It's going to take you that long. You're going to point with you anyway. So.

“Okay. Track your symptoms for two months and we're doing kind of productivity initiation, distractability completion, sleep patterns and mood.”

Yes, boom. Boom. Okay. Step two. Talk with a qualified professional about an ADHD assessment. What is a qualified professional? I'm not going to. I know. So here's a deal. There are especially now. There are lots of different roads to get to where you need to get to. Right.

Let's start from my favorite. I'm biased because I'm a psychiatrist. I feel like going to a psychiatrist sometimes gives you the best evaluation.

And the only reason I'm saying that is because you have the benefit of going to a medical physician. So they understand medical background. You have the benefit of going to a psychiatrist. So they've done the psychiatry residency where they've done the therapy side of things and they've done the medication side of things. So it can be if that person is appropriate for an ADHD medication after the evaluation and has ADHD. This could be a one stop shop kind of thing. But there is a desert and deficit.

Yeah.

“That's a problem in many communities, many countries for many people. And you know, sometimes you're like, do I go to my primary care? Do I go to a pediatrician? Do I go to a nurse practitioner?”

We're only as good as what our system allows because access to care is a huge issue and then there's so many barriers to care whether that's there's literally not enough psychiatrists, whether that's a cost issue, whether that's a, you know, they aren't taking your insurance or, you know, there's so many different things or that they're saturated. They can't see patients. You could go to your primary care doctor or your pediatrician or and that's a beautiful place to start that's a beautiful place to start generally there's a lower barrier to access with that.

A lot of times they'll do an assessment that involves getting information from collateral resources. So talking to, you know, like for kids, they'll talk to parents. They'll talk to teachers. They'll get it scales to look at ADHD behaviors. So depending on what is available to you, that's another road. Then you can do the therapist road. There's many different layers. You could do a neuropsychologist who could do neuropsych testing where you do a comprehensive evaluation of everything that's going on is this.

ADHD is this depression is this anxiety is this bipolar. So they will do a full it's super long and expensive and expensive. That's what I did. That's what we did with two of our kids. Yeah, and it was expensive. Like I would not have been able to do it had all of this started happening. And I was aware of what was happening, like even just a couple years before that. So here's the deal. There are other resources. So besides the therapist route, besides the neuropsychologist route, other layers of therapists that could potentially do the evaluation.

Some of them, like with nurse practitioners, not a therapist and nurse practitioner is something different. Some of them can prescribe. Some of them cannot with therapists generally. They cannot prescribe.

But again, we're not talking about what we just got to get the evaluation assessment done first. So you know what you're dealing with and I do find that this is a big roadblock.

One of the most important things that I tell anybody who's starting this process is look up the provider ahead of time. Look at their reviews. Look at what they treat.

Look at all these things because it's unbelievable how strongly some people feel about ADHD. Some people are completely unwilling to even address it. And so it gets to be really difficult when you're going into an evaluation and it's hard to even get that evaluation from them. And so I think that the people who really enjoy treating ADHD, looking at ADHD, evaluating ADHD, they put it pretty prominently on their information.

“So I think that's important. You can look at reviews, you can get word of mouth.”

And you honestly, you deserve that. You deserve a good assessment that is personalized for you, right, near worth it. Yeah, step three step three discuss options and there's lots of options on that board.

Medication therapy coaching tools systems. Let's talk about the options. Yeah, a lot of people they immediately think, if I have ADHD, I'm going to be put on at all and that's what's going to happen.

No, so let's go through some of the different options. Number one, if you're looking at ADHD management, there is medication and there's non medication. So let's start with the medications side of things. Medication broken up into two big classes. There are stimulants and there are non stimulants. The stuff you've heard about at or all riddle and vivance. Those are all in that stimulant class of medications. They work in two different ways. One is to help with alertness and to fight off those sleepiness cues.

“And two is to point towards reward. There was a beautiful Washington University study that was down on this just like Christmas of 2025. So it's relatively recent.”

But stimulants, the issue with that number one, they're controlled substances. So that gets a little weird. But number two, you can't stimulate a person 24 hours a day.

It's like you got to eat, you got to sleep, you got to do normal human functioning things. So even the long acting stimulants really, you're getting about 68 hours of coverage. If that, usually it's four to six hours. Short acting two to four hours. So you're getting these like tall peaks of coverage where it's, okay, if I feel like I am completely regulated at this point, but it crashes down pretty early. You move next into the non-stimulate class of medications. So stimulants are one side non stimulants.

Non stimulants, those are generally agents that work on a couple of different things. There are some that are antidepressants. So they help with anxiety and depression at the same time. There's some that are blood pressure medications. They're all these different types of medications that have multiple usages. And the thing that I generally like about non stimulants is that a lot of times it's 24 hour acting, which people don't know about. Because a lot of times they're like, oh, if I have ADHD, I'm going to have to be started on this medication, which I'm going to hate non stimulants. You're not going to have this two hours of coverage.

“You're going to get a 24 hour. What are the names of non stimulants?”

So guanficing is one. Stratera is one. One you might have heard of is will butren. That's a non stimulant for ADHD. So there's lots of different agents that you could potentially think about adding that give you full coverage that possibly cover more than just the attention component that don't frash you down in two hours and instead just kind of raise that baseline. So they're beautiful agents. It really depends on what you need. If the person is listening is thinking, I am really resistant to the medication because I'm concerned about the side effects.

If they were a patient in your practice, like, what do you say to a patient in your practice when somebody raises that concern? Then toe to medication. So if you, if I explain exactly how those medications work and what the intended effect and what the side effects are and how to get on them, also how to get off of them. If I'm giving you all that information, you're like, no, thank you. I don't want that. That is a perfectly reasonable choice. We go based on what you feel ready for. It's not my job to push medication.

It's not my job to get you there sooner. Like do the tools. The tools are going to help you anyway. So what are the top tools if you're dealing with ADHD? Yeah. And that diagnosis that are the most effective place to start. It can sometimes be really nebulous and hard to figure out exactly where to start, what level to pull.

And then figure out how to optimize and approach that. And I'll tell you from my own experience, I really started to drill down and work on the therapy side of things.

And what are the skills, what are the tools, how can I explore my own behavior so I can figure out what to fix?

“And that I think was life-changing. What is the fourth step if you think you have ADHD?”

Okay. Step four, use trusted resources while you wait. This is important because I think a lot of getting assessed, it can take a while. It can take a long time and if it happens, right? I mean, there's some people that don't have access to it. And so I feel like in that interim learning and exploring your own internal environment. And also relying on resources that you know are reputable that are going to help you that aren't just some random person on the internet that's talking. Like you want to get information from things like journal articles or news, like, and it can some news.

So news papers that cite journal articles. Well, I actually, this is one of the things I appreciate about you that you put a lot of content online. Yeah. And so if you're having trouble gaining access and you are in the waiting game. Following somebody like you, a medical doctor who's talking about this, who lives with this, that's a way for you to learn more and to understand that this is not a deficiency in you. This is something you are just going to learn more about and there are tools that you can use while you're waiting.

“You can learn more and become smarter about this while you're figuring it out. And that's the whole point. And that's why I actually wanted you here because you do put out a lot of content.”

For somebody that's listening and it's thinking, well, this is definitely me, but I'm now 40, 50, six, it's just too late. What would you say? If I had 10 minutes left of my life, I would want to know if I had ADHD. Why? Because I want to understand my brain. I want, I don't think it's ever too late to understand your brain. I just want to know for me going through that ADHD experience. I know firsthand how it feels to have that guilt and that shame compounded at every single thing and for me to analyze every turn I've made.

And to think about it and where did I go wrong and what was happening and how could I have done it better to know that I did do my best. This was a neurological phenomenon that was underlying all of this that was making it difficult.

“You still did a great job. You got through this. You built on this. I want other people to feel that. I do too. Yeah. Dr. Humbani, what are your parting words?”

It's never too late to understand your brain.

I am so grateful that you're here. Thank you for having me. I cannot believe how much I learned today that I did not know. I feel more confident. I feel like I understand myself so much better. This episode is an extraordinary gift that you just gave us because we got to sit down in a private session one on one with a psychiatrist as renowned and as passionate and committed. You are and I appreciate the accessible and realistic way that you talked about what to do next and what to do while you wait and while you figure this out.

And so just from the bottom of my heart and from people all around the world that you will never meet whose lives will be forever changed because of what you shared with us today. Thank you.

Thank you for having me. And thank you. Thank you for making the time to learn about ADHD. I hope you share this with people that you care about. This is a conversation that is for all of us and these tools that we discuss today are things you can start to implement in your life or the lives of people that you love immediately. And in case no one else tells you I wanted to be sure to tell you as your friend that I love you and I believe in you and I believe in your ability to create a better life. And I cannot wait to see your comments. I can't wait to see this shared around the world.

[music]

No, it's my teeth. I'm not coffee. I wouldn't mind another one of those little wolf situations. We're definitely being real. Do you know I was born in Kansas City, Missouri?

Get out of here. I just am, Zara.

“Yeah. Started med school when I was 18. So you must have really dumb is what you're telling me.”

So dumb. I'm catching up to my coffee. So we're going to get some coffee.

It's going to be an ADHD episode because both of you are like boom, boom, boom, boom, boom. Okay, already. This is so fascinating. Oh, I'm so happy. Oh my god. Do you want to try this?

“You have to try this. This is insane. I have to try it. Okay.”

What is that? Is that not the most attached? I have to have that.

It's what is it? It's called the little. I think the signature drink of this local coffee shop called the little wolf shout out. It's a whole milk latte, but it's got this like orange saffron powder on the top and a little bit of brown sugar sweetener. It's like liquid. I don't know what. Oh my god.

“Is that not insane? That might be the best thing I've ever drank in my life.”

It literally will blast us right through this episode and then right into the bathroom. Oh, and one more thing. I know this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not intended as a substitute for the advice of a physician professional coach psychotherapist or other qualified professional.

Got it? Good. I'll see you in the next episode.