Podcast: What You’ve Always Wanted To Know About ADHD

Episode Transcript

Jenn: Welcome to Mindful Things.

The Mindful Things podcast is brought to you by the Deconstructing Stigma team at McLean Hospital. You can help us change attitudes about mental health by visiting deconstructingstigma.org. Now on to the show.

Hi, folks. Good morning, good afternoon, good evening, wherever you are joining us from and whatever time you are joining us. Thank you for taking the time to tune in to “What You’ve Always Wanted to Know About ADHD.”

I’m Jenn Kearney. I’m a digital communications manager for McLean Hospital, and my co-host today is ADHD expert extraordinaire, Dr. Roberto Olivardia, and if you are tuning in, it’s because you probably know somebody or it’s you yourself that you feel like it’s hard to stay focused or organized, and if it’s a person who has ADHD, oftentimes it’s not just lack of focus.

It could be inattentiveness, impulsiveness, a nonstop energy flow, and if it’s not wrangled, it could impact schoolwork, friendships, jobs, relationships, and you might feel like it’s impossible to keep up with other people, be on time, and handle those small and what we would probably consider pretty boring details.

And while ADHD is common, it definitely has a lot of stigma associated with it, and if somebody is symptomatic, especially if you’re an adult, you might feel kind of hopeless, but Roberto and I are going to talk all about how it really is never too late to recognize and treat ADHD, what ADHD actually is and what it isn’t, how we can manage it in ourselves and others, and so many more things.

So if you are unfamiliar with Dr. Olivardia, you are in for a huge treat. Roberto is what I like to call an empathetic ball of energy who has been treating patients for the last 20 years since his internship at McLean.

So he runs a private practice in Lexington, Massachusetts, and specializes in the treatment of body dysmorphic disorder, obsessive compulsive disorder, ADD and ADHD, skin picking disorder, and males with eating disorders, and Dr. Olivardia also treats patients with other anxiety and mood disorders.

So Roberto, hi. I have this giant grin on my face ‘cause I’m just so excited to have you. This has been a long time coming for me, so I am going to try to tamper my joy and really get down to the nitty-gritty. So can we just start by talking a little bit about what ADHD is and what it isn’t?

Roberto: Absolutely, first of all, it’s great to be here and to be here talking to you, Jenn. Yeah, I’m really excited to be talking about this because ADHD is one of those things that in the popular culture is sort of put out there as a phrase, and yet it’s vastly misunderstood.

So in a nutshell, ADHD consists of different categories of traits and symptoms. So we have an attention dysregulation. So even the name attention deficit is a bit of a misnomer.

People with ADHD don’t lack attention, and I should also preface this by saying that I’m talking as a professional who specializes in the treatment of ADHD, and I’m also speaking as a lifelong member of someone with ADHD, and a parent of a teenager with ADHD, so I come at this on all different angles.

So you’ll often hear me say “we” as I talk about people with ADHD. People with ADHD don’t lack attention. It’s more that the attention is really dysregulated.

If it’s something that’s interesting, people with ADHD can have sometimes better levels of attention than people without ADHD, what we sometimes call hyper-focused. But if it’s boring and not interesting or stimulating enough, and when we talk about the brain, we could talk about why that is, it’s really difficult.

So a lot of people would say, “Well, isn’t anyone when they’re bored, their attention waxes and wanes a bit?” Absolutely, but for people with ADHD, as opposed to thinking of attention as a dimmer switch, like a light switch, which most neurotypical brain, ADHD brain is like the classic light switch.

Either we’re in or we’re off, so attention doesn’t have that regulation. Impulsivity is another factor, doing things without thinking, often, again, to ground oneself or to seek stimulation, and a lot of times when we think of impulsivity, we think of the kind of impulsive kid that might be bouncing off the classroom walls, which includes hyperactivity, which is another trait.

However, impulsivity doesn’t always have to be expressed that way. Sometimes the impulsivity can be in things like binge eating issues. It could be in gambling problems, in substance abuse.

It doesn’t always have to be the kid that runs across the street without looking both ways, although that certainly can be one of the traits. Hyperactivity, which is, again, this sort of physical, almost like as if there’s this inner motor that people with ADHD have.

However, what’s so important also, ‘cause one of the myths is that ADHD doesn’t affect girls and women as often as it does boys and men. That’s not true.

You may not see that hyperactivity in that physical form, let’s say, with certain population, girls with ADHD, for example, you might not see.

However, in the ADHD world, we’re conceptualizing sort of a mental hyperactivity ‘cause there’s a difference between being totally spaced out or checked out, but a lot of kids with ADHD who might not be physically moving around, who might have enough, perhaps, anxiety or enough of wherewithal of like, “Well, if I get up out of my seat, I might get in trouble,” but in their heads, there’s a lot of activity and motion going around.

And then the other component of ADHD are problems with executive functions. So executive functions are all the things that our brain needs to do to accomplish a goal. We need to manage time. We need to prioritize, organize, working memory, all of these things which are really things that affect every life domain.

That’s why ADHD does not just affect school. It affects every life domain, and when people have executive function, or I should say everyone with ADHD will often have some level within that spectrum of executive function problems.

Jenn: So I know that you had mentioned the ADHD brain having the on/off switch. It almost seems like it’s hard for folks who have an ADHD brain to have a dimmer switch. Can you talk a little bit about what we actually know about the ADHD brain?

Roberto: Absolutely. What’s so exciting about this field is there’s a lot of great information out there, and unfortunately there’s a lot of not-so-great information that kind of muddles the good information.

So in a nutshell, we have all these neurochemicals in our brain, and one of them is dopamine, and dopamine is implicated in reward behavior.

It’s implicated in motivation, and what we know is that a neurotypical brain might have adequate levels of dopamine, which means it doesn’t take much for that brain to feel grounded, to feel stimulated.

What we know about ADHD brains is that they have less available dopamine. So at baseline, people with ADHD, we have a bored brain. I think of myself as someone whose orientation is what is going to stimulate me.

I’m always looking towards what is going to give me pleasure and/or stimulation, ‘cause not everything that’s, everything that’s pleasurable is stimulating. Not everything that’s stimulating is pleasurable. So sometimes even in stimulation, that can come in the form of conflict.

It can come in the form of drama. It can come in the form of urgency and dangerous situations that sometimes particularly young people with ADHD might be told like, “What were you thinking doing that? Wouldn’t you know that’s a dangerous situation?”

It’s medicating those levels of dopamine. So in order to regulate our attention, we need to be stimulated. We need to be connected to what we’re doing, and you almost want to think of the ADHD brain as just needing a lot more rope, so to speak, to tie us down into something, to anchor us down.

Another neurochemical called GABA, which is an inhibitory neurotransmitter, and what that means is when we have appropriate levels of GABA, we’re appropriately inhibited. So the individual that might say, “Oh, I want that candy, but I should wait until after dinner.”

That means the GABA levels are working, that you have appropriate levels of inhibition. ADHD brain, we have low levels of GABA, so we have a bored, uninhibited brain.

And why I think that’s so important to start with is for parents, for educators, for clinicians, for everyone, and for people themselves who have ADHD, when you understand that this has a neurological underpinning, now we can understand, oh, it’s not that my kid is misbehaving on purpose, or it’s not that I just lack willpower.

It’s that there’s a neurological underpinning. Now it doesn’t mean, okay, well, that means I am just going to give into these impulsivities, but it does mean we have to work at it.

It’s so important, and the work that McLean Hospital does around de-stigmatization is so important because once you have people saying, “Oh, I’m a failure,” or “I’m stupid” or, that’s when it starts to turn into other things which we’ll talk about.

So it’s so important to understand this is how the brain is wired, and all of those things are involved with the executive functions. So it can be very difficult, and to know too that executive functions have nothing to do with intelligence.

I work with individuals who have very high IQs who have very poor executive functions, and we conflate the two. We assume that kids who are smart, intelligent individuals are going to be really good at organizing their lockers and to get papers in on time.

That isn’t always the case. And for clinicians who are watching this webinar to know that it’s so important to diagnose and put ADHD on the clinical map.

It vastly gets underappreciated clinically, so if you’re working with a patient with depression and ADHD, binge eating disorder and ADHD, you are working, you have to work with the ADHD, because even treatment and therapies often have this assumption of good executive functions, like cognitive behavioral therapy when we have people write mood logs or cognitive distortion worksheets and stuff.

We’re expecting that somebody’s going to have that sheet, remember where they put it, write on it when something comes up, bring it back the next session. I know for a lot of my ADHD patients, that isn’t going to work, so we have to figure out some other way of doing it.

Jenn: So I wanted to address a lot of the stigma around ADHD in kids specifically because the picture that’s so often portrayed from when, even from when I was growing up, is a kid with ADHD is typically a young boy, doesn’t perform well in school, bouncing off the walls at home and being that class clown that’s wreaking havoc in the classroom.

I know that it’s typically lesser diagnosed in girls and women because the symptoms are different, but how much of that picture is actually true, and what can ADHD look like in kids in general?

Roberto: That’s a great question, and the thing is it can look so many different ways, all based on all of these different variables. So I grew up in the 70s and 80s. I was not diagnosed with ADHD as a child, but looking, nowadays if I were growing up, I absolutely would be. I have all of my report cards.

My dad, who did not have ADHD, saved them all, and you can see it written down. I was a bit of a class clown. I was careless and rushing through assignments. I talked a lot.

So I wasn’t the kid that wreaked havoc, but if I could get in a good joke in there, then I could get in a good joke.

I was a very mischievous kid. I was certainly impulsive, but not impulsive in a way that was conduct disordered, and so that’s important too, because only 20% of kids with ADHD have a conduct disorder, which means 80% do not.

I actually had very good social skills, and that was actually what got me through in a lot of ways. So although I did well in school, I can’t say that I was a good student until I went to college, for me, my experience. I just navigated really well, and there were things that were really, really difficult.

Procrastination was my middle name. Getting stuff done, when I say last minute, last minute exactly. Now I look back, I’m like, “How did I do that?” I hated school. To me, school was a social venue, and so it was my social skills that were the thing that got me through.

So most teachers liked me, some didn’t, but most did, and at the same time, I don’t think anyone would have known behind the scenes sort of how difficult it was for me to even just sit to read a book was very, very difficult.

And I should also mention about 50 to 60% of people with ADHD have a learning disability as well. I have a son with dyslexia, and looking back, I definitely had issues with reading as well, so that neurochemistry is similar, but to even sit still for 20 minutes was really tough.

I remember in third grade, book time where kids would pick up a book and they’d sit and read it, and I’m thinking after 10 minutes, “Are they really reading that?” And that narrative starts at a very young age.

Everyone that I know with ADHD, however it presented and manifested, has that experience where they realize there’s something different about me, and how it could get spun sometimes into a bad different.

For some people, it could be, well, I don’t know. It’s just different. It just is, which is how I promote this idea of, yes, you are different, but it doesn’t mean you’re defective or that you’re bad.

But you have kids who absolutely could be bouncing off the walls, and then you have some kids, I work with some kids who it doesn’t really get picked up until they go to college because they’re well behaved. They’re straight-A students. They’ve overcompensated.

They might be putting in three times the amount of work as what, their intellectual capacity is so high, but they’re putting, they’re just very hardworking, and then in college, where you have a lot more unstructured time and less adult supervision, it sort of can present itself, and it’s not that the ADHD just started in college.

It was just there, but ADHD is one of those things that’s so interactive with the environment, with the family, with your education. There are so many variables that I can look back at and think, “Wow, my life could have been very different.”

If I were maybe in a more rigorous school system, I would have failed classes. Maybe if I wasn’t the youngest of three, and there’s just, my parents retired by the time I came along, and I gave them the biggest run for their money.

If I were the oldest, I rebelled as it was, but not nearly as much as I probably would’ve if I were more the oldest. And so it really can look very different, and yet, Jenn, there are these universal things that if you get... Every year we have an ADHD conference.

This year, it’s going to be virtual, which people can then log into. It’s usually the first week of November. CHADD, which is one of the leading ADHD organizations, puts it together. But when you go to one of those conferences in person, it’s like you’re with your people. You just feel-

Jenn: It’s like a family reunion.

Roberto: It really is, and I’ll tell you why. The first conference I spoke at in 2008, it was in California, and it was at Disneyland. I mean, come on, like Disneyland, California, and Anaheim. Right across the street is Disneyland.

I’m like already, “This is going to be a cool conference,” and I was registering, and right next to me was a table with an iPod, a sneaker, a book, some pens, and I said, “Oh, are you guys doing a silent auction or auctioning those off?” And she said, “No, that’s our lost and found section.”

And I was like, “There’s one shoe. There’s not even two. It’s one shoe,” and she’s like, “Yep, welcome to the ADHD conference.”

But you know what, Jenn? I was like, “I’m home,” like, “Okay, let’s get this going,” and story after story, but it does, it interacts though with, if you think about the notion of intersectionality and this idea that a woman’s experience, a person of color’s experience, a person who is in a higher socioeconomic status.

There are all these variables, and yet there’s this thread that I would say most people with ADHD can relate to.

Jenn: And while it might not necessarily be losing one shoe, it is a level of relatability, exactly.

Roberto: Yes.

Jenn: So I’m curious, is there a relationship between ADHD and speech impediments or speech disabilities in children?

Roberto: Yes, so seeing that 50 to 60% of people with ADHD you’ll often see have some learning issues, learning disabilities, and a lot of times with speech issues, sometimes, not all speech issues, but speech issues can be an early sign of a language-based learning issue and learning disability.

So for example, it’s not uncommon for people with dyslexia to have speech issues when they’re younger because of the way that they’re encoding language, ‘cause dyslexia is a language-based learning disability. So no, it’s not uncommon to see some of those issues.

And again, there are people with ADHD that will never have those problems. There are people with speech issues who don’t have ADHD, but there is definitely this overlap of that, things that might require early intervention that you’ll see in kids with ADHD, definitely.

Jenn: So out of curiosity, how is ADHD linked to anxiety and depression? Obviously it’s not just associated with those two mental health disorders, but how is it linked to any other ones?

Roberto: So what I always tell people is ADHD rarely travels alone, that it, by the nature of it. So one, the experiences that people with ADHD can have, because the truth is a lot of people with ADHD, certainly if they’re undiagnosed and if it’s untreated, unmanaged, but even for people where it’s treated, they’re often exposed to a lot more messages around like, oh, you’re not trying hard enough, or, oh, you’re smarter than that, or, what were you thinking?

And sometimes it’s well meaning. It’s not even people thinking that they’re being harsh in those languages, in those words, because I think, again, people might have the expectation like, you’re a bright person. Why would you do X, Y, and Z?

So all of that negative messaging can definitely play with people’s heads in terms of them developing sometimes issues of an imposter syndrome. Maybe I’m not that smart. Maybe I’m just a good hustler. Maybe I’m sort of just getting by, and this idea of being found out that can develop into anxiety.

It can certainly impact your mood and your sense of self-esteem and self-worth if you have very poor executive functions. A lot of the adults I work with, they don’t feel like adults. They’re like, “I feel really helpless because I can’t do the things as well as other people can.”

And in addition to that, because of the neurochemistry of ADHD, we also know it lends itself to increasing the predisposition towards anxiety disorders, mood disorders, any addictive behavior or disorder.

In fact, Russell Barkley, who is the godfather of ADHD research, and I agree with this, that he said if you have unmanaged, untreated ADHD, you will have some impulsive, addictive type of behavior.

I work with a lot of people with eating disorders like bulimia and binge eating disorder and that comorbidity with ADHD, but it could be cannabis. It could be porn. It could be gambling. It could be spending money, just anything that’s sort of getting that level of stimulation.

We also know people with ADHD are at higher risk for developing personality disorders like borderline personality disorder. They’re more likely to develop various anxiety, depression, substance abuse.

So I think it’s so important for all clinicians, just like in an intake, a lot of people will ask about history of mood disorders, anxiety, suicidal thoughts, people with ADHD. I’m part of a campaign now where we’re starting to spread awareness of ADHD and suicide, and people with ADHD, independent of a comorbid disorder, are more likely to engage in self-harm behaviors, more likely to engage in suicidal behaviors.

But we don’t ask as much in the clinical community about ADHD, or when we hear about it, we think, “Okay, well, if they’re not in school anymore, it’s not an issue,” and it’s like, no, no, no, no, because that ADHD will undermine the treatment of whatever else it is that you’re working on if the ADHD is not managed, if it’s not treated.

So it absolutely can lend itself to that, and also keeping in mind that ADHD can look like other disorders. I do a lot of consultations where people are like, “I don’t know if I have ADHD or bipolar disorder or bipolar spectrum,” ‘cause if you think of symptoms of impulsivity, engagement in dangerous behaviors, sleep issues, emotional dysregulation, you see those in both.

Now, there are these differential factors to sort of tease out, but I’ve worked with people who get diagnosed with bipolar disorder who don’t have bipolar disorder. They have ADHD, and vice versa, and then I’ve seen people where they get diagnosed with one when they have both. And so 30% of people with ADHD have an anxiety disorder.

About 20% will have either a depressive or bipolar spectrum, and then you’ll see, again, substance abuse. If you look in research of substance abuse populations, binge eating disorder. The FDA-approved medication for binge eating disorder is Vyvanse, which is an ADHD stimulant medication.

So if that doesn’t tell people enough of the potential comorbidity, I don’t know what does. So we should always be assessing for ADHD, getting history, and then making sure that that’s being treated. Otherwise it will undermine whatever else you’re working on.

Jenn: So I know you had mentioned that ADHD sometimes could be misdiagnosed as being a different disorder. Are there some misdiagnoses that are more common than others?

Roberto: I would say ADHD and bipolar disorder are very commonly. That’s one I see. I see a lot of people with ADHD and OCD sometimes can get misdiagnosed in the sense that, for people with ADHD, they can have sometimes these sort of hyper-focused, almost like obsessive traits, but it’s for a different reason.

So for example, I can remember I grew up in a family where we ate dinner together, which now I’m very grateful for. At the time, I thought of it as a massive annoyance. But if I was in the middle, it would take me so long sometimes to just get into, let’s say, understanding math.

Math was not a strong suit, and there’s a learning disability called dyscalculia, which is like dyslexia is for reading and spelling and writing, dyscalculia is for mathematics, and I have no doubt that I had that issue because math was a real struggle for me, and if I finally got the pattern and the rhythm of what I was supposed to do, I needed to finish that.

I couldn’t be interrupted, and I remember distinctly my mom calling me down, “It’s time for dinner.” I’m like, “Oh, I can’t stop this right now, so you’re just going to have to wait,” and I didn’t say it nicely.

I wish I had known to be like, “Okay.” It took me a long time, but I don’t think I understood that back then that that’s this urgency of like, no, no, no, no, like you’re ruining my hyper-focus, and it could come across as oppositional.

It could come across almost as like perfectionistic, like OCD-like. It wasn’t that. It was, I am on this moving train, and if I halt the brakes on this, I don’t know if I can get this train working again, so I need to finish this out.

Similarly, before writing a paper in college, we call it having procrastivity, which is procrastinating by doing something productive, which would be cleaning my room, where maybe I wasn’t always cleaning my room any other time, but before I had to write that paper, suddenly I need to Windex the mirror.

And so I would engage in cleaning my room from top to bottom, and it would look, quote-unquote, like OCD, which I don’t use that term like, oh, I’m so OCD, ‘cause that’s not appropriate, but that’s what my friends would say.

They’re like, “Oh my gosh, you’re being so OCD,” and I’m like, “No, not really, ‘cause it’s not really around me being perfect or whatever.” It’s that, well, one, I can’t think clearly with clutter. I can’t.

I need as much sort of, it’s almost like my environment is a reflection of how my mind works. And then part of it was also I couldn’t get into writing the paper yet, and so it’s almost like I needed to exhaust every other thing that needed to be done, and then it’s like, I guess I’m going to write the paper now.

So it can look like OCD, and then having said that, about 30% of people with OCD have ADHD. So OCD, bipolar disorder, those are the ones that I would see definitely where they can get misdiagnosed in that way. Borderline personality disorder actually would be another one.

Jenn: So how often are folks able to successfully manage ADHD without the use of a medication?

Roberto: So it really varies. Just like ADHD, it’s different in different individuals, and to also know, even within an individual, it could be different depending on what it’s interacting with. You almost have to think of ADHD as very different than other diagnoses like depression, let’s say.

ADHD is not a mental illness. It’s a neurodiverse condition, so it’s all about what it’s interacting with. Let’s say if I were, if my job included being an accountant, which would be in my nightmare job, in an alternate universe, that’s what is meant to torment me, is I would without a doubt have to be on something ‘cause I would fall asleep.

I would never be able to get that done. So for adults with ADHD, it is paramount to them for their wellbeing and their mood to do something that feels very stimulating and fulfilling to them.

I don’t know how people do jobs or work that they don’t like. I don’t get that. I don’t judge it. When I was younger, I was almost in awe of it. How do people do that? And I knew at a very young age I have to do what I love to do, and music was the only thing.

I love music, and that was, I was like, “Well, maybe I’ll just be a starving artist and play drums in a punk band,” and that was it, because I couldn’t see when I see what other people did, and then to my parents’ savior is my high school offered a psychology class my senior year of high school, and that changed everything.

So in the work that I do, like right now, my dopamine levels are elevating. I’m in dopamine land right now, so I’m constantly stimulated. I love people. I love elevating people as best as I can. I’m working with a different person every hour.

I specialize in different things. This is totally catering to my ADHD brain. So my need for medication would not be the same as if I were an accountant. So I always tell people that because I don’t want people to judge themselves.

I certainly don’t want parents to think, oh, they’re not good parents because their children might need to be on medication. It really to me is almost like, if we were to just use the analogy of vision, that if you have poor vision, and if you have poorer vision, you just need a stronger prescription of glasses or contact lenses.

We wouldn’t say, “Hey, just squint through the day. You can get by. Come on.” We wouldn’t say that, but with medication, there’s this stigma that it’s over, and granted, there are lots of people who are diagnosed with ADHD that don’t have ADHD.

But Jenn, the research shows that far more people are underdiagnosed with ADHD than is the case, far more people. I work with adults all the time who don’t come in to see me because they have ADHD.

They come in because they have binge eating disorder. They have a substance abuse problem. They’ve been fired from their 14th job of being fired, and then it gets uncovered through our work that they have ADHD, and then it’s this epiphany for them of, oh my gosh, of course.

A lot of adults past the age of 30, 35, often will get diagnosed with ADHD when their kids do, because, again, if you were not the conduct-disordered kid growing up, I know the kids that I knew growing up that were diagnosed with ADHD were those kids, and granted a lot of them were my friends.

They weren’t boring. They were more fun, but those were the kids that were diagnosed, and so a lot of adults are diagnosed when their kids are. So it really depends on that person, what they need to do, and some people notice, let’s say in high school, they really need that medication to really help them engage in all these.

And then some people when they go to college, they’re like, “You know what? I’m not in a building seven hours a day. Their classes are much more spread out. I have a lot more time. I can manage this better.”

For other people, it’s the other way around. I’ve worked with people that, in high school, because everything is super structured and their parents are there, and we often say that a parent or parents can be the frontal lobe where all our executive functions are housed, and then you go to college, you don’t have a frontal lobe coming with you, and that’s where the medication.

So it really, really varies. I’ve seen it in identical twins where one needed the medication and the other didn’t, and they have the same DNA. So it goes to show it’s really individual and no one should be made to feel less than or they’re not trying hard enough, or the worst is that they’re taking the easy way out. Medication doesn’t make you successful.

Medication puts you on an even playing field to then do what you need to do to avail yourself to strategies and to do the hard work, in the same way that glasses don’t get you a promotion. Glasses enable you to see clearly so you can read what you need to read and get to then work hard to do all of those things.

Jenn: So when you said that a lot of parents end up being diagnosed at the same time as their kids, to be clear, can adults develop ADHD, or is it that ADHD is a condition that started in their childhood and was brought to the forefront when they were adults?

Roberto: That’s a great question. We are born with ADHD. So ADHD is a highly heritable condition. Frankly, I’ve never worked with someone who doesn’t see ADHD in their biological family.

My mom, who passed last October, she’s definitely the one with ADHD, but I also credit that because I tell her that her, she was from Brazil, and she came to this country just, her family thought she was nuts, and she’s like, there’s this couple that she was cleaning their house and the woman was going to have a baby.

The husband was going to MIT for school, and she said, “Could I be the nanny? Could you sponsor me, and I’ll be the nanny for this baby? I just want to go to America.” She was not educated. She did not know a word of English.

She grew up in poverty, and her family is like, “That’s so impulsive. That’s so crazy.” Now the funny thing is, in Brazil, all of my family, they all refer to themselves as electrica, which means they’re all electric, and I’m like, “We call that ADHD.” And so I credit-

Jenn: That’s such a delightful way of recognizing having that electric energy about you.

Roberto: Isn’t it? We’re all electric, and when I went to Brazil, I’ve only been there once when I was 11, we were there for six weeks, and I met, ‘cause my mom was the only one that came over here, all of her siblings, and when I met her older brother, my mom was a ball of energy.

She was fierce. She was an amazing, amazing woman who lived 86 amazing years, and her brother made her look like the Buddha. He was very, very hyper, but so loving and so, but I tell her that.

When I started understanding ADHD, I’m like, in some ways, one of the theories as to why we might even see higher rates in the United States is because we are a nation of immigrants, and people that, a lot of people, granted there are some people that come for fear of persecution and violence, but for a lot of people like my mom who just were seeking something better and said, “Whatever, I’m just going to do it,” and that would... So you are born with it.

If you have ADHD, I think it’s like 70% chance you’re going to have a child with ADHD. So when my wife was pregnant with my son, I was like, “Be prepared.” And I can tell you, I could have diagnosed him prenatally.

Every ultrasound we got, the doctors, the radiologists would be like, “Whoa, you’re pretty active,” and it was pretty apparent. The difference is that it just doesn’t get diagnosed or it gets thought of as like, oh, you’re electric, or, oh, school, or school wasn’t for me.

Sometimes people have, again, those narratives of like, “Oh, I just counted myself out of those opportunities and whatnot.” But when I talk to these adults who were diagnosed as adults and you look in their history, it’s all there.

It’s all there, even, again, when I look back in my own history. When I do talks and presentations about my experience, I have this eighth-grade autograph book. I was in the same school from pre-K to eighth grade.

I grew up in Somerville, Massachusetts, and in the eighth, and I was looking through these, and it even was striking to me how many of them were like, “Roberto, have a great summer. Don’t get into trouble.” “Hey, Roberto, be careful. I don’t want to see you in prison.” “Roberto, you’re one silly kid,” teachers that would just hold... I was very verbally impulsive.

But it’s all there, so it doesn’t just show up there. Or what happens is that the executive demand has changed, and so sometimes you’ll have people that are like, “No, I never had these issues before,” but maybe it’s because they were in environments where the executive demand might’ve been low, and then as your executive function demand increases, then you start to see it.

Jenn: So based on what you’ve said so far, it seems like it can never really be too late to be diagnosed with ADHD, but at what age can it start being diagnosed?

Roberto: So absolutely never too late to not only be diagnosed, but to be managed and treated, and I remember I gave a talk once.

Actually, the talk was on hoarding, but I mentioned, it was to a group of senior citizens, and I had mentioned ADHD very briefly, and after the talk, a man who was 90 years old, I can almost cry thinking of this, that he came up, he had tears in his eyes and he said, “That five-minute thing you said about ADHD,” he goes, “That is me exactly, and for the first time in my life,” he said, “I actually feel that I’m not a dunce,” because when he was younger, his teacher actually wrote a note to his mom saying he was a dunce.

That was the word that they used, he said, because he was too stupid to learn. He told me about his life. He had a very successful life by all objective measures, an entrepreneur and businesses, which is, again, an industry that you see filled with people with ADHD, and he goes, “But I always thought I was a fraud,” that imposter syndrome.

And that is just the importance of just disseminating that information. So how young? There could be kids at four and five.

Typically at around school age is where you start to, but it’s very important also in understanding, a full diagnosis is getting all the history, getting a lot of information, ruling out everything else, because ADHD can, other things can mimic that.

If you have a sleep disorder, if you’re in a house where there’s dysfunction or trauma, there are a lot of other things that can mimic these symptoms that we wouldn’t want to say, “Oh, they’re running around. They’re impulsive. They can’t pay attention. They have ADHD.”

We’d want to look at, and ruling out all of those other things, but typically I would say it’s when you start to see a kid go to school.

remember my son, who’s amazing, I love him, and when he was in this gymnastics class, he was like four, and the gymnastics teacher would say, “Okay, everyone, it’s circle time,” and we all sit in a circle. This is a room filled with all these cool things.

I had a hard time sitting in a circle, and I’m an adult, and he’s just running. And people would say, “Oh, boys will be boys,” even though, again, there were girls that were doing that too. But the fact is all those other kids, even though they wanted to go and jump on the trampoline, they got themselves in that circle.

You could tell it was hard, but they got themselves there. He was off and running, and I had to sort of coax him. Now, what was important as a parent is I understood it.

I wasn’t like, “Oh my gosh, get in the circle time. What are you doing?” I’m like, “You know what? I get why you don’t want to be. Circle time is boring. What are we doing? We’re in gymnastics. Let’s jump on the trampoline.”

However, so that’s important too, because if you are a parent, it can be very, very difficult to understand this way of being if you don’t have this wiring, and I get it, and I don’t want parents to feel...

A lot of parents will say to me, “Oh, I feel like I failed my kid. I was being harsh.” I’m like, “We don’t know what we don’t know,” and so all parents have the same intention is to do what’s right by their kids, and although he did need to get in circle time, it was important for me to understand why, A, that is actually harder for him to do, and so that it doesn’t come across as punitive, because then that can set up a very unhealthy dynamic in a parental parent-child relationship.

Jenn: So how do you work with young kids who may have ADHD, especially the ones that can’t focus or sit still? I know that you talked about having a little bit of that relatability, but what advice do you have for folks with those kids?

Roberto: Yeah, I think, well, first is just a lot of education, and even with kids who are very young, what I told you about dopamine and GABA, I break it down into language that even they can sort of take in, because it’s important for them to know you’re not bad, that there are these things that, yes, ‘cause I want to validate to them these things are harder, and at the same time, I don’t want them to feel, okay, well this is an excuse for me like, oh, I have ADHD.

I don’t have to do that. And there’s a responsibility that we have to sort of work with that in some way, and so it’s starting with that piece, and then with parents, it’s helping them understand, because an ADHD brain is... The term neurodiversity, it’s a bit out of the box, and sometimes these kids might have to do things that are out of the box.

I remember very clearly in third grade I had to write what seemed like a book, but it was probably a paragraph on Athena, the goddess of wisdom. We were all given gods and goddesses, and this is typewriter days before computers, and I just, I couldn’t think straight.

It was like blank page, blank page, and my brother had a cassette of Queen, the rock band Queen, and “Another One Bites the Dust,” that song, and for all of you who don’t know that song, oh my gosh, please know that song. It’s one of the best songs.

Jenn: It’s a jam. It’s in my top 10.

Roberto: Bass line, best bass line. So the beginning’s like, and I played that, and all I can tell you, Jenn, is it just poured out of me.

I had the music on, and then once the song ended, I had to rewind it and play it, and my dad, who was a teacher, he did not have ADHD, he was like, “What are you doing? You can’t have music while you’re doing work. That’s going to distract you.”

And I said, “I don’t know, Dad. All I can tell you is that I was looking at a blank piece of paper, and with the music, it’s just,” and I don’t remember how I described it, but I was trying to explain to him, this is helping me.

This is not distracting me, and to his credit, which I’m eternally grateful for, he said, “Okay, I’ll come back in 10 minutes,” he said, “and we’ll see.” Little moments like that could make a huge difference, ‘cause had he said, “Nope, you can’t do this,” and he ripped the tape recorder away from me, it would have been a fight.

That was just how I was wired. And he came back and it was all written. I had literally written it in like, and I have never written a paper, and that includes my dissertation, my master’s, without music.

In fact, on my dissertation acknowledgements page, after thanking my family, my wife and my mentor, who, Harrison Pope, who’s a psychiatrist at McLean, was my mentor, I thanked Nirvana and the Go-Go’s and Green Day and Joan Jett because that was the music I was listening to while writing my dissertation.

And I listened to it loud, and that could seem so contra-indicated, but part of having ADHD and what I encourage with the young people I work with and for parents is you’re going to be your own researcher.

You’re going to be your own observer, and my motto has always been, I’m just going to do whatever works, as long as it doesn’t hurt me or hurt anyone else. You just got to do what works, and I have done very bizarre, unconventional things to get through. In grad school, when I have hundreds and hundreds of pages to read which I cared about, unlike high school.

I didn’t really care about a lot of what was assigned to me. How I had to read it, Jenn, is I discovered by accident that I could read with more concentration on a moving subway train, on the Orange Line in Boston, oh yeah, even during rush hour, than I could sitting in my apartment I was living in at the time.

I don’t know, motion, the stimulation in the same way that some people go to Starbucks to do their work rather than doing their work in their apartment. So I was like, “Okay, I can read six times faster,” and with more so on Sundays, I used to take a hunk full of those articles. I’d introduce myself to the train conductor, and I’m like, “I’ll pay multiple fares, but I’m going up and down this Orange Line for hours,” and they’d always say, “Oh, that’s fine.”

I’d pack myself a little lunch, and I was on that train with my highlighter reading, and it could be crowds of people going in and out. That’s what I did. So it’s encouraging people, try different things, utilize different things, and if it doesn’t work, it doesn’t work.

Then we move on to something else. And then for the, especially for kids to understand not to see themselves as less than in that way is really important.

Jenn: I love all of that so much because when I have to do my most important work, which oftentimes is writing, for me it’s epic film scores, and I had a geometry teacher in high school introduce us to that during an exam. He put on the “Gladiator” soundtrack,

Roberto: Oh, great.

Jenn: And ever since then, it’s just been epic film scores for me, and that’s what got me through my thesis, so you are speaking my language, my friend. Out of curiosity, what are your thoughts on an ADHD coach for a child?

Roberto: So coaches can be very, very helpful. So in my role as a therapist, I work with certainly all the comorbidities that we might see, and I definitely integrate coaching in there in terms of helping people figure out strategies that work for them.

A coach though can have sort of more frequency, and sometimes the sessions aren’t structured like a typical 45-to-50-minute session like a therapist would be.

I’m working right now with someone who’s in graduate school, is writing, getting through his dissertation, and we talk about the sort of macro strategies, but then he also works with an ADHD coach as an adjunct where, 15 minutes a day, checks in with the coach, okay, what’s your goal today?

What are the three, four bullet points that we can use, and then to check in later in the evening, where did you go? And I integrate some of that, but a coach can be really helpful.

I work with a lot of adults who work with ADHD coaches around, whether it’s getting household things done, whether it’s getting schoolwork done and things like that, because not all therapists integrate that necessarily in their practice, but they can be very, very helpful.

Jenn: So we’ve received heaps of questions around young kids using cannabis to help manage their ADHD. Do you have any suggestions for how parents can approach teenagers that are feeling relief from their symptoms by using cannabis, but might not necessarily, they might not, should not be using it?

Roberto: They absolutely should not be using it, and I feel very, very passionately about this. Maybe on the page, Jenn, you can provide a link. I did a webinar. One of the greatest resources is ADDitude. It’s A-D-D-I-T-U-D-E, additudemag.com.

I’m on the scientific advisory board for ADDitude, but I fell in love with this. It’s now mainly a website. I think they might still have it in printed form too, but I fell in love with this magazine as a parent of a then infant with ADHD, as a professional, but I did a webinar for them about cannabis and ADHD, and I delved into, anytime I do any of these webinars, I take it very seriously.

I look into the information, and frankly I thought, “Okay, I don’t think it’s good for their brain, but is it that harmful?” And let me tell you, it’s alarmingly harmful to a developing brain, and yet it’s the most widely abused substance for people with ADHD.

So it absolutely stimulates those receptors in the brain that cater to what people with ADHD are seeking relief from. So we never want to stigmatize people or moralize addiction in this way by saying, “Oh, you’re a pothead,” or any of these kind of... We want to understand when they say, “This helps me sleep.” “This helps ground me.” “I’m not all over the place in my head,” they’re absolutely right.

It does all of those things, and it’s neurologically harmful to the brain, particularly a developing brain, which typically is around by the age of 25 our brains are done developing. For people with ADHD, it’s about 27 to even 28. It’s a little bit later.

So the research that I refer to in this webinar, and even as I’m talking now, is really what we know prior to that age. Someone starts using cannabis after 30, I wouldn’t advocate it, but I can’t speak to the level of harm.

However, I can speak to the level of harm. It makes all those ADHD symptoms worse over time. Contrary to popular belief, you can be addicted to cannabis. Today’s cannabis is not your grandfather’s cannabis. It’s a much more potent form.

THC levels that were at maybe 3 to 4% in the 60s and 70s could be at minimum 12 to 15%, and if they’re edibles and dabbing, could be at 80, 90%. You almost want to think of it as a different substance in the brain.

So you want to start the conversation by first asking your child, “Tell me what this does for you,” because the truth is most kids with ADHD who use cannabis don’t even talk about the high, the sort of euphoric high.

They will often talk about it in language of self-medication. “I feel just grounded. This is the only thing that can help me fall asleep ‘cause my head is racing.” They’re talking about self-medication. So you want to join them with that in saying, “Gosh, that must be hard to have those symptoms.”

So I understand the appeal of it, and we have to understand the research, and the truth is this isn’t good for your brain. It’s going to make all of those things worse. But I highly recommend people to check out that.

It was actually a two-part webinar, because over 15,000 people signed up for that first webinar, it’s that much of an issue, that we had a whole part two of just questions and answers.

Jenn: So are young folks diagnosed with ADHD self-medicating with drugs or alcohol often? Is there any research out there on outcomes of those kids that are self-medicating?

Roberto: A lot of them definitely are self-medicating, and a lot of them will say, a lot of the people that I work with, adults whose addiction started when they were in adolescence, said that it often started with the appeal of just grounding.

Again, with ADHD, it’s almost like there’s this baseline of almost feeling untethered to something. And that could have its positives, which we can talk about, but the negatives of that is that you just don’t, it takes a lot, and if you think about even at the end of the night, sleep disorders go hand in hand with ADHD.

To this day, it’s very difficult for me to just fall asleep. It’s a three-ring circus to basically I have to have, talk about again, which can look like OCD, I have to have so many things and all my ducks in a row to get me in bed, because I’m just thinking, and it’s not anxious thought.

Sometimes it’s anxious thoughts, but sometimes I’m thinking of things I’m excited about, things that, oh, that would be a really cool thing, or I’m reflecting on the day, or I’m thinking about “Another One Bites the Dust” and the bass line in it. It could be anything.

So yes, a lot of kids with ADHD are self-medicating, and so when they’re on proper treatment, and one of the concerns with stimulant medication is, oh, are they going to get addicted to that?

Timothy Wilens, who is at Mass General Hospital, who’s an ADHD substance abuse expert, he has done a wealth of research that has shown that people with ADHD, when they are treated with stimulant medication, are less likely to relapse, are less likely to experiment over time.

And it’s a shame because honestly there are some rehabilitation centers that count stimulants as a violation of sobriety, and that’s wrong, because if you have ADHD, that stimulant medication could be one of many tools that you use to keep your sobriety going.

So with any substance abuse population, you always again want to assess for ADHD and try to understand that. Again, we don’t want to moralize addiction, and we want to understand that there is something about what these drugs are doing to their brain that is self-medicating.

Jenn: Do you have any recommendations for folks who do have sleep issues related to their ADHD?

Roberto: Yes, so with that, I would say it’s really about thinking... I like to think of ADHD as something that is so, again, contingent upon the external, because we’re so outwardly like, “What’s going to stimulate me?”

Now granted, I have a very, very active imagination. I have a very cool inner world that can stimulate me, but only if nothing is on the external to stimulate me, but we have to think of that with everything else. So in order for me to go to sleep, it’s not like somebody who says, “Oh, it’s 10 o’clock. I’m going to go to sleep now.”

That requires an internal cue that then affects the external. That doesn’t work for me, because if I’m doing something, it could be four in the morning and it doesn’t matter to me. If I’m engaged and stimulated, I could easily be up all night.

It would take a lot for my body to finally say, “Whoa, Roberto, I know you’re stimulated, but we need to get to sleep right now,” which was, in high school and college, I shudder to think. When I meet someone that’s not pulled an all-nighter, I’m like, “Really?”

And not just writing papers, just having fun or doing things like that. Shenanigans is what I would call them. So I need to be cognizant of what am I doing two hours before going to bed. I’m readying my brain, dimming the lights down.

I change into the clothes I’m going to sleep in two hours before, and it might seem these silly things, but it’s literally like, then I look at, and I’m like, “Oh, I guess I’m going to bed soon.” That’s how I have to sort of do it. I keep my room very cold because I need weight on me. I don’t know how people will sleep with a sheet on them. I don’t know.

I have a heavy comforter. I sleep with a wedge pillow. There’s a weird vestibular thing. If I sleep like this, if this is my head, I feel like I’m sleeping like that. It’s my whole life I’ve felt that way. I’ve always propped pillows up so that I’m sleeping on a bit of an incline.

I have a whole host of sleep disorders. When I was a kid, sleep talking, night terrors, sleep paralysis, sleep apnea, all goes hand in hand with ADHD. If you are a chronic snorer, get a sleep study, because you could have sleep apnea, but it’s about readying yourself.

Now, for some people, being aware. When I work out now, hopefully be able to go back to the gym now that they’re starting to open up, but when I work out, I work out in the evening, Jenn. I work out at a 24-hour gym.

So 10:00 PM is when I’m working out, me and eight other people that are at the... It’s the same eight of us. And you might say, “Wouldn’t that activate you?” No, I go home, I take a shower. I’m better able to sleep that night. For someone else though, with ADHD, it could be the total opposite.

So it’s, again, you’re being your own researcher, but you definitely want to be aware. I don’t watch certain shows or action. During the last presidency, I have to say I couldn’t watch the news or hear anything in the news hours before bed because it would really rev me up, and that gets my mind sort of just stimulated and hyper-focused.

So it’s readying yourself, making your bed comfortable, and making it be a place that has comfort and groundedness to it.

Jenn: I know we’re already bumping up toward the end of the hour. Do you have time for two more questions?

Roberto: Sure, absolutely.

Jenn: Amazing. So the first question is that you had previously mentioned ADHD adults often experience boredom due to lack of stimulation or interest, which can lead to poor time management at work.

What advice would you have for an adult with ADHD who’s looking for a long-term career, but has struggled with maintaining interest in previous jobs they’ve held?

Roberto: Yeah, so first is to get a sense of, is this something that really fits in terms of not only your strengths, but your interest level in that way?

And there are a lot of jobs that people would say, “Yes, however, this other aspect I can’t do.” I actually get a lot of emails, and why I’m very open about my own personal experiences, I think there’s a lot of power in just sharing stories and recognizing I just want to be one of many other faces out there.

But when I get emails, and I’ve gotten dozens of these from people who say, “Wow, I never thought I could get a PhD because I would assume writing that dissertation would just, I wouldn’t be able to manage that.”

And I’ve talked about sort of my experience of riding the subway, listening to music and things like that, and it’s like, yes, we might need support though around it. So when you go into these jobs, you want to be as honest with yourself as possible, and this is where it’s, to me, it’s just kind of this radical acceptance, to use a DBT term, of this is what it is.

I can’t expect that I’m going to have the same time management skills as somebody else does, but that doesn’t mean I’m... I’m a very punctual person. My kids know me as being compulsive about time. They didn’t know me in high school where I was late all the time.

I was threatened to be suspended. I was late that often in high school. I work at it. Time is not this internal concept to me. I have to write Post-it notes. I have to set alarms on my phone. Some people work with a coach in terms of doing that.

When I pack for when I travel, anytime I have to fly, I wish I had, I can show it to you, but if let’s say the plane is taking off at 7:00 AM, I have to write down, okay, 7:00 AM, and I put an arrow, and I’m like, “That means I have to be at the airport by five,” ‘cause I want to be there two hours before, and I put an arrow.

That means I have to leave my house at that time. It’s only going to take maybe 20 to 30 minutes. I have to leave my house at 4:30. That means I have to wake up at this time ‘cause I definitely want to... I like taking a shower before going on a plane. That’s that time. That means I have to get to bed this time the night before. That means I need to...

So I’m backtracking time to understand how that works, because years ago, it would be I am packing overnight. I have almost missed a flight. I have, because I’m just, you’re focused on these other things. So it’s making time concrete and not feeling shame.

find honestly, Jenn, one of the biggest obstacles to a lot of adults, probably more so than kids, is the shame that they feel about having to do these kinds of things. When I pack, I draw a stick figure, I’m not kidding, a stick, I call it stick man, and I put arrows to every part of the body like, oh, the hair.

I need shampoo, conditioner, gel, or the eyes. I need this, this, this. I don’t know how people just open a suitcase and just pack. I don’t understand that. It’s like my mind doesn’t work that way. I need it to be, because otherwise I’m going to miss something or it’s going to all, it’s sort of disorganized in my head. So it’s availing yourself to those strategies and knowing that you’re not alone in having to do those things.

Jenn: And for so many other folks, it’s going to look like overpreparedness to an extreme, but for you, it’s just, it’s exactly what you need, and that’s just what works for you.

Roberto: Absolutely, because if I didn’t do that, then I would miss... If I was going to a conference, I would pack everything but the suit.

It’s almost like, how many times would I go to a supermarket where my wife might say, “Oh, I really need,” I don’t know, watermelon, and I will come home with everything but watermelon, but now I never go to a supermarket without a list.

I always will have a list written down, and there are times you barter with it and you think, “Oh, I won’t need one this time.” Well, I know I’m at a point in my life now where I know what I need, and that’s the other thing is I say is an upside is if you avail yourself, especially with these young people that I work with.

I know myself really, really well, Jenn, and not just because of all the things that make me a psychologist, but because of my ADHD, because I’ve had to study myself for my lifetime to get through and navigate things, I know instantly what works and what doesn’t because I’m so good at... I’ve been my own test subject for all these years, so that’s the upside to it is if you avail yourself to it, you really will know yourself really well.

Jenn: And that self-awareness that comes into play, once you actually take the time to learn yourself, you’re more self-aware and you’re unconsciously more accepting of who you are, it lowers your anxiety, you have better self-esteem. It all ends up falling more into place.

Roberto: 100%.

Jenn: Alright, last but certainly not least, we want resources. What books are you most often recommending for individuals or parents of kids with an ADHD diagnosis?

Roberto: So there are a lot of good ones. So starting with, in terms of video, Russell Barkley is the leading researcher on ADHD. He’s a researcher, he’s not a clinician, and I only say that because sometimes parents almost get a little scared because he talks about ADHD as being this life-impairing disorder, and it can be.

That’s a thing. I attribute the down moments of my life to ADHD, and I attribute the amazing, successful moments to ADHD. It’s like a coin to me. I can’t separate the heads and tails. So just as a caveat, when people hear that to think, okay, this doesn’t mean this is the absolute course your kid will take, but if it’s untreated, unmanaged, it can really get in the way of people’s physical health, their mental health.

So any YouTube lecture by Russell Barkley, highly recommend. There’s a great YouTube channel called How to ADHD. A young woman, she’s in her early thirties, her name is Jessica McCabe, she has ADHD. She’s not a clinician or researcher.

However, she curates the information for her videos really well. She consults with all of us in the ADHD world, the experts, and they’re very colorful. It’s very well suited for an ADHD audience, but she might have a topic on ADHD and procrastination and she’ll tell you the underlying neurological reasons why people with ADHD procrastinate.

These are tips, these are strategies, and she’s just very relatable. I would highly recommend that. As far as organizations, there’s Children and Adults With ADHD, or CHADD. They are the leading organization. I’m on the professional advisory board for CHADD.

For adults, there is the Attention Deficit Disorder Association, which is the first organization that is catered just towards adults with ADHD. They have webinars, and on CHADD, there’s a lot of free content and webinars and articles.

ADDitude is my number one resource. They have just, again, lots of free webinars, articles, checklists, and things like that, and it’s catered towards children through adults, women, men, people of color. We try to represent all of the different facets of ADHD.

There’s another great organization called Understood, understood.org, which is more catered towards parents who are raising children who not only have ADHD, but have learning disabilities, might be on the autism spectrum, sort of all the sort of neurodiverse conditions.

As far as books, my favorite are, so “Driven to Distraction” by Ed Hallowell and John Ratey is actually probably the first book that really put on the map adult ADHD.

My really good friend and colleague Ari Tuckman, he wrote a book called “More Attention, Less Deficit,” which to me is probably the most comprehensive understanding of all facets of ADHD, and that’s actually probably my favorite book about ADHD, “More Attention, Less Deficit.”

He also has a self-help workbook called “Understand Your Brain, Get More Done,” and it’s an executive function workbook, and it’s written in a very, again, they know their audience about, okay, we’re going to talk about time management.

This is the science in layperson’s terms why this is an issue for you, so let’s take the shame away from it. These are things that we do and strategies of sort of what can help you in that way. There are a whole host of books.

Stephanie Sarkis, who is an ADHD, who’s a psychotherapist, ADHD coach, she has a whole host of books, one in particular for college students that’s just for that transition to college for kids with ADHD, the things for them to consider, accommodations, ‘cause I see I work with a lot of college students, and some of whom are like, “I’m done needing accommodations,” or “I don’t want to have to need those accommodations,” or sometimes they want them, they just don’t know where to go to find them.

There are great books about women and ADHD by a woman named Sari Solden, S-A-R-I, and the last name is S-O-L-D-E-N. She wrote the first book really that was about women with attention deficit disorder.

She just published with Michelle Frank, her co-author, a book about women and ADHD and acceptance, ‘cause women with ADHD can be very hard on themselves for not having the soccer schedules together or managing work and home life and all of these things which already could be an executive landmine for anybody, let alone someone with ADHD.

So those are just some of the resources that come to mind. You can put my email address, Jenn, in any link, and please feel free, if there are questions that we didn’t get to, feel free to email me. It may take me a little while to get back to you, but I will get back to you, resources.

If you live in another part of the world or the country and you’re looking for ADHD people, I can do my best at finding you a referral in your local area.

Jenn: I love how you said “Here are just a few resources,” and then you rattled off, as I wrote them down, you rattled off 11 off the top of your head.

I feel like that alone speaks volumes to who you are as a provider and a researcher and as somebody who has been so engaged in this. This has been exceptional, so thank you so much. We could have talked for three hours,

Roberto: Absolutely.

Jenn: But you gave us enough time out of your busy schedule, and for that, I am eternally grateful. So Dr. Olivardia, thank you so much. This has been phenomenal.

Roberto: Thank you.

Jenn: And if you have stayed with us this entire time, first of all, a hat tip to you. Well done, and this actually concludes the session. So until next time, be nice to each other, but most importantly, just be nice to yourself. Thank you again, Dr. Olivardia. Take care.

Roberto: Thank you.

Jenn: Thanks for tuning in to Mindful Things! Please subscribe to us and rate us on iTunes, Spotify, or wherever you listen to podcasts.

Don’t forget, mental health is everyone’s responsibility. If you or a loved one are in crisis, the Samaritans are available 24 hours a day at 877.870.4673. Again, that’s 877.870.4673.

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The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.

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