This is the Empowered Caregiver Show.
If you are a caregiver or know someone who is,
this show is meant to uplift you through education and support,
while also lifting up every caregiver's invaluable role in society.
Now, here is the Empowered Caregiver and your host,
Liza Helen Brand.
You are listening to the Empowered Caregiver
and I am your host, Liza Helen Brand.
And if you listen to my show regularly,
you will often hear me reference the fact that I have ADHD.
I do this for a couple of reasons.
First, it often impacts me in the moment.
So instead of just dismissing it, I choose to address it.
You know, ADHD is a part of me.
It's a part of who I am.
As long as I'm awake, it impacts me.
It impacts my ability to function.
It impacts my relationships.
My work performance, my self-esteem, my mental health.
I cannot think of one area of my life that is not affected or impacted
by the fact that I have ADHD.
So if I can call it out, if I can explain it,
if I can raise awareness about how it impacts people like me,
then I hope that information can help others.
And if you have ADHD and you hear me talking about my struggles
and you can relate, then hopefully you know you are not alone.
So with that said, I am here today with Kelly Pickens
from Undivided Attention, which is located here in Madison, Wisconsin.
Kelly is an ADHD-certified clinical service provider
and a certified attention deficit consultant.
She has also been a family nurse practitioner for over 20 years.
And Kelly has ADHD diagnosis herself.
So she has firsthand lived experience.
Kelly works with men and women.
And I'll talk to her more about that in a minute,
but I think she has kind of a target of working with women.
I know it impacts both, and I know that women can really struggle
with the ADHD diagnosis and just the acceptance of that
and it's the whole just difference between girls and boys.
So we're going to dig into that a little bit.
Because I think when a lot of people hear ADHD,
their minds just go to the little disruptive boys that just can't sit still.
However, it does.
It really impacts men, women, young people, older people,
the whole spectrum.
So today we're going to learn more about ADHD
and how it impacts all areas of people's lives.
Because like I said, it is so, so, so much more than the inability
to just pay attention or sit still.
ADHD often is downplayed and can be the butt of a joke,
which is hard and hurtful.
But the reality of what we know, it's still fairly a new diagnosis.
So with that said, it is a serious diagnosis.
And when left untreated, it can have a negative impact across all domains
of a person's life, including their education, their occupation,
their social opportunities, relationships, finances, legal issues,
even your overall general health and well-being.
So with that said, let's jump right in.
Sally, thank you so much for joining me today.
And before we get started talking about the ways ADHD impacts people
and what we know can help, how do you define ADHD or what exactly is it?
Right. Well, here's the elevator pitch.
ADHD is an inherited neurodevelopmental disorder.
There are subtle but impactful structural, chemical,
and metabolic differences in the brains of people with ADHD,
which affect how they think.
Feel and act, and a nice way to define it is it's a pattern,
presence in childhood, but maybe not always impairing,
of having an interest-driven nervous system with attentional dysregulation,
the ability to hyper-focus.
Oh, yeah.
Difficulty with time management, emotional dysregulation,
as you mentioned, impaired working memory,
and subsequent to all of this is the rejection sensitivity.
And most of this is not in the DSM,
and what it really amounts to is executive dysfunction or impaired self-control,
which is really a struggle to do the right things at the right time.
And a lot of people really dislike the name and want to change it
because most people with ADHD neither have a deficit of attention,
nor do they have overt physical hyperactivity.
So here's my proposal for a new name.
It's disorder of dysregulated attention, mood, memory,
and time management, aka, dammit.
Dammit.
I love it.
Dammit.
I have it.
That's a proposal.
Yes.
Yes.
I think we should go with that.
Okay, when you started it, when you started naming it all off,
I'm like, I have ADHD.
I lost you midway through that.
But when you said summed it up with dammit, yes, that is what it is.
Right.
So you have on your website that you were diagnosed with ADHD at 48.
Can you tell me a little bit about your personal journey
and what led you to get the ADHD diagnosis?
Yeah, well, so it was January of 2020,
and I needed to do some continuing education credits for my licensure,
my NP license.
And so I opened up the catalog in alphabetical order right at the top,
adult ADHD.
And I thought, I wonder what's new in adult ADHD.
I thought I knew about ADHD.
But as I was going through this program, I learned two things.
One, I knew pretty much nothing about ADHD,
despite being a family nurse practitioner for 17 years at that point.
And two, I had it.
This was absolutely shocking.
ADHD was not on my radar.
I had actually pursued neuropsych testing for,
I thought it maybe I had dementia a couple years prior to this.
But nobody mentioned ADHD.
But of course, you know, I didn't tell the neuropsychologist
that, you know, I took the family car for a spin when I was 14,
and that, you know, I was grounded most of my growing up
and skipped most of my senior in high school,
because I still got good grades, you know,
like somehow, despite all of that,
I was able to graduate high school with honors.
But then things fell apart in college.
And like, you know, there were cycles of like holding things together
and then cycles of things falling completely apart,
mostly feeling like I was holding my life together by a thread.
But I really just thought I was a bad person.
I didn't, I never would have put ADHD into that.
I was going to ask, I was going to ask you that, you know,
how do you not know?
How do you not see the struggles?
But totally can relate.
For me, it was college, everything fell apart.
I just didn't know if high school was much more small.
I went to a small rural high school, a lot of handholding,
a lot of, you know, a lot of structure.
A lot of structure, and I got to college
and wow, the wheels fell off, exactly.
And I think, you know, to what you said,
a lot of people, and I'm correct me if I'm wrong,
specifically females just internalize it
and think that they're just a bad, dumb,
and capable, disorganized, whatever you want to call it, person.
Absolutely.
And that presents us anxiety or depression.
Or both.
And so they're often misdiagnosed.
Yes, makes total sense.
Let's talk statistics for a minute.
It was very hard for me to find concrete numbers
on the number of adults impacted by ADHD.
This most likely has to do with the fact that the diagnosis
wasn't really used before the 1980s.
Now we talked earlier that a lot of people just internalize
these fall, you know, these ADHD characteristics in themselves.
But the diagnosis itself really didn't come around to the 1980s.
So you would think that 40 years would be plenty of time
for the medical and teaching professions to get up to speed.
But I feel like there is still so much around ADHD
that we now know, however,
it's not getting into the hands of the people that need it the most,
including the medical and teaching professions as well as parents.
In October 23rd, 2023, an article in psychiatrist.com said,
numerous studies have tried to quantify the prevalence of ADHD
in adults, but because trials often use different methods
and measures, it's been hard to pin down a consistent number.
Estimates have ranged from as low as 2.5%
to as high as 5% in the adult population.
And when it comes to children, there are studies out there
that show over 9% of youth under 18 have the diagnosis
with boys being diagnosed twice the rate of girls.
I'm here today with Kelly Pickens, founder of Undivided Attention.
Kelly, what are your thoughts about how we diagnose ADHD
and what are some of the misconceptions?
Well, one thing is, you know, there's no one test to diagnose ADHD.
And people have historically tried to use that as an argument
that it doesn't exist.
But, you know, there's no one test to diagnose irritable bowel syndrome
or fibromyalgia or depression or even bipolar disorder.
Like, these are clinical diagnoses and there are many other examples
of this in medicine.
Now, there are clinicians out there who are using some of like
the latest in technology, like functional MRIs or spec scans
or qualitative EEGs.
And it's possible that this could become the future of ADHD diagnosis.
But right now, we're not there in terms of, you know,
the technology being affordable or reliable or accessible
enough to really be implemented in most clinical settings.
So, for now, still, the best way is just a thorough interview
with a knowledgeable clinician.
And it is a misconception that neuropsychiatric testing
is required to get the diagnosis.
That's really only if you're also questioning if there's like
a learning disability, maybe dyslexia present or something like that.
But the reality is it's hard for adults to get diagnosed
because, as you mentioned, clinicians just haven't received any training.
And sadly, there's also a lot of implicit bias against ADHD
and around neurodivergence in general, it's ableism.
But really, it comes down to ignorance.
You know, they don't know what they don't know.
And there are a lot of complex reasons for that,
which that's a whole another episode.
But suffice to say, it's not really their fault.
I don't blame clinicians for their bias or lack of knowledge.
Maybe the bias if they chose to ignore, you know,
recent evidence and research, but they can only do that
if they've been presented with your information.
Sure.
And there are still no questions on the psychiatric board exam
on adult ADHD.
Kind of unbelievable.
Yeah.
And the kicker is adult ADHD untreated,
reduces life expectancy by 12 to 20 years.
Wow.
That's on par with diabetes.
That's a lot.
And, you know, we all medicine and society is a whole.
We take diabetes very seriously.
Right.
But we have been brushing ADHD off for decades.
And we as a society are super failing people with ADHD.
I am speaking with Kelly Pickens from Undivided Attention.
When we come back, I want to ask Kelly what the process is for diagnosis
and what you can do if you have a loved one
that you think may have ADHD.
And we want to have a birthday.
And they know by a time cry today.
They know by a lot of day.
You take that job for another day.
And we want to have a birthday.
And all my home is on a Friday.
And all these moons look Friday.
And all we want to do is get by today.
And we want to have a birthday.
And they know by a lot of Friday.
They know by a lot of day.
And you can save that job for another day.
Hey, we're going to have a good day.
You're listening to the empowered caregiver.
And I am your host, Liza Helen Brandt.
Today, I'm here with Kelly Pickens from Undivided Attention.
She is an ADHD specialist who works with men and women.
And before the break, we discussed ADHD and the flaws in getting diagnosed.
And I fell short of being able to ask Kelly about the diagnosis process.
So if somebody gives you a call, what are the steps?
Can you walk me through what you do at your clinic undivided attention?
Yeah.
So what I do is when someone requests a book in appointment with me,
which they can do directly from my website, that triggers a process
where I send to them numerous forms, surveys, questionnaires,
and computerized cognitive tests for them to complete,
which is not necessarily very ADHD-friendly, unfortunately.
You said it not me.
I was just thinking it.
But it's a lot of workup front on their part.
But what that does for me is it frees up my time for them.
So before they come to see me, I have most of my questions answered.
And that allows more of them to be asking questions.
And we can just then really spend a lot more time diving deeper down into what ADHD really is,
and which is critical for how you move forward with your ADHD.
Yeah.
And I think doing that homework at home for most people that have ADHD
or feel like they have ADHD is very interesting because that's when it's like,
oh, yeah.
Yep.
Oh, yes.
Exactly.
So the light bulb really goes on.
So it can be just kind of what's the word that I'm looking for valid?
Validating.
Yes.
Yes.
So it's easy to know that ADHD impacts attention and that it can create hyperactivity
because that's in the name.
To me, as someone who struggles with ADHD, it is so much more than that.
I really want to spend a good chunk of our time talking about the other areas in your life
that are impacted when you have ADHD.
I have with me today ADHD specialist and founder of Undivided Attention, Kelly Pickens.
Kelly, you have on your website that ADHD impacts your nervous system and memory.
It impairs your reward and pleasure pathways and creates time blindness
and can cause rejection sensitivity and emotional dysregulation.
So those are a lot of big words and big terms and a lot to talk about with each and every one of them.
So let's dig in.
Can you tell me more about the nervous system in ADHD?
The sound bite of how one of the most complex disorders affects one of the most complex phenomena
in the known world, the human nervous system.
I think it helps to utilize the power of metaphors.
So here's one many people I've heard.
Ferrari brain with bicycle brakes, driving down a winding mountain road.
The ADHD nervous system is always going, always reacting, can't filter out
what isn't important, irrelevant information, struggle to direct their behavior
towards the things that are important over things that are interesting.
And this comes mainly from dysregulation of dopamine and norepinephrine,
which are two neurotransmitters implicated in ADHD.
And the areas of the brain affected is pretty much everything, except for the occipital region,
which is responsible for visual processing.
But really, it's so complex, it affects every region of the brain and how specifically
they communicate with one another.
And the consequences of all of this is that having an interest-driven nervous system
and not being able to put the brakes on your thoughts, your feelings, and sensations,
and all of this varies.
The consequences of all of that is going to be situational.
But one thing that doesn't vary is the shame associated with every dropped ball,
every misdeployment, every bad test grade.
And that shame compounds for several reasons.
One is that you know better, it's not a problem of knowing what to do.
You know how to do homework, you know how to read a clock until what time it is.
And you know how to do these things, it's a problem of making your body do it.
And that's very confusing to everyone.
And so people try to hide their struggles to do what they know.
To do the things that are important, but boring, repetitive, mundane,
require multiple steps and complex preparation organization.
That makes so much sense.
One final thought on the nervous system.
And I just want to make sure I'm understanding this.
And I don't want to open a whole new can of worms.
Because like I said, each one of these topics, we could do a whole show on
and on how at ADHD impacts an individual.
But before the show started, I just shared a little bit how I am really getting to this realization
that I am always stuck in fight or flight.
And I just can't even relax or let loose the slightest.
I mean, I can, but it's always there.
Right.
Is that ADHD?
Absolutely.
So you know, when you have an interest-driven nervous system,
but the majority of the things that you have to do in life are uninteresting,
you have to tap into basically brute force and anxiety to accomplish most of the things in your life.
Right.
And you know, this is exhausting.
It is, it's, you know, leads to burnout, exhaustion, meltdowns, and rejection sensitivity.
Because you're always in a cycle of being, you know, your brain is leading you towards these things that are interesting.
And you're leaving behind all of the important things.
So you're always playing catch-up.
And you're just receiving a lot more negative feedback about the things that you didn't do that you should have done.
And you beat yourself up because you didn't do them.
And you think you should be able to.
But it doesn't make sense.
You don't know how to ask for help to do the things you know how to do.
And this is what I call the ADHD stress cycle.
This chronic stress of not being able to do important things that you know how to do.
Yes.
That makes so much sense.
And you know, I do.
And then we'll talk about, you know, procrastination a little bit later on because that definitely plays into it.
It'll come right back to this.
Yes. It's like the fire alarm is always going off inside me.
And I kind of need that to get things done.
Because there's no dopamine to do it.
Yes. And I often and just exhausted.
Because it's physically tiring to be.
When you hear, when you actually hear a fire alarm go off, you know, and then
everyone's a little panic, even just, you know, practice, whatever.
And it's all ended.
It wipes you out. I mean, it can.
Yeah. And that is just about every day of my life.
And I know that I am not alone in this.
So when working with you, how do you address this in your treatment?
Well, first people with ADHD really need to deeply understand what it is and what it means for them.
And once you really understand what it means to have an interest-driven nervous system,
you can start to interrupt that stress cycle.
You know, disability occurs when demands outweigh an individual's resources.
Like that is stress.
So we start the process of flipping that equation.
We increase resources and work to reduce demands.
And the first thing we're looking to for increasing resources really is medications.
Stimulant medications are first line treatment for anyone with ADHD over age six.
They get dopamine and norepinephrine to the areas of the brain needed for motivation,
attention, alertness, arousal, and they strengthen the breaks.
Wonderful. I need to talk to you more about that.
When we come back, we are going to pick up where we left off.
We're going to talk more about working memory, time blindness,
the different aspects of ADHD.
Not only what they are, so you have that level of awareness, but what we can do about it.
You are listening to the Empower caregiver.
And I am your host, Eliza Helen Brandt.
Today I am here with Kelly Pickens from Undivided Attention.
And Kelly, I am going to try my hardest to reign my own ADHD
and so I can get through these questions and not get off track because they are so important.
Now we are talking about different ways that ADHD can impact an individual.
And the next question on my list is working memory.
What does that mean?
And where do we see this being impacted or impacting children and adults?
Yeah, so I like to call ADHD dementia light.
It's a joke, but in all seriousness, memory impairments are hugely impactful.
And working memory is the ability to hold on to information while you're doing something else.
So let's say you're doing the dishes.
And in the middle of doing dishes, remember that you need to pull out a pork tenderloin
from the freezer for tomorrow's dinner.
But your hands are covered in dish suds and then the phone rings and it's your mother.
So you take the call and also the dog needs to go outside.
And letting the dog outside, you see, you forgot to switch the laundry.
You forget that you were even doing dishes.
Kelly, I feel like you've been spying on me.
And that tenderloin literally no longer exists until tomorrow when you're driving home from work
and you start to think about dinner.
So that's what it looks like in adults, right?
And in kids, it might look like forgetting to complete all the steps of a task.
For instance, if you ask your child to take out the garbage
and they've done it numerous times before, but they repeatedly forget to put a new garbage bag back in the can.
It doesn't matter how many times you remind them to do it.
If you are not reminding them right then, at the moment, at the point of performance,
they will not remember. They will forget.
And these things, you know, everyone can be forgetful from time to time, right?
The difference in ADHD is the frequency with which this occurs
and the negative impact that it has on the individual and the people around them.
So out of sight, out of mind applies to everything in a person in ADHD's life, including people.
Interesting. Can you expand on that?
Well, so that's one of the reasons why a lot of people with ADHD have difficulty maintaining relationships.
It's because, you know, really people with ADHD are going to be focused on whatever is in their immediate visual field.
And when people aren't there, they're not thinking about that person necessarily.
So, you know, they may forget to call, forget to reach out and maintain relationships.
And the other person may think that, you know, you're doing that intentionally, but it's never intentional.
It's just, if I don't see you, I can't think about you.
Yes, I'm so glad that you said that because I have a daughter that lives in L.A.
And she's breaking my heart and ever reaching out to mom and she has ADHD.
And so, yeah, that makes that makes perfect sense.
So what are some tips or tricks for people with poor working memory?
Yeah.
Find an image of a hazard sign, print out multiple, multiple copies and post them all around your house, your car, your purse, your wallet, your backpack.
With the warning that says, do not trust your memory ever.
And make all of your memory as external as possible.
Post it notes, voicemail message, text yourself, email yourself.
Use the notes, the calendar, the reminder apps in your phone.
Keep try erase markers or like bath crayons in your shower.
Ah, that's a great idea.
Not sure I'll remember that, but that's a great idea.
Okay, I will have to try harder.
I'm assuming that this is a skill that takes some time to develop and learn because I'm going to tell you, I have tried some of those tricks.
And then it's like, I need a reminder to remind me that I set a reminder, you know, the string around your finger to remember that.
Absolutely.
Remembering to remember and then remembering where you wrote it down.
I mean, these are things like this is why I say it's dementia light.
It is.
You also mentioned time blindness on your website.
What is that?
And how does that show up in ADHD?
In a couple of ways.
Well, number one is our perception of, you know, how long tasks will take is really unreliable.
So any task that has a negative emotion associated with it, we will perceive that to take so much longer than it does in reality.
And the opposite is true for tasks that are interesting, fun, immediately rewarding, etc.
So, you know, the other part is that people with ADHD have a hard time holding the future in mind.
You know, their own future.
So there's a saying in the ADHD land now or not now.
Everything is now or not now.
There is no later.
You know, we often think, well, I don't want to do that right now.
It's going to take forever.
I just don't have time to do that right now.
I'm going to do that later.
But later never comes.
Later.
There's only now.
You're right.
Or not now.
You're right.
You're so right.
Oh, Kelly.
So you have on your website that ADHD impairs your reward and pleasure pathways.
Now, this one I feel like I'm not as familiar as some of the other areas.
Can you tell me more about that?
Yeah.
So dopamine is the neurotransmitter involved in reward prediction and motivation.
It's also the signal to your motor cortex that makes your body do a thing that will result in a reward.
So without dopamine in the right areas of the brain, you really can't sense a reward and then there's just no doing of the thing.
There's no willpower.
Dopamine is motivation.
It's willpower.
It's doing, right?
And a decent analogy here is like your car's idle.
If your car is idling too low, it's more likely to stall out.
You know, so you have to give it more gas more quickly, especially if you're stopped on an incline to prevent it from stalling out.
So ADHD brains can stall out.
Any rewards that are too far in the future are not going to trigger motivation for the ADHD.
And that's kind of true of renegative consequences as well.
But dopamine also plays a role in our sense of wellness and contentedness.
And that's something called hedonic tone.
ADHDers may have low hedonic tone.
And there can be kind of like this baseline mental state of just like.
Yeah.
You know, it's something between, you know, boredom and frank depression, unless you're in hyperfocus.
Yeah.
So it sounds like there's just it's hard to find that baseline, right?
I mean, is it common to go from up to down to here to there?
Absolutely.
Yes.
So yeah, I mean, we also, you know, so we so we are our hedonic tone or our like pulse for what is going to make us feel like things are okay.
Everything's okay.
We're good.
We feel fine.
You know, the input needed to get there as much higher than that for a neurotypical person and neurotypical person kind of hovers around like, yeah, things are good.
Everything's fine.
I don't need anything more than what is happening right now.
But people with ADHD can often feel like.
I need something more and there's something just.
Yes.
Yeah.
It's hard.
You almost kind of just have to make that sound because it's not words for it.
But that exactly sums it up beautifully in my mind.
Anyways.
So when you're talking about dopamine, there was one little side thought going off.
And I'm just curious about social media and, you know, how how that plays in because I hear that people go there for dopamine hit dopamine hit.
What does that look like in in ADHD?
Well, that's definitely a loaded question and that for sure is an episode all and of itself.
People with ADHD probably are among the group of people who have a lot of negative impacts from spending time on social media because that's not true for everyone.
You know, some people can feel good using social media.
But a lot of people who maybe already have maybe a little bit of a lower self a scene.
Right.
I'm going to social media is going to amplify that.
And also, you know, if you if you don't do things with intention, you can lose time very easily.
And often when we go to like social media, it's different than like, okay, I'm going to watch one episode of the Golden Girls right now, right?
Like that episode's over, you know, 20 minutes to go by.
So there's no time, like you're just there's no end.
Yeah.
So time disappears.
I had to throw out social media because I feel like it's really made my ADHD worse.
And I don't know if it can if that makes sense, but it's impacting me in not a good way.
In some ways, it's a mix, right?
Because social media also can put put into words and put into pictures what we can't just like verbalize and contextualize about our symptoms.
You know, that's one thing about memes that have been so wonderful is like, they're so relatable.
Yes.
Yes.
Definitely.
And you know, I I love to learn.
I love to seek out information.
And when you get a phone or computer in front of you, I mean, it's endless.
You could spend the rest of your life.
They're taking in taking in.
And so yeah, yeah, we definitely could do a whole show on that.
There is another thing that I want to talk about.
There is a term called rejection dysphoria.
Can you explain that and how it impacts those with ADHD?
And if you have any tips on what to do?
Yeah.
So when any of us gets called out for some sort of like misstep mistake or like other transgression,
this triggers a trauma response in the autonomic nervous system, right?
The autonomic nervous system functions to keep us alive.
So let's say two-year-old Jimmy is about to put a fork in the light socket
and mom yells from across the room, Jimmy, no.
That's scary, right?
It shocks us.
It grabs our attention and it triggers that response.
And that's fight, flight, or freeze.
But there's a secondary response.
And that response is shame.
And it's the sense of being really conspicuous and judged.
And that you messed up.
So the first is gasp.
And then the tears of shame fall, right?
And shame is important.
It's present in all mammals because it's how we learn.
It's very motivating for us to change and grow and get along with others.
We don't want to keep messing up.
We don't want to be kicked out of the group.
We're a social species.
We depend on each other for our survival.
And we want to survive, right?
In ADHD, though, we are getting called out for mistakes,
mishaps, whatever.
We receive negative feedback on an order of magnitude more often
than our neurotypical peers.
So kids with ADHD receive 20,000 more negative feedback messages
by the time they are age 10.
And there is a ratio of what is healthy that will create healthy self-esteem
and it's five positive to one negative.
So ADHDers are live in shame.
Live in shame, yeah.
And so we're getting all these negative feedback messages.
And this can lead to rejection sensitivity
where even the perception that someone is being critical of you
can trigger a very big fight-flight freeze and shame reaction.
And that for some people can turn into rejection sensitivity, dysphoria.
And dysphoria means unbearable pain.
It's the feeling of, you know, you get called out.
It triggers this sense of, you know, being punched in the gut.
And it can ruin the day, the week, or longer in RSD.
Rejection sensitive to dysphoria.
It's like a form of PTSD.
Yes, I would say longer.
I remember in first grade, student next to me
dropped their box of crayons and I looked down
and was watching them pick them up.
I can't remember if it was male or females.
And the teacher said, well, just don't stand there.
Help.
And just the shame.
And I'm going to be 50.
And I can recall that like it was yesterday.
Right.
And so how do you, how do you deal with that?
How do you let that go?
Because it is so real.
And it just breaks my heart.
And I see these parents yell, yell, yell, yell these kids.
Yes.
Well, first of all, if you are a parent who has a child with ADHD,
you must stop yelling immediately.
But if you are a person with ADHD and RST, RSD,
the therapies, the interventions that treat PTSD
that re-regulate the autonomic nervous system,
that increase the tone of the rest and digest system,
not the fight or flight system,
all of these approaches, these somatic exercises and EMDR
and trauma approaches can help re-regulate the nervous system.
It's a lot of letting go of should.
I should be able to do this.
And then there are also medications that can help.
There's a category of medications to treat ADHD called
alpha-2 agonists.
And they seem to tone down the fight or flight response
and help us just focus on what's important
and not irrelevant thoughts, feelings, and sensations.
I love that.
And that's kind of where I'm at on my ADHD journey right now.
I am exploring EMDR and just how to get rid of just decades
of shame and pain that live in your body.
They don't, it doesn't go away after the instance happened.
So remember that parents, yes.
When we come back, we are going to talk about
another big topic, emotional dysregulation.
You are listening to the empowered caregiver and I am your host,
Liza Helen Brandt.
Today I am here with Kelly Pickens from Undivided Attention.
Kelly is an ADHD certified clinical service provider
and a certified attention deficit consultant.
She's also been a family nurse practitioner for over 20 years
and she has ADHD herself.
So she has first hand experience.
Today we are talking everything ADHD.
We covered a lot of ground.
If you missed it, you can find the replay of today's show
on civicmedia.us.
We are on Spotify, YouTube, and Apple podcast.
So I highly recommend that you check it out and share it
with loved ones that you know that have ADHD
or you think that they may.
There's tons of useful information and conversations going on here today
and on that note, I want to jump back in.
So before break, I had mentioned emotional dysregulation.
What is that and how is that impacted with ADHD?
Yeah, so emotional dysregulation and ADHD can take many forms.
And one of them we just talked about is rejection sensitivity.
We talked about low hedonic tone.
And there's also the opposite of rejection sensitivity dysphoria
which is praise sensitive euphoria.
The thing is dopamine is associated with a sense of wellness and reward.
So when we do find a hyper focus that is triggering a lot of dopamine,
we can get very excited.
You know, the emotions that people with ADHD feel and express
are appropriate to the trigger or situation.
They are just more intense than what others expect
or what might be considered socially appropriate.
Feel things more deeply and express them more vividly.
Period.
Period.
Enough said, drop the mic.
Yeah, that makes a lot of sense.
And my ADHD mind was going a million miles per hour.
So now I got to pull it back to where we're at.
Tell me a little bit more about the emotional dysregulation.
How does that show up?
Can you give an example?
Well, let's say for instance, you know,
you've finally had like you've been in between hyperfocuses for a while
and you've just kind of been in the mith stage.
But then you discover a new hobby and you're so excited about it.
All you want to do is talk to everyone about it.
And so, you know, you're very exuberant about it.
You overshare.
It's a lot of that.
People may say that like you're too much.
Yeah.
You know, maybe you get shrushed in libraries or at dinner
because you start talking about something you're excited about.
Your volume goes up.
Yeah, as you get more excited.
Start talking faster.
Start talking faster.
All these things, right?
So that's, you know, one way that it can show up.
And what's, what's, if you're finding yourself in that situation
and you're reading the room and you're like,
oh, I'm a little bit too much right now.
I can sense it.
How do we take it down a notch?
Right.
Deep breaths, you know.
I mean, mindfulness practices are really helpful for ADHD
and, you know, learning what is happening in your ADHD.
And then realizing like, oh, this is ADHD.
This isn't me being a bad person or like, you know, too much or too loud.
This is ADHD.
And now I recognize it and I can take a deep breath and just pause.
Like, we have to start learning how to build in a pause, right?
Just strengthen the breaks.
I like that.
And, you know, one thing that I think I would add from my personal experience
and if you disagree, you can say that you disagree is also raising your level of curiosity
and awareness.
I mean, yeah, especially even when it goes to meditation.
Okay, meditation and ADHD.
Don't go hand in hand, right?
But if you start getting curious, right?
What are these thoughts?
Yeah.
What are these feelings?
Where are they coming from?
Yeah.
What are they trying to tell me?
Right.
And that is mindfulness.
Yes.
Yes.
So I just want people to know that it's a misconception that mindfulness and meditation, I think,
is sitting there thinking of nothing.
Right.
That's exactly.
That's not it.
And it's been extremely helpful for me personally.
So today, it seems more common than not to receive multiple mental health conditions
and diagnosis.
In fact, research shows that more than half of people who receive one psychiatric disorder
or a diagnosis will receive a second or a third within their lifetime.
And about a third will receive four or more.
So I'm talking about four or more DSM-5 mental diagnosis.
Kelly, can you expand on that?
And is there anything you would want listeners to know about?
I cannot say this word.
Cool.
Call more bibidi.
Cool.
Bibidi bibidi boo.
Call more bibidi.
Thank you.
And ADHD.
Yeah.
Look, I mean, how we, you know, science and Western medicine have approached, quote, unquote,
mental health has been so siloed and rigid.
You know, we've historically not done a good job considering how dimensional a person is.
Within the context of their genetics, their environment, their experiences, particularly during development.
And just as you say ADHD is accompanied by these other psychiatric disorders,
the opposite is also true.
At least 40% of clients who present to a mental health service, you know, four services
will also have ADHD.
And so mental health providers really need to have much more, you know, much higher index of suspicion for ADHD.
And not be surprised that they are seeing a lot of ADHD because look, it's common.
You mentioned the statistics earlier.
Yeah.
The DSM-5 reports six to 10% of children globally with another 5% being very, very close to meeting that criteria.
So close to 15% of the world.
And we used to think two thirds of people outgrade ADHD.
I mean, we used to think everybody out grew it.
And then we thought, well, maybe two thirds outgrow it.
But as of 2021, there was a study that was published in the University of Washington School of Medicine.
And it turns out actually only about 10% of people outgrow their ADHD.
So adult ADHD is common.
It's probably the most common, quote unquote, mental disorder there is.
And 70% of the adults out there who have it have not yet been diagnosed.
That makes a lot of sense.
And when I originally read the 2.5% of adults, I'm thinking no way.
That's way under.
Yes.
I'm speaking today with Kelly Pickens from Undivided Attention.
Kelly is an ADHD certified clinical service provider and certified attention to deficit disorder.
I almost said consultant, that's a mouthful.
So ADHD expert, let's just leave it like that.
Perfect.
Kelly, can you just end by letting people know where they can find you and what are some of the services and approaches that you take?
I think the best place to start is my website.
And that's www.uaadhd.com.
And the first thing that I do for all of my clients is provide validation, period.
What a great place to start.
The most important thing.
I wish we had more time.
We were doing so good on all the questions I prepared and I tried my hardest to stay on track.
But we will absolutely have to talk.
Again, there is so much to learn and know and share when it comes to ADHD.
Thank you so much, Kelly, for being here today.
Thanks for having me.
