0:02

Kikpod acknowledges the traditional

0:04

owners and custodians of the land

0:07

in which we're recording this podcast.

0:09

The euluket, woolen clan of the

0:11

Boonerong who are part of the

0:13

Koolin Nation. We pay our respects

0:15

to our elders, past and present

0:17

and extend our respect to

0:20

aboriginal and terrestrial islander

0:22

peoples today. You're listening to

0:24

It's My ADHD. A Kickod

0:27

miniseries with me. Before we get

0:29

started, I wanted to give you

0:31

a heads up that this series

0:33

is about my experience of ADHD.

0:35

This won't be a one-size-fits-all guide

0:38

to ADHD. But I do hope

0:40

that my experience and the resources

0:42

that I share will help you. Episode 1.

0:45

I think I have ADHD. Wake

0:47

up. He Harvey. My four-year-old son called out to me. Hmm. To put

0:49

Blooey on for him and to go back to bed or to get

0:51

up. That is the question. Maybe I'll put Blooey on just for a

0:53

few episodes while I have a shower. Do I have time for a

0:55

workout this morning? Yeah, actually, let me do Pilates before I have my

0:58

shower. Yeah, actually, let me do Pilates before I have my lardis before

1:00

I have my shower. Let me do I do Pilates before I'll do

1:02

Pilates Pilates before a work out this morning, Pilates before a workout Pilates

1:04

before a work out this morning, before I, before, before I, before I,

1:06

before I have my workout Pilates before, before I, before I, before I,

1:08

before I have my shower? Pulatis before, before I, before I, before I

1:10

have my shower? P' Pilates, before, before, before, before I have my shower?

1:12

Pylardis, before, Oh look, she had a birthday!

1:15

Oh wait, shit, I need to organize

1:17

Harvey's birthday party. Google's ideas

1:19

for four-year-old's birthday parties.

1:21

Josh comes out and asks, don't

1:24

you have to go soon? I look at the

1:26

time. Shit, I'm like, rush the shower to

1:28

rinse off. Head to my wardrobe, flicking

1:30

through the piles of outfits off.

1:32

Head to my wardrobe, flicking through

1:34

the piles of washing I haven't

1:36

put away yet to find something to

1:38

wear. Can't he just see that I'm stressed? Who

1:40

am I kidding? This isn't his fault. It's mine.

1:42

It always is. Why can't I just be more

1:44

organized? Oh no, Harvey can feel my energy shifting.

1:46

He's a starting to too. Shit, I haven't spent

1:48

any time with him this morning. Mom guilt hits

1:50

me hard. I give him a cuddle and rush

1:52

out the door apologizing to Josh for anything I've

1:55

said in the last 10 minutes. I back out

1:57

of the driveway and I feel my heart rate

1:59

rising. My breathing, intensive... and yep, that's a tear on

2:01

my cheek. I am sick of letting not only

2:03

myself but others down. I'm halfway to

2:05

work, shit, I forgot my lunch. Okay, I'm only

2:07

five minutes late to the meeting, got

2:10

lucky with traffic. But why can't I seem

2:12

to move past this never-ending to do

2:14

list in my head? Okay, Steph, get your

2:16

heading to the meeting, any moment now. Oh

2:18

joy, there's a slide with a bunch of

2:20

numbers on it. Okay, concentrate. My earring falls

2:22

on the table and makes a noise because I

2:25

haven't stopped playing with it. Why am I always

2:27

playing with my earrings? Fuck, they're on to

2:29

the next slide now. Were you even listening? Ads

2:31

relook over slides post meeting to my to-do

2:33

list. And on and on it goes. Every

2:35

day, all day, my mind wonders. I have

2:37

conversations with myself and convince myself that I'm

2:40

not doing anything right. For a long time when

2:42

I'd have mornings like this, which to be honest

2:44

lately happens more times than it more times than

2:46

a dozen. I thought I thought I was lazy

2:48

and inconsider doesn't. It wasn't until after I

2:51

had my first son Harvey and went back

2:53

to work that I started wondering if this

2:55

wasn't normal and if the way I talked

2:57

to myself after having a morning like this

2:59

wasn't what everyone did. At the same time

3:01

I'd started seeing more people online getting diagnosed

3:03

with ADHD but it wasn't the naughty boy

3:05

in primary school it was women and moms

3:07

in their late 20s 30s and 40s whose

3:10

experience sounded oddly similar to mine so I decided

3:12

to look into it. The more I read

3:14

about it and watched videos online, the closer

3:16

I came to believing that this may in

3:19

fact be the answer to why I am

3:21

the way I am. Can't help but pick

3:23

at my skin? Me. Right up on stemming?

3:25

Maybe that's why I'm always playing with my

3:27

hearing. Zoning out of convos to have my

3:30

own conversation in my own head. Yep. Rejection

3:32

sensitivity? Well, do I ever? Misplacing things on

3:34

the regular. Why can't I just keep my

3:36

keys in the same place all the time?

3:39

And this wouldn't be an issue? Constantly late

3:41

or assuming I have more time so this

3:43

time blindness thing sounds pretty spot on. Monthly

3:45

bills are overdue every month. Every year I

3:47

start a new habits journal and rarely last

3:49

more than a few days or a week

3:51

with it. Goal setting in general is near

3:54

impossible for me unless the goal can be

3:56

completed within the month. I can be happy

3:58

one minute, incredibly aggravated the next. I'm constantly

4:00

doing like a quarter of a task before

4:02

moving on to the next. Whether it's knitting,

4:04

eating popcorn or scrolling, I have to be

4:06

doing something when I'm watching TV. And these

4:08

were all the things that I was saying

4:10

pop up online and all the things I

4:12

knew too well. However, what I

4:14

was also seeing online was an immense

4:16

amount of judgment towards people opening up

4:18

about ADHD. I saw people making videos

4:20

about how much of a joke it

4:22

was that everyone had ADHD these days

4:24

and that everyone is now just jumping

4:27

on a trend. So seeing this definitely

4:29

started to put a doubt in my

4:31

mind. Was I just so desperate to

4:33

find an answer to the things I

4:35

hated about myself that I'd just jump

4:37

on a trend? But then I spoke

4:39

to Em Rushiano on the kickiano on

4:41

the kick bumpod. And just like I

4:43

had when watching the videos online, I

4:45

found myself nodding along and relating to

4:47

so much of what she had to

4:49

say when it came to her experience

4:51

with ADHD. Are you one of us?

4:53

Am I? Are you? I feel like

4:55

you think you are. You know what?

4:57

I don't want to, I've not spoken

4:59

to anyone about this. No. But a

5:01

lot of what you've just said, I'm

5:03

like, can relate, can relate. work was

5:05

really busy at this time and I'd

5:07

heard from a friend that the process

5:09

to getting diagnosed was all consuming. So

5:11

I decided to park the idea of

5:13

getting assessed for a later period. If

5:15

you're a regular listener to the kick

5:17

pod you'd know that in the first

5:19

half of last year laws and I

5:21

both did quite a lot of self-discovery

5:23

work with our coach and through that

5:25

work uncovered a lot of things we

5:27

were brushing to the side like our

5:29

fears, our desires, our values and it

5:31

was honestly through this work that made

5:33

me rethinkink about seeking assessment. So I

5:35

did. I spoke to a friend who

5:37

had been diagnosed, and she passed on

5:39

a recommendation of a psychologist. The process

5:41

took around three months, and after our

5:43

very first session, my psychologist said, if

5:45

it makes you feel any better, I

5:47

think you might have ADHD. So when

5:49

I got the official diagnosis a few

5:51

months later, I wasn't surprised. But that's

5:53

where the part of the story ends.

5:56

I stopped reading about ADHD. I stopped

5:58

listening to podcasts about it. I was

6:00

so overwhelmed with the idea of living.

6:02

And that's where the idea of this

6:04

podcast came from. I thought that if

6:06

I had a project like this, not

6:08

only could I learn more about what

6:10

ADHD actually is, maybe I could also

6:12

learn some skills for making my life

6:14

a little easier. And if I did

6:16

this for myself, maybe it could help

6:18

someone else who's seeking a diagnosis or

6:20

trying to explain their ADHD to a

6:22

loved one. It took some strict deadlines

6:24

from our producer and some seriously well

6:26

organized documents, of course, not done by

6:28

me, for me to get my shit

6:30

together and actually get it done, of

6:32

course. Otherwise it likely would have just

6:34

stayed as an idea as an episode

6:36

with episode one. In this episode, I

6:38

speak with holistic psychologist Beck McMilliam. Beck

6:40

has ADHD herself and does ADHD assessments

6:42

for adults. Whilst I've done my own

6:44

research, I'm far from an expert, so

6:46

I wanted Beck to define what ADHD

6:48

is and what the different types of

6:50

ADHD are, what the process of getting

6:52

a diagnosis with a psychologist can look

6:54

like and also discuss this idea that

6:56

everyone has ADHD these days. So he

6:58

is Beck. Hello! Hello! Guys

7:00

full transparency. This is the first

7:02

episode of the many series that

7:05

we're recording. So I am extremely

7:07

excited to be sitting down with

7:09

the lovely Beck Macwilliam to talk

7:11

about everything ADHD. It's going to

7:13

be a fantastic podcast today. I

7:16

thought we'd probably start right. you

7:18

know, with I think something that

7:20

is very necessary to cover off,

7:22

but maybe just the definition back

7:24

of ADHD. Yes, yes. So this

7:26

is going to sound very clinical

7:29

because I want to make sure

7:31

that I'm doing the diagnosis justice.

7:33

So this is straight from our

7:35

diagnostic and statistical manual of mental

7:37

health disorders, which is a big

7:39

term for our DSM-5. So that's

7:42

what psychologists use in Australia and

7:44

around the world to diagnose people

7:46

with ADHD. So for someone to

7:48

meet criteria for a diagnosis of

7:50

ADHD, they will have to have

7:52

a persistent pattern of inattention and

7:55

or hyperactivity and impulsivity that in.

7:57

with functioning of development as characterized

7:59

by the below. So for anyone

8:01

at home, if this sounds very

8:03

wordy, make sure you can always

8:05

pause and go back and go

8:08

through it. But for inattention, six

8:10

or more of the following symptoms

8:12

have to be present for the

8:14

last six months for children and

8:16

for adults that are over the

8:18

age of. 17, at least five

8:21

of these symptoms have to be

8:23

present to meet criteria for inattention.

8:25

So often fails to give close

8:27

attention to details or makes careless

8:29

mistakes. Often has difficulty sustaining attention

8:31

in tasks or play activities. Often

8:34

does not seem to listen when

8:36

spoken to directly. Often does not

8:38

follow through on instructions and fails

8:40

to finish work. Often has difficulty

8:42

organizing tasks and activities and activities

8:45

and activities to finish work. and

8:47

often avoids dislikes or is reluctant

8:49

to engage in tasks that requires

8:51

sustained mental effort, often loses things

8:53

necessary for tasks or activities, is

8:55

often easily distracted by stimuli, or

8:58

is often forgetful and daily activities.

9:00

So for that inattention to be

9:02

highlighted, we need to have either

9:04

six in children or five in

9:06

adults of those or more. For

9:08

hyperactive and impulsivity, again, six or

9:11

more in children and five or

9:13

more in people over the age

9:15

of 17. So the criteria for

9:17

that is often fidget with or

9:19

taps hands, feet or squirms in

9:21

seat. Oh, sorry, we just had

9:24

a bit of a moment there

9:26

to rest up. As I'm also

9:28

doing. Often leaves seat in situations

9:30

when remaining seated is required. often

9:32

runs about or climbs in situations

9:34

where it's inappropriate, often unable to

9:37

play or engage in leisure activities

9:39

quietly, is often on the go

9:41

or acting as if they're driven

9:43

by a motor, and often talked

9:45

successfully, often... out answers before a

9:47

question has been completed, often has

9:50

difficulty waiting their turn and often

9:52

interrupts or intrudes on others. So

9:54

those are the criteria for hyperactivity

9:56

and impulsivity. As well as those,

9:58

we also need to make criteria

10:00

for these. So several inattentive or

10:03

hyperactive impulsive symptoms were present prior

10:05

to the age of 12. Several

10:07

inattentive or hyperactive impulsive symptoms are

10:09

present in two or more settings.

10:11

So this is at home, at

10:13

school, at work. There is clear

10:16

evidence that the symptoms interfere with

10:18

or reduce the quality of life

10:20

for someone. So social, academic, occupational

10:22

functioning. And the symptoms do not

10:24

occur exclusively during the course of

10:27

an episode of something like schizophrenia,

10:29

a psychotic disorder, or are not

10:31

better explained by any other mental

10:33

health disorder. So then, from this

10:35

criteria, we then specify whether someone

10:37

has, and there's three types of

10:40

ADHD. So we talk about the

10:42

combined presentation, so that's if both

10:44

inattention and hyperactive impulsive impulsive are

10:46

met for the last six months,

10:48

predominantly inattentive presentation. So that's where

10:50

inattention is present. However, hyperactive impulsive

10:53

is not met for the last

10:55

six months. and then we have

10:57

predominantly hyperactive impulsive presentation and that's

10:59

where hyperactivity and impulsivity is met

11:01

however inattention is not met for

11:03

the last six months we then

11:06

because it doesn't end here we

11:08

then specify if there if this

11:10

person is in partial remission so

11:12

when full criteria was previously met

11:14

however fewer than the full criteria

11:16

have been met for the last

11:19

six months and the symptoms still

11:21

result in impair in their social

11:23

academic or occupational functioning. Then finally,

11:25

and this is it for the

11:27

big long-winded DSM-5 diagnosis, we then

11:29

specify what the current severity is.

11:32

So there are three severity levels

11:34

so we have mild so this

11:36

is few if any symptoms in

11:38

excess of those required to make

11:40

the diagnosis are present and symptoms

11:42

result in no more than minor

11:45

impairments in social occupational functioning. Then

11:47

we have moderate, so this is

11:49

where symptoms or functional impairment between

11:51

mild and severe are present and

11:53

then severe. So this is where

11:56

many symptoms are in excess of

11:58

those required or several symptoms that

12:00

are particularly severe or present or

12:02

the symptoms result in marked impairment

12:04

in everyday life. We then want

12:06

to note though that severity may

12:09

vary by context and fluctuate over

12:11

time. So these severity levels of

12:13

mild, moderate and severe can change.

12:15

You know, someone that might be

12:17

diagnosed with moderate when their first

12:19

diagnosed with 80 HD might actually

12:22

go down to mild once, you

12:24

know, they're... maybe on the right

12:26

medication, maybe they're seeking support with

12:28

a psychologist or an ADHD coach,

12:30

they can actually go down to

12:32

wild over time. So it's very

12:35

dependent by context and time. I'm

12:37

so glad that we started there

12:39

because there is so many different

12:41

avenues I want to go from

12:43

here, but I think first of

12:45

all, the three different types. I

12:48

want to start there because when

12:50

was it that combined? Has combined

12:52

or have they all always existed

12:54

or was it? kind of because

12:56

from my memory, and I'm not

12:58

a psychologist, so I've, you know,

13:01

my memory is just from what

13:03

I know from like school and

13:05

stuff, it's always been the assumption

13:07

that it's more the hyperactive side,

13:09

right? I haven't known so much

13:11

about the inattentive. I was diagnosed

13:14

with a combined type, which was

13:16

also confusing because I think whenever

13:18

I saw things online about maybe

13:20

people were talking about their ADHD

13:22

symptoms or I started doing some

13:24

of those online tests. Obviously until

13:27

some of the results came back

13:29

from the test but during the

13:31

test I was answering the questions

13:33

like I'm not going to have

13:35

ADHD because I had this assumption

13:38

of like what those symptoms were

13:40

and then when I kind of

13:42

was answering things kind of differently

13:44

as you said like combined means

13:46

you kind of in both camps.

13:48

I was like oh I'm a

13:51

bit of both not knowing that

13:53

combined was a thing yes so

13:55

yeah talk to us has there

13:57

always been the three of them

13:59

or when have they come in

14:01

if not yeah so they have

14:04

been around I think the big

14:06

thing was I think only recently

14:08

I would say probably the last

14:10

let's say 10 years is becoming

14:12

more apparent that we're looking at

14:14

these different types more rigorously. So

14:17

from a psychological standpoint, we've always

14:19

kind of looked at these different

14:21

types, but I think, and you

14:23

might have seen this, but I

14:25

think in schooling we always looked

14:27

at that child that was kind

14:30

of like hyperactive jumping around the

14:32

room, maybe the class clown or

14:34

maybe distracting other people in the

14:36

class as the typical ADHD. So

14:38

we didn't really look at inattention

14:40

as being a part of it,

14:43

but it's such a big part

14:45

of it. You know, I think

14:47

that. all of those criteria is

14:49

that we went through I'm not

14:51

going to go through it again

14:53

because it's just such a mouthful

14:56

but I think all of those

14:58

things can be more internal. We

15:00

can't really see them externally a

15:02

lot of the time and so

15:04

that's why I think that hyperactivity

15:07

was that main site or that

15:09

that main presentation that we saw

15:11

a lot more of. So I'm

15:13

loving like things like today where

15:15

we're kind of talking about these

15:17

diagnoses so that people can actually

15:20

see no like these inattentive aspects

15:22

are just as much a part

15:24

of ADHD as the hyperactive impulsive

15:26

side. How how does it I

15:28

mean obviously if they've got different

15:30

the different types like that's one

15:33

way of it presenting differently but

15:35

how can it or how commonly

15:37

is it? presented differently in women

15:39

and girls versus boys and men.

15:41

Yeah, so again, I want to

15:43

highlight that for women it is,

15:46

it tends to be more that

15:48

predominantly inattentive type. combined type but

15:50

more predominantly inattentive type because it

15:52

can manifest as like daydreaming forgetfulness

15:54

zoning out perfectionism people pleasing I

15:56

think women, especially girls, I'll say,

15:59

learn from a very young age

16:01

to mask their symptoms, right? And

16:03

so it may not be as

16:05

outward, but it's things like, as

16:07

I was saying before, like daydreaming,

16:09

forgetfulness, maybe starting one task and

16:12

then going to a million others.

16:14

That was... I think part of

16:16

that delay in us looking at

16:18

that because it was more internal

16:20

we weren't really seeing the external

16:22

symptoms as much. I know though

16:25

that some women and it's something

16:27

that I see quite a lot

16:29

when I'm doing diagnoses is that

16:31

from that hyperactive impulsive side it's

16:33

more of that talking over people

16:36

or maybe finishing the sentences of

16:38

people when they're excited those kind

16:40

of symptoms can arise from that

16:42

hyperactive impulsive impulsive. that impulsive side,

16:44

it could be things like spending

16:46

all their money or going shopping

16:49

and not looking at their bank

16:51

account or, you know, sadly, addictive

16:53

personalities as well. So, you know,

16:55

maybe people utilizing drugs or alcohol

16:57

to kind of self-sooth or to

16:59

self-manage. So, you know, there's so

17:02

many things that I guess are

17:04

different in women to males. And

17:06

I'm not saying that those kind

17:08

of things don't come across with

17:10

males, but I think, you know,

17:12

that masking... And the perfectionism in

17:15

the people pleasing is definitely a

17:17

theme that I'm seeing a lot

17:19

of. Yeah, for sure. I think

17:21

it's a societal kind of pressure,

17:23

regardless of ADHD. I want to

17:25

talk about the process or the

17:28

different processes that people can go

17:30

down. You know, different things like

17:32

who they're talking to, if you

17:34

know anything about average weight times,

17:36

like how much it can cost.

17:38

I think just having an idea

17:41

of like a what's ahead of

17:43

you. a process like this is

17:45

always so helpful in making that

17:47

step. Definitely. I think it's one

17:49

of the most helpful things because

17:51

people go, where do I even

17:54

start? You know with this, it

17:56

can be so overwhelming. So there

17:58

are different avenues that you can

18:00

take. So within Australia, psychiatrists and

18:02

psychologists can diagnose people with ADHD.

18:04

And so what I always say,

18:07

or would I always kind of

18:09

ask people when they come to

18:11

me for a potential diagnosis? I

18:13

say, what is it that you're

18:15

after? Are you trying to better

18:18

understand your brain and what's kind

18:20

of going on? Is it because

18:22

you just want medication? Like, what

18:24

is it that you're actually after?

18:26

Because that will determine whether I

18:28

say, yep, I'd love to do

18:31

this ADHD assessment and report with

18:33

you. I mean, I'll always love

18:35

to do that. or if it's

18:37

something like they just want medication,

18:39

I go maybe the best pathway

18:41

is to go straight to a

18:44

psychiatrist. So. from my perspective, obviously

18:46

I'm talking from a psychology perspective.

18:48

We tend to send, you know,

18:50

questionnaires and psychometric assessments before the

18:52

clinical interview happens. So this is

18:54

things like the ASRS, which is

18:57

like the adult self-report scale, the

18:59

conners, so all of these different

19:01

kind of questionnaires that we can

19:03

get a bigger picture of what's

19:05

kind of going on from a

19:07

self-report perspective. we then send a

19:10

questionnaire or two for a loved

19:12

one around them. So someone, we

19:14

tend to like it to be

19:16

someone that's known them for about

19:18

five to ten years just so

19:20

that, you know, they have knowledge

19:23

of different times throughout their life.

19:25

And then we also ask for

19:27

report cards if they're available. I

19:29

tend to work with mainly people

19:31

18 years and over, so sometimes

19:33

that can be really hard to

19:36

get people's report cards. But it

19:38

can kind of just give us

19:40

a bit of an idea of

19:42

how people showed up during schooling.

19:44

From there, we then have the

19:47

clinical interview phase. So for myself...

19:49

I use, and this might not

19:51

make a lot of sense for

19:53

people about, aren't psychologists, but I

19:55

use the ace and the diva.

19:57

So they're clinical interview questions that

20:00

have been, you know, they're very

20:02

evidence-based for lack of better words.

20:04

So I utilise that and we

20:06

kind of go into a bit

20:08

of a history around, you know,

20:10

schooling, social life, things throughout childhood

20:13

up until adulthood. and also what

20:15

the kind of symptoms are that

20:17

are arising. And beside me, I

20:19

have my little DSM, which is

20:21

like our Bible, which I was

20:23

talking about before, and I'm ticking

20:26

off the symptoms to see if

20:28

they're kind of meeting criteria as

20:30

we talk through it. Then from

20:32

there, we go away and we

20:34

write a report that's based on

20:36

that information that was gathered, as

20:39

well as the psychometric assessments that

20:41

we had sent back to us

20:43

from loved ones and from that

20:45

client. And then we have a

20:47

feedback session. So that's when we

20:49

go through the report and we

20:52

kind of talk about, you know,

20:54

if there was a diagnosis meant.

20:56

And what that looks like, so

20:58

that's when we talk about the

21:00

severity levels, what the actual diagnosis

21:02

is, and we talk about recommendations

21:05

as well going forward. So this

21:07

might be, you know, you potentially

21:09

might want to look at medication,

21:11

or you potentially might want to

21:13

look at therapy, or you know,

21:15

here are some other tools that

21:18

you can utilize in the interim,

21:20

because I think that feedback session

21:22

and having a bit of a

21:24

pathway is so helpful for people.

21:26

because otherwise you're kind of getting

21:29

this diagnosis and it's like what

21:31

do I do with this like

21:33

where's next. So that that tends

21:35

to be you know from what

21:37

I've seen quite a universal or

21:39

quite an Australian way of doing

21:42

it for psychologists. If we were

21:44

to talk about monetary wise, it

21:46

is dependent therapist to therapist. And

21:48

this is where before when I

21:50

was kind of talking about when

21:52

I'm first talking with someone that

21:55

does come to me about wanting

21:57

assessment, I'm asking them why they

21:59

want it. Like if it is

22:01

purely for just medication or just

22:03

going down that pathway. save some

22:05

bucks if they go straight to

22:08

psychiatrist. Exactly it. That's exactly it.

22:10

So I'm not here to be

22:12

like, yes, everyone come to me.

22:14

I want them to obviously get

22:16

what they need and what's going

22:18

to be best for them. So

22:21

yeah, sometimes going straight to a

22:23

psychiatrist can be a cheaper pathway.

22:25

So it's so dependent, again, therapist

22:27

to therapist with. how much it

22:29

is. What I've seen though, because

22:31

I did a little bit of

22:34

research into it, what I'm seeing

22:36

is it tends to be around

22:38

1,500 to 2,500, is the norm

22:40

for the whole norm. That's if

22:42

you're going through a psychologist for

22:44

that, because obviously there's a lot

22:47

that comes with that, you know,

22:49

or the clinical interview side, the

22:51

report writing side, etc. And then

22:53

with a psychiatrist, again, it's really

22:55

dependent. It depends on how thorough

22:58

they are around it. But it's

23:00

usually around that, again, that 1500,

23:02

maybe more. Is there any cost

23:04

covered by Medicare or anything like

23:06

that? Yeah, good question. So with

23:08

psychologists, there isn't anything that is

23:11

covered by Medicare. But if people

23:13

do have private health care, depending

23:15

on their level of cover, they

23:17

can get rebates from that. With

23:19

psychiatry, yes, you can, with that

23:21

referral, from the doctor, you can

23:24

get a rebate from that. Again,

23:26

I'm not sure how much, but

23:28

usually you can get some form

23:30

of a rebate from that. So

23:32

that obviously is an option as

23:34

well. Something that I found out

23:37

in my assessment was that I

23:39

wasn't just getting assessed for ADHD.

23:41

It was like, okay, we're actually

23:43

going to try and cover off

23:45

a couple of different things here

23:47

because there's some things that, you

23:50

know, whether it's anxiety or depression,

23:52

like there's things that come up

23:54

for people with ADHD that are

23:56

also other mental health conditions. I

23:58

really want to talk about that

24:00

because I think the moment I

24:03

knew that in the assessment, it

24:05

released a lot of that initial

24:07

fear that I'd had about the

24:09

assessment, which was, I think when

24:11

you think that you're just going

24:13

in for this ADHD assessment and

24:16

diagnosis, if it's not ADHD, like,

24:18

holy shit, what am I going

24:20

to do? Because I've never been

24:22

able to fix these things, whereas

24:24

going into it and then suddenly

24:26

knowing, okay, so it might not

24:29

actually be ADHD, but at all

24:31

these other things too in the

24:33

process. So hopefully something comes up

24:35

that I'll be able to learn

24:37

more about and manage. That was

24:40

really helpful me to know. So

24:42

I just want people to know

24:44

that as well, like when you

24:46

do go into the process, and

24:48

I'm assuming that this is what

24:50

most psychologists, assessments are like. Yes,

24:53

thank you for coming back to

24:55

this because I think it's such

24:57

an important part of the process.

24:59

And I'm kicking myself that I

25:01

forgot to talk about it before,

25:03

because making sure that we're looking

25:06

for... co-occurring diagnoses as well as

25:08

differential diagnoses. So with ADHD there

25:10

are quite a lot of other

25:12

diagnoses within our DSM Bible that

25:14

have overlapping symptoms. So things like

25:16

oppositional defiance disorder, intermittent explosive disorder,

25:19

other neurodevelopmental disorders, anxiety disorders, post-traumatic

25:21

stress disorder, bipolar disorder. as well

25:23

as many others, actually have some

25:25

symptoms that are quite related. And

25:27

so we need to make sure

25:29

through that diagnosis process that we

25:32

are making sure that they aren't

25:34

at play or that they aren't

25:36

also co-occurring. So the co-occurring piece

25:38

is saying that you might have

25:40

ADHD, but you also might have

25:42

an anxiety disorder. You might have

25:45

a depressive disorder. There might be

25:47

other things that play as well

25:49

that maybe after, so during that

25:51

feedback. session, that the psychologist might

25:53

say to you, hey, it's looking

25:55

like it could be this, maybe

25:58

we need to kind of... of

26:00

explore that as well or maybe

26:02

you need to go and see

26:04

a psychiatrist or someone else to

26:06

kind of go a little bit

26:09

deeper into that. So that's a

26:11

really important piece. If a thorough

26:13

assessment and diagnosis isn't completed, it

26:15

is quite easy for people to

26:17

be misdiagnosed. And again, it's just

26:19

the impact that that can have.

26:22

I've had clients that have been

26:24

put on medication for bipolar and

26:26

then it's caused so many issues

26:28

and then it actually was ADHD.

26:30

So there's just so much that

26:32

can happen that can cause, you

26:35

know, some real, not lifelong, but

26:37

some real... just

26:39

hardships I guess in people in trying

26:41

to come to terms with that and

26:43

I guess when I do go through

26:45

the diagnosis process with someone and then

26:48

I do diagnose them with ADHD there

26:50

can be so many emotions that arise

26:52

from that like I almost think it's

26:54

like the stages of grief that can

26:57

come up and especially with people that

26:59

have been misdiagnosed or just maybe not

27:01

even that maybe just being diagnosed for

27:03

the first time you know I see

27:06

people go through a grief and then

27:08

anger and then you know, sadness, happiness,

27:10

but then acceptance. Like there's so many

27:12

different stages that people can go through

27:15

once they get that diagnosis and I

27:17

just want to validate that because I

27:19

think sometimes people. believe that maybe they

27:21

you know should be okay after a

27:24

diagnosis or you know it should be

27:26

all sunshines and rainbows. But it's not

27:28

the case because it's really easy for

27:30

us to kind of reflect and go

27:32

I wish I had have known that

27:35

earlier or that those symptoms make so

27:37

much more sense now or you know

27:39

whatever it is. So I just really

27:41

wanted to highlight that that you know

27:44

that process can look so different person

27:46

to person and that it's really yeah

27:48

it's likely that it's likely that there

27:50

will be so many emotions that arise

27:53

from it. I want to talk about

27:55

the symptoms I suppose that show up

27:57

because I think something for me that

27:59

I found really interesting when I learned

28:02

more about it. And even before my

28:04

diagnosis, I was actually, I remember a

28:06

conversation that came up. I was mid

28:08

the process. So I'd been told by

28:11

this point, look, it's more than likely

28:13

that you have it, but I hadn't

28:15

received my report yet. So I was

28:17

trying to like learn a lot about

28:19

it in this process at this point.

28:22

And I remember being in a conversation

28:24

with a couple of people. I don't

28:26

believe or maybe one other person in

28:28

the room had or thought they had

28:31

ADHD and then the rest of the

28:33

people in the room didn't identify with

28:35

it or and the conversation was really

28:37

interesting because it was very much around

28:40

that narrative of like doesn't everyone have

28:42

a little bit ADHD or it was

28:44

it was talking to some of the

28:46

symptoms that they'd seen online like forgetfulness

28:49

or running late and all that sort

28:51

of stuff and they were very much

28:53

speaking about it quite blase in the

28:55

way that's like oh I'm I'm late

28:58

sometimes or like I forgot my keys

29:00

the other day like oh I must

29:02

have ADHD like almost making it like

29:04

this kind of light joke and I

29:06

was sitting there thinking like I don't

29:09

know how feel about this conversation yes

29:11

and then obviously since I've learned since

29:13

then that it isn't that you know

29:15

these these symptoms are unique to people

29:18

with ADHD like they happen they're very

29:20

human experiences but I would love for

29:22

you to kind of decipher the difference

29:24

in like the severity of how it

29:27

can show up for someone with ADHD

29:29

versus a neurotypical brain. Yes, wonderful question

29:31

because I think this comes up a

29:33

lot. And I guess the biggest thing

29:36

here... is the fact that it happens

29:38

most of the time for these people.

29:40

So for people with ADHD. So it

29:42

is common for us to have moments

29:45

of forgetfulness, like as a human being,

29:47

you know, and I don't think the

29:49

fast-paced nature of our life, you know,

29:51

helps some of these things. So it's,

29:53

yeah, it can be, yeah, quite normal

29:56

to have experiences of forgetfulness, of inattention,

29:58

of maybe getting excited and talking over

30:00

people. Yes, yes, yes, yes, yeah, rejection

30:02

sensitivity, all of those things. But with

30:05

the big distinction for people with ADHD

30:07

is that it's happening majority of the

30:09

time, pretty much every day for most

30:11

people. So, and it has to be

30:14

that it's happening a lot of the

30:16

time for at least six months or

30:18

for the last six months. So that

30:20

is the big distinction there, I think.

30:23

And I think that... to be honest,

30:25

was probably the main driver for me

30:27

to actually go and get assessed because

30:29

it was these things that were happening

30:32

so frequently and there were things that

30:34

I had the motivation to want to

30:36

change about myself. And maybe if I

30:38

ever got to changing it, it would

30:41

be for like a couple of days

30:43

and then it would somehow come back

30:45

and then I would just feel so

30:47

shit about myself and so down and

30:49

so upset and I just would wonder

30:52

like how an earth did people... change

30:54

these things or like find these new

30:56

habits or whatever like if we're talking

30:58

writing into a journal every day or

31:01

whatever I mean like I've gone through

31:03

some really good patterns or habits where

31:05

I have journaled a lot and it's

31:07

and it's worked really well and then

31:10

there's been other times where I've tried

31:12

every freaking scheduling planner journal that there

31:14

is and I'll get one I'll be

31:16

like this is the one that's going

31:19

to stick and that I'm going to

31:21

do and then it doesn't happen and

31:23

then I just think there is something

31:25

wrong with me or like if I'm

31:28

late I'm late more often than not

31:30

and I hate it but it's a

31:32

fact and I know for a fact

31:34

that I've got friends who have been

31:36

late to something but they're like never

31:39

late you know like it's so there's

31:41

there's those differences and I think it's

31:43

just so important to talk about definitely

31:45

and even talking on that that lateness

31:48

it can also go the opposite way

31:50

where people have learned to mask or

31:52

they're so anxious innocent that obviously is

31:54

talking from having ADHD that they're actually

31:57

super early because they're so worried about

31:59

being late so it can go that

32:01

opposite way and I guess we need

32:03

to talk about that as well in

32:06

a sense that these masking tools that

32:08

people create, they're energy consuming because within

32:10

them it's actually more natural to be

32:12

a little bit later or not be

32:15

so consumed by timing or you know

32:17

whatever the symptom is but they've learned

32:19

to mask and that is just it's

32:21

just energy consuming. I think the one

32:23

that I from learning more about it

32:26

that I think I've masked the most

32:28

with is the and I remember when

32:30

I was getting assessed it kind of

32:32

coming through my brain in this way

32:35

is the interrupting in conversation or you

32:37

know because I They're so, like, countless,

32:39

like, almost every conversation I have every

32:41

day. Not only have I got my

32:44

own conversation going on in my head,

32:46

but the conversation in my head is

32:48

very much, like, no, don't, don't, don't,

32:50

don't, don't, don't, don't, don't, don't do

32:53

it, don't, don't, don't, don't, don't, don't,

32:55

don't, don't, don't, don't, don't, don't, don't,

32:57

don't, don't, don't, don't, don't, don't, don't,

32:59

don't, don't, don't, don't, don't, don't, don't,

33:02

don't, don't, don't, don't, don't, don't, don't,

33:04

don't, don't, don't, don't, don't, don't, don't,

33:06

don't, don't, don't, don't, don't, don't, don't,

33:08

don't, don't Oh my God. And maybe

33:10

it's been, honestly, I think maybe even

33:13

with the podcast, like it's been this

33:15

thing that we've done for five years

33:17

now that I know I've got better

33:19

and better with interviews to like sit

33:22

back and just wait. But I do,

33:24

I find it exhausting. Like 100% and

33:26

you can probably see me here like

33:28

an eye slope ways to not. because

33:31

I think at the end of the

33:33

day it's usually coming from a place

33:35

of there's no ill intent us doing

33:37

these things it's just because we're excited

33:40

and we want to kind of add

33:42

to the story and so I guess

33:44

this is where it's important to talk

33:46

about this because we don't want people

33:49

thinking that we're trying to minimize what

33:51

they're saying or that we don't care

33:53

but it's just because we want to

33:55

relate and we want to to add

33:57

to that in a really beautiful way.

34:00

the important as well is that. It's

34:02

a hard school to learn and I

34:04

guess as well we don't want to

34:06

be masking ourselves so that we're not

34:09

being our authentic self but we also

34:11

need to find what's appropriate. Which can

34:13

be hard. It's a it's a learning.

34:15

In a world that's not necessarily made

34:18

for the for ADHD is that at

34:20

least. Yeah it's a neuro divergent person

34:22

trying to fit into a neurotypical world

34:24

which is difficult and I think we

34:27

need to. we need to validate that

34:29

and have compassion towards that. For sure.

34:31

Lastly, from a perspective of both psychologists

34:33

but also someone who has ADHD themselves,

34:36

how do you feel about... ADHD being

34:38

a trend. And I'm quotation marking that

34:40

because that's not something I like to

34:42

say aloud. But yeah, what do you

34:44

think about it? Like what do you

34:47

feel about people saying that, that it's

34:49

a trend that people are jumping on?

34:51

What do you feel about people talking

34:53

about it more on social media? Just

34:56

yeah, what are your thoughts? You probably

34:58

heard my grumble as you were saying

35:00

because it's honestly a pet peeve of

35:02

mine because I think it is so

35:05

invalidating for people that actually have ADHD

35:07

and Sadly, and I'm not saying that

35:09

people, that doctors or psychiatrists or psychologists

35:11

or whatnot are ever coming from a

35:14

place of, again, ill-intent or anything like

35:16

that, but I think there's been a

35:18

couple of even just clients that have

35:20

come through that have said, you know,

35:23

and maybe I've highlighted, oh, you've got

35:25

quite a few traits of ADHD, and

35:27

they've gone, oh, yeah, I kind of

35:29

thought I did, but I went and

35:32

spoke to my GP and they've said,

35:34

oh, it's just, you know, it's over

35:36

treated, or yeah, they just, they brush

35:38

them off, it's a trend now, etc.

35:40

And I just think it's so, so

35:43

invalidating and it stops people from learning

35:45

about themselves and understanding. how their brain

35:47

works because once we know that you

35:49

know 80 HD could be at play

35:52

it's it's about utilizing that and and

35:54

working with strengths around that so it

35:56

does upset me as you can probably

35:58

tell by by the way that I'm

36:01

talking about it because I just think

36:03

it can do so much damage at

36:05

the end of the day. I completely

36:07

agree and I think I think if

36:10

you're looking at going through the assessment

36:12

process I think as well like there

36:14

is so much more I think what

36:16

people don't understand and why they must

36:19

think like, oh, it's just this trend

36:21

that people can go and like just

36:23

get diagnosed and like, whatever. There is

36:25

so much more than just like taking

36:27

off some symptoms when you are being

36:30

kind of assessed. So it's, I completely

36:32

agree, it's totally invalidating when you have

36:34

kind of found the courage to get

36:36

the assessment, get the diagnosis, you're processing

36:39

it all, and then you hear these

36:41

conversations that everyone has it, or it's

36:43

a trend, or oh my gosh, or

36:45

it's just not a big deal, or

36:48

whatever. And as I said, maybe one

36:50

day you can get to a point

36:52

where the severity isn't. you know so

36:54

much on your life and you found

36:57

ways to manage it and you're embracing

36:59

it in a different way and you're

37:01

looking at it from a like a

37:03

positive lens and that's awesome like great

37:06

love would love that for all of

37:08

us but if you're not there yet

37:10

those kind of comments about it being

37:12

a trend can be so hurtful that's

37:14

it and I think exactly what you

37:17

said let's be real about it because

37:19

not everyone is going to be you

37:21

know embracing it and feeling super positive

37:23

about it because it is a process

37:26

and they might be at a different

37:28

state during that grief process of it

37:30

so we do we need to be

37:32

so careful and I was actually thinking

37:35

about this on the plane the other

37:37

day and I was got my laptop

37:39

out the person beside me was probably

37:41

like, what is she doing? Because I

37:44

was just like, I just thought about,

37:46

you know, if someone does say to

37:48

you that it is a trend or

37:50

something like that, like how do you

37:53

respond to that? So I actually created

37:55

a little, you know, you can copy

37:57

and paste this, anyone at home that

37:59

wants it, but I thought. This might

38:01

be helpful for people that want to

38:04

answer it in a way that's still

38:06

compassionate, but is asserting that maybe what

38:08

they're saying isn't the best. So this

38:10

is what I came up with on

38:13

the plane. So I get why it

38:15

might seem that way. ADHD is definitely

38:17

getting more attention now, but that's not

38:19

because it's a new trend. It's because

38:22

we're finally recognizing how it shows up

38:24

in different people, especially adults and women,

38:26

who are often overlooked before. More awareness

38:28

means more people are getting the support

38:31

that they've always needed, which is a

38:33

good thing. Oh my god, I love

38:35

that! I feel like I just need

38:37

to like put that in a little

38:40

caption. You know what I am? I'm

38:42

going to put it in a little

38:44

tile post to the Instagram so that

38:46

you can read it over and over

38:48

again and memorize it and everyone can

38:51

have the same response. I thought that

38:53

was beautiful. Thank you so much. As

38:56

Beck mentioned psychologists and psychiatrists can diagnose

38:58

people with ADHD but the process is

39:00

a little different and I suppose the

39:02

why behind you would go to a

39:05

psychiatrist versus psychologist might be a little

39:07

bit different too. So I wanted to

39:09

talk to a psychiatrist and to get

39:11

the perspective of a psychiatrist so I

39:13

spoke to Dr. Diane Grogot. Diane's psychiatrist

39:15

with 30 years experience in private and

39:18

public practice and she specializes in ADHD

39:20

and addiction psychiatry. founded the Victorian Adult

39:22

ADHD Interest Group to share expertise and

39:24

resources to improve the lives of patients

39:26

with ADHD. And she mentions a bunch

39:29

of resources in today's chat. So we'll

39:31

pop them all in the show notes.

39:33

This is my reminder to you that

39:35

if you're like me and absorb some

39:37

stuff in a podcast and think to

39:39

yourself. Oh, I should really like look

39:42

at that or look into that or

39:44

Google that. Well, we'll make it easy

39:46

and we'll make sure it's in the

39:48

show notes, but this is just my

39:50

reminder for you to actually go and

39:52

check the show notes for them because

39:55

it's really incredible information. And I hope

39:57

that you get as much out of

39:59

my chat. with Diane as I did.

40:01

She is phenomenal. Diane, welcome. Thank you

40:03

Stephanie. I'm so excited and I'm also,

40:06

my eyes are darting to everything on

40:08

the table that you brought. for me

40:10

for this conversation. Thank you. The toy

40:12

is to keep your attention. That is

40:14

the best little toolbox I've ever seen.

40:16

So many bits and bobs guys, which

40:19

will probably come up in this conversation.

40:21

But I think to start, we've just

40:23

heard from Beck, a psychologist, to understand

40:25

a little bit of the process of

40:27

getting assessed for a diagnosis with a

40:30

psychologist. And I would love to know

40:32

because I personally haven't spoken to a

40:34

psychiatrist yet. What the process is like?

40:36

How does someone seek out an assessment

40:38

with a psychiatrist? Does it look any

40:40

different if they are someone like myself,

40:43

for example, who has a diagnosis from

40:45

a psychologist? Does my assessment with a

40:47

psychiatrist look any different to someone who

40:49

hadn't seen a psychologist first? That kind

40:51

of vibe. Okay. Well, for start I'm

40:53

a psychiatrist, so I did a Bachelor

40:56

of Medicine and Surgery, six years worth,

40:58

and I used the surgery for cutting

41:00

up. birthday cakes these days. But I

41:02

do understand the scope, which I know

41:04

is very often, so I'm a doctor.

41:07

I've delivered babies and an appendicectomies and

41:09

I streamed into extra training and psychiatry,

41:11

so that's mental health. So we get

41:13

to do anything which might affect the

41:15

way your brain works, if it's to

41:17

do with your thinking and your feelings

41:20

and emotions. And there's a great overlap

41:22

with us and psychologists, obviously. But anything

41:24

to do with medication, a doctor has

41:26

to be involved or a trained nurse

41:28

practitioner. With ADHD, part of the assessment

41:31

is the discovery phase, what is it?

41:33

What does it mean to me? How

41:35

have I managed a very busy brain?

41:37

And what have I done good and

41:39

bad to try and get around it?

41:41

Two is beginner, which is biological. Just

41:44

get your brain working, so it can

41:46

reliably be in the zone you want

41:48

it to be. And then that medical

41:50

phase is probably over. Most people... unless

41:52

they've got other major medical things, they

41:54

go into the intermediate phase, which is

41:57

allied health, so it's psychologists, counselors, ADHD

41:59

coaches, and that's where the psychologists do

42:01

their amazing work. Because once your brain

42:03

can work, people go, oh, those techniques

42:05

for conflict resolution that I learned ages

42:08

ago with a busy brain, now I

42:10

can use them now that my brain

42:12

can focus. And psychologists end up doing

42:14

this early stage because nobody else is

42:16

doing the whole thing. The final stage,

42:18

I think, fourth phase is self-management for

42:21

life, which is that, tell me what's

42:23

your birthday. Tenth of January. All right,

42:25

so if we made the tenth of

42:27

every month, Stephanie, celebrate and check-up day.

42:29

Okay. And this is a day when...

42:31

you're going to wake up in the

42:34

morning and go, darling, it's my birthday

42:36

for my month, you know, cup of

42:38

tea and some flowers, lovely, okay, now

42:40

you've got yourself some dopamine and you're

42:42

standing on top of your mountain of

42:45

awesome, then you can look at the

42:47

stuff like the traffic fines that's in

42:49

your car, okitoke, and so... That's the

42:51

day which the 10th is where all

42:53

that stuff instead of annoying you or

42:55

being pushed away has been sitting quietly

42:58

waiting for the 10th and on the

43:00

10th you're feeling good and you can

43:02

look at the things and you can

43:04

go now you can wait for another

43:06

month yep I'll do you today yep

43:09

I'll delegate you to the husband because

43:11

he'll probably pay it quickly. All right

43:13

so and then during the month you

43:15

did you have this little speech thought

43:17

bubble like I need to go to

43:19

the dentist. and then if you wrote

43:22

it on a balloon it just disappeared

43:24

up into the sky or you're trying

43:26

to hang on to too many and

43:28

you're overwhelmed and then you lose a

43:30

lot of them or you couldn't be

43:32

bothered so you write you know you've

43:35

got a thought bubble dentist and you

43:37

put a little string and you stick

43:39

it on the tenth and when you

43:41

get to the tenth you'll decide if

43:43

you want to deal with that as

43:46

like dog training you know this is

43:48

where you do you do you do

43:50

it on the couch you know and

43:52

life is So much, that's good regulation,

43:54

that's knowing where things are meant to

43:56

be and getting them organized and having

43:59

fun doing it at the same time.

44:01

I like the idea of it, like

44:03

being such a positive, because I think

44:05

I have at times not looked at

44:07

a celebration, I've maybe picked a day

44:10

in the week where I'm like, okay,

44:12

I'm gonna get all my admin done

44:14

at this point, but I haven't thought

44:16

of it in that way of like,

44:18

maybe I'll light a candle and like,

44:20

have a. cupcake while I do this

44:23

or something like that and they do

44:25

think that that would make a massive

44:27

difference to the motivation of actually getting

44:29

it done. And if you up your

44:31

background dopamine you can think better with

44:33

or without medication. Say if you and

44:36

a whole lot of friends and kids

44:38

and dogs were doing a... road trip

44:40

up to Queensland. Well, you're driving along

44:42

and you can go, oh, does anybody

44:44

need to go to the service centre?

44:47

I've just seen the Golden Arches. Or

44:49

by the time they realize, or stop

44:51

fighting or wake up, you've gone past.

44:53

And then there's stress. So instead if

44:55

you go, I can see the Golden

44:57

Arches, don't even talk to the people

45:00

in the back, you just pull in

45:02

and stop. And then you go, does

45:04

anybody want to get some food or

45:06

do we need to give the dog

45:08

or do? basic things. You know what?

45:10

This is ADHD coaching and if you

45:13

had an eating disorder I could get

45:15

you 40 sessions with a psychologist, dietician,

45:17

various people, counselors, a year, 40 sessions

45:19

paid under Medicare. You've got ADHD, I

45:21

can get you nothing. If I could

45:24

get 10 sessions with my patients with

45:26

a couple with the, say the GP

45:28

does all the work, of the assessment

45:30

and starts the medication. If I could

45:32

get you some sessions with a nurse

45:34

practitioner to tweak the medication so you

45:37

can get your sweet spot regularly all

45:39

day without leaving yourself in a bad

45:41

position. Oh, medication is not working, Dr.

45:43

Grocott. Oh, really? I'm drinking again. Oh,

45:45

really? What time? Four o'clock. Oh, when

45:48

do you think your medication is wearing

45:50

off? Oh. Do you think that's the

45:52

behaviour you usually do when you've got

45:54

no dopamine? Oh, funny that. Okay, so

45:56

it's an educational thing. So if you

45:58

had some sessions with a nurse or

46:01

a GP or a psychiatrist to be

46:03

able to titrate your medications, that's just

46:05

right. It's like putting on clothes, you

46:07

know, you're warm enough and not too

46:09

hot, not too cold. You don't feel

46:11

good about that. If you had those

46:14

sessions and then you moved into the

46:16

intermediate phase and you had some sessions

46:18

with an ADHD coach teaching these really

46:20

simple basics with some medication, people's lives

46:22

change and then we do the things

46:25

to help them have a regular checkup

46:27

from the neck up once a month.

46:29

You're going to do that on the

46:31

10th now for the rest of their

46:33

life. Then they can really delight in

46:35

their busy brain and they can enjoy

46:38

the trip. So medication, okay, we've got

46:40

what are the types? Okay, there's the

46:42

stimulant medication There's Daxanthetamine and we have

46:44

a short and a long acting of

46:46

that and there's Ritalin which is methylphenidate

46:49

and we have a short and too

46:51

long actings of those ones Now, you've

46:53

heard of sinking your phone or synergy,

46:55

S-Y-N, that's Latin or Greek, I'm not

46:57

sure, for together. So in your brain,

46:59

you've got a whole lot of brain

47:02

cells called neurons, and they're like little

47:04

computers, and they talk amongst themselves and

47:06

they're in local area networks. So if

47:08

we stimulated one at the back of

47:10

your brain, you would be able to

47:12

see something, or if we stimulate one

47:15

here, you might twitch your finger or

47:17

something like that. to see where you

47:19

are and has some ability to get

47:21

you back on track when you're not

47:23

on track anymore. So the way the

47:26

brain cells talk to each other in

47:28

these spots called, we call them synapses,

47:30

like the USB ports in a computer.

47:32

So you've got one brain cell wants

47:34

to send a message across a gap

47:36

to the other brain cell. This one's

47:39

going to, the sending one's going to

47:41

produce a whole lot of little chemicals,

47:43

dopamine being one of them, like basketballs,

47:45

okay? It's going to let a... a

47:47

whole bag of balls go into the

47:49

gap and some of them will get

47:52

to the other side into the hoops

47:54

and if they get in the hoops

47:56

you get a ping, get enough pings

47:58

the message goes on and you've transferred

48:00

the message and then what happens the

48:03

basketballs they get recycled. So it's wonderfully,

48:05

wonderfully designed. Back through the vacuum cleaners

48:07

into the bags waiting to do another

48:09

thing again. All right, easy. What would

48:11

happen if you were blessed with the

48:13

5% of the hunter-gatherer genes, 5% of

48:16

the population, hunter-gatherer genes, you actually can

48:18

create extra vacuum cleaners. So you send

48:20

out your dopamine and it gets sucked

48:22

back in too quickly. You don't necessarily

48:24

get good messages. But if you work

48:27

harder or you find yourself in a

48:29

dopamine-rich environment, the messages are normal. So

48:31

you get intermittent issues. So ADHD is

48:33

not attention deficit. You don't have any

48:35

lack of attention. Okay, it's attention dysregulation

48:37

and if you can't regulate your thinking

48:40

you can't regulate your feelings and you

48:42

can't regulate your responsibilities and your relationships.

48:44

But it's actually in most cases too

48:46

many vacuum cleaners. Now that's a very

48:48

simplistic thing but if you've got too

48:50

many vacuum cleaners on your sending side

48:53

you can work harder to overcome that.

48:55

or if you put medication in, what

48:57

they do is they plug vacuum cleaners.

48:59

Okay, so Ritalin plugs vacuum cleaners, Dex

49:01

plugs the vacuum cleaners and also gets

49:04

out, kicks the dopamine out of the

49:06

bag, so Dex is a little bit

49:08

stronger. Yeah. And let me tell you

49:10

about cocaine and myth. Okay. They both

49:12

plug back in cleaners, but they also

49:14

on the sending side, they get jammed

49:17

into the basketball hoops and they give

49:19

a great big ping and then the

49:21

whole thing breaks. And then you've got

49:23

less receivers, less basketball hoops, and you're

49:25

more likely to be a sitting duck

49:28

for addiction. So addiction occurs on the

49:30

receiver. side and medicine occurs on the

49:32

sending side. So chemicals that do both

49:34

are nasty and chemicals that do just

49:36

the one are not addictive and they

49:38

are stimulants for ADHD. Except they don't

49:41

stimulate people with ADHD. They normalise them.

49:43

They stimulate people who don't have ADHD.

49:45

So the terminology is crazy. But there's

49:47

such a fear of stimulants. and the

49:49

thought that it makes people go crazy,

49:51

no it actually doesn't. And as far

49:54

as is it addictive, we just roll

49:56

our eyes and go, we can't get

49:58

our patients to take their medication, they

50:00

keep running out. And then they go,

50:02

I'll see if I can do without.

50:05

And I go, well, did you have

50:07

a plan B? You can see if

50:09

you can do without any time you

50:11

like so long as you've got 14

50:13

days. Because if you need to go

50:15

back on it, because you've got an

50:18

exam coming up and your life might

50:20

not work very well without it. And

50:22

you're wanting me to fit you in

50:24

quickly to do another script. So as

50:26

you can see, I try and organize

50:28

my people. Totally. The most you can

50:31

do is six months. So I say

50:33

to my patients, here's your six month

50:35

script. It will expire at the end

50:37

of six months. Make sure you pick

50:39

it up so you can pick up

50:42

a month at a time. every 21

50:44

days so you don't get to the

50:46

end and oh Dr. Grocott I've got

50:48

um I've just realized they only last

50:50

six months I did tell you but

50:52

anyway you weren't listing because you didn't

50:55

have your medication I tell them again

50:57

again and again okay don't let it

50:59

expire get your medication and I say

51:01

as soon as you leave here now

51:03

make another appointment for five and a

51:06

half months so and I sound like

51:08

mum and I do and once they

51:10

get organized they do it for themselves.

51:12

Like your mother told you what to

51:14

do and eventually you did it for

51:16

yourself. So that's... Oh I love it.

51:19

I think the last thing I would

51:21

love to ask about it because I

51:23

will admit it has probably been the

51:25

only thing that I am a little

51:27

bit concerned about I think is medication.

51:29

stripping, I think the parts of me

51:32

that I do love at all. And

51:34

I wonder, is that a myth? Yeah,

51:36

gay. If you do lose your mojo,

51:38

it's either the wrong drug or the

51:40

wrong dose. So, Dix and Padamene and

51:43

Ritalin are the, one or the other

51:45

is the thing to start with. And

51:47

they work 70 to 90% in people.

51:49

It's one of... in terms of medicine,

51:51

we haven't got many medications that work

51:53

so quickly and so easily for people.

51:56

I was going to say that's the

51:58

other thing, isn't it, is you can

52:00

kind of work out pretty quickly if

52:02

it's working for you. It's not like,

52:04

I think there's other medications, maybe it's

52:07

for depression or something, but you have

52:09

to be on it for a certain

52:11

amount of time before you know if

52:13

it's actually going to work. 30 milligrams,

52:15

10 milligrams, a little white tablet. usually

52:17

decks is a bit stronger than Ritalin

52:20

but not for everybody. You take one

52:22

tablet and if you have ADHD and

52:24

you haven't got all these other things

52:26

happening, other massive medical problems, usually within

52:28

30 minutes you notice something. and it

52:30

lasts for three to four hours and

52:33

it's off. So it's a bit like,

52:35

again back to the brain, you've got

52:37

your frontal lobe, this is your teacher

52:39

in a classroom, the rest of your

52:41

brain is the kids. And they have

52:44

nicely, providing they know what to do,

52:46

but on a hot windy day the

52:48

teacher is screaming at them it's not

52:50

working, she gets laryngitis and she goes

52:52

and the whole class erupts. It's like

52:54

giving the teacher a little microphone. and

52:57

if you have the short acting it's

52:59

like a little battery it'll kick in

53:01

in 30 minutes and last about four

53:03

hours and then it's dead and if

53:05

it's a long-acting the long-acting decks amphetamine

53:07

takes about an hour to work and

53:10

might last up to 12 hours if

53:12

you're lucky quite often not or you

53:14

take the long-acting there's a long-acting Ritalin,

53:16

Ritalin, L.A. which can be about eight

53:18

hours and then there's concerta which is

53:21

a long-acting Ritalin. as well, which is

53:23

about maybe 10 hours. So you have

53:25

to keep taking it. So it's like

53:27

putting glasses on my face to be

53:29

able to focus. So I've got my

53:31

teacher in the classroom. She's got a

53:34

little microphone. And what would you want

53:36

to do? You might start the day

53:38

with a fast acting, quick acting one,

53:40

and then you put the long acting

53:42

one, which has got a long battery,

53:45

so that when the little one dies,

53:47

the long one takes over, and then

53:49

that might end, oh, four o'clock. Why?

53:51

Because I'm drinking. Why? Because the class

53:53

is in eruption again. You might then

53:55

have another little short acting ready to

53:58

go to keep you going all day.

54:00

Yep. Okay. about I reckon the third

54:02

of people prefer decks, a third prefer

54:04

Ritalin, and there's a third it doesn't

54:06

matter. So whichever one I choose for

54:08

you, I've got a two-thirds chance of

54:11

it working. So I go, okay, let

54:13

me equip you with some short acting.

54:15

So you take one test dose to

54:17

see if it works. And then what

54:19

you're aiming to do is to see

54:22

how strong it is. It's like trying

54:24

on clothes. And I go, okay, go

54:26

into that dark change room and see

54:28

if it works. And you go, well,

54:30

I can't tell. I know. Because the

54:32

part of the brain that can tell

54:35

is the part of the brain that

54:37

isn't working. And that's the difficulty. So

54:39

I like to start with short acting

54:41

for my adult patients to get used

54:43

to it. And I say, I want

54:46

to know what happens on the drop-off.

54:48

And you'll. my brain squiggly again. It's

54:50

like I'm in the, in a pool

54:52

and I can't see the goal and

54:54

I can't see where I'm supposed to

54:56

be and I'm drowning and I go

54:59

for a donut or I land myself

55:01

on the raft of negative self-talk because

55:03

that helps me stay afloat. Okay, I

55:05

want to know about your behaviors when

55:07

your, when your brain's squiggly again so

55:09

that you know. So that when you

55:12

can say, okay, this medication started to

55:14

die at four o'clock or maybe two

55:16

o'clock, well, good. Well, you need to

55:18

get yourself a little $5 tablet thing

55:20

case for your, on your key ring,

55:23

and you have your medication there, and

55:25

you can put some colored tick tax

55:27

in, and if somebody at work looks

55:29

at you... and said, oh, what's he

55:31

doing to take a medication? You go,

55:33

oh, do you want to tick tag?

55:36

You give them a colored one, you

55:38

take a white one, you do not

55:40

have to tell anybody. And what you

55:42

do is you set a little song

55:44

alarm for half an hour before you're

55:46

going to need it. So if your

55:49

brain's going to go at four o'clock,

55:51

well, you're going to need the medication

55:53

at three, short acting again at three

55:55

30 so that you don't drop into

55:57

the squiggly zone. in that really lovely

56:00

I'm functioning zone because if you're going

56:02

in and out of that or into

56:04

too much too much is too much

56:06

adrenaline too much dopamine hyper focus and

56:08

I'm anxious and I reckon when I

56:10

see new people there that lovely zone

56:13

is really narrow because they're living in

56:15

the fear and the what's wrong with

56:17

me and overwhelmed by the traffic fines

56:19

and whatever and what will my life

56:21

be like? They're living in war zone

56:24

and they often do all these things

56:26

to get themselves into the good zone

56:28

of dopamine which takes them too far

56:30

into the yeah so if somebody says

56:32

oh I took the medication and it

56:34

made me really anxious I go is

56:37

the medication either too strong or have

56:39

they got such a little narrow area

56:41

that they're aiming for that they can't

56:43

cope with much medication yet so it's

56:45

a process So we get them to

56:47

find out what's comfortable and that will

56:50

change. It may change with your responsibilities,

56:52

your time of the month for a

56:54

lady. And it may change, usually does,

56:56

as they start to get good at

56:58

managing their lives, they clean up their

57:01

traffic fines, and then they wake up

57:03

in the morning and they feel good.

57:05

So they're not wading through a whole

57:07

lot of something that sucks you dopamine.

57:09

You just go straight into a good

57:11

dopamine zone, you feel good, and it

57:14

feels as if life is lovely. So

57:16

the times in your life when you

57:18

say, oh, I was functioning well, well,

57:20

if you mentally think that was my,

57:22

you know, the good zone, that was

57:24

too much and that was too little,

57:27

and your good zone was big. And

57:29

then what happens, you get a few

57:31

traffic fines or things. go wrong and

57:33

it's like the sealing the attic of

57:35

all the fears start to come down

57:38

and down and down so it's really

57:40

hard to maintain that nice feeling for

57:42

very long and that's the same for

57:44

every human being on the planet it's

57:46

just that ADHD people have less control

57:48

in getting to finding out which zone

57:51

they're in but by the time people

57:53

have been on medication you know for

57:55

a few months they go oh okay

57:57

I'm now cleaning up a life and

57:59

I go good you probably past the

58:02

medication beginner called titrating the medication stage

58:04

in the beginning stage. Now you're into

58:06

the intermediate which is you probably don't

58:08

need a doctor at this stage. You

58:10

know it might be just six monthly

58:12

scripts or something. Go and see your

58:15

ADHD coach, your psychologist, your gambling counselor,

58:17

whoever else you need to see. So

58:19

that's the process we're looking at. Amazing.

58:21

Thank you so much. Let me just

58:23

tell you a bit about pregnancy. Yeah,

58:25

actually I do have ladies who have

58:28

been through ADHD with pregnancy. The medication

58:30

increases dopamine and increases adrenaline. Okay. So

58:32

if you had twins and your placenta

58:34

would be perhaps risky, I would not

58:36

do ADHD medication because of the possibilities

58:39

of any difficulties there. But so we...

58:41

We talk to our moms and their

58:43

partners and go, okay, well, the question

58:45

is, if something went wrong, could you

58:47

live with yourself? And there's a risk

58:49

of things going wrong with any pregnancy,

58:52

obviously, and we want to keep it

58:54

as the minimum. Most women with ADHD

58:56

will go, I have to work, and

58:58

I have to think, and I've got

59:00

two toddlers. And the baby inside me

59:03

would be more stressed with the cortisol

59:05

of me screaming. So I just think

59:07

I'm going to use the minimum amount

59:09

of medication to sort this out. So

59:11

that's often what women do. The other

59:13

one is the breastfeeding. Not very much

59:16

comes out in the breast milk. And

59:18

we've got this little thing we try

59:20

to feed in the morning. express if

59:22

you've got extra milk that's lovely that's

59:24

for it that's for the next feed

59:26

take your short-acting medication do some morning

59:29

work and then feed the baby with

59:31

the breast milk with no with no

59:33

medication at all obviously and there might

59:35

be a little bit in the afternoons

59:37

and the other thing that you can

59:40

do with the decks but not with

59:42

the ritalin is trying to flush it

59:44

out with large doses of vitamin C

59:46

because the decks goes out through the

59:48

kidneys and if you're excreting a lot

59:50

of acid from ascorbic acid, it may

59:53

go quickly. Ritalin goes through the liver,

59:55

so whatever enzyme factory you've got in

59:57

your liver, you're stuck with it. But

59:59

look, there's lots of support. There's lots

1:00:01

and lots of support. And yeah. I

1:00:03

think that's really interesting because I think,

1:00:06

I think I just thought blanket statement.

1:00:08

or you can't have it when you're

1:00:10

pregnant. So I think it's really interesting

1:00:12

to understand if you feel, because I

1:00:14

have heard stress and stuff like that,

1:00:17

is honestly one of the worst things

1:00:19

for an unborn baby, and just on

1:00:21

pregnant women in general. So I think

1:00:23

it's nice to know that there is

1:00:25

an option, particularly if you are someone

1:00:27

who are used to taking the medication

1:00:30

to and know what life is like

1:00:32

without it. So that's comforting to know.

1:00:34

Yeah. And everybody wants not to not

1:00:36

to take medication. And when you've got

1:00:38

your frontal lobe or lobe on. this

1:00:41

part of the brain can see two

1:00:43

things without having to kill one off.

1:00:45

You can go, I hate taking medication,

1:00:47

but if I was a diabetic I'd

1:00:49

be taking it. I can still hate

1:00:51

it, but I choose to do what

1:00:54

is helpful for me at the time.

1:00:56

So rather than I hate it and

1:00:58

I don't take it or I have

1:01:00

to take it. So people are concerned,

1:01:02

oh will I be dependent on it?

1:01:04

Well I'm dependent on oxygen but I'm

1:01:07

not dependent on having to wear lots

1:01:09

of layers of clothing and or... well

1:01:11

I can't drive without my glasses so

1:01:13

I would write I'm short-sighted so I

1:01:15

need my glasses so I choose to

1:01:18

wear them. It's one of those things

1:01:20

where once the fears could die down

1:01:22

and people actually see what's available they

1:01:24

go oh gosh probably fun. known about

1:01:26

that earlier would have been nice. So

1:01:28

look, thanks very much for helping people

1:01:31

know. Because if, look, if every kid

1:01:33

in school who has the, instead of

1:01:35

having short-sightedness, their brains are short-sighted, every

1:01:37

kid with ADHD in school who cannot

1:01:39

function and cannot attend, if someone said

1:01:42

it would be easy if this child

1:01:44

was screened for ADHD or anything else,

1:01:46

trauma. ADHD interferes with your connection with

1:01:48

your frontal lobe and the rest of

1:01:50

you. So does trauma, so does fear,

1:01:52

so does blood alcohol, pain, other medical

1:01:55

conditions, other psychological conditions. So just because

1:01:57

they've got ADHD doesn't mean they haven't

1:01:59

got lots of other things and they

1:02:01

need to be screened and then properly

1:02:03

assessed. And then when you do the

1:02:05

management plan, you go, okay. here's a

1:02:08

project management which is the quickest and

1:02:10

easiest thing to fix and sometimes we

1:02:12

have debates with oh is it trauma

1:02:14

and do they have borderline personality or

1:02:16

is it ADHD I go well could

1:02:19

be both could be one could be

1:02:21

other if I give them a pill

1:02:23

and in half an hour I know

1:02:25

I may not know but at least

1:02:27

it's quick and cheap and easy to

1:02:29

try medication and people who found the

1:02:32

medication has been life-changing keep coming back.

1:02:34

Well, I have to say, I am

1:02:36

very grateful for your analogies because it

1:02:38

has helped me so much in picturing

1:02:40

what you're doing. So thank you. And

1:02:42

yeah, definitely some of those resources that

1:02:45

you mentioned, we'll link them in the

1:02:47

show notes for sure, because I think

1:02:49

it's always helpful, especially when you listen

1:02:51

to a podcast. I find that I

1:02:53

absorb some of it and then sometimes

1:02:56

it just goes out the other area,

1:02:58

so it's nice to have something to

1:03:00

revisit. Yep. Thank you. And that's it

1:03:02

for episode one. But before I go,

1:03:04

I wanted to leave you with an

1:03:06

ADHD special share, a resource that I

1:03:09

found incredibly helpful in. journey that

1:03:11

I think you might

1:03:13

too. It is It is

1:03:15

the book I Year

1:03:17

I Met My

1:03:20

Brain Bozley and I am so

1:03:22

and I am so

1:03:24

incredibly grateful that

1:03:26

I actually got to

1:03:28

sit down with

1:03:30

Matilda for this this mini

1:03:33

series so you will actually

1:03:35

be hearing from

1:03:37

her in the next

1:03:39

episode. Things that

1:03:41

we struggle with are

1:03:43

often the things

1:03:46

that society that society oh

1:03:48

you're a good

1:03:50

person if you're on

1:03:52

time a you can

1:03:54

do all of

1:03:57

the little on time, and

1:03:59

work and things like

1:04:01

that of so you

1:04:03

don't go oh

1:04:05

there's something wrong you

1:04:07

go oh I'm

1:04:10

a bad person. today's

1:04:12

episode Beck so suggested

1:04:14

a bunch of

1:04:16

resources which I'll link

1:04:18

in the show

1:04:21

notes oh, I'm a If

1:04:23

you have any feedback

1:04:25

on this episode

1:04:27

I'd really really love

1:04:29

to hear from

1:04:31

you. Send us a

1:04:34

DM with a

1:04:36

voice memo via the

1:04:38

kick in the show notes

1:04:40

Thank you so much

1:04:42

for listening and be

1:04:44

be very very soon.

1:04:47

soon.