PODCAST. Gender Disparities, Coping Strategies, and Managing Late-Diagnosed ADHD with Dr. Kathleen Nadeu, PhD.

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In the latest episode of the ADHD Wise Squirrels podcast for late-diagnosed adults, our Chief Wise Squirrel, Dave Delaney, speaks with Dr. Kathleen Nadeau, PhD, founder of The Chesapeake Center and an internationally recognized authority and author on ADHD. With a career spanning several decades, Dr. Nadeau shares her profound insights into the complexities of ADHD, particularly focusing on its impact on older adults, a demographic that has long been overlooked.

The Journey of ADHD Recognition

Dr. Nadeau delves into the historical context of ADHD diagnosis, noting that it wasn't until the 1990s that adults began to be diagnosed with the condition. Initially thought to be something children outgrew, it has become evident through further studies that most individuals continue to struggle with ADHD into adulthood. She highlights a significant shift in understanding, especially with the release of seminal works like Driven to Distraction by Edward Hallowell and John Ratey in 1995, which brought adult ADHD into the public consciousness.

ADHD in Older Adults

A focal point of the discussion is the rising prevalence of ADHD diagnoses in older adults. Dr. Nadeau emphasizes that as the population ages, with projections indicating more people over 65 than under 18 by 2030, recognizing and treating ADHD in older adults becomes increasingly important. This demographic shift calls for a reevaluation of ADHD as a disorder that affects individuals across the lifespan, not just children and teenagers. She explains that ADHD is not a deficiency of attention but a dysregulated attention system.

Gender Differences in ADHD

The conversation also covers the gender disparities in ADHD diagnosis. Historically, ADHD has been perceived as a disorder primarily affecting hyperactive boys. However, Dr. Nadeau points out that girls and women often go undiagnosed due to their symptoms being less disruptive and more internalized, such as inattentiveness and anxiety. This has led to a significant number of women being diagnosed later in life, often when their children are being evaluated for ADHD.

The Coat of Many Colors

Dr. Nadeau introduces the concept of ADHD as a "coat of many colors," indicating the diverse ways ADHD can manifest. From hyperactive, impulsive behaviors to inattentiveness and executive functioning challenges, ADHD presents uniquely in each individual. This diversity underscores the need for personalized approaches to treatment, management, and understanding that ADHD exists along a continuum.

Managing ADHD: Strategies and Insights

Throughout the episode, both Dave and Dr. Nadeau share personal anecdotes and strategies for managing ADHD. Dave discusses his own late diagnosis at age 50 and the coping mechanisms he developed unknowingly over the years. Dr. Nadeau reinforces the importance of finding the right environment and support system to help individuals with ADHD thrive. She advocates for a nuanced understanding, recognizing ADHD as a type of brain rather than a disability.

Cultural Perspectives on ADHD

Dr. Nadeau also touches on the cultural aspects of ADHD diagnosis and treatment. She recounts her experiences in Europe and Japan, where ADHD is less recognized, and stimulants are rarely prescribed. This highlights the varying degrees of acceptance and understanding of ADHD across different cultures and the challenges that come with these disparities.

Final Thoughts

The episode concludes with Dr. Nadeau sharing resources for further information, including her extensive body of work available through The Chesapeake Center. Her dedication to improving the lives of individuals with ADHD is evident as she continues to educate and advocate for better recognition and treatment.

Wise Squirrels are encouraged to tune in to gain a deeper understanding of ADHD and to explore the wealth of knowledge Dr. Nadeau offers through her acclaimed ADHD books and clinical work. Whether newly diagnosed or seeking to support a loved one, this episode provides valuable insights and practical advice for navigating the ADHD journey.

Enjoy the show? Please give us some love by leaving a review or becoming a Patreon supporter. Thank you.

• Transcript

  0:00

  I didn't know you were Nashville.

  Yeah, I've been here. 16 years. I'm from Toronto originally. So moved moved here by way of Ireland. Wow. That's kind of a circuitous route. Yes. Yes. So my wife is from Tennessee. And I met her in Galway, Ireland on the west coast there. And we lived abroad for a few years and then moved, moved to got married, moved to Toronto. And then she did six winters. And she's like, Yeah, for that. And we had two kids, and we still have them.

  0:31

  They survived the winter. Yeah, that's right. That's right. Yeah. Yeah. But ya know, I've been I've been really excited to speak with you. And thank you for, for all the back and forth this morning. Or this afternoon? Yes. Well, I'm glad it's it's worked out. And, you know, this is a topic that is near and dear to my heart. Because, you know,

  0:57

  older adults have just been an older age, it's been 55 and up

  1:04

  as just a population that has received absolutely no attention. Yeah, no, you're absolutely right. It's it's interesting. What do you know, the year offhand? Because I've been, I've been

  1:16

  mentioning this to people lately, kind of out and out and about, and I don't know what year adults were able to be diagnosed with ADHD like, you know, in their adulthood, because they know this. It's relatively new, like 90s. Right, I think. Yeah. Well, they there's always been the rare possibility of diagnosis. You know, even in the 80s and 70s.

  1:43

  They considered it residual ADHD that most people got over, but there were a few unfortunate souls that had residual ADHD. So you know, it, it could be diagnosed, but the only people that were diagnosed in those days were outliers, you know, the most extreme of the extreme and nobody would deny Oh, my God, yes, this person still has ADHD.

  2:10

  There is an interesting phenomenon. And that is that we

  2:15

  very mistakenly thought that people outgrew it after adolescence, because of a big study that was done in which they only asked the young adults.

  2:29

  And young adults with ADHD are not terribly accurate in self reflection. And many of them didn't like the diagnosis in the first place, felt it had been thrust upon them by teachers and parents, and they were done with it. And so this very inaccurate reporting came out that most people outgrow it. And then when we started looking at parent descriptions of young adults, absolutely, they had not outgrown it, they were struggling with it. And interestingly, a book just came out, co authored by a wonderful guy who's been in the ADHD field forever. Tony Rothstein, he and a woman co author wrote a book called you're not done yet to parents about their 20 Something offspring with ADHD you're not done yet.

  3:30

  Really expect them to act like grown ups, can you?

  3:34

  So but you're right in the mid 90s, the book Driven to Distraction came out in 95. And that became sort of an instant bestseller. It was written by Halliwell and rady. And

  3:53

  there was just a flood of requests for interviews about adult ADHD. And there were articles in the New York Times and the Wall Street Journal, and you name it, and just all of a sudden coming out of the woodwork. And

  4:09

  as a result of that a few adult ADHD clinics were created in the 90s. And what's fascinating, I mean, first of all, we were denying that adult still had it. And we certainly were denying that females had it. Right. And yet, guess what happened when these adult ADHD clinics were formed? The majority of people seeking diagnosis there were female.

  4:39

  The majority of adults, and then they just oh, well, we're still very correct. That is primarily a male disorder. And it's just that females are more comfortable seeking mental health services and that's why there's a skewed you know, baloney Baloney, but that's, yeah, that's where that came from. And you're absolutely right. It was the mid 90s

  5:00

  And here we are all these years later. So, almost 30 years later. Yeah. And statistics tell us that here in the US by 2030, which is only six years from now, there will be more people in the US over the age of 65, than under the age of 18.

  5:24

  And so here is this disorder that we thought was children, okay, children and teenagers. But we're going to be more older adults. I mean, forget adults, of course, there many, many more adults than there are people under age 18. And, ironically, it's really getting turned on its head that maybe we should talk of it as a disorder of adults over 55 that also affects children. Yeah, that's a good point. That's a good point. Yeah. Cuz it's interesting, like when I've learned, like, I was diagnosed last year at 50. So just before my 51st birthday, so it's been Yeah, I mean, I've learned obviously, I learned a ton because of course, I started this podcast and jumped right into everything, because that's what I do.

  6:15

  But it's it's been interesting to learn. Yeah, how, how women girls were pretty much ignored. Early on, because of it being sort of thought of as this naughty boy hyperactive boys syndrome. Meanwhile, you know, the girls were just as hyperactive but more possibly, in their minds looking out the window daydreaming, inattentive, more so

  6:43

  and then, and then women being diagnosed more and more, as you were saying, I think also with with, you know, the, I think it's like something around 80%, right, with hereditary as well. So like, so many children aren't get diagnosed. And then as the parents are treating the child, or you know, they start seeing the symptoms in themselves. And they're like, oh, wait a minute.

  7:05

  Well, and I think of real ADHD, as being hereditary. I mean, there are other ways to develop the same set of symptoms that have to do with oxygen deprivation, or lead exposure or brain injury. But those are insults to the brain that can lead to this set of symptoms. But what I really think of is true ADHD, is a type of brain not a damaged brain, not an injured brain, but just a type of brain that's really quite common.

  7:42

  It is, yeah, it's, I know, last I heard, it was like five to 8% of Americans have ADHD and something like 20% don't know they do.

  7:53

  Have you heard similar statistics? Like around that? Would you I mean, I would almost just now knowing what I know, being out and about, I'm like, whenever I like, I'll talk to people, I'll be like,

  8:06

  oh, like I'm thinking those numbers are probably a lot more. Well, the thing is, we have always acted as if ADHD was this discrete diagnosis that you either had or you didn't have? Actually, it exists along a continuum. And like, almost everything exists along a continuum. And it's really kind of arbitrary. Where you draw the line of Do you that habit. And it just seems kind of absurd to me that you haven't if you have six symptoms, but you don't have it, if you have five symptoms, you know,

  8:45

  who wrote that rule? It's just completely arbitrary. And, of course, some people are impacted by this type of ADHD brain that they're completely dysfunctional.

  9:01

  But most people with ADHD are not completely dysfunctional, and many are actually quite successful in life, if they can find the right pathway. Yeah. And I realized now so much of my own life, career, family, everything, you know, I've developed these coping mechanisms, these coping strategies unknowingly. Thinking that like, I mean, a lot of the things that I've learned about ADHD I realized, I mean, like, everybody has trouble focusing time from time to time not everybody has ADHD from time to time to be clear, of course, because that's something I hear a lot.

  9:44

  But the fact that like, these common traits, if you will, of ADHD are things that I just assumed everybody had at the same level and so the, the strategies I would come up with myself

  10:00

  To help me get more done in a day, or to stay focused on specific tasks, or, you know, I almost feel like every productivity expert out there and I know a few are all probably ADHD ears, whether they know it or not.

  10:15

  Do you find that to be like these kind of commonalities with adults with ADHD, like the coping mechanisms they've developed over the years kind of unknowingly, or masking without knowing? Well, I mean, they, you knew you were developing coping mechanisms, you just didn't know it was related to something that we call ADHD. Right? And I really frankly think ADHD is a huge misnomer. It's not a deficit of attention. It's much more complicated than that. And I imagine you have you experienced this in your own life that this type of brain that we call ADHD is really capable of an intense hyper focus that most folks are not capable of. Yes. But it's not I what I say is a better description is that it is a dysregulated attentional system.

  11:18

  Sometimes, and I am an adult with ADHD myself. Yeah. And I did very well in school, simply because I liked it. And we tend to do well at things that we're interested in, in like, but I was such a hyper focuser as a kid, that one of my grandmother's insisted on having my hearing tested when I was eight years old. Because I could sit in the middle of a chaotic living room, I was one of four kids with my nose in a book, and people would be calling me and I'd have absolutely no idea they were calling me because I was in that book. And, and that's just as typical of ADHD as the, I can't pay attention to this book, because I'm not interested in this book.

  12:11

  Yeah, that's a great, that's a great point. Yeah. Because a lot of people think of like, just kind of cliche sort of stereotypes of ADHD and sort of pop culture or what have you. And they they right away think of that. Yeah, I you have a lecture called a coat of many colors. Tell me a little bit about that. And sort of the Yeah, that just from that. Well, what I really wanted to emphasize there is that ADHD is manifested in many, many different ways. And the public that doesn't, I mean, why would they be knowledgeable about this thing that even all of us professionals don't fully agree on? Is that

  12:58

  the hyperactive impulsive knotty pain in the neck driving all the adults crazy little boy, that's the stereotype is just one way that it is manifested. And there are so many different issues that we lump under executive functioning issues, which really has to do with self management issues. But not all of us have the same self management issues like this. Speaking of myself, I don't have any emotional regulation issues. I'm not short tempered. I'm not easily frustrated. I'm not anxious. I'm, you know, I'm not. But in terms of tracking time, for example, that's one of my biggest challenges is that I just get so engrossed in what I'm doing or distracted. Yeah, what I'm doing that the passage of time just feels very slippery to me. Like, when I was waiting to get the email from you just as a for example. Yeah, I'm on my email, of course, waiting to get the link. Yeah. And I really had to argue with myself to stop myself from opening other emails while I can make use of this time, and I knew that if I opened one of them, you know, then I wouldn't see your opening. Right, right. Right. That's interesting. Yeah. So you sort of have you put in like other like, what are some other ways or maybe common things that you see like, techniques or tactics? Again, I mean, it shows differently, but there are obviously commonalities. I mean, it is an acronym after all, but

  14:50

  as far as like what adults can do, who have ADHD to help them sort of like, like the example you just gave of like, okay, I know I'm gonna

  15:00

  Get distracted by open another email. So like, don't do that. Like I show up. Like if I have a meeting, for example, somewhere, I always show up like 30 minutes even an hour early. I don't show up. I'm not rude about it like, I'll you know, I'll sit in the car or what have you. But I'm curious about some of the strategies are common things that you see there. And you do that you arrive an hour early to be sure you're not late. Yes. Because the reason I'm asking is that,

  15:35

  because of ADHD, distractibility, very often arriving really early, is a bad tactic. Unless you're going into an environment where you're captive, basically, like, I wouldn't advise somebody to get there an hour early and sit in your car, because you're going to go on your phone, you're going to start listening to the radio, you're going to oh, I'll go across the street and get a cup of coffee, I mean, you're going to, you'll have too much time to get distracted.

  16:08

  Now, if you're sitting in a dentist's office an hour early, that's not going to happen. I mean, you're a captive audience, and they're gonna come get you. But I think that we really have to manage our brains and distraction, that we will find if, in fact, I've been in any number of conversations where people say, I've sort of figured out exactly how much advance warning I need, like if I need to leave the house. A seven minute warning is perfect. If I give myself a 10 minute warning, then I might think I had time to do just one more thing. And I'm late. Yes, I'll do one more thing and not gathered together. You know, my wallet, my phone, my keys, and so I'm still late, right? Yeah, we need to not give ourselves too much time to get lost in the ether. But I'm going back to this coat of many colors. One of the reasons why ADHD is a coat of many colors, is that I really believe that this thing we call ADHD, and I call it a type of brain. I don't think as a disability, though, I don't think of it as a gift. I think of it as a type of brain that has advantages and challenges, like, like all brains do. But ADHD has, I believe, more psychiatric comorbidities than any other disorder. And in fact, the psychologist who used to be at Yale for many years, Tom Brown, now he's retired and living in California, but he wrote about that and called ADHD is a foundational disorder, meaning that he believed that it made you more vulnerable to other disorders. I mean, one of the things that we know genetically is there seems to be a genetic cluster that contains ADHD, anxiety, depression, and addictive tendencies. Yes. And no one can inherit that whole cluster, or any part of it.

  18:32

  Yeah, and I doubt it. Yeah. And I certainly have the experienced all of the above I mean, I depression to a lesser degree, but certainly anxiety. I mean, I was being treated for anxiety before my diagnosis. And

  18:46

  in when I was working with my doctor on some some medication.

  18:52

  We actually paused after several months, we pause to all the all the different stimulants and doses we were experimenting with to see what was a good fit for me, and decided, hold on, let's treat the anxiety and get that in a better shape, and then reintroduce the stimulants. And that seemed to work much better for me. So yeah, cuz I and I have learned that like anxiety, especially anxiety and depression, being comorbidities of ADHD. And I know

  19:24

  the thing that's really stood out to me, that I learned recently from Russell Barkley was about life expectancy in the life expectancy being up to 13 years less for those undiagnosed and untreated, because possibly up to that much because of these, these underlying things, and he was talking about how like, you can treat anxiety, but for an ADHD ear.

  19:55

  You got to get back to the root cause and treat the ADHD as well.

  20:00

  or your it's just going to continue same with like addiction and things like that. Like if you're an alcoholic, let's say, and you're being treated for that, if the ADHD is there, the ADHD needs to be treated as well as the alcoholism. Does that make sense to us? Although getting back to the coat of many colors, this there's also a large group of people for whom their anxiety greatly decreases once they're on stimulants, because the anxiety was really being caused by the ADHD. But your case you're talking about

  20:40

  another disordered and they're mutually influencing each other. Yeah, yeah. So it's always the case. And I remember a quote, that I thought was so descriptive. When I was interviewing all the older adults I interviewed for my book was a gentleman that said, for me, ADHD is like boxing with an invisible opponent, and you don't know where they are, and you don't know where they're going to hit you.

  21:14

  That's great. That's great. Yeah, I always Yeah. I always say, Yeah, my metaphor is, is the wrong operating system. So like, I'm like running an app, although I'm like an Apple device, like a great device. But I'm running Android operating system. So like, it works, something's worked fine. Everything's okay. And then other things are like really sluggish and slow. Or sometimes I crash

  21:38

  is here, profession these days when you're not doing podcast, I'm really an expert in communication, strategy and skill. So I've worked in marketing, and communications and promotions roles. But then I discovered public speaking about 15 years ago, and I wrote a book called new business, networking, all about networking, growing your business and career by using online and offline methods. Because I love people, I love meeting people. I love performance and, and delivering presentations, I have a background with improv comedy as well. And, and so all of these things I've realized, like, I'm obviously I'm extroverted.

  22:16

  But I'm very highly creative. And I love I love being with people. And I work from home, which sucks most of the time, because, like, I was just in San Diego for a speaking engagement. And my wife's always like, yeah, you need to get out of the house to go talk to people more because that's, that's your happy place. And, and I've realized, by the way, in my own research and studying about ADHD, in his podcasts and things that as a public speaker, standing on stages, or doing improv or what have you, when I'm on stages in front of audiences, and they're laughing and responding, I'm getting this huge rush of dopamine. And I'm like, Oh, that's my happy place. That's why I love it so much. And I've learned this. Yes. And interestingly, my daughter, who also has ADHD, did improv and was just great at it. I mean, that's, that's a perfect match for the ADHD brain, ah, you know, bounce off of, and if you think about it, I've worked with so many students that have had enormous difficulty writing papers, you know, here's an assignment, write a five page paper on Henry the eighth or whatever. And they're looking at a blank page, there's nothing to bounce off of,

  23:39

  give an ADHD brain something to look at, you know, they're gonna riff off of it, disagree with it, add to it, whatever, you know, they've got something to respond to. And our brains are very responsive. Like I used to say, if I had to play trivial pursuit for a living, I would starve to death. Because that is there's one answer. There's one answer only. And you have to sort around in that jumbled filing cabinet in your mind to find the one answer. But you give me a topic. I can talk to you about it for hours. That's interesting. Yeah. That sounds familiar to me too, actually. Because yeah, I've always hated trivia games like that with single answers, but I could play name that tune. No problem. Right. So

  24:31

  that has it's, it's really fascinating. What are some of the differences you see? Because obviously, women have really gotten the short end of the stick as far as ADHD diagnosis because of whether it was just a misunderstanding or misogyny or whatever was causing the lack of diagnosis for girls, especially back in the day, but what are you what are some differences with

  25:00

  Among the genders with or more for, for women when it comes to ADHD?

  25:07

  Well, I think I think there are multiple reasons why girls and women go under diagnosed. I mean, part of it is change happens so slowly in the medical world, and find it in a particular way. And all the research that was done was based on that definition. And so nobody going to oops, we were completely wrong. And so all that research is biased, and you know,

  25:38

  so that there, so we are dragging that legacy forward very slowly admitting that, yes, I guess adults have it too. And we were sort of getting that far. But we, we haven't yet developed criteria appropriate for adults, we just tried to tweak the criteria that we develop looking at old boys, so that and forget about females, we weren't looking at female girls. So we don't have that legacy in terms of diagnosing women. So part of it is just the mindset that and if you go out into the general public, that's the stereotype. It's a hyperactive misbehaving little boy.

  26:28

  I think what happens is in childhood, it's the adults that define what's going on. It's not the child. And so little boys were driving a lot more adults crazy. Yeah. Teachers and parents were going, what am I going to do with this kid? You know, he won't anyone sit down. He won't do this, you won't get. And that's not true for females. We weren't driving everybody crazy. I mean, if you'd asked my parents, I was the perfect child. I had my nose in a book. I made good grades. I did what I was asked to do. I had a younger brother who was just the classic hyperactive boy and then he has a look at him. Boy, does he have it? Right. You know, he was hot tempered. He was loud. He was impulsive. He hated school or the you know, strong willed, you name it. Yeah. And so the way nobody knew what was going on between my ears, and I wouldn't have known what to tell them had they asked me. Yeah. And so

  27:42

  ADHD in females is a much more internalized disorder. And so years ago, when Pat Quinn and I wrote the book understanding girls with ADHD, we developed question lists, ask your daughter x, if they're in elementary school, ask them why if they're in middle school, let them tell you about their experience. And the experiences are very different. Number one, girls in general are less active. I mean, just,

  28:17

  if you just look at kids on the playground, girls, less physically active, they are less oppositional.

  28:25

  Howard Abacha did a classroom study of girls and boys with ADHD years ago. And what he found in classroom observation is the girls never argued with the teacher or the teacher, they might argue with a peer they might be very verbally aggressive with a peer somebody hurt their feelings or made them angry. Yeah, not with the adults now. Hmm.

  28:53

  Interesting. And there are there are a very few girls who are oppositional and loud and aggressive. But it's such a tiny percentage. That's not what the girls look like. And we know that girls are much more likely to feel anxiety, because they know they're having trouble keeping up with things and kind of frantically Where did I put my homework and oh my gosh, I forgot my lunch and my mom's gonna be so mad at me and introduce all this anxiety about their ADHD. And so they get diagnosed with anxiety. We know she's anxious. Look at her so anxious. Not understanding that that anxiety is the result of I'm really having trouble managing my life. Yeah, and, and to this day, I have to check and recheck and recheck. For example, this morning I told my husband that I had this podcast at 2pm.

  29:59

  That's where it was.

  30:00

  As in my mind, right? And I know myself, so I have to keep going back to my calendar is that oh, I'm so sorry. No, it's at 1pm. I do that too. I like yeah, I live in dive on my calendar. Like, if it's not on my calendar, it doesn't happen. And I checked it multiple times, I'm always like, double or triple checking things.

  30:20

  Yeah, that's, that's, that's a big one. As far as like executive functioning, or executive functioning skills, or executive function, um, one thing that I've noticed, and I know, you know, we kind of talked a little bit about how sort of the,

  30:35

  it's a bit of a pickle with like, the DSM five, not including things or being very slow to, to innovate or to update things. And, and it's like, so many professionals, medical professionals like yourself, like no specific things, but because they're not in the DSM five yet, then it's a bit of a pickle that way. But I had two questions there one is around, well, let me go with executive functioning skills. So I follow like Dr. Brown's

  31:07

  kind of explanation of, of the spirit, there isn't really my understanding, at least is that there isn't really any consistent. There are, there were like some categories, five or six categories, I guess, of executive functioning skills, but nothing that's like, concrete, like, is that right? Like it's not included in the DSM five? Or am I messing this up? Well, you're you're sort of asking me a whole lot of questions.

  31:34

  But that they're all pertinent. The, the Diagnostic and Statistical Manual absolutely does not address executive functioning skills, because that's a new concept that didn't make it into the DSM. Right. So everyone in the field, everyone knows believes, operates as if executive functioning challenges are the underlying set of challenges experienced by people with ADHD, but you will not find that in the DSM. And that's how slow they are to change. So you, if you you mentioned Ross Barkley, he certainly has defined ADHD in terms of executive functioning skills. And when you say, is there a definitive list of executive functioning skills, you'll find sometimes five listed, as in Tom Brown's add scale, sometimes you'll find eight functions listed.

  32:41

  Basically, executive functioning skills, our self management skills, and also the skills we need to accomplish what we want to set out to accomplish. And of course, there are an enormous number of skills involved in getting from an idea to a reality, right. And all of those are different types of executive functioning skills. And they all have different names, depending on who you're talking to, even though a lot of the times your work like short term memory and working memory, I believe are the same, right, like are similar, at least, like a lot of a lot of the, you know, time management skills versus punctuality versus, you know, like, a lot of the things have the same name or similar. It's a similar just, I guess, is that right? Yeah, exactly. And, and I don't pay much attention to what exactly are you calling it because I have an overarching concept of what are the executive functioning skills of the brain. And we know those are higher order cognitive skills they take place in the prefrontal lobes of the brain. Those skills are the skills that we associate with maturity.

  33:55

  And in ADHD, we know that

  34:00

  our prefrontal lobes develop more slowly and or underactive because of lower dopamine levels. So we're always telling parents subtract three years, if you've got an 18 year old, they have a 15 year old brain that they're operating with,

  34:19

  about operating systems. And, you know, I've known I have been in this field for so long that I have, I feel like it sort of raised two generations, at least people with ADHD and people that are wildly dysfunctional at age 18 may actually learn to be pretty darn functional by the time they're 35. Yeah. And I remember working with a guy years ago, who was the black sheep of his highly high achieving highly successful family, and he was doing drugs in high school and

  35:00

  Get up in class and blah, blah, blah and everything else, all his siblings went off to very competitive schools. And he went to the local community college immediately got his girlfriend pregnant. I mean, you know, every parent's like, Oh my God, he's Yeah, self in both feet simultaneously. And so that's what was going on in his life when he was 18 or 19 years old. But I didn't meet him until his wonderful son, the product of that very unplanned pregnancy, walked into my office 10 years later, and his parents long since divorce.

  35:43

  And so this little fella comes into my office, by the way, he's a middle aged man now, and he's a very successful cartoonist. Oh, wow. Nice. Yeah. Very cute kid. But he came in and I diagnosed him with ADHD. And a couple of weeks later, I get a call. And it's his dad, saying, You just diagnosed my son. And I think I have it too. Can I come see you? Oh, wow. Right. So now it's like 2829 years old,

  36:15

  divorced, hasn't finished college struggling financially has this 10 year old he's concerned about. And so I worked with him for quite a few years. And when he was diagnosed and went on medication, he went back to community college, his brain was able to do it. Then he got associate's degree, he went to a four year school, he got his bachelor's degree. He was in technology, he got a good job, you know, and I wouldn't hear from him for two or three years. And then he'd say, Hey, Doc, I want to talk to you. This is what's going on.

  36:57

  I helped him sort of communicate with his bosses about meetings drive me out of my mind, and I can't listen anyway. And that his boss says, Well, you're a great employee. And if I'm gonna get more work out of you, by keeping you out of meetings, then by God don't come to the meetings. Yeah, that's great. Yeah, he went back and got a master's degree, he married this time very thoughtfully, and appropriately. And so by the time he was 40, he was a very functional successful guy. And some people would say, well, he doesn't have ADHD anymore. And I say baloney that his brain grew up he'll he picked a field that he was very well suited for. He had supports around him, he had created an environment in which he could function. Yeah. My understanding too, and that's, that's fantastic. I mean, I love the love hearing that it for four adults with to receive an ADHD diagnosis. My understanding is that like they have to tick, or the doctor has to tick enough boxes

  38:13

  around topics like how your life is being sort of disrupted. And like, any sorry about my thumb keeps every time I talk with my hands something about ADHD, I think.

  38:28

  What are your thoughts with that? As far as like, yeah, these these types of these types of things? Now? I think that's ridiculous. Yes, I think we are sort of conflating diagnosis and disability.

  38:46

  Everyone with ADHD isn't disabled by their ADHD. And in my job as a psychologist that specializes in is to help people not be disabled by their ADHD, am I hearing them have ADHD, I haven't changed their brain. I help them understand how to manage their brain I, I have this concept that I call planting yourself in the right garden. And there is an Eastern philosopher who and I think it's a great metaphor. If a plant is struggling, you don't blame the plant. You decide does it need more water? Does it need fertilizer? Is it getting enough sunlight? Is it in the wrong climate? You need to plant it in the place where it can thrive. And that's the metaphor I use with all the people that I work with that all people with ADHD don't thrive in the same place.

  39:49

  We're all unique individuals with lots of other things going on in our brains in our lives. But a big big part of my job is to

  40:00

  Help people understand the environment in which they're going to thrive. And I got so frustrated with this idea of well, look, you don't have ADHD anymore.

  40:13

  This big public debate with another ADHD expert, who would not diagnose a young woman with ADHD who had had ADHD, because she graduated from college. She had a functional romantic relationship. She had a job, she had a life. So we can't diagnose her with ADHD anymore. And so I wrote this very tongue in cheek article with news parents, if your child graduates from college, they won't have ADHD anymore.

  40:49

  Get him there, and they don't have it anymore. But or they couldn't find a job. I guess they caught it again. They have a job. I guess they don't have it again. They got fired up. So I guess they got it again, you know, like it's a virus or something. I mean, it's it's an absurd notion because it is a type of brain. And I think that

  41:14

  in a funny way, I think we are the victims of our Puritan heritage here in the US. And a lot of people don't have ADHD can be very judgmental. judgey judgey, about ADHD. And not only that, but they can be very judgmental about taking stimulants, taking performance enhancing drugs. How dare you want to enhance your performance, it should be pure grit and hard work.

  41:51

  And so I read all these articles that just made me cringe about people trying to convince people they have ADHD to get these performance enhancing drugs. Will you know, give me a break coffee gives me a performance enhancement. Cigarettes are so addictive, because they're performance enhancing food, fairly performance enhancing too, as sleep. I mean, all of these things are really dangerous. Yeah.

  42:23

  So it's interesting, too, because like i

  42:28

  Excuse me on that point, like I, I feel like when I talked to some people they think, I think partly because of like, the controversy around like OxyContin and sort of the the overprescribing of so many people there. And then, but I don't know enough about redl in the 80s and 70s. When and maybe you can speak to this a bit. We're like, I've never really researched it. So I don't know was Ritalin like overprescribe were people being like children, especially naughty boys, I guess were they being like, overly diagnosed or overly medicated on Ritalin back in the 80s? or so? Or was that just No, they were not ideal with this question all the time. And if anything, we continue to under diagnose ADHD. interesting phenomenon. battle took place.

  43:31

  Maybe in the 70s. I'm not sure if my dates here between the Church of Scientology and the American Psychiatric Association.

  43:41

  Because the American Psychiatric Association started claiming, basically that Scientologists were sort of practicing what they deemed to be psychotherapy without a license that they were doing things that were not trained to do, and in many cases, they felt they were causing damage. So the Church of Scientology retaliated very consciously and ferociously by vilifying Ritalin. Oh, interesting. Yes, it was, I mean, what is real and have to do with, you know, APA, and up, put them out of the therapy business, but then they came back,

  44:26

  started inventing insane stories. I remember some story about some child on Ritalin jumped off a bridge to his death. I mean, it's just absurd stories. And a lot of parents were terrified of putting their child on this awful drug. I was living in Europe in the mid 90s. And I remember one of the very popular French weekly magazines had a picture of a giant riddle until on the

  45:00

  cover. And and it said obedience pills. And all an article about American parents don't know how to raise children. And so they give them obedience pills.

  45:13

  And I was there living there for over a year in the mid 90s. And American parents would come up to me saying, My child is suffering in school here. They don't recognize ADHD. They use public humiliation and shame for behavior control in the classroom.

  45:41

  So it was

  45:44

  it's interesting, I mean, that we look at everything through a cultural lens.

  45:50

  In France, they they were not looking at neurodevelopment. I mean, they their version of psychiatry was Freudian. Still. Yeah. Interesting. Yeah. And I think it's interesting too, because like you,

  46:10

  like, I've heard like, in Japan, for example, you they don't prescribe stimulants at all. And in fact, if my understanding, at least, is that if you go to Japan, you can't even legally bring stimulants with you, at least last I heard. I don't know if that's still accurate or not.

  46:26

  But, ya know, so I was, I'm Canadian, excuse me, well, I'm A chimeric. And now I guess, because I'm a naturalized American. But as a Canadian growing up, you know, advertising drugs on TV was illegal. And in the States, it's always been the case. And so I have family members who like know, every drug under the sun, because they probably taken them to some extent. And I say this because like, I was very every time I go to the doctor, or nurse, you know, I was sick, I had a flu or cold or whatever, the nurse would always say, like, what what medication are you on? And I say, I'm not on anything. And they'd be like, no, no, what, what drugs are you prescribed to? Nothing, I'm not on anything. And they would always be flabbergasted American that's not on any prescriptions. And then, as soon as I get naturalized last year, I get diagnosed. And David, now they got me I'm on stimulant state anti anxiety meds. So like they got me through American

  47:30

  ADHD. Yeah. Right. Well, it's, you know, the cultural, I started doing more and more thinking and writing about this, because all behavior exists in a cultural context. Yes. And if anything, I think the US is a particularly good place to have an ADHD brain. And the reason I say that is, we have many more degrees of freedom to reinvent ourselves here in the States. I mean, it's just just kind of a normal thing to do. Right. And I remember living in France, that I mean, they had a saying in France, that ideally, your children are on the rails, silk lay, right. And then they're on track, and they're just gonna stay on that track. And it was just unheard of, to change your college major to change your career to know you decide what you're going to do. And that's how you spend your life and that

  48:37

  very poor for someone with ADHD. Whereas here, we really

  48:45

  understand that there are huge benefits. I mean, the number of people with ADHD that are entrepreneurs is much higher than in the general population, because it's very competitive. You have to have ideas. idea generation is an ADHD trait, you have to be a risk taker, you need to be restless, you want stimulation, and you're gonna go out there and start something. Yes, yeah. Yeah, yeah. I have, oh, sorry. I didn't mean to cut you off, go on. That's okay. I was just gonna say I have a presentation I'm doing called the route down. And it's my next book that I'm working on now. Because it's very much about my own diagnosis with ADHD and what I've learned, but also, it's about, like, I just did this presentation for a group volunteer entrepreneurs, because it's like, you're 60 to 80% more likely to have entrepreneurial intentions and nearly 100% more likely to start a business with ADHD. So yes, yeah, that's why I was like, getting excited when you were saying that because it's yes, I'm aware of the time and we've

  49:53

  done it. Before we do in great contrast to the US where

  50:00

  I think there's some positive aspects to the wild west there also, as we all know, some very negative aspects.

  50:08

  Yeah, yeah. I was in Switzerland a number of years ago to talk at a number of private schools. How do we deal with this thing called ADHD because they just didn't and they had no training. Day before I went a day early to get a little less jetlag. And I go in the cultural museum in Zurich, walk in the front door, and there are the values of Switzerland emblazoned on the wall. And I said, this is so perfect. This is why it's so hard to have a PhD in Switzerland. The acronym that I created is P pad.

  50:53

  Precision, punctuality, order and discipline. Those are the four values of the country, Switzerland, the watchmakers? Yes, I'm sure LD, and Japan, very similar. I spoke at the very first ADHD conference in Japan. And I can say, I've never felt like a rock star in my life until I go to Japan. I was literally mobbed by Japanese women, saying please help. Please help. Please help. Your there's no one here to help us.

  51:30

  That's amazing. Yeah, we should be very thankful. On that note, I'm very thankful for you to spending your time and insights. This has been amazing. How can people get a hold of you learn more about what you do if we didn't even get into talking about all your, your 15 books?

  51:45

  Well, as you can tell, I like to write Yes. So people can learn more about me and my center and my books and everything by going to the Chesapeake center.com. That's the name of my clinic, the Civic Center and we are absolutely dedicated to helping people of all ages with this type of brain we call ADHD. Thanks a million. This has been so much fun. I really do appreciate it. Thank you. Great. Thanks for inviting me.