Stuff You Should Know
Hosted by Josh Clark
Today, the conclusion of the two-part episode on ADHD. See omnystudio.com/listener https://omnystudio.com/listener for privacy information.
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Hello, everyone. In case you're listening to these episodes out of order, we gave a heads up in episode one that we have a kind of a grown up talk about ADHD in these two episodes. So we wanted to say if you're a parent with a kid who has ADHD, maybe listen to it yourself first before you share it with them. On with the show.
Welcome to Stuff You Should Know, a production of iHeartRadio.
Hey, and welcome to the podcast. I'm Josh and there's Chuck and Jerry's here again, and we're starting up part two of our double episode on ADHD.
That's right. And if you remember in part one, we discussed ADHD. Some people have it, some people don't. And we're going to talk right now about how you can figure that out.
And that's called diagnosis. Right now, where we are scientifically. Is that the biggest factor on whether or not you have ADHD or not is hereditary. If you have kids and you have ADHD, as a parent, you, your kid has about a 50% chance of having it as well.
Mm-hmm.
And like we mentioned in the first part, a lot of adults from, especially our generation, Gen Xers.
Yeah.
Have, are now getting diagnosed in their, you know, 30s, 40s, 50s because they found out that their kid has ADHD and they're like, wow, little Chucky Jr. Looks a lot like big Chucky.
Yeah, that's a symptom. I thought that was charming.
Exactly.
I thought it was a bug.
And even if they don't recognize it in them, you, there's a 100% chance that their spouse will be like, I really think you have this too.
Yeah, but there are some other factors, right?
Uh, yes. Um, there's issues during pregnancy. That's a big one. Usually exposure to alcohol or tobacco, um, premature delivery, uh, if you didn't weigh very much when you were born, if you were exposed to lead as a kid, if you had a brain injury as a kid. There's a lot of concern about some other stuff. I think you said at the very outset of part one, um, there isn't any research that suggests watching too much TV or living in a go-go-go world. Um, there is some research that suggests that, um, blue number one and blue number two food dyes may actually at least exacerbate ADHD symptoms. But for the
most part, they think it's a combination of genetics, uh, the environment you were raised in, and then possibly like actual environmental factors like, um, being exposed to lead or your mom, you know, smoking when she was pregnant with you.
Yeah. And just to kind of clear up the, the TV and the screen thing, um, watching TV or being on screens too much or too much TV, uh, quote unquote, isn't going to, uh, help give you ADHD. But there is a connection there. Uh, if you are a kid with ADHD, the pull toward a screen is going to be way stronger. Uh, than a kid who doesn't have it. Uh, that short attention span is gonna, um, really crave, uh, like the flashy graphics that, that video games or cartoons can deliver you.
Hmm.
Uh, it'll deliver that steady dose of dopamine. Um, they've done studies, it was, I found one, a large study of five-year-olds, uh, that compared attention span of kids who watched less than thirty minutes per day of TV with those who spent more than two hours, uh, in front of a TV. And of course, we mean, you know, screens, basically.
Right.
Uh, and pretty dramatic results. Uh, the kids who, um, watched the most TV had, uh, almost an eight times more of a chance of meeting the ADHD diagnosis criteria.
Uh, and it even outranked other things that cause attention problems like, uh, you know, lack of sleep or, uh, parent stress, economic stress, stuff like that.
Wow.
So there, there's a link, it's not gonna give you ADHD, but if you have a kid with ADHD, then you should probably just monitor screens even more, you know, you should be doing that anyway, but maybe even more so.
Yeah, because those sites are designed to release dopamine and train you to come back and do it again and again and again. And so kids with ADHD who don't normally have a flood of dopamine, when they get it, they really learn to do that thing that, that gives them that dopamine, which again, doesn't give you like a feel-good rush, it just comes along with that and tells your brain, this is a really important thing to do, so do it again and again and again.
Yeah, uh, for sure. It's also like, the age of your kid is really important when you're trying to diagnose, if you're preschool-aged or younger, or I guess that counts as all ages younger than preschool, but you know what I mean? Um, that, it can be a lot tougher because there are other developmental delays that may look like ADHD, uh, that change and you may not be able to get a really good diagnosis until they're, you know, six, seven, eight years old. Uh, and even when they're older, like, you know, teenagers, you gotta rule out a lot of stuff like, uh, learning disabilities, um, mood disorders, if you have like, vision or hearing problems or a sleep disorder, a lot of that stuff can, can fool ya into thinking you have ADHD, so it can be tricky.
It can be, um, so, there's two lists, there's an inattentive list and then there's a hyperactive list.
And each one has, I think, nine, like- Criteria, things like, you know, you lose things frequently, you appear to to zone out while people are talking to you, stuff like that. And if you have six out of the nine on the inattentive list, you have inattentive type ADHD. If you have six out of nine on the hyperactive list, you have hyperactive type ADHD. And if you're really running up the numbers and you've got six of nine on inattentive and six of nine on hyperactive, you've got the combined version of ADHD. Adults, it's the same thing, although the criteria is adjusted a little bit for, you know, runs around rambunctiously in class.
You don't do that, but say you feel restless at during meetings, like it's really hard to sit still.
You may be mentally doing that.
I would love to jump up and spin in a circle.
Right, right.
But a kid will actually do that, whereas the adult in the meeting will just struggle through that.
Exactly. So the criteria is essentially the same, it's just kind of adjusted for adults. And then for adults, it's five of nine.
For either list. And then also with kids, when you're diagnosing kids, you look at their educational records, you talk to their parents, you talk to their guidance counselors, you get as much information as you possibly can to to properly diagnose somebody with ADHD. Because there's not one like, here's our ADHD test, whether it's a blood test or a written test, there's, you're basically pulling all of these disparate info together to to put together like, okay, this kid has ADHD and it's this kind.
Yeah. And that's why, you know, parent teacher conferences are super valuable. I think when you first start to have to do that stuff, you're just like, oh, God, kill me, I gotta, seriously, like, because your experience is from when you're a kid, like, what a waste of time. But it's not at all. When you go in there as a parent, you know how your kid is at home. You don't know how they are at school.
Because you don't have a little camera in their classroom where you can just sit around and watch what they're like, so.
Rich parents do.
Right, maybe so. But you can really glean, like, I think when you have challenges with a kid at home as a parent, you're dying to know if it's just you.
Or if it's just the way it is at home, in other words, obviously not just the parents' fault. But you're wondering, so you're like, when we get in there with Ruby's teachers, we're always just like, so what's going on? What's she like? Does she have trouble with this or that? And sometimes it's like, yeah, she has the same trouble with this or that at home. And sometimes it's like, no, it's not at all at school. And so it's really super enlightening.
Yeah, that is super enlightening. Does it make you feel better? Or is it more just like it just answers the question that you have?
Yeah, just I think, you know, knowledge is power. So just knowing that stuff, that dude, we should start doing that with you and Jerry. They need to be adult versions of parent teacher conferences.
Oh, that's a great idea.
You know?
I would be so anxious.
Oh, no, it'd be good. We do it over drinks.
Okay. One other thing, you can find a lot of really great, accurate diagnostic tests on sites like TikTok, which have lots of misspelled words in the title. So those are always really great to test whether you have ADHD or not.
Be aware of the, I mean, social media stuff can help. There's a lot, some good resources, but what was that study? Like half of the stuff on TikTok was just wrong?
Yeah, I think 52%.
Yeah, when it came to this? Yeah, more than half.
Yeah. So one of the big questions that we're still answering today, and if you haven't picked up that we don't have a full grasp of ADHD in any way, shape or form yet, that's correct. But one of the factors that we're trying to figure out is the prevalence of ADHD among kids and among adults. And it's kind of all over the map. It does seem like we're starting to kind of zero in a little bit. We're figuring out like the criteria to really like, to really diagnose ADHD. And it seems like the numbers are starting to get a little smaller as, as time goes on and we get a little better with recognizing ADHD.
Yeah. And correct me if I'm wrong, because I know that you found some other numbers. But we'll just go through them and you can just say. If I'm off.
Wrong.
Between ages of three and 17, so school age kids in the US, United States of America, around 10% have been diagnosed with ADHD. That number does get bigger with age because a lot of times you won't get tested until a little later. And some, you know, diagnostic testing requires money and sometimes a lot of money. I mean, you can do like a, just a sort of psychiatric evaluation. Maybe if your kids go into a therapist or something and they may just look at criteria and ask a few questions, but if you want like a real deal diagnostic, diagnostic evaluation, like those aren't cheap and that sucks because like these numbers are kids who have been
diagnosed because they were able to be diagnosed. So there, I'm sure there are a lot of situations where that's not possible.
There's also a shortage of psychiatrists in the United States. So it's, it's often, there's a long waitlist to even be seen from that psychiatrist. You have to pay a lot of money to. Not all psychiatrists specialize in ADHD. So you really need to find from an even like smaller pool to choose from of psychiatrists. And then also, once they diagnose you, that the, the outlay of money is not over there. Like you have to keep seeing them and they charge you every time for that. And psychiatrists are medical doctors, so their fees are not on the par or on the order of a psychologist or a therapist. They're four or five times more on average, probably.
I'm pulling that out of thin air, but I, it's very clear that you're going to pay more for your psychiatrist than you would for a therapist.
Yeah, for sure. Generally, still, boys are more likely to get that diagnosis than girls. About 13% to 6%. There's also variations by race. I believe the highest percentage is black kids are at 12%, 10% for white kids, 8% for Hispanic kids and 3% for Asian children, which is just super interesting.
It is interesting for sure and there's gotta be some clue in there somewhere.
That seems like there's, that's weird that there's a difference because I think all of those numbers were for kids in the United States.
Yeah, it was.
I think globally, they've come up with in a 2017 study across the world that five, almost 5.3% of kids have ADHD. And there's a, there's a question like, okay, is this over diagnosed? Because I said that the prevalence rate seemed to be kind of getting a little smaller as we zero in better and better. But the diagnostic, or the rates of diagnosis have really picked up, or they really did at the beginning of the 21st century. Between 2005 and 2014, diagnoses of kids with ADHD doubled, doubled. That's crazy. That's a huge increase, doubled.
It's almost like 100% more.
Yeah. And, you know, there's just no scientific consensus right now on whether it's an over diagnosis or whether it's just, we know more now and there's less stigma, there's more kids getting tested now. There, you know, the, the criteria changed in 2013 from the DSM four to the DSM five.
As far as that threshold. So all of those things probably factor in to the, to the doubling, I would think.
Yep. One thing though, if you are taking your kid in to be tested, make sure that it's, since they kind of evaluate the kid against the expectations of their grade level, if they're young for their grade.
Yep.
That needs to be taken into account because they can, they can easily be misdiagnosed because they're actually not at that grade level yet because they're not of that age quite yet, even though they're in that grade.
Yeah. And with COVID kids, you know, potentially missing out on, depending on what happened, where you were on a lot of valuable schooling. So, yeah, it's, it's important to look at, uh, cause, cause Ruby is young for her grade. So in some cases, she's like eight or nine months younger than some of her classmates. Uh, and then when you throw, even though she did COVID kindergarten, which was a real boon, um, they did their best. It wasn't like regular school still. So, uh, teachers and educators are having to sort, and parents are having to sort through all of that still.
Chuck, just to kind of give a hat tip to some of our listeners in other countries, I saw that the NHS says in the UK, 5% of kids have ADHD. In Australia, they estimate 6% to 10% of kids have ADHD. Canada, 5% to 7%.
Not bad, eh?
And then our friends in Germany can expect a percentage of 4.33% for the percentage of kids that have ADHD in that country.
Funda bar.
So what about adults? Because as we now realize, adults have ADHD too, or they probably had it in childhood and it was just undiagnosed and they just didn't get diagnosed until later in life. That's typically what happens.
Well, my friends, let's take a break and find out those results right after this.
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Lately, I've been learning some stuff about insomnia or aluminia. How about the one on borderline disorder? Better yet, reporter. Heard that one before.
All right. What a cliffhanger that was.
Our adult listeners on the edges of their collective seat. Seats? Seat. Collective seat?
Yeah, collective.
Yeah, cuz it's collective.
Collective soul.
Oh, that's a good one.
The rate of the condition into adulthood is all over the map. Some, you might look at one thing that says, eh, about 5%. Cuz, you know, that's kind of what it is for kids-ish. And then you might read something else that said, no, like 75% adults have it. It's really, really startling when you start looking into this as an adult. There was a study from 2021 that said, that found that it can fluctuate over time. And, you know, it's kind of what I was talking about, being on the spectrum. But about 9% of those diagnosed as kids, they said, had quote unquote, "fully recovered" in young adulthood. So I don't know if, what that means, though.
That, like, are systems in place such that they've learned to manage it?
Yeah, that's the weird thing is there's no known cure for ADHD. All of the stuff that we use for is just managing it. But I think one of the reasons also that they were like, it's just a childhood disorder that you outgrow, is because some people actually do somehow.
So you actually can. Okay, so that may be the 9% or part of that 9%.
I guess, but to pull one of your old, old school words, and it seems hinky to me. Like, I don't understand how, yeah. I don't understand how you could outgrow something that arises from your brain being literally different than other people's brains.
I don't get it. But maybe we just don't, don't understand it quite yet, but it is true. I'm not 100% sure. But for the most part, it does seem like if you have ADHD as a kid, you have it as an adult as well.
Yeah, and if you're an adult with ADHD, you're probably seeing it play out with organization and focus.
You know, a lot of times with your job, but in just in your life as well, because it's always there. You might have some pretty severe mood swings. You might be a procrastinator.
A lot of times you're misdiagnosed because it might make you really anxious. So there's like, no, you have anxiety. Or it might really bum you out with these mood swings and they might say, oh, you're just depressed. All of that could just be ADHD or a comorbidity.
Yeah, and we'll talk about comorbidities in a second. Oh, I got it. But with adults, you know, again, adults don't get up in meetings and run around the table and they're like, just go ahead, I'm listening, you know? Instead, they're just going to sit there and just, you know, use all of their energy to not do that and then also to try to focus on what's being said. And then, girls with ADHD, Chuck, tend to fall through the cracks much more frequently for a couple of reasons, but the main one that I saw is that girls are so expected to be like, demure and quiet and self-possessed, that girls learn to mask their symptoms
earlier than boys do, who are, can get away with being more rambunctious than girls can. So it goes undetected. And then finally, when they, you know, grow up and have a family, they're just like, I can't, there's too many plates, I can't do this. I'm just exhausted and I'm not doing any of this the way that I'm supposed to be. And they'll usually get diagnosed with depression and then anxiety or something like that, but if they find the right doctor, they'll be properly diagnosed as ADHD.
For sure. You mentioned comorbidities. Autism is a very interesting one. Thirty to eighty percent of people with autism spectrum disorder are also diagnosed with ADHD and about twenty to fifty percent of people with ADHD also have autism spectrum disorder.
And you're just like, why, why aren't they the same percentages? But it turns out that ADHD is actually more common than autism, so that brain rustler is solved.
For sure, and there is a lot of overlap there. I think before 2013 with the updated criteria in the DSM V, they thought that was like a mutually exclusive thing. And some people, this is much the minority for sure, but there are some researchers that do think it's just sort of a single condition manifesting in a couple of different ways.
But most researchers don't think that. They think it's like, you know, two separate things that live alongside one another a lot of times.
Right, and Chuck, I just, I just realized, I don't know if we've shouted out Livia this whole time yet for helping us out with this one, but she did a great job.
She did a great job, and before I forget, the other thing as far as ADHD and autism spectrum disorder is you're more likely to just do better if you have one or the other than if you have both. That may feel intuitive, but I think it was, you know, a fair saying.
Did I interrupt and interject that Livia thing?
No, it's fine.
Depression's another one, Chuck. I think kids with or people with ADHD are five times likelier to have depression than neurotypical peers.
And they're not exactly sure why. A lot of people are like, well, it's obvious. I mean, like, it's, it can be a really hard life to have ADHD, especially when it's undiagnosed and untreated. So of course, people have depression. Other people are like, no, we're talking about actually like clinical, like, brain-based depression.
It's possible that there's actually, they share similar roots in the, the structure of the brain, and that might account for it, that there's a lot of overlap physically between depression and ADHD.
Yeah, for sure. And about 40% of kids, and I think we touched on this a little bit in part one, also have anxiety, which just makes it all tougher to deal with, because it kind of feeds on itself. 30 to 50% of kids with ADHD fit the criteria for a couple of other conditions, one called oppositional defiant disorder and conduct disorder, which we should maybe cover, we could probably cover both of those in one episode at some point.
We should, man. One of the most heartbreaking things I've ever seen in my life was on a plane and this kid was just kicking the back of my chair, nonstop, hard. And I turned around to look, like, what the heck's going on?
You mean, said, "Don't, Josh, no."
Right. And the parents were there with him and they just gave me a look like, "What? What do you want us to do? We can't do anything."
And I've never seen two people look more tired and more defeated in my life and their kid was probably only three or four. And it was just like, like, I still today, I just feel so bad for those people. Because that's your kid and like, there's not a lot of understanding or treatment with that. And certainly not out in the general public who turns around like, you know, "What are you doing? Why is your kid doing that?"
Yeah. And in the old days, like, you would tie your kid to a plane seat or something, barbaric like that.
Yeah, which I'm sure helps a lot.
No. All right, so if you don't have ADHD, like me,
it helps to grow older because you do get a little wiser and you do gain empathy, hopefully, at least I have.
So it's hard to put yourself in someone's shoes until you are close to someone with ADHD. And then it, like I said, it really benefits everyone if you can, if you can lead with empathy and understanding, like in your case with that kid even. And that's coming from someone with ADHD, recognizing maybe this behavior in a kid. But it can be hard if you don't have it to understand this stuff.
Yeah, so people, like, low empathy generally with people walking around who know about autism are probably like, "Yeah, that's, that's, that has to do with autism." Turns out it's a huge symptom with ADHD too. And probably the exact same stuff applies to people with autism. But with ADHD, it's not that you don't care, you couldn't care less, or whatever. You do care, you just either lack the ability to, like you said, put yourself in that person's situation. So, so your empathy- Can be triggered or you lack emotional empathy, which is where you're like, oh, man, that's terrible that that happened to you, but I'm not feeling empathy like I don't feel it.
That's, that's the difference. They're not sure how many people with ADHD have low empathy and exactly how it works, but it is a huge problem because again, like they're, if you can't, if you can't empathize with people, that's a basic human thing.
And that will really cut down on the number of connections you have with people. Because if somebody's telling you something and they've just, you know, inserted that pop like the end of it and like, this is what happened. And you're like, oh, uh huh. Like you're just taking their words at face value and you're losing the emotional components, missing, it's not landing on you. And they're just like, well, what is wrong with you? What like you, did you not hear what I just said?
And you can stop and think about it and be like, oh yeah, that's crazy. But like in the moment, it's not, it's not there.
Yeah. Yeah, totally. Um, another, and this is something I never knew anything about until we started researching this, but a false memory or faulty memory can be an issue if you have ADHD. Uh, and it's not just, um, well, I just don't remember things as they really were. It can literally be like a false memory. They've, they've done tests with kids and it, they showed that kids with ADHD are much more likely to remember things that weren't on a list. And, and this is sort of the key here. Uh, not only that, but be really emphatic that those memories were correct and trying to defend those memories. And that can be, uh, not only
a frustration, but a real challenge, especially as you get into adulthood to sort of be able to construct your autobiography of who you are, because that's all based on your memories.
Yeah. Because if you can accept that you have false memories and that you embellish stuff that you don't remember inadvertently, you don't know that you're doing this, you start to question all of your memories, like which ones are true, which ones are made up. That's a huge problem individually, but also as far as relationships go, you're accidentally, inadvertently gaslighting the people that you're like, no, that, that totally didn't happen. Or you said this, I didn't say that. And to, to get to a point where you can trust the other person's version of events, what you're doing, you're having to.
Disavow your own version of reality.
And rely on somebody else's version of reality. And that's probably the hardest mental thing a person can do.
In their life is abandon, like, just not, like, not trust their view of reality and be like, okay, I trust your version instead. It's one of the hardest things you could possibly ever do. And that's what it requires to not accidentally gaslight people and not get in arguments all the time because your memories are false.
Yeah, and I imagine, you know, you keep kind of going back to this, how so much of this can lead to a lack of ability to connect with people in different ways. I imagine when you find your person or your persons in your life, it may be, maybe a smaller number than it would have been otherwise, but I, I would think that maybe some of those connections, because so much trust is involved, can be even deeper sometimes.
Yeah, oh, for sure. If you can find somebody that you feel like you can be yourself around and just let your guard down and they accept you as you actually are, you hang on to those people, for sure. And that's true whether you have ADHD or autism or nothing.
For sure.
Like, if that's, if, how, whenever you find those people, but it's like you said, they're going to be much fewer and farther between because you're lacking that initial easiness of like, oh, I like you, oh, I like you too, let's start hanging out more and
And cultivate a friendship naturally without even thinking about it. Each relationship is a lot of work for people with ADHD. So, yeah, of course, you're going to have fewer of them.
Yeah, for sure. You, and these are, you know, we're kind of going through just sort of like what it's like to live with it. So, some of these are, are downers. But you are more, I believe, twice as likely to be injured in life. If you have ADHD, which sounds kind of weird, but it makes sense, you know, if you're distracted or distracted, or if you're impulsive, if you take more risks, that's going to lead to more injury in life. There's also this very, very strange thing called the ADHD sway, where it's a literal physical imbalance, a postural imbalance that's associated with ADHD, which could be a short stuff on its own, maybe.
I think so. You may find this hilarious video, I think on Instagram, of somebody saying like what it's like walking next to somebody with ADHD. And because the ADHD person will accidentally walk in front of you, or walk like kind of sway too close to you or something like that, you end up, the guy who was like walking along next to this girl who's talking to him, and like he ends up having to like climb over like a jungle gym, and ends up having to walk through a bush and like all this, all this stuff. And the person with ADHD is totally oblivious that all this is going on. But it's because of that, that ADHD sway. They don't, as far as I know, no one knows exactly what it is, but they think it could have something to do with the differences in brain structure.
Has something to do with the balance as well, because that's in the brain as well as in the ears.
Fascinating. All right, we're in the, act one, two, three, four, five. We're headed toward the act six.
Wow. Is this the one where the guns go off?
Oh, I hope not. So we're headed toward act six, and we will talk more about the destruction of masking behaviors right after this.
Buy smart, drive for less, and trade for more. That's Toyota affordability. And it all starts with a great deal on the truck from your local Toyota dealer.
That's right. Make a smart buy on the off-road Ready Tacoma or half-ton Tundra, two of Toyota's most capable and longest-lasting trucks, built with the strength for the tough jobs, the tech to power your next big adventure, and the rugged style for everything in between.
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I've been learning some stuff about insomnia or aluminia. How about the one on borderline disorder? Better yet, birth order. Heard that one before, but it was so nice. I learned it twice. Everybody listen up.
Oh, it's Charles and Joshua. It's tough, it's tough, it's tough.
So Chuck, you promised that we're gonna talk about masking. So I feel like my back's against the wall. I have to start talking about masking, which I will right now. Okay.
Okay. Are you masking? Right now?
Sure, yeah. I think at all times, people with ADHD mask. To varying degrees, for sure. I feel very comfortable on the episode, but you know. Yeah.
I didn't mean to put you on the spot. I was kinda just joking. What is masking? Let me ask you that.
Masking is camouflaging your symptoms to blend in better.
And how bad can that get? And how bad is that for somebody?
In some ways, it's necessary and needed just to navigate the world, just to blend in. And not to blend in like, don't look at me, but to seem... But to be able to interact with people in levels that they're not like, huh? What's wrong with you? They're paying attention instead to what you're saying or, you know, the, the value that you have.
You have to, if you have ADHD and autism, a lot of neurotypical disorders, if not all of them, require you to mask to be able to just kind of live in the world, right? So in that sense, it stinks. And there's a lot of, I think you kind of mentioned it either earlier in part one. Some employers are starting to create more neurodiverse, inclusive workplaces where it's just like, just be yourself. But traditionally, if you wanna just make it in the world, you have to mask to some degree, right? And so in that sense, that's okay. Or at the very least, that's not the most insidious version of masking. The problem with it is that starts to carry over throughout.
Other parts of your life and you find that you eventually develop a version of yourself that you assume other people would prefer to be around. And in a lot of cases, you're probably correct. And so in addition to, you know, all of the exhausting this that it keeps from not, you know, getting up and running around the conference table during a meeting and being like, no, go ahead. I'm like, just keep going. I'm listening. You, you also, your self-esteem takes a real nosedive because what you're training yourself is that your you is, is not good enough. You have to, you have to hide yourself for people to accept you or value you. And that's the most insidious part of masking.
Yeah, I can't imagine that to, to, even it can get so bad where you lose your sense of self because you're masking so much. Obviously, something like this can manifest in bad ways. Mood swings, anger, those are symptoms that can be associated with ADHD because of the masking. And, you know,
regulating those mood swings, being unable to, to be sort of generally in a stable emotional state can be very, very challenging. And that takes a lot of energy. And that's part of the fatigue that can come along with ADHD is your, if you're always on or playing a role that you think you should play to fit into work or life or the world, it's gotta be exhausting.
It is. So you're more irritable. So you're more prone to like, get mad at somebody who cut you off in traffic, whereas like a neurotypical person might be like, huh, that guy's having a bad day or what a jerk or something like that, you know?
You add all this stuff together and research consistently shows that people with ADHD have lower self-esteem and lower self-compassion too than neurotypical people. And that's, yeah, again, like I said, it's a really insidious. Part of ADHD and just being neurodiverse in general. Again, it's not just ADHD people who have to mask. Anybody who isn't neurotypical will feel like they have to mask at least in some situations, unless they make a conscious decision not to do that. It's almost like resisting an impulse and just being like, I am going to be me in every situation. And to tell you the truth, I'm not even sure that that's possible.
Yeah, and resisting impulse is one of the challenges anyway.
Right, yeah, exactly. Good point.
So, you know, as far as families go, we already mentioned that that can, you know, family members may be on eggshells. There have been studies that have shown that you may have a lower parental warmth and especially maternal warmth toward a kid with ADHD, which is super sad. More stress, more depression, they found among, among mothers especially. And if you have like one neurodiverse child, one kid with ADHD and two or three other kids or just one other kid who is neurotypical, that can be really challenging for, for everybody, including the neurotypical kid.
And they have found adults with ADHD have about a twice as likely chance of getting divorced as a neurotypical couple.
Right, so yeah, there's a lot of challenges just in, in living everyday life at home even, not, not even just at work or at the mall or something like that. There's some other real bummer downsides to having ADHD as a population. You're very susceptible to addiction because again, like these things flood your brain with dopamine, so you learn to do those over and over and over again. So it's really easy to get addicted to just about anything if you have ADHD. There's a study of people who were in treatment in the US, I can't remember when it was conducted, but they found a quarter of them had ADHD.
And another quarter, between 24% and 62% of homeless people in the US were found to have ADHD. Despite, again, only maybe 3.1% of adults globally having the disorder. So they're disproportionately represented in those.
Yeah, for sure. So here's the good news, everybody. We've been through five acts and a third of some good things, some bad things and real challenges.
We laughed, we cried.
We laughed, we cried, for sure. It's a very, in fact, one of the most highly treatable conditions or disorder. I don't even like saying disorder, you know, but I guess that's how they list it, that you can have. There are a few things you can do treatment-wise. There is coaching, there's therapy, and there's medication. You may try one of these things, you might try two, you might try all three as an individual or a parent if you're helping your kid through the situation.
That's, well, that's the, that's the most effective usually is all three of those.
Yeah, I mean, medication can be very effective. As of 2016, 62% of kids in the US that are diagnosed were on medication. 30% of those were only on medication. 32% were on medication and behavioral treatment. And 15% shunned the medication and just did behavioral treatment.
And that's kind of understandable for a parent to make a decision and that many parents to make the decision like, I don't want to put my kid on speed.
Because again, like, central nervous system stimulants are the go-to drug for treating ADHD because it really, really works. It's like flipping a light switch, I understand, where like, just even from the first dose, you're like, oh, this is what it feels like to be neurotypical.
And one of those stimulants that is prescribed, one, one type, Adderall, Vivant, Strattera, they are literal amphetamines. So the idea of putting your kid on amphetamines really does not sit right with a lot of parents, even though the, the state of understanding, the consensus in the professional ADHD community, despite a lot of non-professionals giving contrary advice.
Yeah, anecdotal usually.
Study after study has shown that kids on stimulants for ADHD treatment do not get addicted to those stimulants, like it just doesn't happen. And then it also doesn't set them up for increased addictions later in life. And it may actually decrease, some studies have shown, the proneness to addiction of other stuff later in life even too.
Fascinating.
And I don't want to be just like a lackey for psychostimulants as ADHD treatment. There's a lot of different info out there, but from what I could tell when I researched it for this, the professional community generally agrees they are not harmful to be on even long term.
Yeah, there are a couple of kinds. There's immediate release medicines, that's sort of as needed, like a maybe up to four hour effective time window. You may crash really hard after that, or get really tired or depressed after that. There are extended release medications that that's sort of the morning pill that can last all day sometimes, sometimes it's six hours, sometimes it's up to 16. Sometimes people tag team those, take that pill in the morning and then either as needed or in the afternoon or evening, one of the immediate release medicines. And you have to get screened, you know, for something like this, they're
going to do like a cardiovascular screen for health risks and stuff like that. But it's sort of, I believe they haven't found link to cardiovascular disease, right? But didn't they, there was something about the heart you found that was contrary to that, right?
Yeah, there's a study in the Journal of the American Medical Association that I think from like 2023, that was like, actually, we studied some dudes in Sweden and it seems like they're, they were at an increased risk of cardiovascular disease from long-term psychostimulant use from ADHD. So.
Again, it's possible that we just don't know enough or people haven't been on it long enough. But again, these things were developed in the 50s and kids have been on them since the 70s, 80s at the latest, when they started putting them on, well, effectively speed to treat this stuff. And there doesn't seem to be a lot of research that suggests they are harmful.
Right. If you don't respond well to those, if the side effects are no good, there are other medicines that you can take that are not stimulants, alpha antagonists sometimes. Sometimes like they found that some medications to treat high blood pressure like clonidine have, you know, improved ADHD symptoms. So, you know, talk to your doctor if this is something you're interested in and, you know, just, we're not medical professionals. So, you know,
No, good point.
Speak to your doctor and like, really do some research and dig in. It's, you know, putting your kid or your adult self on a, on any kind of medication is not something to take lightly. So just, you know, really, really dig in there and ask questions.
For sure. And no, no shade on you if you're a parent that's like, I don't care what you say, I'm not putting my kid on speed.
Totally, totally get that. Like, I respect anybody's decision about that because it doesn't mean that you don't care about your kid. I respect anybody's decision about stuff like that.
Of course.
So I said that the most effective, I guess, approach to treating ADHD is not just medication, but also different types of therapy and then also some other interventions like exercise and nutrition. And when you put all that together, it's much easier to treat ADHD symptoms. One of the first things, especially with kids with ADHD, is family training.
Where you, you teach the family how to teach the kid how to act and behave, like what's expected of them, what the consequences are, and not just the kid, the whole family is supposed to fully understand and be very clear on all of the house rules and the structure of the family. And I guess so the younger kids can effectively tell on the kid with ADHD when he misbehaves or she does.
And I saw that authoritative parenting type is the most effective, which was described as high control with high warmth and high support.
Oh, interesting.
But also that means, okay, so high warmth, right? Does that mean that some parents make a decision to not be warm to their kids? Like, they think that that's the best way to raise kids?
Well, I mean, sadly, sure, there are all kinds of parents. But I feel like that probably, high warmth probably means extra warmth, like being really attuned to
Gotcha.
Providing that, that extra warmth would be my guess.
On fire, like a furnace of a parent.
You mentioned exercise, of course, that's good for everybody when it comes to mood regulation and your brain functioning at its highest. But for sure, if you have ADHD, it can increase dopamine, it can improve your executive functioning. If you have a lot of pin of energy, especially if you're a kid, you know, with hyperactivity, exercise can really, can really help, for sure.
Coaching is another one, too. There's therapy, obviously, but coaching is huge in the ADHD community because you're not like, okay, what's wrong with you? Let's figure out all your traumas and stuff like that. It's like, okay, you're having trouble with time management? Let's figure out what works for you for getting better at time management. And it's, it's a legitimate way to approach ADHD symptoms. So are productive strategies, where, that will probably also come out of coaching sessions. And one thing that you'll learn very early on is phone calendars that are easily accessed, that you can put reminders on all the time, alarms on your phone, anything that can remind
you can become like second nature to use, to really help you navigate ADHD symptoms and remember important stuff.
Systems, baby. That's the key.
That's right.
Getting systems in place, ADHD or not, systems are just, the older I get, the more I realize that. If you don't have a system in place, then you're just, you're just
You're lost.
flailing, you know? You gotta get a system. They did, you know, outcomes are pretty good. There was a survey, this is a little bit old, but it's, you know, I think it's probably still pretty, pretty on par, but 2020, 2020 12? 2012 survey of 351 English language studies. So I guess this is like a meta-analysis of long-term outcomes that people with ADHD found that 72% of people treated had improved outcomes when it comes to everything from self-esteem to fewer accidents behind the wheel, less rates of addiction, antisocial behavior, increased employment, increased academic success. So 72% if you are treated.
That's, that's great. That's really successful.
Yeah, there's a lot of good resources too for ADHD. There's a researcher named Melissa Orlov. She holds marriage seminars that really kind of paint ADHD in a, almost exclusively positive light. And if you're a couple that's tried like traditional marriage counseling, you've been like, this isn't working. It's because that stuff's geared toward neurotypical, typical people. Hers is geared toward neurodiverse people.
Melissa Orlov is very frequently criticized as being overly positive about ADHD. There's a researcher named Gina Perla who came out with a much more balanced look. It seems like ADHD called, is it you, me, or adult ADHD? Which is a, yeah. And then Russell Barkley has written a lot of books too for kids and parents and adults. And he was the president of the American Psychological Association for a while.
So he's no slouch?
No. And again, be very wary of who you're listening to on social media, but there are psychiatrists who specialize in ADHD who post a lot on social media and can be really helpful on Instagram too, that I wanted to shout out are Perry Nichols Mandanis. It's great. And then the psych doctor MD Sasha Hamdani, she has ADHD herself and she wrote a book called Self-Care for People with ADHD.
All great resources. And you know what? Let's skip listener email altogether and just encourage people to support one another, dig into those resources, try and lead with empathy and understanding. You get much further in life. And rate and review our show.
Well put, Chuck. Very nice. In the meantime, if you want to get in touch with us, you can email us. You can send us that email to [email protected].
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