193: Dr. Sasha Hamdani: ADHD, Anxiety and How to Regulate your Emotions

What if ADHD isn't just an attention problem—but also a problem of emotional regulation? My guest, Dr. Sasha Hamdani, is a board-certified psychiatrist, ADHD specialist, author, and someone who has lived with ADHD herself. She brings a unique perspective to a part of ADHD that often gets overlooked: emotional sensitivity. We explore why some people feel emotions faster, more deeply, and for longer—and what's actually happening in the brain when a small trigger sends you into an emotional spiral. Dr. Hamdani explains the relationship between the amygdala, frontal lobe, dopamine, executive function, and emotional regulation, and why ADHD can sometimes be confused with anxiety, depression, trauma, or other conditions. But this conversation goes far beyond diagnosis. We get into practical tools for managing emotional overwhelm in real time—from delaying your response to a triggering text to moving your body when your nervous system is activated—and why practicing these skills can actually help rewire the brain over time. In this episode, you'll learn: • The overlooked connection between ADHD and emotional sensitivity • Why ADHD can be mistaken for anxiety, depression, or other conditions • What happens in your brain during an emotional spiral—and how to interrupt it • How to strengthen emotional regulation, executive function, and resilience • Why sleep, movement, screen time, and your physical health affect how your brain functions • How neuroplasticity allows you to build healthier emotional patterns over time We also discuss the impact of short-form content and highly stimulating screens on attention and anxiety, especially in children, and why understanding your own emotional patterns may be one of the most powerful places to start. My biggest takeaway is that the goal isn't to stop being sensitive or eliminate difficult emotions. It's to understand how your brain responds to them so you have more control over what happens next. Learn more about Dr. Shah: Website: www.drshah.com https://www.drshah.com Clinic: next-health.com https://www.next-health.com/ Instagram: @extend_podcast and @darshanshahmd Learn more about Dr. Sasha Hamdani: Website: drhamdanimd.com https://www.drhamdanimd.com Instagram: @thepsychdoctormd What if sensitivity isn't something to suppress, but something to understand? Dr. Hamdani's new book "Too Sensitive" is available now! Get your copy today at: drhamdanimd.com/toosensitive https://www.drhamdanimd.com/toosensitive Thank You to Our Sponsors: Next Health Longevity Summit: Head to next-health.com/summit https://www.next-health.com/summit to secure your spot at the first ever Next Health Longevity Summit on September 12th in Nashville! Speakers include: Dr. Shah, Dr. Jeremy London, Dr. Vonda Wright, Dr. Louisa Nicola, LeAnn Rimes, Dr. Will Cole and more! This one day will give you the opportunity to try the latest in longevity! Momentous: Head to livemomentous.com/drshah https://livemomentous.com/drshah and use code DRSHAH at checkout for up to 35% off your first order!

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Dr. Darshan Shah?

  Before we get started with this episode, I'd like to invite all of you to the first ever Next Health Longevity Summit, happening in Nashville, Tennessee, at the Conrad Hotel on Saturday, September 12, 2026. This is an all-day summit where you're going to be hearing from some of the best speakers in longevity's medicine, including Dr. Vonda Wright, Dr. Luisa Nicola, many of the podcast guests that you've heard here on the Extend Podcast, and of course, I'm going to be there, curating the entire day. We also have incredible vendors coming, so you can try the latest technologies in health, wellness, and longevity. Go to next-health.com/summit and buy your ticket today. We only have 400 spots and

• 0:39Dr. Darshan Shah?

  they're going quickly. That's next-health.com/summit. I look forward to seeing you all there.

• 0:48Dr. Darshan Shah?

  Welcome to Extend with me, Dr. Darshan Shah, a podcast dedicated to cutting-edge science, research, tools, and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21, and trained and board-certified at the Mayo Clinic, I've accumulated three decades of practice as a board-certified surgeon and longevity expert. Over that time, I've discovered that a mere 20% of health knowledge yields 80% of the results when it comes to your health span. We are living in a new era where we are creating a new healthcare system, no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world-renowned experts, offering you a step-by-step guide to proactively avoid disease, and most importantly, extend your health span.

• 1:34Dr. Darshan Shah?

  Welcome to Extend. I'm your host, Dr. Darshan Shah. Today, we're joined by an extraordinary guest, Dr. Sasha Hamdani. She's a board-certified psychiatrist who has dedicated her career to reshaping how we understand neurodivergence, mental health, and emotional regulation. Dr. Hamdani is a prominent voice in psychiatry and the author of the insightful new book, Too Sensitive, where she explores the complex interaction of ADHD, emotional dysregulation, and how our brains process stimuli. In this episode, we dive deep into the often overlooked emotional components of ADHD, why traditional diagnostic criteria miss so many adults, particularly women, and how foundational, physical health, metabolic function, and

• 2:18Dr. Darshan Shah?

  lifestyle factors intertwine with our mental well-being. Dr. Hamdani shares her own deeply personal and professional journey with ADHD, offering practical tools to help you understand your unique internal patterns and navigate emotional sensitivity. Get ready for a fascinating conversation that will completely change how you view your brain and your health.

• 2:44Dr. Darshan Shah?

  Dr. Hamdani, I'm so excited to talk to you today about the topic of ADHD and emotions and sensitivity in your new book, Too Sensitive. So, thanks so much for joining me.

• 2:54Speaker 01

  Oh, I'm so happy to be here.

• 2:56Dr. Darshan Shah?

  Yeah, it's so incredible to have a physician that has been passionate about a topic enough to write a book about it, which is, this is your second book on this topic, and you have so much incredible knowledge around this, that I think is kind of a black box for a lot of people still. I mean, I think a lot of times, people go and they're seeking help for a lot of different various issues, but then they get slapped this diagnosis of ADHD and get written a prescription. And I see this a lot, right? Do you see this happening?

• 3:24Speaker 01

  All the time, if they even get to that point. A lot of times, because it's poorly understood, they're getting misdiagnosed. It's anxiety, it's depression, it's, you know, it's so many different things, but the prescriptions flow readily.

• 3:37Dr. Darshan Shah?

  Yeah, yeah. And then, the unfortunate thing about the prescriptions is, or fortunate is, people do feel a lot better sometimes, and they end up just using them as a crutch for a long time. Almost, they feel like it's a permanent solution to their problem, and they really have no pathway to stop taking the meds. And so, I think that's another thing I see a lot, too, is like, okay, you're on this medication now, what are you going to do? And they go, I'm just going to stay on it forever.

• 4:04Speaker 01

  See, for me, that, to some degree, sometimes that doesn't bother me as much, because if we are talking about true underlying pathology, I think correcting with the right medication, obviously, with lifestyle modification and other things, can be life-changing for some people. I'm talking about, like, when people, you know, for whatever reason, are misdiagnosed, or given medications that don't actually apply to them, and then those people, sometimes, maybe they do feel a little bit better, or maybe, you know, it's given as part of this complicated regimen, and they're like, I don't know what part is helping what part. Then it's hard to get off of, and then it just complicates everything else. So, like,

• 4:49Speaker 01

  at the end of the day, it's, you know, with medication, if you're going down that road, and I'm very pro-medication for the record, like, I think medications are incredibly useful tools, but we need to know how to use them, how to get off of them, and we need to know all of those things on the front end.

• 5:05Dr. Darshan Shah?

  Right. And to your point, it's really important to have the right diagnosis first, right?

• 5:09Speaker 01

  Always.

• 5:10Dr. Darshan Shah?

  Yeah, exactly. So, you know, before we get started and go down the rabbit hole of this, I'd love to know a little bit about your history and why this became a topic of passion for you.

• 5:20Speaker 01

  Yeah. So, a little bit of background. I was diagnosed with ADHD in fourth grade, and it was picked up in a time where it wasn't commonly picked up for girls, but I think I presented more like a boy, and I was more hyperactive, I was disruptive, and so, it got picked up, it got brought to the attention of my parents. My parents were like, okay, I think we do need to address this. We started on medication, took that, did relatively well, went through my schooling, got into medical school, which we went to the same medical school.

• 5:51Dr. Darshan Shah?

  We went to the same medical school. We just made that connection today. How incredible. Kansas City, Missouri.

• 5:57Speaker 01

  I'm telling you.

• 5:59Dr. Darshan Shah?

  A lot of good doctors come out of that program.

• 6:00Speaker 01

  I think so. So, I went through, got to medical school, and, you know, by some way, got through medical school, got through training, you know, became a psychiatrist, really got into my field, managed ADHD. It was, you know, a tumultuous road in terms of figuring out what the right medication, what the right intervention, what the right behavioral stuff was, but I think finally got into a relative flow. And then, 2024, my dad passed after this rapid, almost, he had had IPF, and so, we were dealing with his lung issues and figuring out what was going on. And then, just incidentally, 2023,

• 6:41Speaker 01

  diagnosed with stage one lung cancer. And we're like, stage one, that sucks, but, you know, we'll work with it, we'll figure out, do the treatment plan. You know, after he had done one round of chemo, one round of radiation, he was like, I don't feel great. We go do a repeat PET scan, it was everywhere. It had seeded to lymph nodes, and he died 13 days later. So, I think in that process, and this is a little bit embarrassing for me to say as a psychiatrist, because I feel like I should have my finger on the pulse in terms of my own emotional climate, it was the first time I linked that my emotions directly impact my functional status. So, I think when, when I was looking at it through that lens, the bigger something was emotionally, if I couldn't process what was happening,

• 7:26Speaker 01

  that's what would tank me. If, from an ADHD perspective, if I was overwhelmed, or if there was a lot to do, I could hack my way around it, I could delegate, I could find the right people to help me, but I couldn't delegate my emotions. And so, when there was something emotionally heavy, or something that I needed to process through, that's when it was most difficult for me. And so, that kind of got me down this road of looking at just emotional sensitivity as a spectrum, and how people process emotions, and how it's tied to functioning on a daily and basic level. And then, that's where the book came from.

• 7:58Dr. Darshan Shah?

  Yeah. So, it's almost like taking a step back or 10,000-foot view on a diagnosis like ADHD, and seeing, how does this, the overall emotional state of the person affect their, I guess, how much are suffering from this, or how much, or how you even treat

• 8:15Speaker 01

  impactful, yeah.

• 8:16Dr. Darshan Shah?

  Yeah.

• 8:16Speaker 01

  And I think ADHD in general is pretty poorly understood. I think there is a huge piece of it missing, because right now, our diagnosis really was studied with hyperactive young boys, so observable behaviors. ADHD, that doesn't encapsulate so many people that are suffering from ADHD, and I think one of the biggest problems with that is that it doesn't talk about the emotional side of ADHD. And so, as a result, because it doesn't talk about those, you know, those elevations and depressions that come with ADHD, people get misdiagnosed with anxiety, and depression, and bipolar. And so, especially for, like, a subset or a population, like, adult females, for a long time, they were

• 8:57Speaker 01

  completely, completely skipped by criteria. These are the people that, historically, have been put on medications for anxiety, put on medications for depression. By the time I'm seeing them, they've been on 10 antidepressants that have never worked. So, I think being able to look at ADHD more comprehensively, look at that emotional component of ADHD, and then understand, okay, medication aside, getting the right diagnosis important, but what are the tools that you can use to manage that emotional side of things? Because I think for a lot of people, you know, you've been told every time something emotional happens, like, take a deep breath, do this. And it's really more about, you know, the advice might be sound, but it's, how do I apply it? When

• 9:42Speaker 01

  do I apply it? And how can I do that and start practicing it when I'm not in a dysregulated state, so I can use it when I need it?

• 9:48Dr. Darshan Shah?

  Right, right. That makes so much sense. So, you know, for the people that are listening to this, I think a lot of people wonder, because they've heard from friends, that there are medications for ADHD, if they have ADHD or not, right? And to your point, a lot of times, when you're going through very emotional situations, you might either get mixed diagnosed with having ADHD, or not get the right diagnosis. So, when you see a patient that is coming to you and says, you know, I think I might have ADHD, how do you think through that diagnosis? And like, what are the key indicators to you that you should be thinking about ADHD as a diagnosis?

• 10:21Speaker 01

  So, there are two things that are happening. When you look at ADHD, one part is truly ruling in the ADHD. Is this ADHD? And I think that's looking at everything, because I think at its base, ADHD is a dysregulation issue. So, it's not just attention, but you have to look at attention, and energy, and motivation, and all of these multifactorial pieces. The second part, which I think is equally important, and that's why it takes a skilled provider to find out what it is, is ruling out everything else. I want to make sure that this isn't anxiety. I want to make sure this wasn't trauma. I want to make sure this wasn't depression. I want to make sure it's nothing medical. I want to make sure this isn't a thyroid disorder, or like, underlying metabolic difficulties,

• 11:02Speaker 01

  or anything like that. So, I think that there's two parts of it. It's ruling it in and ruling out other things.

• 11:09Dr. Darshan Shah?

  Got it. And so, ruling, by ruling it in, and you described this as a dysregulation, what's going on biochemically or in the brain that creates attention deficit disorder?

• 11:21Speaker 01

  So, there, again, this is something that I think... Deserves so much more data and research and research, not just in the scope of what our criteria is now, just focusing on the attention part of it, but looking at everything comprehensively. But I think a lot of when you look at ADHD, you're looking at neuroanatomical differences. And you're also looking at underlying wiring and neurotransmitter imbalances. And not necessarily, a lot of people think, you know, when we talk about dopamine imbalances and things like that, a lot of people are like, I don't have dopamine in my brain or I'm missing dopamine. It could be that you're, you know, the amount of dopamine you have is totally fine.

• 12:04Speaker 01

  It's just in the wrong place at the wrong time. So when you look at from the anatomical side, like just from a very basic level, the emotional areas of the brain, so like that amygdala, that threat detector in the brain are a little bit more hyper responsive. And the frontal lobe in charge of decision making and processing tends to be a little bit under responsive. And that connection between the two is weak. So now you have this heavy emotional center that's taking in all of the stimuli that's coming in and processing it in real time. And you're getting triggered emotionally and processing, and then your frontal lobe is maybe a little bit laggy to catch up. So now you're processing all of the stuff with this emotional overlay on top of it,

• 12:48Speaker 01

  which makes it insane that we haven't included that in the criteria.

• 12:51Dr. Darshan Shah?

  Right, right. I, I think, you know, for a lot of people, that understanding this emotional component to ADHD can become something completely new that they've never heard about. And so it's really important that you've highlighted that and give, and we're going to talk about the tools here in a little bit, but for the person out there that is listening, like you guys have diagnostic criteria for ADHD. Is, are there like online questionnaires or standardized questionnaires that people can do to understand if they're at risk for ADHD or if they should see someone to get diagnosed with it? Or is the best way to really know, to see a psychiatrist or psychologist and get, get a diagnosis?

• 13:32Speaker 01

  I truly believe that the best way to know is go to a mental health professional. Not because, I think the ruling in ADHD might not be so hard. Like I think because of where criteria stands right now, it's asking very observable things that you might be able to recognize in yourself, like problems with disorganization, problems with forgetfulness, difficulty initiating tasks, can you stay in your seat? Are you fidgety? Do you interrupt? Like all of these things, for the most part, people have a pretty good gauge on. My issue with those criteria is that it, number one, misses a lot of other things. And number two, you could be getting those things from other stuff. You could be anxious, you could be depressed, you could be, you could have hypothyroidism or hyperthyroidism.

• 14:15Speaker 01

  So it's important to, yes, like if I've had patients come to me and they're like, I did this online, I have ADHD. I was like, nope, that, that doesn't, that doesn't mean you have ADHD. It's, you've talked about symptomology, but you need to understand like the actual longitudinal nature and the patterns and all of these other things, and you need to be able to rule things out. And that's what's not discussed in those online surveys.

• 14:41Dr. Darshan Shah?

  Yeah, that's absolutely true. And you know, coming from my functional medicine perspective, like you've mentioned thyroid and other disorders at the same time, like I think anyone with any type of mental health diagnosis should undergo a full functional panel, looking at their hormones, looking at the state of their metabolic health, and really doing a deep dive on other things that could be going on beyond what's just going on in their head, right? And so.

• 15:04Speaker 01

  I think, I think it's really important to understand the underlying medical picture when you're looking at mental health, for sure, for sure. Because I think it's going to be, number one, really important for figuring out exactly diagnostically what's going on. Are we treating the wrong thing? Number two, from like a, just a logistical medication perspective, it's all going to be impacting other things as well. So you really need to know, what's my baseline? What, what, what levers can I pull to get the right management?

• 15:31Dr. Darshan Shah?

  Right, right. And if anything, treating the underlying physiological, you know, problems, the underlying physical diseases will just make the treatment of the mental health issue much easier, right?

• 15:43Speaker 01

  For sure.

• 15:44Dr. Darshan Shah?

  Right? I mean, definitely they have to occur hand in hand. So I've had a few people on here talk about EEG, and this is like a really hot topic now is EEG and, and doing brain mapping on people, using the electrical signals of the brain. And obviously like this is done for the purpose of trying to delineate, like is this really ADHD versus depression versus something else? How do you feel about EEG and using that as a modality to help with the diagnosis?

• 16:11Speaker 01

  I don't know. I don't think the data is there right now. So I don't think I can lean on that and say like, this is going to give me a significant, it might give me data, but it's not, as of where it stands right now, it's not going to give me a data is, is this ADHD, is this not? And so that's where I kind of, like, when you look at, you know, some of these, looking at really expensive scans, looking at really expensive, like neurological interventions and things like that, sometimes I'm like, let's just go back to basics. Let's figure out what's happening medically, let's figure out what's happening psychiatrically, and then kind of put together those pieces.

• 16:44Dr. Darshan Shah?

  Yeah. So to your point, I mean, the real diagnosis should occur with a mental health professional that's also taking into account your physical symptoms and doing blood work to kind of see what's going on in, in the rest of your body at the same time.

• 16:57Speaker 01

  That's typically why I, I lean on, and it's not a hard and fast rule, but I really do like getting that diagnosis through psychiatrists because they've had that medical school training, because they've had the psychiatry residency. But I will admit to this, access to care is a huge problem. Like this, this is not, you know, I can say these things, but getting to a psychiatrist is difficult. Getting to even a primary care doctor can be really difficult. So I tell people, you know, when you're exploring ADHD diagnostically and trying to figure out information, if a doctor isn't available to you, just make sure you're getting information from the right places. I think that's really important. Like when you go online and there's such an incredible onslaught of information, especially

• 17:40Speaker 01

  about ADHD, and some of it is good and some of it is so bad. And so it's, it's finding out what information and what clinical pieces you can actually trust and put together so you can understand your own internal environment better.

• 17:53Dr. Darshan Shah?

  Yeah, absolutely. So when you're looking at some of the tools that people can use regarding their emotions and emotional dysregulation that you've probably written in, in the book, I'd love to kind of hear, kind of, how do you explain it in the book? And like, what do you, what do you tell people to, first of all, like when they're looking at the mirror themselves and they're trying to figure out how to manage their symptoms, how do you tell them to kind of approach it?

• 18:17Speaker 01

  Number one, starts from understanding yourself, your patterns. And I think that that's a really interesting phenomenon because I don't think many people have thought about this emotional side of it. You know, they think about ADHD, and I've been guilty of this too, because even when I was in medical school, I was like, I, I know what it means to be ADHD. It's like you're really hyper and you're all over the place and you're, and I don't think that's how I'm presenting right now. And so I, I think it was just difficult for me to actually understand that diagnosis and see myself in it. But I think with this book, with Too Sensitive, the way that it starts, so the first chapters are truly about the neurobiology, like how your brain is wired, because I feel like

• 19:00Speaker 01

  that's the best spot for understanding. You'll know, you agree. But then it moves into the emotional sensitivity spectrum, because I think part of the issue is there wasn't a lot of verbiage of what's normal and what's not. Like what's, what's too sensitive, what's not sensitive enough? So it's start, you know, if you're looking at it on a spectrum and you'd put like the middle as situationally appropriate, you're elevating and depreciating based on what's happening. And then you look at one side and you're looking at apathy, where it's, well, emotional things are happening, but I'm not really moving one way or the other, I'm kind of numb. Then you look at the other end of the spectrum, where I live, it's just, you feel emotions very robustly, you feel things quickly and deeply and for a long time.

• 19:45Speaker 01

  And so I, I think when you figure out where you fall on that spectrum, then you actually start looking at like, okay, I'm neurologically processing this differently. In which case, if I'm, if I am processing things very deeply, very quickly, what tools can I use in that moment to help me get through that? Because I don't necessarily want to make you less sensitive.

• 20:05Dr. Darshan Shah?

  Right.

• 20:05Speaker 01

  I want to just give you more control. Yeah.

• 20:08Dr. Darshan Shah?

  Yeah, that makes a lot of sense. And so when someone, let's talk about both sides of the spectrum, right?

• 20:14Speaker 01

  Yes.

• 20:14Dr. Darshan Shah?

  So someone is really in this apathy mode where they're just not experiencing or they're suppressing emotions. How do you discuss the tools with that type of person?

• 20:25Speaker 01

  Well, first, we have to figure out where is that coming from, right? Because I think with apathy, it's a little bit different than the other end of that kind of a highly emotionally sensitive spectrum. For people who I feel move into that apathy, is it depression? Is it an underlying medical thing? Is it burnout? Is it sleep? Like, where is this coming from? Because I think once you get into a spot where you move someone from feeling that numbness, the natural pendulum kind of moves more into the median most of the time. And so trying to address that with, is there some underlying functional reason for this? Now, there are some people who just don't elevate or depreciate much. They don't swing much one way or the other.

• 21:08Speaker 01

  And so, you know, for those people, then it depends on like, how dysfunctional is this to your life? Is this impacting you? Because if you're fine with that, if emotions don't go up or down, but you're like, that's just my baseline. We don't need to correct anything at all.

• 21:25Speaker 01

  I feel like on the other end of the spectrum, I feel like there is, those are the people that are intensely disrupted by their emotions. And usually those are the ones that the emotions can feel so big and overwhelming and scary that they drown in that moment. And so the tools, which are all, by the way, tools you have heard of over and over again, it's really just how to apply them, how to use them, how to practice them. And then the step further is the latter half of the book is actually real world examples, where it actually walks you through, like, this is happening, it's how to solve it in real time. So I think with people on that end of the spectrum, I think it is such a useful exploration

• 22:06Speaker 01

  of how to manage these kind of difficult feelings and emotions to give you a little bit more agency.

• 22:11Dr. Darshan Shah?

  Yeah, I think, you know, the people on that side of the spectrum that have, can we call that emotional dysregulation?

• 22:18Speaker 01

  Yeah, I would say highly emotionally sensitive, but yeah.

• 22:20Dr. Darshan Shah?

  Emotionally sensitive, okay, got it. They seem to be kind of always kind of living on the edge of having another breakdown of some kind, whether it be crying or, or, you know, just.

• 22:31Speaker 01

  Emotions are like right here.

• 22:32Dr. Darshan Shah?

  Yes, right here, ready to break down. How does someone like recognize when they're getting really close to that breakdown moment?

• 22:40Speaker 01

  We know.

• 22:41Dr. Darshan Shah?

  You just know.

• 22:44Speaker 01

  It's not even like a, like, for example, with me, I'm acutely aware when I'm kind of in that. If something is, I'll give you an example that happened last week. Yes, last week with this press tour for the book. And it's like a very weird concept to write a book about emotional sensitivity and then have to do press. Like, it's just bizarre. But, you know, you'll get these kind of things where, you know, you'll, you're slated to appear on a podcast and then last minute they'll cancel. And so in my brain, what my brain is telling me is they canceled because you're too small of a fish. Or they canceled because they saw something that they didn't like.

• 23:27Speaker 01

  Or you're not, what you wrote about is not important enough for them to deal with. Spin, spin, spin, spin, spin, and then emotions are up here. I feel all that. And so it's a matter of, I know, I know that I'm doing this. I know that, but that's just my nervous system is dumping alarm chemicals telling me that something dangerous is happening. This is what I'm dealing with. And so it really becomes, how do I regulate my way out of that moment?

• 23:52Dr. Darshan Shah?

  Yes.

• 23:52Speaker 01

  Because I don't, I think I'm still going to be acutely triggered. It's getting less, but I still, because I'm tired, man. But like.

• 24:00Dr. Darshan Shah?

  Right.

• 24:01Speaker 01

  But I think, I think that I'm still, maybe, I, maybe, I feel like when I'm 80, I mean, I feel like things impact me significantly from an emotional side. But the thing that I like about this book is that it's like, okay, well, here's how we work through this moment. This sounds like me, this sounds like what I'm going through.

• 24:22Speaker 01

  Here are the steps.

• 24:23Dr. Darshan Shah?

  So that was a perfect example. So, and that's good to know, because I think what you're saying is you're going to spin and it's going to happen. It's going to be dependent if you're on a book tour or if you have like a difficult conversation with a boss or something, it's going to happen. And the goal is not to become someone who is not having emotional volatility or depth. It's really to recognize when that's happening and then implement some of the tools you're talking about.

• 24:47Speaker 01

  Totally.

• 24:48Dr. Darshan Shah?

  Right? Okay, so let's talk about some of these tools, because I feel like this is a great conversation, whether you have ADHD or not, right?

• 24:53Speaker 01

  I know.

• 24:54Dr. Darshan Shah?

  Anyone can use this.

• 24:55Speaker 01

  Yeah, it's not written just for people with ADHD. A lot of the research stems from that because it is so common. But, I mean, this is, I feel, I haven't had a conversation with a person who either doesn't identify with that themselves or doesn't have someone in their direct circle that they feel it doesn't apply to. So I think that everyone is touched by this to some degree. But what I would say is when I was going through this in research for this book, trying to figure out what are the tools that can help in the moment and over time to help you build that emotional resilience, it all fell back on tried and true things that, you know, things like challenging negative thoughts

• 25:37Speaker 01

  and mindfulness in the moment and delaying reaction and moving your body. These are all things you know, you know, you've heard a thousand times, especially if you are an emotionally sensitive people and people are like, you're blowing this out of proportion, this is not a big deal. And there were, the next words out of their mouth is like, just go take a walk, you'll forget about it. Like, so some of that advice might be sound, but I hate it. Like, don't tell me that, because that's not helping me. But knowing neurologically what is happening in my brain in that moment, this is how I'm feeling it. This amygdala is literally on fire, my frontal lobe isn't kicked on. How do I, how do I chase that balance a little bit better?

• 26:17Speaker 01

  And so seeing how you feel and appreciated in the moment, like there are times, like with this book tour example, I was, it wasn't that I was just calm and, you know, sitting down and like my brain was spinning. I was anxious and pacing and my husband was on the other end of the couch and he was like, easy. What is that? Like, what was just in your phone then made you jump up? And I was just very restless, because I was, I was just, just building up this emotional response. And I knew in that moment that if you had told me, just take a deep breath, I would have punched you in the face. Like, I'm not going to do that, I can't do that right now.

• 26:58Speaker 01

  But then I thought, and I was like, okay, I know, I know I'm spinning up. I feel my emotions right on the surface. I'm, I'm feeling this with intensity across my body. I need to move, I need to get out this anxious energy. I need to give my body a chance, push that oxygenated glucose to my frontal lobe so that can kick on. And so I just started doing, I had seen on a podcast like two hours earlier, how like doing squats were good in terms of, you know, and so I'm like standing there and like I'd gone from like pacing all over the place to like just doing squats. And it was like, what's happening?

• 27:42Speaker 01

  But, but I'll tell you, within two minutes, I was like, okay, all right. We're, you can feel that kind of alarm response calm down a little bit. And then I was able to actually tell him what's going on and hear what he was saying in a way that I wasn't like, no, that's not it. So it just, it truly does help in that moment, but you have to understand what's happening in your body. And you have to know what skills to apply and when to apply them.

• 28:11Dr. Darshan Shah?

  Yeah, no, it's so true. So, you know, part of what you're saying is just recognizing that this is happening and then also having the wherewithal to recognize like this is a physiological process that's happening, right?

• 28:24Speaker 01

  For sure.

• 28:24Dr. Darshan Shah?

  Because it's a physiological process, physiological solutions exist, like moving your body, doing squats, getting the blood flow going, right? And so I think that that's a really important point to make is like, people aren't just telling you to go for a walk because they want to avoid you. It's actually, you know, a treatment for this is moving your body.

• 28:42Speaker 01

  It can be, I just don't want someone else to tell me to do that.

• 28:45Dr. Darshan Shah?

  Right, exactly. You've got to tell yourself to do it.

• 28:47Speaker 01

  I've got to tell myself, I'll figure it out on my own.

• 28:49Dr. Darshan Shah?

  Right.

• 28:53Dr. Darshan Shah?

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• 29:36Dr. Darshan Shah?

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• 29:44Dr. Darshan Shah?

  Okay. So what are some of the other things that people can do?

• 29:47Speaker 01

  So the tools that I had, I narrowed it down to 12 because I felt like there were the most impactful and the, and the best data behind them. Cause it's important to like categorize it based on like what actually has data behind it. So in that, yes, there's the movement, there's challenging negative thoughts. One of my absolute favorites, which sounds so dumb, and I recognize that is delaying your response because that has never occurred to me. But you know, when you get a text message that you're, that may be giving you bad information or they're writing something that's making you acutely anxious in that moment. My initial response is to follow up immediately,

• 30:29Speaker 01

  send a bazillion texts of clarification. I want to know emotional tone behind this because I'm not appreciating that from the text message. I want to know what your thought process is. I want to know how this affects our relationship going forward. I like, I want to, to alleviate my own anxiety. I need to resolve this potential conflict I've built up in my head immediately. I feel like it took me a long time to understand if I am able to pull myself out of that moment and purposefully delay that immediate, almost muscle memory response, I can give my amygdala time to calm down. I can give my frontal lobe time to kick in and then my response is so much more measured. Sometimes I go back to the phone and I'm like, I truly don't need to respond to

• 31:13Speaker 01

  that. It's just information they're giving me. Or I see what I have typed out and I'm like, that's insane. I can't send that to a human being. And so it, it just allows you to pull away from the moment, but that is such a skill. That's something that initially feels really weird and feels like I, I can't do that in this moment. But if you're able to practice it in times where it's lower stakes, it becomes, you start to see, this actually does help me. So then when it's a higher stakes moment, you're like, okay, I know what to do now. So I think it's, I think these kinds of things, applying it in, in moments where like, it's not life or death in your brain, really helps you

• 31:57Speaker 01

  build those skills and helps push you more towards that true emotional intelligence and resilience.

• 32:02Dr. Darshan Shah?

  Yeah. Yeah. I think about like, you know, back when there was no text messaging, it was emails and you were always told like, sleep on it, send the email the next day. Now it's like, everything is so instantaneous with phones and text messaging that you can, you know, whip out a response immediately, probably when you're in the worst state of mind sometimes. And so it's, uh, yeah, the more distance you can have from your phone, the better, especially when these kinds of messages come through that do initiate an emotional response.

• 32:30Speaker 01

  Burn it started over, throwing my phone into the sun. I know. I just like, and I feel like I have an eight-year-old girl and she sees me on my phone doing social media or things like that. And she's like, Mom, when can I have a phone? And I was like, I hate my phone.

• 32:44Dr. Darshan Shah?

  Yeah. I say the same thing.

• 32:45Speaker 01

  I hate my phone. There's nothing good in there.

• 32:48Dr. Darshan Shah?

  I say the same.

• 32:48Speaker 01

  So it's, it's, you know, it's, phones are just like a hotbed. My feelings get hurt all the time in there.

• 32:54Dr. Darshan Shah?

  Yeah. Yeah, it does. Not, not a lot of good stuff comes to the phone. Exactly. Where there's social media, text messages, all of it. Exactly. And then, you know, that, that also brings up another point. Like, you know, we were talking a little bit earlier about children and kids, and I also have a nine-year-old and obviously they're all asking for phones, right?

• 33:13Speaker 01

  Yes.

• 33:13Dr. Darshan Shah?

  And they all already have some sort of device, whether it be an iPad or a computer. And I worry about these children developing more anxiety and more attention deficit.

• 33:22Speaker 01

  Yeah.

• 33:23Dr. Darshan Shah?

  With the amount of immediate responses they have to have and everything that they're doing on that device, right? Whether it be a game, messaging, et cetera. And, you know, my kids, sometimes they have two devices open at the same time.

• 33:35Speaker 01

  I know. Right. It's a whole thing.

• 33:37Dr. Darshan Shah?

  Yeah, exactly. So, you know, what does the research show around exposure to devices and developing anxiety or attention deficit? Is this a real problem? Or, and what can we do to mitigate some of this?

• 33:48Speaker 01

  So first and foremost, devices don't cause ADHD. So like, I get this question all the time. Like, I've been on TikTok for so long. Like, am I, I gave myself ADHD. I'm like, no, you didn't. Like, it, it can exacerbate an underlying problem for sure. And I think, and this is like a hot take because I am on social media, which is, makes it feel very hypocritical. But I do think overwhelmingly, just this, like, incredible rate of consumption of like, short form, like, like the difference between TikTok and Instagram versus YouTube. I mean, although YouTube has shorts, but you know, this, the way that people get into this almost like

• 34:31Speaker 01

  dopamine loop of scrolling, scrolling, scrolling, scrolling, things like that. And the way that, I mean, have you seen some of those, like even TV shows and games for kids right now? It is so stimulating. It's not like, you know, like when we were younger, it was just like, you wouldn't, like, these cartoons were like Garfield and it was like-

• 34:51Dr. Darshan Shah?

  Tom and Jerry.

• 34:52Speaker 01

  Tom and Jerry.

• 34:53Dr. Darshan Shah?

  Yeah. Like, things would take forever to materialize and happen. And now it's like, it almost seems like a, like a drug trip, watching some of these cartoons for kids.

• 35:00Speaker 01

  It's insane. And like, some of it is frankly, like drivel. I'm like, who did this? Who approved this? And it's just like this rapid content. I'm like, this has no message. This is crazy. I don't, like, I, I hated this so much. Like, I've sat in on some of these shows and I'm like-

• 35:20Dr. Darshan Shah?

  You know, I'll tell you, like, I watch some of these shows with my kids sometimes. Like, this is one called The Wonderful World of Gumball. Have you seen this?

• 35:26Speaker 01

  No.

• 35:27Dr. Darshan Shah?

  Oh my God. Don't subject yourself to it. It's crazy.

• 35:29Speaker 01

  Okay. I thought you were going to tell me something good. Okay.

• 35:30Dr. Darshan Shah?

  No, no, no, no. It is exactly that. It is like, no message, just craziness happening constantly. Lots of visual, and, and I could see how these kids get like, they get completely addicted to, like, everything is built now to create a dopamine loop, to your point, right?

• 35:47Speaker 01

  For sure. I mean, my kids will watch TV and I'm like, blink, blink. You have to blink. You have to do all these, like, and that thing is like, you know, commercials. There's no, there's no break in that. And there's no ending. Like, if I wanted to watch a show, uh, okay, like two seconds later is Dateline. So I have to go, like, my parents are going to watch that. I don't have the TV. Like, you'd get a break in content just because of the scheduling on the TV and fighting for channels. There is no-

• 36:17Dr. Darshan Shah?

  There's no break.

• 36:18Speaker 01

  There's no break. You could watch till you were 25 years old and you would have no break and you would, and my kids would love that. But it is one of those things where I'm like, it's, it's important enough that I do think that this constant hyper stimulating media does fragment focus, for sure. I don't think it gives you ADHD, but if you have an underlying ADHD, it can make it much worse. I think it can make anxiety worse. I think. So what I tell people, and I'm not anti-TV. We use TV all the time in our, in our house. But it's one of those things where it has to be balanced with other things because I, I can't just, and I'm saying I can't just let my kids watch TV all

• 37:02Speaker 01

  day because they're like emotionally fragile after that. They, you know, it's like, they don't eat, they don't blink, they don't do, like, we need you to integrate with the human world for a little bit. They don't like that.

• 37:16Dr. Darshan Shah?

  I definitely think, you know, it, there needs to be time limits, especially the way the content is now. That is much less than what it was when we were kids or when I was a kid. You could watch TV for two or three hours and not get overstimulated. Because it's like boring content a lot of times. But now every piece of content just creates so much massive stimulation. And to your point, like, they are very emotionally dysregulated after.

• 37:37Speaker 01

  Totally. Especially in that transition to pull away. I'm like, why are we having a tantrum now?

• 37:44Dr. Darshan Shah?

  Right. Exactly. And is the only solution then is just time limitations?

• 37:48Speaker 01

  Um, time limitations and then other stuff, like doing other things to kind of counter about, like go touch some grass, go play a game. Let's go and do, like, one thing that we started doing is like evenings were really hard because they were, they were tired from the day that, you know, and we're trying to do dinner and wrap up things and get ready for the next day. So it's, it's a, it's a tough time in our house. And that's a really easy time that I found myself being like, okay, just watch TV. It's easier. But then like, just even trying to pull them away from that. I was like, I can't have a tantrum before bedtime every single day. And so we've started, we go on this family bike ride around that time. And bike riding, you know, because you were in Kansas City,

• 38:31Speaker 01

  trying to bike ride in July and August in Kansas City is like a suicide mission. It is so, it is so difficult and hot and-

• 38:40Dr. Darshan Shah?

  And humid.

• 38:41Speaker 01

  Wet. Yeah. So it's, it's, um, but you know, it's something that we can do as a family that doesn't require screens.

• 38:48Dr. Darshan Shah?

  Yes. Give another option. Yeah. We try to go for a walk after dinner now and this, that way it avoids the screen time. Is there a tool in the book that kids could use when they, when parents are noticing them getting emotionally dysregulated? What is something that you can do with your kids? Like, you mentioned a bike ride, so it's getting physical. What's another tool that works well with kids?

• 39:07Speaker 01

  So part of this book, and this is coming from someone who is emotionally sensitive, who has an emotionally sensitive child. It's interesting because so many skills of how to deal with an emotionally sensitive child require you to be in a emotionally preserved place, to be able to provide modeling for them. And I felt like it was increasingly difficult for me to manage his sensitivity while working or while being in such an emotionally dysregulated state myself, especially around my dad passing. It was so hard for me to parent. And so I think all of these, every single one of these is a useful thing that the more you practice, the more you can also use

• 39:49Speaker 01

  with your children. Because I think they're all skills that you've heard, that you, that you've used, that you have told your kid probably to use. But knowing, how do I apply this? When do I apply it? And, you know, in our house, some, not that we're the gold standard, our house is- A whole thing, most of the time, but I think especially with my dad's stuff, I couldn't shut off that kind of emotional attack. I felt things deeply and it was hard for me to get through that moment. And I think even when my kids were really little, also giving them to say, showing them like, Mom is sad right now. How do we work past that? Mom is anxious right now. What would, can you tell me a skill that could help me? Let's work on this together. So showing them that yes, it's fine. It's safe to have emotions.

• 40:32Speaker 01

  You, that is something that is part of the human experience, but how do we work through this? I think is really useful. So seeing, having your kids see as you're navigating this is also a huge, huge benefit.

• 40:45Dr. Darshan Shah?

  Yeah, that's so true as well. They learn so much from their parents and

• 40:48Speaker 01

  Yeah.

• 40:48Dr. Darshan Shah?

  and understanding what your parent is doing can sometimes, you know, they, they learn from seeing not what you tell them. So if they see you do something to regulate your own emotions, they'll mimic it.

• 41:01Speaker 01

  I know. And that's why like, we've really tried to minimize, like even on planes, planes are so hard for us because it's just, number one is so boring. But number two is just like, oh, you, you have your phone and that's where like my emails live and that. So I'm like trying to do work. They don't see that. They just see me being on a screen.

• 41:20Dr. Darshan Shah?

  Absolutely.

• 41:21Speaker 01

  And so we've tried to like bring books with us and do that. And so it's, it's a work in progress. So if you see me on a plane and I'm scrolling.

• 41:30Dr. Darshan Shah?

  I'm gonna buy you a book.

• 41:31Speaker 01

  Yeah, buy me a book.

• 41:32Dr. Darshan Shah?

  Absolutely. You know, let's talk about anxiety real quick. Can you talk a little bit about the science of what people are experiencing when they have anxiety and

• 41:40Speaker 01

  Yeah.

• 41:41Dr. Darshan Shah?

  are there tools that can help also from your book with people that are getting close to feeling like they're having that, gonna have that anxiety attack?

• 41:49Speaker 01

  For sure. I, I think that with emotional sensitivity, once you get, once you feel something so robustly, you're really fighting off that neurological onslaught of all of these alarm chemicals mounting up that look like anxiety. That is the same. We're working on the same mechanisms that trigger anxiety. So when you are dealing with those big responses, big anxious feelings, these tools can help because they calm down the same areas. With anxiety, you're still looking at that amygdala, that threat response telling you, there's something to be anxious about. You're in trouble. This is a problem. You're in danger. That's all happening in real time. And that frontal lobe that's supposed to calm you down, nowhere to be found. Like where are you?

• 42:30Speaker 01

  And so this is so nice in terms of what can I do in this moment? Because like the most incredible thing about the brain is that you have the capacity to rewire it. You have the capacity to bake things and enhance things and make them better, which I think is such an incredible thing about psychiatry and about neurology and about, I, I actually about all of medicine, that you're able to have this impact on, I, I know that this is how I feel and these thoughts are very automatic. But you know, with, with practice and with working on this, there is going to be a time where they won't feel as automatic and as urgent.

• 43:14Speaker 01

  And I think that's incredible. That, and that makes psychiatry to me so hopeful.

• 43:19Dr. Darshan Shah?

  Right. Yeah. Cause you can make changes.

• 43:21Speaker 01

  Yeah.

• 43:22Dr. Darshan Shah?

  And, um, you know, to your point, like the, the brain is so neuroplastic, meaning that if you're making changes on a consistent basis and doing it like daily and getting to habits and routines, these changes will become more automatic and therefore one day even more permanent.

• 43:39Speaker 01

  Yes.

• 43:39Dr. Darshan Shah?

  Yeah.

• 43:40Speaker 01

  Yeah.

• 43:40Dr. Darshan Shah?

  You know, you mentioned the frontal lobe a few times.

• 43:42Speaker 01

  Yeah.

• 43:42Dr. Darshan Shah?

  And, um, I, I think one of the things that you talk about is executive function, right?

• 43:46Speaker 01

  Yes.

• 43:47Dr. Darshan Shah?

  So how can people improve their executive function and their frontal lobe?

• 43:51Speaker 01

  So executive function are basically the set of skills that are goal directed. So moving your brain, if you want to get from point A to point B, what are the steps I need to take? What's the planning? What's the execution of these steps? So when you're looking at executive function, there's definitely steps in terms of, how can I enhance my focus for this? How can I increase my motivation for this? How am I going to allocate energy for this? And then the other big part is like, what's my emotional state? Is that going to allow me to do that? Task and to figure out and plan out what I need to do. So I think when you are looking at all of those multifactorial pieces of executive function and how to get from point A to point B, you can enhance that, but you have to kind of figure out what do I need to work on in that moment?

• 44:35Speaker 01

  So if you're working on it from the emotional side, use these tools, like learn to kind of manage your emotional climate. And I know that's not easy. That's something that I actively am working on, but like, being able to grab hold of something and be like, okay, let me try to work through this and reduce that activation so I can get through. Because I think if you can manage the emotional side of it, a lot of times you can get those things done. If it is an energy component, like I simply don't have the energy for this. Go to sleep. Like, like that, I mean, unfortunately, that's one of those things. A lot of people are like, I can take caffeine, I can drink, you know, I can have an energy drink and, and those don't actually give you energy, right?

• 45:19Speaker 01

  They're just fighting off your sleeping excuse. The thing that gives you energy is truly that restorative sleep and letting your body kind of restart. So I, I think, and if you're looking at motivation, you have to look like, what is, what's it about this goal? Is it, is it overwhelming? Is it that you don't truly have that drive to get there because of, you know, whatever conflict that you have about it? Is it that, you know, just those initi- initiation steps are too difficult? Like, what is it that we don't have a good entry point into it? So you have to kind of figure out what part of it is making the task difficult and then go from there.

• 45:54Dr. Darshan Shah?

  Yeah, that's a, that's a really good point. I also try, when I have an overwhelming goal, is to try to break it down into components, right?

• 46:01Speaker 01

  Sure.

• 46:01Dr. Darshan Shah?

  Just what are the, what are the first steps I need to take? The most baby steps I can do in order to make some progress towards it? And that helps to reduce the anxiety around it. Also, I think helps just the thought process of, of the, like to your point, like improving executive function, there are ways to get into a habit of breaking down your goals into

• 46:21Speaker 01

  Yeah.

• 46:22Dr. Darshan Shah?

  smaller pieces that are achievable, that then rewires your brain into thinking that goals are achievable in general.

• 46:28Speaker 01

  I can do this. And there is a certain like that initiation hump, just gaining momentum after that. You, things start to click and pay because you've already kind of gotten a little bit of a release of dopamine. Your brain's working a little bit better. Then do the next little step. Your brain works a little bit better and you just keep going from there.

• 46:45Dr. Darshan Shah?

  Yeah. Yeah. It's so powerful to know and understand that your brain can be rewired. And with doing things again and again, that these rewirings can become more permanent. Neuroplasticity is so powerful.

• 46:59Speaker 01

  It's so powerful and it's so amazing as a concept because I think what leads to a lot of this hopelessness is that people are like, I have this. I was born this way and this is how I'm going to stay. And so it's just an incredible concept that yeah, I, I think is so hopeful that we, we do have the capacity to change our brains.

• 47:19Dr. Darshan Shah?

  Yeah, that's so awesome. Well, I'm so excited to read your book and I can't wait to read it. And this was a great kind of intro, a little taste of what you have to write about. And I can't wait to read about all 12 of these tools and start using them in my own life. So I really appreciate you coming on the podcast. Thank you so much for doing this. Before I let you go, for someone that wants to get started down the journey of, you know, managing ADHD anxiety or just emotional regulation in general, other than reading your book, what are the top three things that they can do?

• 47:49Speaker 01

  Oh my gosh. Know your patterns. Know your patterns. That's huge. Cause a lot of times I feel like people get into these situations where they're trying to solve problems and every day feels like they're reinventing the wheel. They're just, they, because they're, they're isolating little things. And once you kind of look at, what are my patterns? Then you start to understand what are the holes and then you understand how to fix them. So I think that's the first thing. Second thing, sleep. Sleep. You should be sleeping. And that's something that is, I, I find sleep super boring and I'm very bad at it. So I think it, it has taken a lot of discipline and focus to get to a spot where I'm like,

• 48:28Speaker 01

  this is so important for my brain to function and for me to process and for me to deal with kind of emotional sensitivity in the first place. Huge. Last thing I think, and these aren't in a specific order, the last thing I think is just like overall, look at your body as a whole. So like, once you understand and like just looking at your brain and your body separately. And like, this is good for my brain, but you might be doing something a little bit counterintuitive for your body. Looking at something for your body, which might be counterintuitive. Look at all of it. This is all part of your body. So I think that's the problem a lot of people get into. It's just they treat the brain and they forget about the body. They treat the body. They forget about the brain. All of it should be together.

• 49:12Dr. Darshan Shah?

  Absolutely. That's such a great point. Thank you so much, Dr. Hamdani. It's such a pleasure having you.

• 49:17Speaker 01

  Yeah.

• 49:17Dr. Darshan Shah?

  Can't wait to have you back on your next book. Where can people learn more from you and how do they get the book?

• 49:22Speaker 01

  So you, I, you know, you can find me on all of the socials. So I'm on Instagram, I'm on TikTok, I'm on YouTube. And my name is the Psych Doctor M D.

• 49:33Dr. Darshan Shah?

  Okay.

• 49:33Speaker 01

  And the book is out on August 25th, which I think is around when this will release. And you can get it anywhere books are sold.

• 49:41Dr. Darshan Shah?

  I love it. Thank you so much for joining me today.

• 49:43Speaker 01

  Thank you so much for having me.

• 49:47Dr. Darshan Shah?

  Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps to support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today. Especially if you have any underlying health conditions or on any medications. Your doctor knows your personal health situation the best and it's always important to seek their guidance.