Podcasts about concerta

Medication of the stimulant class

  • 106PODCASTS
  • 155EPISODES
  • 28mAVG DURATION
  • 1MONTHLY NEW EPISODE
  • May 30, 2025LATEST

POPULARITY

20172018201920202021202220232024


Best podcasts about concerta

Latest podcast episodes about concerta

Rio Bravo qWeek
Episode 192: ADHD Treatment

Rio Bravo qWeek

Play Episode Listen Later May 30, 2025 19:03


Episode 192: ADHD Treatment.  Jordan Redden (MSIV) explains the treatment of ADHD. Dr. Bustamante adds input about pharmacologic and non-pharmacologic treatments. Dr. Arreaza shares the how stimulants were discovered as the treatment for ADHD. Written by Jordan Redden, MSIV, Ross University School of Medicine. Comments and edits by Isabelo Bustamante, MD, and Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction.ADHD is a chronic neurodevelopmental condition characterized by inattention, impulsivity, and/or hyperactivity. While it's often diagnosed in childhood, symptoms can persist well in adulthood. The treatment for ADHD is multifaceted. It often includes medication, behavioral therapy, environmental modifications, and sometimes educational interventions which are especially effective in younger patients. Ongoing evaluation is needed during treatment. Treatment needs adjustments over time.Starting with medications: Stimulants are the most well-studied and effective pharmacologic treatment for ADHD. These include methylphenidate-based medications such as Ritalin, Concerta, and Focalin, and amphetamine-based options, like Adderall, Vyvanse, and Dexedrine. Discovery of stimulants for ADHD> Dr. Charles Bradley discovered stimulants as the treatment for ADHD around 1937. ADHD did not have a name at that time, but it was known that some children had behavioral problems related to poor attention and inability to control their impulses, but they were still intelligent. Dr. Bradley was a psychiatrist who was working in the Bradley Hospital (Rhode Island), he was studying these children and, as part of his experiments, they developed severe headaches. He gave “Benzedrine” (a decongestant) to his pediatric patients to treat severe headaches, and he discovered that Benzedrine improved academic performance and interest in school and improved disruptive behavior in some children.How do stimulants work.Stimulants work primarily by increasing dopamine and norepinephrine levels in the brain, which helps improve focus, attention span, and impulse control. They typically show a rapid onset of action and can lead to noticeable improvements within the first few days of use. Dosing is individualized and should start low with gradual titration. Side effects can include reduced appetite, insomnia, headaches, increased heart rate, and emotional lability.Types of stimulants. Stimulants come as short acting and long acting. They can come as a tablet, liquid, patch, or orally disintegrating tablet. After the discovery of Benzedrine as a possible treatment for ADHD, more research was done over the years, and Ritalin became the first FDA-approved medication for ADHD (1955). The list of medications may seem overwhelming, but there are only two types of stimulants used to treat ADHD: methylphenidate and amphetamine. Long-acting stimulant medications are often preferred for their consistent symptom control and lower potential for misuse. Vyvanse (lis-dexa-mfetamine) is a widely used long-acting amphetamine-based option. As a prodrug, it remains inactive until metabolized in the body, which results in a smoother onset and offset of action and may reduce the risk of abuse. This extended duration of effect can help patients maintain focus and regulate impulses throughout the day without the peaks and crashes sometimes seen with shorter-acting formulations. Of note, Vyvanse is also approved for Binge Eating Disorder. Many of these medications are Schedule II controlled substances, so to prescribe them you need a DEA license. Other long-acting options include Concerta, an extended-release methylphenidate, as well as extended-release versions of Adderall and Focalin. These are especially helpful for school-aged children who benefit from once-daily dosing, and for adults who need sustained attention during work or academic activities. The choice between short- and long-acting stimulants depends on individual response, side effect tolerance, and daily routine.For patients who cannot tolerate stimulants, or for those with contraindications such as a history of substance misuse or certain cardiac conditions, non-stimulant medications are an alternative. One of the most used is atomoxetine, which inhibits the presynaptic norepinephrine transporter (NET). This leads to increased levels of norepinephrine (and to a lesser extent dopamine). Guanfacine or clonidine are alpha-2A adrenergic receptor agonists that lead to reduced sympathetic outflow and enhanced prefrontal cortical function, improving attention and impulse control. These alpha agonists are particularly useful in younger children with significant hyperactivity or sleep disturbances.Non-pharmacologic treatments.Behavioral therapy before age 6 is the first choice, after that, medications are more effective than BH only, and as adults again you use CBT.Medication is often just one part of a broader treatment plan. Behavioral therapy, especially in children, plays a critical role. Parent-training programs, positive reinforcement systems, and structured routines can significantly improve functioning. And for adolescents and adults, cognitive-behavioral therapy (CBT) is particularly helpful. CBT can address issues like procrastination, time management, emotional regulation, and self-esteem which are areas that medication doesn't always touch.Using medications for ADHD can be faced with resistance by parents, and even children. There is stigma and misconceptions about mental health, there may be concerns about side effects, fear of addiction, negative past experiences, and some parents prefer to treat ADHD the “natural” way without medications or only with supplements. All those concerns are valid. Starting a medication for ADHD is the first line of treatment in children who are 6 years and older, but it requires a shared decision with parents and patients. Cardiac side effects are possible with stimulants. EKG may be needed before starting stimulants, but it is not required. Get a personal and family cardiac history, including a solid ROS. Benefits include control of current condition and treating comorbid conditions.The presentation of ADHD changes as the person goes through different stages of life. For example, you may have severe hyperactivity in your school years, but that hyperactivity improves during adolescence and impulsivity worsens. It varies among sexes too. Women tend to present as inattentive, and men tend to be more hyperactive. ADHD is often underdiagnosed in adults, yet it can significantly impact job performance, relationships, and mental health. In adults, we often use long-acting stimulants to minimize the potential for misuse. And psychotherapy, particularly CBT or executive functioning coaching, can be life-changing when combined with pharmacologic treatment. There are several populations where treatment must be tailored carefully such as pregnant patients, individuals with co-occurring anxiety or depression, and those with a history of substance use. For example, atomoxetine may be preferred in patients with a history of substance misuse. And in children with coexisting oppositional defiant disorder, combined behavioral and pharmacologic therapy is usually more effective than either approach alone.Comorbid conditions.Depression and anxiety can be comorbid, and they can also mimic ADHD. Consult your DSM-5 to clarify what you are treating, ADHD vs depression/anxiety.Treatment goes beyond the clinic. For school-aged children, we often work closely with schools to implement 504 plans or Individualized Education Programs (IEPs) that provide classroom accommodations. Adults may also benefit from workplace strategies like structured schedules, noise-reducing headphones, or even coaching support. Ongoing monitoring is absolutely essential. We assess side effects of medication, adherence, and symptom control. ***In children, we also monitor growth and sleep patterns. We often use validated rating scales, like the Vanderbilt questionnaire for children 6–12 (collect answers from two settings) or Conners questionnaires (collect from clinician, parents and teachers), to track progress. And shared decision-making with patients and families is key throughout the treatment process.To summarize, ADHD is a chronic but manageable condition. Effective treatment usually involves a combination of medication and behavioral interventions, tailored to the individual's needs. And early diagnosis and treatment can significantly improve quality of life academically, socially, and emotionally.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text rev. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). Understanding ADHD. Accessed May 2025. https://chadd.org National Institute for Health and Care Excellence (NICE). Attention Deficit Hyperactivity Disorder: Diagnosis and Management. NICE guideline [NG87]. Updated March 2018. Accessed May 2025. https://www.nice.org.uk/guidance/ng87 Pliszka SR; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894–921. doi:10.1097/chi.0b013e318054e724 Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. doi:10.1542/peds.2019-2528 Texas Children's Hospital. ADHD Provider Toolkit. Baylor College of Medicine. Accessed May 2025. https://www.bcm.edu Wolraich ML, Hagan JF Jr, Allan C, et al. Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis. UpToDate. Published 2024. Accessed May 2025.https://www.uptodate.comThe History of ADHD and Its Treatments, https://www.additudemag.com/history-of-adhd/Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

ADHD Mums
PSA! Concerta? Gone. Vyvanse? Broken – And Jane Called It a Year Ago

ADHD Mums

Play Episode Listen Later Apr 3, 2025 25:45


Semana em África
A semana dos desencontros em torno da República Democrática do Congo

Semana em África

Play Episode Listen Later Mar 21, 2025 14:15


Nesta edição da Semana em África, o destaque foi dado nomeadamente à Republica Democrática do Congo e ao bailado diplomático para obter um cessar-fogo no leste do seu território onde os rebeldes do M23, apoiados pelas tropas ruandesas, tomaram o controlo de partes substanciais do Norte e do Sul Kivu. Na passada terça-feira, estavam previstas conversações directas entre o executivo congolês e representantes do M23 em Luanda, no âmbito da mediação do Presidente Angolano. Contudo, a poucas horas do encontro, os M23 cancelaram a sua participação. Paralelamente, no próprio dia em que deviam decorrer as negociações de Luanda, os Presidentes da RDC e do Ruanda mantiveram um encontro directo no Qatar, sobre o qual nada filtrou. Mantido secreto até ao fim, este frente-a-frente apanhou Angola de surpresa. Para além de expressar estranheza pelo facto de esta reunião ter sido organizada “sem consentimento” do mediador da crise no leste da RDC, Luanda lamentou, ainda, o facto de Félix Tshisekedi e Paul Kagamé terem negociado uma possível trégua fora da agenda da União Africana.Esta semana ficou igualmente marcada pela tomada de posse nesta sexta-feira da primeira mulher Presidente da Namíbia. Netumbo Nandi-Ndaitwah foi investida aos 72 anos, perante numerosos Presidentes e chefes do governo regionais, nomeadamente o Chefe de Estado de Angola, bem como o da África do Sul. A tomada de posse da nova Presidente, pilar da Swapo, partido da luta de libertação, coincidiu com a data do 35° aniversário da independência deste país outrora ocupado pela África do Sul.Paralelamente, no Sudão, estes últimos dias foram marcados por lutas particularmente renhidas. Nesta sexta-feira, o exército anunciou ter retomado o controlo do palácio presidencial em Cartum que estava nas mãos das Forças de Apoio Rápido há mais de dois anos, ou seja, praticamente desde o começo da guerra civil.Em Moçambique, esta semana teve novamente o selo da violência. Uma manifestação no passado dia 18 de Março na zona da Casa Branca, nas imediações da capital, foi reprimida pela polícia com o balanço de pelo menos um morto, o que gerou revolta no seio da população.Acusada uma vez mais de ter usado balas reais contra os manifestantes, a polícia disse ter actuado em conformidade com a lei. No mesmo sentido, o Ministério do Interior garantiu que no caso de agentes terem ultrapassado as suas prerrogativas, eles seriam sancionados. O Presidente da República, Daniel Chapo, por seu turno, disse na quinta-feira que os promotores das manifestações estavam "bem identificados".Também na actualidade moçambicana, o projecto de exploração de gás natural liquefeito da francesa TotalEnergies obteve um empréstimo de 4,7 mil milhões de Dólares do banco EXIM, agência oficial americana de crédito para a exportação. O projecto em causa, bloqueado desde 2021 devido aos ataques terroristas no norte de Moçambique, tem vindo a ser contestado não apenas devido aos efeitos nefastos sobre o meio ambiente, mas também devido aos abusos que segundo ONGs foram cometidos contra a população local pelas forças de segurança que protegem o recinto da TotalEnergies. Neste sentido, o anúncio deste empréstimo não deixou de ser denunciado por ambientalistas.Esta semana ficou igualmente marcada pela decisão americana de estabelecer uma lista de 43 países africanos cujos cidadãos vão sofrer restrições de entrada nos Estados Unidos. Entre os países que ainda têm hipótese de reverter a situação pelo diálogo com Washington no prazo de 60 dias, figuram Cabo Verde e São Tomé e Príncipe. No caso deste último país, a chefe da diplomacia são-tomense, Ilza Amado Vaz, confirmou ter recebido pedidos de esclarecimentos americanos, embora não tivesse sido notificada oficialmente da inserção do arquipélago nessa lista. Também algo surpreendido com esta decisão americana, o Primeiro Ministro cabo-verdiano Ulisses Correia e Silva descartou, no entanto, eventuais motivos políticos.Noutro quadrante, na Guiné-Bissau, a Frente Popular e o Espaço de Concertação das Organizações da Sociedade Civil que junta cerca de 50 organizações não-governamentais dirigiram na segunda-feira uma carta ao Presidente Francês Emmanuel Macron em que o acusam de branquear o “regime ditatorial” do chefe de Estado da Guiné-Bissau, ao manter relações de proximidade e ao apoiar Umaro Sissoco Embaló a quem se referem como "ex-Presidente".Recorde-se que o chefe de Estado cumpriu cinco anos no poder no passado dia 27 de Fevereiro, facto pelo qual a oposição e ONG sustentam que segundo a Constituição ele já não é Presidente. Este último que alega terminar o seu mandato no dia 4 de Setembro, quinto aniversário da data em que o Supremo Tribunal o proclamou Presidente, marcou recentemente eleições gerais para 23 de Novembro de 2025.

The Dysregulated Podcast
Those Dexy Blues

The Dysregulated Podcast

Play Episode Listen Later Feb 2, 2025 17:52


Send Me a Message! In this episode of The Dysregulated Podcast, I take a look at the all-too-familiar "Dexy Blues"—the wave of anxiety and depression that hits when stimulant medications like Vyvanse and dexamphetamine start to wear off. I share my experience with these emotional crashes, how my prescription had to be adjusted to soften the blow, and some quick tips to help avoid those tough afternoons. I also reflect on my friends' experiences, how these medications affect her differently and showing how reactions to even the same drugs can vary from person to person. If you're on ADHD meds, I think you'll really relate to this one!----Follow my journey living with mental illness and the hard-fought lessons learned along the way. Lived experience is the driving force of this podcast, and through this lens, my stories are told. This is a raw, honest, and authentic account of how multiple psychological disorders have shaped my past and continue to influence my future.Support the showTo support the show, CLICK HEREYou can follow me on Instagram: @elliot.t.waters

Direto ao Assunto
Teixeira da Cruz: "É preciso Concertação Social na Justiça"

Direto ao Assunto

Play Episode Listen Later Jan 13, 2025 15:41


Antiga ministra Paula Teixeira da Cruz aplaude reunião de trabalho na AR com agentes de justiça no próximo mês. E concorda com PGR: faz sentido controlar servidores de processos mediáticos.See omnystudio.com/listener for privacy information.

Lo Psiconauta
Ep. #721 -

Lo Psiconauta

Play Episode Listen Later Dec 7, 2024 25:11


La terapia farmacologica dell'ADHD si basa spesso sull'uso del metilfenidato, uno degli psicostimolanti più efficaci e sicuri. Questo farmaco aiuta a migliorare attenzione, controllo dell'impulsività e gestione dell'iperattività. Disponibile in formulazioni a rilascio pronto ("Ritalin") e modificato ("Medikinet", "Equasym" e "Concerta"), il metilfenidato può essere personalizzato per adattarsi alle esigenze del paziente. Il metilfenidato appartiene alla classe degli "psicostimolanti" ed è un inibitore del reuptake della dopamina e della noradrenalina. La sua azione farmacologica principale consiste nell'aumentare la disponibilità di questi neurotrasmettitori nelle sinapsi, potenziando la trasmissione nelle aree del cervello coinvolte nella regolazione dell'attenzione, del controllo degli impulsi e dell'attività motoria. Questo meccanismo rende il metilfenidato altamente efficace nel trattamento dell'ADHD, migliorando le funzioni esecutive e la capacità di concentrazione. ⭐️ Scopri “psiq: Salute Mentale: Istruzioni per l'uso”, il nuovo libro del Dr. Valerio Rosso: https://bit.ly/psiqVR oppure anche https://www.psiq.it ⭐️ ⭐️ Accedi adesso GRATUITAMENTE alla VideoLezione "La Verità Scientifica sugli Integratori": https://lifeology.it/integratori-sq/ ⭐️ ⭐️ Scopri il VideoCorso "PREVENZIONE PRATICA": https://lifeology.it/prevenzione-pratica/ ⭐️ ⭐️ Vai alla VideoLezione Gratutia "PREVENZIONE EFFICACE": https://lifeology.it/prevenzione-sq/ ⭐️ ⭐️ Scopri il progetto MIDNIGHT MELODY, in collaborazione con il Dott. Valerio Rosso e il Dott. Gennaro Romagnoli: https://nutritonic.shop/ ⭐️ ⭐️ Scopri “BODY BRAIN ROUTINE”, il nuovo libro di Valerio Rosso, Gennaro Romagnoli e Marco Zamboni: https://lifeology.it/bodybrain-routine/ ⭐️ ⭐️ Scopri MoveMotivation, un'esperienza trasformativa per far emergere e consolidare la motivazione all'attività fisica: https://lifeology.it/move-motivation/?utm_source=yt_ads_ret&utm_medium=mm_vale_1⭐️ ⭐️ Scarica GRATIS la tua copia di “psiq: Lifestyle Principles” ⭐️ È un eBook che ti permetterà di scoprire i principi della Lifestyle Medicine e migliorare drasticamente la tua vita: https://psiq.it/lifestyle-principles/ ⭐️ ⭐️Iscriviti subito a MINDFITNESS, un mini corso GRATUITO in cui imparerai delle strategie pratiche per ottimizzare il tuo cervello: https://psinel.com/br-iscrizione-mini-corso-mindfitness/ ⭐️ Il Dott. Valerio Rosso è un medico specialista in neuroscienze e un pioniere italiano nella divulgazione della medicina dello stile di vita, riconosciuto per il suo impegno nella diffusione on line di informazioni basate su evidenze scientifiche. Il Dott. Rosso è autore di numerosi articoli scientifici e divulgativi, e partecipa regolarmente a conferenze e meeting come relatore, condividendo le sue conoscenze sui benefici di una vita sana e attiva. La sua dedizione alla medicina preventiva e al miglioramento delle performance cognitive e fisiche lo ha reso un punto di riferimento nel campo. Con una visione olistica della salute, il Dott. Rosso promuove un approccio che combina dieta, esercizio fisico, gestione dello stress, relazioni, controllo dell'ambiente e lotta alle DIPENDENZE per ottimizzare la qualità della vita delle persone che lo seguono sul suo ecosistema digitale.

The Dysregulated Podcast
Building Back Better - Working Around My ADHD

The Dysregulated Podcast

Play Episode Listen Later Dec 2, 2024 15:40


Send Me a Message! In this episode of The Dysregulated Podcast, I reflect on a successful two weeks of annual leave. For the first time in years, my car, room, and even the house is all clean—and have stayed that way for over a week! It might sound silly, but those with ADHD will understand this all too well. Not only that, but I also laminated a heap of podcast posters (mindfulness exercise) and put them all around Newcastle! I even looked after our family cat Mabel this week, and everything around me is in order. Unbelievable! I do thank my medication Vyvanse, along with my decision to create a vision for the two weeks, build some structure and routine into my days, as helping me navigate away from the blockages ADHD can cause.But ADHD remains a cruel disorder, as I reflect on a friend who just lost their job due to unmanaged ADHD challenges. This stark contrast reminds me how vital treatment and support are. Tune in for my raw, genuine and very real account of what life is like living with ADHD.

Radio Bilbao
Faltan algunos medicamentos en las farmacias, ¿Está garantizado el suministro?

Radio Bilbao

Play Episode Listen Later Nov 9, 2024 19:08


Los fármacos que más problemas plantean son Concerta, indicado para el TDAH, Ozempic y Orfidal 

Nem Sei o Que Dizem
Concertação de Preços - Episódio 541

Nem Sei o Que Dizem

Play Episode Listen Later Oct 18, 2024 5:15


Já concertaram os vossos? No YouTube: https://youtu.be/uMPZctrJhvo

Resposta Pronta
CCP: "É um Orçamento do Estado pouco ambicioso"

Resposta Pronta

Play Episode Listen Later Oct 11, 2024 5:09


O representante da Confederação do Comércio e Serviços fala num OE que cumpre com o acordado em Concertação Social, mas com pouca ambição. João Vieira Lopes admite ainda assim que vai ser viabilizado.See omnystudio.com/listener for privacy information.

A soma dos dias
Ep. 68 - O escalar de tensões no Médio Oriente e o acordo da Concertação Social

A soma dos dias

Play Episode Listen Later Oct 4, 2024 12:30


Neste episódio temos em destaque o conflito no Médio Oriente. O Irão disparou quase 200 mísseis sobre Israel, em retaliação às ofensivas israelitas nos países vizinhos que provocaram a morte de líderes tanto do Hamas como do Hezbollah. Vamos perceber o que é que isto implica para a região, o mundo e a economia e se ainda vamos a tempo de travar a escalada do conflito.Na segunda parte, o acordo em sede de Concertação Social. O Governo e os parceiros assinaram o acordo de rendimentos, visando temas desde o salário mínimo, ao IRS e IRC. Mas as negociações para o Orçamento do Estado podem pôr em causa o entendimento. Com Celso Filipe e Catarina Almeida Pereira, numa edição de Marta Velho.

Noticiário Nacional
2h Concertação social. CGTP não vai assinar acordo com Governo

Noticiário Nacional

Play Episode Listen Later Oct 1, 2024 9:14


Antena Aberta
Acordo na concertaçao social: vitória do governo?

Antena Aberta

Play Episode Listen Later Oct 1, 2024 47:02


Acordo para a valorização salarial e crescimento da economia: o que significa e o impacto que pode ter?

Economia dia a dia
O que esperar da reunião de Concertação Social marcada para esta quarta-feira?

Economia dia a dia

Play Episode Listen Later Sep 24, 2024 4:54


Armindo Monteiro, o presidente da CIP (Confederação Empresarial de Portugal), que ficou de fora do último reforço do acordo de rendimentos, admite voltar a assinar um acordo de concertação social se algumas das propostas apresentadas pela confederação forem incluídasSee omnystudio.com/listener for privacy information.

Painel Eletrônico
Deputado José Medeiros defende uma concertação entre os Três Poderes e os partidos políticos para combater as facções criminosas

Painel Eletrônico

Play Episode Listen Later Sep 19, 2024


Life in Lucca with Andrea
S3 #4 with Diana Stidl

Life in Lucca with Andrea

Play Episode Listen Later Aug 23, 2024 41:38


Ciao and Welcome to Life in Lucca with Andrea…My guest today is Diana Stidl. Diana is of German origin and lived in the States for many years before making Lucca her permanent home. Listeners to this podcast will know that there is always something happening in Lucca, and you can guarantee, if it's worth attending, Diana will be there, and, as a consequence, you are always guaranteed an interesting conversation when you are in her company. So, I was delighted when Diana agreed to be interviewed… Diana's RecommendationsTrattoria Gigi… Piazzo del Carmine, 7Nonna Clara… Via Santa Croce, 71H&G Lounge… Via San Giorgio, 36Restaurant Mecanate… Via del Fosso, 94Gelateria Momo… Via della Fratta, 11Gelateria Piero… Via Roma, 25Pasticceria Stella… Traversa II Via Pisana, 50 Sant'AnnaPasticceria Tiffany... Via Gaetano Luporini, 1054Bar Fuori Controllo… Via Santa Croce, 94Inside the WallsWalk the WallsAnfiteatro… just off Via FillungoClimb the Guinigi Tower… Via Guinigi, 29Palazzo Pfanner… Via degli Asili, 33Palazzo Mandi… Via Galli Tassi, 43Take in an evening concertA guided tour… resident tour guide Paola Moschini see S1 Ep2Outside the WallsVilla Reale… Via Fraga Alta, 2, MarliaNottolini Viaduct… Via Tempietto, 388Tour of the Carrera Marble cavesLotus Lake… MassarosaPietrasantaViareggioFavourite Italian Word/PhraseMeravigliosa… wonderfulIn boco al lupo… good luck… respond with ‘crepe'… to seal the luck! Connect with DianaEmail: dianainbellaitalia@gmail.comSubscribe, Follow, Review, DonateI self-fund this podcast, so if you enjoy listening, I would be ever so grateful if you could visit the Ko-Fi supporter webpage ko-fi/lifeinlucca and DONATE the equivalent of a gelato or two, as this helps me to produce further episodes. You could also hit the SUBSCRIBE or FOLLOW button now so that each new episode will appear, as if by magic, in your podcast library. And, if you've a little time to spare, please do leave a REVIEW. Website: https://shows.acast.com/lifeinlucawithandreaE:mail: lifeinlucca@hotmail.com Instagram: andreas_life_in_lucca Twitter: @mountains46 Ko-fi: ko-fi/lifeinluccaGrapevine MagazineDiscount Code: GVLIFE10Website: www.luccagrapevine.comClick Subscriptions > Grapevine on-line… complete the online formOur Italian JourneyWebsite: https://ouritalianjourney.com Hosted on Acast. See acast.com/privacy for more information.

Miguel Sousa Tavares de Viva Voz
A concertação entre políticos para não mexer no MP “com medo da opinião pública” e o “clamor” que pode ter influenciado a ministra

Miguel Sousa Tavares de Viva Voz

Play Episode Listen Later Jun 27, 2024 23:13


Miguel Sousa Tavares analisa os dias que marcam a Justiça: o recurso às escutas que "em Portugal se tornou no primeiro instrumento de investigação", as polémicas propostas  do pacote anticorrupção, sem esquecer as declarações recentes da ministra Rita Júdice. O cronista vê sinais positivos na aproximação entre Montenegro e Pedro Nuno Santos para uma reforma, mas conclui que o medo da opinião pública domina as ações dos políticos. Olhamos ainda para o desempenho da seleção no Euro. Para Sousa Tavares, "o futebol é um jogo simples que os treinadores tentam complicar o mais que podem". See omnystudio.com/listener for privacy information.

PodCast IDEG
Resumo Semanal - 07/06/2024 - Gaza, México, Índia, CSNU, Península Coreana e COSBAN

PodCast IDEG

Play Episode Listen Later Jun 7, 2024 14:40


Salve, salve, Cacdista! Veja os destaques do Resumo de Notícias da semana (31 de maio e 7 de junho): - Gaza: Brasil assina declaração de apoio a plano dos EUA por cessar-fogo; - México: Claudia Sheinbaum será 1ª mulher a assumir presidência no país; - Índia: primeiro-ministro Narendra Modi vence eleições, mas seu partido perde maioria no Parlamento; - CSNU: Dinamarca, Grécia, Paquistão, Panamá e Somália são eleitos para ocupar assentos não permanentes no Conselho de Segurança da ONU; - Península Coreana: Coreia do Sul anuncia suspensão de acordo militar com Norte após envio de balões com lixo; - COSBAN: vice-presidente Geraldo Alckmin participa da VII Sessão Plenária da Comissão Sino-Brasileira de Alto Nível de Concertação e Cooperação.

PsychRounds: The Psychiatry Podcast
ADHD Series: Methylphenidate and its Formulations

PsychRounds: The Psychiatry Podcast

Play Episode Listen Later May 24, 2024 24:18


Join us as we discuss methylphenidate for the treatment of ADHD. This includes medications such as Ritalin, Concerta, Jornay, Daytrana, and Quillichew!

Lately
The ADHD economy

Lately

Play Episode Listen Later May 24, 2024 32:13


Everyone knows someone who is on Adderall: ADHD diagnoses are at an all-time high and trending on TikTok. Our guest, Daniel Kolitz, author of The History of Adderall for Pioneer Works, tells us about the rise of the medication, how it's changed the way we work, and his own experience on and off the drug.Also, Vass and Katrina self-diagnose via some questionable online quizzes.This is Lately. Every week, we take a deep dive into the big, defining trends in business and tech that are reshaping our every day.Lately is a Globe and Mail podcast.Our executive producer is Katrina Onstad. The show is produced by Andrea Varsany. Our sound designer is Cameron McIver.Subscribe to the Lately newsletter, where we unpack more of the latest in business and technology.Find the transcript of today's episode here.Survey alert! We want to know about you and what you'd like to hear on Lately. Please go to latelysurvey.ca to fill out a brief survey (less than five minutes, we promise) and we'll enter your name to win one of three $50 gift cards you can use to shop online. We'd love to hear from you. Send your comments, questions or ideas to lately@globeandmail.com.

Hasrizal
Bolehkah Sembuh Jika Ada ADHD?

Hasrizal

Play Episode Listen Later May 15, 2024 2:40


Mendoakan agar individu yang telah pun menerima diagnosis ADHD supaya sembuh dengan memakan ‘ubat', mungkin tidak begitu tepat dan mengguris hati sesetengah mereka. Sebabnya, individu ADHD tidak akan sembuh daripada ADHD berkenaan. Tiada kesembuhan, kerana ia bukan penyakit dan situasinya bukan sementara. Stimulan yang diambil bukan ubat, stimulan yang diambil adalah bantuan untuk membolehkan fungsi-fungsi eksekutif yang terganggu kerana ADHD itu diatasi selama mana stimulan tersebut masih berada di dalam sistem tubuh badan individu berkenaan. Jika stimulan yang diambil adalah versi rembesan perlahan seperti Concerta ataupun Tyvense, dengan nama yang berbeza-beza di antara satu negara dengan satu negara lain, maka kesan baik daripada pengambilan stimulan itu akan aktif di dalam tubuh badan lebih kurang dalam sepuluh ke dua belas jam. Selepas daripada itu individu berkenaan akan kembali kepada keadaan asalnya. Analogi mudah untuk kita faham ialah seperti orang rabun yang memakai cermin mata. Bila pakai cermin mata, pandangan yang kabur itu dapat dijelaskan. Apabila cermin mata itu ditanggal, maka dia kembali ke sifat rabun yang asal. Begitulah juga dengan individu ADHD. Cuma perubahan baik ialah stimulan yang memperbaiki fungsi eksekutif membolehkan banyak pekerjaan yang dahulunya sukar untuk dibuat kini mungkin dapat dibuat dengan lebih baik. Seterusnya, menghasilkan hasil yang lebih mendatangkan rasa kepuasan dan gembira. Boleh mengurangkan kebarangkalian kegagalan melunaskan aktiviti, projek, kerja, pembelajaran, dan pengajian. Ia boleh menyumbang kepada kualiti kehidupan yang lebih baik. Maka kalau daripada dimensi itu mungkin doa sembuh ini tadi ada munasabahnya. Namun, mendoakan kesembuhan kerana makan ubat, hakikatnya individu ADHD tidak akan sembuh kerana ia bukan penyakit, dan stimulan bukan ubat. Ia adalah kelainan otak di antara mereka ini dengan individu-individu yang bukan ADHD. Ia telah ada semenjak lahir dan ia kekal sepanjang hayat. Apa yang barangkali berubah adalah strategi mengatasi gangguan-gangguan tersebut dan bagaimanakah cabaran-cabaran dan kelebihan yang ada di sebaliknya dapat dimanfaatkan untuk kualiti kehidupan yang lebih baik. --- Send in a voice message: https://podcasters.spotify.com/pod/show/hasrizal/message

Die Thronsitzung
Folge 63 - Howdy Sisters, lass uns mehr masturbieren!

Die Thronsitzung

Play Episode Listen Later May 9, 2024 81:19


Willkommen in der ADHS Selbsthilfegruppe - aka. der Thronsitzung. Wir therapieren hier unsere schnellen Themenbrüche - unter anderem reden wir innert kürzester Zeit über Poké Bowls, Familie, Masturbation, Knie Pickel und den ESC. Du kommst nicht nach? Dann brauchst du definitiv kein Concerta oder Ritalin. Gratuliere!

Brain Shaman
Roland Verment: Using Neurofeedback and Nootropics to Change Your Brain Waves | Episode 75

Brain Shaman

Play Episode Listen Later May 8, 2024 119:02


Roland Verment is a neuropsychologist, biohacker, and the owner of Neurobics, an at-home neurofeedback service. In this interview, we discuss how to understand and change the brain via neurofeedback and nootropics.We talk about brain waves (delta, theta, alpha, beta, and gamma) and how they correspond to various brain states, regions, neurochemicals, and disorders, including: OCD, ADHD, autism, bipolar disorder, schizophrenia, anxiety, depression, PTSD, Gilles de la Tourette's syndrome, and visual neglect). Learn how to manipulate these brain waves in order to increase your creativity, organization, productivity, memory, happiness, focus, flexibility, calm, balance, and overall brain health. We also discuss: EEG, fMRI, sleep, resurrecting old childhood memories ("time traveling"), alcohol, meditation, medications, VR, emerging tech, and nootropics (including: caffeine, rhodiola, alpha GPC, Huperzine A, and  cerebrolisin). *CONNECT & LEARN MORE*Instagram: @neurobicsneurofeedback     or               @rolandsnapFacebook: @Neurobicswebsite: neurobics.careRESOURCESNEUROANATOMY- anterior cingulate cortex - frontal lobe- hypothalamus- occipital lobe- parietal lobe- temporal lobe- visual cortexCOMPANIES - AppliedVR- BrainBit- Cleverpoint- Divergence Neuro- GrayMatters Health - Headspace - Kernel- Muse- Tripp PEOPLE- Andrew Huberman - Cody Rall - Jay Gunkelman- Josh Sackman- Kirill Krasnogir - Tim Ferris SUPPLEMENTS & DRUGS - alpha-GPC - CDP-Choline-  Cerebrolysin -  Huperzia serrata (Huperzine A) -  lithium -  Methylphenidate (brand names: Ritalin and Concerta)-  rhodiola (active compound: salidroside) Learn more at: neurobics.care (or on Instagram @or send me a text message here

TonioTimeDaily
Traumatic self-medication and fake relationships of my past. I

TonioTimeDaily

Play Episode Listen Later Mar 25, 2024 33:35


“Self-medication, sometime called do-it-yourself (DIY) medicine, is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions, for example headaches or fatigue. The substances most widely used in self-medication are over-the-counter drugs and dietary supplements, which are used to treat common health issues at home. These do not require a doctor's prescription to obtain and, in some countries, are available in supermarkets and convenience stores.[1] The field of psychology surrounding the use of psychoactive drugs is often specifically in relation to the use of recreational drugs, alcohol, comfort food, and other forms of behavior to alleviate symptoms of mental distress, stress and anxiety,[2] including mental illnesses or psychological trauma.[3][4] Such treatment may cause serious detriment to physical and mental health if motivated by addictive mechanisms.[5] In postsecondary (university and college) students, self-medication with "study drugs" such as Adderall, Ritalin, and Concerta has been widely reported and discussed in literature.[5] Products are marketed by manufacturers as useful for self-medication, sometimes on the basis of questionable evidence. Claims that nicotine has medicinal value have been used to market cigarettes as self-administered medicines. These claims have been criticized as inaccurate by independent researchers.[6][7] Unverified and unregulated third-party health claims are used to market dietary supplements.[8] Self-medication is often seen as gaining personal independence from established medicine,[9] and it can be seen as a human right, implicit in, or closely related to the right to refuse professional medical treatment.[10] Self-medication can cause unintentional self-harm.[11] Self-medication with antibiotics has been identified as one of the primary reasons for the evolution of antimicrobial resistance.[12] Sometimes self-medication or DIY medicine occurs because patients disagree with a doctor's interpretation of their condition,[13] to access experimental therapies that are not available to the public,[14][15] or because of legal bans on healthcare, as in the case of some transgender people[16] or women seeking self-induced abortion.[17] Other reasons for relying on DIY medical care is to avoid health care prices in the United States[18] and anarchist beliefs.[19]” -Wikipedia --- Support this podcast: https://podcasters.spotify.com/pod/show/antonio-myers4/support

The Rush Limbaugh Show
The Tudor Dixon Podcast: Meds Gone Wild: A Prescription for Disaster

The Rush Limbaugh Show

Play Episode Listen Later Mar 6, 2024 39:15 Transcription Available


In this episode, Tudor, Bob Schwartz, and Michelle Sarkisian discuss the dangers of overprescribing medications, especially to children. Bob shares his harrowing experience with Concerta, which led to acute psychosis and long-term neurological damage. The group criticizes the medical community's lack of informed consent and the pharmaceutical industry's influence on institutions. They explore the connection between medication and mass shootings, emphasizing the need for accountability and legal action against irresponsible prescription practices. The Tudor Dixon Podcast is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Monday, Wednesday, & Friday. For more information visit TudorDixonPodcast.comFollow Clay & Buck on YouTube: https://www.youtube.com/c/clayandbuckSee omnystudio.com/listener for privacy information.

The Buck Sexton Show
The Tudor Dixon Podcast: Meds Gone Wild: A Prescription for Disaster

The Buck Sexton Show

Play Episode Listen Later Mar 6, 2024 39:15 Transcription Available


In this episode, Tudor, Bob Schwartz, and Michelle Sarkisian discuss the dangers of overprescribing medications, especially to children. Bob shares his harrowing experience with Concerta, which led to acute psychosis and long-term neurological damage. The group criticizes the medical community's lack of informed consent and the pharmaceutical industry's influence on institutions. They explore the connection between medication and mass shootings, emphasizing the need for accountability and legal action against irresponsible prescription practices. The Tudor Dixon Podcast is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Monday, Wednesday, & Friday. For more information visit TudorDixonPodcast.comSee omnystudio.com/listener for privacy information.

The Tudor Dixon Podcast
The Tudor Dixon Podcast: Meds Gone Wild: A Prescription for Disaster

The Tudor Dixon Podcast

Play Episode Listen Later Mar 6, 2024 39:15 Transcription Available


In this episode, Tudor, Bob Schwartz, and Michelle Sarkisian discuss the dangers of overprescribing medications, especially to children. Bob shares his harrowing experience with Concerta, which led to acute psychosis and long-term neurological damage. The group criticizes the medical community's lack of informed consent and the pharmaceutical industry's influence on institutions. They explore the connection between medication and mass shootings, emphasizing the need for accountability and legal action against irresponsible prescription practices. The Tudor Dixon Podcast is part of the Clay Travis & Buck Sexton Podcast Network - new episodes debut every Monday, Wednesday, & Friday. For more information visit TudorDixonPodcast.comSee omnystudio.com/listener for privacy information.

Semana em África
A semana em que o Senegal mergulhou para uma crise política inédita

Semana em África

Play Episode Listen Later Feb 9, 2024 9:31


Neste recapitulativo desta semana em África, o destaque vai para o Senegal cujo Presidente, no final da semana passada, anunciou a sua decisão de adiar as presidenciais que estavam inicialmente previstas para o dia 25 de Fevereiro. Esta decisão qualificada pela oposição de "golpe constitucional", foi validada na segunda-feira pelos deputados da maioria presidencial, sem os votos dos parlamentares da oposição retirados à força do hemiciclo. Durante esta mesma sessão conturbada as presidenciais foram agendadas para o dia 15 de Dezembro.Esta situação não deixou de gerar preocupação, nomeadamente na União Africana, nos Estados Unidos e na CEDEAO que, num primeiro tempo, reclamaram o diálogo e a organização de eleições o mais rapidamente possível. Numa nova tomada de posição durante a semana, a CEDEAO exigiu a reposição imediata do calendário eleitoral inicial.Cabo Verde, um dos países membros da CEDEAO, deu conta da sua preocupação perante a crise política vigente no Senegal. Vizinha directa do Senegal, a Guiné-Bissau também vê com preocupação os últimos acontecimentos no país, onde várias entidades da sociedade civil apelam à greve e à manifestação contra o adiamento das presidenciais. Foi neste sentido que o Presidente guineense Umaro Sissoco Embalo se deslocou a Dacar na quinta-feira para evocar com o seu homólogo senegalês a crise política.Entretanto, na Guiné-Bissau, a actualidade dos últimos dias continuou a ser densa. No passado fim-de-semana, o líder do Madem-G15 regressou ao país. A sua chegada gerou alguma confusão no aeroporto de Bissau que resultou na detenção de alguns apoiantes desse partido. Na sequência destas detenções condenadas por Braima Camara, o partido reuniu-se para abordar os preparativos das eleições legislativas que o Presidente disse recentemente pretender convocar rapidamente. O Madem-G15 também apelou à reactivação da comissão permanente da assembleia nacional popular dissolvida no passado mês de Dezembro.Noutra actualidade, em Cabo Verde, o governo e os parceiros sociais assinaram nesta segunda-feira o segundo Acordo de Concertação Estratégica, que prevê o aumento do salário mínimo até 20 mil escudos (181 euros) em 2027, mais 81% desde a sua criação.Esta semana em São Tomé e Príncipe, foi aprovado na generalidade esta semana o Orçamento Geral do Estado, um orçamento que todavia não conta com o apoio do FMI que o governo tentava viabilizar nestes últimos meses.Por fim, em Moçambique, na passada quarta-feira tomaram posse os 65 edis saídos das sextas eleições autárquicas realizadas no dia 11 de Outubro e 10 de Dezembro, eleições marcadas por uma forte contestação dos partidos de oposição que denunciaram casos de fraude.

The Gazette Daily News Podcast
Gazette Daily News Briefing, November 24

The Gazette Daily News Podcast

Play Episode Listen Later Nov 24, 2023 2:54


This is Stephen Schmidt from the Gazette Digital News Desk, and I'm here with your update for November 24, 2023.According to the National Weather Service it will be mostly cloudy Friday in the Cedar Rapids area, with a high near 33 degrees.The wind will pick up a bit as well, with gusts reaching as high as 25 mph.There's been a national shortage of ADHD medications for more than a year, and patients have been affected here in Iowa as well. What started with manufacturing delays for a producer of Adderall in October 2022 has turned into erratic availability of methylphenidate, sold under brand named Ritalin and Concerta.The shortage is caused by multiple factors, including production problems for manufacturers and limits the U.S. Drug Enforcement Agency puts on how much controlled substances a company can produce, said Mike Brownlee, chief pharmacy officer for the University of Iowa Hospitals & Clinics.Dr. Robin Kopelman, a psychiatrist who works with adult female patients through Meadowlark Psychiatric Services in North Liberty, said the monthly hunt for medications is an additional hardship for adults with ADHD.Health care providers like Kopelman say they have gotten creative to help patients get needed medications. This might involve prescribing a slightly smaller or larger dose, switching brands or using a different form of the medicine, such as slow release, she said. The FDA in August approved a generic form of ADHD drug Vyvanse, which has created some additional options.This year's corn and soybean harvests are virtually complete in nearly every area of the state, with one exception: south-central Iowa.“Farmers in south central Iowa still have over 10 percent of their corn for grain crop remaining to be harvested,” the U.S. Department of Agriculture reported back Monday.That region of the state is often the last to finish harvest, according to USDA crop reports that date back more than a decade.This year, part of that lag might have been caused by some replanting of soybeans, which delayed their maturation and harvest, said Clarabell Probasco, an Iowa State University Extension field agronomist who monitors part of that area.Despite the delays in that area, Iowa's soybean harvest is considered complete, and about 97 percent of the state's corn had been harvested as of the beginning of the week. The work has been aided by a streak of mostly rainless weeks.EntreFEST, the two-day conference celebrating entrepreneurialism and innovation, returns to Cedar Rapids in 2024 after two years in Iowa City.The conference will be held June 13-14. Venues will include the Geonetric Building, 415 12th Ave. SE, and the Olympic Theater, 1202 Third St. SE, with more to be announced.In addition to keynote speakers and panels, EntreFEST features dozens of smaller sessions that cover all aspects of business and entrepreneurship. Attendees are able to ask questions and interact with speakers, while happy hours and live entertainment give attendees the chance to network and unwind afterward.More information about venues, speakers and tickets will be announced soon

Le Devoir
4. Votre attention SVP - Les visages multiples du TDAH

Le Devoir

Play Episode Listen Later Oct 17, 2023 20:32


Marianne cherche la source de ses maux, Mathilde cherche à les apaiser et Rémi raconte comment il en est venu à revendre des psychostimulants.Avec la participation de :Annick Vincent, psychiatreMarianne Fortier, étudiante à l'universitéMathilde Parent, élève de 5e secondaireÉquipe :Philippe Papineau, animateurFélix Deschênes, réalisateur et recherchisteNos remerciements à Valérie Duhaime, à Marie-Ève Brassard, à Jacob Prévost, à Xavier Kronström Richard et à Julien ForestPour joindre l'équipe du balado : balado@ledevoir.com

Explicador
Pacto Social coloca em causa a Concertação Social?

Explicador

Play Episode Listen Later Sep 26, 2023 22:55


Armindo Monteiro, presidente da CIP, refere que CES "é um pilar e não pode ser beliscado". Sérgio Monte, secretário-geral adjunto da UGT, deixa o aviso: "Decisões têm de ser discutidas em Concertação.See omnystudio.com/listener for privacy information.

Dads With Daughters
Balancing Act: Managing ADHD and Parenting With Peter Shankman

Dads With Daughters

Play Episode Listen Later Sep 18, 2023 27:09


On this episode of Dads with Daughters, host Christopher Lewis invites entrepreneur and author Peter Shankman to discuss their experiences as fathers raising daughters. They start off by sharing relatable stories about dealing with slime during the pandemic and the challenges of explaining divorce to their young daughters. Peter emphasizes the importance of being present for his daughter and finding balance in his life through managing his ADHD. Peter shares his personal journey with ADHD, discovering it as an adult and developing coping mechanisms to navigate the condition. He believes that medication is not always necessary for success and suggests exploring alternative coping mechanisms. As the author of "The Boy with the Faster Brain," he aims to help kids with ADHD feel less misunderstood and prevent them from experiencing shame in the long run. The conversation also delves into the concept of neurodiversity and the beauty of thinking differently. They discuss the importance of understanding and embracing neurodiverse needs, highlighting what children are good at, and finding ways for them to have fun while learning. The episode concludes with a heartwarming story about a spontaneous trip to a water park that the speaker and his daughter will cherish forever. Join Christopher Lewis and his guests for inspiring conversations and practical advice on raising strong, independent daughters every week on Dads with Daughters. If you've enjoyed today's episode of the Dads With Daughters podcast, we invite you to check out the Fatherhood Insider. The Fatherhood Insider is the essential resource for any dad that wants to be the best dad that he can be. We know that no child comes with an instruction manual, and most are figuring it out as they go along. The Fatherhood Insider is full of valuable resources and information that will up your game on fatherhood. Through our extensive course library, interactive forum, step-by-step roadmaps, and more you will engage and learn with experts but more importantly with dads like you. So check it out today!   TRANSCRIPT Christopher Lewis [00:00:06]: Welcome to dads with daughters. In this show, we spotlight dads resources and more to help you be the best dad you can be. Christopher Lewis [00:00:17]: Hey everyone, this is Chris. And welcome back to the Dads with Daughters podcast, where we bring you guests to be active participants in your daughters lives, raising them to be strong, independent women. Really excited to be back with you again this week. As always, we're on a journey together in looking at ways in which we can best raise our daughters to be those strong, independent women that we want them to be and to be able to be successful in their own journeys as individuals. And every week I have the pleasure of being able to bring you different dads that are doing it different ways, dads that you can learn from and be able to get different ideas from, different experiences from, because every father fathers in a little bit different way. And that's great because we don't have to be the same type of dads, but we can learn from each other and be better fathers in the end. And that's what this show is all about. Today. We got a great guest with us. Peter Shankman is with us. And Peter is a I'm just going to say he's a multi entrepreneur. He has done many different things in his career that has led him down the pipeline of being very successful in what he does. But most recently, he has become a author, a kids author, I'm going to say, because he has a brand new book called The Boy with the Faster Brain. And it's a little bit of, I'm going to say a little biographical in a way, in the sense of talking about his own experience and finding out that he had ADHD and what that journey was like for him. But also it's a book to allow for other kids and parents to be able to explore that in a little bit different way. So we're going to be talking about that as well. He also is a father of a daughter. He has a ten year old daughter and we'll be talking about that as well. Peter, thanks so much for being here today. Peter Shankman [00:02:07]: My pleasure. My dog obviously says hello as well. Christopher Lewis [00:02:10]: Well, I love being able to talk to different dads, and what I would love to do first and foremost is turn the clock back in time. I said you have a ten year old daughter, so I want to go back to that first moment, that first moment when you found out that you were going to be a father to a daughter. What was going through your head? Peter Shankman [00:02:26]: It's actually a really funny story. When I first found out, when my wife called me, most dads, they find out they're going to be a dad in some special way, the wife does something sweet, they put a little onesie inside the dinner table or something. I'm coming back from a meeting in Washington, DC. I'm on the Metro, heading over to Union Station to get an Amtrak back to New York, and my phone rings, and I see it's my wife, and I'm like, hey, honey, what's up? Because I'm pregnant. Okay, well, I turn around to, like, the 14 guys on the subway. I'm like, should I get them cigars? How does this work? So, yeah, that was how I found out in that amazing and overwhelming way. And of course, when we found out it was a girl, I was sitting in her my wife's office. She was at work. She's like, they're going to call us soon. I'm sitting there, I wanted a girl. I don't know why, but I wanted a girl. And so I was really excited. I was going to be this great girl dad, and I like to think I've kind of lived up to that. We have a lot of fun. She is a daredevil to an extent. Like, her dad haven't taken her Skydiving yet, but I know that's on the I'm sure that's on the list the second she and is 18. Christopher Lewis [00:03:20]: So one of the things that I hear from a lot of dads is that in becoming a father, there's fears, but there's also some fear going into raising daughters. And I guess for you, what was your biggest fear in raising a daughter. Peter Shankman [00:03:34]: Who'S going to be like me? I think there's a ton of fear, but my fears weren't the norm. I didn't have that whole, oh, I'm going to get a shotgun, and she can't date. That's not my thing. I wanted to get hurt. The only way you learn is if you get hurt, right? At least in my experience. My fear is that she was going to be she's a very sensitive kid. She cares about everything. We live in New York City, homeless capital of the world. I live two blocks west of Times Square, and so when COVID hit, it just decimated our area because all the homeless population in New York City was moved into a five block radius around my apartment because all the hotels here were turned into homeless facilities, which is fine, but they weren't made into homeless facilities with services. They were just made into places for people to stay. And that was a huge problem because you can't take 9000 people, put them in a five block radius and not give them services. And so it was tough. I had her explain to my daughter at age seven, the, no, honey, he's not dead. The needle sticking out of his arm means he has a problem, but he's getting help. It was tough. So she's very sensitive, and she cares that she wants to solve the world's problems. And sometimes, as much of a bitch as it is, you need to explain, honey, you can't solve all the world. Not all the world's problems can be solved at this moment. On the walk to the corner store and we've had countless talks about that, about what we can do to help homelessness. So we volunteer and we work at a soup kitchen. We're on the Hell's Kitchen litter brigade, and we built a dog park in an empty space overlooking Port Authority under the bus bridges. That this empty area. So we do things. But I call her Warrior Princess, and I love that she's as sensitive as she is. She will change the world, but I want her to live her life and not have to solve every single problem that the world throws at her. There has to be a middle ground there because unfortunately, she definitely got my sensitivity. Christopher Lewis [00:05:21]: I mentioned you've got your hands in a lot of different things. You've had that for many years and you have been a multi entrepreneur in many different ways and been successful in many different ways, but you have been busy. So talk to me about balance and how you have been able to balance being that serial entrepreneur as well as being able to be present and engaged with your daughter as you've raised her. Peter Shankman [00:05:51]: So my balance for me comes from my ADHD. There are certain things I have to do in my life to make sure that I can live the life I want in the way I want it and be the dad I want, I think, for lack of better word. So what does that mean? My day starts around 430 every morning with exercise. If I am not exercise, I am not the best person I could be. And so for me, I was up at 430 this morning. I was on the peloton. I got my couple of hours in. That's my definition of balance because I'm on that bike before she wakes up. And so when I get off the bike, I take a shower, I wake her up and I'm present. Right. The dopamine, the serotonin, the adrenaline that I receive from that ride gives me that balance, lets me be the best dad I could be, the best person I could be, the best entrepreneur I could be, best parent I could be, the best son I could be, best boyfriend I could be. So it has to start with that. From there, there are other things I'm able to do. I take her on as many business trips as I can. I'm speaking in January, I just landed the confirmation yesterday. I'm speaking in Greece at a keynote in January. And part of the contract, they have to fly me and my daughter out. So Florida school for a few days, we're going to Greece, things like that. So last summer we went to Michigan. I had to give a keynote at McIntyre Island. We spent an extra couple of days trips and around the island and Michigan, things like that. So for me it's sort of figuring out how to do that and where to go and what to do and making sure that as busy as I am, she's included and understands it. She doesn't just see me at a computer doing busy work. She understands. Today daddy's speaking. Tomorrow daddy's going on TV. Everything makes sense. It's a circle. Christopher Lewis [00:07:25]: So being a father is not always an easy thing. There are highs, there are lows, there are ups and downs. I mean, it's a roller coaster of a ride at times. What's been the hardest part for you as a father to a daughter? Peter Shankman [00:07:39]: Wiping slime off every conceivable surface in my house. We discovered slime during the pandemic, and it doesn't fucking end. It just never ends. There's always more slime to be made. But no, if that was the worst thing, I'd be thrilled. I think the hardest thing. I've had to answer the question several times, why aren't you and Mommy married anymore? We get divorced when she was three, and so for the first couple of years, anytime I did anything that didn't involve her, there was jealousy and there was a fear that I was going to leave, when in fact, nothing could be obviously further from the truth. I'm constantly here. It's gotten easier. So I think that the hardest thing for me as a girl. Dad hasn't really hit yet. I think it's going to come as she gets older. There have been a couple of times where I've seen her. Her teachers have told me that, yeah, she's very active, she has tons of friends, but sometimes she just prefers to sit by herself at the playground and read or make her own games up. And that doesn't really bother me so much because I was a loner, too. There's a big difference between being alone and being lonely, and I think she understands that already. That's the case. She's doing better than me. At the end of the day, I think the goal is I just want her to be happy, and I know that's going to come with some sadness, but I'm okay with that because you have to have that balance. Christopher Lewis [00:08:49]: You talked about that you try to make memories with your daughter that probably at age 18, you're going to be taking her Skydiving. There's been other experiences. What's been the most memorable experience that you and your daughter have been able to share together? Peter Shankman [00:09:01]: Here's a classic ADHD moment. Last summer in late July, early August, we were bored one night, and I tell her, she's not allowed to be bored. Even the inside of your mind goes on forever. It's endless. You cannot be bored. There's always something to do. So she's like, Daddy, I have nothing to do. I'm like, all right, let's search something. Let's look something up online. What do you want to look up online? Let's look up the biggest water slides in the world. Great. So we sit down in front of the computer and we start looking up the biggest lives of the world. And would you believe one of the top ten water parks in the world is in Tenerife. So I'm like, would you believe one of the largest water parks in the world is in this small little island to African called Tenerife? We should go there. She didn't say that, I did. And so I look at her calendar, I'm like, yeah, you have like, three more weeks of summer camp, and you have like, ten days between summer camp. Yeah. Let's go to tenerife. And so we booked a flight like that night, right? And I pity god, I pity whoever this kid marries. This kid, god, this kid better be rich, because it's not even about money for me. I just have billions of miles because of how much I travel for work. But yeah, she's going to want to go somewhere. She better make no, actually, screw that. She better make a lot of money. She better be able to do this because the funniest line she ever said to me was once she goes, how come Mommy, when Mommy and I get on a plane, when Daddy and I going to play me sit in the front, and when Mommy and I get on, play me sit the back? I don't know. You have to talk to mom about that. I can't really sorry escape and avoid that one. But no, what it comes down to is that ADHD brain kicks in. We went Tenerife, spent four days sliding down these amazing waters. I had a blast. And it was just this, what a wonderful way to end fourth grade or end third grade, fourth grade. And those are the kind of things that I want her to remember for the rest of her life. And I want to do with her these just random, spur of the moment, let's go somewhere and have fun trips. There are times for the other side of the coin, too. Her mom is taking her to Paris at the end of August, and they've been planning this for over a year and a half, and I think it's wonderful, right? They have their schedule. They know exactly what they're going to do every day. They're going to do this this day and this, this day and sit here. That's great. And I love that. And there's definitely a place in the world for that. My idea of travel is, okay, we're here, let's figure it out, right? And so if she has the best of both those worlds, I think that's amazing. Christopher Lewis [00:11:09]: Now, I mentioned at the beginning of the show that one of the reasons that we're talking today is you've got a brand new book, and this isn't your first book, but it is your first children's book that you have written called The Boy With the Faster Brain. And you've talked about ADHD in the past, but more on the business side of things. And you also have had a number of other books out there in talking about business customer service and influencing and things like that. Talk to me about the genesis of this new book and what made you decide that you wanted to move into writing a book for kids. Peter Shankman [00:11:48]: I wrote this book because I don't want any kid to have to grow up feeling as broken as I felt. I had a pretty rough childhood, and that doesn't mean I grew up in a van down by the river. It doesn't mean that my parents weren't totally supportive. They were. My problem was that I grew up in New York City, in the public school system, in the where ADHD didn't exist. What existed was, sit down, you're disrupting the class disease. And I had that very, very bad. And so every day, every single day, I would come home with a note from the teachers about the fact that I was disruptive, that I couldn't sit still, that I was causing trouble for the other students, that I was being a disruptive influence. The irony, of course, is that I was being disruptive because every time I felt like I couldn't focus, I would crack a joke. And what winds up happening when you crack a joke is the class laughs and you get a dopamine hit, which would allow me to focus. So, ironically, I was getting in trouble because I was trying to focus, but I wasn't told, hey, your brain thinks different. Your brain is different. Let's figure out better ways for you. I wasn't told that. I was told you're being difficult and there's something wrong with you. And when you spend the first 18 years of your life hearing that, you spend the next 30 trying to unlearn the fact that you're broke. If I can help kids who are five, six, seven years old today learn at that age that they're not broken, that they're gifted, then they won't have to spend the next 30 years of their lives in therapy like I had. And they're not going to assume that every good thing that they do is actually just a fluke and they haven't had any of their true success at all. Waffles. Shut up. They won't assume they've had any real success in their life at all. I assume that everything I've done every day today is the day that The New York Times writes a story about what a fraud I am. And every day when they don't do it, it's obviously because I'm not important enough for The New York Times to write a story. This goes on every single day. So if I can help a child understand that having a different brain is actually a good thing, and I can stop them from going down the shame spiral for the next 30 years, then it's worth every single thing. And it was a fun book to write in typically ADHD fashion. I had people from the day I launched faster than normal. I had people say, oh my God, just do a kids book and ADHD. I said, yeah, I should. It took five years to do it, and then I wrote it in 2 hours. And when I wrote it, I found this amazing illustrator out of Brazil and she did all the illustrations, and the book was Live in a Month. And so it's one of those things where I really, really believe that children with neurodiverse brains are going to save us all. Nothing new has ever come from anyone with a normal brain. And that doesn't mean there's not a place in the world for normal brains. There are. But if you want creative, I just gave a talk last month to Morgan Stanley 80,000 employees about neurodiversity because they finally are at the point where they understand that neurodiversity is something that should be celebrated and something that can improve your company and improve your bottom line. So now I'm getting calls from Adobe, from Google to go in and talk about this stuff. And that's my goal, is to help expand that conversation. Companies are finally spending more on mental health. I'm speaking to schools all about this, and the boy with the faster brain, like I said, was really written for those kids. I remember I spoke to a school in Wayne, New Jersey, a couple of months ago, and this kid comes up to me the end of the talk, and I'm going to cry because I can't talk about this crying. Kid comes up to me fifth grader, his eyes were down the entire time, sitting on the floor. He wasn't really looking. And he comes up to me, the end, his eyes are still down. He goes, I just want to thank you have never read a book about someone like me before. And I just gave him like the biggest hug. That's what I want to do. And if this book does that even in slightest, then I have succeeded beyond my wildest dreams. Christopher Lewis [00:15:13]: You talk about the importance of everyone understanding neurodiversity more and how not only impacts us as parents, but how it impacts the child. What are some of the biggest let's just say, what are some of the things that people don't understand the most when it comes to neurodiversity? And what do parents need to understand if they believe that their own child is neurodiverse and they want to be able to support them better? Peter Shankman [00:15:42]: Well, the first one is most definitely that your child is not broken, your child's gifted. The premise of children with neurodiverse needs special help. Just to be normal is bullshit. You're not normal. That's the beauty of it. That's what I want, right? You want to not be normal. You want to be thinking differently. You want to have this fun. So that right there is the very first answer. And so I would take it a step further and say that, yes, when you're told there's something different about your child, your first instinct is to freak out don't learn as much as you can. Talk to more than one doctor. It's like buying a house. You don't just go visit one house. Talk to more than one doctor because you might have a misunderstanding of what neurodiversity is. Again, when I was growing up, it was sit down and disrupt in the class, and so you felt like everything you were doing was wrong, when in fact, I was reading on a college level from first grade because I loved it so much, right? It was the stuff that I was bad at, the stuff I didn't love so much that I was bad at that I couldn't math, science, things that I just couldn't grasp. So it's all about figuring out what the kid is good at and highlighting those things, really enjoying those things, letting the kids have fun with the things that are most important to them. Look, I'm not anti medication. I think in some instances, I have a prescription for Concerta. I think I took last time I took a pill was about five weeks ago, six weeks ago. I just rarely take it. I take it on days when my assistant says, if you don't get these five expense reports into me today, and we get them to the client, you're not getting paid. She goes, Take your damn pill and do it. So be it. But most of the time for me, I am able to use other ways to focus and other ways to get that dope meaning. So work with your kid and understand there are different ways and different things they can do to learn about themselves, and they're not broken. This is not a death sentence. It's not a curse, nothing like that. CHristopher Lewis [00:17:26]: I have to agree with you there, because I found out also as an adult that I had ADHD. And people in my life have probably always known they've always known that I had that in my life. The way that I thought, the way that I did things, the way that I balanced many other things. But just like you, I tried medication, found it, didn't really do what I needed it to do. And I've built a lot of coping mechanisms throughout the years to be able to deal with it. Now, if I talk to my partner in my life, I think she would probably tell you that there are still some times where she probably thinks that I probably should be on some meds to be able to calm things down. But she understands, and we learned together that I had this in my life as well. And at least one of my daughters I know has it as well, and she does not want medication either. And we've talked about coping mechanisms and things that they can do to be able to be successful in that regard. And I think that for parents, it's good to understand that your child does not have to be on medication to be able to be successful. In some cases, you might need that, but it doesn't mean that you have to do that. And that doesn't have to be just because that you have a diagnosis doesn't mean the first step means medication. Peter Shankman [00:18:47]: And that's the thing, I think, that a lot of parents don't understand, is that medication doesn't need to be a first line of defense. It could be a last resort. It can be combined. It should be combined. Pills don't teach skills. Right. If you're out there taking medication every day, there's tons of stories about kids who get on meds when they're five years old. They're on meds, so they're 25. Then they're kicked off their parents insurance, and they can't afford it. Now. What? They've learned nothing. Right? So now all of you don't have the crutch of medication. Now what do you do? So, yeah, there's a lot of things that can be done in addition to medication. Dialectical Behavioral Therapy. CBT, DBT, regular therapist. And I've been going to the same therapist now for over 20 years. The guy's amazing. He looks like Einstein. He has a social acuity. He is the technological acuity of a turnip. But he saved my life more than once. So those are the things that you need to understand, is that medication is just one arrow in the quiver of everything you're doing. Christopher Lewis [00:19:37]: Peter, I think you made this clear, but I want to hit home the point that for you, as you share this book out into the world, you get it in front of different audiences, you get it into local libraries, you get it into those local bookstores. You get it in front of the PTAs and teachers. What's the biggest takeaway that you want for parents and kids in reading this and leaving at the end of the book? Peter Shankman [00:20:03]: Different kids learn differently. You can't sit 35 kids in a classroom and expect them all to be automatrons and do the exact same thing. That's what happened to me. And it starts off with, you sit wherever you want, and then a couple of weeks later, they notice you getting distracted. They move you to the front of the room. Well, now when you get distracted, it's a lot easier for the teachers to see that you're getting distracted now. You get in more trouble quicker. What they should do is they should push in the back of the room, and they should say, okay, you know what? I get the way you are. If you need to stand up or walk outside, do a couple of jumping jacks, whatever, do some deep knee squats, whatever, come back in with a little bit more dopamine, feel free. Those are the kind of things that I'm seeing now in some schools. It's wonderful. We also all grew up with the premise of sit down in the morning, watch your cartoons while eating two bowls of chocolate frosted sugar bombs, then get driven to school. How about we take a 30 minutes walk, then give a kids a couple of eggs and some protein and a big glass of water, and then send them to school? So different things. They tried that in Texas. They replaced 20 minutes of recess with an hour every day, and they replaced breakfast and lunch that were mostly carbs and sugars with proteins and good fats. And they saw something like a 19% decrease in outbursts from ADHD, outbursts from boys, and a I think it was like a 29% increase in girls participating in class because girls present ADHD differently than boys do. And so that's massive. That's massive. Did nothing else. But they gave them more exercise, and they changed the food. So you look at things like that, you're like, wow. Christopher Lewis [00:21:26]: Peter, we always finish our interviews with what I like to call our Fatherhood Five, where I ask you five more questions to delve deeper into you as a dad. Are you ready? Peter Shankman [00:21:33]: Go for it. Christopher Lewis [00:21:34]: In one word, what is fatherhood? Peter Shankman [00:21:37]: That I've walked the face of this earth? Christopher Lewis [00:21:39]: When was the time that you finally felt like you succeeded at being a father to a daughter? Peter Shankman [00:21:43]: When I picked up my daughter from school earlier this year. One day, I picked her up almost every day, and I picked her up, and the teacher came over to me, said, no big deal. Just want to let you know that Jessa and a boy got into a little argument, and Jesse used a curse word when talking to him. I said, well, what'd she say? He goes, she called him an asshole. And I know that she totally got that from me, because we're on our scooter. We go on our scooter every day to school, and you try scooting in Manhattan, you're going to call someone asshole on every trip. It's just what it is. And so he goes, she called him an asshole. I go, we fucking deserved it, right? And the teacher just cracked up. That was when I knew I was a good parent. That's what I knew. I was a great dad parent. Christopher Lewis [00:22:28]: Now, if I was to talk to your daughter, how would she describe you as a dad? Peter Shankman [00:22:32]: Dad is crazy. Dad makes me laugh. Dad is a skydiver. And dad goes on TV a lot, and he loves me very much. Christopher Lewis [00:22:41]: Who inspires you to be a better dad? Peter Shankman [00:22:43]: My father. Without question. My father. And then I think my daughter as crazy as it sounds. Because when I had sort of my awakening in 2016, when I realized everything, this is when I realized about my ADHD, when I wrote the first book on ADHD, everything. In 2016, I caught my awakening year. I realized that the only people whose opinions really matter to me are my daughter, my parents, my girlfriend. That's it. And I stopped caring what other people thought. And that was just this incredible, incredible level of freedom. And so. Yeah. I'd say my daughter inspires me because I want to do the best job I can for her, because she's who matters. Christopher Lewis [00:23:19]: You've given a lot of piece of advice today as we finish up today, what's one piece of advice that you'd like to give to every dad? Peter Shankman [00:23:27]: I think there comes a point when we realize that we feel like we're trapped, right? Oh, I have a kid. I'd love to be living in Asia right now. There's no question about it, right? Especially with what's happened to America in the past, like, five years. I'd love to be gone. I'd love to be in Asia. I love Asia, for I could live like a goddamn king on one 10th the amount of money it cost me to live in New York. And I could live 20 times better if I was in South Vietnam or something, right know? But you can, right? But the one thing you can control is the people you associate with. And one of the greatest quotes I ever heard ever came from an old skydiver friend of mine. And you want to listen to old Skydiver because if they're still alive, if Skydiver 40 years, they've done something, right? And this guy said to me goes, I was complaining about how the people who I live in the city with don't understand why I go up to the Skydive every weekend. The people who I Skydive with don't understand why I want to come home every weekend. You know, come home because I like things like hot water, and I go up to the drop zones. I like jumping. I was kind of surfing that duality, right, where both things were different. And this old guy looks at me and goes, you know, if you can't change the people around you, change the people around you blew my mind. I'm like, that's the best piece of advice ever gotten. And it goes back to what I said earlier. Life's too short to surround yourself with annoying people. So the best piece of advice if you can't change the people around you, find better people. Christopher Lewis [00:24:35]: Peter, if people want to find out more about you, about the book, about your other books, where's the best place. Peter Shankman [00:24:41]: For them to go? My entire life is@shankman.com my email is peter@shankman.com. All my books are on Amazon. They're everywhere. And then I'm at Peter Shankman on all the socials except Twitter. I quit Twitter because I just cannot take what has become. But other than that, I'm at Peter Shankman everywhere else. I'm pretty big on Instagram, so, yeah, feel free to follow me anywhere you'd like. Christopher Lewis [00:24:58]: Well, Peter, I just want to say thank you. Thank you for sharing your story. Thank you for writing this book for kids like you and other kids that, as you said, may have been not seeing people like themselves in books. And I wish you all the best. Peter Shankman [00:25:15]: Pleasure was mine. Great to be here. Christopher Lewis [00:25:17]: We know that no child comes with an instruction manual, and most dads are figuring it out as they go along. And the Fatherhood Insider is full of resources and information that will up your game on Fatherhood. Through our extensive course, library, interactive forum, step by step, roadmaps and more, you will engage and learn with experts, but more importantly, dads like you. So check it out@fatheringtogether.org. If you are a father of a daughter and have not yet joined the Dadswithdaughters Facebook community, there's a link in the notes. Today dads withdaughters is a program of Fathering together. Find out more@fatheringtogether.org. We look forward to having you back for another great guest next week, all geared to helping you raise strong, empowered daughters and be the best dad that you can be. Christopher Lewis [00:26:06]: We're all in the same boat and it's full of tiny screaming passengers. We spend the time we give the lessons we make the meals we buy them present bring your AC because those kids are growing fast. The time goes by just like a dynamite calling astronauts and firemen carpenters and muscle men get out and be the one to them be the best that you can be be the best that you can be you close.

The Personal Brain Trainer Podcast: Embodying Executive Functions
#47: Medication and Executive Functions

The Personal Brain Trainer Podcast: Embodying Executive Functions

Play Episode Listen Later Sep 11, 2023 46:23


In this episode, Erica and Darius explore the topic of medication as a supportive tool for enhancing executive functions such as inhibitory control, working memory, and cognitive flexibility. With special focus on ADHD, dyslexia, and other conditions that influence executive skills, they explore: The role of stimulant medications like Methylphenidate (Ritalin, Concerta) and Amphetamines (Adderall, Vyvanse) in optimizing neurotransmitter levels for better focus and impulse control. Alternative non-stimulant options, such as Atomoxetine (Strattera) and Guanfacine (Intuniv), and how they may be suitable for those who don't respond well to stimulants. Potential roles of supplements and dietary changes in enhancing cognitive functioning. Remember, medication is not a one-size-fits-all solution and should always be considered after exploring other options and as part of a broader treatment plan. Consult your healthcare provider to tailor the best course of action for you or your loved ones. Links: EF activities: https://tinyurl.com/yeytwn7v  More EF activities: https://tinyurl.com/3brpf52j   EF coaching program/course: https://tinyurl.com/n86mf2bx  One to one sessions with Dr. Warren: https://learningtolearn.biz/  One to one sessions with Darius: www.dyslexiawork.com Executive functions and Study Skills Course: https://tinyurl.com/n86mf2bx BulletMap Academy: https://bulletmapacademy.com/ Learning Specialist Courses:https://www.learningspecialistcourses.com/ Executive functions and Study Skills Course: https://tinyurl.com/n86mf2bx Good Sensory Learning: https://goodsensorylearning.com/ Dyslexia at Work: www.dyslexiawork.com Brought to you by ⁠⁠⁠⁠https://goodsensorylearning.com⁠⁠⁠⁠ ⁠⁠⁠⁠https://learningspecialistcourses.com⁠⁠⁠⁠ ⁠⁠⁠⁠https://bulletmapacademy.com⁠⁠⁠ ⁠⁠⁠https://www.dyslexiaproductivitycoaching.com

Creating a Family: Talk about Infertility, Adoption & Foster Care
Introduction to Prenatal Substance Exposure

Creating a Family: Talk about Infertility, Adoption & Foster Care

Play Episode Play 58 sec Highlight Listen Later Aug 9, 2023 58:06 Transcription Available


Are you considering adopting or fostering? Or taking in a relative's child? Do you suspect or know that the birth mom used drugs or alcohol during pregnancy? Join us today to learn how these substances might impact the child and how you parent. Our guest is Dr. Lisa Prock, a Developmental and Behavioral Pediatrician, Director of the Developmental Medicine Center at Children's Hospital, Boston, and Clinical Director of the Translational Neuroscience Center at Harvard Medical School and Children's Hospital Boston. She is an Assistant Professor of Pediatrics at Harvard Medical School.In this episode, we cover:Foster, adoptive, and kinship parents and caregivers often need to consider whether they are the right family to parent a child with prenatal alcohol and drug exposure.The US government estimates that about 10% of children born in the US have been prenatally exposed to alcohol, drugs, or both. How common is prenatal substance exposure for foster and adoptive children, as well as those kids living with grandparents and other relatives?Are there signs or symptoms with a child that may have been exposed to alcohol and drugs in utero, absent confirmation from the mother?What is known about the amount or timing of alcohol or drug use and the impact on the baby or child?Short-term and long-term impacts of the following substances:Alcohol-does it matter the type of alcohol?Methamphetamines  Adderall, Concerta, Ritalin or other ADHD medicationOpiates/opioids-prescriptionOpioids-illegalHeroinFentanylMethadone, Suboxone, Subutex, BuprenorphineMarijuanaEcstasy, inhalantsTobacco-smoking cigarettes or vapingHow common is dual exposure/polysubstance exposure—alcohol and drugs?Do children who have been prenatally exposed to alcohol or drugs have a greater risk of abusing drugs in adolescence or adulthood?How do you get a child diagnosed with prenatal substance exposure?What should parents consider when trying to decide if they are the right family for a child with prenatal exposure?Creating a Family's Prenatal Substance Exposure Trainings for Parents, Daycare/Preschool Teachers, and Afterschool Staff. Support the showPlease leave us a rating or review RateThisPodcast.com/creatingafamily

Focus Forward: An Executive Function Podcast
Ep 28: The Gift of ADHD: Expert Tips to Unlock the Power of an ADHD Brain

Focus Forward: An Executive Function Podcast

Play Episode Listen Later Jul 19, 2023 66:12


Last week, I had a blast hosting another free webinar for Beyond BookSmart that was all about ADHD. Amy McDuffie, an Executive Function coach and ADHD expert, joined me to explore how the ADHD brain works and what the roles of medication, therapy and executive function coaching are within the larger umbrella of ADHD treatment. We also took some time to cover some of our coaches' favorite tools and strategies that can support the areas of executive functioning that people with ADHD often struggle with, and featured psychiatrist, Dr. Theresa, to fill in some of our expertise gaps around ADHD medication. So, today, I'm bringing you the audio from the webinar AND a bonus Q&A section that Amy & I did after the webinar (there were just too many great questions we didn't get to!) If you joined us live and just want to hear the bonus content, you can skip ahead to around 47 minutes to listen to just that. And if you didn't get a chance to watch the webinar at all, be sure to look for the link in the show notes below!For those who have been blessed with careful ears, you'll hear me share in this episode that I was recently diagnosed with ADHD myself. Because of my recent diagnosis, this episode is particularly close to my heart. I hope you enjoy listening half as much as I enjoyed being a part of these important conversations and if you do, be sure to give us a 5-star review on the platform you're listening on! And last but certainly not least, thank you for being a part of the Focus Forward community. Here are the show notes for this week: Watch our webinar, How to Thrive with ADHD After a Diagnosishttps://thinkingoutsidetheclassroom.wistia.com/medias/u3pueh40rsSlides from our webinar, How to Thrive with ADHD After a Diagnosishttps://www.beyondbooksmart.com/hubfs/How%20to%20Thrive%20with%20ADHD%20After%20a%20Diagnosis%202023.pdfWatch our webinar about Motivation:https://thinkingoutsidetheclassroom.wistia.com/medias/o3it96iuotBeyond BookSmart ADHD Success Kithttps://www.beyondbooksmart.com/adhd-success-kit-2022Focus Forward Ep 13: How to Unlock the Superpowers of ADHDhttps://www.beyondbooksmart.com/podcast?wchannelid=y1lzulxlcs&wmediaid=by637tasziFocus Forward Ep 18: Flipping the ADHD Narrative: How "The Disruptors" is Changing the Way We Talk About ADHD (ft. Nancy Armstrong)https://www.beyondbooksmart.com/podcast?wchannelid=y1lzulxlcs&wmediaid=wwh3rsdpbw2-Minute Neuroscience: ADHDhttps://www.youtube.com/watch?v=w8JnDhp83gATranscriptHannah Choi 00:04Hi everyone, and welcome to Focus Forward, an executive function podcast where we explore the challenges and celebrate the wins, you'll experience as you change your life by working on improving your executive function skills. I'm your host, Hannah Choi. Hannah Choi 00:18Oh, you guys, thank you so much for taking the time to go to Apple podcasts and rate Focus Forward. For me, it really means a lot to see that little number next, all those stars go up. I really appreciate it. If you want to help us out, and you haven't already rated it, you can scroll to the bottom of the Focus Forward section of your Apple podcasts app and give us a rating and hopefully it's five stars. If it's not, email me, tell me why. Thanks, guys. I really appreciate you all so much.Hannah Choi 00:47 I had a blast hosting another beyond booksmart free webinar last week, this time, all about ADHD. Amy McDuffie joined me again as one of our ADHD experts. And we covered what ADHD is and what it is not how the ADHD brain and medication work, the roles therapy and executive function coaching play for people with ADHD, and the benefits of pairing those interventions for maximum success. We also took some time to cover some of our coaches favorite tools and strategies that can support the areas of executive functioning that people with ADHD often struggle with. And this webinar was an updated version of the ADHD fundamentals webinar that we held in June of 2022. So today, I'm bringing you the audio from this year's ADHD webinar. If you listen to Focus Forward regularly, you may notice that much of the content is similar to the ADHD focused episode we did in October of 2022. In fact, I even used some of the audio from last year's webinar in that episode, I really hope you listen anyway. And don't report me for plagiarizing myself, although you'd have to report me to me, and I'm cool with it. So it's all just such good stuff. And I want to share it with as many people as possible in as many formats as we can. So some people like to watch video to learn, and others like to listen and still others prefer to read. And as a coach, I really recognize the value of honoring these differences in people. And so this is me making that happen. If you'd like some visuals while you listen, the slides from the webinar are linked in the show notes. Also, today, you'll hear me share that I was recently diagnosed with ADHD myself. And so this webinar and that ADHD episode are particularly close to my heart. In fact, doing all the research for the ADHD episode last year confirmed what I had been wondering for quite a while. Hannah Choi 03:02At the end of our webinar presentation last week, Amy and I answered some of the Q&A topics that our attendees asked both with their registrations and during the live webinar. And people asked such good questions. So good. And if you listened to the Focus Forward episode of the audio from our Laziness vs. Executive Dysfunction webinar, all about unlocking motivation, you may remember that Amy, Vin and I sat down the next day to answer more Q&A topics. Because there were some great questions we couldn't get to before this latest webinar ended, Amy and I decided to meet up again, just like last time, so stay tuned at the end of the webinar audio for the bonus content. If you joined us live and you just want to hear the bonus content, you can skip ahead to about 46 minutes to listen to just that. And if you missed the webinar, and you want to watch it, the link to it and our other webinar presentations is in the show notes. Okay, now on to the show. Hannah Choi 04:07All right. So hello, and welcome to our webinar "How to Thrive with ADHD After Diagnosis". We are so thrilled to welcome people joining us from across the US and around the world as we saw, and we have closed captions available. So if you'd like to use those, be sure to turn them on. My name is Hannah Choi, and I'll be your moderator for tonight's event. I use she her pronouns and I'm the host of our podcast, all about executive functioning called Focus Forward. So if you listen there, you might know you get to see a face to the name or Yeah, face to my voice. I have been an executive function coach at beyond booksmart since 2017, and I have coached dozens of students from elementary age all the way up to college and I also work with adults and I'm a mom of two kids who are 11 and 14 and I live in Connecticut. I am also joined by Amy McDuffie who you may recognize from our laziness versus executive dysfunction webinar around motivation. Amy, would you please introduce yourself and share your background and your roles with Beyond BookSmart?Amy McDuffie 05:14Yes, thank you, Hannah. Hi, everyone, I have been a coach and executive function consultant with beyond booksmart. For over two years. I use she her pronouns, and my background is in special education, specifically in behavior and learning disabilities, with students from elementary through high school. And I'm also a former behavior specialist. These opportunities allowed me to really experience both the gifts and challenges of students diagnosed with ADHD. Much of my work in the school setting focused on providing interventions for students, and coaching teachers on how to best provide support. I'm also the parent of two pretty awesome teens, ages 14 and 17. And I'm so glad you all are here. And I'm really excited to be with you.Hannah Choi 05:59Thank you, Amy. And for those of you who are joining us who may not be familiar with Beyond BookSmart, we have been providing one on one executive function coaching with students and adults since 2006. Even before that term executive function became widely known. And you may already know this term since ADHD and executive function skill challenges are so closely bound. But if it's new to you, you're not alone, I promise. Executive function skills are mental skills that we use to navigate our lives and get through our days. They include attention, memory, time management, planning, prioritizing, and emotional regulation. And many of our clients have an ADHD diagnosis, which gives us extensive experience in supporting individuals with ADHD or similar challenges. And today's webinar is an updated version of the ADHD fundamentals webinar that we ran last summer, which was hosted by Jackie Hebert. And that webinar was one of our highest attended webinars. So we know that this topic is really important to people. And I am personally thrilled to be hosting this time, because the topic is really close to my heart, I was recently diagnosed with ADHD. And I've been doing a lot of the same navigation of new waters that many of you likely are. And so I'm really happy to be here with you today. So you may be joining us today because you or your child was recently diagnosed with ADHD, but maybe you just suspect a diagnosis. And if this is the case, we really encourage you to listen to the webinar, and then reach out to your pediatrician or your primary care provider for guidance on what to do next.Amy McDuffie 07:37Thanks, Hannah. It can be really overwhelming when you learn or suspect that you or a loved one has ADHD. There's just so much information out there. And it can be hard to sort through it all. But we find it can also be a huge relief to get a diagnosis because it gives you context for your or your child's struggles, and also a defined place to look for help and support, which you are doing right now. We're here tonight to provide that for you. So here's what's here's what to expect in our webinar. First, we'll briefly define ADHD and explore some common assumptions about it. Then we'll move to learning about medication options. Then we'll touch upon behavioral approaches to treating ADHD, and share some of our coaches favorite tools and strategies that can make life a little easier. We'll share some resources and answer some of your questions before we finish up. So please use the Q&A function at the bottom of your screen throughout the webinar.Hannah Choi 08:38Yes, thanks. And because we're not medical doctors - Sorry mom and dad! We will be sharing a recording of some of the webinar from last summer. We had Dr. Theresa Cerulli join us to discuss the option of medication to treat ADHD. Dr. Cerulli is a graduate of Tufts University, University of Massachusetts Medical School, Harvard Longwood residency program in adult psychiatry, and Harvard fellowships in Medical Psychiatry and neuro psychiatry, and she is a board certified physician in psychiatry and is on the faculty at Beth Israel Deaconess Medical Center in Boston, and for the neuroscience Education Institute, so we'll hear from her later.Amy McDuffie 09:21All right, so you might be wondering just how common is ADHD? You're in very good company. Research from the National Institute of Mental Health, the NIMH reveals 11% of children and 4.4% of adults meet the criteria for ADHD, with males diagnosed at a higher rate than females. Now those statistics are from 2011. So we hope that NIMH updates their data soon. But with that degree of prevalence, you can see why it's essential to educate caregivers, children and adults with ADHD and help them identify supports to manage their symptoms.Hannah Choi 09:59Yes, and thanks to the efforts of high profile and successful people with ADHD, there's less stigma associated with a diagnosis. In fact, you'll meet many people who consider their ADHD a superpower of sorts. And it provides great energy and creativity when channeled effectively. There are so many great examples of people with this superpower from Simone Biles that you can see on the screen now, and astronaut Scott Kelly and so many others, and ADHD does not have to be a hindrance to success. All right, but all of that inspirational wisdom still leaves us with an important question. Hannah Choi 10:35What is ADHD? And what is it not? All right, so ADHD is a brain based condition that impacts daily life. And it often can affect motivation. And it often runs in families. And it has three subtypes, there's hyperactive impulsive, and then there's inattentive, which you may know as add the ADD is what it was formerly called. And now it is called ADHD inattentive type. And then there is the third type, which is the combined type that has characteristics from both. And ADHD directly impacts executive functioning. And ADHD is not a result of poor parenting. It is not a choice. And it is not something that children typically outgrow. And it is not a learning disability. And it's also doesn't have to be an immovable barrier to success and happiness. And I want to touch upon just a few of these points. Not everyone outgrows it. But with intervention, you can manage symptoms, and sometimes the symptoms just change over your life, because the demands on us change. So the symptoms can look different as we age. And ADHD is not considered a learning disability because it's a medical condition that, as we learned, impacts your it will what you'll learn as we will learn it impacts neurotransmitters in the brain. And research indicates that 30 to 50% of children with ADHD also have a specific learning disability, and that the two conditions can interact, which can make learning extremely challenging.12:10Yes, let's talk more about that for a minute. It's not a learning disability, but a medical condition. And understanding these dynamics can really help us empathize with individuals with ADHD. So if you attended our Laziness vs. Executive Dysfunction webinar, this may sound familiar. So ADHD is characterized by lower levels of the neurotransmitters dopamine and norepinephrine, affecting how the ADHD brain perceives both reward and pleasure. And this leads to a lack of enthusiasm per task, and a tendency to prioritize short term rewards over long term rewards. Another significant difference in the ADHD brain involves the default mode network, which activates during daydreaming or when we're not focused on a task. In ADHD, this network is more often activated constantly diverting attention toward unrelated thoughts. So that explains why staying focused on tedious or repetitive tasks can be such a chore with ADHD. It really isn't a matter of well, it's a matter of neurology. And that's why brain based interventions can be really effective for individuals with ADHD.Hannah Choi 13:26Yes, so true. Thank you, Amy. Alright, so now that we know what happens inside the ADHD brain, let's take a look at how ADHD can show up in behavior. Okay, so here is the top of an iceberg. And this is the part that everyone sees when a person has executive function challenges due to ADHD. The people around them see the top they see the behaviors that are problematic. They're forgetful, they seem lazy and scattered. They're sloppy or moody, they behave impulsively, and sometimes can even be rude to others. Does this sound familiar to anyone? Now remember that icebergs are actually mostly hidden under the water. And it's the same with executive function challenges. When we look deeper, we can see the specific skill deficits that people with ADHD can often have and that are causing the challenging behaviors that impact those around us. And so a person may have a poor sense of time or difficulty planning ahead, when that can make them seem scattered, and they may have trouble regulating emotion and seem irritable or moody. When they have no strategies to self monitor, a person can look impulsive, and students or adults who are too overwhelmed to get started can look lazy. And when they have no systems to track to sorry, excuse me to track their belongings or to maintain their focus, they can be forgetful. And when a person has trouble thinking flexibly, it can affect their problem solving and perspective taking and that can often come off as rude or demanding behavior. Beer. And as I mentioned in the beginning, ADHD can impact one or more of these skill areas. So you can see how it can directly impact our ability to manage everyday demands.Amy McDuffie 15:13Thank you, Hannah. So we'll shift now to the role of medication for ADHD. Many of you wrote in with questions about that, and we recognize that medication is a personal choice. And for those who are considering it, we wanted to provide some support there. So let's hear from Dr. Cerulli to learn how that works.Theresa Cerulli, MD 15:33So medications, I will say, it should be something to at least discuss with your providers medication isn't for everyone, but should at least be considered for everyone is how I would have I would think about it. And mostly because of the data. Looking at this was these were NIMH funded studies, not pharmaceutical funded studies years ago, looking at the role of behavioral interventions versus motivate medication intervention, interventions, versus combined in treating ADHD, and the sitter. So the surprise was that medication interventions, compared with behavioral interventions alone, the medication invent interventions were more significantly impactful. And then we all made the assumption that the combined medication and behavioral treatment would be even more impactful and which was true, but not to the extent that they had anticipated. So it does look like a main a main part of the treatment intervention should be medication should at least be considered this is neural neuro biologically based. And the sometimes it's hard to make headway in your behavioral strategies, meaning I call that "from the outside in" using strategies you learn in your environment, with some coaching, hopefully, and therapy, from the outside in, those strategies become hard to learn, and or utilize if you're also not not working from the inside out and helping with the neurobiological aspects in terms of what's happening in the brain. So initially, at least considering the combination of therapies, internal and external, so to speak, are, are considered them should should at least be considered. That's how we think about it. And here's our ADHD brain here on on the slide with the power switch in the frontal lobe. Think of the brain as a large electrical circuit, it really is that we're sending electrical signals when one part of the brain is talking to another part of the brain. So in the ADHD brain, all the circuitry is there, there's nothing that's we're not missing something. There's not, you know, holes in the section of the brain that's involved in attention concentration. But it just, it turns out that there's a higher level of stimulation is needed to literally turn the circuit on. And the reason that this switch here is in the frontal lobe this on switch is because that's the area that's mostly involved in ADHD, from what we can tell that area is under active or hypo active. If you look at functional scans, have somebody do a concentration task that has ADHD, and you scan them in a functional scanner, looking at what happens. And it turns out that that area of the brain that's used with concentration and attention is under active, it's too quiet. It takes something stimulating to flip the switch, which is where the medications come in. I get this question all the time. Why in the world would you talk about stimulant medications? For somebody who's already hyperactive and impulsive? It's kind of counterintuitive. And the reason is because you're not trying to stimulate the whole person. You want to stimulate that frontal part of the brain that Its job is to help us focus, concentrate, built around, filter out background noises, organize and plan. You're trying to turn it on to do its job most efficiently and effectively. So choosing the right medication is the question we get all the time. It should be in partnership certainly with somebody who really knows ADHD well, and the primary care physicians are especially if you're working with kids, the pediatricians are quite familiar but all with adults with ADHD your internist may or may not be they because the stimulant medications, which are many of the options we have available, are controlled substances. A lot of the internists and general practitioners for adults are their little hesitant to be involved in in prescribing so we usually refer you to a psychiatrist and neurologist, somebody who does this on a more routine basis. For ADHD, there are stimulants. There are also non stimulants. The non stimulants have some similar effects in the brain. Not quite as strong, I would say Say is the stimulants and we'll go through them quickly through the pros and cons. Stimulants have been around for years and years the gosh, Ritalin 1950s There was some amphetamines available even before that in the 1930s not yet used for ADHD but at least existed so stimulants have been around for more years than I have been concert they've been well studied. They're relatively affordable because there's many options and so usually there's a lot of generic brands that are available which insurance is more willing to pay for so that has that advantage. Cons is that they are controlled substances. They do have the potential for addiction. If we have clients that working with when there's any concern around that we are really careful usually move that would be someone I'd move to a non stimulant is first line. Some examples of stimulants you may have heard of certainly, Ritalin, Concerta, and meditate those fall into the methylphenidate category of stimulants. There's a second stimulant category and that's amphetamines. Some of the names you may have heard of there are Adderall, Vyvanse and dexedrine. So stimulants, if that's the umbrella term, under stimulants, you have two subcategories methylphenidate and amphetamines. And then there's about 29 or so total stimulants if I wanted to make a list and but most of those 29 fall into either methylphenidate or amphetamines in some form, some are long acting, some are short acting. An example in the methylphenidate Ritalin itself and its original form that tablet lasted only about three and a half, four hours. And that was it, which is why it was so hard to get tend to go to the nurse's office at lunchtime to take their second dose of Ritalin than they needed a third dose after school and potentially another for homework. It was really kind of rough that up down on off feeling. Concerta is a long acting rhythm and it's still Ritalin. It's just a 10 to 12 hour version that you can take once in the morning and have it last throughout the day. So there's many methylphenidates that are short acting, many that are long acting, some that are in between. Same thing with amphetamines, the non stimulants, they aren't controlled substances, there is no potential for addiction. That is one of the beauties of the non stimulants. They haven't been out as long so we don't have as many available. In fact, there are only for adults, we only have two non stimulants FDA approved for treating ADHD. In children, we had three new we now have four because Quelbree came became available last year as another non stimulant available for actually kids and adults. So we don't have the long list of that we do with stimulants where there's I said 29 I think it's actually even a little more than that now. Preparations, non stimulants we're more limited choice, but they do have their advantages that it's not that they don't have side effects, stimulants and non stimulants both can have side effects. The side effects with the non stimulants are just a bit different. I already said that not addictive, there's no withdrawal risk. They're not quite as strong. If you looked at the robustness of response, you're going to get more effect over and above not on a stimulant over and above not taking a stimulant compared with what we call the robustness of of effect of a non stimulant. But it really should be tailored to the individual and discussed with your individual provider. Hopefully someone that really is specialized in ADHD.Amy McDuffie 23:41All right, that was great information. So medication provides a place to start for many with ADHD. But as some educational professionals say, "Pills don't teach skills". I know it might sound silly, but it's worth noting for the reminder it provides medication as we just learned can set the stage to make learning and applying new skills easier by turning on the brain's ability to focus, which allows us allows us to take better advantage of other beneficial supports. Also, because some people choose not to take ADHD medication, it's important to explore these other supports. So the other half of the equation is how you go about learning new habits and behaviors. Let's find out more about two options therapy and coaching. Both of which can teach you different ways of thinking about your ADHD, and tools and strategies to support the areas that you or your child find challenging. So therapy and executive function coaching work together to address the negative behaviors and habits that have been learned over time, but in different ways. Therapists help transform negative patterns of thinking influenced by living with ADHD and constructively rebuilt the way people feel about themselves. Their therapy can be a really helpful piece of overall treatment, particularly if there's self esteem issues, or coexisting mental health conditions like depression or anxiety that are part of the big picture. The longer that ADHD is untreated, it's more likely that there are deep seated beliefs about self worth, and potential that can be holding a person back. It's significant to note that a child with ADHD could receive 20,000 corrective or negative comments by the time they are age 10. Now that's fertile ground for feelings of shame to take root. We're not therapists, so we can't elaborate on the specific benefits and approaches to therapy. But we really encourage you to find a therapist who has experience supporting people with ADHD.Hannah Choi 25:56Yes, I know that my therapist has been invaluable to me as I figured out how to manage my ADHD and all the emotions that come with that diagnosis. So managing those emotions, and those negative narratives that come along with it are just one part of the puzzle. Because ADHD impacts executive functioning so directly, working specifically on developing good habits to level the playing field is really, really helpful. And that's where executive function coaching can help. So what is executive function coaching, it supports clients to explore their strengths and their challenges, and then refine their tools to manage their daily life challenges. And all of this helps foster healthy habits. And having a coach is beneficial for everyone, actually, regardless of your ADHD diagnosis, because you don't have to have ADHD, to have stroke struggles with executive function. And life can just be tough enough for everybody. So learning some new strategies is always helpful. And as we said before, Amy and I are both coaches, and we have been for some time now. And I just love how we get to teach adults and students, all those executive function skills like organizing, planning, prioritizing, managing time, and maintaining focus, learning to assess yourself and work more efficiently. But it's really so much more than just building on those specific skills and habits. Right, Amy?Amy McDuffie 27:26Absolutely. Yes, I definitely agree with you there, Hannah. I also really just value the strong trust and rapport that I get to build with clients. And I love those moments when I get to see a shift in confidence and autonomy. You know, really our goal is our goal as coaches is for clients to develop the skills they need in order to become successful and independent.Hannah Choi 27:51Yes, there's just nothing like it when we see our clients finding that. And also, everybody comes from a different place and has different needs and different challenges. And so what what I really like about that one on one aspect of coaching is that it can really help clients focus on their specific goals and their needs. So Amy, what do you see in your clients with ADHD when they first start coaching?Amy McDuffie 28:19Yeah, that's a really, really important question, because clients often come to us when they're feeling pretty frustrated, which is completely understandable. And oftentimes, individuals with ADHD experience much more frustration and failure than they do success, which ends up having a negative impact on their self perception, and also increases stress. So this can become a real barrier leading to the self-reinforcing negative cycle, and also results in less efficient processing. Because our brains just don't function well under stress. I know I've seen clients come into coaching with the assumption that they just can't improve their grades or stay on top of their work. Because this combination of past failure and unhelpful habits have really diminished their confidence in it for taking any steps towards making a change. And that's why it's really important to help clients with ADHD recognize their strengths. And as coaches, we can build upon those strengths and draw parallels between the skills needed to generalize that success to other areas. We also initially work on finding small wins and help clients recognize the benefits from these changes, which then leads to greater self confidence. And this increase in self-confidence and feelings of success then became motivating to build upon this habits and ends up creating a positive cycle of success that can really snowball into some major changes.Hannah Choi 29:51Yes, it's so it's just so great to see that happening. So let's talk about some of the specific tools and strategies that we coaches use to teach people with have ADHD, or just executive function challenges to make the life a little easier. So a common common common executive function skill challenge area for people with ADHD. And actually, I would say for most everybody is planning, prioritizing and time management. And so let's start with that time management. One helpful strategy is using timers and then blocking out your time, we really liked the Pomodoro Technique, which you may have heard of before, and it involves setting a timer for a focused work period, then that's usually about 25 minutes, the brain doesn't really like to work longer, in general. So 25 minutes is often a good amount of time. And then after the timer goes off, you take a five minute break, make sure you set a time and mercy or five minute break doesn't turn into an hour, and then restart that cycle. And then if you're finding it difficult to get back to work, after the break, you can try stretching or getting up and walking around having a snack or a drink, or just maybe switching to a different activity temporarily. And when prioritizing what you're going to work on in those blocks of time, some people like to decide ahead of time, what they're going to work on, based on the difficulty of the task or its urgency, and then others like to start with what they're feeling most motivated to work on. And it really just depends on what works best for you. And as all tools. And what we really say to all of our clients all the time is we really, really want you to try things out, and then see what works best for you. And as a person with ADHD, the way that you do things might look different from the way everyone else does. And I'm here to tell you that that is okay. And a tool that we like to use for planning is called peak performance. And what peak performance does it helps you to learn to pay attention to when you're most productive. And so this can give you some insights on how to schedule your days. So if you tend to get tired in the afternoons, I think that's pretty standard for most people, scheduling a focus to work session in the afternoon is not maybe a realistic expectation. And if you have a hard time winding down after school, jumping right into homework when you first get home might be stressful and unproductive.Amy McDuffie 32:17Yes, thank you so much, Hannah. I totally agree it's so important to recognize those peak performance times during the day. And I think it's also really helpful to determine why the task is important to you, you know, to remind yourself of the potential benefits, which may not always seem immediate, but could have some greater benefit down the road. And this can really help boost motivation for taking the steps to get started. Some other strategies that can help with focus include things like taking notes, using checklists, asking questions, and just writing information down in your own words. It's really about creating opportunities for engagement and active participation whenever possible. And some people find it's also helpful to drink water or to gum, also to use alternate seating or even stand and to create opportunities for movement. And this is definitely something to consider in the school environment where students do a lot of sitting.Hannah Choi 33:21I also wanted to touch on some strategies that can help remember help with remembering to take your medication. And this could be ADHD medication or any other prescriptions you might have. Memory can be a big challenge area for people with ADHD. I know it is my kryptonite. We suggest setting up automatic refills for prescriptions that allow this and adding a reminder in your calendar for the following month when you receive this month supply. And you can create a recurring alarm as a reminder to take your meds or and then also like keep them in something like near something that you use daily, maybe by your planner or bedside table or the kitchen counter. And ordering a three month supply when possible. You can't do this without medications can reduce how often you need to reorder, which is really helpful. And if the current Adderall shortage affects you, being proactive is crucial. Your pharmacist may need to collaborate with other pharmacies to source refills, and finding a cooperative pharmacy will make things much easier. Let's see. All right. I'm gonna go with this one. Let's see. How do you know when a teen is being lazy versus when it's ADHD? This sounds very familiar to me. Amy. Does it sound like that to you?Amy McDuffie 34:48It's that's a that's a tough question to be honest. Yeah, I'm happy to start out on that one. Yeah. I you know, coming from you know, a behavioral behavioral person Active, excuse me, I really like to find out, you know, where the problem issue is, and also, you know, help determine why that's happening. So I feel like, that's a really important step here. Like, you know, how, how is this child being impacted? And, you know, why is that occurring? Because I do think that, you know, behavior serves a function. And I think we need to determine that before we can identify, you know, if it's ADHD related, which it very well could be, or if it's more of a behavioral issue. So, I don't know, Hannah, what are your thoughts on that?Hannah Choi 35:39Yeah, well, it reminds me of the last webinar that we, that we both hosted back in May, where it was actually the topic of the webinar. And, and, and we, we do like what like you just said, it's, it's, I mean, I would say it's not laziness. It can feel that way. As the parent, I can very much feel that way. It can also feel that way, as a person with ADHD, sometimes I find myself, I like catch myself thinking, I'm being really lazy. And then I realized, like, wait a second, I'm just not, I'm not figuring out why. And I'm not figuring out a tool to help me get past that what feels like a laziness barrier. I do know that a lot of screen time can deplete what little dopamine people with ADHD already have. So extended amounts of screen time can can make it feel like everything else is really boring, which can impact your motivation. So you know, if there's, you might want to have a discussion with yourself, if you're the person who's experiencing that, or with your partner or with your child, if, if there might be some dopamine depletion going on from a lot of screentime, which is totally normal. Everybody, does it. I'm not at all saying is there's anything wrong with it, but it can be, there can be a connection of it there. So yeah, all right. Um, let's see. Oh, here we go. Can you give an example of how ADHD can be a superpower? I would like to take that one.Amy McDuffie 37:20Yeah, absolutely. Absolutely. Yeah.Hannah Choi 37:24So that Default Mode Network section that you were talking you and Dr. Cerulli were talking about earlier is, is it's both a challenge and also a superpower. So even while I'm talking right now, I have like a lot of ideas going on in my head. And what I'm doing is like making all these connections between topics. And I feel like I'm really good at synthesizing information. Because I have this deep, I even I'm focusing on talking right now to all of you, I have this default mode network that is like susceptible, making all these connections out here. And I feel like it gives me some really creative ideas. And I also feel like it really helps me as a podcast host. Because I feel like it helps me come up with some really cool questions and make connections that a more linear thinker might not make. It does require extra effort to stay focused and to kind of ignore that default mode network when I when I really need to focus. So it's a it's a challenge, and it's also a superpower. And also, there's just a lot of energy behind the things that people with ADHD are really interested in. So I think that that is, you know, some of the most successful CEOs in the world have ADHD. What about you, Amy, what do you see in your clients are the students that you used to work with?Amy McDuffie 38:46I really, I really value the creativity that I feel like many individuals with ADHD have. And you mentioned, Hannah, you know, the energy and I think that's, that's such an important part that to frame it as a positive. And, you know, that kind of goes, you know, really into, like, the dialogue about ADHD that we really should reframe it as, you know, as a positive and look at, you know, you know, the gifts that ADHD can bring for individuals.Hannah Choi 39:19Yep, I agree. Okay, here is a great question. I'm so glad somebody asked this. How does mood play into executive functioning with my daughter who has to attempt inattentive ADHD getting into the frame of mind to do anything is a big challenge. Yeah, so just to get a little brain nerdy. So our executive function skills reside in our frontal lobe or prefrontal cortex which is right behind our foreheads. And we can only really access them when we are at rest and digest when our body when we're not stressed out. We're not upset we're not anxious. And so if you, if you already are struggling with executive functioning, which a person with ADHD does, and also one of those really big, important executive function skills in there that do that does really challenge people with ADHD is emotional regulation. So regulating your emotions so that you can stay up in the front part of your brain, the top part of your brain where your executive function skills are is a huge part of success. Right? Like, if you already have trouble accessing them, and your emotions are not being managed, then it makes it even harder to get started even harder to get over the anxiety that you might have or the frustration you might feel or the fear you might have for what you're going to work on.Amy McDuffie 40:45Yeah, absolutely. Hannah, I mean, it really that emotional regulation or self regulation piece, it really is the starting point, you know, of things to focus on and then to work on building strategies from there.Hannah Choi 41:00Yeah, yep. Somebody asked about screen time. We could literally talk about screen time all night.Amy McDuffie 41:07Yeah, yeah. And I feel like that's, that's such an important question. Because, you know, it's one that we all we all live. Yeah. So I'm, if that's okay, Hannah, I'm happy to share. Okay. So this is something that I've, you know, that I've actually been working on with a client, and, you know, having two teenagers myself, it's something that we address in our own home as well. And I feel like, you know, for me, the approach that I like to take is to really look at, you know, how we spend our time, so, you know, how your kids are spending their time. And, you know, really what they're missing, you know, are there things that they have enjoyed doing in their lives, their hobbies, other things that might be sacrificed, if they're spending tons of time on the screen. So I like to, you know, kind of approach things from that angle in terms of, you know, what else could you be doing with your time, and then, I love the approach in my own house of, you know, taking the, the adolescent need for independence and autonomy. And, you know, really talking with my kiddos about, you know, are you in control of your phone? Or are you allowing your phone to control you and, you know, taking that approach and teaching them about, you know, the intention of all of the the apps and, you know, wanting to, you know, maintain our attention and take our time away. So, those are just some approaches that I use, you know, in my own house and with with my client as well. How about you, Hannah?Hannah Choi 42:44Yeah, I really love that last point that you made, because learning to, to reflect on our own experience, and then take what we've learned, and then apply it to our life to make positive change is is such an important skill to learn as a teen because you're soon going to be an adult and not have your parents around to help you monitor all that. So learning that self awareness, and just self control is so great. So I love that. I love that you mentioned that. Yeah, I got to interview Dr. Clifford Sussman, who is a psychiatrist who specializes in screen addiction. And he had some really, really great tips for, like you said, working with your, with your child, your teen to, to, you know, work together to come up with a potential solution for you know, setting reasonable limits, while also giving them that autonomy and independence that they do crave. And they do need because they need to develop that skill for success in life outside of, you know, our safe and cozy homes. And then he also talked a lot about See, here's where my memory is... so anyway, just listen to the episode!Amy McDuffie 44:06That is a great episode, Hannah. That's one of my favorites.Hannah Choi 44:12We are live folks, we are live. Here's one. How can you tell if it is anxiety or ADHD? Oh, whoever wrote that? I feel Yeah, I feel you. What do you see in your clients? Amy?Amy McDuffie 44:28Oh, wow. I honestly he and I often see both of those in conjunction and, you know, the symptoms of anxiety and ADHD. There's definitely some overlap there. And you know, we talked about the you know, the cycle of failure and I what I have seen is when clients expect have that experience of past failure, it causes more anxiety and that anxiety you know, leads to avoidance with Whether it's for, you know, completing assignments or the thing they have to do, and it just, it does create that ongoing cycle. So it's, it's hard for me to separate the two, honestly, when I think about the work that I do with my clients, because I do see it often together. How about you?Hannah Choi 45:18Yep. Yep, I agree. I mean, I agree personally, that is, has been my experience. And I also see it in my clients as well. I know, for me, personally, I have a lot of anxiety around forgetting things, because memory is my most challenged area. So I am, I am often anxious that I am, you know, forgetting an important appointment or forgetting to do something that I told someone I would do. And so I have to use a lot of strategies to support myself there and I don't succeed every time. I have recently double booked myself. And so you know, it happens. But I encourage you to explore both. And to, like Amy said, it's hard to separate them, I do think it's pretty common to have both. And, and also, like, maybe we even internalized this as a child, you know, you you like all those corrective messages we heard, you know, we talked about earlier, it's, you know, when you hear that over your over the years and years, it's, it's hard not to come a little anxious about that. Hannah Choi 46:20Okay, so this is where we ended our Q&A section of the webinar. Now keep listening to hear the rest of the conversation that I recorded with Amy the next morning. And in keeping with my goal of authenticity, you can hear some sounds of daily life in the background of my recording. My mother in law, who I love dearly, did not realize I was recording. Good morning, Amy.Amy McDuffie 46:46Hey, good morning.Hannah Choi 46:48Thanks for coming back. It's not too early, but it is the morning, but I appreciate the quick turnover. Amy McDuffie 46:56Yeah, absolutely.Hannah Choi 46:58That was so fun last night. I'm so glad we got to do that again.Amy McDuffie 47:01Yeah, me too. I really, I really enjoyed that I could talk about, you know, ADHD is something I could talk about all day. So.Hannah Choi 47:10Okay, well, then I'm glad we're talking about it. So I was laughing so hard internally, because as you know, every time we were practicing, I kept almost I kept saying not almost saying I kept saying laziness versus execution webinar. Not laziness versus executive dysfunction webinars. SoAmy McDuffie 47:31yeah, that would be a different webinar, for sure. It'll be different. Yes, exactly. I mean, that would that would be a different source of motivation, for sure. SoHannah Choi 47:51All right, so yeah, so I was very proud of myself control and yours as well, because I know you were wondering if I was gonna say it?Amy McDuffie 47:59Well, and I was trying not to think about it too much, because then I didn't want to internalize it and say it myself. So I feel like we did. We did well, with that. We did. We did. We said the word.Hannah Choi 48:13 All right, let's dive into some of these questions that are just so good. I love. I just love how thoughtful everyone is. And so some of these questions were submitted during our live Q&A. And some of them were submitted when people registered for the webinar. So we've just kind of mixed them together. Okay, so here's the question when searching for a therapist, what kind of therapists should I look for?Amy McDuffie 48:39Yeah, so Hannah, I'm happy to jump in on that. One. I would recommend looking for a therapist who is experienced working with individuals with ADHD. And you know, also if you you know, feel comfortable and know someone who has an ADHD diagnosis, you know, maybe getting a recommendation from them as well. Then what do you think?Hannah Choi 49:01Yeah, for sure, you can also ask your psychiatrist or your whatever the doctor is that you're working with, for medication, if you take medication. I do know on Psychology Today, the different therapists will have profiles. And then and then on their profile, it'll say whether they work with people with ADHD, although I did reach out to one and she she told me that she doesn't work with ADHD. People with ADHD but it says so on her profile. So you might, you might and then they went to check back again. I noticed it was gone. So you might you might that might happen to you, but I encourage you to persevere. Yeah, yes. But yeah, absolutely. Someone who has experience and then you meet you might also meet with the person for the first time if you've never met with a therapist before. You may not know this that it can take a couple tries to find a therapist that you really gel with. But it's worth pursuing. It is frustrating because you have to tell your story, again to a new A person. But um, hopefully, hopefully you find the right one on the first try. Yeah. All right. Next, how do you approach a college age student who has been diagnosed with ADHD but will not accept help and wants to fix himself? And how do you help with the shame that they feel I actually entire my own personal experience real quick, I ended up when I got diagnosed, I realized, oh, there's actually nothing wrong with me, this is just how my brain is wired. So I actually felt a lot of relief, getting a diagnosis, so that I can understand the opposite experience. And it does, it can really feel like there's like something wrong with you, and that needs to be fixed. But, you know, as we talked about last night, it is it is just, you know, it's a, it's the way that your brain is, you know, it's neurotransmitters, it's not character flaws. And so I don't know if you know, approaching it from a real matter of fact, sort of factual viewpoint, that this is what's going on in your brain. And it's not necessarily like you as, as your essence, your soul, your person. What do you think?Amy McDuffie 51:16Yeah, I think that, that the education piece is so crucial. Because just having that having the understanding, knowing why that's happening, I think can really help with that piece. And in terms of, you know, addressing the shame piece, and dealing with denial, I think it's really important, you know, as, as parents, as professionals to really normalize our own struggles, and normalize the fact that everyone has challenges and struggles and things that we that we fail at. And, you know, just really, you know, trying to approach it from that perspective that, you know, this is this is what I'm dealing with, and that, you know, we all have those things. And I feel like that's a really important part in conjunction with the education piece.Hannah Choi 52:11Yeah, yep. Showing that empathy. And, and, and acknowledging their, their feelings and not denying them those feelings. And, yeah, yeah, it is hard, though. Yeah. What's what what I feel like is that, that, eventually, people who are feeling that way will hopefully feel, see the superpowers see the benefits of it, and are and are able to shift their perspective from something like wrong with them something that needs to be fixed to something like, oh, how can I leverage the, you know, the, the actual, like, really great things about this? And, you know, it does take a lot of work? Not, you know, it's definitely not easy, but I think that a shift in mindset can can help as well. Absolutely. Just wanted that therapy piece and executive function coaching thing coming.Amy McDuffie 53:05Right. Right. And I think also, you know, if it's possible, you know, to connect them with someone who has ADHD and has, you know, worked on some strategies and, you know, is able to share their perspective, I think that can be really helpful as well, because so many people are diagnosed with it, and, you know, are very successful. So I think that's a helpful piece, too.Hannah Choi 53:31Yep. Absolutely. And that we are seeing much less of a stigma around it, and people are more open to talking about it. And so hopefully, they are, you know, your your kid kiddos are able to connect with other people, I think, yeah, that's a really good point that you brought up, Amy. Thank you. All right. So next one. All right. Let's switch to an adult perspective. If you work in an office job, where you stare at computers all day, how can one unplug and not lose motivation to do other stuff? I feel like I can't separate myself from my electronics and I procrastinate on other things I need to do. That's a really I think this challenge for anybody right, regardless of your diagnosis. Yes. Especially in this day and age, this is you are absolutely not the first person to ask this question. I think many of our adult clients are saying yes, yes. Amy McDuffie 54:33Yeah. I agree with you there. Yes, absolutely. Because we do spend so much time, you know, staring at our screens, whether it's work or anything else, I think it's really helpful to you know, to actually schedule time away from the computer away from the screen, and, you know, whatever that looks like, whether you're actually in an office or working from home, but you know, scheduling that time and committing to sticking to it. I also think it's really helpful to enlist support, you know, whether from a family member or a friend, you know, to help you commit to that, whether it's, you're able to go for a walk, or whatever the thing is, where you're breaking away from it, you know, having support can be really motivating.Hannah Choi 55:25I have an adult client that I work with currently, and he is dealing with this exact same challenge at work. And he is lucky that he has an office so he is able to shut his door. So what he does is he schedules work time on his calendar, so he looks busy, so that people, you know, interrupt him less, and then he also shuts his office door. If you don't have an office door to shut, you can have, you could even put up a sign like I'm busy working, putting on headphones is a nice visual cue to other people that you are busy. And then the phone, the phone is a big one, they've done studies and they have found that we are I think 30% less effective. Just having our phone on our desk, even if it's flipped over and silenced, we are less productive. So I really encourage you to put your phone, like you know, leave your phone in your I don't know, on your friend's desk or your co workers desk or in your work bag or something. So it's really, really out of the way out of you know, the temptation zone. That can you really help if you feel like you can't put it away or you can't for some reason, maybe you need to be on call for a sick child or you have some other commitment where you really need to be connected to your phone. They do have apps that can help you with focus. So there's don't My favorite one is Focus Dog, which there's like a dog that makes doughnuts while you're focusing. We talked about that one before. There's also there's also Forest and you know, all those other focusing apps - the Flora flora. Yeah, those are both really like pre pretty ones. Right? So, if you want the tasty donuts get Focus Dog, Pretty one get Flora Forest or, or Flora. Those are some tools that you can use if you if you can't physically move your phone away from your Yeah, your workspace.Amy McDuffie 57:31Yeah, that's, that's great to know, to Hannah about the productivity. I need to I need to work on that.Hannah Choi 57:39Yeah, it's and I've actually asked my, a lot of my college clients, I challenged them to not have their phone with them when they're working. And they all begrudgingly admit that yes, they were more productive when their phone wasn't. So yes. But yeah, it is it is a powerful distractor having that there. SoAmy McDuffie 58:01yeah, definitely. Yeah.Hannah Choi 58:03All right. So let's see. Here's some more though is two more that will combine any tips for college freshmen with ADHD? What may be some good routines to practice over the summer? Great question. And then how do I help my teen who was diagnosed last month with ADHD? Learn some strategies to make things easier on them during the summer? While the pressure of school is off? Yeah, that's a great question. Yeah. Amy McDuffie 58:32Yes, are so great. And I, I love the thoughtfulness behind that. And, you know, taking advantage of summer time being, you know, a low stakes situation without the pressure school. And I really think it's a great time to work on things like organizational skills, whether it's your physical space to get that set up, you know, before school starts, or, you know, working on, you know, learning to use a planner or a Calendar, Google Calendar. This is something that I actually work on with my kids during the summer. You know, in terms of, you know, Google Calendar, and you know, helping them manage whether my daughter is dog sitting or babysitting, she uses like a physical wall calendar as well. So you know, whatever the organizational system is, that's going to be helpful just to get in the habit of using that. I feel like it's really important over the summer. What about you?Hannah Choi 59:29Yeah, yes, I'm working on that right now with a client where I'm encouraging them to. I joke and say, you have to change your relationship with your planner, you have to move beyond just holding hands. And so yeah, so I'm really encouraging them to write everything down in their calendar. And it's like you said, it's such a low stakes time. So even when they're going to hang out with friends, I encourage them to put it in their calendar. So they can just get in the habit of making the calendar event, you know, and then maybe even sharing it with their friends with their friends can also have it on their calendar, just to be a little bit of a role model and also have some built in some accountability. So, that's is such a great time to practice it.Amy McDuffie 1:00:20One of my clients, we actually started this summer, working on a schedule for laundry.Hannah Choi 1:00:27Because there's so many executive function skills. Yes, yes. And cooking, too.Amy McDuffie 1:00:33It's a good one, too. But yeah, so you know, even things like, you know, working on, you know, managing your chores, or, you know, setting up a plan to manage your laundry can be really hard to work on in the summertime. Yeah, so with one of my clients was laundry, like, we literally, you know, worked on making a schedule and a plan for the week of, you know, when to tackle laundry, and, you know, even down to, you know, pulling in some habit stacking that in the morning, right after the shower, we're going to start laundry and, and go from there. And it was really effective. And I think that's such a helpful thing to focus on in the summertime,Hannah Choi 1:01:16Especially for kids who are heading off to college. And we've, you know, we've talked about that, before, it's come up on a couple conversations on the podcast anyway, it's such a huge, huge thing. And there's so many executive function skills out there. Yeah. And also cooking to cooking is a really great way to practice executive function skills of planning and prioritizing and organization, and time management. And it, there's so many involved in there. And then also, they're learning the valuable skill of how to cook right is so important as you prepare to leave to leave the nest. Yeah, though. Yeah, absolutely. You're right. It is, it's such like a great low stakes environment to practice those things. And they, and they really, and you don't need to practice them in an academic way. You know, like the examples that we just gave have nothing to do with academics. But, and that's what's so cool about executive function coaching is how transferable all of the skills that our clients learn, like, like our student clients, learn, you know, strategies to support their academics, but all of those strategies are transferable to, you know, their daily life activities. It's pretty cool.Amy McDuffie 1:02:36Yeah, absolutely. And it's, it's so valuable, too, because, you know, just thinking about things like laundry and cooking, I mean, those are skills, you you have to have your entire life unless, you know, you're in a situation where someone does that for you have to learn to manage those things. And I think back and I wish that someone had like, either really kind of worked on those things with me in a more direct way. I mean, I figured them out, as we do. Yeah, right. Right. You know, it really does just make me aware of the value of, you know, really directly teaching the skills and the systems that you can apply across the board.Hannah Choi 1:03:19And what is so great about that is that you can directly teach your kids those, those executive function skills without them even realizing that they're learning. So, you know, if you sat down and very, very formally said, now, we should work on time management, and, you know, like prioritizing, they're gonna roll their eyes and say, No, thank you. But, you know, just don't mention them and they're gonna learn them just accidentally.Amy McDuffie 1:03:48Exactly, exactly. There's so many ways to naturally weave that in. Yes, yeah. If we, if we formally approach it with our own kids, I feel like at that point, like, they're, they're no longer listening. Yeah.Hannah Choi 1:04:01That's right. It's like when they're little and you would like, I don't know, you'd like hide the spinach and something tasty. Like, if you tell them there's spinach in here, they're gonna like, I'm not gonna eat that. decided in there. They don't know. Exactly, exactly. Sorry, kids. Parenting is all about tricking you.Amy McDuffie 1:04:23It's actually it's not manipulation. It's education. Hannah Choi 1:04:28That's right, disguised as a brownie or laundry. Amy McDuffie 1:04:32You'll think this later.Hannah Choi 1:04:34And you'll do the same to yours if you have them. Thanks again for joining me, Amy, such a pleasure.Amy McDuffie 1:04:41Absolutely. Hannah. This was great. Thank you so much.Hannah Choi 1:04:45And that is our show for today. Thank you so much for taking time out of your day to listen, I hope you learned something new about ADHD or maybe you just found a new view of it. It truly can be a superpower with the right interventions. tools and strategies. As I mentioned before, if you want to watch the entire webinar, you can find the link to it in the show notes. I also included some links to the slides that we shared during the webinar. I hope you join me at our next webinar. You can find more about our upcoming events by signing up for beyond book smarts monthly newsletter, the monthly think, or by checking the Events page in the resources section of our website. If you know anyone who might want to learn more about ADHD, please share this episode with them. You can reach out to me at podcast at beyond booksmart.com and also you can subscribe to Focus Forward on Apple and Google podcasts, Spotify or wherever else you get your podcasts. And as always, if you listen on Apple podcasts or Spotify, you can give us a boost by giving us a five star rating. We would love it. Sign up for our newsletter at beyond booksmart.com/podcast will let you know when new episodes drop and we'll share information related to the topic. Thanks for listening

Podcast Notes Playlist: Latest Episodes
Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects

Podcast Notes Playlist: Latest Episodes

Play Episode Listen Later May 31, 2023 122:11


Huberman Lab Key Takeaways Check Out the Huberman Lab Podcast Episode Page & Show NotesCan't get enough of Andrew Huberman? Check out our member only collection packed with Huberman's greatest tipsRead the full notes @ podcastnotes.orgIn this episode, I explain how medications such as Adderall, Ritalin, Vyvanse and other stimulants work to increase focus and treat attention-deficit/hyperactivity disorder (ADHD). I explain the brain circuits involved in focus and the key roles dopamine and norepinephrine play in their regulation. Then I explain how stimulants such as Adderall and Vyvanse can increase focus and reduce hyperactivity in kids or adults with ADHD, and how and why Ritalin and other medications (e.g., Modafinil, Guanfacine) may work better for some. I explain the long-term effects of ADHD medications on height, cardiovascular health, hormones, predisposition to addiction and psychosis, and whether these treatments can be used and then stopped. I also discuss the immense individual variation in dosage sensitivity for these medications and the negative side-effects that occur from recreational use. This episode ought to benefit anyone with ADHD, their parents, those on ADHD medications or anyone curious about how these medications work. For the full show notes, visit hubermanlab.com. Thank you to our sponsors AG1: https://athleticgreens.com/huberman Maui Nui Venison: https://mauinuivenison.com/huberman ROKA: https://roka.com/huberman HVMN: https://hvmn.com/huberman InsideTracker: https://insidetracker.com/huberman Momentous: https://www.livemomentous.com/huberman The Brain Body Contract https://hubermanlab.com/tour Timestamps (00:00:00) Stimulants & Attention-Deficient/Hyperactivity Disorder (ADHD) (00:03:21) Sponsors: Maui Nui, ROKA, HVMN (00:06:35) The Brain-Body Contract (00:07:22) Attention, Prefrontal Cortex & ADHD (00:16:27) Stimulants “Sympathomimetics” (00:21:29) Adderall, Dopamine & Norepinephrine (00:25:58) Sympathomimetics, Dopamine & Norepinephrine (00:31:05) Sponsor: AG1 (00:32:20) Vyvanse is Timed-Release D-Amp (00:36:36) Ritalin, Concerta (00:40:10) Dopamine & “Noise Reduction”; Norepinephrine & “Signal Amplification” (00:45:28) ADHD: Focus, Hyperactivity & Impulsivity; Drug Selection & Dose (00:50:57) How do Stimulants ‘Calm' ADHD? (00:54:480 Neuroplasticity & Neuromodulators (00:58:06) Kids, ADHD Diagnosis & Treatment; Predispose Addiction? (01:04:02) Sponsor: InsideTracker (01:05:12) ADHD Medications: Individuality, Doses, Tapering & Long-Term Use (01:13:28) Medication & Long-Term Effects: Height, Cardiovascular Risk, Alcohol (01:19:32) Cortisol & Hormones (01:27:45) Psychosis & Addiction; Methamphetamine (01:38:20) Recreational Use, Addiction & Psychosis; Habituation (01:42:30) Drug Holidays; Ritalin & Long-Term Effects (01:45:35) Modafinil, Armodafinil; Side-Effects (01:53:03) Guanfacine, Alcohol (01:58:03) ADHD Medications (02:00:26) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Social Media, Neural Network Newsletter Title Card Photo Credit: Mike Blabac Disclaimer

Huberman Lab
Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects

Huberman Lab

Play Episode Listen Later May 29, 2023 122:11


In this episode, I explain how medications such as Adderall, Ritalin, Vyvanse and other stimulants work to increase focus and treat attention-deficit/hyperactivity disorder (ADHD). I explain the brain circuits involved in focus and the key roles dopamine and norepinephrine play in their regulation. Then I explain how stimulants such as Adderall and Vyvanse can increase focus and reduce hyperactivity in kids or adults with ADHD, and how and why Ritalin and other medications (e.g., Modafinil, Guanfacine) may work better for some. I explain the long-term effects of ADHD medications on height, cardiovascular health, hormones, predisposition to addiction and psychosis, and whether these treatments can be used and then stopped. I also discuss the immense individual variation in dosage sensitivity for these medications and the negative side-effects that occur from recreational use. This episode ought to benefit anyone with ADHD, their parents, those on ADHD medications or anyone curious about how these medications work. For the full show notes, visit hubermanlab.com. Thank you to our sponsors AG1: https://athleticgreens.com/huberman Maui Nui Venison: https://mauinuivenison.com/huberman ROKA: https://roka.com/huberman HVMN: https://hvmn.com/huberman InsideTracker: https://insidetracker.com/huberman Momentous: https://www.livemomentous.com/huberman The Brain Body Contract https://hubermanlab.com/tour Timestamps (00:00:00) Stimulants & Attention-Deficient/Hyperactivity Disorder (ADHD) (00:03:21) Sponsors: Maui Nui, ROKA, HVMN (00:06:35) The Brain-Body Contract (00:07:22) Attention, Prefrontal Cortex & ADHD (00:16:27) Stimulants “Sympathomimetics” (00:21:29) Adderall, Dopamine & Norepinephrine (00:25:58) Sympathomimetics, Dopamine & Norepinephrine (00:31:05) Sponsor: AG1 (00:32:20) Vyvanse is Timed-Release D-Amp (00:36:36) Ritalin, Concerta (00:40:10) Dopamine & “Noise Reduction”; Norepinephrine & “Signal Amplification” (00:45:28) ADHD: Focus, Hyperactivity & Impulsivity; Drug Selection & Dose (00:50:57) How do Stimulants ‘Calm' ADHD? (00:54:480 Neuroplasticity & Neuromodulators (00:58:06) Kids, ADHD Diagnosis & Treatment; Predispose Addiction? (01:04:02) Sponsor: InsideTracker (01:05:12) ADHD Medications: Individuality, Doses, Tapering & Long-Term Use (01:13:28) Medication & Long-Term Effects: Height, Cardiovascular Risk, Alcohol (01:19:32) Cortisol & Hormones (01:27:45) Psychosis & Addiction; Methamphetamine (01:38:20) Recreational Use, Addiction & Psychosis; Habituation (01:42:30) Drug Holidays; Ritalin & Long-Term Effects (01:45:35) Modafinil, Armodafinil; Side-Effects (01:53:03) Guanfacine, Alcohol (01:58:03) ADHD Medications (02:00:26) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous, Social Media, Neural Network Newsletter Title Card Photo Credit: Mike Blabac Disclaimer

A Dopamine Kick (Another ADHD Podcast)
2. EVERYDAY ADHD - Paul's Story (Taking Concerta for ADHD)

A Dopamine Kick (Another ADHD Podcast)

Play Episode Listen Later May 2, 2023 59:09


Everyday ADHD is a bonus episode featuring a collection of lived ADHD experiences from some of our listeners.  We know that having ADHD can make you feel alone, broken and different. Our aim is to amplify the voices of our community so that you can find solidarity in our shared experiences. In our second episode we sit down with Paul where we discuss Paul's amazing success after taking his ADHD medication, how sleep apnea lead to him eventually getting an ADHD diagnosis, anxiety, dopamine, binge eating and loads more. This was such a great conversation. Thank you Paul!Episode ResourcesApp: Google KeepApp: TickTick To Do listBook: The Checklist ManifestoWe release new episodes EVERY SUNDAY EVENINGOur Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

Your Anxiety Toolkit
Sexual Side Effects of Anxiety Medication (& Antidepressants) | Ep. 332

Your Anxiety Toolkit

Play Episode Listen Later Apr 14, 2023 35:34


Hello and welcome back everybody. We are on Week 3 of the Sexual Health and Anxiety Series. At first, we talked with the amazing Lauren Fogel Mersy about sexual anxiety or sexual performance anxiety. And then last week, I went into depth about really understanding arousal and anxiety, how certain things will increase arousal, certain things will decrease it, and teaching you how to get to know what is what so that you can have a rich, intimate, fulfilling life.  We are now on Week 3. I have to admit, this is an episode that I so have wanted to do for quite a while, mainly because I get asked these questions so often and I actually don't know the answers. It's actually out of my scope. In clinical terms, we call it “out of my scope of practice,” meaning the topic we're talking about today is out of my skill set. It's out of my pay grade. It's out of my level of training.  What we're talking about this week is the sexual side effects of antidepressants or anxiety medications, the common ones that people have when they are anxious or depressed. Now, as I said to you, this is a medical topic, one in which I am not trained to talk about, so I invited Dr. Sepehr Aziz onto the episode, and he does such a beautiful job, a respectful, kind, compassionate approach to addressing sexual side effects of anxiety medication, sexual side effects of depression medication. It's just beautiful. It's just so beautiful. I feel like I want to almost hand this episode off to every patient when I first start treating them, because I think so often when we're either on medication or we're considering medication, this is a really common concern, one in which people often aren't game to discuss. So, here we are. I'm actually going to leave it right to the doctor, leave it to the pro to talk all about sexual side effects and what you can do, and how you may discuss this with your medical provider. Let's do it. Kimberley: Welcome. I have been wanting to do this interview for so long. I am so excited to have with us Dr. Sepehr Aziz. Thank you so much for being here with us today. Dr. Aziz: Thanks for having me. Kimberley: Okay. I have so many questions we're going to get through as much as we can. Before we get started, just tell us a little about you and your background, and tell us what you want to tell us. Dr. Aziz: Sure. Again, I'm Dr. Sepehr Aziz. I go by “Shepherd,” so you can go ahead and call me Shep if you'd like. I'm a psychiatrist. I'm board certified in general adult psychiatry as well as child and adolescent psychiatry by the American Board of Psychiatry and Neurology. I completed medical school and did my residency in UMass where they originally developed mindfulness-based CBT and MBSR. And then I completed my Child and Adolescent training at UCSF. I've been working since then at USC as a Clinical Assistant Professor of Psychiatry there. I see a lot of OCD patients. I do specialize in anxiety disorders and ADHD as well. Kimberley: Which is why you're the perfect person for this job today. Dr. Aziz: Thank you.  WHAT ARE THE BEST MEDICATIONS FOR PEOPLE WITH ANXIETY & OCD (IN GENERAL)? Kimberley: I thank you so much for being here. I want to get straight into the big questions that I get asked so regularly and I don't feel qualified to answer myself. What are the best medications for people with anxiety and OCD? Is there a general go-to? Can you give me some explanation on that? Dr. Aziz: As part of my practice, I first and foremost always try to let patients know that the best treatment is always a combination of therapy as well as medications. It's really important to pursue therapy because medications can treat things and they can make it easier to tolerate your anxiety, but ultimately, in order to have sustained change, you really want to have therapy as well. Now, the first-line medications for anxiety and OCD are the same, and that's SSRIs or selective serotonin reuptake inhibitors. SNRIs, which are selective norepinephrine reuptake inhibitors, also work generally, but the best research that we have in the literature is on SSRIs, and that's why they're usually preferred first. There are other medications that also might work, but these are usually first-line, as we call it. There are no specific SSRIs that might work better. We've tried some head-to-head trials sometimes, but there's no one medication that works better than others. It's just tailored depending on the patient and the different side effects of the medication. SSRI'S VS ANTIDEPRESSANTS DEFINITION Kimberley: Right. Just so people are clear in SSRI, a lot of people, and I notice, use the term antidepressant. Are they synonymous or are they different? Dr. Aziz: Originally, they were called antidepressants when they first were released because that was the indication. There was an epidemic of depression and we were really badly looking for medications that would work. Started out with tricyclic antidepressants and then we had MAOIs, and then eventually, we developed SSRIs. These all fall under antidepressant treatments. However, later on, we realized that they work very well for anxiety in addition to depression. Actually, in my opinion, they work better for anxiety than they do for depression. I generally shy away from referring to them as antidepressants just to reduce the stigma around them a little bit and also to be more accurate in the way that I talk about them. But yes, they're synonymous, you could say.  BEST MEDICATION FOR DEPRESSION Kimberley: Sure. Thank you for clearing that up because that's a question I often get. I know I led you in a direction away but you answered. What is the best medication for people with depression then? Is it those SSRIs or would you go-- Dr. Aziz: Again, these are first-line medications, which means it's the first medication we would try if we're starting medication, which is SSRIs. Other medications might also work like SNRIs again. For depression specifically, there are medications called serotonin modulators that are also effective such as vortioxetine or nefazodone, or vilazodone. But SSRIs are generally what people reach for first just because they've been around for a long time, they're available generic, they work, and there's no evidence that the newer medications or modulators work better. They're usually first line. Kimberley: Fantastic. Now you brought up the term “generic” and I think that that's an important topic because the cost of therapy is high. A lot of people may be wondering, is the generic as good as the non-generic options? Dr. Aziz: It really depends on the medication and it also depends on which country you're in. In the US, we have pretty strict laws as to how closely a generic has to be to a regular medication, a brand name medication, and there's a margin of error that they allow. The margin of error for generics is, I believe, a little bit higher than for the brand name. However, most of the time, it's pretty close. For something like Lexapro, I usually don't have any pressure on myself to prescribe the brand name over the generic. For something like other medications we use in psychiatry that might have a specific way that the brand name is released, a non-anxiety example is Concerta, which is for ADHD. This medication uses an osmotic release mechanism and that's proprietary. They license it out to one generic company, but that license is expiring. All those patients who are on that generic in the next month or two are going to notice a difference in the way that the medication is released. Unless you're a physician privy to that information, you might not even know that that's going to happen. That's where you see a big change. Otherwise, for most of the antidepressants, I haven't noticed a big difference between generic and brand names.   Kimberley: Right. Super helpful. Now you mentioned it depends on the person. How might one decide or who does decide what medication they would go on? Dr. Aziz: It's really something that needs to be discussed between the person and their psychiatrist. There are a number of variables that go into that, such as what's worked in a family member in the past, because there are genetic factors in hepatic metabolism and things like that that give us some clue as to what might work. Or sometimes if I have a patient with co-occurring ADHD and I know they're going to be missing their medications a lot, I'm more likely to prescribe them Prozac because it has a longer half-life, so it'll last longer. If they miss a dose or two, it's not as big of a deal. If I have a patient who's very nervous about getting off of the medication when they get pregnant, I would avoid Prozac because it has a long half-life and it would take longer to come off of the medication. Some medications like Prozac and Zoloft are more likely to cause insomnia or agitation in younger people, so I'll take that into consideration. Some medications have a higher likelihood of causing weight loss versus weight gain. These are all things that would take into consideration in order to tailor it to the specific patient. Kimberley: Right. I think that's been my experience too. They will usually ask, do you have a sibling or a parent that tried a certain medication, and was that helpful? I love that question. I think it informs a lot of decisions. We're here really. The main goal of today is really to talk about one particular set of side effects, which is the sexual side effects of medication. In fact, I think most commonly with clients of mine, that tends to be the first thing they're afraid of having to happen. How common are sexual side effects? Is it in fact all hype or is it something that is actually a concern? How would you explain the prevalence of the side effects? Dr. Aziz: This is a really important topic, I just want to say, because it is something that I feel is neglected when patients are talking to physicians, and that's just because it can be uncomfortable to talk about these things sometimes, both for physicians and for patients. Oftentimes, it's avoided almost. But because of that, we don't know for sure exactly what the incidence rate is. The literature on this and the research on this is not very accurate for a number of reasons. There are limitations. The range is somewhere between 15 to 80% and the best estimate is about 50%. But I don't even like saying that because it really depends on age, gender, what other co-occurring disorders they have such as depression. Unipolar depression can also cause sexual dysfunction. They don't always take that into account in these studies. A lot of the studies don't ask baseline sexual function before asking if there's dysfunction after starting a medication, so it's hard to tell. What I can say for sure, and this is what I tell my patients, is that this sexual dysfunction is the number one reason why people stop taking the medication, because of adverse effects.  WHAT MEDICATIONS ARE MORE PRONE TO SEXUAL SIDE EFFECTS?  Kimberley: Right. It's interesting you say that we actually don't know, and it is true. I've had clients say having anxiety has sexual side effects too, having depression has sexual side effects too, and they're weighing the pros and cons of going on medication comparative to when you're depressed, you may not have any sexual drive as well. Are some medications more prone to these sexual side effects? Does that help inform your decision on what you prescribe because of certain meds? Dr. Aziz: Yeah. I mean, the SSRIs specifically are the ones that are most likely to cause sexual side effects. Technically, it's the tricyclics, but no one really prescribes those in high doses anymore. It's very rare. They're the number one. But in terms of the more commonly prescribed antidepressants and anti-anxiety medications among the SSRIs and the SNRIs and the things like bupropion and the serotonin modulators we talked about, the SSRIs are most likely to cause sexual dysfunction. Kimberley: Right. Forgive me for my lack of knowledge here, I just want to make sure I'm understanding this. What about the medications like Xanax and the more panic-related medications? Is that underneath this category? Can you just explain that to me? Dr. Aziz: I don't usually include those in this category. Those medications work for anxiety technically, but in current standard practice, we don't start them as an initial medication for anxiety disorders because there's a physical dependency that can occur and then it becomes hard to come off of the medication. They're used more for panic as an episodic abortive medication when someone is in the middle of a panic attack, or in certain cases of anxiety that's not responding well to more conventional treatment, we'll start it. We'll start it on top of or instead of those medications. They can cause sexual side effects, but it's not the same and it's much less likely.  SEXUAL SIDE EFFECTS OF MEDICATION FOR MEN VS WOMEN  Kimberley: Okay. Very helpful. Is it the same? I know you said we don't have a lot of data, and I think that's true because of the stigma around reporting sexual side effects, or even just talking about sex in general. Do we have any data on whether it impacts men more than women? Dr. Aziz: The data shows that women report more sexual side effects, but we believe that's because women are more likely to be treated with SSRIs. When we're looking at the per capita, we don't have good numbers in terms of that. In my own practice, I'd say it's pretty equal. I feel like men might complain about it more, but again, I'm a man and so it might just be a comfort thing of reporting it to me versus not reporting. Although I try to be good about asking before and after I start medication, which is very important to do. But again, it doesn't happen all the time. Kimberley: Yeah, it's interesting, isn't it? Because from my experience as a clinician, not a psychiatrist, and this is very anecdotal, I've heard men because of not the stigma, but the pressure to have a full erection and to be very hard, that there's a certain masculinity that's very much vulnerable when they have sexual side effects—I've heard that to be very distressing. In my experience. I've had women be really disappointed in the sexual side effects, but I didn't feel that... I mean, that's not really entirely true because I think there's shame on both ends. Do you notice that the expectations on gender impacts how much people report or the distress that they have about the sexual side effects?  Dr. Aziz: Definitely. I think, like you said, men feel more shame when it comes to sexual side effects. For women, it's more annoyance. We haven't really talked about what the sexual side effects are, but that also differs between the sexes. Something that's the same between sexes, it takes longer to achieve orgasm or climax. In some cases, you can't. For men, it can cause erectile dysfunction or low libido. For women, it can also cause low libido or lack of lubrication, which can also lead to pain on penetration or pain when you're having sex. These are differences between the sexes that can cause different reporting and different feelings, really. Kimberley: Right. That's interesting that it's showing up in that. It really sounds like it impacts all the areas of sexual playfulness and sexual activity, the arousal, the lubrication. That's true for men too, by the sounds of it. Is that correct?  Dr. Aziz: Yeah.  Kimberley: We've already done one episode about the sexual performance anxiety, and I'm sure it probably adds to performance anxiety when that's not going well as well, correct? Dr. Aziz: It's interesting because in my practice, when I identify that someone is having sexual performance anxiety or I feel like somebody, especially people with anxiety disorders, if I feel like they have vulvodynia, which means pain on penetration—if I see they have vulvodynia and I feel that this is because of the anxiety, oftentimes the SSRI might improve that and cause greater satisfaction from sex. It's a double-edged sword here. COMMON SEXUAL SIDE EFFECTS OF ANTIDEPRESSANTS Kimberley: Yeah. Can you tell me a little more about What symptoms are they having? The pain? What was it called again? Dr. Aziz: Vulvodynia. Kimberley: Is that for men and women? Just for women, I'm assuming. Dr. Aziz: Just from vulva, it is referring to the outside of the female genitalia. Especially when you have a lack of lubrication or sometimes the muscles, everyone with anxiety knows sometimes you have muscle tension and there are a lot of complex muscles in the pelvic floor. Sometimes this can cause pain when you're having sex. There are different ways to address that, but SSRIs sometimes can improve that.  Kimberley: Wow. It can improve it, and sometimes it can create a side effect as well, and it's just a matter of trial and error, would you say? Dr. Aziz: It's a delicate balance because these side effects are also dose-dependent. It's not like black or white. I start someone on 5 milligrams, which is a child's dose of Lexapro. Either they have sexual side effects or don't. They might not have it on 5, and then they might have it a little bit on 10, and then they get to 20 and they're like, “Doctor, I can't have orgasms anymore.” We try to find the balance between improving the anxiety and avoiding side effects. SEXUAL SIDE EFFECTS TREATMENT Kimberley: You're going right into the big question, which is, when someone does have side effects, is it the first line of response to look at the dose? Or how would you handle a case if someone came to you first and said, “I'm having sexual side effects, what can we do?”  Dr. Aziz: Again, I'm really thorough personally. Before I even seem to start a medication, I'll ask about libido and erectile dysfunction and ability to climax and things like that, so I have a baseline. That's important when you are thinking about making a change to someone's medications. The other thing that's important is, is the medication working for them? If they haven't seen a big difference since they started the medication, I might change the medication. If they've seen an improvement, now there's a pressure on me to keep the medication on because it's working and helping. I might augment it with a second medication that'll help reverse the sexual side effects or I might think about reducing the dose a little bit while maintaining somewhere in the therapeutic zone of doses or I might recommend, and I always recommend non-pharmacological ways of addressing sexual side effects. You always do that at baseline. Kimberley: What would that be? Dr. Aziz: There's watchful waiting. Sometimes if you just wait and give it some time, these symptoms can get better. I'm a little more active than that. I'll say it's not just waiting, but it's waiting and practicing, whether that's solo practice or with your partner. Sometimes planning sex helps, especially if you have low libido. There's something about the anticipation that can make someone more excited. The use of different aids for sex such as toys, vibrators, or pornography, whether that's pornographic novels or imagery, can sometimes help with the libido issues and also improve satisfaction for both partners. The other thing which doesn't have great research, but there is a small research study on this, and not a lot of people know about this, but if you exercise about an hour before sex, you're more likely to achieve climax. This was specifically studied in people with SSRI-related anorgasmia. Kimberley: Interesting. I'm assuming too, like lubricants, oils, and things like that as well, or? Dr. Aziz: For lubrication issues, yes. Lubricants, oils, and again, you really have to give people psychoeducation on which ones they have to use, which ones they have to avoid, which ones interact with condoms, and which ones don't. But you would recommend those as well. Kimberley: Is it a normal practice to also refer for sex therapy? If the medication is helping their symptoms, depression, anxiety, OCD, would you ever refer to sex therapy to help with that? Is that a standard practice or is that for specific diagnoses, like you said, with the pain around the vulva and so forth? Dr. Aziz: Absolutely. A lot of the things I just talked about are part of sex therapy and they're part of the sexual education that you would receive when you go to a sex therapist. I happen to be comfortable talking about these things, and I've experienced talking about it. When I write my notes, that would fall under me doing therapy. But a lot of psychiatrists would refer to a sex therapist. Hopefully, there are some in the town nearby where someone is. It's sometimes hard to find someone that specializes in that. Kimberley: Is there some pushback with that? I mean, I know when I've had patients and they're having some sexual dysfunction and they do have some pushback that they feel a lot of shame around using vibrators or toys. Do you notice a more willingness to try that because they want to stay on the meds? Or is it still very difficult for them to consider trying these additional things? Are they more likely to just say, “No, the meds are the problem, I want to go off the medication”? Dr. Aziz: It really depends on the patient. In my population that I see, I work at USC on campus, so I only see university students in my USC practice. My age group is like 18 to 40. Generally, people are pretty receptive. Obviously, it's very delicate to speak to some people who have undergone sexual trauma in the past. Again, since I'm a man, sometimes speaking to a woman who's had sexual trauma can be triggering. It's a very delicate way that you have to speak and sometimes there's some pushback or resistance. It can really be bad for the patient because they're having a problem and they're uncomfortable talking about it. There might be a shortage of female psychiatrists for me to refer to. We see that. There's also a portion of the population that's just generally uncomfortable with this, especially people who are more religious might be uncomfortable talking about this and you have to approach that from a certain angle. I happen to also be specialized in cultural psychiatry, so I deal with these things a lot, approaching things from a very specific cultural approach, culturally informative approach. Definitely, you see resistance in many populations. Kimberley: I think that that's so true. One thing I want to ask you, which I probably should have asked you before, is what would you say to the person who wants to try meds but is afraid of the potential of side effects? Is there a certain spiel or way in which you educate them to help them understand the risks or the benefits? How do you go about that for those who there's no sexual side effects, they're just afraid of the possibility? Dr. Aziz: As part of my practice, I give as much informed consent to my patients as I can. I let them know what might happen and how that's going to look afterwards. Once it happens, what would we do about it if it happened? A lot of times, especially patients with anxiety, you catastrophize and you feel this fear of some potential bad thing happening, and you never go past that. You never ask yourself, okay, well now let's imagine that happens. What happens next? I tell my patients, “Yeah, you might have sexual dysfunction, but if that happens, we can reduce the medications or stop them and they'll go away.” I also have to tell my patients that if they search the internet, there are many people who have sexual side effects, which didn't go away, and who are very upset about it. This is something that is talked about on Reddit, on Twitter. When my patients go to Dr. Google and do their research, they often get really scared. “Doctor, what if this happens and it doesn't go away?” I always try to explain to them, I have hundreds of patients that I've treated with these medications. In my practice, that's never happened. As far as I know from the literature, there are no studies that show that there are permanent dysfunctions sexually because of SSRIs.  Now, like I said, the research is not complete, but everything that I've read has been anecdotal. My feeling is that if you address these things in the beginning and you're diligent in asking about the side effects of baseline sexual function beforehand and you are comfortable talking with your patients about it, you can avoid this completely. That's been my experience. When I explain that to my patients, they feel like I have their back, like they're protected, like I'm not just going to let them fall through the cracks. That has worked for me very well. Kimberley: Right. It sounds like you give them some hope too, that this can be a positive experience, that this could be a great next step. Dr. Aziz: Yeah, absolutely. Kimberley: Thank you for bringing up Dr. Google, because referring to Reddit for anything psychologically related is not a great idea, I will say. Definitely, when it comes to medications, I think another thing that I see a lot that's interesting on social media is I often will get dozens of questions saying, “I heard such and such works. Have your clients taken this medication? I heard this medication doesn't work. What's your experience?” Or if I've told them about my own personal experience, they want to know all about it because that will help inform their decision. Would you agree, do not get your information from social media or online at all? Dr. Aziz: I have patients who come to me and they're like, “My friend took Lexapro and said it was the worst thing in the world, and it may or not feel any emotions.” I'm explaining to them, I literally have hundreds of patients, hundreds that I prescribe this to, and I go up and down on the dose. I talk to them about their intimate lives all day. But for some reason, and it makes sense, the word of their friend or someone close to them, really, carries a lot of weight. Also, I don't want to discount Reddit either, because I feel like it's as a support system and as a support group. I find other people who have gone through what you've gone through. It's very strong. Even pages like-- I don't want to say the page, but there's a page that's against psychiatry, and I peruse this page a lot because I have my own qualms about psychiatry sometimes. I know the pharmaceutical companies have a certain pressure on themselves financially, and I know hospitals have a certain pressure on themselves. I get it. I go on the page and there's a lot of people who have been hurt in the past, and it's useful for patients to see other people who share that feeling and to get support. But at the same time, it's important to find providers that you can trust and to have strong critical thinking skills, and be able to advocate for yourself while still listening to somebody who might have more information than you. Kimberley: I'm so grateful you mentioned that. I do think that that is true. I think it's also what I try to remember when I am online. The people who haven't had a bad experience aren't posting on Reddit. They're out having a great time because it helped, the medication helped them, and they just want to move on. I really respect those who have a bad experience. They feel the need to educate. But I don't think it's that 50% who gave a great experience are on Reddit either. Would you agree? Dr. Aziz: Right. Yeah. The people who are having great outcomes are not creating a Reddit page to go talk about it, right? Kimberley: Yeah. Thank you so much for answering all my questions. Is there a general message that you want to give? Maybe it's even saying it once over on something you've said before. What would be your final message for people who are listening? WHEN SSRIs IMPACTS YOUR SEX LIFE: ADVICE FROM DR AZIZ Dr. Aziz: I just want to say that when SSRI's impact your sex life, it's really important for psychiatry, and especially in therapy, that you feel comfortable sharing your experiences in that room. It should be a safe space where you feel comfortable talking about your feelings at home and what's going on in your intimate life and how things are affecting you. Your feelings, positive or negative towards your therapist or your psychiatrist, whether things they said made you uncomfortable, whether you feel they're avoiding something, that room should be a safe space for you to be as open as possible. When you are as open as possible, that's when you're going to get the best care because your provider, especially in mental health, needs to know the whole picture of what's going on in your life. Oftentimes, we are just as uncomfortable as you. And so, again, a lot of providers might avoid it because they're afraid of offending you by asking about your orgasms. As a patient, you take the initiative and you bring it up. It's going to improve your care. Try not to be afraid of bringing these things up. If you do feel uncomfortable for any reason, always let your provider know.  I always tell my patients, I have a therapist. I pay a lot of money to see my therapist, and sometimes I tell him things I hate about him. He's a great therapist. He's psychoanalytic. Every time I bring something up, he brings it back to something about my dad. He's way older than me. But he's a great therapist. Every time I've brought something like that up, it's been a breakthrough for me because that feeling means something. That would be my main message to everyone listening. Kimberley: Thank you. I'm so grateful for your time and your expertise. Really, thank you. Can you tell us where people can get in touch with you, seek out your services, read more about you? Dr. Aziz: Sure. I work for OCD SoCal. I'm on the executive board, and that's the main way I like to communicate with people who see me on programs like this. You can always email me at S, like my first name, Aziz, that's A-Z-I-Z, @OCDSoCal.org. If you're a USC student, you can call Student Health and request to see me at the PBHS clinic. That's the Psychiatry and Behavioral Health Services clinic on campus at USC. Kimberley: They're lucky to have you. Dr. Aziz: Thank you. Kimberley: Yes. I love that you're there. Thank you so much for all of your expertise. I am so grateful. This has been so helpful.

A Dopamine Kick (Another ADHD Podcast)
65. Starting Dexamfetamine for ADHD (A Personal Review)

A Dopamine Kick (Another ADHD Podcast)

Play Episode Listen Later Feb 26, 2023 24:46


In this episode we discuss starting on ADHD medication Dexamfetamine. If you are a regular listener, you'll probably familiar with Shell's ADHD medication journey so far, and although she has not had much success on the previous medications that she's tried Shell is hoping dexamfetamine is the one that makes a difference. It's Shell's second week on dexamfetamine, so we explore how she's been feeling, all positives, the negatives and what the overall experience on Dex has been like so far We'll update you on Shell's journey in future episodes as time goes on . See you next week for another episode of shenanigan and ramblings! * If your wanting to know what it feels like on other ADHD medications, please check out our other episodes on Vyvanse and Concerta. This is a personal  medication review, not everyone will react to medication the same, so if you have any concerns about the current medication you are taking please talk to you prescriber.Dexamfetamine is a medication that belongs to the class of central nervous system stimulants. It is similar in structure and effects to dextroamphetamine, and is also used primarily to treat attention deficit hyperactivity disorder (ADHD) Dexamfetamine works by increasing the levels of certain neurotransmitters in the brain, such as dopamine and norepinephrine, which help to regulate attention and other ADHD symptoms.Episode resourcesThis website has loads of information on what to take to your GP should you be in the process of needing to see someone about ADHDhttps://www.adhdadult.uk/List of symptoms, diagnostic criteria for ADHD and further information:https://www.qandadhd.com/diagnostic-criteriaIf you identify with 5 symptoms on each list often, it may be something you want to speak to your doctor about.We upload a new episode every Sunday evening.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

A Dopamine Kick (Another ADHD Podcast)
60. Taking Concerta 27mg and 36mg for ADHD (A Personal Review)

A Dopamine Kick (Another ADHD Podcast)

Play Episode Listen Later Jan 22, 2023 35:38


This week we're talking more about Shell's favourite topic! Medication!!!!We dive deep into Shell restarting Concerta, how it made her feel, what positive effects she had, what negative side effects she experienced and ultimately why she has decided to stop taking Concerta for good!We also waffle on about the absolute drama that happened at a recent Seed talk we attended, and Sparky gives us an update on how his NHS ADHD referral and  overall journey is going so far, which to be honest can only be be summed up so far in one word 'disastrous!'Please keep in mind this is a personal medication review about Concerta and doesn't  necessarily mean this is how the medication would make you feel. Everybody responds to all medications differently. If you are experiencing any of the side effects Shell mentioned in this episode speak to your health care provider. Episode resourcesCheck out the website below to find useful linkshttps://www.adhdadult.uk/List of symptoms, diagnostic criteria for ADHD and further information:https://www.qandadhd.com/diagnostic-criteriaIf you identify with 5 symptoms on each list often, it may be something you want to speak to your doctor about.See you next week for another episode of shenanigans!We upload a new episode every Sunday evening.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

Focus Forward: An Executive Function Podcast
Ep 18: Flipping the ADHD Narrative: How "The Disruptors" is Changing the Way We Talk About ADHD (ft. Nancy Armstrong)

Focus Forward: An Executive Function Podcast

Play Episode Listen Later Jan 18, 2023 35:00


Through a series of fortunate events, I was connected with Nancy Armstrong, who is the Emmy-nominated Executive Producer of "The Disruptors," the first comprehensive documentary about attention deficit hyperactivity disorder (ADHD) and its effect on kids, adults, and their families. I had the pleasure of sitting down with Nancy to have a conversation about her experience raising her own children who have ADHD and why she wanted to create a comprehensive film to help dispel the myths around ADHD and show the world that ADHD is about so much more than deficits.When you view the film, you may notice a star-studded cast of actors and other talented individuals. Astronaut Scott Kelly, musician Will.i.am, Paris Hilton, and more share the challenges and successes of living with ADHD. The film also features Dr. Ned Hallowell, a renowned ADHD expert and New York Times best-selling author, who's helped lead the charge on ADHD awareness for decades. If you're listening before January 26, 2023, you can watch The Disruptors for free! (Info in the show notes) Show Notes:Learn more about “The Disruptors”Watch “The Disruptors” for free! Use code TDB-BBS. Available from 1/19/23 - 1/26/23. If you're reading this after January 26th, 2023, click here to find out how to watch.Learn more about Nancy ArmstrongDownload our free ADHD success kitContact us!Reach out to us at podcast@beyondbooksmart.comIG/FB/TikTok @beyondbooksmartcoachingTranscriptHannah Choi 00:04Hi everyone and welcome to Focus Forward, an executive function Podcast where we explore the challenges and celebrate the wins you'll experience as you change your life by working on improving your executive function skills. I'm your host, Hannah Choi. Hannah Choi 00:20Through a series of fortunate events, I was connected with Nancy Armstrong, who is the Emmy-nominated executive producer of a documentary film called The Disruptors. This film is all about attention deficit hyperactivity disorder, or ADHD, and how it can affect kids, adults and their families. I got to sit down with Nancy and have a conversation about her experience raising her own children who have ADHD, and about why she wanted to do something to help people learn about it, dispel myths about it and show the world that ADHD is about so much more than deficits, even though the name might make you think otherwise. When you view the film, you'll see a star studded cast of actors and other talented individuals. Astronaut Scott Kelly, musician will.i.am, Paris Hilton, and more share the challenges and successes of living with ADHD. Ned Hallowell, a renowned ADHD expert and author shares both his expertise on ADHD and also his personal experience living with it. Even though these people are all famous, their stories are presented in a way that is just so relatable and real to the rest of us. Gosh, you guys, this documentary is really special. Even before I talked with Nancy, I could tell that it was made with the love and attention a topic like this deserves and just hadn't been given yet. Our Podcast Producer, Sean Potts, says he deeply wishes that he had had the opportunity to watch this when he was younger. That film is powerful message is that yes, having ADHD creates challenges and frustration for people. But ADHD is much more than those challenges and frustrations. Many of the very good things in our world are here because of people with ADHD, who had the creativity, the curiosity and the energy to create them. Watching the film. And hearing this message throughout, it reminded me so much of the clients that I've worked with, who have ADHD, and who have created systems to manage the challenges and work to discover the positive sides. So I am so proud and happy to share Nancy's work with you. And I hope you get a chance to watch after listening to our conversation today. And guess what? If you're listening before January 26, 2023, go to the show notes and click on the link to register for access to view The Disruptors for free. There's a code that you'll need to enter to watch. So make sure you get that you can find that listed in the show notes too. If you're listening after January 26. Keep listening to the episode to hear Nancy share where you can find the film or just look in the show notes for those links. Okay, here we go. Hannah Choi 03:19Hi, Nancy. Thanks so much for joining me today. My thanks for having me. Could you introduce yourself to our listeners?Nancy Armstrong 03:26Sure. I'm Nancy Armstrong. I'm the executive producer of the disruptors.Hannah Choi 03:30I just want to tell all of our listeners that you should absolutely watch this documentary, it was just excellent. It made me laugh. It made me smile. It brought tears to my eyes. And it just made me feel so much hope for people with ADHD and their parents. So thank you for for making it.Nancy Armstrong 03:50Thank you for saying that. That means the world to me.Hannah Choi 03:52Oh, good. So tell me the story of how did you end up being the executive producer of an ADHD documentary? Nancy Armstrong 04:00Well, I have three children with ADHD. And my son was definitely my firstborn. And the most challenging. We sort of figured out very early on something unusual was going on with him. We couldn't figure out what it was. He seemed normal, but also incredibly active to the point of us getting kicked out of Mommy and Me class at when he was a toddler. So there were a bunch of signs in the beginning, and we couldn't quite figure out what it was. And then finally, at age eight, he was diagnosed after going through a round of tests, he was diagnosed with ADHD. And that was great that we understood it finally, but that was kind of the beginning of our journey, learning how to manage it, learning how to treat it. Also in that same office, my husband raised his hand and said I have all those symptoms. And the doctor said well, it's genetic. So that was the beginning of our journey and and it was just incredibly difficult going through the K through 12 system and also I had this idea that well, my husband has it. And he was very successful. He had all of the challenges of ADHD. But he also had some pretty impressive, impressive strengths that I didn't even tie to ADHD until I met Ned Hallowell, and talked to him about my son. And he also met my husband, Tim. And he said, Well, you know, all those strings are ADHD too. And we just kind of went, what that's there, everything is tied together. So that was the beginning. And I thought, Man, there should be a documentary on this. And so for 10 years, I waited for someone to make this documentary, and they never made it. And so finally, in 2018, I quit my job and decided to make the film because I knew it could help so many people, not only in this country, but around the world. And that we finally had to reframe ADHD from this deficit disorder model, to something that is two sides of a coin, on the one hand challenges but on the other hand, incredible strengths. And if you can maximize those, it can be a huge asset.Hannah Choi 06:00I really loved how, how Ned in in the documentary talked about how, like, let's look at the challenges and then flip them over and see what the what the positive of all of those challenges are. And, and I really loved how he worded that I love him. He's so great. Yeah.Nancy Armstrong 06:19Symptoms, you know, it's like every, for every symptom, that is an impediment. Distractibility, impulsivity and hyperactivity, you know, with Ned's analysis is you flip each one of those on its head, and you get a positive. And if you can learn to accelerate those positives, then the negatives will be less prominent, you'll you'll be motivated to be on time to get organized and to do all those things, because you'll want to accelerate your gifts.Hannah Choi 06:48Yes, yes, absolutely. And I see that a lot in the clients that I work with as, as an executive function coach, not not all of my clients have ADHD, but the ones that that do, I do notice that when they start to figure that out, they are much more motivated to start using tools and strategies, because they're excited about all these other things that I that I can take advantage of and make happen, it becomes maybe easier to do that. And then it's more, it's less challenging and more rewarding.Nancy Armstrong 07:18Yeah, and the more the world understands it that way, rather than looking at a child with ADHD and saying, Oh, you're disorganized, your homeworks not turned in, you're late, you know, all the all of these challenges to be to be addressed in a different way of, Oh, you're very curious, you're very creative, you have a lot of ideas, you have boundless energy, and to sort of approach it that way, and will work on your challenges is much more positive way to go through your formative years, and I think can make a huge difference in outcomes.Hannah Choi 07:49Absolutely. And with that confidence, it bringing that confidence piece in if you can not look at it, like from a deficit viewpoint, then that confident you're able to build that confidence back and, and or maybe not build it back, but just build it. And, and then, and then they can go so much farther with that. Yeah, I really like how, how it was addressed in the documentary that unfortunately, it ADHD is named, it brings up the deficit within the name, which is a shame, it's too bad to can't be named something else with the positive in there instead.Nancy Armstrong 08:26And we haven't figured that out yet. Yeah, I really tried. Why the will, I am said, Ada. I have my friend Kenny Dichter, who's in the film calls it a 10 Attention Deficit advantage, but really, it's not an it's a deficit of attention. It's really an abundance of attention going in too many directions. So the name is, you know, not only trivializes the diagnosis, but it's also kind of incorrect.Hannah Choi 08:51Yeah, I feel like it kind of has, its what typical society, the systems within the society needs, it needs you to in order to function smoothly and properly, it needs you to be able to focus with the appropriate amount on one thing at a time. And so it's it's harder to fit into that system that's, that's built. My family and I were talking about it about it yesterday, and we were saying, and one of my clients said this, too, he you know, he said people with ADHD, and I think it came up with the the son of the boy who likes to go fishing. I can't remember his injuries, maybe a Hogan. Yeah. You know, he, like he they were saying like if he didn't he wasn't living in today's world, then it wouldn't have been a problem. It would have been like a really great benefit. Because and that's what my clients said. He's like, if you're out in the, you know, in the bush, you want someone with ADHD because they're going to notice everything, and they're going to be able to pay attention.Nancy Armstrong 09:54Well, that's why people with ADHD are more suited to certain kinds of careers, you know? With high stimulation, so firefighters, ER doctors, you know, newsroom producers, they need environments with a ton of stimulation. It doesn't stress them out, like it might stress out a neurotypical person, it turns them on. So we tried to get as many people in the film in those kinds of careers, you know that we have many, many, well known people from different walks of life, that have used ADHD to their advantage while still managing the downsides. And they all talked about how tough it was going through school growing up. But then they've kind of turned that corner and realized what they were good at. And we're able to accelerate that into an incredible career.Hannah Choi 10:42Yeah, I love the variety of people that you had, how did you connect well, with all of them? Nancy Armstrong 10:46Some of them we knew. As soon as we got, you know, Hall of Fame astronaut, Scott Kelly on board, you know, everyone wants to be part of that group. So it was extremely helpful when he said yes, and will.i.am said yes right away. So that was incredible and a lot of people. Honestly, Howie Mandel just said, I think it's important. I think this is an important film. So I was surprised at how many people said yes, but I think it was because they knew what the mission of the film was. And they want to reframe ADHD once and for all, and because the world has it wrong, and we need to get it right.Hannah Choi 11:22 Yes, yes, I agree. I interviewed Bob Shea, who's a children's author who has ADHD. And he felt the same way. He was really happy to talk about his challenges. He was diagnosed as an adult, he was really happy to talk about his challenges, because he is for the same reason. Yeah. So did creating the documentary change anything for ADHD, about ADHD? For you, I mean, your experience change? Nancy Armstrong 11:46Well, I think it's funny. First of all, I will say the experiences are all universal. And that was really surprising to me that as we interviewed all of these families, it was the same story of our family. So it is interesting, it's a real community and the same story of all the public personalities that spoke so everyone has had this sort of shared universal experience that they don't know, it feels very isolating, like, you're the only one going through it. And you're the only one having this experience. But it's actually very universal among 10% of the population. So you're not alone. But also how difficult it is, even when you know, what it is and how it works and what you can do to help you still, as a parent, fall down every once in a while, and there's a lot of parental guilt. You know, in fact, while I was in the middle of making the film, my 16 year old daughter said to me, "You're making a film on this, and you still don't get it". And I thought, Oh, interesting. Wow, every day, and I'll still say, the dumb thing of like, What do you mean you missed 10 homework assignments, you didn't turn it? What are you doing, like, you know, it's not intentional, it's just, that's what happens. And you have to put systems in place to help them and, you know, try to avoid situations like that, but they're going to happen, that's just the nature of growing up with ADHD.Hannah Choi 13:04And, and that brings back the how important it is for parents and people to learn about ADHD so that they can recognize maybe something is going on, that their child could get help with earlier than later. The the story of Zara really just broke my heart, my heart went out to her mother, she, she's seems like it was really painful for her to remember back to before she knew that her daughter had ADHD. And just thinking, you know, there's so many families out there that are going through or have gone through that.Nancy Armstrong 13:37Oh, yeah, the story is so relatable. I mean, people have told me they watch the film, and they cry through the whole thing. Which is, means it's hitting a nerve, a very universal corner, particularly of parental guilt. And same things I should say, because these kids will really push you to the brink of your sanity and patience. Because there really, there's a relentlessness about so many kids with ADHD that is hard to parent. But I think it's so healing for parents to watch the film. And so healing for kids to watch the film to know that it's not just them. And this is the way your brain is wired. And it's okay. It will be challenging growing up, but you can harness it and make a great life for yourself.Hannah Choi 14:20 Yeah, it's yeah, it's beautiful. It really is a beautiful message in there. And you brought up the brain. I love that you had an explanation of the brain and how that works. And I've noticed in my work with people, when they find out how their brain works and how their brain causes them to do or not do things really, really helps. It really helps to just understand and feel better about it.Nancy Armstrong 14:44I thought it was important to show the brain science behind this because there is so much confusion, particularly this myth that ADHD doesn't exist. So I wanted to blow right through that with the brain science showing exactly how the brain works. Where ADHD is, you know In the brain, and you know how it's working in the brain, and also to show if people decide to use stimulant medication as one of the tools, what that's actually doing in the brain and how for people with ADHD, if there's no high that they get, it only calms them down. I mean, that's a critical thing to understand is that people with ADHD takes stimulant medication, there's no euphoria, it just brings them there, their dopamine is here, and it brings it to here. You know, with a person who is not ADHD, they're no normal dopamine level then shoots up. That's why they're getting a high because they're having something unnaturally high in their brain. So that's important to understand. And I understand there's, you know, there's an Adderall shortage, it probably it's either supply chain, or it has to do with the fact that too many doctors, regular doctors, like primary care physicians, or pediatricians are just writing prescriptions for pushy parents of kids who haven't been properly diagnosed. And that's a problem we need to solve. But that has no relationship to people who have been diagnosed properly with ADHD and need that medication because it's making a huge difference in helping them live a better life.Hannah Choi 16:13Yeah, and that's another reason why understanding that brain science is so important to help people understand that the medication is not you know, like how the medication works. Once you understand how it works, it's a lot easier to understand why someone would take it because it really does sound like quite contradictory. Why would I give stimulant medication to someone who already has a lot of energy? So but when you understand how the brain works, then it makes sense. Yeah. So in addition to that, which what are some key takeaways that you feel are really important for parents to and parents and educators? Right, and just people in the world that interact with other people that might have ADHD? What can they take away from your film?Nancy Armstrong 16:56Well, one of the messages of the film is if we could just help people understand in broader society, that these are imaginative, creative beings, that just need a little more support to get on the right track. And I'm talking mostly about children who really struggle because, you know, the very nature of a sort of assembly line, rote approach to education is anathema to the ADHD brain. So if you have children in your class that are late that are not turning in homework, it might make sense to investigate what's going on, rather than just writing them off as a bad kid. Maybe this is a child with ADHD, maybe the parents, no, maybe they don't. But as soon as you understand those children in your class that have ADHD, you can approach them differently. And there's a relationship that can happen between a teacher and a child that makes a world of difference. If the teacher writes the child off, the child knows, and they give up, and there's, that's the end of that, that's the end of eighth grade science. That's it. Or if the child can have understanding from the teacher, if the teacher can say, Okay, I know you have ADHD, so I know these things are going to be difficult for you. But these things are going to be easier for you. So let's make sure we're focusing on your strengths and some of your challenges. And that's a that creates a relationship. And, you know, I remember my son had a Spanish teacher freshman year in high school, who was so determined for him to succeed. He just said, I know you can do it, I know you can do it. And my son felt sort of an obligation to that teacher, to prove him not prove him wrong, you know, so the teachers can have an incredibly positive impact on children. And I think to empower teachers with that knowledge is a huge takeaway. And then I think for parents, you also have an incredible responsibility and ability to have such a positive impact on your child, if you can control your response to them, which is incredibly difficult day in and day out. Everyday is Groundhog Day, what we just talked about yesterday is now happening again today, as if yesterday never happened. So it does require Herculean patience, and that's a good thing to develop in life anyway for an adult way. But, you know, just love your child, even when they're, you know, really behaving badly is to just love them through those moments. You'll feel like a better person, you'll feel like a superstar person if you can do that. And your child will fare so much better under those circumstances. So I think that the the message is like parents are kind of the childhood cure for ADHD because without parents by your side fighting for you advocating for you, loving you, it's really hard to get through.Hannah Choi 19:39And I love that that message came through really strongly with the families that you interviewed the parents. You could tell they they just love their children so much and just we're trying so hard to to help them and and their hearts are just breaking for them. It was it was very moving. It was very, very moving to watch that. Nancy Armstrong 20:01Oh, thank you. And I see that in school, we do screenings, we've done screenings all over the country. And the parents, we do q&a, usually afterwards. And parents cry through that q&a. I mean, it's the same pain. It's so universal. And you know, it's interesting, they're doing, I just read, they're doing a screening in Ireland, they, so there's a screening in Ireland, and they're doing a q&a Afterward, I won't be there. But it's just amazing that all over the world, the screenings are happening, and people are having this new conversation about ADHD and, and finding community, which I think is so important. I've never had one public conversation about it, until I made the film. And, you know, the film was like a forum for those conversations.Hannah Choi 20:44Yeah, yeah. Well, I mean, that's, that is exactly why I'm doing this conversation. This, that's exactly why I'm doing this podcast is to have more of these conversations. And hopefully, even just one person hears the conversation and recognizes that it's okay to talk about and that it's helpful to talk about it. And it's helpful to find the community and, and, actually, that's something that that that you guys brought up in the documentary was how important it is to try to reach people because there are services and there are support supports and information and knowledge and, you know, family support and child support and medication support. But helping people learn about that and get access to that is, is the hard part. And so thank you for doing the work that you're doing and why I do what I do. Nancy Armstrong 21:36So, yeah, yeah, that's another thing that's really concerns me is that there, there's a dearth of ADHD experts in the country and around the world. So one of the things I think we really need to do is have more training for primary care physicians, more training for pediatricians, because they don't have the requisite amount of training to really deal with this. And they're going to have to because there won't, in the absence of experts, it will fall to them. And we saw in the film, you know, Bear's pediatrician told his mother to cut Concerta in half. And Concerta is a time release medication. So you can't cut time release medication in half. Bear was given a whole day's worth of, of a methylphenidate because of cutting that in one shot because of cutting that medication in half. So that's unacceptable, you know, primary care physicians prescribing this medication need to know how to prescribe it, and how to tell parents to use it because they don't know it's up to the doctors, and they're obviously under trained.Hannah Choi 22:43Yeah. And Bear's mom was, you know, had the, the, the knowledge that there was someone else she could ask that she, you know, could get more information, but not everybody realizes that a lot of people, you know, have the experience, you know, where they, they either don't trust the doctor, so they don't look for more help. Or they, they just take the doctors word for it. And they don't realize like, oh, you can ask for more you can if it doesn't feel right, you can look for help elsewhere.Nancy Armstrong 23:14So I'm glad, or if one medication doesn't work, and that is a painful process is that trial and error process. If one doesn't work, there's another one that might and, you know, good for her for sticking it out and finding I think it was focalin that finally, like, just gave bare target symptom relief with no side effects. And he, you know, his life just got so much better because he was happier. You know, no child wants to be disruptive in class. They're not doing it on purpose. Their brains are wired differently. And they're telling them to move when they're supposed to sit still. They're telling them to speak when they're supposed to be quiet. So getting that support is incredibly valuable to child because children just want to go to school every day and fit in. It's like going to school every day where everyone has blue paint, and you show up with yellow paint. It's a horrible feeling. I mean, you know, my son now is 21. But he just recalls how despairing he was how bereft he was at having that experience every day and how hopeless it made him feel. Even though we were on top of it, even though we were supporting him. It's still like they're going there for eight hours a day. And if they feel that they're out of step the entire time. That's got to be a terrible feeling.Hannah Choi 24:29Yeah, and that early, early, early experience of that, you know, all those experiences that we have, create those connections in our brains and then to unlearn those feelings about yourself and to unlearn the your expectations of how people are going to react to you. And that's that is a lifelong process. I mean, regardless of your if whether you have ADHD or not like the things that happen to us as children, you know, it's stuff we have to deal with for the rest of our lives. Nancy Armstrong 25:00They make lasting, you know, they make indelible marks on your psyche. And, you know, the other thing with kids is because they miss social cues because they're a little out of step socially. They get bullied, kids with ADHD are bullied two times more than kids without ADHD, and more than half of kids with ADHD are bullied. And that is a terrible thing to have to overcome, you know, and leaves lasting damage. And so even though I was a parent who was pretty on top of it, I mean, it was very unpopular in my town, because just golf parents up, I mean, I was pretty relentless. Trying to stop it, and you know, why would stop one and another one would pop up. But, you know, it's still it still leaves a lasting mark on their emotional development.Hannah Choi 25:46Yeah. And that brings up the importance of, of, you know, reaching out if, and getting therapy and therapy to help develop strategies to get you through your day, but also therapy to help, you know, with those emotions that come along with, like, not fitting in to, to what society expects people to, to act like. I imagined that that's really helpful. I was glad that you guys address that in the document in the documentary, and coaching as well. Is that Nancy Armstrong 26:16Yeah, very important. I mean, there's a toolbox of things that can really help manage ADHD. And I don't think the film doesn't advocate for any one of them. More specifically, it's really a multi pronged approach that is, is, you know, the best prescription for managing ADHD.Hannah Choi 26:33Yeah, absolutely. So, as an executive function, coach, I'm, you know, always curious about how you have challenges affect different people, what areas of executive function challenge you?Nancy Armstrong 26:46Well, I don't have ADHD, I think I grew up with it, I think I'm one of there's like, 25, there's 25%, or 30% of people who have symptoms in childhood, but outgrow them when their brain reaches full maturity. And my brain didn't really reach full maturity until I was 30. So that's kind of another sign of ADHD or we lag behind. But my husband definitely still has it, both the positives and the negatives. And, as do my children, and I think the biggest one for adults, that is, details. It's those details and time management and, you know, those kinds of things. So I'm a compulsive list maker, you know, which is probably my way of overcompensating for, you know, the challenges I had in my, you know, childhood and 20s. Super organized now, like psychotically, organized basically swung the pendulum from total disorganization to militant organization. So I'm probably more regimented now as a as a reaction to being so unregimented.Hannah Choi 27:55Yeah, right. Right.Nancy Armstrong 27:57It's a coping. It's a coping skill.Hannah Choi 27:59Yeah, absolutely. I, I have a terrible my working memory is, is pretty atrocious. And so I am like, crazy about writing things down and making lists and resetting reminders. And it's still forget things here and there. But yeah, I think you have to, you kind of have to go to the other side. And with that comes, that comes with maturity, right? As we get older, we can recognize the value of doing those things. And it's harder when you're little. But I loved how the kids started to say it, like, especially Zara, she mentioned that she realized that, that working a little harder and try and doing different things to make things better for herself, really, really paying off in the long run, which I loved.Nancy Armstrong 28:40And, I think for adults, too. We had an adult female in the film, and I think it was really great to see how it affects an adult's life. You know, I think a lot of adults weren't diagnosed as children and then figure it out when they have children. Because otherwise I wouldn't figure it out. You know, if you're, if your children are, it's kind of when your kids get diagnosed, that you go, "Oh, that's exactly me, too". You know, my mother, I think had a pretty serious case of ADHD. We never understood what it was. And I think she felt bad about it for so much of her life, not knowing exactly why she was the way she was, but knowing she was different. And it was, you know, just it was what it was. So I think it's super helpful for people who think they may have ADHD. And it's to the degree to which it's really causing impairment in your life. Everyone forgets who he is, and, you know, forgets things every once in a while, but it's the degree to which it becomes untenable in your life and starts to really interfere with being successful.Hannah Choi 29:37Right? Yeah, I used to work at an office for students with disabilities at a community college. And so often, like our kids would come in to get tested for learning disabilities, or they would go to an outside source to get tested for ADHD. And their parents who would always come in or call or somebody say, oh, my gosh, I realize now that that's me, like I I finally have an explanation for why I have had challenges in my life. And so, yeah, it's it's wonderful to see adults figuring that out. Nancy Armstrong 30:07Yeah, I think it's a huge relief. Absolutely. You know, you know, as Eliza said, In the film, before she found out, you know, she, where she was diagnosed, she just thought she was terrible at adulthood. Yeah. And that's, you know, it's heartbreaking, very successful. She's very successful entrepreneur, but, you know, keeping all the details and time management and all those things were really a challenge for her but big picture thinking, and, you know, creating things she was great at.Hannah Choi 30:36Yeah, yeah, one of my clients. He's an adult who actually has graduated from coaching, but he was diagnosed at 33. And he's the same way, you know, just really great at the big, the big picture and harder with the details. And, and he said, it just explained everything for him in his life. And now he's just doing so great. And he, it's really wonderful to see the progress that he's made, figuring out how his brain works, and what works and what doesn't so. So is there anything else that you want to mention? Nancy Armstrong 31:17I want to tell people where to find the film. You can find the film on iTunes, Apple TV, Google Play YouTube, Amazon Prime and Vudu.Hannah Choi 31:26Yeah, I've watched it on Amazon.Nancy Armstrong 31:28We can screen it at your schools. You know, I think we, we need to get this film in schools.Hannah Choi 31:35Absolutely. Yes, I will put all the information in the show notes for how they can find out more about screenings, and about the film itself, and the important message that it's sharing with everybody. Really appreciate it. Is there anything else that you're working on? Is this inspired you to do something else?Nancy Armstrong 31:59Right now I'm focusing on promoting the film. Whenever we, you know, reach the tipping point. It's not we're not there yet. So I want it to be ubiquitous. And I think it will be a sort of an evergreen film. I mean, we have the world's we follow a diverse number of families and, and have all these, you know, well known people speaking in the film, so I think this will be the film. And until it's out there everywhere. My work is not done.Hannah Choi 32:27Yeah. Oh, good. Great. Yes. It's, I just tell everyone, please go watch this movie, this documentary. It's, first of all, it's just so well made. It's so easy and enjoyable to watch. Heartbreaking at times. And so uplifting and full of hope at the end, and actually not even just at the end throughout. And I just, I loved it. I loved every minute of it. So thank you for that work.Nancy Armstrong 32:55Oh, well, I made the film with Atlas films. Director is Stephanie Soechtig and another producer, Kristen Lazar, and they are brilliant documentary filmmakers. And they've done, you know, a number of documentaries that have really taken a subject and turned it on its head, like, set up the Devil We Know, Under the Gun. So I was extremely excited when they said yes to working with me on this. And I think the film is is good as it is, in large part because of working with them. Hannah Choi 33:24Well, thank you so much, Nancy, for joining me today and sharing about your film and for continuing to do the work that you're doing to help people understand ADHD and understand people with ADHD it's so important to so thank you for doing it.Nancy Armstrong 33:38Oh, thank you so much for having me. I really appreciate it.Hannah Choi 33:43And that's our show for today. Be sure to check out the show notes for links to learn more about The Disruptors. And as I mentioned before, beyond booksmart is offering free access to view the film through January 26 2023. So I really hope you get to take advantage of that. Thank you for taking time out of your day to listen, I hope you found my conversation with Nancy inspiring, and that you get a chance to view the film. As Nancy aims to do with The Disruptors. We here at focus forward. I also hope to help as many people as we can with each episode. So please share our podcast with your colleagues and your friends and your family. You can subscribe to focus forward on Apple and Google podcasts, Spotify, or wherever else you listen. And if you listen on Apple podcasts or Spotify, you can give us a boost by sharing that five star rating. Sign up for our newsletter at beyond booksmart.com/podcasts. We'll let you know when new episodes drop and we'll share information related to the topic. Thanks for listening

A Dopamine Kick (Another ADHD Podcast)
59. Prozac (Fluoxetine) for ADHD and Anxiety (A Personal Review)

A Dopamine Kick (Another ADHD Podcast)

Play Episode Listen Later Jan 15, 2023 25:41


In this episode we discuss the use of Fluoxetine (Prozac) for ADHD and Anxiety as Sparky tells us all about starting  the medication and what impact it had. Fluoxetine (Prozac) is an SSRI Anti Depressant medication prescribed for depression and anxiety based disorders. There is some emerging studies showing evidence to suggest it can help with ADHD symptoms too (although it is very small)Sparky discusses the positive effects of Fluoxetine, the side effects, how he felt whilst on the medication, if it helped with his ADHD symptoms and anxiety! Shell starts another dose of Concerta and so clearly before you know it the conversation turns into rambling on how feel about IKEA!and.... back to meds!PROZAC, CONCERTA AND IKEA!Episode resourcesCheck out the website below to find useful linkshttps://www.adhdadult.uk/List of symptoms, diagnostic criteria for ADHD and further information:https://www.qandadhd.com/diagnostic-criteriaIf you identify with 5 symptoms on each list often, it may be something you want to speak to your doctor about.See you next week for another episode of shenanigans!We upload a new episode every Sunday evening.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

A Dopamine Kick (Another ADHD Podcast)
53. Starting on ADHD Medication Concerta. (Concerta vs Elvanse/Vyvanse)

A Dopamine Kick (Another ADHD Podcast)

Play Episode Listen Later Dec 4, 2022 32:18 Transcription Available


This week were discussing the ADHD medication Concerta. It's Shell's first week on Concerta so Sparky takes to the mic to question Shell on how she's been feeling since starring on the medication, all positives, the negatives and what the overall experience has been like so far on Concerta.We also touch upon the differences between Concerta and Elvanse/ Vyvanse, whilst making a very surprising discovery about one of the medications.Thanks for listening to us ramble! Episode resourcesThis website has loads of information on what to take to your GP should you be in the process of needing to see someone about ADHDhttps://www.adhdadult.uk/List of symptoms, diagnostic criteria for ADHD and further information:https://www.qandadhd.com/diagnostic-criteriaIf you identify with 5 symptoms on each list often, it may be something you want to speak to your doctor about.See you next week for another episode of shenanigans! We upload a new episode every Sunday evening.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.comSupport the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

Health Is Hell
Teacher Confessions

Health Is Hell

Play Episode Listen Later Nov 14, 2022 61:40


What's it REALLY like to manage a school shooting? Are students with special needs a "lost cause?" How does under-funding actually affect students and teachers? Are celebrity children as entitled as we think? Confession: I recorded the intro you're about to hear ages ago, before receiving any submissions (NOT a usual occurrence but alas, I had taken my Concerta and was feeling extra productive). I thought I'd be curating a lighthearted inquiry into the lives of teachers, proving those authority figures we feared and revered as kids were fundamentally just humans trying to figure it all out. This episode became MUCH more than that - it's a juicy, shocking, enlightening and at times downright brutal look into the realities of educational systems in the U.S. and abroad. My intro does not accurately reflect how honored and humbled I am to help tell these stories - but it does show, as a graduate of a 'hippie' NYC private school, how much I needed to hear them. Our anonymous contributors are or were teachers in Canada, Kentucky, Los Angeles, New York City, London, Seattle, Texas, and Utah, at schools ranging from the uber-elite (think: children of world-famous athletes, musicians, and tech entrepreneurs) to Title 1 public institutions housing hundreds of refugees from Africa and Syria. They share perspectives about: -being a white teacher for a predominantly black student body -teaching students with cognitive disabilities, as well as emotionally and physically violent behavioral issues -how to manage school shootings and lockdowns -establishing authority over (and gaining respect from!) rich, entitled children -the day-to-day reality of under-funding -social climbing amongst teachers in the private school system -tempestuous parent-teacher relationships -refugee crises in the U.S. On both sides of the wealth spectrum, our teachers also have valuable insight into effective leadership, gaining a child's trust, how to shape young minds….and why middle schoolers shouldn't be allowed to wear Moncler. A piece of wisdom from a contributor: “I truly feel that students want to be heard and need to be heard, and if you are a good listener, you can encourage them to speak.” GOT A SECRET TO GET OFF YOUR CHEST? Email ali@aliweissworld.com. Degenerate MERCH is available for purchase on my Instagram - DM me! Tales of Taboo is part of the Eve Podcast Network and a Forever Dog Production. Cover art photos by Erika Flynn. Follow Ali on TikTok: https://www.tiktok.com/@aliweissworld Follow Ali on Instagram: https://www.instagram.com/aliweissworld/ Follow Tales of Taboo on TikTok: https://www.tiktok.com/@talesoftaboo Follow Tales of Taboo on Instagram: https://www.instagram.com/talesoftaboopod/ Learn more about your ad choices. Visit megaphone.fm/adchoices --- Support this podcast: https://podcasters.spotify.com/pod/show/talesoftaboo/support

MedMaster Show (Nursing Podcast: Pharmacology and Medications for Nurses and Nursing Students by NRSNG)

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/MethylphenidateConcertaNursingConsiderations    Generic Name methylphenidate Trade Name Ritalin, Concerta Indication ADHD, narcolepsy Action improves attention span in ADHD by producing CNS stimulation Therapeutic Class central nervous system stimulant Pharmacologic Class none Nursing Considerations • can cause sudden death, hypertension, palpitations, anorexia, hyperactivity, insomnia • may decrease effects of Warfarin and Phenytoin • do not use with MAOIs • monitor cardiovascular system • monitor for behavioral changes • monitor for dependence • do not consume caffeinated beverages “Drug Holiday” used to assess dependence and status

Dream Hustle with Shana Recker
Coming to Terms with my ADHD

Dream Hustle with Shana Recker

Play Episode Listen Later Sep 28, 2022 32:59


In this episode, I share an inside look at how I learned I have ADHD and what I'm doing about it. From the medications (Concerta), I'm testing, to looking back at my business and how my ADHD has affected it positively and negatively and everything in between. The past two weeks have been a journey for sure and I feel like it's just getting started. Join Shana on Instagram: https://www.instagram.com/quantumleapqueenChalene Johnson: https://www.instagram.com/chalenejohnsonWes The Barber: https://www.tiktok.com/@wes__the__barber?lang=enSupport the show

Charlottesville Community Engagement
August 16, 2022: Charlottesville extends police chief survey by one week; Safety prep continues for school year; Planning funds awarded for Three Notched Trail

Charlottesville Community Engagement

Play Episode Listen Later Aug 16, 2022 18:25


In today’s edition:As the school year approaches, Charlottesville’s Deputy City Manager gives an update on efforts to make safer routes for walking pupilsThe federal government will give $2 million to help Albemarle plan for the 25-mile long Three Notched Trail A long-time Charlottesville musical institution celebrates the century mark tonight with a free concertA member of the public housing authority’s Board of Directors has been reappointed but there’s still two vacanciesCharlottesville will extend a community survey for police chief by one more weekLots of updates from Charlottesville City Manager’s report including an update on the possibility of ranked choice voting This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit communityengagement.substack.com/subscribe

Something Shiny: ADHD!
A Conversation About ADHD Medications - Part II

Something Shiny: ADHD!

Play Episode Listen Later Mar 30, 2022 31:47


Big Ol' Disclaimer: We are not doctors or prescribers, but two therapists who have a lot of experience working with folx on/off, loving/hating, trying/not trying all types of medications and accommodations for ADHD. Please seek medical advice for all your medication questions!  Continuation of disclaimers galore: we are not giving medical advice, just our opinions. The importance of having a therapist or someone who can help you monitor medications if you are on them. Isabelle describes what it's like to be off of her ADHD medications while she's been pregnant/breastfeeding children the last couple of years (stimulant medications, see below, are often not recommended during pregnancy/breastfeeding, though other forms of meds are safe for pregnancy/breastfeeding—another reason why it's so important to have empowered conversations with your doctors, prescribers, and therapists!) It's hard when part of your accommodations is medication and that leg of your scaffold is not available. Non-medical or pharmaceutical interventions for ADHD are effective and include: diet, working out, getting adequate sleep, mindfulness activities (not all the time) but a practice during the day can help with frustration tolerance, fidget toys, finding ways to get the energy out, finding more existential interventions to get yourself excited about things instead of anxious or angry about things. David using the idea of guessing the color of the tie of the annoying dinner companions he was previously angry about having to go to—switching an annoying task to an exciting one (those meddling mendelson's with their zebra zingers!) David also mentions there are some ideas around microdosing with mushrooms, cannibis, ketamine, etc. and he's never seen them work, not that they don't, but that he doesn't even know how to begin talking about them working and is not comfortable talking about it as an expert (if you are one, email us at somethingshinypodcast@gmail.com! We'd love to have you on the show to talk more!). Also those microdosing interventions would clearly not work (and be illegal!) with kids. There are really different kinds of ADHD medications, including antidepressants like Wellbutrin (buproprion), which works on inhibiting the uptake (or increasing the quantity of) dopamine, serotonin, and norepinephrine in the brain (which works with the neurotransmitters affected by the brain difference that is ADHD). While a number of other medications can be prescribed for ADHD, David and Isabelle drill down into specifics about the stimulant meds most often prescribed for it: Ritalin and Adderall. Each of these meds have a line of meds that come from them (each med is more related to one or the other). Ritalin is more of a stimulant while Adderall is a stimulant with a mild anti-anxiety component to it. People will have sometimes have side effects to Adderall that makes them feel like there are ants running under their skin or a cold sensation, it's typically a reaction to the anti-anxiety part of the med; those folks can take the Ritalin or Wellbutrin route sometimes. David shares the story of how he was lucky and Ritalin worked for him; however, his curiosity and studies wanted him to try a newer class of meds like Focalin. He noticed 3 weeks later that it was working; he noticed it was working because he picked up a piece of paper on the floor to throw it away—on the first try! Yet three weeks later he couldn't remember his partner's face when she wasn't in the room and having intense intrusive thoughts of feeling awful and very depressed. He didn't realize it was the medication right away, but his partner helped him connect the dots and it felt better as soon as he got off of the meds. Even though he tried a different med in the Ritalin family and it should've worked for him but it didn't. David honors how if he was a kid, they would talk about how his behavior was improving, and how he was performing better on tasks, but he might not be able to vocalize his depressive thoughts and changes in recall—so important to not make someone take medication. If medication works, people with ADHD will take it (because it works). They often don't want to take it when it doesn't work. People can sometimes feel that people feel really zombie-like, or off, or not like a person—but then you see all these neurotypical-world gold stars for performance but they miss that there's a person underneath it who is experiencing it working or not working, too. It can take so much patience and tenacity to find a good fit. David and Isabelle reveal that they also specialize in working with trauma, and even specific to survivors with ADHD, it can impact what type of ADHD medication they can tolerate. Medications that come in and out of the body really quickly (like short-release stimulants) can lead to rage-filled or anxiety-filled moments when it stops and starts, because. Imagine a triangle with a lopsided or long triangle, like a duckbill—there are medications like a Vyvanz that has a much slower ramp off which tends to be more effective for trauma survivors. If you have ADHD and you're thinking about medication, try one. ADHD medications can be done in extended release (8-10 hours) or in short-release form (4-8 hours), that's roughly how long you're going to notice the effects. This means you know really quickly whether the med you are trying works for you, typically within an hour. If you're trying a new med, ask your prescriber to avoid the XR or extended release version of the medication, because you don't need a 10-12 hour experience to know if it helps (or is awful). Isabelle thinks of a metaphor or being on a rollercoaster which you know will end, versus the feeling when the rollercoaster operator walks away while you're on it. This all gets to be a complicated question around kids: do you medicate to help preserve self-esteem or do you not medicate to preserve self-esteem? Whatever the kid needs to preserve self-esteem becomes a good gauge for all this. It's really helpful for your child to be in therapy with someone who understands ADHD. A lot of kids won't want to take medication because no one else is taking medication, because they're normalized with their peers, but they also might want to take it for certain reasons; it helps to have a safe place to report how the medication feels because parents aren't trained to hear what it's like when a side effect of a medication is rearing its ugly head, for example, and professionals like therapists and psychiatrists and doctors, are trained to do. David errs on the side of going slow, having a lot of eyes on it; shame might make you want to keep this private, but it's not about shame, it's about making other people see it so the kids can feel better. Isabelle explains why she kept interrupting David and how her working memory was at capacity and she didn't want to forget what she's hearing or asking. David names that he steamrolled through Isabelle's question and that wasn't her interrupting him, that was on him. David was on a hyper focused rant, it was not interrupting, it was social conditioning that makes her feel like she did, and Isabelle loves David's hyper focus and does not find it ranty, but rather part of the passion of removing the barriers to access to this information. Isabelle struggles to remember what she wanted to ask, and David prompts Isabelle to remember by retracing what they were talking about. Isabelle wonders: how can you tell the med is working? David recommends running an experiment on yourself: start a task, (like: read a book, or spend 30 minutes cleaning a garage), with no meds. The next day, do the same task and with the meds notice: how did it feel? Did it feel different? Was it easier to start/stop? Did you find a rhythm? Were you less angry/anxious? Did you make it longer before you got distracted. It's your own experiment on yourself, to see if it's helping with the tasks you want help with. And then the next important question: how is it making you feel? You are noticing the behaviors medication is helping with rather than thinking it needs to “fix” you as a person. It's a noticing dirt in corners, sitting still disability, not a learning disability. If you're observing a loved one on medication or not—how important to not equate the behavior with trying/not trying, caring/not caring, putting in effort, etc.—but rather noticing the task and how you do it and how you managed transitions and frustration tolerance. If the medication is working, it should make you less angry. Transitions could be difficult for any age person. Knowing what you need the medication for is the most important task. For example, David does not need it for work because he loves it and is interested in it, but needs it for grocery shopping. We all need to be stewards of our own experiences and there ain't no shame in the medication game. For example, if you need the medication to be in the car for three hours to hug someone who smells weird, take the meds: what does David mean? He means everyone's family trip they don't want to take. We all have that family member or friend. And that medication may be running around the block, or shopping, or caffeine, or a puzzle. What about pregnancy/breastfeeding and ADHD meds? An episode focused on this to come! In the meantime/additionally, check out this resource.DAVID'S DEFINITIONSPsychopharmacology: The study of medicine used to alter brain states and behavior.Self-Stimulants (emotions you use to make your heart beat faster, arouse your nervous system, up your stimulation level): anger, excitement, anxiety or fear. Non-medical interventions: Besides using emotions (see self-stimulants above) or medications (see below) for working with ADHD, also know that the following things have been shown to have big impacts: diet exercise/movement getting enough sleep fidget/sensory toys existential interventions (changing something anxiety or anger-provoking to something excitement-provoking, or harnessing the self-stimulant idea above) How do you know the med is working? Start a task, (like: read a book, or spend 30 minutes cleaning a garage), with no meds. The next day, do the same task and with the meds notice: how did it feel? Did it feel different? Was it easier to start/stop? Did you find a rhythm? Were you less angry/anxious? It's your own experiment on yourself. When you have a gauge of if the med is working, you ask: how is it making you feel? The medication should make you less angry. Notice transitions and your frustration tolerance. What are some types of medications for ADHD? Non-stimulant: small chemical restraints, like a heavy blanket. Slows you down by slowing down your blood pressure. Often more effective for folx experiencing more anxiety alongside their ADHD, because it works against the anxiety. Eg. Strattera, Intuniv (Guanfacine), etc.Stimulant: You don't have to be angry to be interested, or nervous to be focused, you are just stimulated (your nervous system is stimulated with the medication). Eg. Adderall, Ritalin, Concerta, Focalin, etc.   Adderall - stimulant with a hint of anti-anxiety (in how the molecule works in the brain)  Ritalin - pure stimulant  Focalin - extended release form of Ritalin, lasts longer  Stimulants: Short-release v. Extended Release (or XR)Stimulant medications go in and out of the body relatively quickly. Some medications, like Adderall or Ritalin (or non-XR medication, XR meaning Extended Release) go in and out of the body within 4-8 hours (about how long you feel the intended effects, based on dosage and of course each person's unique metabolism). Other meds that are XR or like Focalin, have a much slower release in the body or a slower drop-off and last longer (8-10 hours). There are pros and cons—a trauma survivor, for example, may notice their flight/fight/freeze response is activated by the quick kick-in and drop-off of a short-release med and do better with a longer release med. It totally depends! One advantage is that you will know often within the hour if an ADHD medication is working or not for you. If you're trying a new med, ask your prescriber to avoid the XR or extended release version of the medication, because you don't need a 10-12 hour experience to know if it works for you or not. Antidepressant: Can be typical or atypical, and connect to changing the levels of certain neurotransmitters (mainly serotonin, as the class of drugs known as SSRI or selective serotonin reuptake inhibitors) in the brain. For example: Wellbutrin (atypical antidepressant, generic name bupropion) is off-label prescribed for ADHD, and works by inhibiting the uptake of (or increasing the quantity of) dopamine, serotonin, and norepinephrine in the brain. All of those neurotransmitters are affected by the brain difference that is ADHD. e.g. Zoloft, WellbutrinREMINDER: We are not doctors or prescribers, but two therapists who have a lot of experience working with folx on/off, loving/hating, trying/not trying all types of medications and accommodations for ADHD.  Please seek medical advice for all your medication questions!-----Cover Art by: Sol VázquezTechnical Support by: Bobby Richards

Something Shiny: ADHD!
A Conversation About ADHD Medications - Part I

Something Shiny: ADHD!

Play Episode Listen Later Mar 16, 2022 24:29


Big Ol' Disclaimer: We are not doctors or prescribers, but two therapists who have a lot of experience working with folx on/off, loving/hating, trying/not trying all types of medications and accommodations for ADHD. Please seek medical advice for all your medication questions!  Continuation of disclaimers galore: we are not giving medical advice, just our opinions. There are a lot of doctors in the world who know what medical terms actually mean and what they mean long term, we very much are aware that psychopharmacology is not our specialty, but we have a lot of experience with people trying medication. Nobody really talks about medication without being hyperbolic: it's talked about as something that saved your life or that is awful. Most people who find something really effective medication or accommodation don't talk about it everywhere. They just take the win and talk about it with their therapist. People often get the pop-psych version of what antidepressants, antipsychotics, anticonvulsants, stimulant, etc. meds are, v. How often we talk about something like insulin or blood pressure medications: they carry more shame, stigma, myths and misperceptions. ADHD is a medical condition that can have psychiatric consequences. This is something that is medically warranted but not psychiatrically warranted at all times. People think you can't go to a regular doctor and get ADHD medication, but you can: it is a neurological difference and a medical condition. Not every person with ADHD needs medication AND it's not a deficit if you have to take medication. A dilemma David experiences as a therapist is that he is hired by his clients to help wean them off of a medication; we have these thoughts around dependency and what it means to be on meds. What's strange is how differently we view medication as opposed to other accommodations; for example, no one suggests you work a program to improve your vision to remove your need for eyeglasses (if such a thing exists, barring LASIK), but it's something we do with medications. David just accepts he's wearing glasses because they're super effective. We don't talk about how effective ADHD medication is for those who want to take it. Isabelle pauses to do a real-time look up of the numbers on efficacy, it is so much more effective than it is for other psychiatric conditions because it is a medical condition (70% of adults and 70-80% of children shortly after starting treatment, per the Cleveland Clinic—see the link below; this is contrasted to a 50% efficacy for antidepressants per the National Health Service—also see link below.).  Also a way to think about how quickly you find a med that works for you, versus an antidepressant. It's important that an ADHD med can help you and not be the right medication for you. Individuals with ADHD require more stimulation to do boring, nonstimulating, low-novelty tasks, so they'll self-medicate with their own emotions, using anger, excitement, anxiety or fear—all of those make your heart beat faster, arouse your nervous system. Those emotional states are stimulants. David describes gamifying pairing his socks to make his self-stimulant through excitement rather than anger. For people who find anger or anxiety shutting them down in life, when those things get in your way, you might want to think about ADHD medication—it's not just about impacting focus, it's about the emotional consequences that come with ADHD. David reviews how non-stimulant medication (eg. Like Strattera) works like small chemical restraints, slows you down. More effective for anxiety-heavy ADHD. Stimulant medications (eg. Like Adderall and Ritalin) are more a way to stimulate your nervous system so you don't need to self-stimulate to reach that condition.  David describes that he didn't get medication until he was in undergrad or college, the before moment was: “someday I'll read a book.” And the after was “I could read a book,” this is why he's such an advocate for people finding what works for them, medication nor not, medication for David was the difference between being a C/D student to becoming an A student. The closest he ever got to as focused as he was on meds was when David convinced himself he would be homeless if he didn't finish a book in 8th grade, aside from that he didn't read. To name the abuse of stimulant meds: people can abuse any substance: you can abuse food, for example. It's important that these drugs are prescribed with therapy, so that a person starts to learn what a medication works for and what it doesn't work for. The medication doesn't change your life, you take the medication so you can change your behavior, to fix your life. It's not speed and doesn't make everyone do a lot of work; rather, it changes to give people with ADHD a more accurate appraisal of their work, but people without ADHD will appraise their work higher (while their actual performance doesn't change, it just makes you think you performed better). Because of how impacted the self-esteem is of folx with ADHD, this boost in appraisal makes it so they become more accurate when on the medication (e.g you'd normally think you're horrible at a thing, but on the medication you might recognize you are slightly above average). It reminds Isabelle of Jessie Spano in Saved by the Bell abusing caffeine pills and recognize how horrible Zack Morris was on that show (see links below if you missed this cultural moment) and how the show is essentially a symbol of toxic masculinity. Returning to caffeine—it has a very different impact on your body if you have it every day v. once in a while. If you drink it regularly, it can be a vasodilator (which helps your blood pressure) and helps you with dopamine and serotonin, v. If you have it once in a while it increases your blood pressure—why a random coffee feels so much worse than it did before. This is also why any client that tries medication often has to re-evaluate their caffeine intake. Which is why if you take ADHD meds and also have caffeine, you may turn into Jessie Spano, having a horrible day, feeling anxious and scared.Articles Mentioned:Cleveland Clinic source on ADHD med efficacyNational Health Service reference on antidepressant efficacySaved by the bell clip Isabelle is referencing — Jessie Spano “I'm so excited, I'm so scared” Zach Morris is Trash (short clip show from Funny or Die; in case you want to catch up on what led up to the moment Jessie was so scared and excited): “That time Zack Morris got Jessie Hooked on Caffeine Pills”DAVID'S DEFINITIONSPsychopharmacology: The study of medicine used to alter brain states and behavior.Self-Stimulants (emotions you use to make your heart beat faster, arouse your nervous system, up your stimulation level): anger, excitement, anxiety or fear. What are some types of medications for ADHD? Non-stimulant: small chemical restraints, like a heavy blanket. Slows you down by slowing down your blood pressure. Often more effective for folx experiencing more anxiety alongside their ADHD, because it works against the anxiety. Eg. Strattera, Intuniv (Guanfacine), etc.Stimulant: You don't have to be angry to be interested, or nervous to be focused, you are just stimulated (your nervous system is stimulated with the medication). Eg. Adderall, Ritalin, Concerta, Focalin, etc. REMINDER: We are not doctors or prescribers, but two therapists who have a lot of experience working with folx on/off, loving/hating, trying/not trying all types of medications and accommodations for ADHD.  Please seek medical advice for all your medication questions!-----Cover Art by: Sol VázquezTechnical Support by: Bobby Richards