The ADHD Doctor: How to Focus, Stop Procrastinating, Manage Your Emotions, & Feel in Control

Today on the Mel Robbins podcast, worldrenowned  ADHD doctor and psychiatrist Dr. Sasha Hamdani is. here with the six signs you may have missed your  whole life. How to focus, stop procrastinating, and finally feel [music] in control. This  is the ultimate guide to adult ADHD. [music]. Please help me welcome Dr. Hamdani to the Mel  Robbins podcast. Thank you for having me. I.

am beyond excited that you're here. I have been  wanting to do a comprehensive and eyeopening and. helpful episode about the topic of ADHD with  a medical doctor for over two years. This is. a topic that impacts me at a deeply personal  level. It impacts my children. It impacts my. husband because he has to live with me. Where I  want to start is if we take everything to heart.

that you're about to teach to us about what ADHD  is, what it isn't. Mhm. And more importantly, what to do if this is something that sounds like  you or someone that you love, what's going to. change about my life? If you're dealing with this  chronic overwhelm and it's been hard for you to. place a name to what you've been experiencing  and you've been beating yourself up for years,

I think this is going to give you the clarity  to see that number one, your brain isn't broken. This is just a different wiring. And number two,  it's going to give you the language and the tools. and the steps of where to go next so that you  can actually start navigating this condition. You said something that just struck me because  I think when you talk about the topic of ADHD. Mhm. you immediately think about attention.  Yeah. And you think about focus and maybe you.

think about like, you know, the little kid who  can't sit still. Yeah. But you said overwhelm. Yeah. And beating yourself up. Yeah. Could  you speak a little bit to the emotional side. of what we're going to talk about and what might  change based on what you're about to teach us, how much time you got, cuz I feel like that is the  a huge overlooked part of ADHD. I think ADHD at. its base, first of all, I hate the name ADHD.  I think it's stupid. So, Dr. Hamdani, what is.

ADHD? Yeah. So ADHD is a neurodedevelopmental  condition which stands for attention deficit. hyperactivity disorder. I think ADHD at its base  is a regulation issue. Yes, attention is part of. it. Difficulty regulating attention, but also  difficulty regulating motivation, difficulty. regulating energy, difficulty regulating emotion,  that's a huge one. Difficulty regulating sleep,

difficulty regulating appetite. And anybody with  ADHD has felt this. And if I'm speaking to you, these are things that you've probably experienced,  too. Because it's not as simple as, well, I don't, you know, it's hard to stay on task today. It's  okay. I am so overwhelmed and I have beaten myself. up about this and now I feel paralyzed with this  guilt and shame and this overlay of this emotional.

component. And I think unless we really really get  on top of this and start looking at the emotional. regulation part of ADHD, we're never going to  fully encapsulate the full picture. I'm looking. at our executive producer, Tracy, who I've worked  with for 10 years, and I'm smiling at you, Tracy, because I cancelled two days of taping last week  because I found myself in this state where the.

word I was using is I am so overwhelmed right now  and I feel so flooded with emotion. I don't even. feel like myself. I can't function right now. But  I didn't think that was related to ADHD. It feels. very affirming to hear that. Well, actually the  wild swing of emotion, Mel, is a core part of how.

ADHD can present because it's not just an issue of  your ability to direct your attention. It's also. your inability to process emotion in a way that  is somewhat modulated. It goes in wild swings. Mhm. And because if you truly are somebody that  has this condition, you have always lived with. wild swings. I don't even know what it's like to  regulate your emotions. Like what what does that.

even mean in your world, Dr. Hamdani? What does  regulate mean? Because if you do have ADHD or. you love somebody who does, yeah, we're having  a completely different experience of life than. somebody who goes through life without an ADHD  brain and body. For sure. For sure. And I think. when you when you drill down and actually look at  what regulation is, right? Like for mood, right?

If this is kind of normal baseline and this is  down in the depths of depression and this is like. so happy and elevated, right? People generally  they they have a normal eb and flow that can. happen situationally with ADHD. It can feel like  ups and downs and ups and downs and it's usually. coupled with anxiety and productivity issues and  all of this mashed together overwhelming. Yes.

It's like you feel like a hurricane. You feel like  a hurricane. Like I can start cleaning the closet, but then all of a sudden I crash and I've got  clothes off hangers everywhere and now I'm like, what did I do again? Yeah. I think a  lot of people can argue, you know, well, sometimes people have emotional dysregulation  or emotional swings because they're not getting. enough done. I'll tell you if like even in my own  case, I can feel these kind of emotional swings.

and I can feel extremely overwhelmed and I might  get to a spot where I'm getting all of the stuff. done like all of the stuff I've delegated or I've  gotten rid of and it's off of my to-do list and I. still feel that overwhelm and that pit in my  stomach and that just like I want to hide. I. can't do anything right now. I just want to hide.  That is emotional dysregulation where it's like I. I I have the logical part of my brain that's like  you don't have anything to worry about. You're.

fine. This things are going well. You're okay. But  still, you're having these big ups and downs that. you're dealing with at the same time. And I think  that's so vital to talk about because that's what. gets misdiagnosed. Well, my greatest wish for  this episode, other than the person listening, really feeling empowered and seen and having your  expertise to really help you take the next step.

to get the support that you deserve and to better  understand yourself. And my second bigger mission, okay, is that this sparks a change in the way  that ADHD is defined because you can see that. if society thinks ADHD is jitteriness and, you  know, kind of the typical little boy like our. son was bouncing around in a classroom that can't  sit still and can't focus. And if that's all that.

we think it is, then doctors and pediatricians  don't have the right definition for it. So, of course, they're going to continue to go,  "Well, only if you're jittery does it look like. this." But anything in the realm of dealing with  emotions must be something related to anxiety or. depression. We're going to keep seeing this  problem. Originally, the ADHD criteria was. developed looking at hyper young boys. It's not  even our criteria is not even built to look at.

everyone else. It's not built to look at girls.  It's not built to look at adults. I think part. of the biggest flaw in this, right, is that when  you just moving on from like the hyper young boys, part of the issue is they're looking at these  highly observable behaviors like these are the. kids that are disrupting classes and these are  the kids that can't stay in their seat, right? But. what about all those other presentations where the  only people they're disrupting are themselves and.

they are just getting passed from class to class  to class to class and then later Mel those are. the people that are getting diagnosed with anxiety  and depression because by the way you're too old. to have it now. That was me. Yeah. I've also never  heard anyone say that the way that you can present. there's the external disruption, but I hadn't ever  heard anybody say or you could be somebody that's.

internally disrupting yourself. Yes. With your  thoughts, with your inability to stay on task, with your emotions. That's exactly how I felt all  the time. And that's what I hear day in and day. out when I'm hearing from women over and over and  over again that I my whole life I have felt like. something was off. There was something missing and  they have never put together those pieces and then.

their child gets evaluated and that's when the  pieces kind of come together. I'd be curious to. hear your thoughts about something. ADHD in kind  of culture and society. Yeah. Kind of feels like. an eye roll. Because people have thrown the word  around so much and live in a world where everybody. has fragmented their attention by being online.  Yeah. And at the same time, we have a neurological.

condition which here in the United States is  classified as a protected disability. Yes. We have. all of this research around it. And so the term  is kind of in popular culture and thrown around. You know what I mean though about the eye roll? Oh  yeah, you got ADHD. It's not even that. They get. those eye rolls from their doctors. M I have heard  from another physician when I was talking about,

you know, I I've been doing some advocacy work  online talking about ADHD and he made he it was. obviously a he made the comment, "Oh, so you can  give Adderall to all the housewives who need it?". And I was like, "You're gross. I got to get out of  here." Like, but it it like that is kind of what. this what this feels like. It feels like that's  just kind of the like medication is the easy way.

out and like everybody has it and it's easy to  qualify. You talk to anybody who is trying to get. a good ADHD diagnosis, there are so many hoops  in place there. It is hard to get a diagnosis. because it is like people are turned away from or  discouraged just openly discouraged or hostile. The thing that I experienced as a parent is, well,  oh, you're just trying to get your kid extra time. on a test so you can get him into a good school.  Yeah. I'm like, no, I'm trying to have him not.

struggle with depression and hate himself because  he feels like a a freak in school. Yeah. Like, he's not a behavioral problem, you idiots. Like,  this is a kid who's struggling. Yeah. And why do I. have to cry in front of a bunch of administrators  to get him properly assessed? And so I also feel. because of parents pushing their kids and trying  to game the system, there's also a little bit of. like, oh, do you really have ADHD or you know, did  your parents just push for this so that you could. get the extra time and accommodations that way?  And it's really hurt people and hurt our ability,

I think, to get heard and to be diagnosed.  And I think that's part of it for sure. I. think there is, you know, people ask me a lot,  is this underdiagnosed or overdiagnosed ADHD? And my answer to that is it's both, right? It's  overdiagnosed in some populations and it's wildly. underdiagnosed in some. Like there's some racial  and socioeconomic populations where ADHD is so far.

down the list of what it could be. And it's just  immediately this is oppositional defiant disorder, this is a behavioral issue, this is some  other kind of weird attachment thing. So these kids aren't getting help. And then there  are other people where it's almost like they're. entering like a pill mill situation where  like I know this one doctor and he's really. loose with aderall. There's a wide range. And I  think that truly I think that if we had better.

criteria that properly nail down what we're  looking at more comprehensively then people. wouldn't give these eye rolls. They wouldn't  give like because we would be treating what. we're looking at. I agree with you. What exactly  is happening in the ADHD brain? So, this is going. to be extremely oversimplified, but I think it's  important. The way that I describe it is there's.

a couple of things that you a couple of areas of  the brain that you really need to know about. And. the first one is the frontal lobe. So, directly  under your forehead. Think of that as like the. very smartest part of your brain. Decision making,  judgment, processing, that's your frontal lobe. Then you have this amygdala, which is this  little almond shaped central area of the brain, and that's in charge of all of that emotional  data. So with ADHD, you're dealing with a couple.

of things happening. Number one, you're dealing  with a prefrontal cortex, smartest part of the. brain. It's a little bit thinner and a little bit  less responsive. Oh, really? Yes. And then you're. dealing with an amydala that's a little bit more  hyper reactive. And then you're dealing with the. connection between the two which isn't as strong.  So what you're going to get is you feel things. strongly because that amigdala is like alarm  chemicals like something is happening and that.

prefrontal cortex is sometimes slow to filter and  figure out exactly what to do with it. M the other. thing that's happening in the brain alongside  all of that is you have to talk about dopamine. And again, when you think about ADHD in general,  that's very oversimplified, but dopamine is that. neurochemical that's in charge of alertness and  attention and emotional regulation and mood. So,

it's it's present and doing many different things  at once. And a lot of people think that it's a. lack of dopamine. you have low dopamine and  that's what's causing all this. It's really. that the dopamine you have present isn't in the  right place at the right time. And so that can. change with hormones, that can change with age,  that can change with stress, that can change, that can just be an underlying deficit or  dysregulation. So when you have those kind.

of factors all at once, you're dealing with just  a tremendous amount of input that you're getting. and a kind of weak filtering system. And so  you're just you're doing the best you can. When you talked about the prefrontal cortex  and being kind of the thinking and like the. secretary of the brain, the processor,  and then you talked about the amygdala, the little almond, it made a lot of sense to  me where you're like, the input is overloaded. and the connection between those two things is  weak. Yeah. which is why it is hard for somebody.

that has this neurological condition called  ADHD to actually regulate the signals coming. into here and all the sensory crap coming into  here. Correct. So that makes perfect sense why. it would be hard if the connection's weak for us  to take all the input into the thinking part of. the brain and process it. Yeah. and at the same  time take all the input into the sensory part, the amydala, and also appropriately regulate and  process that too and send signals to your body and.

your mind. Now, when you use the word regulation,  let's just say the person that's listening has. never really heard that term or doesn't quite um  know what you mean. Yeah. How do you want us to. think about what the word regulation looks like?  Because I'll tell you, as I'm hearing you talk, Yeah. I immediately had a flashback to going to  Baker Library at Dartmouth College. Got my books,

fully intending on studying Dr. Hamdani. Okay.  I go to sit down. Now all I can do is hear my. stomach. Now all I can do is hear the people  in the corner over there. Now I'm looking at. the person and an hour or two goes by. Mhm. And  then I start to think, wh why can't I just do. what everybody else is doing? what is wrong with  me? Mhm. And I have example after example and. the emotional side of this and the wreckage that  it caused internally for me and the self-hatred.

that it causes. Mhm. That is like it there's  a level of when you finally get a diagnosis, there's almost like relief and grief at the same  time. Sure. because you start to understand how. much unnecessary suffering you inflicted upon  yourself because you didn't know what you were. dealing with. Oh, and it's it's the same story you  hear over and over again. I have had people who.

have come to me and they knew something was off.  They have felt this guilt, this shame, and so they. go to their doctor. The doctor is like, "This is  anxiety. you're anxious about something or you're, you know, depressed about how things are.  They're started on medication. Medication. doesn't work. Okay, go back to the doctor. This  isn't working. Try another medication. Go back. to the doctor. I've had people that have been on  10 different medications. they have never found.

relief or they found very partial relief and then  you actually evaluate them for ADHD and you get to. the bottom of like oh okay you're having this  emotional dysregulation that's happening all. right let's treat the ADHD and all of this gets  significantly better than any other medication the. way that I describe it is for people who have  diabetes and they start to lose their vision. Now all of a sudden they go to their doctor and  they're like, "I'm losing my vision." And then.

this would be like if the doctor was like, "All  right, cool. Let's get you some glasses." No, the correct answer is let's work on the diabetes.  Let's let's fix this underlying problem. And that. underlying problem is that ADHD that's causing all  of these things. You just described my life story. So undiagnosed ADHD. Yeah. super hard on myself,  studious, hardworking, and had no idea what was.

going on, but had lots of anxiety. Yeah. And the  anxiety started growing from middle school through. high school. Got worse and worse and worse. And I  got put on Zoloft at the age of 22. Yeah. I took. Zoloft until my mid-40s because I was diagnosed  with anxiety. Yeah. And while the Zolaf for me. at least kind of turned down the volume of the  chronic like state of alarm that I lived in,

Mhm. it never really solved solved anything. Mhm.  And it wasn't until our son Oakley was diagnosed. with ADHD that I'm like, "Wait a minute." I went,  I got a neurosych evaluation. I got a clinical. diagnosis. I stopped taking anxiety medication.  I haven't had a panic attack since. I haven't had. anxiety problem since because the entire time  we were treating the wrong thing. Correct. The.

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Peace of mind starts with the right partner.  Visit Amica.com and get a quote today. I read. in your work that there are three different types  of ADHD. Mhm. I didn't know that. What are the. different types of ADHD? Okay, let me show you.  Okay, first one, inattentive ADHD. And we touched. on this briefly. Inattentive ADHD typically  are the daydreamers. They tend to be forgetful,

difficulty with organizing things, difficulty  with remembering where you place something, difficulty with initiating tasks, difficulty with,  you know, if there's a big task coming up in front. of you, you tend to avoid that. So these are  your typically this is how females assigned to. birth present. Okay. Inattentive ADHD. Inattentive  check. [laughter] hyperactive or impulsive ADHD.

This is the second form of ADHD and this is well  one of the ways that males can present and this. is both physically and verbally impulsive. These  are the kids that are having difficulty kids and. adults difficulty staying in their seat. They're  fidgeters. They are impulsive in speech in that. they're interrupting. They are blurting out  answers in conversation. They have difficulty.

participating in conversation. So this is this is  that hyperactive type. And then the third type is. the combined type picture. Oh, and combined type  picture is just a combination of both of those. um features. So you can have inattentive features  and you can also have the hyperactivity component. Um, fun fact, this is what I am. How do you know?  You know what I'm saying? Because it feels like.

it's a little general, like all of it. So, you can  kind of find situations for yourself. But how do. you know what you are? And why is it important to  understand which of the three you might be? So, I mean, you really are going to know once you  get a good solid evaluation, right? Because I. think that part of getting a great evaluation,  a very sound evaluation, is equal parts, yes, ruling in ADHD, but also ruling out everything  else. I want to make sure that this isn't anxiety,

that this isn't depression, that this isn't  bipolar, that this isn't some thyroid issue. or some medical issue underlying it. So there's  within the evaluation where you're talking about. ADHD, you go from childhood and you kind of look  at longitudinal patterns because again with women. specifically, it's hard because every month we  look different hormonally. So catching you at. at one spot in your cycle versus another spot,  you might look different and you might present. a little bit differently. So you're looking for  longitudinal patterns. Can you break apart how.

does the emotional side impact girls? When you're  looking at females um they typically fall into. this pattern of more the inattentive presentation.  So these are the daydreamers. They're forgetful. They have difficulty organizing things. They have  difficulty with routines and and motivation to. get tasks done. And so these are the people that  in general can be a pleasure to have in class.

They're getting passed along and they're doing  well, but internally they're working so hard. So. hard. And you know what? That doesn't get better.  You get through um your elementary school years, you get to puberty, then all of a sudden you  get smoked by hormones. Now hormones immediately. change things. Now instead of physicians and again  not the fault of physicians right this is a fault.

of criteria but now instead of physicians looking  at this child and saying whoa like we missed. something you're having like all these mood swings  and school is hard for you and friendships are. hard for you and all of that. They're saying  you're a teenager. These are hormones. Get. used to it. like this is what you hear as like a  13-year-old girl and then they have to get through. it. So, you just kind of just bear it and then you  get into college and your demands get harder. You.

start getting into more serious relationships  and then maybe you get into a situation where. you're trying to start your own family. Okay, now  you're getting hit with another wave of hormones. and actually during pregnancy estrogen levels  are a little bit higher, dopamine levels are a. little bit higher. So you might do okay, but then  postpartum comes and rocks your world. And so you. get this drop in estrogen, drop in dopamine, so  you can't regulate the way you used to. And so.

now you go to a doctor again, you're like, "Things  are bad." And they're like, "It's hormones." Like, "Let's put you on an anti-depressant cuz you're  depressed. This is postpartum depression." And so. it gets missed again. Then you get through all  of that and you get through your reproductive. years and now you're in pmenopause and things are  chaotic cuz your estrogen drops again and you're. like something is wrong. [laughter] Something  is wrong and now it's well your you're hormonal.

like give it 10 years we'll see you later. Brain  fog. Yeah, there you go. This happens during p per. menopause. So we in fact that's you've described  my whole life. I know I had postpartum depression, crashed. I started having severe brain fog  and other symptoms from pmenopause. So, you. get hormones which help but didn't help the brain  fog. Yeah. And again, like it was just diagnosed. with anxiety, living with anxiety, struggling,  struggling, struggling, pushing through postpartum.

depression. Oh my god, the sobbing as you're  breastfeeding. Like just I don't feel like myself. Oh my just and then pmenopause, then the creams,  then the and then all of a sudden ADHD diagnosis, and it's like, wait, what? And it felt as soon as  I was not only diagnosed but found the medication. that worked for me, it's like all of a sudden  after 47 years, I felt like I was in my body.

Yeah. And that gets missed. It get missed over and  over and over again because our criteria doesn't. catch that. Is it common in women that if you have  undiagnosed ADHD that it can cause anxiety and. depression? Yes. Why? A lot of times like when you  look at ADHD there can be anxiety and depression. that come that is a separate thing that travels  along with it. That that can happen. But for a.

lot of people because again circling back to that  emotional regulation part of ADHD that everyone. seems to miss and that is so critically important  to getting a comprehensive picture of ADHD. Number. one, if you've gone through your whole life and  you've thought that there's something wrong with. you and you're less than and you're broken, that's  going to make you anxious. If you can't do the. things that you know perfectly well that you are  capable of, that's going to make you anxious. And.

you know what? It's probably going to make you  pretty depressed, too. If you're going through. these huge moments of this energy dysregulation  where you are getting tons done and then it's like. you've hit your max and then you crash, you  have this huge crash and then you feel like, okay, I have literally nothing left in my tank.  That looks like depression. But these are all. emotional dysregulation issues that are happening  and so that that's why you see that with ADHD. Um.

is there a connection between undiagnosed ADHD  and eating disorders? Yes, there is. But I think. that again that stems from dysregulation and it  stems from a lot of ADHD. you're not able to be. mindful about certain things. So sometimes it's  not actually, you know, when people think about. eating disorders, they think about, you know, on  one extreme that you're not eating enough and on. the other extreme you're eating too much. Like  for the extreme where you're not eating enough,

a lot of times with ADHD, sometimes it can be  like you don't really have hunger cues. And. and this is outside of the medication. It's just  your body isn't communicating, telling you you're. hungry. And I know personally if I get invested  in a task that I'm truly interested in, I can go. 8 hours and I'm not eating, I'm not drinking, I'm  not getting up. Y on the flip side with like binge. eating disorder and things like that, there can be  a time where you're trying to stimulate your own.

dopamine. You're trying to like get things going  without even knowing that's what you're doing. And. you're grabbing for things and you're eating and  you don't even know and you can look down. you're. like, "Okay, that was a whole sleeve of Girl  Scout cookies." Like that. So there's like you. can be on either end. So yes, there are linkages  with disordered eating on both ends. And what's. interesting is again this kind of distinction  that you're seeing, Dr. Hamdani, of the external. presentation versus the internal turmoil. How  I describe it is it's like the outside of your.

house is on fire versus the inside of your house  is on fire. Like it just feels like both are on. fire. [laughter] Both are literally in flames.  The way we look at it now is we only care if we. can see the flames. Flames are going on inside the  house. What What would you say to somebody who has. received this episode from someone that cares  about them? Yeah. because the person who cares.

about them sees these patterns and has sent this  episode, you know, in a text saying, "Hey, you. know, I'd love for you to listen to this because  this sounds a little bit like what you might be. dealing with. What do you want the person who's  hit play and is starting to really process what. you're saying for the first time?" I think if you  are listening to this episode, I don't want this.

episode to push you one way or the other. This  is not meant to convince you that you have ADHD. This is not meant to push you in one direction.  It's meant to ask you questions about your own. internal environment so that you can start digging  deeper and figuring out is there something here or. is there something that needs to be addressed? And  what I want to reiterate about all of this is that. I think good compassionate care and diagnosis  stems from a very non-judgmental and shamefree.

place. And so just being able to look at this  episode and and whatever other research you do in. a very compassionate and self-compassionate way,  I think you'll be able to receive information and. actually start to put together patterns about your  own behavior a little bit better. And that might. be ADHD, it might not be. What do you think  the biggest misconception is about ADHD that. keeps people, especially women, from getting help?  That you have to treat it with medication. I don't.

think you have to. I there there are some people  that are on medication and it is life-changing. for them. And so I'm never going to and even when  I was talking about anti-depressants before, same. thing. That can be life-changing for some people.  So, I'm never going to go back on that because a. medication is a tool and can be wonderful. But  also being able to actually commit time and. figure out therapeutic tools that might work. It  is also so critically important. And some people.

don't need medication. They they get through with  doing cognitive restructuring and work through. therapy that can be extremely beneficial. I so  appreciate your answer. What I find reassuring. about what you're saying is there are other ways  you can support yourself and we're going to get. into that very specifically about what to do and  how to get a diagnosis and what are the things. that you can do and what are the medications. Um  you know I remember when I got my diagnosis it.

was both an extraordinary relief Yeah. and I had  a lot of grief and anger. Yeah. Is that common. to feel a sense of grief? Like when you finally  understand what's been there the whole time? Yes. When I evaluate people, I actually tell them about  that. Like I don't know what this evaluation is.

going to show or if it's ADHD, if it's not ADHD,  but depending on what we go through, this is just. a deeper exploration of what's going on in your  body. And it might you might feel like this is an. answer. This is what I've been looking for. And  it might feel like I wasted so much time and I'm. grieving that loss of time and potential and all  of that stuff. And to them I say that is normal. Like you are allowed to feel those things. That's  that's perfectly normal and there should be space.

for that because that is a very valid expression  of what's happening. But I also tell them that in. that time it wasn't wasted because what you were  doing the hard work you were building routines. you were building structures you were building  workarounds that eventually as you have the right. tools and scaffolding those are going to come  in handy for you. those are going to make this. process a little bit easier because I've also seen  on the flip side of things when people are started.

on medication and they don't have that scaffolding  in place and then when they're off medication it's. like they're floundering again. So I think this  multiffactorial approach of doing lifestyle and. behavioral modification with medication if that's  appropriate can be extremely helpful. It was. life-changing for me. I'd love to talk about the  connection between being high achieving Yeah. and. how that especially in women can hide ADHD. Mhm.  Especially from ourselves. Yes. So, I'm going to.

introduce you to the concept of masking. Have you  heard of that? Uh not in the context of ADHD. So, masking is when you have it can be conscious or  unconscious camouflaging of your symptoms. And. this is something that women do exceptionally well  because I think from a young age we're sensitized. to do this because we don't want to be in trouble.  We don't want to stick out of a crowd. We don't.

want to bring a lot of attention to us. I'll give  you an example with me. Like I was a combined type. presentation. So I was very hyperactive. Like I  couldn't stay in my seat, a big fidgeter. But I. learned I can't get up all the time in class.  I'm getting in trouble constantly. So, I would. like squish my thighs down on the seat or I'd grab  the bottom of my chair and like try to suction cup. myself to the chair because I'm like, I I need to  physically restrain myself from getting out. Now,

from a productivity and a masking perspective,  you also see things like perfectionism. I don't. want to get in trouble. you see things like  um overcompensating, like I'm gonna stay at. work extra long and I'm going to overprepare  and I'm going to get things ready because I. don't want to get in trouble. I know I'm going  to miss something, so I'm going to prevent that. from happening. Um, you see things like within  relationships and knowing that there's like that.

emotional regulation. You see a lot of women just  kind of accepting stuff that they might not think. is appropriate for any of their peers, but they're  like, I was probably in the wrong. I was a little. bit too emotional. I chased them away. And so, in  order to protect that emotional sensitivity, they. don't want to get into conflict. They don't want  to fight. They don't want to do things like that. So, I mean, there's lots of different ways that  are directly impacting and and harmful to someone.

who is continuing this mask for a long time.  Eventually, that mask gets too heavy to hold. Is ADHD a superpower? No. Everyone asked me that.  I am so jealous of the people who say that it is. I'm jealous of the people who say that it is. And  the reason for that is I feel like there are some. things that ADHD has brought me that I wouldn't  have otherwise. Like being on social media,

going to the White House, getting book deals, like  that is because of my ADHD. That's because of that. hyperfocus. That's because I was interested in  something and it it bled into this area. But. there's also things on a day-to-day scale that I  feel so limited by. And I feel like the analogy. that I give is it's like a superpower that I have  very little agency over because it's like you can. fly now and that's your superpower, but you can't  choose when or where. So, you're just going to.

blast off into space at any given time. [laughter]  So, it's I feel like I love I love the concept. of a positive reframe and I think there is some  beautiful beautiful things about ADG. I really do. But I think there's also some things that are  really difficult to deal with. And I think when. people continuously focus on that superpower  trope, it kind of for me it it it diminishes.

a struggle. And so I feel like the best way to  approach ADHD is just realistically. They're. good. Just like anything else, there's good stuff,  there's bad stuff, and it's how you deal with it. I appreciate you saying that because I always  thought that it sounded like toxic positivity. Yeah. By somebody who doesn't have ADHD.  And when you also consider Dr. Hamdani, what you're teaching us, which is for  decades, yeah, medical professionals,

society, the DSM has not included the full scope  of ADHD, especially the emotional dysregulation. There is no superpower to feeling constantly  overwhelmed in your life. And yes, there are. some small benefits. And I love the analogy that  you said. It's like having a superpower you can't.

be in control of. Like I would love to be able  to throw fire from my palms, but I don't want it. going off at the wrong time. Yeah. And there's  a lot of anxiety that comes with going through. life thinking you can't trust yourself. Yeah. You  can't trust yourself to follow through. You can't. trust yourself to be on time. You can't trust  yourself to remember. You can't trust yourself. to not screw this up yet again. And so I really  appreciate you saying that. Is there something.

surprising that you've discovered in your practice  that most people with ADHD struggle with and may. not even realize it? Yes. So, we've we've talked a  lot about the emotional regulation side of things. Yes. There is a neurological phenomenon that  you see in almost 100% of people with ADHD. They. experience some component of rejection sensitive  dysphoria. Rejection sensitive dysphoria. What. does that even mean? That's a big thing. It's a  big thing. It's a mouthful. Rejection sensitive.

dysphoria is this incredibly robust emotional  response. Sometimes physical but mostly emotional. response to real or perceived rejection or  criticism or this fear of disappointing someone. It is this internal emotional response flooding  of neurochemicals that happens. How do you. define this? What this is? It is a neurological  phenomenon when you look at emotional sensitivity.

Okay. Right. And you have which you have if you  are somebody struggling with ADHD. I'm saying. just part of the human condition. Right. Emotional  sensitivity in general. You have if you're saying. this is kind of normal emotional sensitivity. You  have emotions down, emotions up, situationally. appropriate. You're right in the middle. You have  lack of emotional sensitivity where people really. aren't responding in the way that they should  be. They don't feel big highs. They don't feel.

big lows. Maybe not situationally appropriate.  Then you have people that are highly emotionally. sensitive. And they are the people who feel things  quickly and deeply and for a long time. Mhm. And. I would put rejection sensitive dysphoria as like  the the ending point of that as most emotionally. sensitive because when they feel something even if  it's not actually happening if they perceive that. there is a risk that I'm disappointing you or that  there's some rejection or the person doesn't like.

me their world caves in they start turning inwards  and it becomes this flooding of neurochemicals. and alarm chemicals that are happening that  literally paralyze other areas of the brain. Wow. Mhm. Holy cow. Mhm. You have a brand new  bestselling book, Too Sensitive. I love the. title. Thank you. Why is this rejection sensitive  dysphoria important to dedicate an entire book.

to this? Because no one talks about it. So,  we don't have the tools and the language to. treat it appropriately. Can you show us what  this may look like in day-to-day life? Yes, I can. I can show you with text messages from you.  Oh god. [laughter] Okay. Oh, these are So, the. team has screenshot my phone. Okay. Go ahead. Or  actually screenshot their phone and something that. I've said. Okay. So, if we're looking at just this  screenshot with you responding to something that.

I'm saying and all it says is no worries. Okay,  for me what is happening in my brain is is she mad. at me? Is she unhappy with me? Does she want me  on the podcast still? I am spinning because in my. brain I've attached a level of uncertainty because  I'm afraid that there is rejection and criticism. underlying this. And that to me is a direct  reflection of my own selfworth. So I am going to.

spin on this. I'm going to ask other people about  it. I'm going to show my phone to other people and. be like, "What do you think about this message?"  And I am going to waste a tremendous amount of. emotional energy on this. Now, the things that I  could do with this is that I could chew on it for. hours and hours, which is what I love doing and  that's what I usually do. Alternatively, I could. do things like I could overcompensate. I could  send you a text message back and be like, "Okay,

I'm just making sure that we're cool." Or, "Okay,  I I want to reiterate our plans." And you're like, "I am busy." I like the, you know, so there's  there's a lot of emotional handholding I would. need in that moment. I might do things like I  get that text message, I've already decided that. you're mad at me. I'm done now. And that that had  been my trajectory in my 20s with relationships.

I would read into neutral interactions. I would  read them as threatening in some capacity and I. would be like, I don't need this. I'm studying. I  don't need this. And I would end the relationship. because you're not going to push me away. I'm  going to leave first. You see different patterns. And it is truly when you take a neurologically,  emotionally sensitive person, which is something. you see a lot of in ADHD, and you put them in  these everyday kind of situations because of that.

emotional dysregulation, they have a hard time  filtering that information because that emotional. part of their brain is popping off before that  logical part. So, they are just running with. this flooding of emotional chemicals. And if  you think about that, like this is the stuff. that keeps me up. This is the stuff I worry about.  This is the stuff I I reality test with people and. they get so annoyed because I'm like constantly  going and asking them like, "Is this normal? Is. this not there?" There there's so much I I don't  want to say life loss, but that's what it feels.

like. I'm just spending so much time doing that.  I have spent a lifetime doing this. So if and yet. at the same time I'm just doing the best I can to  manage all the inbound. Anyway, if you relate and. you read messages like this, what do you do? Yeah.  And for the record, it's not just messages. Like. it can be things like for me I'm so sensitive  to tone, to shifts in tone. I'm sensitive to.

body language. Like I'm sensitive to like I can  pick up an energy in a room before I go in. Same. You know, it's like so this is this is one of  those things about being emotionally sensitive. and then simultaneously being emotionally  disregulated is that those things hit hard. Yes. So recognizing it is huge. That's a big big  big thing that I I think is really important. The. other thing that we see is important are things  that work in the moment to reduce activation.

Some easy ones are things like movement. And it  doesn't have to be like do heavy cardio or or lift. weights. Do some sort of movement that's going to  increase that oxygenated glucose to get to that. frontal lobe. So, okay. So, I see the text message  now. I'm like, yes, I do squats. You can you can. because think about what you're doing. Like once  you understand neurologically what's happening, you're dealing with this overactive amydala and  this underperforming frontal lobe. Oh, I see.

Oh my god, I just got it. So in that moment,  the input from just a simple text message is. like Yes. And that floods your brain. Yes.  And your thinker, your prefrontal cortex, Uhhuh. is like, I don't know what to do. I can't  come online. Something's going on. Like, ah. And. so neurologically even though a text message seems  stupid and in inconsequential. Yes. Neurologically.

your brain is screwed. You you are responding to  a threat like you have seen a murder. When you. are actually assessing threat like whether it's  a social threat, whether it's a physical threat, your brain doesn't know the difference in that  moment. Your body is responding in the same way. So you're having this flooding of neurochemicals.  And so what you need to do now is understanding, okay, my emotional center is overwhelmed. My  frontal lobe is not working as well as it should.

And then you look at that situation and whether  it's like, okay, I can utilize movement and that's. going to get some oxygenated glucose to my frontal  lobe where it's supposed to be. And hopefully we. can get that thinking back on board. The other  thing you could do, delay the reaction. And this. is something that it took me so long. I understand  neurologically I am flooded right now. I know that. in 10 to 15 minutes I'm going to feel different.  And so in 10 to 15 minutes I will reassess this. and I will even do things like I'll set an alarm.  I'll set an alarm 10 to 15 minutes I'll come back.

and gosh darn it I do feel different. But I  think what's important is that like with this. book too sensitive. I don't want to make you less  sensitive. I want to help you be more in control. I love that. I don't want to make you less  sensitive. I want to help you be more in control. That is the perfect statement for us to then talk  about how you feel more in control. Um because.

I'm sure as you've been listening or watching  and you're really taking in everything that Dr. Hamdani is teaching you and me today. You are  thinking of like 13 people in your life. Yeah. Or you are thinking, "Wow, this sounds like  me." So, what are the steps you should take if.

you think you or someone that you love may be  dealing with ADHD that's not diagnosed? Yeah. Let's go through this cuz I think a visual will  help. So, I'm going to pull up a visual. Great. So, if you think you have ADHD, let's  start with the first step. So, first step, track your symptoms. It is so important to  number one, know your baseline. Number two, it's also needed to understand how your  treatment is progressing. If that's kind of what.

it and whether that's therapy or whether that's  medication, are those holes being fixed? Yes. So, what symptoms am I tracking? Okay. So, if you do  these things, you get a gold star from me. I want. you to track initiation of task, distractability  during the task, like are you getting pulled out. of the task, completion of task? So, I would lump  that all into one, but I think it's important to. make those distinctions like where is the problem?  Is it starting? Is it staying in the task? Is.

it actually getting it done? That's important.  Number two, I think that is vitally important, is sleep. Sleep. Track what you're doing with  sleep. I want to know how long you slept. I. want to know I if your sleep was fragmented.  Are you waking up in the middle of night? Is. it hard to fall asleep? So, give me as much data  as you can. This can be notes on your phone. Like, this doesn't need to be something super formal.  Okay? And the third thing that I want you to. track that I think is really important is mood.  I actually don't give a lot of guidance on this.

because it's almost an interesting diagnostic  fact to see how you track mood. However you want. to track your mood, just give me some sort of mood  data point. Okay? Because I want to see number one. how how that pattern progresses over time. And  then especially for women, if you crossorrelate. that with your hormonal cycle, I want to see that  too cuz if there's a strong hormonal component, we need to look at that as well. Got it.  So if I were to do this for a couple weeks, you'd get some good data because then you could  go and has it been like this in the past? Ideally,

ideally I don't want a couple weeks. I want  like enough for two hormonal cycles. So Oh, so you want two months? I want two months. Okay,  great. You can have two months. It's gonna take me. that long to get an appointment with you anyway.  So, okay. Track your symptoms for two months. And. we're doing kind of productivity, initiation,  distractability, completion, sleep patterns, and mood. Yes. Boom. Boom. Okay. Step two.  Talk with a qualified professional about an.

ADHD. What is a qualified professional? Who do  I go to? I know. So, here's the deal. There are, especially now, there are lots of different roads  to get to where you need to get to, right? Um, let's start from my favorite. I'm biased cuz I'm a  psychiatrist. I feel like going to a psychiatrist. sometimes gives you the best evaluation. And the  only reason I'm saying that is because you have. the benefit of going to a medical physician. So,  they understand medical background. you have the.

benefit of going to a psychiatrist. So, they've  done the psychiatry residency where they've done. the therapy side of things and they've done the  medication side of things. So, it can be, you. know, if if that person is appropriate for an ADHD  um medication after this evaluation and has ADHD, this could be a one-stop shop kind of thing. But  there is a desert and deficit Yeah. of access in. many communities, many countries for many people.  And you know, sometimes we're like, do I go to my.

primary care? Do I go to a pediatrician? Do I  go to a nurse practitioner? Like absolutely, we're only as good as what our system allows  because access to care is a huge issue. And. that there's so many barriers to care. Whether  that's there's literally not enough psychiatrists, whether that's a cost issue, whether that's a,  you know, they aren't taking your insurance or, you know, there's so many different things  or or that they're saturated. They're they.

can't see patients. You could go to your primary  care doctor or your pediatrician or and that's a. beautiful place to start. That's a beautiful place  to start. Generally, there's a lower barrier to. access with that. A lot of times they'll do an  assessment that involves getting information. from collateral resources. So talking to, you  know, like for kids, they'll talk to parents, they'll talk to teachers, they'll get at scales to  look at ADHD behaviors. So that depending on what.

is available to you. That's another road. Then you  can do the therapist road. There's many different. layers. You could do a neurosychologist who could  do neurosych testing where you do a comprehensive. evaluation of everything that's going on. Is this  ADHD? Is this depression? Is this anxiety? Is this. bipolar? So, they will do a full It's super long  and expensive. And expensive. That's what I did. That's what we did with two of our kids. Like, and  it was expensive. Like, I would not have been able.

to do it had all of this started happening  and I was aware of what was happening like. even just a couple years before that. So here's  the deal. There are other resources. So besides. the therapist route, besides the neurosychologist  route, there are other layers of therapists that. could potentially do the evaluation. Some of them  like with nurse practitioners, not a therapist, a nurse practitioner is something different. Some  of them can prescribe, some of them cannot. Um.

with therapists generally, they cannot prescribe.  Right? But again, we're not talking about well, we just got to get the actual assessment done  first so you know what you're dealing with. And I. do find that this is a big roadblock. Here's what  I will tell you about any provider that you see to. save you time, to save you heartache, one of the  most important things that I tell anybody who's. starting this process is look up the provider  ahead of time. Look at their reviews. Look at.

what they treat. look at all these things because  it it's unbelievable how strongly some people feel. about ADHD. Some people are completely unwilling  to even address it. And so it it gets to be really. difficult when you're going into an evaluation and  it's hard to even get that evaluation from them. And so I think that the people who really enjoy  treating ADHD, looking at ADHD, evaluating ADHD,

they put it pretty prominently on their  information. So I think that's important. You. can look at reviews. You can get word of mouth  and you honestly you deserve that. You deserve. a good assessment that is personalized for you,  right? And you're worth that. Yeah. Step three. Step three, discuss options. And there's  lots of options on that board. Medication, therapy, coaching, tools, systems. Let's talk  about the options. Yeah. A lot of people,

they immediately think if I have ADHD, I'm  going to be put on aderall and that's going to. be that's what's going to happen. No. So, let's go  through some of the different options. Number one, if you're looking at ADHD management, there  is medication and there's non-medication. So, let's start with the medication side of things.  Medication broken up into two big classes. There. are stimulants and there are non-stimulants.  Stimulants, the stuff you've heard about, Aderal,

RI, Vivian, those are all in that stimulant class  of medications. They work in two different ways. One is to help with alertness and to fight off  those sleepiness. And two is to point towards. reward. There was a beautiful Washington  University study that was done on this. just like Christmas of 2025, so it's relatively  recent. But stimulants, the the issue with them, number one, they're controlled substances.  So that gets a little weird. But number two,

it's you can't stimulate a person 24 hours a  day. Like you got to eat, you got to sleep, you got to do normal human functioning things.  So even the long acting stimulants really you're. getting about 6 to 8 hours of coverage if that  usually it's 4 to 6 hours short acting 2 to four. hours. So you're getting these like tall peaks  of coverage where it's okay I feel like I am. completely regulated at this point but it crashes  down pretty quickly that you move next into the.

non-stimulant class of medications. So stimulants  are one side. Non-stimulants, non-stimulants, you those are generally agents that work on a  couple of different things. There's some that. are anti-depressants, so they help with anxiety  and depression at the same time. There's some. that are blood pressure medications. There all  these different types of medications that have. multiple usages. And the thing that I generally  like about non-stimulants is that a lot of times.

it's 24-hour acting, which people don't know  about because a lot of times they're like, "Oh, if I have ADHD, I'm going to have to be started  on this medication, which I'm going to hate.". Non-stimulants, you're not going to have this 2  hours of coverage. You're going to get a 24-hour. uh What are the names of non-stimulants?  So, guanosine is one. Stratera is one. One. you might have heard of is Wellbutrin.  that's a non-stimulant for ADHD. So, there's there's lots of different agents that  you could potentially think about adding that.

give you full coverage that possibly cover more  than just the attention component that you know. don't crash you down in two hours and instead just  kind of raise that baseline. So, they're they're. beautiful agents. It really depends on what you  need. If the person who's listening is thinking, I am really resistant to the medication because  I'm concerned about the side effects. Y if they.

were a patient in your practice, like what do you  say to a patient in your practice when somebody. raises that concern? Then don't do medication. So,  if you if I explain exactly how those medications. work and what they're what the intended effect  and what the side effects are and and how to get. on them, also how to get off of them. If I'm  giving you all that information, you're like, "No, thank you." Like, I don't want that. That  is a perfectly reasonable choice. We go based.

on what you feel ready for. It's not my job to  push medication on you. It's not my job to get. you there sooner. Like, do the tools. the tools  are going to help you anyway. So, what are the. top tools if you're dealing with ADHD? Yeah. And  that diagnosis that are the most effective place. to start. It can sometimes be really nebulous and  hard to figure out exactly where to start, what. lever to pull. That's when I think a therapist  can come in very very very handy because they.

are able to take that data from your patterns,  synthesize it, figure out where the holes are, and then figure out how to optimize and approach  that. And I'll tell you from my own experience, I really started to drill down and work on the  therapy side of things and what are the skills, what are the tools, how can I explore my own  behavior so I can figure out what to fix. And. that I think was lifechanging. What is the fourth  step if you think you have ADHD? Okay, step four.

Use trusted resources while you wait. I think  this is important because I think a lot of. getting assessed, it can take a while. It can take  a long time and I if it happens, right? I mean, there's some people that don't have access to it.  And so I feel like in that interim learning and. exploring your own internal environment and also  relying on resources that you know are reputable.

that are going to help you that aren't just some  random person on the internet that's talking like. you want to get information from things like  journal articles or news like and again some. news so newspapers that site journal articles.  Well, I actually this is one of the things I. appreciate about you that you put a lot of content  online. Yeah. And so if you're having trouble.

uh gaining access and you are in the waiting game  Mhm. following somebody like you Mhm. a medical. doctor who's talking about this, who lives with  this, that's a way for you to learn more and to. understand that this is not a deficiency in you.  this is something you are just going to learn. more about and there are tools that you can use  while you're waiting and you can learn more and. become smarter about this while you're figuring  it out and that's the whole point and that's why.

I actually wanted you here because you do put out  a lot of content for somebody that's listening and. um is thinking well this is definitely me but  I'm now 40 50 60 it's it's just too late what. What would you say? If I had 10 minutes left in  my life, I would want to know if I had ADHD. Why?

Because I want to understand my brain. I want I  don't think it's ever too late to understand your. brain. I just want to know. For me, going through  that ADHD experience, I know firsthand how it. feels to have that guilt and that shame compounded  at every single thing. And for me to analyze every. turn I've made and to think about it and where did  I go wrong and what was happening and how could I. have done it better to know that you I did do  my best. This was a neurological phenomenon.

that was underlying all of this that was making it  difficult. Like you still did a great job. You got. through this. You built on this. I I want other  people to feel that. I do too. Yeah. Dr. Hamdani, what are your parting words? It's never too late  to understand your brain. I am so grateful that.

you're here. Thank you for having me. I cannot  believe how much I learned today that I did. not know. I feel more confident. I feel like I  understand myself so much better. This episode. is an extraordinary gift that you just gave us  because we got to sit down in a private session. one- on-one with a psychiatrist as renowned  and as passionate and committed as you are.

And I appreciate the accessible and realistic way  that you talked about what to do next and what to. do while you wait and while you figure this out.  And so just from the bottom of my heart and from. people all around the world that you will never  meet whose lives will be forever changed because. of what you shared with us today. Thank you.  Thank you for having me. And thank you. Thank.

you for making the time to learn about ADHD. I  hope you share this with people that you care. about. This is a conversation that is for all  of us. And these tools that we discussed today. are things you can start to implement in your life  or the lives of people that you love immediately. And in case no one else tells you, I wanted to  be sure to tell you as your friend that I love. you and I believe in you and I believe in your  ability to create a better life. I cannot wait.

to see your comments. I can't wait to see this  shared around the world. So, [music] thank you, thank you, thank you. I'm going to welcome  you in to the very next episode the moment. you hit play. I'll see you there. Thank you  for watching all the way to the end here on. YouTube. And if you're asking yourself,  "Okay, what should I watch next?" You're. going to love this video and I'll welcome  you in [music] the moment you hit play.