Episode 025: Live Q & A - Part 1 - Prescribers, Meds, & Relationships

Isabelle & David welcome guests to a live Q & A (previously recorded) and describe the origins of the podcast, when the two were working together. David had given a presentation and had been gifted a microphone to record his presentation and turn it into an audio book. Isabelle had been welcomed by David to the tribe of folx with ADHD as she slowly realized her own ADHD diagnosis, and was hopeful she had it because it could remove so much shame, blame, guilt, and doubt and increase her understanding of herself. She was brimming with questions for David. They wanted to make a podcast to remove the barriers to this information, which you may normally pay a therapist for—not everyone can pay for a therapist, let alone reach one or feel comfortable going to one. David recalls his brother, who’s mission was to increase understanding to reduce suffering, which is a great way to sum up what the podcast is all about: to increase understanding about ADHD to reduce even one person’s suffering. Without further ado, the two begin to answer questions asked by Q & A participants, the first being, why, when asked [a broad question like: what do you want to know about ADHD?] Their mind goes blank and they can’t think of anything? David names that it reminds him of straddling two countertops like Jean Claude Van Damme (see clip below) and could come from two angles. If someone has ADHD and they’re reading a structureless question, it’s so broad, too little to think about—structuring the question would be very helpful and sparking specific ideas. If the asker is someone without ADHD, they might not know how many parts of the world ADHD touches, how people learn differently, how people hum at different energies, what natural homeostasis looks like for different people. You might not think ADHD has something to do with someone’s sexual appetite, why textures feel strange, why someone seems selfish, why someone doesn’t take care of themselves, why someone is ruggedly independent and ask people for help (fill in the blank), etc. Isabelle notes how she’s noticing that a particular shade of pink on her screen always makes her feel nauseous when she sees it. How to narrow down a broad question, or deal with ordering food—think about categories. As an adult you can (sort of) get whatever you want, and that is a huge question. On a side note, why do buffets exist, Isabelle wonders, while David likes a buffet. What kind of food do you want, hot or cold? Hand food or silverware food? Spicy food, etc.? So one way to rephrase the question is to sprinkle in a category or detail. How important is it to see someone (as a prescriber or therapist) who has a lot of experience with ADHD? Maybe not so important. David names that he would consider what somebody’s biases around ADHD are and ask that question: what do you think of that diagnosis, do you often see people with this diagnosis, etc. We often forget that we have hired them, that psychiatrists and other prescribers work for us, we hired them, we can decide that we don’t work with it. Someone who is willing to try together to find something that works for you and be willing to experiment with you, v. When someone is naming the connection between stimulant medication and drug abuse, the question is not, is it the right thing to do, it’s: does it work? Examples include people who have been off of meds but now drink 13 cups of coffee? David makes it clear that psychiatrists work with psychiatric issues—ADHD is a medical issue. A general practitioner or doctor can prescribe you medication; you don’t have to go to a psychiatrist unless there’s a psychiatric issue. In the ADHD world you’re often working in one of two ways: do you need gas, or do you need brakes? Do you need something to speed you up or slow you down? When people look at it as a psychiatric issue, they try antidepressants or anti-anxiety meds, but when people are medicated to reduce anxiety they act out to increase stimulation. David also names neuropsych evaluations have a hard time differentiating between anxiety and ADHD—sometimes it’s less important to know what it is, than to see what works (more sleep, which meds, which interventions?) Next question: What about people who’s partner has ADHD and gets irritated by their behaviors that may connect to ADHD? David names how important psychoeducation to understand what’s going on. Is it the person’s ADHD or their middle finger? Is it their inattentive type behaviors or do they really want to hurt you? David names the study (cited below) that shows that when someone feels like someone is intentionally shocking them, it hurts more, and when it’s not intentional, we feel the pain less. “He did it again, didn’t mean to,” and when you were in a fight and realizing what someone is not intentionally doing to you. Knowing where you can expect things to change and where you need to expect acceptance are important things. It’s not that you’re helpless and someone with ADHD is going to destroy your life, let them go, etc. just to know where the struggle busses are (for example, being on time v. Quality time), you create an accommodation around the idea that misses will happen, but don’t set it up so that the person who’s in the hot seat is always having to defend themselves. David gives the example of how his behavior might change if his partner shamed or blamed him for showing up later than expected. He would still show up late, he just might not text—because he would change the behavior around the shaming and blaming. That’s why getting diagnosed can be important. What if someone doesn't want to get diagnosed or get support? When someone doesn’t want to change, it’s an important piece of data, too. You don’t have to listen to this podcast, you don’t have to get more information, but these behaviors have to change and you they have to be more understood, so how are we going to do that? People often dismiss their ADHD diagnosis because of the stereotypes and myths. Noah jumps in and interjects that it helps in friendship to not take it personally, like in his friendship to David, he needs to not take his lateness personally, and David has to not take his ready-to-go-ness personally, either.

Jean Claude Van Damme counter split straddle clip (from "Time Cop" (1994)-- please note this is the scene that leads up to the famous counter splits and also note there is some adult language, violence, and action film cliches involved). Side note, there are compilations of his famous split scenes available if you google them.

What about that study on shocks being more painful if you think you were shocked intentionally? Check it out here.

Cover Art by: Sol Vázquez

Technical Support by: Bobby Richards