Dr. H Answers Your ADHD Questions

Dr. H Answers Your ADHD Questions

Our host responds to listener emails this week about ADHD and…  medication and addiction, anxiety issues, sensory processing disorder symptoms, OCD and the pandemic, and more.

Thank you to all of our listeners who sent in an email! A special shout out goes to awesome Distraction listener, Gray, who shared his thoughts with us in a voice memo!

If you have a question, comment or show idea we want to hear from you! Write an email, or record a voice memo on your phone and send it to [email protected]

Dr. Hallowell’s books mentioned in this episode:

Delivered from Distraction

Driven to Distraction

Learn more about our sponsor, OmegaBrite CBD. Distraction listeners can SAVE 20% on their first order with the code: Podcast2020. Shop online at OmegaBriteWellness.com.

Distraction is created by Sounds Great Media. Our producer is Sarah Guertin and our recording engineer/editor is Scott Persson.

Check out this episode!

A transcript of this episode can be found below.

Dr. Ned Hallowell:

This episode of Distraction is sponsored by OmegaBrite CBD formulated by OmegaBrite Wellness, creators of the number one Omega 3 supplements for the past 20 years. OmegaBrite CBD. Safe third party tested, and it works. Shop online at OmegaBriteWellness.com.

Hello and welcome to Distraction. I’m your host, Dr. Ned Hallowell. Thank you so very much for joining me. We have a growing audience and we hope it continues to grow. Please tell your friends about us, assuming you like what we’re doing. Today’s show we’ll be doing one of my favorite episodes, responding to your emails and questions. If you listen to these questions and enjoy them, please send us your questions. As we normally do in these episodes, my producer, the inestimably wonderful, Sarah Guertin will read to me your emails so I can respond. Without further ado, let me invite Sarah to read me the first email.

Sarah Guertin:

Hey. Happy to be here. All right. This first email says, “Hi, Dr. Hallowell. My son was diagnosed with dyslexia and ADHD in September. He also has sensory processing disorder, but now I’m wondering what he truly has since his symptoms are very similar between SPD and ADHD. Since learning this, I’ve read eight books and changed his school. While he is better, I want to be sure to give him all the support and resources for him to navigate well through life’s journey. I struggled to know how to best help him in what he really needs. He has had three years of occupational therapy, but we’ve hit a wall. What is the best way to get them on a path of treatment that is right for him? He is attending a school for kids with learning differences though I’m not sure I can afford to keep him there as I’m a single self-employed mom. He’s a happy, amazing kid aside from the struggles he faces with the differences, but I don’t want to make things worse. I love your podcast. It has helped me understand and sometimes given me ideas. Any advice for the bumbling parent? LB.”

Dr. Ned Hallowell:

Well, LB, first of all, you’re anything but bumbling. Any parent who reads eight books and changes the school and paying a tuition she can barely afford, I’d say is anything but bumbling. I would say you’re a candidate for mother of the year. As for your son’s problem, you didn’t mention medication. You said he’s had occupational therapy for the sensory processing disorder, I assume, but I didn’t see any mention of medication. Sensory processing disorder by the way is not the one I would put at the top of the list in terms of ease of helping to improve. You want to make sure you really go after the ADHD. Often the SPD, the sensory processing disorder, will follow. You’ve been doing the OT, the occupational therapy. You’ve kind of nailed that one. You said, “We’ve hit a wall.” I’m not sure what you meant by that.

I can guess he’s stalling out. He’s not doing well. The three hallmarks of the treatment of ADHD are number one, education. You want to know what it is and what it isn’t. I’d recommend my book Delivered from Distraction, which came out in 2005, but the information in it is still current. I’ll have a new book for you in 2021, but as of now Delivered from Distraction. Read that so you really understand what ADHD is and what it isn’t. For example, it is not a deficit of attention. It’s an abundance of attention. Simply need to control it. I don’t see it as a disorder. I see it as a trait. It can become a disorder or it can become a superpower depending upon how you manage it. You begin with education and letting your son know that he’s got a race car for a brain, a Ferrari for a brain, but the problem is he has bicycle brakes. We need to somehow strengthen the brakes.

You want to get him in a good frame of mind so he doesn’t feel like he’s being fixed. So he doesn’t feel like he’s being remediated. So he doesn’t feel like he’s fundamentally defective, which is what the term ADHD implies. Instead, tell him he’s got a Ferrari engine with bicycle brakes. There are many ways of strengthening those brakes. As I say, you start with education. Then a trial of medication makes a lot of sense, unless it goes against your brain for some reason. Most parents say, I don’t want to use medication, but they don’t really know why they don’t want to use medication. Their reasons are rooted in wrong information or lack of information or both. Talk with your doctor. I would recommend a trial of medication. Remember, a trial of medication is just that. It’s a trial.

If it does anything you don’t like… If he turns purple, you just stopped the meds. He’ll go back to his original color. You don’t want to proceed as if it were a permanent intervention. If it works and by work I mean he gets improved focus, improved control over his engine with no side effects, other than appetite suppression, without unwanted weight loss. If you get that result, which you can achieve 80% of the time, then it makes everything else so much more easy to do. People often say to me, why don’t we do a year or two of non-medication treatment before starting medication? I say fine. I’m happy to do that with you. I’ve written books about that, but it’s sort of like saying, why don’t we do a year or two of squinting before we try eyeglasses?

Why not go to the proven intervention that is safe and effective? Why wait because it makes everything else you do more effective. Then the third element… We have education. We have trial of medication, 80% of the time it will help. The third element is coaching, which includes everything from how to get up in the morning and get dressed, to how to make your bed, to how to plan your homework, to how to listen in class, to how to take notes if you’re old enough to do that, to how to hand in papers on time, to how to stop procrastinating. All that comes under the heading of coaching. That can be done by an ADHD coach. The de facto coach is you, the parent, usually the mother. The problem with that is as the child gets older the coaching comes to feel like nagging.

What a hired coach does or a hired tutor does is what a mom would do minus the nag factor. Those would be my recommendations, but start with the recommendation of getting rid of yourself designation as a bumbling parent. You’re anything but. Educate as to what ADHD is. I recommend my book Delivered from Distraction. Consider your pediatrician for a trial of stimulant medication. Then bring in the coaching, addressing whatever the target areas of need are. Hope that makes sense, LB. Please give us follow up. Love to hear how he’s doing as time marches on.

Sarah Guertin:

This email is from Diana. She wrote in part, “Hello, Dr. Hallowell. First, let me say how much your work has personally and professionally impacted my life. Back in 2015 when I first started learning about how my daughter might have ADHD and that I myself might also have ADHD, it was your book Driven to Distraction that launched and guided me through this world of self discovery. Your book also enabled me to effectively advocate for the accommodations my own children need at home and in school, as well as giving those same tools to the students in my classroom, as a science teacher. In the more recent past and present, however, it has been your Distraction podcast that has opened up the flood gates to the multitude of other resources, which have skyrocketed my growth about ADHD since my diagnosis, and now too the diagnosis of my daughter, testing of my son for ADHD and navigating the most effective treatments for us all.

The reason for this email though, is not entirely to share my appreciation for you, but to ask for advice about, and possibly connections for writing my own book about my experiences with ADHD. Thus far, I have nearly an hour’s worth of voice memos with full pages of the book laid out along with ideas for more content and a broad framework for scope and scale of the book. Unfortunately, this is where I begin to flounder. Since I have no clue how to make connections in the publishing realm, do you happen to have any advice for this or contacts I could pursue in this endeavor to write my book? Your help and advice would be most greatly appreciated and valued. All my best, Diana.”

Dr. Ned Hallowell:

Well, Diana, what a wonderful email. What a wonderful goal you’ve set for yourself of writing a book. That’s fantastic. One of the best ways to treat ADD is to develop a creative outlet. The reason I write so many books is if I don’t have a book going, I get depressed. I’ve found in working with people with ADD over the years, the ones who do best always have some kind of creative outlet, whether it’s writing or gardening or cooking or investing in the stock market. There’s some kind of creative outlet, an outlet that allows you to be spontaneous and access your unconscious and create. It is something that our brains really need to do. If we don’t do it… It’s like a cow that doesn’t get milked. We just get all stuck up, plugged up. Good for you. Wonderful goal.

Now what you’re going to need is structure. You can do that by hiring a coach. You’re also going to need an agent. It’s very hard to sell a book as an unpublished author if you don’t have an agent. It’s possible, but it’s extremely difficult. You can go online and Google agents and literary agents. The best ones or in New York or Boston, although there were agents all over the place. If you find an agent, you see, they’ll take on the task of helping you get the book written. Then selling it. What you can do once you have an agent is write, what’s called a proposal. The agent can sell the book based on the proposal. It has to be a fairly detailed, for someone who hasn’t been published, a fairly detailed summary of what the book will include.

Once your agent sells that proposal, then you get an advance. That’s a sum of money that you get to support you while you write the book. Now, if the book doesn’t earn back the full amount of the advance, you don’t have to pay it back. It’s called an advance on royalties, but it’s really a gift. You don’t get royalties until the book earns out as it’s called, until it earns back the amount of money of the advance. In the unfortunate case, it doesn’t earn that much money, you’re not on the hook. The publisher takes the risk, which is really quite wonderful. The agent usually takes 15% of the advance, but you don’t have to pay the agent anything if he or she does not sell the proposal. That’s in a nutshell the best way to get published.

You’ve done the hard part, which is gathered up your experience. Now you’ll have to sort through your voice memos and develop an outline, and a table of contents. That’s what usually goes into a proposal. Good for you for doing it. It’s a wonderful thing to do. You’ll feel very gratified and you will help an awful lot of people if the book manages to get published or you could self-publish. Now you can do eBooks on Amazon. There’s a whole way of doing that as well. You don’t have to rely on a New York publisher picking up your book. I hope that answers your question and good luck. You have to be crazy to write a book. It’s no way to make a living. It’s a good way to torture yourself. I’ve been writing them for many years now. I just finished my 21st book. I guess it’s a fine madness, if you will. It’s not a way to feel good, but it is a way to feel very fulfilled and satisfied.

Sarah Guertin:

“Hi, there. I listen to your podcast on Spotify to help with my ADHD, OCD, and insomnia, which is an ongoing issue. I think I have other underlying problems, but that’s another story. I’m constantly learning about it. I’m doing online courses to understand my brain and others and how it all works, but I’m stuck. As a result of COVID became isolated with all my usual helpers and I’m scared. I’m 24, female in Melbourne, Australia. I live out of home at the moment in a share house on a noisy street and can’t concentrate. I’ve decided to move back home because it seems to be my only option for a healthy and financially stable lifestyle. I am currently having a meltdown. My parents both obviously have undiagnosed ADHD along with my younger sister, but she has been diagnosed. The house is full of clutter. I’m slowly trying to organize my old room, which is full of the classic hoarding of old clothes from all people from my family.” She has another sister, too.

“I suffer from OCD and like things to always have a place. I love self-learning and love how my brain works most of the time. I think I’m a genius to be honest. I just cannot seem to understand what is a good decision. Do I move home where the clutter is never ending and don’t think it will ever be perfect? Will I be overwhelmed with a house full of ADHD? I can’t think. I’m trying to be positive. I help people often. I’m kind and actually enjoy organizing, but this is so much that I’m currently living out of my car because I’m stuck in between the two houses. I’m stuck. I’m anxious. I need help. What actions do I take? What advice do I listen to? Where do I look for help? Thank you for your help so far. Your podcasts make me feel safe wherever I’m sleeping at night.” She put in parentheses a different bed every night. “I hope you are well. I appreciate the work you do. Hailey.”

Dr. Ned Hallowell:

Well, Hailey, what a wonderful email. What an amazing young woman you are. Gosh. I can’t remember the last email where someone said, “I actually think I’m a genius.” I love that you think you’re a genius because you are. Genius just means extraordinarily talented in some domain or another. I can tell just by reading your email, you are. What you need is what most of us with ADHD need, namely, some structure. You need to take all these wonderful ideas and images and thoughts and feelings that are ping-ponging around in your brain all day and most of the night and shape them, direct them, organize them. Like I say, ADD, you’ve got a Ferrari engine for a brain, but with bicycle brakes. Your Ferrari is zinging all over the place. You can’t decide on where to land. I think you need somebody to work with you, whether that could be a friend, if you can’t afford a professional help or a coach, probably it cost something, or an actual medical professional to take you on and help you construct a game plan so to speak.

It’s very hard to do it on your own. I would not. As for moving home, I assume the price is good. That’s an advantage. If you could create a space of the house that’s yours and if you could have it neat and tidy, then the chaos going on around you wouldn’t necessarily be a problem. If you all love each other, even if you’re a little chaotic, that’s fine. We can deal with chaos as long as there’s good feeling. You want to have good feeling. That force of connection is very formative as long as it’s positive connection. You say you suffer from OCD. It sounds like that can help you actually if you use that to get organized and have things in place. I think you really do need someone to sound off your ideas with and make some plans and set some goals. We really do well when we have goals.

Then someone to hold you accountable. That also helps if you could be held accountable. You have enormous potential, believe me for a 24 year old woman. I can just tell from your email, how much you’ve got going on inside that really zinging and zagging and zigging and zagging mind of yours. If you got some help and then I would certainly consider a trial of medication. You didn’t mention that in there, but you’ll need an MD to help you with that. When the meds work, they’re amazing. They really work wonders. If they don’t work, you just don’t take them.

The stimulant meds are in and out of your system very quickly. You can find out pretty fast if the meds will be helpful to you. If they are helpful to you and they help about 80% of people, then it makes all the rest of the interventions that you need so much easier. When you can focus, it’s like when you have eyeglasses. You can learn and do everything more felicitously. How’s that for a word, felicitously. Thank you so much for writing to us, Hailey. Please keep us posted on your progress. Let us know if we can help you in any other way. You are a genius. Don’t forget that.

[SPONSOR BREAK]

Dr. Ned Hallowell:

Before we get to the next question, I’d like to take a moment and talk with you about our wonderful sponsor, OmegaBrite CBD. As many of you listeners know I’ve been taking OmegaBrite CBD supplement for the past few months. It’s the newest supplement from OmegaBrite Wellness, creators of the number one, Omega 3 supplements for the past 20 years, which my wife and I have taken for quite some time now. We really swear by them. OmegaBrite’s founder, Dr. Carol Locke, graduate of Harvard Medical School, and her team set the standards for purity, safety and efficacy in the world of Omega 3s and have now brought that same commitment to excellence with their CBD supplement. I love the CBD because in my own case, it’s helped me with my reactivity, my natural impatience. I can be very impatient, reactive, peremptory. Since I’ve started the CBD, that’s sort of been blunted. I’m not like that. It hasn’t taken away any of my mental fastball at all. I encourage you to give it a try. You can find OmegaBrite CBD online at omegabritewellness.com.

As a special for Distraction listeners, the OmegaBrite folks have given you a 20% discount off your first order, but you have to use the promo code, podcast 2020. That’s pretty simple. Podcast 2020. Go to omegabritewellness.com. Order up some OmegaBrite CBD and some fish oil. While you’re there, you can also pick up some vitamin D. They also make that. Put in podcast 2020 and you’ll get 20% off.

[SPONSOR BREAK END]

Dr. Ned Hallowell:

All right. Sarah, what does the next email have to offer us?

Sarah Guertin:

“Hey, Dr. Ned. I don’t have a question. I just wanted to give my thanks to you. I’m a 28 year old from Australia who is only just diagnosed with ADHD late last year. I failed out of university when I was 21 and went through a lot of self hatred and depression, not understanding why I couldn’t cope. I decided to come back to university and subsequently found out about the ADHD and my whole life suddenly made sense. It was a rollercoaster of emotions. I spent some time feeling really down about it. Earlier this year, I discovered both you and Peter Shankman. Both of your perspectives on ADHD have completely changed my mindset and life. It’s allowed me to really appreciate my strengths. I’m now managing my weaknesses properly. I wouldn’t give my ADHD away if I could. I’m also getting nearly exclusively A’s on all my assignments as well and have regained a fire in my belly that had all but died out.

Anyway, that was a bit of a tangent. I was writing to you just to tell you that when I’m having a bad day or I’m feeling lost, I often go to your podcast and listen to an episode. I really like your short episodes where you give your thoughts on a topic. There’s something about the way you talk about your experiences that calms me down and makes me feel like everything is and will be okay. Thank you for doing what you do. I really appreciate it. Regards, TCM.”

Dr. Ned Hallowell:

Oh my goodness. What a wonderful email. Thank you. Thank you. Thank you so much. I’m really glad that I’m able to help you calm down and think that everything will be okay. I think what you’re finding is the truth of my little aphorism, never worry alone. I was taught that by my teacher way back when I was a resident. Dr. Thomas Gutheil. He used to say to us, it’s okay to worry. In fact, it’s a good thing to worry. Just don’t worry alone. I think you must find in listening to the podcasts, a companionship, an affiliation that always makes us feel better. When we’re alone, we globalize. We catastrophize. We lose hope. When we’re in connection, it doesn’t have to be in person like the podcast isn’t in person, we feel the energy. We feel the whatever it is that has not yet been discovered, that happens when a person connects, even just by listening because you’re inputting even though you’re listening. You’re also adding to my words with images, associations, thoughts, feelings.

Dr. Ned Hallowell:

If I started to describe the lake where my kids and I used to go growing up, you’ll think of a lake that you go to. That in and of itself will be calming and pleasant for you. You’re clearly on your way to doing wonderful things. I’m so glad you discovered Peter Shankman. I’m so glad you discovered me. Both Peter and I think of ADHD as something that if you manage properly can really enhance your life in a unique and wonderful way. I’m glad you’re discovering that. I’m glad you’re discovering the pot of gold at the end of this particular rainbow because it’ll be with you for the rest of your life. Thank you for writing in. I can’t thank you enough for your encouragement of me, which I need just like anybody else. Thank you again, TCM, from all the way from Australia where so many wonderful people live. Sarah, we have another one?

Sarah Guertin:

This next email is from Steven. He wrote in part “Dr. Hallowell, I’m 42 years old and was diagnosed with ADD at 39 by both a neurologist and psychologist. Before the diagnosis. I did well in college, earning three degrees, including a doctorate. I’ve been successful enough in the work world. Though, in retrospect, I see how strengths associated with ADD helps me and hindered me through the formal education process and how an earlier diagnosis would have been helpful. As I age my increasing difficulties with ADD correlate 100% with attempts to balance parenthood, my wife and I have three young children, career and related responsibilities. I’m convinced that I successfully self-medicated prior to marriage and children with long hikes distance running, long bike rides and time outdoors. That’s a bit harder to come by now. I need additional help. I’ve been taking generic Adderall for just over two years, either 10 milligrams XR, or single, or double dose of five milligram tabs as needed.

Overall, I’m satisfied with the medications impact. I tried generic Ritalin prior with a slightly lesser result. I find that when I skip a day of medication, I’m 100% okay, especially, if I’m not at my desk job. Self-medicating with exercise works better anyway, sometimes, but on the second day of not medicating, I become noticeably irritable, starting in the morning, far sadder than circumstances warrant and I’m generally a less agreeable husband and father.

One solution is to medicate daily, without exception.” Then he put this in bold. “But I’m hoping that my experience isn’t a sign of addiction. If it is what actions should I take? Finally, I’m otherwise healthy and fit. I rarely drink alcohol. I use no other drugs, recreational or prescription. I’m not prone to addictive behaviors. I take Omega 3 supplements per your suggestion. I do find that if I take an XR pill in the morning, I feel a drop-off late afternoon. I usually work through such or take a five milligram tab at onset of drop-off, especially if I plan to work or have meetings that evening, but taking medications too late in the day does affect my sleep.” It kind of goes on from there, but that’s the general question that he’s asking.

Dr. Ned Hallowell:

Steven, you’re obviously an incredibly talented person as so many people with ADD are. I’m really glad you got diagnosed and you got on medication. The fact that you feel funny after two days does not mean you’re addicted at all. It just means you’re suffering from some residual side effects, but you’re not addicted. If you were addicted, you would go into withdrawal. You’d have cravings. You’d become irritable. I do think it means you need to tweak the medications. What I would suggest is switching from Adderall XR to Vyvanse. Amphetamine is the active ingredient in both, but with Vyvanse the drop-off is smoother. I’ve found with most of my patients when they switch from Adderall XR to Vyvanse, they don’t have that crashing, as it’s called, period when the medication is wearing off. You’re managing it properly, by the way, to use the five milligram immediate release Adderall to temper that. I’m glad that’s working well for you.

Of course, exercise is the best of all in terms of self-medicating. Continue with the exercise. You might add in some meditation, which you can do five or 10 minutes once or twice a day. Don’t forget the vitamin C, vitamin connect. Stay connected with the people you care about. That all will help with these raggedy feelings that you can get. Push exercise. Push meditation. Push human connection. I would tweak the medication in the way I just suggested to switch from the Adderall XR to Vyvanse. Keep the immediate release Adderall toward the end of the day, but don’t take it too late or you will get insomnia as you’ve experienced. Thank you, Steven. Please stay in touch with us. Let us know what progress you make. Sarah, do we have any more?

Sarah Guertin:

This last one is a voice memo that we received from a listener named Grey. Grey reached out to us several months ago, Ned, when you did your meatloaf episode. He wrote to us and told us that he is a fan of meatloaf as well. Here’s what he recorded.

Grey:

“Hello, Dr. Hallowell. Greetings to you again. This is Grey, your meatloaf pal. I have a four year old daughter. We are working our way through classic kid appropriate music. We’ve been listening to The Sound of Music recently. After listening to Maria and I Have Confidence a few times, it dawned on me. Have you ever heard a better or more musical description of ADHD? Someone who has trouble following rules, but is a joyously good person and is determined to succeed despite repeated negative feedback. Perhaps you can name a future book, chapter, holding a moonbeam. I would love to hear your comments. Thanks.”

Dr. Ned Hallowell:

Well, thank you, Grey. Thank you for continuing our meatloaf association. I hope you are experimenting. There are as many recipes for meatloaf as there are cures for hiccups. Sometimes meatloaf will give you the hiccups. One of my favorite meals. I love to pair meatloaf with a baked potato. I don’t know about you. Then a nice salad or peas, but I don’t often get to have the peas because no one in my family likes them. I love them. I don’t know how you feel about peas. They go well with meatloaf and a baked potato. Anyway. Yes. Holding a moonbeam. Yes. That’s wonderful. I’m so glad you’re introducing your daughter to the world of ADD in such a positive way, which is indeed how it is. I think that’s terrific.

I love the image. Wanting to do well and do right, but not really inclined to be a conformist and paint within the lines. She’ll be carving out her own painting as the years go by. With a wonderful father like you and I’m sure a mother as well, it will all be coming up roses and moonbeams for you all. Thank you. Thank you so much, Grey. Please keep me posted both about your daughter and about your experiences in the world of meatloaf.

All right. If you have a question you’d like me to address in a future episode and it can be about anything including meatloaf or moonbeams or kangaroos in Australia, write an email or record a voice memo on your phone just as Gray did. Send it to us at [email protected].

If you’re on Facebook, be sure to like the Distraction podcast page. We post links to episodes, relevant articles and the occasional cute dog video, which I’ve got to make another one of those soon. It’s a good way to stay connected with the show and other Distraction listeners. We’re on Instagram and Twitter. Please give us a like and a follow on there as well. Now, if I knew how to do any of those things, I’d do it myself, but someone else does it for me. I’m too old this dog to learn those new tricks, but you are young and Instagram and Twitter savvy. Please do that. Like, follow, embroider and add to. Distraction is created by Sounds Great Media. Our wonderful recording engineer and editor is Scott Persson. Our producer is the estimable, irreplaceable and always effervescent, Sarah Guertin. This is Dr. Ned Hallowell saying goodbye for now.

The episode you’ve just heard was sponsored by OmegaBrite CBD formulated by OmegaBrite Wellness, creators of the number one Omega 3 supplements for the past 20 years. OmegaBrite CBD. Safe, third party tested, and it works. Shop online at OmegaBriteWellness.com.

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