Based on the emails we’ve received, lots of our listeners are struggling with their ADHD right now. Dr. H addresses several questions in this episode including getting diagnosed while in quarantine, educational accommodations, impulsive versus compulsive, and the upside of being forced to slow down. And on a lighter note, Ned learns he’s not alone in his ADHD cooking misadventures!
Do you have a question or comment for Dr. Hallowell? Write an email or record a voice memo and send it to [email protected].
Distraction is created by Sounds Great Media. Our producer is Sarah Guertin (@sarahguertin) and our recording engineer/editor is Pat Keogh.
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A transcript of this episode can be found below.
Dr. Ned Hallowell:
Hello, welcome to Distraction. I’m your host, Dr. Ned Hallowell. And I want to thank all of you who’ve been reaching out to us with your comments and questions. We love them. We love them. We love them. We really, really do. So today we are going to prove it by devoting the entire episode to responding to your emails and questions that we’ve received over the past few weeks.
My producer, the incredibly talented Sarah Guertin joins me now, virtually of course, and she will read to me your emails so I can respond. I have not seen these before. So what I will be offering is an off the top of my head off, the cuff, shoot from the hip immediate response, which I hope will have some sense to it. So Sarah, welcome and would you like to read me the first email?
Certainly. Thank you. It sounds like you might’ve just gotten another one too.
Dr. Ned Hallowell:
Okay. This first email is from a listener named Maria. She wrote, “My eight-year-old son has been recently diagnosed with ADHD. His struggles were the same as me when I was growing up. As a 35-year-old woman and now professional accountant, I can see ADHD traits encroaching my everyday work life. Examples of this are having difficulty focusing on reading a long technical document and regularly interrupting coworkers. I’m fun to be around, but as I continue to move into more lucrative positions, I’m afraid my ADHD like symptoms will hinder my ability to learn more complex technical issues and to be taken seriously. With COVID-19 rampant, would an online ADHD specialist be able to give a proper diagnosis that can be used to start behavioral therapy and possibly if needed be prescribed medication? Thank you for your help. I love your podcasts. Stay safe.”
Dr. Ned Hallowell:
The answer is yes, an emphatic yes. And that’s something I’ve been learning during this pandemic. Pretty much every day I do just what you asked. I’ll make a diagnosis over Zoom on a new patient. Someone that I’ve never met in-person. The same principles apply. You take a history and you reach a diagnosis. So yes indeed and I would urge you to do that because if you do have ADHD and it sounds like you do, getting treatment for it can make an enormous difference.
And the treatment is not just medication. It begins with education and learning about it, what it is, what it isn’t, learning how it plays out in your life, in your relationships, and a number of different ways of dealing with it, which may or may not include stimulant medication. But the answer to your question, yes indeed. You can call my office in Sudbury or my office in New York, set up a Zoom session and I will get on the line and tell you whether you have this mysteriously fascinating condition or not and then take it from there.
If you want to know how to reach my office, just go to my website drhallowell.com.
Okay. Next up is an email from Jessica. She has actually reached out to us in the past, but this time she writes, “I love listening to your podcast and I truly appreciate all the different advice and suggestions you give all of us. You previously recommended me to find a job that best fits my personality and a place that I am happy. After juggling my finances and balancing my life, I took an opportunity and relocated from Southern California to Northern California and became a teacher.”
“I work with students that are in grade six to nine, with moderate to severe special education. I can honestly tell you that. I love my job. I am passionate about working with them. I learned something new every day. They love me and accept me with all of my disabilities. My struggle is standardized tests. I need to successfully complete my CBEST and CSET.”
And I looked those up. Those are California educator exams, but she says “I have failed the test and I have always struggled with all standardized tests. When I was in high school I almost didn’t graduate because of the same reason. I am constantly studying, but nothing seems to help me. What advice can you recommend?”
Dr. Ned Hallowell:
Well, if you have ADHD, which could very well be if you’re having trouble on standardized tests, medication could make all the difference in the world. So I would suggest you go get an evaluation. And again, as I just said, you can do that online during the pandemic and find out if you fit the profile.
Then if you do, you’re entitled both to extra time on the test, on the standardized test as well as if medication is helpful, medication to help you pass it. I had a patient this year, a wonderful doctor who had taken the board exam, which is sort of the equivalent of what you’re trying to pass four times and failed every time. And when we diagnosed her ADD and got her on medication and got her extra time on the test. This time, the fifth try, she passed with flying colors. And that’s not an uncommon story.
So we ADDers often have tremendous trouble with standardized tests, but the combination of extra time and perhaps medication could really make a huge difference for you. So I would get an evaluation and see if this would do the trick for you. Because this is a good chance that it would. Just go to drhallowell.com and we can set something up.
Okay. This email is from Chuck in Georgia. He wrote, “the instant pot story has me laughing and feeling better about my ADD cooking. I’m 55 now, and I’ve become a good cook and baker over the years, despite some failures.” So obviously he’s referring to that episode you released about your instant pot story.
Dr. Ned Hallowell:
But he says, “In college, I was making Kraft macaroni and cheese. I boiled the water and put the pasta in the water to boil the pasta according to the recipe. After boiling the noodles for the time stated on the package, I opened the cheese packet, added the cheese and stirred. I waited a few minutes and the macaroni just wasn’t coming together like it was supposed to do.”
“What I hadn’t done was pour the water and pasta into a colander before returning the cooked pasta into the pot, and then adding the cheese. I had poured the cheese into the boiling water and was waiting for the cheese and pasta to, I don’t know, cook down.”
He says, “If you enjoy this story, feel free to ask about my chicken curry and the wok or my bean burgers. Thanks for your ADD tips, advice and encouragement. They helped me. Thanks even more for Landmark College. My step son is a student there and really developing academically and as a man.”
Dr. Ned Hallowell:
Oh, that’s wonderful. I could see, in fact, I have made Kraft macaroni and cheese, and I almost did just what you did. I almost forgot that you got to drain the pasta before you put it in the cheese. So I could totally identify this. You’d pour in the cheese and then you’re watching it, hoping that it’ll turn into something that looks like macaroni and cheese, but all you’re getting is macaroni and cheese soup. That’s very, very funny.
I just did a little video I was talking about the downside of ADD, and I told the story on myself where I always have grapefruit juice and coffee for breakfast. And I take milk in my coffee. So I had the coffee cup there and I had the glass for the grapefruit juice and I had the grapefruit juice container and the half gallon of milk.
What did I do? I poured the grapefruit juice into the coffee and it’s just why would I do that? Well, I just wasn’t thinking as they say. But then I said the solution is structured. So from now on, I’m going to have the coffee cup and the glass for the grapefruit juice far enough apart, so that I’d actually have to think before I realized what I was pouring.
And now that won’t be foolproof, but it’ll be a step in the right direction other than my point was, don’t try to change yourself, change your system. It’s a lot easier to change your system than it is to change yourself. But thank you for your lovely story. I can just see the Kraft macaroni and cheese and turning into soup. Okay and thank you for your kind words about Landmark. What a great place that is. So do we have another one coming, Sarah?
We sure do. This next one is a little bit longer and I had to shorten it a little bit, but it’s from a woman named Rosemary. She wrote, “I grew up with a mother who was a hoarder and subsequently with the public attention to the problem of hoarding over the last 10 or more years, I came to understand that my grandfather was also a hoarder.”
“My sister and I grew up in conditions where the houses we lived in were always full of garbage, cockroaches, cat, feces, and mice when we lived in places where cats weren’t allowed.” Yeah, she says, “We moved to frequently due to evictions. Hoarding is treated as symptomatic of an anxiety disorder. I suffered from generalized anxiety disorder for several years following my husband’s death and cognitive behavioral therapy helped me a great deal.”
“More recently over the last two or so years, I’ve basically diagnosed myself as falling under the umbrella of what’s called ADHD. I haven’t been formally diagnosed. I am hyper-focused when it relates to my research or other things I find interesting, but I get years behind on taxes and paperwork is a nightmare for me.”
“I’ve always been very impulsive and extroverted, although I think I’m mellowing with age, currently I’m 49. In some, has anyone thought about a connection between hoarding and ADHD? I know that people with ADHD could also have other co-morbid problems. Maybe in my family, ADHD and anxiety have combined in certain ways that led to hoarding or problems that on the surface look a lot like hoarding, any thoughts?”
And then she followed it up with just another quick question. She’s also wondering about the difference between impulsivity and compulsivity saying she doesn’t quite understand the difference because when she gets an impulse, she often feels compelled to act on it.
Dr. Ned Hallowell:
Hmm, that’s interesting. Let’s start with the last question. Impulsive is simply acting without thinking. So you see an apple on the teacher’s desk and you snatch it without a plan, as opposed to someone who has a conduct disorder, they plan to take the apple when the teacher isn’t looking. So it’s a question of volition and that’s contrasting impulsive behavior versus a conduct disorder, low conscience, that kind of thing.
Now compulsive, compulsive is sort of akin to an addiction and you are compelled. You feel compelled to not step on the crack or avoid the number 13,, or not open an umbrella inside as in obsessive compulsive disorder, OCD, the compulsions or these irrational feelings that you have to do something. They’re not impulsive. They’re not spontaneous out of nowhere. They just rise up and they’re usually irrational, superstitious like stepping on cracks or not stepping on cracks.
So you’re quite right. You, you do feel compelled and it’s against reason. You’ve you feel compelled not to step on a crack, even though “that stepping on a crack is no problem.” People step on cracks all the time, but in your mind, your imagination plays a trick on you. And you conclude that it’s extremely dangerous to step on a crack. And so you’re compelled not to.
Impulsive, you suddenly do something without thinking. Compulsive, you are forced to do something out of irrational needs. Now you can also not have it be OCD-like. You can have compulsions like compulsive gambling, which is close to an addiction, sort of cousin to an addiction. Compulsive gambling, compulsive drinking compulsive use of the internet, compulsive shopping.
If you’re on your way to developing what could be called an addiction. So a compulsion in that sense is like a bad habit. It’s hard for you to stop gambling. You’d like to, but it’s hard for you to stop, or it’s hard for you to stop drinking. You’d like to, you’re a compulsive drinker. Or you’re a compulsive user of the internet, which applies to an awful lot of people these days.
You would like to do it less, but you can’t seem to willpower your way to doing it less. And so you are compulsive in that sense. So there are different meanings of compulsive. Now, as for your possible ADD, yes, ADD and hoarding are often found together. And the good news is if you get your ADD treated, you might find it a lot easier to get past the generalized anxiety disorder.
And while the CBT, the cognitive behavioral therapy helped you after the death of your husband, which is very sad, by the way, it sounds like he was pretty young if you were only 49. I’m sorry to hear that. That must’ve been pretty tough for you. But if you are the cousin to hoarding, generalized anxiety disorder, sometimes it goes away when you treat the ADD. Because one of the reasons for anxiety is feeling out of control and people with add often feel out of control.
They don’t know how they’re going to screw up next. They’re waiting for the next mistake to be made or the next reprimand to come their way. And so it creates a very anxious state to live in. And oftentimes when you get the ADD treated, you feel more in control, which immediately reduces your anxiety. Same thing, by the way, a lot of people are diagnosed with depression don’t really have depression. They’re just bummed out because they’re not doing as well as they know they could do.
And when they get their ADD treated, their performance improves markedly. And so what had looked like depression goes away because it wasn’t really depression. It was simply a feeling of bummed out because I’m not where I ought to be. You do that for a while and it can look for all the world like you’re depressed, but you’re not really.
Because once you get your ADD treated and your performance improves both the anxiety and the depression go away. This leads to one of the common mistakes that gets made is that someone goes to see a doctor who’s not familiar with ADHD and gets diagnosed with depression and anxiety, and gets put on a SSRI like Prozac or Zoloft. And that is not what they need.
It’ll help them a little bit, but what they really need as far as medication goes is a stimulant medication, which will help them focus, which will reduce their anxiety and reduce what had looked like depression. But wasn’t really depression.
Again, it comes back to how important it is to get the full and complete diagnosis and not treat symptomatically the anxiety and the perhaps depression.
So yes, go get yourself diagnosed and I hope the explanation of compulsive versus impulsive made sense to you as well. Thank you so much, Rosemary. Please keep writing to us. Do we have another one, Sarah?
We do. This one comes from a listener named Cynthia. She wrote, “My nine-year-old son and I are both ADHD experiencers. I have found your podcast to be excellent and wanted to respond about vitamin connection during quarantine. My hope is that society will appreciate the value of real flesh and blood interactions after this time. I am a musician and piano teacher and I’m hopeful people will appreciate music and making it with others more after this.”
Dr. Ned Hallowell:
Oh, I think there’s no way in the world that we won’t. I think we’re all missing human contact. I think we’re all missing what you get face-to-face that you can’t get. I’m doing my whole practice now via Zoom and thank God for it because I couldn’t do it at all were it not for that. But it’s not the same thing as being in-person with someone.
The depth of contact as one of my colleagues said to me the other day, the depth of contact is so much greater in-person than it can be virtually. Still, the virtual connection is good enough to get the work done, but it isn’t the same. And I think you’re right, this a shelter at home and quarantine is teaching us the value of what I call the human moment, as opposed to the electronic moment.
The human moment is just so much richer and fuller. The electronic moment will suffice, but it’s not as full and rich as the human moment. We have another one, Sarah?
We sure do. Got a couple more for ya. This is from Lauren, who also happens to be an ADHD coach. She wrote, “Hi there. I just listened to your short podcast about how not being around people is tiring.” What we were just talking about. “My ADHD 16-year-old son was telling me this last week. He doesn’t have many close friends in high school so I trying to understand what he was missing.”
“He said, it’s just being around people, seeing them and interacting at any level. He has been more tired, yet not able to sleep very well. It is interesting and makes sense. The funny part is he also says his morale is better at home without the social stresses of fitting in, in school and whatnot. Such funny contradictions, yet they make sense at the same time. Thanks for your insight and encouragement of your podcasts.”
Dr. Ned Hallowell:
Well, thank you. Thank you, Lauren. Yeah, it’s tiring. Not being around people is tiring. My wife said to me the other day, “Why am I so tired?” And it’s because we’re not getting vitamin connect. We’re not getting the human connection. She has me and I have her, but it’s just the two of us in the house. We connect. She’s a therapist also, we connect with our patients or clients over Zoom or telephone, but it is tiring.
I think it is because we don’t appreciate how important vitamin connect is. We don’t appreciate how important those human moments are. And it’s also interesting you said your son’s morale is better at home because the social stresses at school can also be a bummer. So you give with one hand and take away with the other. But when we come out of this, when we can get back to whatever we get back to I think one of the things that we’ll be celebrating and rejoicing, what a great thing it will be to be together.
I mean, an important part of my life and my wife’s life is the church. We attend Episcopal church in Cambridge, Massachusetts called Christ Church. We’ve been going there ever since we got married 32 years ago and it’s a big deal. I love going. People often talk about going to church is a burden.
No, for me, it’s a real replenishment. I loved the music. I loved the liturgy. I loved the stories from the Bible. I love the sermons and I love most of all the community. We don’t have that anymore. We have a virtual church, but I can’t on Sunday morning, go sit in that beautiful space and hear that beautiful music sung by living heart beating humans.
And my wife and I, we both really miss it, even though the church is continuing in its own way. We miss that community. And I’m also a big sports fan, season ticket holder to the Patriots. And we just lost our great Tom Brady, but I don’t know what it’ll be like if we have to play games with no one in the stadium.
When it’s taken away, you really notice how much you appreciate something when you can’t have it. And I think the human connection with other people in a crowd, be it a congregation or a football game or a shopping mall for that matter, all of those were essential parts of my life. I’m a pretty simple guy. Those are my pleasures and I can’t do them. You just go down that list.
Can’t go to a football game, can’t go to church. Can’t go to a movie. Can’t go to a restaurant. Can’t go to a shopping mall. It’s like, “golly” and nothing against my wife and she has nothing against me, but it’s pretty thin gruel, when that’s all you’ve got. And she would say, “What do you mean I’m thin gruel?”
Well, I’m thin gruel put it like that. We need more, we need more sustenance. Then we can get just hanging out, the two of us. It’s hard. We go for walks, we do and we wave at other people walking, but can’t get too close and it’s not easy. And your point is a very good one. When we can get back to it, it’ll be pretty wonderful.
In the meantime, we’re making the best of it and I hope this podcast is providing you with some form of connection. That’s certainly our aim in doing it is to connect with you all because you are our reason for doing it. So Sarah, you have another, I think.
Yes, I have one more. We love all of the emails, but this one I thought was especially touching. So it says, “Hi, I’ve been listening to your recent podcasts in the current COVID world and how it has impacted our lives. I wanted to share my personal experience. I have a 21-year-old son who has been diagnosed with ADHD, depression, anxiety, social phobias, addiction, lying, et cetera.”
“You could use them as an example, in every chapter of a textbook on ADHD. We have been deep in the trenches for many years. A year ago, he returned home from an unsuccessful college experience and his mental health was very fragile. We doubled down on the therapy and other resources, but I didn’t see much improvement.”
“Then COVID-19 became our new normal, the world stopped. He lost his job and has been home for six weeks now. I’ve been so impressed with how much he has improved. To me, it seems like the world has slowed down to his speed and he can now function productively. He has been great. He keeps a somewhat normal daily routine takes his medication daily, does a little work around the house, has maintained his personal space, does his own laundry and exercises.”
“All of his therapy has moved to virtual sessions, including a weekly group therapy. We have been given the luxury of time to figure out that this is all he can handle right now. We will build on this, but this slow world has been a miracle for him. He was obviously overwhelmed before.”
“I’m a little wary of putting too much weight on his success right now, but it sure is a bright spot for me in a world that really could use some good news. Thanks for all of your words of wisdom. I really enjoy your podcast. Sarah.” Not me.
Dr. Ned Hallowell:
Not you. What a lovely, lovely story. That’s so wonderful that given a chance to slow down, all those problems could sort of leave him, drift away, move into the rear view mirror. He needed chance to slow down, have some structure, have some vitamin connect from you. He’s getting what he needs in terms of structure, love, attention, and a pace that he can handle.
And I think success does breed success. So now he’s learning some adaptive life habits that will continue and will strengthen and become durable and will serve him. It’s a great thing seeing how a change in environment, a change in pace, a change in demands. What a difference that can make. That’s a wonderful, wonderful story.
And those of you who are listening, that’s quite a list of problems. He had ADHD, depression, anxiety, social phobia, addiction, lying. That’s why I don’t like the labels because you bury someone under all those labels and the real health can often get lost because you tend not to identify, diagnose health.
We tend not to list strengths or potential strengths, but those are the very factors that have been able to emerge and carry him now that he’s been allowed to have some pressure off and live at a pace that he can handle.
Thanks so much for your email, Sarah. It’s a wonderful story and a very hopeful story as well. Thank you, all of our listeners and sending questions and comments. Please, please, please keep sending them. If we didn’t get to your question today, we will get to it in the next podcast we do on listener comments and questions.
And if you have a question or comment, please, please send it to us at [email protected]. We really live off of your suggestions, comments, and questions. And as you see today, we do take them seriously and answer them to the best of my ability.
In any case, thank you for listening. Thank you for joining our community. Please tell your friends about us as we really want to grow and reach more and more people.
Distraction is a project of Sounds Great Media. Our producer is the amazingly talented Sarah Guertin and our audio engineer and editor is the also amazingly talented Pat Keogh. I am Dr. Ned Hallowell. Thank you for listening.