388 | July Q&A with Brendan Mehan, Will Curb, MJ Siemens, Coach Moira Maybin, Coach Roxie Martin, & Barb

ADHD reWired

This week, we have the full panel of the ADHD reWired Podcast Family joining in for this month’s Q&A Session, recorded on July 13th 2021. Find all the good stuff below! [00:03:56] Maria, a mom and former teacher, asks about subtypes of ADHD. She also asks about structure and looks for tools to strategize while jump-starting a teaching career online and plan better. Eric explains how ADHD “subtypes” shifted to “presentations” because over time, the presentation of ADHD can change. He also goes in depth about the diagnostic criteria, and the differences between children and adults. Most adults are the “combined” type of ADHD, along with Eric himself. When looking for strategies, he goes on to explain how it’s important to look at the functional impairments. Any kind of diagnosis is a starting point, but isn’t prescriptive. Moira explains how as people age, the more we internalize symptoms, so the hyperactivity may be more in thought rather than physically hyperactive. Women are also more likely to be inattentive, in the inattentive type. As Maria put it: “Meta inattentiveness!” [00:09:24] Malika asks about menopause and how she’s observed that her symptoms have become much worse since it came on full time. Moira talks about estrogen, and once someone goes through menopause, the body doesn’t make any more. Estrogen reduces ADHD symptoms, which is why when women are pregnant, they present with fewer ADHD symptoms. And, while women are in perimenopause, the estrogen levels are more erratic than in puberty. She talks about how hormone replacement therapy can be used to replace estrogen, and it also depends on someone’s own health profile and family history, and hormone replacement therapy may not be for everyone. Another suggestion was increasing medication during that time, and a lot of things around lifestyle become important. Resource mentioned here: [0:14:31] Sandra asks, “How can I help my 14-year-old son become more organized for high school, and writing notes for his classes to study from for tests?” Brendan asks parents of ADHD kids: What’s going on with the IEP and the 504? What are the supports happening at school to help him get to where he needs to be? Brendan says the best option is to have someone take notes or provide them for him so that he has good notes to study from, whether it’s a teacher or a peer, so he can study notes that are useful. He explains that someone giving a model can help Sandra’s son understand how he should be taking notes so he can do a better job with moving forward. Brendan also explains to be patient as he practices his new [note-taking] skill, and to leverage IEPs, 504s, and talking to teachers, guidance counsellors, special education teachers, etc. Roxie talks about how she’s had to work really hard to take better notes and that models are helpful. She acknowledges that it’s about incremental changes, because the template or the model doesn’t automatically mean we become amazing at it right away. Resource mentioned here: Eric mentions a course on how to draw your notes. He also explains that sometimes we don’t know what’s important, so we might take notes on everything, then we try to distill what’s important and what’s not. Brendan also suggests taking notes in two different colors, and to switch colors when a concept changes. Will reiterates the sketchnote idea and is great to help create that organization. Will also mentions the Cornell-style of taking notes, then Brendan goes in depth with how they work and how he makes that style work for him. It can be good for [taking notes during] business meetings, too! Moira found how-to books, and suggests that note taking is a life-long skill. As a teacher, she actively tried to teach these tips to her students, not realizing it was because of her own struggle with it. She also recommends having conversations with educators who are going to be more helpful with things like this, so that it can be looked at as building a lifelong skill. It’s also okay for students to rely on their peer groups for good notes, share each other's strengths, and can make studying easier, too. MJ looks at note-taking from the student-perspective and how she would have liked to have been a part of the conversation to explain what works [for her], what doesn’t, and why. She explains that allowing kids to have the voice to explain what does work versus being told how it’s “supposed” to be done could be really helpful. Roxie brings up how it can be difficult to prioritize what’s important. She finds it helpful if she is really specific and succinct about what is going into the note-taking experience and writes a little road map. Eric emphasizes that, with all things ADHD, they require experimentation until we find out what works. [00:30:30] Ryan, who is in her mid-20’s, talks about struggling in the workplace with event planning and asks about a good system and starting place for planning, looking for tools on one hand and methods on the other. Eric says she gets to try a bunch of different tools to find the ones that work. Then, once they “stop working”, it’s likely because it got boring to use. He explains that there isn’t one “right” way to manage “all the things.” One rule, Eric explains, is to, “Get things out of your head. Don’t keep things in your head ever, it’s one of the most reliable places where things get lost.” In other words: Externalize as much information as possible using things like a calendar or a to-do list. He goes on to say that the issue may not be the tool, but how often we are interacting with the tools we have. Eric then explains how to “cue” ourselves when things are coming up, and to write in more information we need on our to-do lists and in our calendars than we think we need. Brendan shares the way he used to consistently screw up his own calendar, and shares what he does now so that others don’t make the same mistakes. He emphasizes writing down a “point-person” when a task or calendar event involves reaching out to someone. Brendan also talks about segmenting the to-do list in “today”, “this week”, and “this month/later”, depending on the individual’s ability to hold information and organize, how breaking it down could reduce overwhelm, and to write specific dates so we know when things are coming up and when they are due. Eric gets really specific: “What you’re doing NOW, what you’re doing NEXT. Everything else is just noise.” Will says the biggest part about using planners is consistency in getting used to that system and how there’s no perfect planner. Using one that’s “good enough” often really helps, and that it’s “okay it’s not perfect.” Roxie finds that when she’s having a hard time getting things done on her to-do list, it’s a good idea for her to check her boundaries if she is saying yes to too many things. Eric-ism: “Just because it got put on your to do list doesn’t mean it has squatter rights to stay there.” [00:39:43] Kim asks about food and diet, and how they went on a whole-food plant-based vegan diet. They’ve found it has helped with their energy and ADHD symptoms, and wonders if that is the experience of others who have gone on a whole-food plan-based vegan diet. MJ talks about how she experimented with pescatarian, vegan, then raw vegan diets in the past. For her, it depended on her activity levels and continues practicing with what her body feels like when she eats certain foods because it’s not always the same. She goes on to explain how it [a diet] depends on a person’s tolerances, allergies, and that it can take some experimentation, and learning and observing what feels good when we eat certain foods. Will says when we switch to diets like that, we tend to “up” the quality of foods we’re eating vs. eating foods detrimental to our ADHD. He also explains that there aren’t any specific studies [with data to back up] on diets that are good for ADHD. Roxie talks about inflammation, and how certain foods can cause inflammation, which causes brain-fog. For her, highly refined foods cause her to feel foggy. Eric talks about how corn is in a ton of things, and when there’s inflammation, it causes brain-fog, which affects quality of life. On an individual basis, he also encourages paying attention to the foods that do make us feel good, and the ones that don’t make us feel good. Experiment, and drink lots of water! Brendan circles back to what Will spoke to - we feel good when we replace “the crap” with broccoli and lettuce and apples and stuff. It’s important to recognize what makes us feel better because extreme diets are hard to maintain, and instead look at the fine-tuning. Moira works with a dietician who gave her an analogy: “When we have a sore throat, we’re not going to eat scratchy foods because it’s going to irritate our throats…. So if we’re eating smooth, cold things, it’s going to feel better. But it doesn’t necessarily mean that we should [always] eat that way.” And if we take something out of our diet like a whole food group but aren’t replacing it with something, we may become nutritionally deficient. [00:48:34] Gina is in the middle of getting assessed for ADHD and wonders about medication to bridge the gap between her strategies and her brain. She asks what it felt like if any of the panelists began taking ADHD medication as an adult. She wonders if medication may have a placebo effect or if it’s actually working. Eric talks about a WOW-effect when taking ADHD meds/stimulant medication. He vividly remembers taking his ADHD medication and, for the first time, he got through a chapter and actually remembered what he just read. For Eric, when the meds are working, it’s a profoundly noticeable difference and shifts him out of neutral. For Brendan, taking ADHD medication was subtle - more of a “heh!” than a “wow”. He noticed he would pick things up and put them away instead of just walking by them, thinking “Oh this must be what neurotypical people do.” Then, Eric and Brendan emphasize that their ADHD medication helps them do the things that normal people make look easy. Moira found that, as she was driving, she wasn’t strategizing while driving. ADHD medication also gave her more peace because she didn’t have as many thoughts. She explains that folks who have ovaries and a cycle, hormones will impact how medication works throughout the cycle. Moira and Eric also explain that a general rule is to increase medication dosage until the side-effects outweigh the benefits. Will is similar to Brendan with how the medication works for him, and finds it really noticeable when he’s not on medication. He notices it takes a long time to form thoughts, has long pauses, and answers things slowly. For Will, medication makes him feel “back to normal”. MJ is also in the “heh” camp like Will and Brendan. The “wow” came later when she noticed that she was able to catch up on two weeks of paperwork when she started medication. Her house got really clean, too. Roxie, while talking with her accountability team, explained how she’s had a hard time activating on some things, and lost sight of the medication piece when it came to activation. She wanted to err on the side of caution and spoke with her doctor about her dosage. She was happy to discover she has options. Eric explains how ADHD medication is a very efficacious medication, which does sometimes require trial and error. Jaclyn asks for advice or resources for ADHD parents of ADHD toddlers, especially regarding discipline. Brendan reframes “discipline”, which feels like having to let the kid “know” they’re in trouble. He likes to think more about boundaries, especially with toddlers. If they cross the boundary, they can be redirected and reign them in, instead of yelling at them. Gentle boundaries > Yelling. Brendan explains having a relationship with and being on the same team as our kids to reduce conflict, even in their teenage years. Moira explains how her and a friend wish, for their past selves, that there was more education about ADHD, being able to talk about people who had been there before as parents with ADHD and toddlers with ADHD. Moira also emphasizes taking care of ourselves, supporting ourselves, finding community, and doing everything we can to be a good parent. Will has a 6-year-old who is diagnosed. As a parent, it calms him down to assume that they are trying their best and don’t know any better. Eric quotes an adage: “[Your kid is] ...not giving you a hard time, they’re having a hard time.” Eric explains how ADHD is a developmental delay, and encourages taking the oxygen mask as much as we need to, especially if - as a parent - we also have ADHD. It’s okay for the adult in the family to take a time-out, too. Brendan and Roxie wrap up the final thoughts about parenting with ADHD. [01:06:08] Will closes the show with a groan-worthy dad-joke. Check out the Other Podcasts on the ADHD reWired Podcast Network: with Brendan Mehan with Will Curb with MJ Siemens with Moira Maybin coming soon - Wait, What Was the Question? with Will Curb and Coach Roxie Martin. Reach out to Will and Roxie at Don't Forget These, Too! — Get your name on the waitlist to join the fall season of ADHD reWired's Coaching and Accountability Groups — Join your ADHD-friendly co-working space! — Support the show by becoming a Patron! — Join Eric, Brendan, Will, MJ, Moira, Roxie, and Barb for an hour of Live Q&A on Zoom, every 2nd Tuesday of the month at 12:30pm Central (10:30am Pacific / 1:30pm Eastern) Other Noteworthy Mentions on the Show: