Cate answers your burning ADHD questions

It’s a solo mailbag episode! Host Cate Osborn grabs her trusty D20 (a dice with 20 sides) to let fate decide which listener emails to answer. 

Cate answers some common ADHD questions from navigating ADHD as a woman, to what it means to have a diagnosis, to how symptoms can shift as we age.

Related resources

• Understood Explains podcast season 2: ADHD diagnosis in adults

• ADHD and: Aging

• Facebook group: ADHD Support for Women by Understood.org

Timestamps

(00:00) Intro

(00:27) The rules

(01:14) Why do previously stimulating activities become routine?

(02:48) What does an ADHD diagnosis provide?

(05:30) What are some tips for self-kindness when dealing with problems we’ve created?

(09:56) How to not get too overloaded by a task

(14:52) Does ADHD become more calm as you get older? Are there future treatments other than medication being developed?

(21:38) A parting word from Cate

(23:04) Outro and credits

We love hearing from our listeners! Email us at sorryimissedthis@understood.org.

Episode transcript

(00:00) Intro

Cate Osborn: Hi everybody, and welcome back to "Sorry I Missed This," the show where we talk about ADHD and all things sex, intimacy, relationships, and communication. It's me, your host, Cate Osborn. And today we are doing a solo-pisode. I'm all by my lonesome today because we are doing a mailbag episode.

(00:27) The rules

Cate Osborn: You may not know this, but I have my very own email at Understood. It is sorryimissedthis@understood.org. And every so often, we get questions, and I get a lot of DMs and a lot of questions in my real life. And so my mailbag tends to stack up. And so I thought it would be fun to randomly choose some of those emails and messages and answer folks's question here in a mailbag episode on "Sorry I Missed This."

And to help me out, I have my trusty D20. If you've ever played "Dungeons and Dragons," this is the dice that runs it all. If you've never played "Dungeons and Dragons," D20 is a dice that is numbered 1 to 20. I'm going to roll the dice. I'm going to count down the little un-emailed answer list. Please don't judge me for having so many unanswered emails. And we will see what questions our dear listeners have.

(01:14) Why do previously stimulating activities become routine?

Cate Osborn: All right, so the first number that we have is lucky number 11. So this question comes from Scone. "Why does my brain disassociate, drift off, and start thinking of unrelated things when I'm in the middle of doing something that is normally stimulating?" That is a really interesting question. And the answer is honestly pretty simple.

The way that our ADHD brains synthesize and absorb information, sometimes stimulating activities become routine, even if you are doing something that you really love and you and you really enjoy, up to and yes, including intimacy. Sometimes it can get repetitive. It can get a little bit boring. And our brains are always seeking out a little bit of novelty. And so it can be easy to start thinking about other things or, you know, "Hey, what if I won the lottery?" or, "Hey, what if I ran for governor?" I think a lot about heists and what would happen if I became president, which I don't think anybody wants.

But that's basically what it is. It's that your brain is just constantly cooking up there. Your brain is constantly working on stuff. And scientifically, I'm sure that there's a much better and more interesting explanation, but your brain is just looking for something to do. And sometimes, even when you're having a good time during the activity, it's not enough to keep your ADHD entertained. So you just start thinking about other stuff and then you go, "Oh, I'm not paying attention to the thing that I was doing," and you got to bring it back around. And that is one of the weird and strange things about living with ADHD. It doesn't matter how entertained or how stimulated you are, sometimes you're just going to check out and start wondering about like grilled cheese sandwiches or something.

(02:48) What does an ADHD diagnosis provide?

Cate Osborn: Okay, number nine. I don't know, I'm going to say that's a nine and not a six. Okay. "How can I get diagnosed with ADHD? I go to a free Baptist clinic and they neither diagnose nor treat ADHD. I really feel like I do have it. I connect with everything I read about it. Also, I have heart failure." Wow. "So I am pretty sure that I can't use any of the standard ADHD meds. So I wonder what I can use if I get the diagnosis."

That is a great question. And, first off, dear listener, I'm so sorry that you're dealing with heart failure. That is very scary, and I hope you're doing okay. But the real truth is that an ADHD diagnosis provides nothing but information more than anything else. The story that I always tell is that I walked into getting my ADHD diagnosis the same person as I was walking out of my ADHD diagnosis except for now I knew what to Google, basically.

And so, yeah, if you feel like an ADHD diagnosis is something that you want to pursue, there is no rule that says that you have to pursue medication. Medication is an incredibly valuable tool for a lot of people with ADHD, but it doesn't necessarily mean that it's right for everyone. Also, there are different types of ADHD medications. There are different things that you can try and explore. But the thing that I always say is even if you aren't sure about getting an ADHD diagnosis, even if you're not sure that you fulfill all of the qualities that you would need to walk out the door with a diagnosis, there's no rule that says that you can't use ADHD tips and tricks and tools and suggestions and systems to support you throughout the day, right? Everybody forgets stuff sometimes. Everybody, you know, struggles with organization a little bit. Everybody has a little bit of executive dysfunction. And the amount to which you do uh, is really kind of dependent on your ADHD diagnosis.

But you're allowed to use organizational systems that are geared towards people with ADHD. And so if you aren't sure about getting the diagnosis, if you're not sure what the diagnosis will provide for some people, it's clarity. For some people, it's confirmation. For me, it was really meaningful in terms of helping me realize that I wasn't broken and that I wasn't a screw up. And there was a reason around the things that I had been struggling with. For other people, it's not that big of a deal. It's not that life-changing. They just go, "Oh, okay," and they move on with their day. So ADHD diagnosis is a personal choice. It is a choice that involves a lot of, I think introspection and even asking yourself what the diagnosis will provide for you. But you're not taking away anything from anyone if you use ADHD strategies in order to manage your life, even if you don't have ADHD.

(05:30) What are some tips for self-kindness when dealing with problems we’ve created?

Cate Osborn: 15. One, two, three. Oh, I like this question. "What are some tips for maintaining self-kindness when coming out of depression and being surrounded by problems of my own creation?"

That's a really good question, and that's honestly something that I struggle with as well. Literally, last week, I did that very classic ADHD thing where I very irresponsibly packed my depression medication, took it with me to the conference where I was speaking, took it every day, it was great, came home and was avoiding unpacking my suitcase. And so I just frankly forgot that my antidepressants existed for almost a week. And so I found myself in a downward depression spiral that was absolutely of my own making. And I was really frustrated. I was really angry with myself and I was like, "How could I be so stupid? How could I be so dumb? I can't believe that I just kept forgetting to take my meds out of my suitcase."

And so I really had to take a step back and I think in answering a question like this, I think it's also really easy to sound a little bit trite or a little bit insincere, but I really do mean it when I say that you have to give yourself intentional grace. You have to give yourself intentional patience. Like even the, even the phrasing in this email, "problems of my own creation," like, yes, I am the reason why I forgot to unpack my medication. But the forgetting, the out of sight, out of mind, the executive dysfunction, the overwhelm of the thought of having to unpack my suitcase and all of the tasks that are related, all of that is related to my executive functioning and my ADHD. And so, yes, I think legally on paper, you could say that was a problem of my own creation. 

But it is also a problem that is directly related to my disability, to your disability, to ADHD. And so for me, one of the best things that I think I have been able to do in terms of pursuing self-kindness is to just take a moment when I feel that frustration coming up when I feel that anger, that self-hatred, that even resentment towards my sometimes lack of ADHD coping mechanisms or, "I wish that I had better skills, but you know, I've only gotten my diagnosis recently," you know, those kind of things. When I find those angry and negative emotions spiraling up, what really helps me is to focus on emotional regulation. And that's hard. It's really hard. It's especially hard work if it's a skill that you are learning or working on. It's even harder if you are a person who deals with something like alexithymia, where maybe you struggle to even know what you're feeling in your body and like what emotion is going on with you.

And it's all so connected because if you think about you're coming out of depression, you know, maybe you've got mess, maybe you've got clutter, maybe you've got garbage and empty cups and empty dishes by your bed. That's a lot of tasks. That's a lot of steps. But those tasks and those steps aren't going to go away if you are being cruel to yourself. And I think sometimes I honestly trigger my own rejection sensitivity to a certain extent, just in terms of really making myself feel like crap instead of just saying, "Hey, you know what? I was in a depressive episode. That is a thing that happens to me sometimes."

Again, I know that it sounds maybe like a really trite answer to be like, "Just be nicer to yourself." But I think just taking time, giving yourself time, maybe do a little detective work as well. Like, "Hey, if I get really frustrated because there's a bunch of empty cups next to my bed when I'm going through depression, can you put a bin there?" Can you make just like one shortcut that makes your life 1 to 3% easier? And I do that a lot. I have, you know, like a dishes bin in my office. I have garbage cans everywhere in my house. I keep cleaning supplies literally within arm's reach because I know that if I make a mess and I'm already feeling crappy and I'm already feeling discouraged, um, it's gonna be less easy for me to like get up and do the thing. So I try and keep stuff handy in order to keep myself clean and fed and watered.

And honestly, dear listeners, I would love to know, this is your call to action for this episode, email me, tell me what you do. Tell me how you handle this because I think this is something that is really going to resonate with a lot of the women who listen to this show. So, all right, next question.

(09:56) How to not get too overloaded by a task

Cate Osborn: Natty one. In "D&D," a one is a very bad roll, but it's okay. We'll go to the first email.

"My partner has a hard time with getting headaches when he gets a lot of tasks. He's on meds, but are there any tips to help his brain not get so overloaded?" 

Break it down. I think that's, that's my number one tip is break it down, right? Especially if, you know, the tasks are producing such a cognitive load that you're getting a headache or you're getting exhaustion or you're feeling a lot of overwhelm. Because overwhelm can manifest in our bodies in a lot of different ways. For some people, it feels like anxiety. For some people, it feels like depression. For some people, it feels like panic. For some people, it's, you know, headaches, eyestrain, that kind of thing. So I would say the first thing is you don't have to manage a lot of tasks at the same time if you don't want to. Is there a smaller component part of the task that you can do? Can you load in a few dishes in the dishwasher and then walk away, go do something else, take your dog for a walk, then come back, load a few more?

I think we put a lot of expectations on ourselves based on how people without ADHD live. "Of course, I should be able to load the dishwasher all at once. Of course, I should be able to vacuum the whole house. Of course, I should be able to clean my bedroom all in one go." But I really think that if you look at how ADHD symptomology works and how ADHD impacts our executive functioning, we are not built to do things in the same way as other people, right?

For me, I tend to use a lot of lists when I'm cleaning. And my list, actually, I have a list. So like, I let a bunch of stuff build up in my hallway and it became sort of an obstacle course of trying to get into my office. And I was like, "Okay, this has gone on for long enough. I need to do something." But even starting that task, that was like a big deal for me. I put it off for months and months and months 'cause it was so overwhelming. But so I made a list. And my list looks like clear path. And I thought, "That's way too much. Like, what does that even mean?" So I broke it down further. And I said, "Bag up costumes because I keep a lot of costumes in my hallway. It's a long story." I said, you know, "Collect trash, take giveaway stuff downstairs, bring bins into office, take boxes downstairs, add like with like."

And then I divided those out even further, right? So Renaissance fair costumes need to get sorted. Regular weird costumes need to get sorted. Props and costumes need to get sorted into separate categories. I break it down into minuscule tasks and then I give myself time. I give myself patience. I say if all I get done today is making that list, at least I've got a list started. At least I've got this small part done. And then I look at the list and I say, "Okay, I might not be able to bag up all of the costumes, but I bet if I start grabbing costumes to put into a storage bag, let's see how much I get done before I start feeling that overwhelm."

And I think being really honest with yourself about overwhelm and when that headache starts creeping in, and when that panic and that anxiety and that depression, and that, again, that feeling of like, "Oh, I'm so stupid and so dumb, I can't do anything right." That's your break time. That's your break moment. That's when you say, "Nope, I'm not, I don't need to fight through this. Instead, I'm going to go pet my dog or touch some grass or play a video game or something." But then also the sort of, I think, converse side of that is also taking the accountability and the responsibility that you need to make sure that you then come back to that task. And that can be the really hard part.

So the facilitation of that can also look like things like timers or, you know, scheduling time on your calendar to make sure like, "Hey, today we're going to do all the trash," or, "Hey, you know, remember to take the bins down to the..." This is a weird rant to go into off of this question, but I'm in my feels today, so I'm just gonna sort of take ownership of that. But I think one of the hardest things for me as a person who talks about ADHD is that I can't tell you what to do. I literally can't. I can't tell you what is going to work for you. I can give you suggestions. I can tell you a hundred different ways that a hundred different people in a hundred different places manage their time or their overwhelm or, you know, even just the daily stuff like taking out the trash or the chores. But I cannot guarantee that any one of those hundred tasks are going to be right for you. So what I can tell you, what I can talk to you about and the thing that I'm really passionate about is helping people build that self-awareness, building that curiosity, that, that sense of investigation of, "I'm going to be a detective about my own systems and structures and what is going to work for me." And so are there any tips to help get his brain not get so overloaded? Yeah, absolutely. There's probably thousands that might work.

But where you have to start is where your partner has to start is with himself. Where is that overwhelm coming from? What does that overwhelm feel like? Does it feel like resentment? Does it feel like depression? Does it feel like a headache? Does it feel like, you know, a panic attack? And moving forward from that point.

(14:52) Does ADHD become more calm as you get older? Are there future treatments other than medication being developed?

Cate: 15, “I would like to know if ADHD becomes more calm as you become older. For instance, if there is a high chance when you're younger that it is so disruptive, but as you grow older, 20s, 30s, 40s, does it mellow out? I also would like to know if effective treatments now are changing. Everything I know about this is that most children are given medicine that mellows them out or they become zombies. A lot of parents do not like giving their children medicine unless they're in class. I would like to know if there is another future treatment that is going to become available to help this.”

That is a great bunch of questions and I think it's really interesting 'cause there's a few misconceptions that we can break. There's a few stigmas that we can break and we can talk about. So let's dive into this question. But the first part is, does your ADHD become calmer as you get older?

One of the big focuses here on "Sorry I Missed This" and Understood.org's "MissUnderstood" initiative is, you know, ADHD in women and aging. And what we see is that for some women, their ADHD does tend to mellow out. For some people, their ADHD does get easier to manage as they get older. But we also see a lot of older women getting diagnosed with ADHD when they start menopause or perimenopause because the systems and structures that they had are breaking down because their ADHD symptoms are becoming more prevalent and affecting their life more. So I think the first thing that you really have to caveat with that question is that it kind of depends. And it kind of depends on what part of your life cycle that we are talking about. And it also depends, I think very deeply, person to person.

However, this wonderful question asker did also highlight this, that is there a chance that when you're younger, it is disruptive, but as you grow older, does it mellow out? I think the way that I would, I would answer that question is that ADHD is changeable, right? Like ADHD changes throughout our lives. And as we develop more skills, our ability to self-regulate, our, our ability to, you know, self-observe, those kind of things, a lot of kids with ADHD who do start out being kind of, you know, the very stereotypical troublemakers in class, a lot of them do wind up being, you know, really good students or not struggling as much because they've developed those tools.

However, I also think that this is an important place to say that a lot of those tools and a lot of those supports are a privilege that not every kid has, right? Especially if you're a kid with ADHD who doesn't have a diagnosis, you might not learn healthy coping mechanisms or the mechanisms that you do learn might, I literally just said this, but they, they might be really unhealthy. And so, yeah, so it's, it's a, it's a complex question because a lot of it has to do with not only the individual but the supports.

But the thing that I would say is that especially when I first started doing this work, there was this sort of notion that ADHD is a kid thing. And, you know, kids who run around in class and they misbehave and they're the class clown and they're loud and they're disruptive. And then, you know, like a magical fairy comes on their 18th birthday and takes away the ADHD and they live the rest of their life as a functional adult. And it's just simply not true.

Again, the way that ADHD manifests, the way that ADHD shows up, a lot of the hyperactivity, instead of being externalized, a lot of times that can turn internal. And again, that's where we see a lot of like those coping mechanisms come in because when your hyperactivity is internalized, it can be really uncomfortable. And that can manifest as things like impulsive decision-making based on factors in your life. For instance, a lot of people with ADHD deal with like I do, I absolutely do, things like impulsive or compulsive spending because the hyperactivity is still there and you need a place to put that energy. And so online shopping or gambling or things like that are a place where sometimes hyperactivity shows up.

And those can be pain points. Those can be shame points. So, yeah, I think that's maybe an answer to that question “is ADHD is going to stick around?” Most people don't, quote-unquote, "grow out of their ADHD." If anything, they learn how to manage it better, but that doesn't mean that you don't have ADHD anymore. ADHD is a neurodevelopmental disorder. You are born with it. You are gonna have it forever. The extent to which it impacts and affects your life, individual to individual, which is annoying. I wish that there was just one answer for every ADHD question, but there's not.

The second part of this question is, are there future treatments coming up that are going to improve the way that we relate to medication? And the answer is certainly yes. I am definitely not a research scientist, but I can tell you that there have been some really exciting and really interesting studies that have started being produced. There's also new medications that are coming out where instead of taking them during the day, you take them at night, they help you sleep, and then they help you sort of function throughout the day, which I think is really cool and really interesting. Frankly, I would love to try that.

And then I also kind of want to touch on this. “Most children are given medicine that mellows them out or they become zombies.” The truth is that medication is really stigmatized. And the way that we talk about medication is, I think, sometimes really polarizing and really damaging because what we see is that when kids are properly medicated, when they are getting the dosage that they need, when they are taking a medication that is right for them, they thrive. We see it reduces the rates of addiction. It reduces the rates of substance use disorder. It reduces the rates of things like eating disorders and binge eating and gambling issues and even driving issues. Like a lot of teenagers with ADHD have issues with driving and they tend to get in more driving accidents.

But yeah, that notion of "we're turning kids into zombies." If that is happening, something is going wrong. If kids are feeling like their creativity is stifled or they're not the person that they were before, that is a medication issue. Especially if your kid is a kid on medication, it is important to involve your kid in that discussion and talk to them about how they're feeling and do they like it and are they comfortable and are they struggling? Are they feeling all right about it?

This idea of: parents don't like giving their kids medicine unless they're in class. That's also okay too. Like I'll be perfectly honest, I don't take my ADHD medicine every day. Sometimes it's nice to give my brain a break. Sometimes it's nice to just sort of have the day off. Especially if I'm not doing anything. But yeah, there's a lot of really interesting stuff going on with ADHD medication. I know Understood even has resources and stuff available regarding medication, so I encourage you to check those out. I'm not a doctor. I will be in a year, but not right now. So yeah, that is my very long-winded answer to that question, the end.

(21:38) A parting word from Cate

Cate Osborn: Well, hey, dear listeners, that is all the time we have for today's mailbag. Thank you to everybody who has written in. We will be doing these again. So once again, if you want to email sorryimissedthis@understood.org, please feel free. We love hearing from you. We love knowing what you love about the show. And I don't know, maybe this is a little bit soapboxy, maybe this is a little bit, I'm just going to go with the word "cheesy" because all my big expensive words have fallen out of my head.

But I hope, dear listener, that in listening to these questions, you realize that there are so many people out there who are struggling with the same things. Every day I get dozens and dozens of questions from people, and so many of them are around the same topics we talked about in today's episode. And so I just want to encourage you that if you are feeling alone, if you are feeling discouraged, if you are feeling overwhelmed, please not only reach out, but also utilize the resources that are available to you. Understood.org has so many incredible education resources. The "MissUnderstood" community is growing and is becoming something really fabulous. And so if you're a person who is feeling that lack of community but that strong sense of overwhelm, especially right now with everything going on, go check it out. I really hope to see you around in the community spots that we have built. But anyway, thank you so much for listening. Thank you so much for being here. And I will see you next time on "Sorry, I Missed This."

(23:04) Outro and credits

Cate Osborn: Thank you for listening! Anything mentioned in the episode will be linked in the show notes, with more resources. Have a question, comment, burning story you'd like to share? Email us at SorryImissedthis@understood.org. 

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

Video is produced by Calvin Knie and edited by Jessie DiMartino. Our theme music was written by Justin D. Wright, who also mixes the show. Production support provided by Andrew Rector.

Briana Berry is our production director. Neil Drumming is our editorial director. From Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Jordan Davidson.

And I'm your host, Cate Osborn. Thank you SO much for listening!