After 5,000 ADHD Assessments, I Noticed This Pattern...

1. 0:00 – 2:33

   The Heartbreaking Reality of ADHD

   1. APAlex Partridge0:00

      Everyone wants to be ADHD until you're starving in your room because your appetite being completely gone, because you're worrying about something so minor that happened that didn't go your way, and now you're overthinking about something constantly, so you can't eat and it hurts. It's a hyperfixation thing, which is where the attention part comes in. We can't focus on school because we're worried about the world around us and our own little goals in our head that aren't told to us. We don't like being told what to do, and that hurts us a lot because the idea of school and being told to sit down is against our very nature, and it hurts us, and it creates this anxious effect, and people online just think it's a silly condition you have or some silly quirk. It's a lot worse than people think, and nobody will understand. They think it's a fake illness, but it's much worse than that. Danielle, you've assessed thousands of people with ADHD. What do you think when you hear someone say those words?

   2. DMDanielle Mulligan1:02

      I hear those words a lot, and I think it's, um, something that has become somewhat popular in the social media world. I think a lot of people talk about ADHD, and I think a lot of people have somewhat jumped on, "Well, I can't concentrate at this time and that time." And I think people think it's somewhat a fun thing to have-

   3. APAlex Partridge1:23

      Mm

   4. DMDanielle Mulligan1:23

      ... because there's people with ADHD that present the really fun side of ADHD rather than the difficult sort of things that were mentioned in that in terms of the, the schooling, in terms of the, you know, the really hard graft and the effort people have to put in on a day-to-day basis is exhausting, and people don't see that, and that isn't publicized the same as the fun parts of ADHD, the hyperactive, impulsive decisions, the fun ex- excursions on holiday that they get into. Like, all of that is seen as being fun and, and happy, whereas-

   5. APAlex Partridge1:58

      Mm

   6. DMDanielle Mulligan1:58

      ... you know, people with ADHD often talk about how they wish they didn't have it.

   7. APAlex Partridge2:04

      Yeah. Oh, so interesting. I think, like, the fun side of it, the sort of bubbly character, the, the loud, energetic person at the party is so often actually just a mask.

   8. DMDanielle Mulligan2:13

      Mm-hmm.

   9. APAlex Partridge2:13

      And people don't see, like, the inner turmoil and the effort that goes into maintaining that facade of, quote-unquote, "normal" just to keep everyone else happy whilst inside often crumbling with, with shame. Like, there's-- I think there's one big misconception about ADHD that does the most damage, and we're gonna come back to that in a moment.

2. 2:33 – 6:47

   Why ADHD Makes You Feel Broken

   1. APAlex Partridge2:34

      But do you think many people come to you as an ADHD assessor believing that they are fundamentally broken?

   2. DMDanielle Mulligan2:41

      Uh, yeah, I think a lot of the time they're, we're a, a last cause. I think it's... They've had years, especially in terms of adults, they've had years of coping, masking-

   3. APAlex Partridge2:52

      Mm

   4. DMDanielle Mulligan2:52

      ... looking like they're coping, feeling like they've not got it together, looking at the world and the world's coping and comparing themselves to, "Well, actually, you know, she's got it together with two kids. Why have I not got it together with two kids?" And not really understanding that they've hidden this for years and years and years, and I think they will see themselves as the problem. And I don't think they come thinking, "I've definitely got ADHD." I think they come and think, "This could make sense. Um, but if it doesn't, then I am the problem." I think it's a really not negative thing, but they come with this really negative side of, "What's wrong with me?" and help me sort of thing. Um, but I do think many, many, many people come thinking that they're just-- they're not, not normal. What is normal? But they're not normal. Um, and I do think social media makes it hard.

   5. APAlex Partridge3:43

      Mm.

   6. DMDanielle Mulligan3:43

      I think, you know, everyone posts the best bits of their life, don't they? And I think more people are starting to document that struggle. I think I'm seeing more things like, you know, like parents documenting the negative side of parenting because it, it's great, but it's hard. And then equally, you're seeing a bit more of that in the ADHD world as well, where not everyone's posting the beautiful side. They're also posting the difficult side. Um, but I think a lot of people walk through the doors or, like, you know, log on, come onto an online assessment and say, you know, "What's wrong with me? Because I'm, I'm still struggling and I've tried everything, and it's no better than it was before."

   7. APAlex Partridge4:21

      I think social media is so toxic generally for ADHD particularly 'cause like you said wonderfully, you end up comparing your behind the scenes, which often could be lying on the sofa completely paralyzed with task overwhelm, fully aware of how much stuff you have to do. You know you've got to text that person back, reply to that email or clean the flat, but because there's just so many highly caffeinated squirrels in your mind, you just can't do it, and you're beating yourself up inside. And then you go on social media, and you see somebody who's got a promotion or they're on that perfect holiday, and that comparison really, really eats away. There's-- the horrible consequence of that is you're-- you end up lying there thinking that you're lazy or you're crazy or you're fundamentally broken. What traits of ADHD do you think are responsible for that feeling?

   8. DMDanielle Mulligan5:09

      So I think the hyperactivity side of it where, like you rightfully said, you're sat there thinking you need to take the washing out, you need to clean the flat, you need to go food shopping, and oh, actually, you've got that assignment at work that you've not finished yet, and, and that task overload and that sort of hyperactivity, restless side of the ADHD, I think is what makes people feel like they're lazy. And saying someone with ADHD is lazy is the most backwards way of thinking you've ever-- Like, it's the-- Like, it shouldn't even be in the same sentence together.

   9. APAlex Partridge5:39

      Mm.

   10. DMDanielle Mulligan5:39

       And it's-- They're not lazy at all. It's that hyperactivity or restlessness, that overthinking, that 100 mile an hour, that, like you say, they just sit there froze and, and people don't know what to do next because they've got so much to do already. And I think that's the biggest thing for me that- That's the unseen. You don't see that-

   11. APAlex Partridge5:59

       Mm

   12. DMDanielle Mulligan5:59

       ... 'cause all you see is a shell of a person sat not knowing what to do, not all of that ticking around inside. And it'd be great if you could, like, see that because I think everyone would go, "Oh, my God. Stop. Turn it off."

   13. APAlex Partridge6:11

       Yes.

   14. DMDanielle Mulligan6:11

       "Turn it off."

   15. APAlex Partridge6:11

       Yeah. [laughs]

   16. DMDanielle Mulligan6:12

       "I don't wanna see it anymore." Whereas, like, that's what people with ADHD deal with every single minute of the day. Even when they're asleep, it's still going on, and I think that's the unseen side that people don't realize, and I think that's probably the hardest thing for people with ADHD, that, that just never stopping.

   17. APAlex Partridge6:31

       Yeah. I don't think there'll be a single person listening to this podcast who hasn't at one point in their life been told that they just need to try harder.

   18. DMDanielle Mulligan6:38

       Yeah.

   19. APAlex Partridge6:38

       And they're thinking-

   20. DMDanielle Mulligan6:38

       Just do more

   21. APAlex Partridge6:39

       ... do more. They're doing so much more. They're trying so much harder than, than the people that ha- say that to them realize. It's just invisible. It's like that internal workload.

3. 6:47 – 10:35

   The Scary Pattern After 1,000s of ADHD Assessments

   1. APAlex Partridge6:48

      This is heartbreaking. You've assessed thousands of people with ADHD. What's the biggest pattern that you see amongst those people that scares you the most?

   2. DMDanielle Mulligan7:00

      So for me, it is the people with ADHD that have a really successful life. So on the surface, they've got a really good job or a good business, or they've got families, or they've got all of the above, and they just go through life, you know, on their success that you don't see the graft they've put in. You don't see the overtime they've put in. You don't see the doubt, the anxiety, um, all of the extra bits that have helped them keep afloat. You just think, "You can't have ADHD. You're really successful." Yeah, but you don't know that I, I sleep for three hours, and I wake up, and I have to then get my notepad and then jot a load of things down because it's all in my head. And, and I think I've assessed, especially in Focused, a lot of successful people that it surprises me that they don't think that ADHD is a thing for them because they've been successful.

   3. APAlex Partridge7:53

      Mm.

   4. DMDanielle Mulligan7:53

      Like, they did well in school. Um, they got good grades. They've got a successful job. But then when you dig deeper and then you find, well, they ended up working for themselves because they couldn't do that whole nine to five. They couldn't do that whole structure. They couldn't fit in that box. But then when they worked for themselves, it was great. And then it's even better when things are going terrible in their company because that's when they kick in, and they're like-

   5. APAlex Partridge8:19

      Yes

   6. DMDanielle Mulligan8:19

      ... "This is what's going on. I'm getting it all."

   7. APAlex Partridge8:21

      Yeah. [laughs]

   8. DMDanielle Mulligan8:21

      But when it's doing well, they're almost waiting for it to fail.

   9. APAlex Partridge8:24

      Mm.

   10. DMDanielle Mulligan8:25

       And I think that's something that has surprised me the most because the world, I think, believes that unless you're that naughty boy bouncing off the walls in school, there's no way anyone can have ADHD. Like, you can't be a successful business person and have ADHD. And I think that people need to understand that success doesn't mean there isn't an impairment. It just means that you're not seeing, like say, that behind-the-scenes footage of the struggle that's real. You're just seeing the great bits that have come out of it. And a lot of people as well I've assessed have, have been driven by their ADHD symptoms that have got them to that position. So that impulsive nature got them in that business, that got them, made that crazy business decision that I would've gone, "No, do not do it. You're gonna lose everything." But then it's worked out because they've just gone with it. And I, I think people... I hear it a lot about, "You can't have ADHD because you're successful," and I think that narrative needs changing a lot.

   11. APAlex Partridge9:23

       Yeah. It's so true. I think high achieving simply means high masking. I was speaking to a, a woman with ADHD who was devastated because she told me she literally walked out of a divorce lawyer's office and s- fell to the floor on the pavement and burst into tears because she, in her head, she couldn't understand why one part of her life was going so well. Her business was flying. She was getting the accolades. She had just accepted some award for, for Entrepreneur of the Year, and yet when she got home in the evenings, she had absolutely nothing left to give any time or energy to her relationship. And the consequence of that, which actually was, in her mind, the most important thing, like, she valued her husband more than anything, and yet because she was having to put on this character so intensely every single day and make strides in an area that she was really only doing, she said to me, to impress somebody who said something to her when she was six years old-

   12. DMDanielle Mulligan10:22

       Yeah

   13. APAlex Partridge10:22

       ... on the playground. [laughs] And the cost of that masking was her marriage fell apart, and she had this breakdown, and she couldn't understand why, and she figured out it was because she was masking so intensely. It's devastating, that feeling of being misunderstood.

4. 10:35 – 12:48

   Why Being Misunderstood Turns Into Shame

   1. APAlex Partridge10:36

      Do you think being misunderstood is the cause of shame and guilt for the ADHD community?

   2. DMDanielle Mulligan10:43

      Yeah, I do, and I think, like say, masking, I think needs to be really unpicked a lot more, um, 'cause I think people don't really understand the exhaustion of that, of trying to be normal to everybody else. Um, and I think, I think it's, yeah, I think it's really, really hard-

   3. APAlex Partridge11:07

      Mm

   4. DMDanielle Mulligan11:07

      ... for people.

   5. APAlex Partridge11:08

      Yeah. I think there's a huge misunderstanding of- often even, like, within family units, I find. Someone gets an ADHD diagnosis, and because the traits that took them to get assessed are considered normal within that family unit because they probably most likely all ha- have ADHD as well, that there's just, uh, they get met with an eye roll or a sigh when they bring it up at the dinner table.

   6. DMDanielle Mulligan11:32

      But then you have the parents that, that do everything.

   7. APAlex Partridge11:35

      Mm.

   8. DMDanielle Mulligan11:35

      Like, I think about my little boy and my little girl, and I get the school bags ready. I get the uniform out. You know, I mask any difficulty they have because I'm all, I, I do it for them-

   9. APAlex Partridge11:46

      Mm

   10. DMDanielle Mulligan11:46

       ... without even thinking about it. So you even have, you know, the parents that, you've got the parents that potentially have exactly the same traits, and they don't see it as a problem because that's what they did. And then you have the parents that they cover it all up until that, that child goes to university And then the child goes to university and realizes they can't do anything and are super overwhelmed and drop out 'cause they can't cope because... And then everyone goes, "Yeah, but you've coped all these years." "Yeah, 'cause mom sat me down and made sure I did my homework, 'cause dad made sure that my clothes were washed," and-

   11. APAlex Partridge12:17

       Mm

   12. DMDanielle Mulligan12:17

       ... and you have this sort of massive sort of misconception of that child's always coped because they've had brilliant parents that have allowed them to cope, or because their household, that was their norm. Their norm was being chaos and doing everything last minute.

   13. APAlex Partridge12:33

       Yeah.

   14. DMDanielle Mulligan12:33

       Um, it's like two sides of, of the coin really that you see a lot of.

   15. APAlex Partridge12:36

       Yes. So, so true. Like, the scaffolding that they have subconsciously relied on for all of their life is just gone, and then suddenly things crumble. And perhaps that leads to an assessment of ADHD,

5. 12:48 – 15:18

   Why an ADHD Diagnosis Can Make Things Feel Worse

   1. APAlex Partridge12:48

      and there's a lot of people that think you get a diagnosis and then suddenly everything makes sense, and then you're on the road to improvement. But because suddenly you become aware of how much you have been reliant on other people up until that point, you can go the other way. Your self-esteem can go in reverse. Do you find-

   2. DMDanielle Mulligan13:06

      And that's not uncommon at all. I s- I find it a lot. I've had a lot of patients where the diagnosis has made things worse-

   3. APAlex Partridge13:13

      Mm

   4. DMDanielle Mulligan13:13

      ... for them, and it's made them feel like it made less sense than if you did have a dia- like, if you... Like, I've had a patient that came to me and said, "I sort of wish I didn't have it, because now I've got it, it makes even less sense than it made before." And that sort of understanding and that narrative around, "Yeah, but I can't have had ADHD because of this," or, you know, "You're telling me I've got ADHD, I'm 46-year-old male, and, and I don't really understand what that means." And their marriage was on, like, a really rocky sort of place and, you know, and then he was worried about his children and, and it was all of that that then came from a diagnosis. So it wasn't a, "Well, that's great, let's take medicine and get better." It was a lot about, "What's medicine gonna do? What about my son? What about my daughter? What about my wife? What about my relationship? What about my job? What about... Do I have to tell people? Do I wanna tell people?" That whole narrative, and it's taken us months to get to a position where-

   5. APAlex Partridge14:16

      Mm

   6. DMDanielle Mulligan14:16

      ... he is accepting the diagnosis. And yes, it makes sense, but it's almost made less sense to him than before. And, and he said, like, why anyone would want ADHD is beyond him because it's awful, and he wishes that he could just take it away and get rid of it [laughs] and throw it in the bin.

   7. APAlex Partridge14:36

      Yes. Yeah. That's heartbreaking.

   8. DMDanielle Mulligan14:37

      Because, yeah, it's been-

   9. APAlex Partridge14:38

      Mm

   10. DMDanielle Mulligan14:38

       ... a real journey that we've been on with him of, uh, 'cause obviously he came to us for an assessment, started treatment, and then there was this really lingering sort of sadness. And I think it was something that we tried to then support him to then get to a position where he wasn't blaming himself, 'cause he went down this whole, "Well, this is all my fault. I should've got seen sooner. Now I'm concerned about my son and my daughter, and I'm concerned that my marriage is gonna break down because I'm sad." And he, it, that's what he said. He said, "I'm, I'm sad that I have this and that it's impacting me so much now, and I don't know what to do." And that's a horrible place for anyone to be in.

   11. APAlex Partridge15:17

       Mm.

6. 15:18 – 17:03

   The #1 Thing ADHD People Blame Themselves For

   1. APAlex Partridge15:18

      What do you think the biggest thing people with ADHD blame themselves for?

   2. DMDanielle Mulligan15:24

      Anything that goes wrong, I think. I don't think it's a, a single activity. I think, you know, if you start an argument with your partner, I think they blame themself. I think they blame themself for the partner being frustrated. Um, and I think that whole rejection, I think, is massive for so many people with ADHD, and I think it's something that you can't fix. I can't teach somebody to just accept rejection. It's horrible for anybody to accept. But for someone who then holds that for years so deeply and can't let it go, it's not so easy to, "Oh, just let it go. It doesn't matter now. That happened when you were six. Like, stop. Stop now. It doesn't matter." But it does matter 'cause that, that, that's what they've based their whole life on.

   3. APAlex Partridge16:12

      Mm.

   4. DMDanielle Mulligan16:12

      And it is huge for people, and it, it cuts deep as well, doesn't it?

   5. APAlex Partridge16:19

      Realizing how sensitive to criticism and rejection you are is one thing after a diagnosis, but then looking back and seeing the fawn that that turned you into and the decisions that you made simply to avoid upsetting someone, and I think that can make particularly women extremely vulnerable. I've spoken to so many people that have had a diagnosis, and I would say about 90% of them have said this, that after the diagnosis, they expected that they would have a sense of relief.

   6. DMDanielle Mulligan16:52

      Or freedom.

   7. APAlex Partridge16:53

      Or freedom.

   8. DMDanielle Mulligan16:54

      Like, "I know what it is now."

   9. APAlex Partridge16:56

      But the, the, the feeling that they were shocked by was on top of the relief, there was this huge grief.

7. 17:03 – 19:31

   The Hidden Grief After an ADHD Diagnosis

   1. DMDanielle Mulligan17:03

      And sadness.

   2. APAlex Partridge17:04

      What do you think people are grieving after a diagnosis?

   3. DMDanielle Mulligan17:07

      What they've missed, what they could have done better. Um, the, the whole teachers, you know, "If you tried a bit harder, you'd get A stars," and, and I think they, they grieve their younger selves-

   4. APAlex Partridge17:20

      Mm

   5. DMDanielle Mulligan17:20

      ... that they can't support and change. And then I think they worry about their future selves 'cause they don't know what that looks like, and I think 'cause a lot of these people have just trooped through life, and they've just got on with it most of the time, that when they're told, "Well, what you've done is brilliant, but actually, you know, maybe try something different," that's scary as well. And then they're grieving their younger self and their childhood self, and then they're scared of their future self 'cause they don't know what... They don't know who they are anymore. Their identity's completely lost, and they've got to then rebuild themselves from the beginning, and I think that's a really hard thing to do-

   6. APAlex Partridge17:57

      Mm

   7. DMDanielle Mulligan17:57

      ... is no matter what age you are, but most of, like, people who get a late diagnosis, to then rebuild your life ... is so daunting

   8. APAlex Partridge18:07

      Yes, it's huge. I spoke to a, a lady who had a diagnosis and she said the biggest thing she grieved was how much of her self she gave to a bad relationship, one that was, in retrospect, clearly toxic, one where she didn't know how to stand up for herself. She was essentially manipulated and gaslit on so many occasions, but because she didn't know how to say no and she didn't know how to put boundaries in place or stand up for herself, she was walked all over in this relationship. And y- and you look back and you can see that happened because I have ADHD. I'm so sensitive to criticism because of my differences. I was criticized 20,000 extra times when I was a child. And when so much comes together and makes sense simultaneously, I think it can be an emotional tsunami post-diagnosis

   9. DMDanielle Mulligan19:02

      And even something as small as being a parent to children and then thinking, "I've gone about parenting the completely wrong way." Like, we're just thinking we're coming to the end of the summer holidays and, you know, people have been at home with the kids and even those slight, you know, "Have I let my kids down?" That guilt of things.

   10. APAlex Partridge19:22

       Mm

   11. DMDanielle Mulligan19:22

       Like, was I not present for my children 'cause I was masking my own sort of difficulties without even knowing? Like, it, it's just honestly must be so overwhelming

8. 19:31 – 22:50

   How ADHD People Learn to Hide It

   1. APAlex Partridge19:31

      From assessing so many people with ADHD, are you still, uh, surprised at how well some people hide their ADHD?

   2. DMDanielle Mulligan19:38

      Massively surprised, and I still continue to be surprised, and I think sometimes the patients are surprised at how well they've masked it. Um, 'cause there was a, a lady recently, um, that I assessed who believed she was, like, a, a really terrible mother 'cause she didn't have it together. So she'd done the whole, "All these people on Instagram have got two kids and they're all coping. I'm a stay-at-home mom and I'm not coping." And I think when you unpicked the puzzle with her, it's, was because of her ADHD. She was just not managing that situation very well. And, and it... And she was putting it to the, "I'm just not made to be a mom. I'm a bad person. Um, my kids would be better off without me." And it was a really negative cycle, that when she understood her ADHD and the fact that the house didn't, she didn't have to follow the kids tidying up every three minutes, and that there was ways we could manage, her life completely changed. And she went down into looking into medication and things, but then didn't like the sound of medication and, and she was just like, "How can I just be better?" And it was sad that she wanted to be better 'cause she was already amazing, and it was then helping her to understand the things she'd already done. So, like, in her, her instance, she was so creative, and the way she did things with her kids were things that I didn't do with my kids. And it was a bit like trying to help her to understand that, you know, she went on a rocket ship to the moon when her-

   3. APAlex Partridge21:06

      Mm

   4. DMDanielle Mulligan21:06

      ... uh, son was scared of the thunder and, you know, it was amazing and, you know, like, how those memories were so important, and yet she was beating herself up at the fact that the house was a mess and the washing was in the washing machine for three days. And it's a bit like, but that doesn't matter. And then equally trying to tell people who are in that frame of mind that the Instagram moms haven't got it together either, and they haven't been diagnosed with ADHD. [laughs]

   5. APAlex Partridge21:31

      Yes. [laughs]

   6. DMDanielle Mulligan21:32

      Um, [laughs] so it's finding that-

   7. APAlex Partridge21:34

      Mm. [clears throat]

   8. DMDanielle Mulligan21:34

      ... balance, um, between the both, but I think to then see the end journey of those people is absolutely beautiful from a clinician perspective. So you come in and they're at the lowest of the lows. They think, "I'm here just to... You know, my friend said it might be ADHD," and I thought, "Why the heck not?" And you think, there must be something that's driven this other than that friend. And then you become on this huge journey of, of understanding and, and figuring out what's happened, when, where, why, and what for, to then unmask this person that just flowers in front of you, and you're like, "Oh, my God, so, you know, you do that and you do this, and you don't think about that and you don't think about this, and yet you think you're a terrible mom, but then look at this and all." Like, your child isn't gonna remember that you, you were late handing that form in for their trip.

   9. APAlex Partridge22:22

      Mm.

   10. DMDanielle Mulligan22:22

       But they're gonna remember the fact that you picked them up every day, and that, you know, you were... You took them on amazing holidays, and that the six weeks holidays were really fun. And, and just, like, pulling that information, um, is really, really beautiful to help them understand as well.

   11. APAlex Partridge22:36

       Yes. I wanna talk about what actually happens within your assessments in a moment, because I think that's really exciting. But I wanna think about the people who listen to this podcast just for a moment. Many of them were missed for, for many, many years.

9. 22:50 – 24:57

   Why So Many ADHD Adults Were Missed for Decades

   1. APAlex Partridge22:50

      Why do you think so many ADHD people are missed, sometimes for decades?

   2. DMDanielle Mulligan22:55

      So I think it's been how quickly the world's changed. Um, so if you go right back to, like, our great-grandparents, where they, you know, they were laborers, they had hands-on jobs, they walked to work, they didn't, uh, have a choice in what foods they needed, they just got given what they were given. The world was easier to somewhat hide ADHD symptoms. And then I think as the world's become everyone has to sit down between 9:00 to 5:00 and do really boring screen jobs, people aren't always built for that kind of work. And I think it's been something that over decades people have gone, "Well, you know, back in the day, there wasn't ADHD." Well, there was, you just didn't see it, and now we can see it 'cause the world is making us see it. And I think what's really sad about things being missed is that the majority of the time it's been those successful people that have been missed because they've used their ADHD as a strength rather than a weakness. Even though behind the scenes, you know, they're on the floor absolutely exhausted.

   3. APAlex Partridge23:58

      Mm.

   4. DMDanielle Mulligan23:59

      They've been driven by their impulsivity. They've been driven by their when they can hyperfocus and when they can't hy- hyperfocus. And I think it's been something that has just I still think so many people are missed, though. I don't think it's, it's fixed. I still think there's a long way to go, and I think people need to understand ADHD from all of the other potential sort of conditions that could happen. So, you know, exploring, which we'll talk more a little bit about, um, in terms of our assessments, but, you know, understanding the whole narrative of that person to be able to unpick what's going on-

   5. APAlex Partridge24:38

      Mm

   6. DMDanielle Mulligan24:38

      ... I think is really important. But I still think a lot of people are getting missed. Even though there's this huge everyone's being misdiagnosed conversation going on in the world right now, I still think there's so many people that slip through the net their whole life.

   7. APAlex Partridge24:52

      Mm. We're gonna get to your assessments just in a moment because I think what you guys are doing is actually really exciting.

10. 24:57 – 25:57

    The Pattern Before an ADHD Breaking Point

    1. APAlex Partridge24:57

       Do you see a common pattern, though, in people perhaps who are about to reach a breaking point and they desperately need answers?

    2. DMDanielle Mulligan25:08

       So, yeah. Um, I see a lot of people coming for assessments where it's a make or break assessment for them, like, whether it's for their marriage, for their job, just for their entire existence sometimes-

    3. APAlex Partridge25:21

       Sure

    4. DMDanielle Mulligan25:21

       ... where they'll sit and they'll go, "If it's not this, I don't know what I'm gonna do," which is, must be a terri- I've never been in that position myself, but it must be a horrible position to be in, thinking like, "If it's not ADHD and I can't get an answer of what's going on with me, then I genuinely don't know what I'm gonna do, or what support I'm gonna get, or where I'm gonna go next, or where I need to go next," and all those unanswered questions that sometimes a clinician can't answer, I think is a really scary position to be in.

    5. APAlex Partridge25:53

       So let's move on to the clinic that you and your team started to, to address this

11. 25:57 – 26:57

    Why Focused Was Created

    1. APAlex Partridge25:57

       problem. What inspired the creation of Focused?

    2. DMDanielle Mulligan26:00

       So what inspired Focused was very much having a service that was affordable for people, um, that gave people a opportunity to come and get support that they needed. Obviously, you've got massive waits in the NHS in different areas. Uh, rights to choose isn't necessarily fully established, and I think it was a way where people within the company had had personal experience of wait times, and it was just something that it shouldn't be so complicated to get an assessment, and it shouldn't be so difficult, and it shouldn't cost thousands and thousands of pounds to be able to do that. Because, you know, if you get a throat infection, doesn't cost you thousands of pounds to fix that. And I think it came from the place of wanting to help as many people as possible as quickly as possible. Um, you know, different companies had big wait times, and I think everyone w- within Focused just wanted the mission of supporting as many people across the UK-

    3. APAlex Partridge26:56

       Mm

    4. DMDanielle Mulligan26:56

       ... as we possibly can.

12. 26:57 – 28:45

    What Actually Happens During an ADHD Assessment

    1. APAlex Partridge26:57

       Fantastic. And how do Focused conduct their assessments differently?

    2. DMDanielle Mulligan27:02

       So we've been on a journey at Focused over the past sort of year, and we, we make sure that when you come into your assessment, we explore your whole story. So it's not just a case of, you know, can you concentrate? Yes, no. Can you not conc- C- can... Are you hyperactive? Like, it's very much like, you know, tell us about what's going on because we're not here to give you ADHD. We're here to see if ADHD is part of your story. And we're also in the process of that exploring what is going on. We wanna know how we can help you and if we're the right people to help you or not. And if ADHD is something, then we wanna take you on that and be on as part of that journey, and if it's not, then we wanna make sure you get the right help that you need. It's almost like this m- many, mini mental health assessment where we explore every narrative. Every stone is turned, and it is absolutely exhausting for patients and for, for clinicians.

    3. APAlex Partridge28:02

       Mm.

    4. DMDanielle Mulligan28:02

       Because, you know, you're constantly, you wanna know about what happened as a child. You wanna know what happened, you know, what's brought them to that assessment. You know, what's going on now, what's happened before, what we're worried about next and, and it is a whole investigation. You have to be like a mini detective.

    5. APAlex Partridge28:18

       [laughs]

    6. DMDanielle Mulligan28:18

       And you've gotta get through that masking as well-

    7. APAlex Partridge28:20

       Mm

    8. DMDanielle Mulligan28:20

       ... because people don't always drop that mask in assessments. And then you've gotta find your way, your way in, uh, which can be quite tricky as well, um, which is a big reason why we do two-hour assessments as well, to be able to give you time. 'Cause you're gonna come, and you're gonna wanna impress me and pretend that everything's okay [laughs]

    9. APAlex Partridge28:38

       [laughs]

    10. DMDanielle Mulligan28:39

        ... when it's not, and it takes quite a lot of our skilled assessors to be able to get those masks dropped.

13. 28:45 – 29:47

    What an ADHD Assessor Is Really Looking For

    1. APAlex Partridge28:46

       Mm. Apart from masking, what, what as an assessor are you actually looking for? 'Cause I think this is super interesting for the people listening who, many people know or think they have ADHD, but many are also thinking, like, what is an assessor actually looking for, if they were a fly on the wall? If someone comes in, what signals make your brain go, "That's ADHD"?

    2. DMDanielle Mulligan29:04

       So we're looking for that, that huge impairment, regardless of if you've been successful or not. Like, what has, what has caused things to be so difficult in your day-to-day life that ma- that makes things so exhausting, that makes things so difficult, and how long has that been going on for, and when did it start? And, and, you know, what... how is it worse now?

    3. APAlex Partridge29:25

       Mm.

    4. DMDanielle Mulligan29:25

       'Cause what... We assess adults for ADHD, so you know, you've got people from 18 to sort of i- in their 60s. We've had people come that are over 60 for assessments. Like, what's going so terribly wrong now that you, you think ADHD is the answer? And unpicking that whole story, which is so fascinating-

    5. APAlex Partridge29:45

       Mm

    6. DMDanielle Mulligan29:46

       ... to understand people's lives.

14. 29:47 – 31:06

    How to Make ADHD Assessments Feel Safe

    1. APAlex Partridge29:48

       And what steps have Focused put in place to make sure that the people who come to you for an assessment feel supported and receive an accurate diagnosis?

    2. DMDanielle Mulligan29:56

       So we did a lot of research, and we've gained a lot of insight into what people need and what people want from an assessment, um, using sort of clinical guidance, you know, building standards. Um, we originally started our assessments being 90 minutes, and we quickly realized we needed to extend that time. Um, the reason being is that we just needed assessments going over, and we just needed to understand more of that story. We've got support with note-taking for our assessors, meaning that they have got time to have that personable, beautiful conversation that flows naturally, rather than sat typing frantically to try and keep up with notes. Um, we've also established, uh, our onboarding process, which we've made simple for patients, but that equally gives us the information that we need from an assessor point of view so that that assessor's going in with a blanket overview of what's going on so that they can unpick and explore that in more detail.

    3. APAlex Partridge30:56

       Mm.

    4. DMDanielle Mulligan30:56

       Um, so we're, we're really trying to have that really thorough, in-depth assessment that everybody deserves, um, without making it super complicated for everyone.

15. 31:06 – 33:30

    The Growing NHS vs Private ADHD Assessment Gap

    1. APAlex Partridge31:06

       Mm. What's the widening gap between NHS waiting lists and private assessment services, and what impact is that having on people seeking answers?

    2. DMDanielle Mulligan31:14

       So the impact that we've seen is obviously the big conversation around right to choose. Um, so I think what's really hard, and isn't made very clear about right to choose, is how in different parts of the country, there's different wait times for everyone. So like, you know, for example, in London, you might get seen within three weeks. In Manchester, it might be two years. In Scotland, it might be six years, and in Isle of Wight, it might be... It's getting on to, like, 50-odd years. It's ridiculous their wait time, 'cause they're just not doing ADHD assessments. And I think one thing that we ensure in Focused is that we keep our quality of our assessments incredibly high so that you don't need to go and pay thousands of pounds for another assessment with another company, because we're making it so that we're meeting the NHS standards, so that we're giving you that quality and exceeding that quality. Because, you know, you're paying for this assessment, and it doesn't matter if you're, you think we're super cheap or if you think we're super expensive. You know, you- when you pay for something, it should be done to the highest of qualities, and we do not drop that just because of our price. We give you a assessment for 289, which includes your onboarding. It includes your two-hour assessment with your clinician, and it also includes that detailed report, um, which you can share with your employer, you can share with your GP, um, to be able to give you that robust sort of care. So for 289, you get all of that support and support with our clinicians.

    3. APAlex Partridge32:48

       Fantastic. A much-needed service. Danielle, I wanna move on to the most unpredictable part of the show, the emotionally unpredictable part of the show-

    4. DMDanielle Mulligan32:57

       [laughs]

    5. APAlex Partridge32:57

       ... and that's the washing machine of woes, which regular listeners will be fully aware is the audience questions. And I know there's a couple of bangers in here that I've been excited to ask you. It's a washing machine, because for me, it represents memory loss. I always leave my laundry in the machine after the cycle's finished.

    6. DMDanielle Mulligan33:11

       You wouldn't be the first. [laughs]

    7. APAlex Partridge33:11

       I ask all my guests that. Do you, do you do that? Do you relate to that?

    8. DMDanielle Mulligan33:15

       [laughs] So I don't do that, but my husband-

    9. APAlex Partridge33:17

       [laughs]

    10. DMDanielle Mulligan33:17

        ... is so guilty of doing that.

    11. APAlex Partridge33:19

        It's also a public service announcement if anyone's listening to go and check their washing machine.

    12. DMDanielle Mulligan33:22

        Check your washing machine.

    13. APAlex Partridge33:23

        Yeah. But do come back. [laughs]

    14. DMDanielle Mulligan33:25

        [laughs]

    15. APAlex Partridge33:25

        Right, Danielle, in the washing machine this week, the first question, the first spin,

16. 33:30 – 34:56

    The Biggest Misconception About ADHD

    1. APAlex Partridge33:30

       [laughs] what's the biggest misconception about ADHD that you would love to correct?

    2. DMDanielle Mulligan33:36

       Lazy. I think we, we touched on it at the very beginning.

    3. APAlex Partridge33:40

       Yes.

    4. DMDanielle Mulligan33:41

       But, but you know, saying someone has got ADHD and that they're lazy in the same sentence just makes no sense in my brain. Um, you know, you're far from lazy if you've got ADHD.

    5. APAlex Partridge33:53

       Mm-hmm.

    6. DMDanielle Mulligan33:53

       Like say, just 'cause you freeze in that emotional overwhelm of a million and one tasks that you need to do does not make you lazy. Um, but that's the biggest one for me.

    7. APAlex Partridge34:03

       Yeah, 100%, and totally agree with you. The next spin, the next question from the washing machine is, if every person listening with ADHD could hear one message from you right now, what would that be?

    8. DMDanielle Mulligan34:16

       You're allowed to be successful and have an impairment. You're allowed to be successful. That's, like, you're allowed to give yourself success and still struggle on a day-to-day basis.

    9. APAlex Partridge34:26

       Yes.

    10. DMDanielle Mulligan34:27

        Um, and I think, I don't want people who are crumbling at the sides but still doing well in employment, are boss in parenting, are every, uh, everything of the above, still not believe that they're struggling. It is okay to struggle and be successful.

    11. APAlex Partridge34:43

        Gosh, amazing. Getting quite emotional.

    12. DMDanielle Mulligan34:44

        [laughs]

    13. APAlex Partridge34:45

        Just before we finish, Danielle, I've got a surprise for you. I wanna deliver to you a letter. This letter was written by the previous guest, and it's a letter to their younger self, which I always deliver to the current guest, and they read

17. 34:56 – 36:11

    A Heartbreaking Letter to My Younger Self

    1. APAlex Partridge34:56

       it.

    2. DMDanielle Mulligan34:57

       So dear younger me, I wish I could sit next to you and tell you something nobody else knew to tell you. You are not lazy, you are not difficult, and you are not broken. I know you've started noticing that things other people find easy feel impossibly hard for you, and eventually, you'll stop blaming the world and start blaming yourself. Please don't. One day, somebody will explain your brain to you, and suddenly, your whole life will make sense. But there will be grief, too. You'll think about all the years you spent trying to become someone easier to understand, all the times you apologized for being too much, all the parts of yourself you learned to hide. But eventually, something beautiful happens, and you stop hiding. You start talking, and the things you once were ashamed of, and thousands of people will hear you and think, "Me too." You were never broken, little girl, who needed fixing. You were just a little girl trying to understand a brain nobody had explained to her yet. I understand you now. I'm sorry it took me so long. Love, your younger self.

    3. APAlex Partridge35:58

       Wow, what a lovely letter, and thank you for reading it so beautifully. On behalf of everybody listening and watching, trying to understand their brains, Danielle, thank you so much.

    4. DMDanielle Mulligan36:07

       Thank you. [upbeat music]

Episode duration: 36:11