Brain Expert: THIS Common Food Turns ADHD Into A Superpower, It's In Your Cupboard!

1. 0:00 – 2:07

   The Heartbreaking Reality of ADHD

   1. JBDr. Jolene Brighten0:00

      The reality of ADHD is that it's a full body experience. It's not just a brain experience. We see alterations in the gut microbiome, in the immune system, and then we see all these co-occurring conditions as well.

   2. APAlex Partridge0:12

      What do you think the biggest thing medicine still gets wrong about female ADHD?

   3. JBDr. Jolene Brighten0:16

      That our hormones play absolutely no role in this. Part of this is because old school feminism was like men, women equal. Don't talk about our hormones affecting our brain because then we're weaker. Here's a study on a man, therefore apply it to a woman, and yet from diagnosis to treatment, it doesn't work.

   4. APAlex Partridge0:34

      And what's happening inside the ADHD brain during pregnancy?

   5. JBDr. Jolene Brighten0:37

      Every woman experiences more fatigue, forgetfulness. The ADHD brain is so much worse because-

   6. APAlex Partridge0:45

      Can I have just a second of your time? If this podcast has helped you understand your brain or made you feel less alone, can you do me one favor? Can you hit the subscribe button? And I'll repay the favor by continuing to book the best and most exclusive conversations on this topic. Please enjoy the episode and always remember, you're not broken, just different, and you have always been enough. [upbeat music] Dr. Brighten, welcome to ADHD Chatter.

   7. JBDr. Jolene Brighten1:10

      Thank you so much for having me.

   8. APAlex Partridge1:12

      I think so many women with ADHD truly believe that they are lazy, fundamentally broken, and that they're bad at adulting. But one day they might feel motivated, full of energy, and then the next they just feel, like, emotionally dysregulated, brain fogged. But you believe that they aren't failing at all, these women. You think there is a, that they're fighting a, a biology battle that they might simply not know about. By the end of this conversation, I want every woman listening to understand why her ADHD might feel different throughout the month. And also, you've put together, through science-backed research, this 14-day meal plan specifically designed for women with ADHD, and that's on the table in front of us, or at least some of it, and we're gonna come back to that right at the end. But firstly, Jolene, you've met thousands of women with ADHD.

2. 2:07 – 5:19

   The ADHD Patient Dr Jolene Will Never Forget

   1. APAlex Partridge2:07

      Can you tell me about one woman that you'll never forget?

   2. JBDr. Jolene Brighten2:10

      Oh. You know, there's this woman in my practice that about a decade ago really made me realize how impactful ADHD is in the worst of ways as women enter midlife. So she was a mom, two kids, also an attorney. So she has raised her kids, she had taken some time off from work. Goes back to work. Her kids are older now, leaving the house, and this is her time to shine, right? This is her moment where she can double down, focus on her career, be able to, you know, give it her all because children are leaving the house. Like, responsibilities are going to ease up. And yet she came to me saying, "I think I'm gonna have to quit. I think I'm going to have to leave work." And I'm like, "What's going on?" And she said, "My brain just doesn't work anymore. I can't hold a thought in my head. I'm so scattered. You know, my job is to make sure that I know the ins and outs of every case." And she's like, "I used to be the person that I could read it one time, hear it from a client one time, and, like, re- repeat it verbatim. Like, I was on fire." And now she's like, "It's barely possible for me to remember the client's name if I don't have it right in front of me." And I felt for her because it was absolutely so devastating to think that, like, okay, I'm gonna arrive at this moment where now I can focus on me. My career can be about me, and yet it felt like her brain was no longer working on her side.

   3. APAlex Partridge3:47

      That is truly heartbreaking. To h- for her to have that internal belief that the way she was presenting, the struggles that she was experiencing, like, she deep down believed that they were part of her character and in some way that she was flawed. How common is that, Jolene? How, how often do people come to you, ADHD women, genuinely believing that they are lazy or broken, and you can see actually that there is a biological explanation that would explain how they're behaving?

   4. JBDr. Jolene Brighten4:17

      I don't think I've ever had a patient that doesn't have a biological explanation-

   5. APAlex Partridge4:20

      [laughs]

   6. JBDr. Jolene Brighten4:20

      ... for why they're feeling the way that they're feeling. But, you know, I was just recently speaking on a stage, and I started by asking everyone a series of questions. Like, how many of you have gone to the fridge, you open the fridge, you don't remember why you're opening the fridge, or you had a whole plan, but then you didn't have the energy to follow through on the plan with that? Or maybe your brain sees a person, it knows the person, but the brain will not give you the name of that person. And everybody's raising their hands, raising their hands, and I said, "Okay, keep your hands up." And the entire room, by the time I was done, had their hands up. And so I said, "Look around," because we think this is an us problem. No one else is struggling with this. Wow, that person seems like they have it all together. Like, I have to be the only one. And in reality, everybody struggles with these executive dysfunctions in some way. The problem for the ADHD brain is that it's a lifelong struggle amplified by our hormonal changes.

   7. APAlex Partridge5:15

      There's obviously a lot to p- unpack here, Jolene,

3. 5:19 – 6:51

   Why ADHD Isn’t Just a Brain Condition

   1. APAlex Partridge5:19

      and, and many people think of ADHD as it simply being a, a, a something that's going on in the brain. But you say that there's a lot more to it. Why, why do you say that?

   2. JBDr. Jolene Brighten5:29

      I think, you know, when we think about medicine, we say, "ADHD, that's a psychia- psychiatric problem," right? See the psychiatrist. You have a hormone problem, see the endocrinologist or gynecologist. You have an immune system problem, see the rheumatologist. And you know who doesn't care about the way medicine silos all of this? Is your body. Your body doesn't care. And the reality of ADHD is that it's a full body experience. It's not just a brain experience. We see, as I outline in my book, alterations in the gut microbiome, gut function itself. We see alterations in the immune system, and then we see all these co-occurring conditions as well.

   3. APAlex Partridge6:10

      I wanna move Jolene to, I think the, the, the missing piece that most women miss, and I wanna demonstrate this by this very expensive prop [laughs] that I've put together.

   4. JBDr. Jolene Brighten6:19

      Very high tech, sir.

   5. APAlex Partridge6:20

      Yeah, yeah. [laughs]

   6. JBDr. Jolene Brighten6:20

      Well done. [laughs]

   7. APAlex Partridge6:20

      This is where the budget goes, I can assure you. Um, so there's three cogs here, three different colored cogs, and one represents the brain, one represents hormones, and one represents the immune system. I always thought that these three different parts of the human body acted independently, but I've learned actually from researching this episode that they're all connected. So when one moves, they all move as well.

   8. JBDr. Jolene Brighten6:42

      This is actually a perfect prop for this. [laughs]

   9. APAlex Partridge6:44

      It works. I know, yeah. [laughs]

   10. JBDr. Jolene Brighten6:46

       Yeah.

   11. APAlex Partridge6:46

       That is money well spent-

   12. JBDr. Jolene Brighten6:47

       [laughs]

   13. APAlex Partridge6:48

       ... every, every two, every one of those two pounds. So

4. 6:51 – 12:14

   The Hidden Brain–Hormone–Immune Connection

   1. APAlex Partridge6:51

      this has a name, right? This is called something called the brain hormone immune triad?

   2. JBDr. Jolene Brighten6:56

      Yeah. Well, that's what I named it. So that's a model that I came up with through my observations in clinical practice. So for people who are watching, you know, we've got this triad, and what I put in the center is either the benefactor or the collateral of this triad is the mitochondria. And we can talk a lot more about that. But this triad is really helping people understand how all these pieces fit together and how important they are, especially, I mean, it's important for everyone's brain and everyone's wellbeing, but especially the ADHD brain. So we've got the brain, which is the puppeteer, if you will, really orchestrating everything with the hormones. Like, you don't have a menstrual cycle 'cause your ovaries just decide to ovulate. The brain is working with them and telling them to ovulate. So we've got the brain connected to the hormones. The hormones also act as neurotransmitters in the brain, and they make neurotransmitters work better or work worse depending on, you know, what level that they're at. Now, connected to that, we have the immune system, and the immune system is regulated by our hormones. If you have a lot of inflammation, that's also going to shift your hormones. You're gonna have to produce more cortisol, which is an anti-inflammatory hormone. We always hear about, "Cortisol is bad," and it's all about stress. Yes, and, um, I actually love cortisol, but it's also anti-inflammatory. So those, those shifts can be happening. And at the same time, the immune system, if it is upregulated and we have neuroinflammation, which we see a lot with ADHDers, that's gonna affect how neurotransmitters work, how the brain is able to produce energy. You know, if you're feeling brain fog, fatigue, you run out of steam too soon, that could be related to immune system dysregulation. And then at the same time, the brain is running this amazing nerve called the vagus nerve. It's a huge two-way highway in which the brain is communicating with the body and the body is communicating with the brain, and one of those communications are inflammatory cytokines, what the immune system is doing, what is happening in the gut, and that tells master control center of the brain, how safe are we? How well are we being taken care of? What's our environment like? So that the brain can then respond.

   3. APAlex Partridge9:05

      This is so, so interesting. I wanna zoom in on, on something you said just a second. I wanna get particularly geeky just for a second, but I think this is really, really important to explain why women with ADHD are tired so much of the time. Now, you said a word a minute ago that made me really wish that I paid more attention at, when I was in my biology class [laughs] at school.

   4. JBDr. Jolene Brighten9:23

      Back, rocking back to 12 years old, right? [laughs]

   5. APAlex Partridge9:26

      You said mi- mitochondria.

   6. JBDr. Jolene Brighten9:28

      Mm-hmm.

   7. APAlex Partridge9:28

      So just quickly, what's, what's, what does that mean?

   8. JBDr. Jolene Brighten9:30

      So the mitochondria, for all, uh, everyone who is like, "I don't remember biology," that's okay. Uh, it's the powerhouse of your cell. Very simply, it is what is producing all the energy for the cells. And so the mitochondria, if they become dysfunctional, if they become fragile, which can happen as part of the perimenopause-menopause transition, if there is too much inflammation, there's too many reactive oxygen species, we can have mitochondrial dysfunction. They don't produce energy in the same way. But the thing to understand about the ADHD brain is that it has always struggled with energy production. It's not as good as utilizing glucose, so that's our blood sugar, as a non-ADHD brain. And so that is why we can feel like, oh, my brain gets really fatigued easily. Like, I'm having a hard time, like, following through on this project, in which we say, "I must be lazy. I'm not focused. I'm not disciplined enough." But really, it's an energy issue. And we can talk about the, you know, why it is that telling an ADHD child to sit still is one of the most detrimental things we do to their brain.

   9. APAlex Partridge10:38

      What do you think it does to a child if you keep telling them to, to sit still, stop fidgeting, you're too much?

   10. JBDr. Jolene Brighten10:44

       Well, I think long term, we're telling them to betray their body and betray their body's signals, and I think that's very problematic because what their brain is saying is, "I'm starving. I'm starving, so I need you to move." Why is movement important? Because our backup, so if, if the powerhouse of the cell fueling all the lights in the house is the mitochondria, then movement is your crank generator, okay? It's your backup energy supply, and you literally have to move. So we've all worked out in some capacity and been sore. That's lactic acid. The brain uses that as lactate, as an energy supply. So even right now, I'm fidgeting. I'm moving. I just happen to be Latina, so it's acceptable-

   11. APAlex Partridge11:27

       [laughs]

   12. JBDr. Jolene Brighten11:27

       ... for me to speak with my hands, but this is, is fueling my brain. So would we ever tell someone who is like, "I'm so hungry. I'm starving," "Suck it up. Like, just deal with it. Who cares that you're hungry? Ignore that your body is hungry"? I mean, maybe someone of, like, the biohacking bros would be like, [laughs] "Ignore that you're hungry."

   13. APAlex Partridge11:45

       [laughs]

   14. JBDr. Jolene Brighten11:45

       But, like, that's not something we would do to a child. So when a child wants to move and their brain is saying, "I'm hungry," you're telling them, "You can't trust your body. Your body is wrong, and you need to disconnect from that. I need you to disassociate from that because other people's comfort is more important than the discomfort your body is signaling."

   15. APAlex Partridge12:04

       Gosh, there's so much here. I think one of the biggest shocks when I was researching this episode is what I'm gonna ask you next, and I've, I've never heard anyone explain it in the way that you have.

5. 12:14 – 14:04

   Why Estrogen Can Change Everything for ADHD Women

   1. APAlex Partridge12:14

      So you say estrogen, which is obviously a huge- hormone is as important as a mitochondrial hormone a- as it is a reproductive hormone. What do you mean by that?

   2. JBDr. Jolene Brighten12:25

      Yes. So everybody's like, estrogen, periods, babies, curves, right? Estrogen is also an antioxidant. It's helping protect the mitochondria. It also helps the mitochondria produce their ATP. What is that? Well, it, it doesn't really matter. All you need to know is it's an energy packet for the cells, that it's energy currency. So estrogen is so crucial to mitochondrial function and for the integrity of the mitochondria themselves. And so your brain is 2% of your body weight, but using 20% of your energy, which is why it is filled with trillions of mitochondria. The other place of a woman's body filled with so many mitochondria are the ovaries. In fact, one- you get an egg ready to ovulate, and there's, like, 600,000 mitochondria in there. This is how crucial our hormones are to our wellbeing. Because the body's not gonna say, "Let's put the little energy powerhouses in some tissue that, like, you know, is expendable." And that's how much of medicine treats our hormones. Like, oh, you're in your reproductive years? Well, you- just take the pill. You don't actually need those hormones. Oh, you're going into menopause? That's natural. You're suffering? So did your ancestors. Like, who cares? But if we stand back and we look at the brilliance of the body, it's packing our brain, it's packing our heart, it's packing these crucial organs, including our ovaries, with mitochondria because they're so crucial to our existence.

   3. APAlex Partridge13:51

      I couldn't believe what I found out, Jolene, when I was researching this episode, and ADHD women are actually have a higher chance of suffering from two medical conditions. But just first, before we get to that,

6. 14:04 – 16:43

   What Medicine Still Gets Wrong About Female ADHD

   1. APAlex Partridge14:04

      what do you think the biggest thing medicine still gets wrong about female ADHD?

   2. JBDr. Jolene Brighten14:10

      I think the biggest thing that medicine is getting wrong about female ADHD is that our hormones play absolutely no role in this. And I think part of this is because, you know, feminism, like old-school feminis- feminism was like, uh, men, women equal. Don't talk about our hormones affecting our biology, affecting our brain, because then we're weaker. And I'm like, our, our hormones affect our brain in the same way that men's hormones affect their brain. Like, trust me, I have a 13-year-old right now, a 13-year-old boy, [laughs] like-

   3. APAlex Partridge14:40

      [laughs]

   4. JBDr. Jolene Brighten14:40

      ... and I see how his testosterone affects his ADHD and his existence. Like, hormones do influence us. They're meant to, and there's nothing wrong with that. And yet so much of medicine has said, "Here's a study on a man, therefore apply it to a woman, because women are just the inferior version of a man with some baby-making accessories, and this should work for you." And yet it doesn't work. Not from diagnosis to treatment, what we place on men, what works for men is not working for women.

   5. APAlex Partridge15:12

      Oh, it makes me so angry. Like, if, if you're a woman and, and you are experiencing such almost neglect at worst, misunderstanding at best, from the medical community, how much shame do you think that puts on that woman?

   6. JBDr. Jolene Brighten15:26

      Tremendous. I mean, we are conditioned very early on by medicine to think we can't trust our body, that our body is betraying us, and the solutions are ty- typically to cut organs out or shut hormones down because we were just defective from the start, and we really aren't. And when we look at the research, so many women have been gaslit by their doctors, told that symptoms are normal. Like, have you tried losing weight? Maybe you're just too stressed. This is just anxiety. In fact, anxiety and depression are so commonly diagnosed in ADHD women, it's usually the first diagnosis they get before anyone clocks that they have ADHD. Now, anxiety and depression, very common i- as part of the ADHD experience, but I would actually submit to people that is because of how we have been misdiagnosed, dismissed, and ignored, and told, "Just try harder. Just do more." And I think that all results in an internalization of shame, of thinking you're broken, of, of going home at night after your day and wondering why kids, everyone else have it together. Why am I the weird one? Why is it that I can't just, like, fit in? Why is it I can't just fill in the blank, right?

7. 16:43 – 29:45

   The Shocking Link Between ADHD, PMDD & Endometriosis

   1. APAlex Partridge16:43

      And on top of all of that, there's two medical conditions that women are, are more likely to, to be diagnosed with, and one is PMDD-

   2. JBDr. Jolene Brighten16:50

      Mm-hmm

   3. APAlex Partridge16:50

      ... and one is endometriosis, if I pronounced that right. [laughs] Why is that? Why, why an ADHD woman, why are they more likely to be diagnosed with those two things?

   4. JBDr. Jolene Brighten16:58

      Well, what we've come to understand about ADHD, you know, I don't know if you've heard this from people, but people will be like, "If ADHD is real, tell me the gene that causes it." And I'm like, that's really cute. Cancer's real. Tell me the one gene that causes it. ADHD is an inheritance of a cluster of genes, and when you look at these other conditions, it's very interesting because for a long time, endometriosis, women were told, "Oh, your period's flowing the wrong way. That's what's going on." But it doesn't explain endometriosis in your eye. It doesn't explain why fetuses have endometriosis. And so what we came to understand is through embryological development, cells that would make up our reproductive tract, they landed in the wrong place, and when estrogen comes online, they become stimulated, and they become problematic. And this is why this is not the same as the lining of your uterus, because they differentiated, they ended up somewhere else, and why they're so problematic. So they're highly inflammatory. They release histamine, which all can amplify and make ADHD worse. When we look at PMDD, what we've come to understand, and it's very interesting 'cause speaking with researchers and other clinicians, those of us who work a lot with PMDD, which, for people listening, is premenstrual dysphoric disorder, people will say it's, like, bad PMS. Like, bad PMS that lives, like, six months out of every single year. Uh, you think about ending your life, running away from your life, blowing up your career, blowing up your family. You have extreme physical, mental, emotional symptoms. So this is a lot more than PMS. But when we look at that- There's these different components. So all these researchers that I've spoken with and other clinicians say PMDD's not one thing, and I agree. Because we see women that histamine is driving PMDD. We see women who progesterone is driving PMDD because of a hormone sensitivity. We see women who are experiencing marked neuroinflammation, and that's really driving their PMDD. But all of these things can be related to ADHD as well. So we've covered the neuroinflammation, but hormone sensitivity is something I outline in the book. You know, you've got a brain that's wired with more connections. Of course it's gonna ha- have more sensitivity. We don't appreciate how much the brain changes across the menstrual cycle. When we are early in our menstrual cycle, we have all this dendritic branching. We are vibing with the environment, filling everything out, and not overstimulated by it. And then when we pass ovulation, we go more internal. There has to be this adaptation. That is very demanding for a neurodivergent brain, which is part of the reason we believe that ADHD women are three times more likely to experience PMDD.

   5. APAlex Partridge19:46

      And then the luteal phase. W- what's going on in that phase?

   6. JBDr. Jolene Brighten19:50

      Yes, so I'm glad you named it, 'cause that's when we pass ovulation. So passing ovulation is when we enter into the luteal phase. And so, you know, classically what we're seeing in PMDD, progesterone production, that only comes following ovulation, that gets metabolized into allopregnanolone. That docks on the GABA receptor, and the, the expected response is you're chill, you're calm, you love your life, and you sleep really well. The PMDD response, due to an inability to adapt to all those rapid changes, is I'm anxious, I'm irritable, I'm raging, I can't sleep. And so, you know, for the luteal phase, there's a lot of thi- We can also talk about the nuances of ADHD even if you don't have PMDD. If you're a woman who's experiencing endometriosis, which ADHDers are twice as likely to have, you might find in that phase you're having more histamine problems. So you feel like you get the flu every time before your period. Um, that might be the reason you're waking 2:00, 3:00, 4:00 AM in the morning. You're feeling really irritable, agitated, even anxious. And that can be because those endometriosis lesions are rich in mast cells. And I say, like, if you look at those mast cells wrong, they just dump histamine. And if you don't have enough progesterone in that phase, estrogen says, "Let's release more histamine," and histamine says, "Let's make more estrogen," and estrogen says, "Sure, and I'll down regulate the enzyme to break you down." They're like best friends in the worst of ways, totally conspiring against you.

   7. APAlex Partridge21:26

      I honestly never knew, like as a man [laughs] , that, that hormones have such a massive impact on, on women with ADHD, but I've obviously got women in my life, and with the knowledge that I've acquired during this podcast and expanding on today, so much makes sense. I'm, I'm thinking of one particular woman in my life, and I can only really describe what I observed. S- almost, you know, one week very articulate. She's able to focus and do tremendous amounts of work and be present. But then the next day sometimes she can be very forgetful with her words, like definitely a lot more emotionally sensitive. Perhaps there was motivation towards a task and now it's suddenly gone. Thinking very bad thoughts to herself, like, "I'm, I'm lazy. Why does h- he want to be with me?" All, all of these sort of negative spiraling thoughts. Is there a hormonal explanation for, for that change?

   8. JBDr. Jolene Brighten22:19

      Absolutely. So I actually, I, I go through this in my book, and I call it the follicular trap. So the menstrual cycle... Shall we go through the menstrual cycle?

   9. APAlex Partridge22:28

      Let's do it, yes.

   10. JBDr. Jolene Brighten22:29

       Okay. So the menstrual cycle, we always begin it with the bleed. So having your period we count as day one. So during that time, you know, you often hear on the internet that, oh, during the, uh, you know, early period, like you have no hormones. Well, your uterus and your ovaries have completely different agendas. The uterus is like, "Clear house. We didn't get a baby. Wah wah. Start it all over again." But the ovaries are already rising. So if I'm gonna test your estrogen, I'm gonna do it day two, three of your period. That's how quickly your estrogen is already coming online. So a lot of women, by day two, three, maybe even takes to day five of their period, they're like, "My brain is coming back online." So my patients will often say, like, "That's the time where I know I can get everything done, and like best time for me to be socializing, best time for me to feel the best," right? And so that's because estrogen is unchallenged and it's rising. Estrogen is going to help dopamine, acetylcholine, serotonin, norepinephrine. Literally she's the it girl. Every neurotransmitter sans GABA is following her around. And so that's the early follicular phase. Now, why I call it the follicular trap is because we think like, oh, I can take on more. I can schedule more. Like, I've got this. Like, I have finally cracked the code on ADHD. You know, the sticky notes are finally working for me, so here we go. And then we overcommit. [laughs]

   11. APAlex Partridge23:55

       [laughs]

   12. JBDr. Jolene Brighten23:55

       So and then, and, and we're gonna talk about that. So w- as we are in the follicular phase, we're getting an egg ready for... It's maturing. It's gonna be around ovulation that the ovaries will spike estrogen, and so this is where you're like, "My brain is working w- really well," unless you have histamine issues. Then you're like, "No. [laughs] That's not me." But, but without the histamine issues, brain is working really well. Uh, you spike the estrogen. The brain says, "Got it. You're ready. You chose your winner. You're gonna release that egg," and then it releases luteinizing hormone. You're gonna get a day or two of feeling still really good. After you ovulate, what's left behind is a temporary endocrine structure called the corpus luteum, and the corpus luteum produces progesterone. It is going to peak five to seven days After ovulation. That's gonna be peak progesterone. So from ovulation until peak progesterone, we actually see a little more hyperactivity in women, more impulsivity can be coming on, uh, you know, m- a lot more, um, movement. So you might be like, "Why can't I sit still? Like, I'm uncomfortable all the time." So we see kind of more of those, um, those y- classical ADHD symptoms that we think of. And part of that is because testosterone's been really high at this phase as well, which is, um, just so everybody knows, your body conspiring with estrogen and testosterone being high is because it wants you to find a mate, capture some sperm, and then it releases an egg. And so you're like, "This is working great for my brain." Your bo- your body has another agenda. So you know, I, I had said to you as I came in that I was like, "I'm probably gonna say something weird."

   13. APAlex Partridge25:32

       [laughs]

   14. JBDr. Jolene Brighten25:32

       I'm gonna be awkward because I'm now in day eight-

   15. APAlex Partridge25:35

       Hmm

   16. JBDr. Jolene Brighten25:35

       ... of that luteal phase, so eight days post, um, ovulation.

   17. APAlex Partridge25:40

       Sure.

   18. JBDr. Jolene Brighten25:40

       And so it is at that point where emotional sensitivity starts to become heightened. Sensory sensitivity start to go up. I literally am in the worst nightmare of an elevator, uh, of my life this morning in the hotel-

   19. APAlex Partridge25:54

       [laughs]

   20. JBDr. Jolene Brighten25:55

       ... because it's, like, loud music, bright lights, and then these weird figures that, like, move, and a guy making direct eye contact with me-

   21. APAlex Partridge26:05

       [laughs]

   22. JBDr. Jolene Brighten26:05

       ... and I'm like, "Oh, this is a nightmare right now for my nervous system."

   23. APAlex Partridge26:08

       Sure. Yes.

   24. JBDr. Jolene Brighten26:09

       That's a really normal experience, but because that's a really normal experience for an ADHD woman, all that planning I did in the follicular phase now is coming back to bite me two weeks later. Now I'm like, okay, so just as you were saying, that woman is like, "I'm a failure. What's wrong with me? Why does he want to be with me?" Yeah, because we're told it must be an us problem. And so here we are in the countdown, seven to 10 days to our period. Everything is changing about our neurochemistry. So now serotonin is going down. Dopamine, norepinephrine, we're not responding to it in the same way. Acetylcholine, oh, why am I forgetting words mid-sentence? Why can't I remember that person's name? Th- where are my keys? Thanks, acetylcholine. And w- all the while, progesterone is raising GABA. Now, this is important. We need that GABA, and we are supposed to flow like this. It's very important for women's brain longevity speaking. But for us, that stop break of GABA, if it's working right, then we don't say the weird things. But you know, if you're stressed, you don't get enough progesterone, then your mouth filter is gone, as my good friend, Dr. Carrie Jones [laughs] likes to say, and now this may be where you're interrupting people. So for women, the impulsivity could look like binge-eating chocolate or shopping, but it may also look like you're sabotaging your friendships because I don't know why neurotypicals think if we talk about ourselves to relate to you, that we're somehow trying to take the, the spotlight off of you. But y- you're blurting out the things. You're trying to connect, but you're doing it awkwardly because the other thing that's happening is you really don't have the energy to mask, to keep it up, to fit in, and you're striving so hard. I think... So, and, and as I use the word masking, I'm sure your audience is familiar with it, I think often people see masking as this, uh, nefarious thing. You're faking being someone else just to be liked and trying to fit in. And I always say, like, evolutionarily speaking, the most important thing for survival was community, and we know that on a biological level. Our entire being knows that. We now have research that shows social isolation is as bad as 15 cigarettes a day. Who in this day and age would smoke 15 cigarettes a day? And yet people are telling us, "Don't mask to try to fit in and have community." Like, why would you deny that of us, knowing that it's threatening our health? So I just wanna validate every woman's experience because I can't even tell you how many patients come in and say this thing to me. But the thing that I will say that is the, like, clue to all of this is women will say, "It's really bad before my period. Things are so bad. My brain is not my own. I don't recognize myself. Like, I can't be trusted. My time blindness is so bad, I can't even book appointments during this time anymore." And then I say to them, "How is it the rest of your cycle? Let's go through it." Well, it gets easier, but it's never totally better, and that's what clued me in years ago, that the PMDD story, the you just have bad PMS story that women were being handed, wasn't the whole story, and that's when I started to clue in of, like, I think we need to have you evaluated for ADHD.

   25. APAlex Partridge29:20

       Hmm.

   26. JBDr. Jolene Brighten29:20

       Because PMDD classically, the cloud moves in, your period comes, the cloud moves out. The sky parts. The sun shines. You're like, "Ah, I'm fantastic."

   27. APAlex Partridge29:30

       [laughs]

   28. JBDr. Jolene Brighten29:30

       But for ADHD women, the mood aspect will do that-

   29. APAlex Partridge29:34

       Ooh

   30. JBDr. Jolene Brighten29:34

       ... but the executive dysfunction never quite resolves.
8. 29:45 – 32:54

   Why Pregnancy Can Make ADHD So Much Harder

   1. APAlex Partridge29:45

      W- Jolene, what about pregnancy? G- I know, uh, a bunch of women that are absolutely terrified of, of pregnancy for many reasons, health anxiety being a huge one. Like, the idea of growing a human inside you is, is terrifying, and it's huge respect. But what's happening inside the ADHD brain during pregnancy?

   2. JBDr. Jolene Brighten30:02

      This is a great question. So I wanna talk about hormones, and we're gonna talk about the immune system as well, because I think that will get the buy-in if you wanna be a mom, [laughs] that pregnancy's not so bad. So initially, we're gonna talk heightened progesterone. Every woman experiences more fatigue, more forgetfulness. The ADHD brain is so much, so much worse. Because as progesterone rises, it starts to kind of block your estrogen's ability to get dopamine up, to get norepinephrine up, uh, serotonin, acetylcholine. We can always talk more about what these neurotransmitters do. And so that's, like, the first trimester. Will you be a slug? Probably.

   3. APAlex Partridge30:38

      [laughs]

   4. JBDr. Jolene Brighten30:39

      It's okay to be a slug.

   5. APAlex Partridge30:40

      Sure.

   6. JBDr. Jolene Brighten30:40

      And I think that's the problem, is that women enter into this incredibly vulnerable state that requires a tremendous amount of energy, and then society says, "Keep cleaning your house. Keep going to work. Keep showing up. Keep doing everything the same, and if you can't, like, what's wrong with you?" Uh, I don't know. I'm just growing an entire human. It's the most energetically expensive thing I could be doing.

   7. APAlex Partridge31:00

      [laughs]

   8. JBDr. Jolene Brighten31:00

      No big deal. So that's in that early phase. And so when we get to, like, 10, 12, maybe 14 weeks, that's when things start to shift, and estrogen becomes quite high in pregnancy. So this is why- If you've ever heard about clot risks in pregnancy, yeah, that's because so much estrogen is up. And that estrogen then, women will be in their second trimester, and, and I wanna honor some women have a different experience, but a lot of women will be like, "Whose brain is this? Why does it work so well? Why do I feel so fantastic?"

   9. APAlex Partridge31:32

      Mm.

   10. JBDr. Jolene Brighten31:32

       "Why am I so grateful for literally everything in my life? Like, what's happening here?" And that's the estrogen rise, but also a shift in your immune system. So we've got two aspects of our immune system. This can be an oversimplification, but I want us all to be on the same page. We have Th1, fights your viruses, fights your bacteria, causes your neuroinflammation, involved in a lot of autoimmune conditions. And we've got Th2, which evolved more for parasites. We don't get so many of those anymore, so allergies, asthma, eczema is hanging out in that Th2. That Th2 is gonna help you be tolerant of baby. Th1 is like, "Are you me? Are you not me? Not me? I destroy you." We don't, we can't have that when we're pregnant because baby is genetically different in all the ways your immune system would not like. And so the immune system shifts. Th2 comes up, Th1 comes down, and so a lot of women will also experience a decrease in their neuroinflammation. Now that's another reason why their brain is working so much better. And so in a lot of ways, pregnancy can be really incredible for women, but then I'm sure the next question that's coming is what about postpartum? [laughs]

   11. APAlex Partridge32:42

       Yeah, I mean, exactly that. Um, I mean, I'm, we're getting super close to zooming in on the food on the table in front of us as well and, and getting to that diet plan at the end, which is gonna sort of supercharge all of this conversation and do wonders for the ADHD brain.

9. 32:54 – 37:02

   The Postpartum ADHD Experience Nobody Warns You About

   1. APAlex Partridge32:54

      But yeah, first, like what about postpartum?

   2. JBDr. Jolene Brighten32:56

      Yes. So postpartum I think is the hardest for an ADHD woman. Postpartum, for every woman listening, I call it the prelude of the things to come. It's like your sneak peek, little trailer of what will perimenopause be like for you. So I would put, you know, there's five Ps in my book I talk about of these huge hormonal transitions, and they make it harder for the ADHD woman, and I would put postpartum and perimenopause as absolute peak hardest time. And so I say that not so that you will be like, oh great, it's all doom and gloom. I say that so you learn to be gentle with yourself. You know that you need coping skills, and you know this is not a you problem. This is a universal problem. So you know, I had this one patient, I remember, you know, before she even knew that she had ADHD, and it was part of why I was like, "Girl, we gotta get you checked," is that she went into postpartum, and almost immediately, so the placenta gets delivered and there goes your estrogen and progesterone. The factory has left and the ovaries are on hiate- hiatus. And she was like, immediately, as soon as I deliver that placenta, I felt like I didn't recognize myself. I didn't know who I was, and I was in the delivery room, and suddenly the beeping was too loud. The nurse touching me was intolerable. I was trying to do skin-to-skin with my baby, and she's like, "And I love my baby, and I want to be with my baby, and at the same time, it was just making my skin crawl to have another human. And then the noises they make. We don't talk about this. Babies are really noisy. [laughs]

   3. APAlex Partridge34:33

      [laughs]

   4. JBDr. Jolene Brighten34:33

      But the noises they make, and then the pressure, the expectation coming on breastfeeding, and the overwhelming sensory sensitivity with that. So the loss of hormones shifting your neurochemistry. But in addition to that, we shift back to that Th1, which is very helpful 'cause we don't wanna get sick, and with breast milk, we're, we're producing all the antibodies for baby. So this is very, very important. But it can be so rapid. So just as I said, like through the, um, through, going through the menstrual cycle, like the changes in the brain can be so rapid. Postpartum is so rapid in the hormones and the immune system shift that it can be so difficult for the ADHD brain to be able to really compensate for that. She was terrified of moving into postpartum depression, and sure enough, she was starting to move into postpartum depression. And it was something, because I've worked with so many women, and she was 39, and I was like, odds are we know ADHD women go into perimenopause about a decade earlier, okay? I didn't know this at the time, but I was like, I know enough of this pattern to know that I need to get you started on some hormones, just a little bit of estrogen and progesterone to help you out. And sure enough, she was like, okay. It... She's like, It felt like I had this frenetic wave, and then like, like an iron just came through and just like smoothed everything out. And so instead of the highs being so high and the lows being so low, I felt like I was adapting so much better. And so I think this is something that science and medicine needs to explore so much more because the biggest, I think, heartbreaking moment for my patients, and even for myself as a woman, is to feel like I'm a failure as a mother. Like I'm failing a child, and it's not lost on us that this is the future of our species. Like, and yet I feel like I'm failing them, and really the reality is, is that medicine and society are failing mothers and failing to give all mothers support, and I definitely think the ADHD mother needs a, a, an extra level of support she's not being given.

   5. APAlex Partridge36:45

      Jolene, we're moments away from focusing in on the food in front of us on that table, because you've also spent about 20, 25 years researching diet and as a nutritionist to figure out what foods really boost female ADHD brains. But before we get to that just in a moment, there's one extra life phase that

10. 37:02 – 43:23

    Why ADHD Can Suddenly Get Worse in Perimenopause

    1. APAlex Partridge37:02

       we haven't touched on, the perimenopause.

    2. JBDr. Jolene Brighten37:04

       Mm-hmm.

    3. APAlex Partridge37:04

       And I saw a, a piece of content the other day. You know the Ibiza final boss that went viral a few months ago?

    4. JBDr. Jolene Brighten37:11

       I didn't see that.

    5. APAlex Partridge37:11

       You know that guy with the, the, the sort of mushroom hair guy who went viral? He was called the I-

    6. JBDr. Jolene Brighten37:15

       Oh, yes, yes

    7. APAlex Partridge37:16

       ... I- Ibiza. He did that funny dance on the dance floor.

    8. JBDr. Jolene Brighten37:18

       That's right. [laughs]

    9. APAlex Partridge37:19

       I heard someone call the perimenopause as for women like the ADHD final boss. Do, do you a- agree with that? Like, what, what happens during that stage of [laughs]

    10. JBDr. Jolene Brighten37:29

        [laughs] That is such a good analogy, honestly. [laughs] Like-

    11. APAlex Partridge37:32

        [laughs]

    12. JBDr. Jolene Brighten37:32

        ... I'm like, oh, I can't even... Yes.

    13. APAlex Partridge37:34

        Is it?

    14. JBDr. Jolene Brighten37:34

        It is the final boss. [laughs]

    15. APAlex Partridge37:36

        The [laughs] final... I feel like it needs some kind of, like, weaponry against it.

    16. JBDr. Jolene Brighten37:39

        Totally. Well, I think about, like, um, my children who are al- you know, playing video games, um, which, uh, it's just, like, a funny aside story. I, um, often share with my patients, like, if you're gonna start testosterone therapy in perimenopause, hide your credit card for the first two weeks.

    17. APAlex Partridge37:54

        Right. [laughs]

    18. JBDr. Jolene Brighten37:55

        Because even if it's the right dose, your impulsivity is gonna be probably pretty bad.

    19. APAlex Partridge37:59

        Sure.

    20. JBDr. Jolene Brighten38:00

        I almost bought a puppy when I started [laughs] testosterone.

    21. APAlex Partridge38:02

        [laughs]

    22. JBDr. Jolene Brighten38:02

        My husband stopped me, and instead bought two pairs of sequin pants that I did not need in the mall, and then I go home, and Nintendo's, like, having its, like, uh, OG video game sale, and I can't even tell you how many video games I bought, and my husband's like, "You don't even play video games."

    23. APAlex Partridge38:18

        [laughs]

    24. JBDr. Jolene Brighten38:18

        And then I was, like, playing Mortal Kombat, like, every day. Like, it was, that was, I was the CEO of, like, playing Mortal Kombat. Um, so I love the final boss analogy, and it really is, like, a, it's a great way to think about it because this is the final brain transition, and it's for the rest of your life. It's roughly about 40% of your life will be spent in the post-menopausal phase. So perimenopause is the transitional years that lead up to menopause. Menopause is 12 consecutive months, no period. You've arrived in menopause. The next day you are post-menopausal. We call everything menopause, so just think it's important to understand the differences because in perimenopause it's a neuroendocrine transition, so it's a brain hormone transition, and it first starts i- universally with progesterone declining. Some women, like myself, progesterone and estrogen's fine, but testosterone was the first to go, but that's not as universal as progesterone will decline, and then estrogen will decline. And while progesterone declining is gonna lead to worse sleep, worsening relationships in a lot of ways too, you know, low progesterone isn't just you feeling anxious and, um, irritable. It's also you not being able to tolerate how your partner is breathing. They are chewing too loud. They absolutely [laughs] are, but a part of that is because we're entering into a vulnerable window. So, you know, much of society would tell you, "You're a problem. You're just a cranky old lady," like, "You're having these issues," but I wanna reframe for women that when you're entering into a vulnerable state, very smart thing for your body t- to do would be to survey the environment and have heightened sensitivity, be a lighter sleeper, be more aware of the lights, the sound, the textures, all of the things because it could be a predator, and your body's just trying to keep you safe. Now, as we move into the estrogen decline, this is where things get wild because as estrogen declines, so does the mitochondrial's production of energy we were talking about. So perimenopause, about a 20% reduction in the utilization of glucose. Postmenopause, about a 20% reduction, but what'd I tell you with AD- ADHD brains? They already struggle with glucose utilization, and so this is where every perimenopause woman, I say they get, like, ADHD light because it's not as bad, it's not lifelong, and when you get into postmenopause, it should resolve two years post-menopausal. If you truly have ADHD, 25% of women will go on to have the most severe ADHD symptoms for the rest of their life, and that's after roughly seven to 10 years of dealing with the most severe perimenopausal symptoms. So as I mentioned, perimenopause comes about a decade earlier for ADHD women and has twice the symptom severity, not just worse ADHD, but also itchy skin, itchy ears, uh, burning mouth syndrome, painful joints, uh, noticing that your skin is aging rapidly. You're having IBS symptoms now, food sensitivities. Like, perimenopause is a whole lot more than hot flashes and night sweats. So ADHDers are experiencing far more symptoms. As I'm thinking about, like, this boss phase, I'm like, yeah, it's literally a battle, and their brain now reduces in glucose, mitochondrial dysfunction arises. Now, as cool as the mitochondria are m- making energy, they're also kinda lame because as free radicals increase, these are what rip apart cells and cause oxidative stress, the mitochondria are like, "All right, is that what we're doing? Cool, I'll do that too," and starts making reactive oxygen species. So there's all of that, then there's estrogen declining, causing a change in microbial diversity in the gut, ADHDers tend to have less microbial diversity as it is, leading to gut inflammation, intestinal hyperpermeability, and ultimately neuroinflammation as well. So this is happening for everyone in perimenopause, which is why women will be like, "Okay, I'm 48. I think I just developed ADHD." No, you're just in a temporary transitional phase. But for the true ADHD person, it's going to be very difficult without intervention. So when I say 25% will have the most severe ADHD symptoms for the rest of their life, that's without intervention. That's if we don't do anything, which is why I wrote a whole book because I'm like, no, immediately no, we're gonna do something about that. And so for every woman who's listening, perimenopause is hard. It's exceptionally hard if you have ADHD, and if you are an ADHD woman, I want you not to be like, oh, wow, dun, dun, dun, doom and gloom, it's all downhill. There's so much that you can do, but also I think we need to acknowledge that it is harder for you, and stop acting like you need to try harder, you need to do more. You need just better systems. Have you tried a planner? Like, estrogen does not care about the planner. She's leaving the building

    25. APAlex Partridge43:19

        So interesting, Jolene. And in many ways, this is the heart of the conversation.

11. 43:23 – 50:21

    The 14-Day Meal Plan for Better ADHD Energy & Focus

    1. APAlex Partridge43:24

       B- because in your book, you have this 14-day meal plan that really is a collision of your two worlds. On the one hand, you've got this huge experience, 20, 25 years as a nutritionist, and on the other hand, you've got this huge experience as an ADHD woman and all of the research you've done in that department, and those two worlds collided, and you've developed this plan to supercharge female ADHD brains. And a lot of the f- the food in that plan is in front of us on this table right now. So let's start with ghee.

    2. JBDr. Jolene Brighten43:53

       Okay.

    3. APAlex Partridge43:53

       Why is ghee on the plan?

    4. JBDr. Jolene Brighten43:56

       Oh, so ghee's gonna surprise a lot of people because we often hear things like, "You should be dairy-free," or if you're perimenopause right now, you've lived through the fat-free era. Ghee is rich in butyrate. Now, butyrate is a short-chain fatty acid that your microbiome should be making for you. Unfortunately, ADHDers have less microbial diversity, and then as, as estrogen declines, we have even less microbial diversity. That short-chain fatty acid, butyrate, helps the lining of your intestines heal. It also helps the blood-brain barrier heal, and it's anti-inflammatory. It helps with lowering neuroinflammation, and it helps with w- helps with lowering systemic inflammation as well, but also the gut lining, and it positively impacts that vagus nerve that we were talking about, which helps that rest and digest, so you get out of the fight, flight, freeze, fawn state of the nervous system that so many of us can find ourselves in, myself included, as my time blindness was trying to tell me that I would never make it here on time today. [laughs]

    5. APAlex Partridge45:01

       [laughs] So interesting, Jolene. And we move on to saffron, which, when buying the props for today's episode, I realized is one of the most expensive [laughs] pound-for-pound foods you can buy. I think it's like, it's like the, the weight of a s- a, a postage stamp, and it was, like, 4 pounds 50, which is about $7, I think. But, but is it worth it? What, what's the science behind saffron?

    6. JBDr. Jolene Brighten45:22

       So saffron is absolutely worth it. Now, I'll say all the science comes from supplements and standardized. But I think that when you look at eating meals, so what cultures are eating saffron? They're also including ghee, turmeric, you know, other things that can be really beneficial. So saffron, for my perimenopausal women, helps with sleep, helps with hot flashes, can help with mood. For PMDD, it's been researched and been found effective. The standard of care for PMDD, we discussed earlier, is SSRIs. That only works for 30 to 50% of women. I'm talking about women who think about leaving this planet before their time. So saffron has been shown to be beneficial for that. And then interestingly enough, they did a study on children with methylphenidate, Ritalin, and saffron and found that when they take saffron, it made their ADHD meds work better. I started to implement that in my practice, and what I found is that luteal lag we kinda get into for women on ADHD meds when estrogen is dropping or taking a back seat to progesterone, and they're like, "My meds don't work," I have found that bringing on saffron actually helps that, ha- them have better efficacy with their medication. And we also know that saffron can help mitigate some of the side effects of drugs like SSRIs. So it is worth it. It is very, very expensive. The good news is you don't need a lot of it. I'm always a food first person, but I will say that, you know, for some of these things like PMDD, ADHD, that are diagnosable conditions, the, the research, clinically speaking, is validated on supplement form, which is about 28 to 30 milligrams that you would take of that.

    7. APAlex Partridge46:56

       So interesting, Jolene. A- and then you brought salsa with you today, which [laughs] which surprised me. Like, why, why salsa?

    8. JBDr. Jolene Brighten47:04

       Oh my God, my book was written on chips and salsa, let me tell you. [laughs]

    9. APAlex Partridge47:08

       [laughs]

    10. JBDr. Jolene Brighten47:08

        So salsa's actually surprisingly a great way to boost your dopamine and your serotonin. So I always tell people, like, uh, 20 minutes of physical activity will buy you two to three hours of focus and peak cognitive performance, but you might find yourself in a situation where you can't exercise. Eating salsa, specifically it's the burn, the capsaicin, can help boost those neurotransmitters, and it may feel counterintuitive, but it's actually incredibly healing for the gut as well. And researchers are so interested in capsaicin, which is in the salsa, the thing that burns your tongue. They've been trying to figure out how to put it in a capsule to sell a supplement, and as it turns out, it's the repeated dose in food that actually has the most benefits. And the reason why when they wanted to put it in a capsule is because it may be preventative against cognitive disease like dementia.

    11. APAlex Partridge47:59

        Moving on. One of the most, or what appears to be one of the most controversial foods at the moment online, potatoes. Why, why do you think potatoes are, are being so misunderstood [laughs] at the moment?

    12. JBDr. Jolene Brighten48:10

        Well, because, you know, after we moved on from fat-free, we moved to carb-free, and women are not supposed to eat any carbs. And here's the reality about potatoes. If you cook them, you cool them, so put them in the fridge, and you eat them the next day, you know, our mutual friends, Rich and Roxy, I was just giving her permission to eat potato salad-

    13. APAlex Partridge48:28

        [laughs]

    14. JBDr. Jolene Brighten48:29

        ... it creates resistant starch. Resistant starch is incredibly beneficial for the microbiome, and it helps you make that butyrate that we started this whole conversation with. So in the 14-day meal plan, we start bringing up fiber-rich foods. I don't go too quick on you because if you're not eating a lot of fiber, you're gonna hate me. You're gonna be the gassy person at work. You're gonna be like, "Why? Why, Dr. Brighten?"

    15. APAlex Partridge48:52

        [laughs]

    16. JBDr. Jolene Brighten48:52

        But in the second week of the meal plan, we get into bringing in more resistant starches. And so people will tell you eating potatoes, white rice, white bread, these things are bad. If you are cooking them, cooling them, you are creating resistant starch. Other ways to get that are, like, green bananas. Who wants to eat a green banana? It's not necessarily me. It's, for some people, but it's not totally for me. So this is another way to boost your resistant starch, diversify your microbiome, and help you get more butyrate.

    17. APAlex Partridge49:19

        So interesting. And just before we move on to a, a, a, a particular habit that really is one of the most important ways to improve ADHD performance. So just quickly, there's blueberries as well, there's walnuts, and there's an avocado. Is there a summary of those three?

    18. JBDr. Jolene Brighten49:34

        Yes. So blueberries, that's... I'm like, people, polyphenol max, right? The kids are always like looks maxing all of these things.

    19. APAlex Partridge49:40

        Yes

    20. JBDr. Jolene Brighten49:40

        All you polyphenol max. So-

    21. APAlex Partridge49:41

        ADHD maxing.

    22. JBDr. Jolene Brighten49:42

        Yeah. [laughs]

    23. APAlex Partridge49:43

        [laughs]

    24. JBDr. Jolene Brighten49:43

        So all of the berries that you can eat, especially blueberries, they're anti-inflammatory, so we talk about that neuroinflammation. Walnuts, they're a great source of omega-3 fatty acids. Yes, they also have omega-6s, but omega-3s are crucial for the ADHD brain. And then avocados, and we'll take it from a different perspective, rich in vitamin B6, essential for helping you have optimal progesterone levels.

    25. APAlex Partridge50:07

        Incredible. So useful. So if I eat all of these on the train home today, I'll finish my book tonight?

    26. JBDr. Jolene Brighten50:11

        [laughs]

    27. APAlex Partridge50:12

        So will that work?

    28. JBDr. Jolene Brighten50:13

        You let me know.

    29. APAlex Partridge50:14

        Yeah. [laughs]

    30. JBDr. Jolene Brighten50:14

        I wanna know. Do the experiment. Be the N of 1. [laughs]
12. 50:21 – 52:37

    The Lifestyle Habits That Can Transform Female ADHD

    1. APAlex Partridge50:21

       food, what lifestyle habits do you think have the biggest impact in, with helping females with ADHD?

    2. JBDr. Jolene Brighten50:27

       Without a doubt, sleep, and it's the most boring, right? Uh, everything that's good for you is incredibly boring. I hope I made it less boring in the book. So we talked about that lactate that ADHD brains are using. Well, as great as I made it sound, the downside of it is if you don't get quality sleep, you don't clear the lactate, now you're foggier the next day. Your brain is like, "I can't even use energy." I say, you know, not getting good sleep is like loading the dishwasher all day and then not running it, and then the next morning you have to eat your breakfast off dirty plates. Ew. Nobody wants to do that, right? That's literally what happens when we don't sleep. But it's not easy to just say sleep to an ADHDer, right? Like, 70% have delayed sleep phase syndrome. We know that there are a lot of reasons ADHDers, they're struggling with sleep. They're struggling with their circadian rhythm. So within the book, I went through, here are the top reasons ADHDers don't sleep. Identify where you're at, and then get in and do the things that are gonna work for you. And the one tip I would tell everybody is wake at the same time every day if you can, because that builds up the sleep pressure that will force your toddler-like brain, because, yes, we're essentially always toddlers, [laughs] to go to sleep at night so that you can get that quality sleep.

    3. APAlex Partridge51:42

       So interesting, Jolene. Thank you very much. And I want to move on to, I think is actually slowly becoming the most popular part of the show. It's certainly the most emotionally unpredictable part of the show, 'cause I read the comments, and this, this is the one that gets, gets a lot of comments, is, is the audience questions. Um, and it's called the Washing Machine of Woes-

    4. JBDr. Jolene Brighten51:59

       [laughs]

    5. APAlex Partridge51:59

       ... and it's right behind me here. It's a-

    6. JBDr. Jolene Brighten52:01

       Love it. [laughs]

    7. APAlex Partridge52:01

       There we go. It's a mini washing machine. What? I'm so interested. I mean, do you, do you relate to the washing machine, forgetting your clothes after the cycle's finished?

    8. JBDr. Jolene Brighten52:08

       Of course.

    9. APAlex Partridge52:09

       Yeah. [laughs]

    10. JBDr. Jolene Brighten52:10

        I mean, yes. We've all, we all have that shirt that smells like mildew now that you're like, "It's done. It's dead to me," like. [laughs]

    11. APAlex Partridge52:16

        It was so reassuring when I s- when I put this section in the show to, to see the comments that so many people related to it.

    12. JBDr. Jolene Brighten52:21

        Yeah.

    13. APAlex Partridge52:21

        'Cause there was so much shame, that, that smell of damp and, and to knowing that it's, it's quite a typical ADHD problem, uh, sh- out of sight, out of mind. So yes, this week, Jolene, in the Washing Machine of Woes, which is where the audience questions live, and there's three this week. Right. The first one, Jolene:

13. 52:37 – 53:28

    What ADHD Women Think Is Normal — But Isn’t

    1. APAlex Partridge52:37

       What's something millions of women with ADHD think is normal but absolutely isn't?

    2. JBDr. Jolene Brighten52:43

       Oh. I would say feeling, like, the extreme emotional reactivity and the ups and downs that are happening in your menstrual cycle, and thinking, "Yeah, I have emotional dysregulation," right? It's, like, a key, uh, executive function running in the prefrontal cortex. But I don't think that we should accept those extreme swings as normal, and I also think we shouldn't pathologize it and just say, "That's just anxiety," or, "That's depression." I think we should get curious about it, because it could be you're not sleeping well, you have a dysregulated nervous system, you're not making space for yourself to decompress like you need to, or it can be, you know, the histamine issues that we talked about.

    3. APAlex Partridge53:25

       So interesting. Thank you very much, Jolene. And moving on

14. 53:28 – 56:55

    The ADHD Symptom Women Blame Themselves For Most

    1. APAlex Partridge53:28

       to the next question: What's the one symptom women blame themselves for most that actually has a biological explanation?

    2. JBDr. Jolene Brighten53:37

       Ooh, I'm gonna go back to the emotional dysregulation and the way that we can go from rage to guilt so quickly. But I think, you know, a lot of women blame themselves for the way they're showing up in social interactions, and then, you know, you... This is something so many of my patients have shared. I have also experienced it. You go to bed d- at night, and you replay everything you did wrong, every TMI, every time you interrupted, and every time your emotions got the best of you. Because sometimes, like, when we're interrupting, that's emotional dysregulation that's causing us to interrupt people, and then we just beat ourselves up, and we just think, like, "I'm the worst person in the world. Why can't I just get it together?" And the reality is there's very basic needs that humans have to meet that are incredibly boring, and we don't do, we don't do well, like drinking water, and sometimes it's as simple as, like, we have to meet your needs earlier in the day.

    3. APAlex Partridge54:34

       Wow. Brilliant answer. Thank you so much, Jolene. The third one's actually really, really heartbreaking. If you could permanently remove one symptom of ADHD from every woman on Earth, which would you choose, and why?

    4. JBDr. Jolene Brighten54:48

       I don't think I would. Because removing the symptom, which in medicine we call a symptom, is really your experience, and it's inherently part of what is your operating system. And so would I like to lessen symptoms, have the symptoms not control your life? Yes. And I think a lot of things that society sees as negative symptoms, let's take impulsivity, right? Could it be negative? Yes. But it can also be leveraged for incredible things. So many ADHDers are entrepreneurs, and you'll never meet more creative people, I feel like, than in the ADHD community when the impulsivity gets the best of them. You wanna brainstorm something? That's your ADHDer. You know, you listening to this right now have probably had someone be in awe of how your brain works, being like, "Oh my God, I could have never seen it from that perspective. I would have, I would have never made those connections. I would have never understood that." And so I think it's important for us to understand that, you know, as much as the symptoms get the best of us sometimes, those same things we call symptoms, they're traits of what we experience, and there are ways that they benefit us, that they also benefit society. And I would go so far as to say there are many ADHD now symptoms that were actually positive attributes that made it that our entire species was able to survive.

    5. APAlex Partridge56:15

       Gosh, an incredible answer. Thank you so much. And wonderful from the washing machine of woes yet again, and incredible answers to back them up. So thank you so much. Just before we finish, Jolene, I've got a surprise for you.

    6. JBDr. Jolene Brighten56:25

       Okay. It's not the Real Housewives? [laughs]

    7. APAlex Partridge56:27

       [laughs] We can watch it if you like. I'm gonna deliver to you a letter that was written by the previous guest.

    8. JBDr. Jolene Brighten56:33

       Oh.

    9. APAlex Partridge56:33

       The previous guest always writes a letter to their younger self, and I deliver it to the next guest, which today is you.

    10. JBDr. Jolene Brighten56:38

        Okay.

    11. APAlex Partridge56:38

        If you could kindly read it out loud.

    12. JBDr. Jolene Brighten56:39

        Okay. Uh, and this is the moment, um, for where all of the ADHDers know how when we would skip ahead and read the next paragraph, right?

    13. APAlex Partridge56:47

        Yes.

    14. JBDr. Jolene Brighten56:47

        The read-around in class.

    15. APAlex Partridge56:48

        Yeah, exactly.

    16. JBDr. Jolene Brighten56:48

        And you're like, "I need to predict what that is and read it."

    17. APAlex Partridge56:51

        [laughs]

    18. JBDr. Jolene Brighten56:51

        Oh, okay, it's only one, one line each. [laughs]

    19. APAlex Partridge56:54

        [laughs]

    20. JBDr. Jolene Brighten56:54

        So,

15. 56:55 – 59:33

    A Letter to My Younger Self

    1. JBDr. Jolene Brighten56:55

       "Dear younger me, I know you think there's something wrong with you. You don't say it out loud, but you feel it every day. You wonder why making friends seems so easy for everyone else, while you always feel like that odd one out." Is this, like, literally everything I already said in this episode? [laughs] This resonates so hard. "You replay conversations, notice every awkward moment, and slowly start believing the problem must be you. I wish I could sit beside you and tell you one thing. There is nothing wrong with you. One day you'll discover you have ADHD, and suddenly years of confusion will make sense. You'll realize you were never lazy, too much, or not enough. You were living with a brain that worked differently, without anyone giving it a name. The hardest part isn't having ADHD. The hardest part is having ADHD and blaming yourself for every single struggle. I know how lonely you feel. I know what it's like to be surrounded by people and still feel completely alone. To wonder why friendships never seem as easy for you." I'm not, I'm gonna, I might cry. Ooh. "To spend years trying to become someone easier to like. But here's what nobody tells you. The more you hide who you are, the lonelier you become. Because even when people love you, you'll wonder if they'd still love the real you. Then something beautiful happens. You'll meet people who think like you, who understand you without you having to explain yourself. For the first time, you'll feel like you belong. Not because you changed, because you finally stopped pretending. You'll grieve the years you spent not knowing. That's real. But although your diagnosis comes late, it isn't too late. One day you'll stop asking, 'What's wrong with me?' And you'll finally realize there was never anything wrong with you at all. With love, your older self." This person's, like, phenomenal. They should write a book.

    2. APAlex Partridge59:08

       They should. You-

    3. JBDr. Jolene Brighten59:09

       Have they? They should

    4. APAlex Partridge59:10

       ... you saw, you saw yourself in that letter?

    5. JBDr. Jolene Brighten59:13

       I think we all just saw ourselves in that letter.

    6. APAlex Partridge59:15

       I think that's a letter to all of, really, of the younger selves, to all of the listeners and viewers, too.

    7. JBDr. Jolene Brighten59:19

       Yeah.

    8. APAlex Partridge59:20

       Thank you for reading it so gracefully and beautifully. Uh, on behalf of everyone listening, grappling to understand their brains, Jolene, thank you so much.

    9. JBDr. Jolene Brighten59:29

       Thank you for having me. [upbeat music]

Episode duration: 59:33