Leading ADHD Clinician Reveals Scariest Side Of ADHD | Ms. Danielle Mulligan

1. 0:00 – 0:25

   Intro

   1. APAlex Partridge0:00

      Danielle, thank you so much for joining us

   2. DMDanielle Mulligan0:02

      Thank you for having me

   3. APAlex Partridge0:03

      It's a huge privilege to have you here. You've assessed thousands of people for ADHD, so I'm sure you'll agree that some major pain points of ADHD are feeling lost, isolated, misunderstood, useless, difficult, unloved, unlovable. All really sad terms. So a very important question to

2. 0:25 – 3:01

   Why ADHD adults feel unlovable

   1. APAlex Partridge0:25

      start, why do you think it's common for people with ADHD to feel these?

   2. DMDanielle Mulligan0:30

      So I think it's common for them to feel it because a lot of the time they, they can mask a lot of things. They can hide and think it's normal for them because it's all they've ever known. So they can go through life sort of thinking, "Yeah, but I've never known any different, so this is who I am and this is how it defines me," until they sort of get a diagnosis of ADHD and understand more. I think it can be such, it can be such a neg- You find a lot of people with ADHD have such low self-confidence and self-esteem because of all those things and because they just think that's the norm, and that's how they're gonna crack on with things, and that they've just got to just move along, and they've just got to understand that the world's against them, a lot of people feel. Um, which is actually super, super sad to think about because I think it's not a nice way to feel like that every single day. Um, and I think in terms of, like, why they feel like that, I think it's because, you know, they're just programmed to go through the day. They're programmed to understand that, you know, they can't do certain things, but they don't know why they can't do certain things. And then if you go and you're paying for something at the shop and you forgot your wallet, you just think you're stupid. Um, and when you don't understand why you've done that, um, it's just such a negative experience and a, such a sad experience for everyone, um, that I think it's, it's hard for them to understand that whole journey when they do get a diagnosis to know that they, they weren't, they weren't that stupid person, they weren't lazy.

   3. APAlex Partridge2:05

      Mm-hmm.

   4. DMDanielle Mulligan2:05

      I don't know if you e- ever were called that yourself before your diagnosis in terms of, "Oh, you're just lazy," or, "You're just, you're just stupid." And people say, "Well, I'm not. I'm not stupid. I'm not lazy." Um, and I think it's, it's really hard world to live in for someone that functions in a different way. I think everyone's trying to make the world fit everyone in one way. Similar to the education system, I think you can't make everyone fit in one box. Um, and I think it's hard when people don't realize that they don't fit in that box, if that makes sense.

   5. APAlex Partridge2:40

      It makes total sense. I suppose living with undiagnosed ADHD is, is living in a constant state of feeling like you're just about keeping your head above water.

   6. DMDanielle Mulligan2:48

      And it's just you. It's just you that feels like that, 'cause everyone's got it together

   7. APAlex Partridge2:52

      And everyone else thinks you're an expert swimmer because you appear to be-

   8. DMDanielle Mulligan2:56

      [laughs]

   9. APAlex Partridge2:56

      ... turning up on time-

   10. DMDanielle Mulligan2:57

       But a swan. You look beautiful on the surface

   11. APAlex Partridge2:59

       ... getting that work submitted. Exactly. So

3. 3:01 – 6:14

   Danielle’s ADHD mission

   1. APAlex Partridge3:01

      who are you? What's your mission in the world of ADHD?

   2. DMDanielle Mulligan3:04

      So my mission is to get as many people assessed as quickly as we possibly can, but not to rip people off. So I came to Focused because Focused is an as- affordable service. Um, so they came and approached me, and I approached them, and they said, "We want you to support our service and build our service, and we don't understand why everybody charges what they charge." So I've worked in other private services where it's like, what, £900 an assessment. And I actually had an experience where I was in an assessment with a lady, and she told me how she got a loan out for the assessment, and I was absolutely mortified 'cause I felt it was my fault, and it wasn't my fault. It wasn't my company, wasn't my issue. But then we know that finances and ADHD don't marry up very well. Um, so the fact that she'd taken this five-year loan out, that I was then panicking she wouldn't be able to pay off [laughs] , which was nothing to do with me, absolutely broke my heart. And from going to the NHS to working privately and then having that experience and I was like, "I don't think this is right. We shouldn't be ripping people off." 'Cause she'd made this huge decision to do this huge life step. Like, you must remember that time when you were making that decision to be assessed. It's not a decision that comes lightly to anyone, and it's a huge decision to make, to then have to get a loan out to make that decision. And then I, I... so I've got me questioning about, you know, why are lots of private companies so expensive? Um, why is it so hard for people to make a decision, uh, that's gonna completely change their life, but then they're getting financially distressed from it? Um, and then luckily, I was in a position where Focused was sort of being born and, and their sort of morals were exactly the same. And they were like, "Why, why are they so expensive? Why, why are people charging, like, £500, £900, thousands of pounds in some cases? Like, w- what is the need for this?" Um, and then obviously their mission was to create an affordable service to reach as many people as possible, to help people find that clarity they need to move on with their life, to, to figure things out, to understand themselves, to, to process everything, to make sense of everything. Um, and that's sort of what moved me over to Focused and, and was very pleased that they sort of had the same morals as me. And they developed this amazing system that, where they can, we can keep the price low, we can get the assessment done, we can make that journey s- seamless for the people of ADHD, um, and reach as many people as possible. Um, so I think my mission is to... I don't want people waiting. I don't think you should wait. You know, five years is such a huge amount of time, um, to understand what's going on for yourself.

   3. APAlex Partridge5:57

      Mm-hmm. It's a truly brilliant mission, and I think, feel like when someone comes for an ADHD assessment or they want to get assessed, they're at a real crisis point, a real critical point-

   4. DMDanielle Mulligan6:06

      Massive

   5. APAlex Partridge6:06

      ... and then they're often-

   6. DMDanielle Mulligan6:06

      It takes a huge decision

   7. APAlex Partridge6:07

      ... hit with a huge wait or a huge bill. Um, out of the people you've assessed at Focused,

4. 6:14 – 10:50

   Post diagnosis emotions

   1. APAlex Partridge6:14

      you must have seen a s- huge difference in emotions post-diagnosis, h- how people react to hearing that news often after years and years and years of feeling misunderstood, being told that they're too sensitive and not understanding why. What emotions have you seen people express after receiving a diagnosis of ADHD?

   2. DMDanielle Mulligan6:33

      I have a lot of people cryUm, so recently I've had a, a lady who just burst out crying on the phone. Um, and it was more because for the first time something made sense, and I think you might have felt that when someone says, you know, "You've got ADHD." It's the first time she sort of went, "I knew I wasn't stupid." And, and she was sort of thinking of her younger self and how her life could be so different if this had been sooner. Um, she was a lady in her 40s, so she'd gone a, a huge g- like, chunk of her life just, just treading water, paddling, you know, being that beautiful swan. Um, but absolutely just treading water underneath. Um, and she just cried for a good half an hour. Um, and I just was there, and I was just being with her in the moment and saying, "No, it's okay to be sad. You're okay to be sad for your younger self." I've had people shout at me. I've had people not blame me, but sort of shout at me because they're upset that it hasn't been caught sooner, and their emotions, which are difficult for them to regulate anyway, um, is to just be angry, and they're angry at the parents, they're angry at the process, they're angry at the fact that their life could've been so different. And I've had people have that relief that it, "Thank goodness it makes sense." Like, "I was more scared you were gonna tell me that I didn't have ADHD rather than the fact that you've told me I've got it." So it really, really varies. It really varies. And I think it, it all, like, is that feedback session I tend to have with my patients. I tend to make sure that we have that time to process, and I always say, you know, "This is the start of your journey. Like, you're gonna go on this heck of a journey now of understanding, you know, you didn't forget that bread at the shop. You know, it just wasn't on your list. And, you know, y- your whole relationships, like, everything, the way you do your work, the way you structure your days, everything is gonna be so different for you because you're gonna understand what's, why you do what you do." Um, so I often make our feedback sessions quite lengthy to make sure that they can, I can be there to help them process that emotion that can be sometimes super intense. 'Cause as AD- people with ADHD, you, you feel emotions way more intensely anyway. Um, so to be, make sure that you're there to support that patient in that moment is really important for me as a clinician, and I, I will sit and I will just let them cry, and I'll say, "It's fine. Just cry. You can cry. I- Do you want a tissue? Do you want a brew? Do you want a biscuit?" Like, it's absolutely fine to sit and cry and be upset. And I've had patients that have said, "I didn't want you to say that I had it." And I'm like, "Why did you not want me to say you have it?" Like, so you've got the exact opposite of that relief. You've got that disappointment, and people are going, "But I didn't want to have anything wrong with me." And what I do to say, "Oh, no, you just, you know, you don't have it. You know, it's the awareness that's on social media and things like that in the public that made you think you might have it, but you're just absolutely normal." So I've had people be upset that they've got a diagnosis, um, which is an unusual response sometimes 'cause you expect that relief more-

   3. APAlex Partridge9:38

      Mm-hmm

   4. DMDanielle Mulligan9:38

      ... than you expect that disappointment. Um, but yeah, a lot of the time some people say, you know, "I was, I was sort of hoping you said I was fine." And I'm like, "Well, you are fine. You, you're absolutely fine. You can still function exactly the same way as everyone else in the sense of you can be s- still be super successful in your career. You can still... You've just got to do it slightly differently to everybody else." Um, so yeah, huge range of emotions.

   5. APAlex Partridge10:03

      I feel like there's a point at someone's life with ADHD way back in the past, most of us won't remember it, where we realized that we were different, and from that point on, we put on a mask and changed who we were.

   6. DMDanielle Mulligan10:18

      Or tried to fit in with everybody else.

   7. APAlex Partridge10:20

      Yes.

   8. DMDanielle Mulligan10:20

      You try and look like everyone else.

   9. APAlex Partridge10:22

      Exactly. And when you get the diagnosis at whatever age that come, you're, you wanna desperately go back in time to that point and put your arms around that younger version of yourself-

   10. DMDanielle Mulligan10:33

       Mm

   11. APAlex Partridge10:33

       ... and say, "You are not broken. You are different."

   12. DMDanielle Mulligan10:35

       It's fine.

   13. APAlex Partridge10:35

       "You are enough. Do not abandon your true self in order to-"

   14. DMDanielle Mulligan10:39

       Mm

   15. APAlex Partridge10:39

       ... "satisfy-"

   16. DMDanielle Mulligan10:40

       Because you've lost yourself as well, uh, when you're putting that mask on-

   17. APAlex Partridge10:43

       Mm

   18. DMDanielle Mulligan10:43

       ... haven't you? You, you're lost a little bit.

   19. APAlex Partridge10:46

       Do you think in the life as a quest for happiness, do you think

5. 10:50 – 12:25

   Does a diagnosis make you happy

   1. APAlex Partridge10:50

      an, a diagnosis equals happiness?

   2. DMDanielle Mulligan10:54

      I don't know if it equals happiness, but I think it, it gives you, that, that relief can give you happiness. Um, and I think that understanding can make things feel easier. Um, and I've had a, a patient, patient recently actually who, uh, medication journey didn't quite work out for him, and he sort of said to me, "But sometimes that diagnosis has just been enough for me because now I'm sitting back and as I'm processing the things I do on a day-to-day, I'm going, 'Oh, I do that because of this.'" And I'm like, "Well, more likely, yeah, that's probably the reason why you do it, and this is a symptom of ADHD that I've never noticed before because I thought it was just me, but actually it's not me." And, and sometimes the diagnosis can be enough for people. Um, and I think, is it happiness? I don't think it's necessarily happiness, but I think it's the journey towards that for people, and I think it's a way for them to start rebuilding themselves and picking themselves up again. Because like you say, you lost yourself when you were that, got that point where you knew you were different, and then you've gotta pick yourself up and piece yourself back together again. And I think that that's the start of the happiness journey for them. So I think it's just one very large piece of the puzzle to start their journey to happiness, but I think it can certainly help them feel clarity.

   3. APAlex Partridge12:10

      I feel like there's so much shame associated with the ADHD experience. Like, you, you rec- you recognize that perhaps you do operate in a certain way that might go against the societal norm of how you've been told, and there can be a lot of shame, and you hide that. You suppress it. You betray your true self.

6. 12:25 – 14:13

   What life events can trigger an ADHD assessment

   1. APAlex Partridge12:25

      Do you think there's a life event or a particular age where someone seeks a diagnosis?

   2. DMDanielle Mulligan12:31

      See, I've seen a huge range of people. 'Cause at first I would've said it was that, um-Sort of mid-30s. Back a few years ago, I'd have said it was the 30 sort of zone. Um, but I'm seeing younger and younger come through, so especially with b- being in Focused, lots more people coming from uni, um, than I would've expected, so sort of your early 20s. Um, but I think that's down to the, the awareness on ADHD, and I think people are, are understanding ADHD a little bit better. Um, and the symptoms are a bit more prominent, so like social media's massive for ADHD, isn't it? Like, everyone's like, "Oh, do this quiz. You've got ADHD." Um, and I think the, the... it is getting younger, but as being a CAMHS nurse previously as well, I would say that we saw a lot of young primary school children as well. So is there an exact age? I, I don't know, but I think... I'm hoping it's getting picked up sooner for people, um, for their journey really. Like, if you think if you'd have got your diagnosis younger, what- how much different would your life have been, like your schooling, your grades, like everything leading up to that point? Um, so I don't think there's an exact age, but I think it's getting younger than it used to be.

   3. APAlex Partridge13:50

      I remember really well one of my earliest criticisms or a comment that I had on a playground that cemented that suspicion that I might be unusual, and that was f- someone said to me, another kid, "You could be one of the cool kids, Alex, if you weren't so weird."

   4. DMDanielle Mulligan14:04

      Weird.

   5. APAlex Partridge14:05

      And I remember that day so well. Um, and I sort of retreated into the library after that and looked out the window and was so s- terrified to go play with the other kids after that.

7. 14:13 – 19:37

   Common ADHD criticisms

   1. APAlex Partridge14:13

      What common criticisms do you think ADHD people get throughout their life?

   2. DMDanielle Mulligan14:19

      Naughty. I hate the word naughty. Especially younger children are, "They're just naughty. They're just a naughty boy. They're a naughty girl." Um, sometimes with girls as well, they get told that they're just not int- they're not interested in anyone else and they're just too independent. And I'm like, how can like a six-year-old child be too independent? Um, 'cause what you tend to find, that presentation's slightly different, isn't it, in men and women. And you tend to find your younger girls, they sort of push it down and hide things a little bit, bit better sometimes, or their hyperactivity's more internalized. And I think they become, "Oh, she's a bit bossy," or, "She's too independent." Uh, but the... I hate the word naughty. That's a big one. Naughty. He's just a naughty boy. And it- they don't understand what that naughty looks like. And weird, I've had people-

   3. APAlex Partridge15:09

      Mm-hmm

   4. DMDanielle Mulligan15:09

      ... be told, oh, they just said that I was unusual or I was weird. And I'm like, "Yeah, but why are you weird? Why do people find you weird? Like, what does that mean?" Um, but I think that's... they're, they're a lot of common ones. Bossy, independent, naughty-

   5. APAlex Partridge15:26

      I feel like there's-

   6. DMDanielle Mulligan15:28

      Weird

   7. APAlex Partridge15:28

      ... I feel like there's so many ways to call a child naughty even without using that word, like stop fidgeting-

   8. DMDanielle Mulligan15:33

      Sit down

   9. APAlex Partridge15:33

      ... stop biting your fingernails, sit down, calm down. Why are you so weird?

   10. DMDanielle Mulligan15:37

       Stop messing with your hair.

   11. APAlex Partridge15:38

       Exactly.

   12. DMDanielle Mulligan15:38

       [laughs]

   13. APAlex Partridge15:39

       I feel like ADHD is almost, in a sense, it's, it's death by a thousand cuts, a thousand and thousands of extra tiny micro-criticisms that neurotypical kids just don't get as a result of our innate differences. Um, do you think that exposure to this tsunami of excess criticisms, how does that affect someone's self-esteem as they turn into an adult?

   14. DMDanielle Mulligan16:02

       Massive. Massive, I think. And a lot of time I spend with patients in adulthood is going through the fact that, you know, their, their self-esteem doesn't exist. It's so negative, and they've got to then rebuild that. Um, because I think it's, it's really sad, and it's all those tiny comments that people don't think about when they say them. Like, and I think when you work in ADHD, you're more cautious about what you're saying to people 'cause you don't wanna upset them. But like, in terms of the impact on self-esteem in, in people with ADHD, it's absolutely massive because they've always been told, "Alex, can you stop messing with your pen? Alex, can you just sit d- can you stop crossing your legs? Can you, oh, can you just stop doing all of this stuff and just be normal?" And no one knows what normal looks like and what even is normal. I hate the word normal as well. And I think that just... 'cause, because then you hold onto that when you've got ADHD, and you, you process that and you think, "I've got to stop fidgeting. I've got to stop doing this," and you almost like zombify yourself a little bit. And you become so external to what's going on, and you isolate yourself because you don't wanna be so different, um, which is sad that people do that, and it's sad that people feel like that. And like you said, you retreat to the library, and you just sort of looked out the window and longed to be part of the popular group.

   15. APAlex Partridge17:18

       [laughs]

   16. DMDanielle Mulligan17:18

       Like, "Please accept me for who I am," and then thinking about, "How can I be accepted?" And like, so you're completely changing your personality when you didn't need to do that, but that's how you were made to feel. Um, I think s- the self-esteem, I think, is one of the biggest hits for people with ADHD. And yes, workplace stress. Yes, relationships. There's so many different impacts in the ADHD journey, but I think that you can't just build your self-esteem in a day by having some little points and say, "I'll look in the mirror and tell myself I'm amazing." It, it's not gonna work the first time. You can get recommendations at work. You can get requirements. You can get things that you need to make your job better, and you can sit down with your partner and make that sort of relationship a little bit easier. But you can't build your self-esteem in a night, and I think it, it's such a hard journey to go on of understanding that and building that up and again and going, you do that because you've got ADHD. ADHD isn't an excuse in why you're doing this, but it's, you just need to then figure out how to work this out, and I think that is a huge thing for people. I don't know about your self-esteem, if you felt that you had to rebuild that.

   17. APAlex Partridge18:28

       It's certainly a lot better now, but I know for a fact that exposure to those 20,000 extra-

   18. DMDanielle Mulligan18:34

       Tiny little things

   19. APAlex Partridge18:34

       ... comments, like they, they turned... I think they create an adult that is so terrified of criticism.

   20. DMDanielle Mulligan18:40

       And anxious.

   21. APAlex Partridge18:40

       And because you're so used to it, you perceive it when it's not there. Like, you see danger even if it's not real.

   22. DMDanielle Mulligan18:48

       Or you think nobody likes you, even when they've not even spoken to them.

   23. APAlex Partridge18:52

       If someone invites you to a party and they say, "Come if you like"-Come if you like

   24. DMDanielle Mulligan18:56

       What does that mean?

   25. APAlex Partridge18:57

       That's not a, a absolute certain invitation. You think that your presence at that party's gonna be a nuisance to them

   26. DMDanielle Mulligan19:02

       Or they don't actually want to, they just said it because they were trying to be kind in front of everybody

   27. APAlex Partridge19:06

       Well, I think that they, they hate you. Like, it, it's a genuine... So much of this stuff doesn't, doesn't compute often to the neurotypical mind. I've s- But it's so true for people with ADHD because of these early years exposure to criticism, and it creates RSD, rejection sensitive dysphoria. And for me, it feels like an instant punch to the gut, like someone's put in a dagger and twisted it. It's excruciatingly painful, my response to criticism. I, I suppose out of the people that you've assessed at Focused,

8. 19:37 – 22:16

   What RSD feels like

   1. APAlex Partridge19:37

      how have they described the feeling of RSD to you?

   2. DMDanielle Mulligan19:42

      So they've, they've described this, like, rollercoaster of emotion. So they've described, like, the tiniest insignificant event being the biggest of deals. So like you say, the mum saying, "Can you just get some milk from the shop?" becomes the most intense situation, and then they have a huge breakdown and, like, they're just like they can't do life. They look for self-worth. They c- can't do it, can't. And then parents like, "I've just asked you to get milk. Like, just go next door to the corner shop and get some milk."

   3. APAlex Partridge20:13

      [laughs]

   4. DMDanielle Mulligan20:13

      And, and, and they just... That because it's not clear, and like you say, that, that structure's broken for them, um, I think a lot of people... So part of what I try and understand is how intense that criticism is for them. Like, if I said, "Oh, that's great, but I sort of didn't want you to do that," 'cause people don't always think about what they say to people, and I think having that, that comment said to someone with ADHD, they, they, they overanalyze it. And you're already going 100 miles an hour thinking every single thing and every event and every purpose event and every other event and every what if event, that you become an anxious mess. And I've met lots of patients in doing assessments where they are a nervous wreck, and they, they're even nervous in the assessment about saying the wrong thing. And I'm like, "There isn't a wrong answer. This is about you." [laughs] Like, if that's h- what happened, then that's what happened. And they're like, "Yeah, but is that what you wanted?" And they question everything that they do, and if that's what they do in an assessment, what the heck are they doing in life? They must be questioning every life event. Like, "Oh, should I put my bag in the car? I'm not gonna put my bag in the car. Ma- maybe I should put my bag in the car." And that must be exhausting, absolutely exhausting. And I think a lot of people have mentioned that just sheer exhaustion of just constantly worrying about everything all the time, and your GP's put you on antidepressants because they don't know what to do. And they've not really unpicked it all, and they're just like, "Well, they don't work because I'm still worrying." And then I shut my eyes at nighttime and think tomorrow's gonna be a new day, and then I worry about everything that happened when I was seven, and I can't change any of that. [laughs]

   5. APAlex Partridge21:45

      [laughs]

   6. DMDanielle Mulligan21:45

      And it's, and it's that whole journey-

   7. APAlex Partridge21:48

      Mm

   8. DMDanielle Mulligan21:48

      ... I think that can be so ha- 'Cause that's your day to day with ADHD. That is life for them. And I think 'cause you are so sensitive to, to that emotion, I think you're sensitive to anything. But you're sensitive to compliments. If I was to say, "Alex, your hair's really nice." "Is my hair nice? Is she joking? Is it not nice? Have I done it differently? Have I put something different on?" And it... You can't even accept that, that compliment, never mind that criticism. So I think it's, it's huge

9. 22:16 – 23:24

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   1. DMDanielle Mulligan22:16

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   2. APAlex Partridge22:17

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10. 23:24 – 25:32

    People pleasing

    1. APAlex Partridge23:24

       show. The best defense for criticisms and rejections is to people please, I guess. I mean-

    2. DMDanielle Mulligan23:31

       Lots of people do that

    3. APAlex Partridge23:32

       Do you... To the extent maybe you could answer questions not honestly in assessments. If they, if they ask, "How are you today?" And your knee-jerk reaction might be to go, "I'm fine."

    4. DMDanielle Mulligan23:43

       Yeah, I'm fine. [laughs]

    5. APAlex Partridge23:44

       But if not, then inside it's chaos and it's turmoil. Do you see-

    6. DMDanielle Mulligan23:47

       A lot

    7. APAlex Partridge23:47

       ... pe- do you see... Can you see through that? Can you see through people pleasing?

    8. DMDanielle Mulligan23:50

       So I always do, like, a little settling in in assessments. So I'll, I'll explain the process and what's going on. I'll be like, "All right, so how... What have you done this morning? What's your j-..." And I try and... And what I find with remote assessments, that process is quicker. So obviously Focused is an online company. Um, and I've been doing remote assessments for about two, three years now with different companies. And I find that settling in period is quicker when they're in their own environment 'cause they're safe. Like, when you're coming into a hospital environment, and then you have to sit down and you're like, "Oh, my gosh, what's going on? What they're gonna ask me? What they're gonna do?" And then you're already super anxious already. I think it's harder to have that little, "Let's calm down, let's relax." But I always have a little minute of talking, like if they've dropped the kids off at school, and I'm like, "Oh, like, how long did that walk take?" Or just talking about random things before flowing naturally into that assessment. Um, 'cause you can unpick a lot if, if they say, "Oh, well, actually I've dropped the kids off late this morning." "Oh, what made you late? Like, what was going on this morning that made you late to drop the kids off?" And that's all piecing into your assessment. But then I think as the patient, they, they stop and they think, "Okay"She's nice, Danielle

    9. APAlex Partridge25:00

       Mm

    10. DMDanielle Mulligan25:00

        ... isn't she? She's lovely. She's asking me about my day, and she's not putting any pressure on myself. And, and I'm feeling like I've just talked about my journey to school, and actually from that journey, I've picked up loads of stuff that's gone on that morning that I've gone, "Okay, so you were 20 minutes late to your assessment. Kids were late to school. You know, you've forgotten to put your packed lunch in your bag for work." And you're picking loads of symptoms up from just that one little story. Um, so I, I find that, like, that settle-in period is so important in the assessments because it's a tough assessment. It's a lot of questions.

11. 25:32 – 32:43

    Is female ADHD harder than male ADHD

    1. APAlex Partridge25:33

       I feel like women have it a lot harder. I've spoken to so many experts, and that seems to be the consensus or the common mantra, that women generally struggle more with the ADHD experience. Do you find that to be the case with the people you see?

    2. DMDanielle Mulligan25:46

       So yeah, and I find a lot of the time women are, are sort of misdiagnosed with sort of anxiety and depression. I find a lot of the time people put, "Oh, you just worry all the time. You're just a worrier. Well, you're a mom. You're supposed to worry." Like, I, and I find we're the biggest maskers is us women, and I think, I don't know if it's an expectation we have on ourselves that we put this huge wall up to say, "You can't break. You gotta keep it together." But then if you've got then ADHD on top of that, it's a lot harder to keep that together. And I think the world makes it harder, like the modern world, I think makes it com- incredibly harder to, to somewhat function in. And I think women, we're, we're a weird little species, aren't we? We- we're very, we're very d- different in the sense of we develop a lot quicker, and I think young girls hide their symptoms in schools. I met little girls that when I did assessments in CAMS where they were the most over-helpful little girls that teachers loved, and no one had a bad word for them. And they were like, "Oh, you know, she's so lovely. She always hands out the forms and the pencils, and she always asks me what if there's any jobs that need doing." But because that's so helpful, nobody sees it as a problem. Whereas little Johnny jumping on his chair is an issue because he's distracting the class. But, you know, little Suzy giving out all them forms is beautiful because it helps the teacher, and I think people don't understand that internal restlessness a lot in women. And I think w- we d- like, don't understand it sometimes 'cause you're constantly felt to be, that you have to be the stronger sort of person, and you've gotta keep it together. And, you know, you've gotta go to work. You've gotta see to the kids. You've gotta cook tea. You've gotta put that in the slow cooker. Oh, don't forget about the washing. But then amplify that with ADHD by a million sort of extra things that are when you read about. You know, did you text your friend back? Are you supposed to be out for tea? Have you got this? Have you got that? Did you do this? Did you s- reply to that email? It's even bigger on top of that, and yes, men also have those stresses, but it feels like those stresses are way more on women. And that expectation of like, especially when I, I have a lot of people that come from having children, and they say like, "I've just not, I've not got it. I've just not got this motherhood. Like, I've just not getting it. My friend's got a baby. She's got it. I've not got it. Why have I not got it? Why can't I do it?" And they try to understand that, and it's like, "Well, I forgot to have my child's jabs. That's terrible, and I didn't wanna forget that. That was really important. Why did I forget that?" Everyone's saying, "I'm sleep-deprived." And there's always a, an answer for women, I think. People always give us answers and say, "Oh, it's because of this. Oh, it's 'cause you're working too hard. Oh, it's 'cause the kids had you up all night." And they never just say, "Actually, it's because there's something going on." Um, and I think it's taken a lot for people to understand that and to unpick that really, um, in terms of why we do what we do.

    3. APAlex Partridge28:45

       I had a fantastic psychiatrist on who he very confidently said, "ADHD women are the most stressed people in the whole world." Do you think there's any truth to that?

    4. DMDanielle Mulligan28:55

       In the whole world, probably not. I think there's lots of things going on in the world that is a lot more stressful. In terms of the ADHD world, I would say they are probably they're a lot more stressed than an ADHD m- male, and I think that's just because they have that inter- that in- the internal restlessness. Where you tend to find males have that external restlessness, that, like, that internal restlessness is just massively amplified, um, f- for, for women, and I think they're more prone to burnout. I think burnout's massive in ADHD alone, but I think it's your women that tend to burn out quicker because they take on way more than they should, um, at home, at work, with the kids. They wanna do this, and the people-please is even bigger, I think, for females. So I think males can people-please as well. I think, like you said, it's sometimes the natural response when you feel different to everyone. But I think it's times a thousand because women have this sort of we can't let anyone down, um, and that sort of motherhood sort of figure. Like, you wanna mother hen everyone, and you're sort of like, "I can't let work down, uh, I can't miss that deadline," and that, and they just pile the stress, and then they burn out, and then they go off sick. And then they're like, "Well, how can I not handle it? It wasn't even that much." And I think, yeah, are they the most stressed in the world? I don't think they're the most stressed people in the world, but I think in the ADHD world, I would say they're a lot more stressed.

    5. APAlex Partridge30:23

       You mentioned burnout there. What do you think, at its very worst, undiagnosed ADHD could look like in this modern world?

    6. DMDanielle Mulligan30:32

       So burnout in terms of lots of short-term jobs because they can't handle the roles that they're in. Um, so they're jumping from job to job thinking they're the problem, when actually it's not necessarily that they're the problem, it's that the roles they're expected to do in the job is somewhat the problem, if that makes sense. Um, I think the modern world is, it, it's changed so much as well, and I think there's huge expectations on people. So like, for example, if we stick with our sort of woman sort of topic, we're expected to bring the kids up. We're expected to work full-time. We're expected to make sure that the house is okay, and it feels like there's so much more pressure in the world, and I think wh-Before social media and before the world became more public, it didn't feel as stressful because I didn't see what you were doing because I didn't know, and I didn't know who you were, and I didn't know what was going on, and that was that. Whereas I think now you've got your Instagram sort of models as such that us going, "Yeah, I've got this together. I've got ADHD, and I'm looking after the kids, and I'm going on holiday." And it's like, how are you doing all of that? And they're just posting what that you w- they want you to see. I think we're getting a few more real-life sort of Instagrammers, sort of pe- influencers as such that are giving us that real reality of what life is like. But I think what, what we post what people wanna see, don't we? We don't post the reality, and I think that makes it hard for people because you've really not got it together 'cause they have, and it, and it... You don't even know who they are. You're not even bothered. Like, Beyoncé's got these kids and that-

    7. APAlex Partridge32:13

       [laughs]

    8. DMDanielle Mulligan32:13

       ... and the other, and she's singing and touring, and you can't even cook tea, and it... I think it makes it even harder. And it... Harder for kids as well as adults. I think it makes it super hard because you never have a break. You don't have a break from the world anymore.

    9. APAlex Partridge32:28

       Well, you don't post the video of you tripping over the suitcase that you still haven't unpacked from two years ago-

    10. DMDanielle Mulligan32:32

        [laughs]

    11. APAlex Partridge32:32

        ... or the returns from online purchases that you still haven't returned because it's just-

    12. DMDanielle Mulligan32:37

        And you've missed the return

    13. APAlex Partridge32:38

        ... and the money that you've lost. Like, that's the reality, and the, the, the shame that comes with all of that.

12. 32:43 – 37:28

    The importance of early diagnosis

    1. APAlex Partridge32:43

       How important is it for someone to get a diagnosis as early as possible?

    2. DMDanielle Mulligan32:47

       I think it's important to be as early as possible because I think the regret you have on sort of, like, little Alex and all of the opportunities you might have missed I think is hard to deal with. I think it's really hard to accept, and I think it's really hard to sort of unpick the things that could've been, and I think that can really impact sort of your mental health sometimes. Um, I think if you can get a diagnosis a lot sooner, I think it can help you understand you, and it can help the world understand you, and that's the hardest thing is that you can accept you do what you do and move on from it sometimes, but the world is like, "Oh, well, why does Alex do that?" Or, "Alex needs to go back in detention and do this." And I think, you know, we, we have to go to education, for example. You have to take your GCSEs. You have to... Like, the world makes it harder for us to be individual, and I think if people can understand you earl- as early as possible and sort of before that point where you go, "Oh, I'm different," I think it's more beneficial to, like, the person's self-esteem, to your wellbeing, to your mental health to be able to go, "I'm not different. This is, like, who I am, and this is what, what... This is why I do what I do." And then rather than having this whole self-discovery in your late 40s where you go, "Oh, okay. Yeah, no, that makes sense," you sort of prevent that feeling different 'cause nobody wants to feel different. We all wanna feel normal. Whatever normal is, we wanna feel it, don't we? And we all wanna be included and involved. And I think th- the earlier someone can understand, as soon as that I feel different comes about, as soon as they can sort of, like, try and understand that, I think that's a massive journey for them that they don't necessarily have to relive, which can sometimes be really painful for people to relive as well.

    3. APAlex Partridge34:35

       What would you say your promise is to the neurodivergent world?

    4. DMDanielle Mulligan34:39

       To help as much as I possibly can. I would love to be able to say, "Even if I don't think you m- you've got ADHD, I'd love to try and understand." You know, you don't come for an assessment for no reason. And I think o- one, one of the sort of statements I say in my assessments is, "You know, if you haven't got ADHD and you don't meet the criteria, you know, I want to understand where I can get the help that you need, whether you've got m- anxiety and depression and that's the cause of things or whether I think you might be autistic. Whatever it is that is perceiving to look like ADHD, and I can't give you ADHD, I wanna be able to promise that I'll find you the help that you need because your journey has just started whether you get ADHD or not." And that self-discovery's real, and, like I say, to press that consultation button and go through answering questionnaires, getting support from family members, that whole journey is a massive journey, and it takes a lot of guts to go and say, "There's something going on with me, and I need to know what." So to then for someone to say, "Oh, well, it's not ADHD. Good luck in the future," I think is a really dagger to the heart, not nice feeling. So the way I try and frame it to people is very much like, "Okay, so you've n- you don't meet the criteria for ADHD, but this is the elements you did meet, and this is what it could look like, and this is where I think you should go next," and, like, direct signpost to people that can help them. Um, as a mental health nurse background, obviously I've got a background of quite a lot of mental health even though I specialize in ADHD, so I feel like it's important for them to say, "Right, i- I don't know what's in your local area, but I will send you a script to talk to your GP and say, 'I've had this. This is what's been said. Go and get the support you need,'" and direct them in the right place. Um, and I think that's... I've always been that person who has to help everyone all the time, even at my own expense sometimes. I think that's why I came to become a nurse, um, 'cause of that, like, sort of solution-focused, let's figure it out together, but I would never wanna leave someone just, like, with no... 'Cause imagine coming for an assessment, being told you haven't got ADHD, and then go, "Farewell. Have a good day." That would be the worst feeling in the world. Like, it probably sometimes even worse than being told you have ADHD in some sense because, you know, you know there's something wrong, but you don't know what it is, and a professional says, "Well, it's not this." And it's like, "Okay, well, what is it then?" And I think it's important to support them on that journey as far as I possibly can. Obviously, I can't go all psychiatrist mode and say, "Oh, I think you've got bipolar," but I can direct you to a place to support with what I think's going on. Um, and I think that's a really important part of the journey as well.

    5. APAlex Partridge37:25

       I wanna move on, Danielle, to my favorite part of the show,

13. 37:28 – 40:36

    Danielle’s ADHD item

    1. APAlex Partridge37:28

       and that is the ADHD item reveal. Your item has been patiently waiting underneath this cloth-

    2. DMDanielle Mulligan37:34

       [laughs]

    3. APAlex Partridge37:34

       ... throughout our entire wonderful chat. Every week, I ask the guests to bring in an item that most represents ADHD, and I'm going to reveal yours now. That is a Rubik's Cube.

    4. DMDanielle Mulligan37:48

       A Rubik's Cube.

    5. APAlex Partridge37:50

       Why does a Rubik's Cube represent ADHD?

    6. DMDanielle Mulligan37:52

       Because when it's going well, it's beautiful. When it's not going so well, it's hard to get back beautiful again. And I think when you muddle that Rubik's Cube up, which I sort of don't wanna do 'cause I'll never get it back, that, for me, can sometimes represent, you know, the worst parts of ADHD. You're trying to get them colors all back to normal, and you just absolutely can't, and you don't know which way to spin it, and you go in, and you go, and you go in, but then when it's beautiful, it looks stunning, and everything's going great. And I think that's, for me, a lot s- of the time how I can represent ADHD as an item is, you know, you can jumble that up, and that's been your life. And when you get a diagnosis, sometimes it goes beautiful, and then it gets jumbled up again. And then you might start medication journey, and it might go beautiful again, or you might get one side that's beautiful, and the other sides might not be quite beautiful, and I think that is a beautiful representation of an ADHD mind.

    7. APAlex Partridge38:48

       What do you think of the word deficit in the, in the name ADHD? Do you think deficit's appropriate?

    8. DMDanielle Mulligan38:53

       I don't really like it. Um, I, I, I think it feels quite like a negative word 'cause it feels like I'm saying there's something missing from you, and I think the way I like to frame ADHD is that actually you, you do things in such a unique way that actually I'm jealous sometimes that you've got ADHD 'cause you'll do something 100 times better than me, and I might do things 100 times better than you. And I think when we say deficit, we f- I think it's like it's really negative word. It feels like a really horrible word to say, like you're missing something. You, you've not got what you need. Um, but then I don't know what we'd put in its place.

    9. APAlex Partridge39:33

       It's a big job, isn't it, to try and change the four letters. I think difference rather than deficit's probably a good start.

    10. DMDanielle Mulligan39:37

        'Cause I know with, like, autism, they changed the disorder to condition, um, to try and make it sound a little kinder, I suppose. Um, so maybe we need to consider our deficit word. Who even makes that decision? Who can change that?

    11. APAlex Partridge39:54

        We seem to have an abundance of attention rather than a deficit of attention when we find something that truly interests us.

    12. DMDanielle Mulligan39:59

        Oh, yeah, you can be well too, too on it, like, on it to the point you don't sleep and eat.

    13. APAlex Partridge40:03

        Exactly. [laughs]

    14. DMDanielle Mulligan40:05

        [laughs] Like, it can be way, way too far. Um, but yeah, it's that, like, imbalance of attention, isn't it?

    15. APAlex Partridge40:11

        Mm.

    16. DMDanielle Mulligan40:12

        Like, y- you've either got it some days, and some days you've not. And I could give you a task and say, "Right, can you write all this stuff, Danielle?" You go, "No, Danielle, I'm not gonna do that." But then a- you might say, "Oh, I'm just doing this task," and you could spend three days on it. So it's that imbalance of it, of attention, isn't it?

    17. APAlex Partridge40:29

        And when you've got the attention and someone interrupts you, it can be very infuriating.

    18. DMDanielle Mulligan40:33

        Um, yeah, 'cause you need to eat.

    19. APAlex Partridge40:34

        [laughs]

    20. DMDanielle Mulligan40:34

        And I don't need to eat. [laughs] I need to

14. 40:36 – 46:55

    Audience questions

    1. DMDanielle Mulligan40:36

       finish this.

    2. APAlex Partridge40:37

       I wanna move on to audience questions, uh, briefly, Danielle, which is called the washing machine of woes because my ADHD item is a washing machine because I always forget my clothes in the machine after the cycle finishes.

    3. DMDanielle Mulligan40:46

       You're not the only one. [laughs]

    4. APAlex Partridge40:48

       Yes, thank you.

    5. DMDanielle Mulligan40:49

       You're not the only one.

    6. APAlex Partridge40:50

       Do you do that? Do you leave your-

    7. DMDanielle Mulligan40:51

       Um, so I don't do that, but my husband does that, and a lot of patients will tell me that that's the biggest thing that irritates the partners is that they'll put the washing in, and it'll stay there for three days, then they have to rewash it.

    8. APAlex Partridge41:03

       And it's the ta- ADHD tax, 'cause it's more money to do the cycle again. But I have been using the Tiimo app. Uh, it's, and they've... It's a productivity app, and they've helped me, helped me get a little bit better at remembering the, to empty the machine. This week, someone has written in and asked... Ooh, this is a long one. "I am a teacher at a school for 13 to 18-year-olds, and I swear that so many of the students have ADHD, which is making them fall behind. However, other teachers aren't interested, and neither are the parents. How can I, A, be sure that a pupil has ADHD, and B, covertly urge them to seek a diagnosis of some sort, or at least get their parents to care?"

    9. DMDanielle Mulligan41:43

       Wow, that is a question, isn't it? So they're a teacher, and they feel a lot of pupils have got ADHD. I suppose a way that they can somewhat track some of these pupils would be to understand what tasks they're doing well in, what tasks they're not doing well in. Do they have to have somewhat, like, written instructions down? So does she have to go out of her way to be able to write down task one, task two, task three, put it in front of them so they're able to complete it? How much extra support do these people need? And then when they get their parents' evenings, that she could feed that back to the parents to help understand that she's gone out of her way and that that's not the norm for the teacher to do. Um, 'cause a lot of understanding ADHD is, is building the evidence of symptoms, and they have to be evident in more than two settings. So as an education, that's one setting, but then if there's lots of examples on lots of symptoms for some of these children, I think she's got a duty of care to hand that over to parents. She can't tell them what to do, but I suppose she could explain the understanding of the impact that's gonna have. Like, a lot of our conversation today has been around that self-esteem, and the worst time for that to kick in is teenage years 'cause you're on the self-discovery of hormones, and everything's going sort of different for you. And if ADHD is a problem for them, that's when they're gonna start feeling really, really different. So I would say see what support these pupils need. Document this support that, that, that's happening, whether it's more time, a extra explanation, written-down instructions, um, if they're more hyperactive than normal, um, and feed that back to parents and explain that you feel it could be something and-See where that conversation could go 'cause I think it, as pa- as a parent and from working with parents, you're sometimes blind to what's going on with your own children, or you don't really wanna see what's going on with your own children, um, or you don't wanna believe there's a problem if there is. And I think if you had the physical evidence, I think that could sometimes support parents to go, "Oh, no. That's not good, is it? I need to sort of understand this in a bit more de- where can I go to get help?" And that might be handy for them to have the next steps for if a parent realizes that they need to get help or if the actual pupil wants help 'cause some people don't. And it's one of those, especially in any mental health as well as ADHD, if you don't want help yourself and you don't wanna change yourself and you don't wanna understand yourself, it's a pointless journey sometimes. You've got to have that, "Something's going on, please help me," drive as such.

    10. APAlex Partridge44:26

        Mm-hmm. Do you ever get a child that perhaps wants or thinks that they have ADHD but their parents don't think it's a real thing, or they don't wanna put a label on their child?

    11. DMDanielle Mulligan44:35

        So I've had a lot of adults in assessments that have told me this, that they've said, like, there's ADHD in the family, for example, and their mom's gone, "Oh, that is just an excuse." And I think especially there's a generation of people, of parents, that don't think ADHD is a real thing. And I think we've all been there at one point before we learned about it, before we understood it, before we researched it. We've all been a, "What's ADHD?" Um, I think my first experience of that was when I saw... I was working on a ward and a young person was on stimulants, which is a huge deal to be on a stimulant medication, never mind at, like, 13 years old. And I think I was like, "Well, why are they on stimulant? That is, that's a big thing to be on," and it took two nurses to sign out and administer. And, and I was like, "She looks fine. What's she on a stimulant for?" Without having that understanding of ADHD, and that's the start of my journey into ADHD, was that patient, um, who's probably in her 30s now, bless her. Um, and it was more like, "Why are you on this medication? What does this medication do? Why is it a controlled drug? Why is two nurses signing it out? Why are you taking it when you look absolutely fine?" Because you take it is why you look fine, is what I've learned sort of in my ADHD sort of career. Um, but I suppose it's, yeah, it's one of those things that we've all been, we've all had a moment where we've said, "It's just an excuse," without having the understanding. And I think, like I say, there's this cohort of parents, especially in your older sort of adults, where pa- they've gone, "I don't want my parents to fill out any information because they don't think I've got ADHD." And then when you say, "Well, what, what's their understanding of ADHD?" And they just, "Ah, they just think it's that naughty boy." And I'm like, "Well, do you want to help your parents understand what it is?" And a lot of the time they just say no 'cause it's a lot of, a lot of effort, and Mum's really stubborn. Mum's really stubborn, or Mum's potentially got undiagnosed ADHD as well 'cause there's always that beautiful pattern that goes on in the families. So, um, yeah, and I think it happens with children now as well. I think there are some parents that don't... Yeah, I think there's two. You've either got parents that push and push and push for a diagnosis that isn't there, and you've got parents that just don't really want to understand. And I think there's huge education that needed both sides.

    12. APAlex Partridge46:54

        I've got something

15. 46:55 – 48:07

    A letter to my younger self

    1. APAlex Partridge46:55

       for you. It's a letter that was written by the previous guest-

    2. DMDanielle Mulligan46:59

       Okay

    3. APAlex Partridge46:59

       ... where they wrote a letter to their younger self, and it ties in quite nicely to what we were discussing earlier. Danielle, I deliver you the letter.

    4. DMDanielle Mulligan47:06

       Okay. So, "To my younger self. Don't be ashamed of how you perceive the world and what you find fun in. Eventually, all this geeky stuff will be cool. Also, look carefully for people's real selves. Don't get thrown off by masks. Be kind to yourself above all."

    5. APAlex Partridge47:25

       Wow, that's really nice.

    6. DMDanielle Mulligan47:26

       That's quite deep too as well, isn't it?

    7. APAlex Partridge47:29

       Truly fascinating, Danielle. On behalf of everyone watching and listening, grappling to understand how their brain works, thank you very much.

    8. DMDanielle Mulligan47:36

       Yeah, thank you very much for having me. [upbeat musical logo]

    9. APAlex Partridge47:42

       Some exciting news. I've partnered with an online ADHD assessment clinic called Focused. Together, we're running a short survey asking questions about people's experiences with ADHD. People who complete the survey and leave their email address can be entered into a prize draw to win £100 in Amazon vouchers. You'll find a link to complete the survey in the episode description. Also, if you're looking for an ADHD assessment, you can use the code CHATTER when checking out to get a discount on their assessment fee

Episode duration: 48:08