The Mel Robbins PodcastThe ADHD Doctor: How to Focus, Stop Procrastinating, Manage Your Emotions, & Feel in Control
EVERY SPOKEN WORD
55 min read · 10,991 words- 0:00 – 2:32
Meet the Guest
- MRMel Robbins
Today, on The Mel Robbins Podcast, world-renowned ADHD doctor and psychiatrist, Dr. Sasha Hamdani, is here with the six signs you may have missed your whole life, how to focus, stop procrastinating, and finally feel in control. This is the ultimate guide to adult ADHD. Please help me welcome Dr. Hamdani to The Mel Robbins Podcast.
- SHDr. Sasha Hamdani
Thank you for having me.
- MRMel Robbins
I am beyond excited that you're here. I have been wanting to do a comprehensive and eye-opening and helpful episode about the topic of ADHD with a medical doctor for over two years. This is a topic that impacts me at a deeply personal level. It impacts my children. It impacts my husband because he has to live with me. Where I wanna start is, if we take everything to heart that you're about to teach to us about what ADHD is, what it isn't-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... and more importantly, what to do if this is something that sounds like you or someone that you love, what's gonna change about my life?
- SHDr. Sasha Hamdani
If you're dealing with this chronic overwhelm, and it's been hard for you to place a name to what you've been experiencing and you've been beating yourself up for years, I think this is going to give you the clarity to see that, number one, your brain isn't broken. This is just a different wiring. And number two, it's gonna give you the language and the tools and the steps of where to go next so that you can actually start navigating this condition.
- MRMel Robbins
You said something that just struck me, because I think when you talk about the topic of ADHD-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... you immediately think about attention.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
And you think about focus.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
And maybe you think about, like, you know, the little kid who can't sit still.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
But you said overwhelm-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and beating yourself up.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Could you speak a little bit to the emotional side of what we're gonna talk about and what might change based on what you're about to teach us?
- SHDr. Sasha Hamdani
How much time you got? 'Cause I feel like that is the, a huge overlooked part of ADHD. I think ADHD, at its base... First of all, I hate the name ADHD. I think it's stupid.
- 2:32 – 7:15
What Are the Symptoms of ADHD?
- MRMel Robbins
So Dr. Hamdani, h- what is ADHD?
- SHDr. Sasha Hamdani
Yeah. So ADHD is a neurodevelopmental condition, which stands for attention-deficit/hyperactivity disorder. I think ADHD, at its base, is a regulation issue. A... Yes, attention is part of it, difficulty regulating attention, but also difficulty regulating motivation, difficulty regulating energy, difficulty regulating emotion, that's a huge one, difficulty regulating sleep, difficulty regulating appetite. And anybody with ADHD has felt this, and if I'm speaking to you, these are things that you've probably experienced, too. Because it's not as simple as, "Well, I don't, you know, it's hard to stay on task today." It's, "Okay, I am so overwhelmed [laughs] and I have beaten myself up about this, and now I feel paralyzed with this guilt and shame and this overlay of this emotional component." And I think unless we really, really get on top of this and start looking at the emotional regulation part of ADHD, we're never going to fully encapsulate the full picture.
- MRMel Robbins
I'm looking at our executive producer, Tracy, who I've worked with for 10 years, and I'm smiling at you, Tracy, because I canceled two days of taping last week because I found myself in this state where the word I was using is, "I am so overwhelmed right now-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and I feel so flooded with emotion. I don't even feel like myself. I can't function right now." But I didn't think that was related to ADHD. It feels very affirming to hear that, well, actually, the wild swing of emotion, Mel, is a core part of how ADHD can present-
- SHDr. Sasha Hamdani
Mm
- MRMel Robbins
... because it's not just an issue of your ability to direct your attention.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
It's also your inability to process emotion in a way that is somewhat modulated.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
It goes in wild swings.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
And because if you truly are somebody that has this condition, you have always lived with wild swings.
- SHDr. Sasha Hamdani
Always.
- MRMel Robbins
I don't even know what it's like to regulate your emotions.
- SHDr. Sasha Hamdani
Mm-mm.
- MRMel Robbins
Like, what, what does that even mean? In your world, Dr. Hamdani, what does regulate mean? Because if you do have ADHD or you love somebody who does-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... we're having a completely different experience of life than somebody who goes through life without an ADHD brain and body.
- SHDr. Sasha Hamdani
For sure. For sure. And I think when you, when you drill down and actually look at what regulation is, right, like for mood, right, if this is kind of normal baseline and this is down in the depths of depression and this is, like, so happy and elevated, right?
- MRMel Robbins
Yeah.
- SHDr. Sasha Hamdani
People generally, they, they have a normal ebb and flow that can happen situationally. With ADHD, it can feel like ups and downs-
- MRMel Robbins
Oh my gosh
- SHDr. Sasha Hamdani
... and ups and downs, and it's usually coupled with anxiety and productivity issues and all of this mashed together-
- MRMel Robbins
Stopping and starting and-
- SHDr. Sasha Hamdani
... it is so overwhelming
- MRMel Robbins
... yes, it's like you feel like a hurricane.
- SHDr. Sasha Hamdani
You feel like a hurricane
- MRMel Robbins
Like, I can start cleaning the closet, but then all of a sudden I crash and I've got clothes off hangers everywhere, and now I'm like, "What did I do again?"
- SHDr. Sasha Hamdani
Yeah. I think a lot of people can argue, you know, well, sometimes people have emotional dysregulation or emotional swings because they're not getting enough done. I'll tell you, if, like even in my own case, I can feel these kind of emotional swings and I can feel extremely overwhelmed, and I might get to a spot where I'm getting all of the stuff done, like all of the stuff I've delegated or I've gotten rid of and it's off of my to-do list, and I still feel that overwhelm and that pit in my stomach and that just like I want to hide. [laughs] I can't do anything right now. I just want to hide. That is emotional dysregulation, where it's like I- I- I have the logical part of my brain that's like, "You don't have anything to worry about. You're fine. This... Things are going well. You're okay." But still, you're having these big ups and downs that you're dealing with at the same time, and I think that's so vital to talk about because that's what gets misdiagnosed.
- 7:15 – 10:09
Why ADHD Goes Undiagnosed in Women
- MRMel Robbins
Well, my greatest wish for this episode, other than the person listening really feeling empowered and seen and having your expertise to really help you take the next step-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... to get the support that you deserve and to better understand yourself, and my second bigger mission-
- SHDr. Sasha Hamdani
Okay
- MRMel Robbins
... is that this sparks a change in the way that ADHD is defined. Because you can see that if society thinks ADHD is jitteriness and, you know, kinda the typical little boy like our son was bouncing around in a classroom that can't sit still and can't focus and if that's all that we think it is, then doctors and pediatricians don't have the right-
- SHDr. Sasha Hamdani
No
- MRMel Robbins
... definition for it, so of course they're gonna continue to go, "Well, only if you're jittery does it look like this, but anything in the realm of dealing with emotions must be something related to-
- SHDr. Sasha Hamdani
Anxiety
- MRMel Robbins
... anxiety or depression." We're gonna keep seeing this problem.
- SHDr. Sasha Hamdani
Originally, the ADHD criteria was developed looking at hyper young boys. It's not ev- Our criteria is not even built to look at everyone else. It's not built to look at girls. It's not built to look at adults. I think part of the biggest flaw in this, right, is that when you... Just moving on from, like, the hyper young boys, part of the issue is they're looking at these highly observable behaviors. Like, these are the kids that are disrupting classes, and these are the kids that are can't stay in their seat.
- MRMel Robbins
Right.
- SHDr. Sasha Hamdani
But what about all those other presentations where the only people they're disrupting are themselves, and they are just getting passed from class to class to class to class, and then later, Mel, those are the people that are getting diagnosed with anxiety and depression because, by the way, you're too old to have it now.
- MRMel Robbins
That was me.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
I've also never heard anyone say that the way that you can present, there's the external disruption, but I hadn't ever heard anybody say or you could be somebody that's internally disrupting yourself-
- SHDr. Sasha Hamdani
Yes
- MRMel Robbins
... with your thoughts, with your inability to stay on task, with your emotions. That's exactly how I felt all the time.
- SHDr. Sasha Hamdani
Mm-hmm. And that's what I hear day in and day out when I'm hearing from women over and over and over again that, "I... My whole life I have felt like something was off. There was something missing." And they have never put together those pieces. And then their child gets evaluated, and that's when the pieces kinda come
- 10:09 – 13:50
Why Is ADHD So Hard to Diagnose?
- SHDr. Sasha Hamdani
together.
- MRMel Robbins
I'd be curious to hear your thoughts about something.
- SHDr. Sasha Hamdani
Hmm.
- MRMel Robbins
ADHD in kind of culture and society-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... kinda feels like an eye roll.
- SHDr. Sasha Hamdani
[laughs] Okay.
- MRMel Robbins
Because people have thrown the word around so much-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and live in a world where everybody has fragmented their attention-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... by being online.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
And at the same time, we have a neurological condition-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... which here in the United States is classified as a protected disability.
- SHDr. Sasha Hamdani
Yes.
- MRMel Robbins
We have all of this research around it. And so the term is kind of in popular culture and thrown around.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
You know what I mean, though, about the-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... eye roll. Oh, yeah, you got ADHD.
- SHDr. Sasha Hamdani
It's not even that. They get those eye rolls from their doctors.
- MRMel Robbins
Hmm.
- SHDr. Sasha Hamdani
I have heard from another physician when I was talking about, you know, I- I've been doing some advocacy work online talking about ADHD, and he made... He, it was obviously a he, made the comment, "Oh, so you can give Adderall to all the housewives who need it." And I was like, "You're gross. I gotta get out of here." Like, but it, it ju- Like, that is kind of what this, what this feels like. It feels like that's just kind of the, like, medication is the easy way out, and, like, everybody has it, and it's easy to qualify. You talk to anybody who is trying to get a good ADHD diagnosis, there are so many hoops in place. There... It is hard to get a diagnosis because it is... It, like, people are turned away from or discouraged, just openly discouraged.
- MRMel Robbins
Or hostile. The thing that I experienced as a parent is, "Well, oh, you're just trying to get your kid extra time on a test so you can get him into a good school."
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
I'm like, "No, I'm trying to have him not struggle with depression and hate himself because he feels like a- a freak in school."
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Like, he's not a behavioral problem, you idiots. Like, this is a kid who's struggling.
- 13:50 – 22:10
What Does ADHD Do to the Brain?
- MRMel Robbins
What exactly is happening in the ADHD brain?
- SHDr. Sasha Hamdani
So this is gonna be extremely oversimplified, but I think it's important. The way that I describe it is there's a couple of things that you re- a couple of areas of the brain that you really need to know about, and the first one is the frontal lobe, so directly under your forehead. Think of that as, like, the very smartest part of your brain. Decision-making, judgment, processing. That's your frontal lobe. Then you have this amygdala, which is this little almond-shaped central area of the brain, and that's in charge of all of that emotional data. So with ADHD, you're dealing with a couple of things happening. Number one, you're dealing with a prefrontal cortex, smartest part of the brain. It's a little bit thinner and a little bit less responsive.
- MRMel Robbins
Oh, really?
- SHDr. Sasha Hamdani
Yes. And then you're dealing with an amygdala that's a little bit more hyperreactive, and then you're dealing with the connection between the two, which isn't as strong. So what you're gonna get is you feel things strongly because that amygdala's like, "Ah," alarm chemicals, like something is happening, and that prefrontal cortex is sometimes slow to filter and figure out exactly what to do with it.
- MRMel Robbins
Hmm.
- SHDr. Sasha Hamdani
The other thing that's happening in the brain alongside all of that is you have to talk about dopamine. And again, when you think about ADHD in general, that's very oversimplified, but dopamine is that neurochemical that's in charge of alertness and attention and emotional regulation and mood. So it's, it's present and doing many different things at once, and a lot of people think that it's a lack of dopamine. If you have low dopamine, then that's what's causing all this. It's really that the dopamine you have present isn't in the right place at the right time.
- MRMel Robbins
Hmm.
- SHDr. Sasha Hamdani
And so that can change with hormones, that can change with age, that can change with stress, that can change... That can just be an underlying deficit or dysregulation. So when you have those kind of factors all at once, you're dealing with just a tremendous amount of input that you're getting and a kind of weak filtering system. And so you're just, you're doing the best you can.
- MRMel Robbins
When you talked about the prefrontal cortex-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and being kind of the thinking and, like, the secretary of the brain-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... the processor, and then you talked about the amygdala, the little almond, it made a lot of sense to me where you're like, the input is overloaded and the connection between those two things is weak.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Which is why it is hard for somebody that has this neurological condition called ADHD to actually regulate the signals coming into here and all the sensory crap coming into here.
- SHDr. Sasha Hamdani
Correct.
- MRMel Robbins
So that makes perfect sense why it would be hard, if the connection's weak, for us to take all the input into the thinking part of the brain and process it-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and at the same time, take all the input into the sensory part, the amygdala, and also appropriately regulate and process that too, and send signals to your body and your mind. Now, when you use the word regulation-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... let's just say the person that's listening has never really heard that term or doesn't quite, um, know what you mean.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
How do you want us to think about what the word regulation looks like? Because I'll tell you, as I'm hearing you talk-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... I immediately had a flashback to going to Baker Library at Dartmouth College, got my books, fully intending on studying Dr. Hamdani.
- SHDr. Sasha Hamdani
Okay.
- MRMel Robbins
I go to sit down. Now all I can do is hear my stomach. Now all I can do is hear the people in the corner over there. Now I'm looking at the person, and an hour or two goes by.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
And then I start to think, "Why, why, why can't I just do what everybody else is doing? What is wrong with me?"
- SHDr. Sasha Hamdani
Mm-hmm.
- 22:10 – 25:03
The 3 Types of ADHD Explained
- MRMel Robbins
I read in your work that there are three different types of ADHD.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
I didn't know that. What are the different types of ADHD?
- SHDr. Sasha Hamdani
[laughs] Okay. Let me show you.
- MRMel Robbins
Okay.
- SHDr. Sasha Hamdani
First one, inattentive ADHD, and we touched on this a, briefly. Inattentive ADHD typically are the daydreamers. They tend to be forgetful, difficulty with organizing things, difficulty with remembering where you place something, difficulty with initiating tasks, difficulty with, you know, if there's a big task coming up in front of you, you tend to avoid that. So it, these are your... Typically, this is how females assigned at birth present.
- MRMel Robbins
Okay. Inattentive ADHD.
- SHDr. Sasha Hamdani
Inattentive. Check. [laughs] Hyperactive or impulsive ADHD. This is the second form of ADHD, and this is, well, one of the ways that males can present, and this is both physically and verbally impulsive. These are the kids that are having difficulty, kids and adults, difficulty staying in their seat. They're fidgeters. They are impulsive in speech in that they're interrupting. They are blurting out answers in conversation. They have difficulty participating in conversation. So this is, this is that hyperactive type. And then the third type is the combined type picture.
- MRMel Robbins
Oh.
- SHDr. Sasha Hamdani
And combined type picture is just a combination of both of those, um, features. So you can have inattentive features, and you can also have the hyperactivity component. Um, fun fact, this is what I am. [laughs]
- MRMel Robbins
How do you know? You know what I'm saying? 'Cause it feels like it's a little general, like all of it, so you can kinda find situations for yourself. But how do you know what you are, and why is it important to understand which of the three you might be?
- SHDr. Sasha Hamdani
So, I mean, you really are gonna know once you get a good, solid evaluation.
- MRMel Robbins
Okay.
- SHDr. Sasha Hamdani
Right? Because I think that part of getting a great evaluation, a very sound evaluation- ... is equal parts, yes, ruling in ADHD, but also ruling out everything else. I want to make sure that this isn't anxiety, that this isn't depression, that this isn't bipolar, that this isn't some thyroid issue or some medical issue-
- MRMel Robbins
Mm
- SHDr. Sasha Hamdani
... underlying it. So there's, within the evaluation where you're talking about ADHD, you go from childhood and you kind of look at longitudinal patterns. Because, again, with women specifically, it's hard because every month we look different hormonally. So catching you at, at one spot in your cycle versus another spot, you might look different and you might present a little bit differently. So you're looking for longitudinal patterns.
- 25:03 – 28:38
ADHD Symptoms in Girls and Women
- MRMel Robbins
Can you break apart how does the emotional side impact girls?
- SHDr. Sasha Hamdani
When you're looking at females, um, ty- they typically fall into this pattern of more the inattentive presentation. So these are the daydreamers. They're forgetful.
- MRMel Robbins
Hmm.
- SHDr. Sasha Hamdani
They have difficulty organizing things. They have difficulty with routines and, and motivation to get tasks done. And so these are the people that, in general, can be a pleasure to have in class. They're getting passed along and they're doing well, but internally, they're working so hard. So hard. And you know what? That doesn't get better. You get through, um, your elementary school years, you get to puberty, then all of a sudden you get smoked by hormones. Now, hormones immediately change things. Now, instead of physicians, and again, not the fault of physicians, right? This is a fault of criteria, but now instead of physicians looking at this child and saying, "Whoa," like, "We missed something. You're having, like, all these m- mood swings and school is hard for you and friendships are hard for you and all of that," they're saying, "You're a teenager. These are hormones. Get used to it." [laughs] Like, this is what you hear as, like, a 13-year-old girl. And then they have to get through it, so you just kind of just bear it, and then you get into college and your demands get harder. You start getting into more serious relationships, and then maybe you get into a situation where you're trying to start your own family. Okay, now you're getting hit with another wave of hormones, and actually, during pregnancy, estrogen levels are a little bit higher, dopamine levels are a little bit higher, so you might do okay. But then postpartum comes and rocks your world. And so you get this drop in estrogen, drop in dopamine, so you can't regulate the way you used to. And so now you go to a doctor again, you're like, "Things are bad." And they're like, "It's hormones. Like, let's put you on an antidepressant 'cause you're depressed. This is postpartum depression." And so it gets missed again. Then you get through all of that, and you get through your reproductive years, and now you're in perimenopause, and things are chaotic 'cause your estrogen drops again. And you're like, "Something is wrong. [laughs] Something is wrong." And now it's, "Well, you're, you're hormonal. Like, give it 10 years. We'll see you later."
- MRMel Robbins
Brain fog.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
There you go. This happens during p- perimenopause.
- SHDr. Sasha Hamdani
So we-
- MRMel Robbins
In fact, that's... You've described my whole life.
- SHDr. Sasha Hamdani
I know.
- MRMel Robbins
I had postpartum depression, crashed.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
I started having severe brain fog and other symptoms during perimenopause, so you get hormones, which help, but didn't help the brain fog.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
And again, like, it was just diagnosed with anxiety, living with anxiety, struggling, struggling, struggling, pushing through. Postpartum depression. Oh my God, the sobbing as you're breastfeeding. Like, just-
- SHDr. Sasha Hamdani
Oh, God
- MRMel Robbins
... I don't feel-
- SHDr. Sasha Hamdani
With the letdown
- MRMel Robbins
... like myself. Oh my, just... A- and th- then perimenopause, then the creams, then the th- and then all of a sudden, ADHD diagnosis and it's like, wait, what? And it felt, as soon as I was not only diagnosed, but found the medication that worked for me, it's like all of a sudden after 47 years, I felt like I was in my body.
- SHDr. Sasha Hamdani
Yeah. And that gets missed. It get missed over and over and over again because our criteria doesn't catch that.
- 28:38 – 31:52
Can ADHD Cause Anxiety and Depression?
- MRMel Robbins
Is it common in women that if you have undiagnosed ADHD, that it can cause anxiety and depression?
- SHDr. Sasha Hamdani
Yes.
- MRMel Robbins
Why?
- SHDr. Sasha Hamdani
A lot of times, like, when you look at ADHD, there can be anxiety and depression that come, that is a separate thing that travels along with it. That, that can happen. But for a lot of people, because, again, circling back to that emotional regulation part of ADHD that everyone seems to miss, and that is so critically important to getting a comprehensive picture of ADHD, number one, if you've gone through your whole life and you've thought that there's something wrong with you and you're less than and you're broken, that's gonna make you anxious. If you can't do the things that you know perfectly well that you are capable of, that's gonna make you anxious. And you know what? It's probably gonna make you pretty depressed, too. If you're going through these huge moments of this energy dysregulation where you are getting t- tons done, and then it's like you've hit your max, and then you-
- MRMel Robbins
And then you crash
- SHDr. Sasha Hamdani
... you have this huge crash, and then you feel like, "Okay, I have literally nothing left in my tank," that looks like depression. But these are all emotional dysregulation issues that are happening. And so that, that's why you see that with ADHD.
- MRMel Robbins
Um, is there a connection between undiagnosed ADHD and eating disorders?
- SHDr. Sasha Hamdani
Yes. [laughs] There is. But I think that, again, that c- stems from dysregulation, and it stems from a lot of ADHD, you're not able to be mindful about certain things. So sometimes it's not actually... You know, when people think about eating disorders, they think about, you know, e- on one extreme that you're not eating enough-
- MRMel Robbins
Mm-hmm
- SHDr. Sasha Hamdani
... and on the other extreme, you're eating too much. Like, for the extreme where you're not eating enough, a lot of times with ADHD, sometimes it can be like you don't really have hunger cues. And, and this is outside of the medication. It's just your body isn't communicating, telling you you're hungry. And I know personally If I get invested in a task that I'm truly interested in, I can go eight hours and I'm not eating, I'm not drinking-
- MRMel Robbins
I'm the same
- SHDr. Sasha Hamdani
... I'm not getting up.
- MRMel Robbins
Yep.
- SHDr. Sasha Hamdani
On the flip side, with, like, binge eating disorder and things like that, there can be a time where you're trying to stimulate your own dopamine. You're trying to, like, get things going without even knowing that's what you're doing, and you're grabbing for things and you're eating and you, you don't even know, and you can look down and you're like, "Okay, that was a whole sleeve of Girl Scout cookies." Like, th- so there's like, you can be [laughs] on either end. So yes, there are linkages with disordered eating on both ends.
- MRMel Robbins
And what's interesting is, again, this kind of distinction that you're seeing, Dr. Hamdani, of the external presentation versus the internal turmoil.
- SHDr. Sasha Hamdani
How I describe it is it's like the outside of your house is on fire versus the inside of your house is on fire. Like, it just feels like both are on fire. [laughs] Both are literally in flames. The way we look at it now is we only care if we can see the flames.
- MRMel Robbins
Mm.
- SHDr. Sasha Hamdani
Flames are going on inside the house.
- 31:52 – 36:36
What to Do If You Think You Have ADHD
- MRMel Robbins
What, what would you say to somebody who has received this episode from someone that cares about them?
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Because the person who cares about them sees these patterns and has sent this episode, you know, in a text saying, "Hey, you know, I'd love for you to listen to this because this sounds a little bit like what you might be dealing with." What do you want the person who's hit play and is starting to really process what you're saying for the first time?
- SHDr. Sasha Hamdani
I think if you are listening to this episode, I don't want this episode to push you one way or the other. This is not meant to convince you that you have ADHD. This is not meant to push you in one direction. It's meant to ask you questions about your own internal environment so that you can start digging deeper and figuring out, is there something here or is there something that needs to be addressed? And what I want to reiterate about all of this is that I think good, compassionate care and diagnosis stems from a very non-judgmental and shame-free place. And so just being able to look at this episode and, and whatever other research you do in a very compassionate and self-compassionate way, I think you'll be able to receive information and actually start to put together patterns about your own behavior a little bit better, and that might be ADHD, it might not be.
- MRMel Robbins
What do you think the biggest misconception is about ADHD that keeps people, especially women-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... from getting help?
- SHDr. Sasha Hamdani
That you have to treat it with medication. I don't think you have to. I, I... There, there are some people that are on medication, and it is life-changing for them, and so I'm never going to... And even when I was talking about antidepressants before, same thing. That can be life-changing for some people, so I'm never going to go back on that because a medication is a tool and can be wonderful. But also being able to actually commit time and figure out therapeutic tools that might work, it is also so critically important, and some people don't need medication. They, they get through with doing cognitive restructuring and work through therapy that can be extremely beneficial.
- MRMel Robbins
I so appreciate your answer. What I find reassuring about what you're saying is there are other ways you can support yourself, and we're gonna get into that very specifically about-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... what to do and how to get a diagnosis and what are the things that you can do and what are the medications. Um, you know, I remember when I got my diagnosis. It was both an extraordinary relief-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and I had a lot of grief and anger.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Is that common to feel a sense of grief, like, when you finally understand what's been there the whole time?
- SHDr. Sasha Hamdani
Yes. When I evaluate people, I actually tell them about that. Like, "I don't know what this evaluation is gonna show or w- if it's ADHD, if it's not ADHD, but depending on what we go through, this is just a deeper exploration of what's going on in your body. And it might... You might feel like this is an answer. This is what I've been looking for, and it might feel like I wasted so much time."
- MRMel Robbins
Ugh.
- SHDr. Sasha Hamdani
"And I'm grieving that loss of time and potential and all of that stuff." And, uh, to them I say, "That is normal. Like, you are allowed to feel those things. That's, that's perfectly normal, and there should be space for that because that is a very valid expression of what's happening." But I also tell them that in that time, it wasn't wasted because what you were doing the hard work, you were building routines, you were building structures, you were building workarounds that eventually as you have the right tools and scaffolding, those are gonna come in handy for you. Those are gonna make this process a little bit easier because I've also seen on the flip side of things when people are started on medication and they don't have that scaffolding in place, and then when they're off medication, it's like they're floundering again. So I think this multifactorial approach of doing lifestyle and behavioral modification with medication, if that's appropriate, can be extremely helpful.
- MRMel Robbins
Hmm. It was life-changing for me. I'd love to talk about the connection between being high-achieving-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and how that, especially in women, can hide ADHD-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... especially from ourselves.
- SHDr. Sasha Hamdani
Yes.
- 36:36 – 38:41
ADHD Masking Explained
- SHDr. Sasha Hamdani
So I'm gonna introduce you to the concept of masking. Have you heard of that?
- MRMel Robbins
Uh, not in the context of ADHD.
- SHDr. Sasha Hamdani
So masking is when you have, it, it can be conscious or unconscious- ... camouflaging of your symptoms. And this is something that women do exceptionally well, because I think from a young age we're sensitized to do this because we don't want to be in trouble, we don't want to stick out of a crowd, we don't want to bring a lot of attention to us. I'll give you an example with me. Like, I was a combined-type presentation, so I was very hyperactive. Like, I couldn't stay in my seat, a big fidgeter. But I learned I can't get up all the time in class. I'm getting in trouble constantly. So I would s- like, squish my thighs down on the seat, or I'd grab the bottom of my chair and, like, try to suction cup myself to the chair because I'm like, I- I need to physically restrain myself from getting out. Now, w- from a productivity and a masking perspective, you also th- see things like perfectionism. I don't want to get in trouble. You see things like, um, overcompensating. Like, I'm going to stay at work extra long, and I'm going to overprepare, and I'm going to get things ready because I don't want to get in trouble. I know I'm going to miss something, so I'm going to prevent that from happening. Um, you see things, like within relationships and knowing that there's, like, that emotional regulation, you see a lot of women just kind of accepting stuff that they might not think is appropriate for any of their peers, but they're like, "I was probably in the wrong. I was a little bit too emotional. I chase them away." And so in order to protect that emotional sensitivity, they don't want to get into conflict. They don't want to fight. They don't want to do things like that. So, I mean, there's lots of different ways that are directly impacting and, and harmful to someone who is continuing this mask for a long time. Eventually, that mask gets too heavy to hold.
- 38:41 – 41:31
Is ADHD a Superpower?
- MRMel Robbins
Is ADHD a superpower?
- SHDr. Sasha Hamdani
No. Everyone asks me that. I am so jealous of the people who say that it is. I'm jealous of the people who say that it is, and the reason for that is I feel like there are some things that ADHD has brought me that I wouldn't have otherwise. Like being on social media, going to the White House, getting book deals. Like, that is because of my ADHD. That's because of that hyperfocus. That's because I was interested in something and it, it bled into this area. But there's also things on a day-to-day scale that I feel so limited by, and I feel like, the analogy that I give is it's like a superpower that I have very little agency over. [laughs] 'Cause it's like you can fly now, and that's your superpower, but you can't choose when or where.
- MRMel Robbins
[laughs]
- SHDr. Sasha Hamdani
So you're just gonna blast off into space-
- MRMel Robbins
Oh, my God
- SHDr. Sasha Hamdani
... at any given time. [laughs] So it's, I feel like, I love, I love the concept of a positive reframe, and I think there is some beautiful, beautiful, beautiful, beautiful things about ADHD. I really do. But I think there's also some things that are really difficult to deal with, and I think when people continuously focus on that superpower trope, it kind of, for me, it, it, it diminishes the struggle. And so I feel like the best way to approach ADHD is just realistically. They're good. They're, they're... Just like anything else. There's good stuff, there's bad stuff, and it's how you deal with it.
- MRMel Robbins
I appreciate you saying that because I always thought that it sounded like toxic positivity-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... by somebody who doesn't have ADHD.
- SHDr. Sasha Hamdani
[laughs]
- MRMel Robbins
And when you also consider, Dr. Hamdani, what you're teaching us, which is for decades-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... medical professionals, society, the DSM has not included the full scope of ADHD, especially the emotional dysregulation. There is no superpower to feeling constantly overwhelmed in your life. And yes, there are some small benefits, and I love the analogy that you said it's like having a superpower you can't be in control of. Like, I would love to be able to throw fire from my palms-
- SHDr. Sasha Hamdani
[laughs]
- MRMel Robbins
... but I don't want it going off at the wrong time.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
And there's a lot of anxiety that comes with going through life thinking you can't trust yourself.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
You can't trust yourself to follow through. You can't trust yourself to be on time. You can't trust yourself to remember. You can't trust yourself to not screw this up yet again.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
And so I really appreciate you saying that.
- 41:31 – 50:56
What Is Rejection Sensitive Dysphoria (RSD) in ADHD?
- MRMel Robbins
Is there something surprising that you've discovered in your practice that most people with ADHD struggle with and may not even realize it?
- SHDr. Sasha Hamdani
Yes. So we've, we've talked a lot about the emotional regulation side of things.
- MRMel Robbins
Yes.
- SHDr. Sasha Hamdani
There is a neurological phenomenon that you see in almost 100% of people with ADHD. They experience some component of rejection sensitive dysphoria.
- MRMel Robbins
Rejection sensitive dysphoria. What does that even mean? That's a big thing.
- SHDr. Sasha Hamdani
It's a big thing. It's a mouthful. Rejection sensitive dysphoria is this incredibly robust emotional response, sometimes physical, but mostly emotional response to real or perceived rejection or criticism or this fear of disappointing someone. It is this internal emotional response, flooding of neurochemicals, that happens.
- MRMel Robbins
How do you define this, what this is?
- SHDr. Sasha Hamdani
It is a neurological phenomenon when you look at emotional sensitivity.
- MRMel Robbins
Okay.
- SHDr. Sasha Hamdani
Right? And you have-
- MRMel Robbins
Which you have if you are somebody struggling with ADHD.
- SHDr. Sasha Hamdani
I'm saying just part of the human condition-
- MRMel Robbins
Okay
- SHDr. Sasha Hamdani
... right? Emotional sensitivity in general. You have, if you're saying this is kinda normal emotional sensitivity, you have, uh, emotions down, emotions up, situationally appropriate. You're right in the middle. You have lack of emotional sensitivity where people really aren't responding in the way that they should be. They don't feel big highs, they don't feel big lows, maybe not situationally appropriate. Then you have people that are highly emotionally sensitive, and they are the people who feel things quickly and deeply and for a long time.
- MRMel Robbins
Mm-hmm.
- SHDr. Sasha Hamdani
And I would put rejection sensitive dysphoria as, like, the, the ending point of that as most emotionally sensitive because when they feel something, even if it's not actually happening, if they perceive that there is a risk that I'm disappointing you or that there's some rejection or the person doesn't like me, their world caves in. They start turning inwards, and it becomes this flooding of neurochemicals and alarm chemicals that are happening that literally paralyze other areas of the brain.
- MRMel Robbins
Wow.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
Holy cow.
- SHDr. Sasha Hamdani
Mm-hmm.
- MRMel Robbins
You have a brand-new bestselling book, Too Sensitive. I love the title.
- SHDr. Sasha Hamdani
Thank you.
- MRMel Robbins
Why is this rejection sensitive dysphoria important to dedicate an entire book to this?
- SHDr. Sasha Hamdani
'Cause no one talks about it, so we don't have the tools and the language to treat it appropriately.
- MRMel Robbins
Can you show us what this may look like in day-to-day life?
- SHDr. Sasha Hamdani
Yes, I can. I can show you with text messages from you.
- MRMel Robbins
Oh, God.
- SHDr. Sasha Hamdani
[laughs] Okay.
- MRMel Robbins
Oh, my... These are... So the team has screenshot my phone. Okay, go ahead.
- SHDr. Sasha Hamdani
[laughs] So-
- 50:56 – 1:01:41
The 3 Steps to Getting Proper ADHD Treatment
- MRMel Robbins
So what are the steps you should take if you think you or someone that you love may be dealing with ADHD that's not diagnosed?
- SHDr. Sasha Hamdani
Yeah. Let's go through this, 'cause I think a visual will help. So I'm gonna pull up a visual.
- MRMel Robbins
Great.
- SHDr. Sasha Hamdani
So if you think you have ADHD, let's start with the first step. So first step, track your symptoms. It is so important to, number one, know your baseline. Number two, it's also w- needed to understand how your treatment is progressing if that's kind of what it w- and whether that's therapy or whether that's medication. Are those holes being fixed?
- MRMel Robbins
Yes. So what symptoms am I tracking?
- SHDr. Sasha Hamdani
Okay. So if you do these things, you get a gold star from me. I want you to track initiation of tasks, distractibility during the tasks, like are you getting pulled out of the task, completion of tasks. So I would lump that all into one, but I think it's important to make those distinctions. Like, where is the problem? Is it starting? Is it staying in the task? Is it actually getting it done? That's important. Number two, I think that is vitally important, is sleep. Sleep. Track what you're doing with sleep. I want to know how long you slept. I want to know i- if your sleep was fragmented. Are you waking up in the middle of the night? Is it hard to fall asleep? So give me as much data as you can. This can be notes on your phone. Like, this doesn't need to be something super formal.
- MRMel Robbins
Okay.
- SHDr. Sasha Hamdani
And the third thing that I want you to track that I think is really important is mood. I actually don't give a lot of guidance on this, because it's almost an interesting diagnostic fact to see how you track mood. However you wanna track your mood, just give me some sort of mood data point.
- MRMel Robbins
Okay.
- SHDr. Sasha Hamdani
Because I want to see, number one, how, how that pattern progresses over time, and then especially for women, if you cross correlate that with your hormonal cycle, want to see that too.
- MRMel Robbins
Got it.
- SHDr. Sasha Hamdani
'Cause if there's a strong hormonal component, we need to look at that as well.
- MRMel Robbins
Got it. So if I were to do this for a couple weeks-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... you'd get some good data, 'cause then you could go, "And has it been like this in the past?"
- SHDr. Sasha Hamdani
Ideally. Ideally, I don't want a couple weeks. I want, like, enough for two hormonal cycles.
- MRMel Robbins
Oh, so you want two months.
- SHDr. Sasha Hamdani
So I want like... I want two months.
- MRMel Robbins
Okay, great. You can have two months.
- SHDr. Sasha Hamdani
I want two months. Thank you.
- MRMel Robbins
It's gonna take me that long to get an appointment with you anyway, so.
- SHDr. Sasha Hamdani
[laughs]
- MRMel Robbins
Okay, track your symptoms for two months, and we're doing kind of productivity, initiation, distractibility, completion, sleep patterns-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... and mood.
- SHDr. Sasha Hamdani
Yes.
- MRMel Robbins
Boom.
- SHDr. Sasha Hamdani
Boom. Okay, step two, talk with a qualified professional about an ADHD assessment.
- MRMel Robbins
What is a qualified professional?
- SHDr. Sasha Hamdani
I know.
- 1:01:41 – 1:04:09
ADHD Tools You Can Start Using Now
- SHDr. Sasha Hamdani
anyway.
- MRMel Robbins
So what are the top tools if you're dealing with ADHD-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... and that diagnosis that are the most effective place to start?
- SHDr. Sasha Hamdani
It can sometimes be really nebulous and hard to figure out exactly where to start, what lever to pull. That's when I think a therapist can come in very, very, very handy because they are able to take that data from your patterns, synthesize it, figure out where the holes are, and then figure out how to optimize and approach that. And I'll tell you from my own experience, I really started to drill down and work on the therapy side of things and what are the skills, what are the tools? How can I explore my own behavior so I can figure out what to fix? And that, I think, was life-changing.
- MRMel Robbins
What is the fourth step-
- SHDr. Sasha Hamdani
Yeah
- MRMel Robbins
... if you think you have ADHD?
- SHDr. Sasha Hamdani
Okay, step four, use trusted resources while you wait. I think this is important because I think a lot of getting assessed, it can take a while. It can take a long time and it, if it happens, right? I mean, there's some people that don't have access to it. And so I feel like in that interim, learning and exploring your own internal environment and also relying on resources that you know are reputable, that are going to help you, that aren't just some random person on the internet that's talking. Like, you want to get information from things like journal articles or news, uh, like, uh, and again, some news, so newspapers that cite journal articles.
- MRMel Robbins
Well, I actually, this is one of the things I appreciate about you, that you put a lot of content online.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
And so if you're having trouble, uh, gaining access and you are in the waiting game-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... following somebody like you-
- SHDr. Sasha Hamdani
Mm-hmm
- MRMel Robbins
... a medical doctor who's talking about this, who lives with this, that's a way for you to learn more and to understand that this is not a deficiency in you. This is something you are just gonna learn more about, and there are tools that you can use while you're waiting, and you can learn more and become smarter about this while you're figuring it out, and that's the whole point. And that's why I, I actually wanted you here because you do put out a lot of content.
- 1:04:09 – 1:07:19
Should You Get Tested for ADHD?
- MRMel Robbins
For somebody that's listening and, um, is thinking, "Well, this is definitely me, but I'm now 40, 56. It's ju- it's just too late," what would you say?
- SHDr. Sasha Hamdani
If I had 10 minutes left in my life, I would wanna know if I had ADHD.
- MRMel Robbins
Why?
- SHDr. Sasha Hamdani
Because I want to understand my brain. I want... I don't think it's ever too late to understand your brain. I just wanna know. For me, going through that ADHD experience, I know firsthand how it feels to have that guilt and that shame compounded at every single thing, and for me to analyze every turn I've made and to think about it and where did I go wrong and what was happening and how could I have done it better, to know that y- I did do my best. This was a neurological phenomenon that was underlying all of this, that was making it difficult. Like, you still did a great job. You got through this. You built on this. I, I want other people to feel that.
- MRMel Robbins
I do, too.
- SHDr. Sasha Hamdani
Yeah.
- MRMel Robbins
Dr. Hamdani, what are your parting words?
- SHDr. Sasha Hamdani
It's never too late to understand your brain.
- MRMel Robbins
I am so grateful that you're here.
- SHDr. Sasha Hamdani
Thank you for having me.
- MRMel Robbins
I cannot believe how much I learned today that I did not know. I feel more confident. I feel like I understand myself so much better. This episode is an extraordinary gift that you just gave us because we got to sit down in a private session one-on-one with a psychiatrist as renowned and as passionate and committed as you are, and I appreciate the accessible and realistic way that you talked about what to do next and what to do while you wait and while you figure this out. And so just from the bottom of my heart and from people all around the world that you will never meet whose lives will be forever changed because of what you shared with us today, thank you.
- SHDr. Sasha Hamdani
Thank you for having me.
- MRMel Robbins
And thank you. Thank you for making the time to learn about ADHD. I hope you share this with people that you care about. This is a conversation that is for all of us, and these tools that we discussed today are things you can start to implement in your life or the lives of people that you love immediately. And in case no one else tells you, I wanted to be sure to tell you, as your friend, that I love you, and I believe in you, and I believe in your ability to create a better life. I cannot wait to see your comments. I can't wait to see this shared around the world, so thank you, thank you, thank you. I'm gonna welcome you in to the very next episode the moment you hit play. I'll see you there. Thank you for watching all the way to the end here on YouTube, and if you're asking yourself, "Okay, what should I watch next?" you're gonna love this video, and I'll welcome you in the moment you hit play.
Episode duration: 1:07:25
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Transcript of episode nUPQImuDUng
