
I HAVE ADHD PODCAST - Episode #298
January 14, 2024
ADHD, Autism, and The Hidden Struggles in Women You Didn't See Coming
Ever feel like the world just doesn’t get what’s happening inside your brain? In this episode of the I Have ADHD Podcast, I sit down with my client and colleague Dr. Priyanka Rao, and we dive headfirst into the wild, twisty world of ADHD and autism—especially how it shows up in women.
We’re talking about the real stuff—like why it’s so dang hard to get diagnosed, the silent battles happening behind the scenes, and why neurodiversity-affirming care is a game-changer (spoiler: it’s life-changing). Dr. Rao opens up about her late-in-life diagnosis and lets us in on what she wished she knew sooner.
Oh, and hormones? Yep, they’re in the mix too. We cover how they mess with ADHD, the overlap with autism, and—most importantly—how you can speak up and advocate for yourself during assessments.
I also unpack some heavy hitters: perfectionism (ugh), why self-diagnosis is totally valid, and how the mental health field needs to step it up when it comes to cultural competence and understanding neurodivergent brains.
This episode is packed with insights, personal stories, and practical tips to help you feel seen, heard, and ready to take on the world (or at least that overdue to-do list).
Hit play and let’s get into it!
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Kristen Carder 0:05
Welcome to the I have ADHD podcast, where it’s all about education, encouragement and coaching for adults. With ADHD, I’m your host, Kristen Carter and I have ADHD, let’s chat about the frustrations, humor and challenges of adulting, relationships, working and achieving with this neurodevelopmental disorder, I’ll help you understand your unique brain, unlock your potential and move from point A to point B. Hey, what’s up? This is Kristin Carter, and you’ve tuned into the I have ADHD podcast. I am medicated, caffeinated, regulated and ready to roll. Today, I just have a guest that I adore, and I’m so excited to introduce you to her. Dr Priyanka Rao is a licensed clinical psychologist based in Minneapolis and the founder of Asha mental health, a private practice specializing in neuro diversity affirming and multicultural inclusive mental health care. She’s an executive coach for leaders and entrepreneurs, especially those with ADHD and as a late diagnosed ADHD or herself, Dr Rao brings both professional expertise and personal insight to her work, particularly in neuro diversity affirming adult ADHD and autism assessment, which we’re going to be talking about today when she’s not working, pre enjoys chasing after her two highly energetic toddler boys, attempting to stop her comically large dog, Loki, from eating all of Her kids food and spending too much time watching every Hallmark rom con she can find on Netflix. Now, listen, I adore this woman so much. She’s been a client of mine for almost a year, and I feel so grateful to her to come and share her experience with me. With you, we’re going to be talking about ADHD in women. We’re going to be talking about the overlap between autism and ADHD, and we’re going to talk about what does it mean to actually be someone who’s focused on neurodivergent affirming care. What does that actually look like? What should you expect when you walk into an assessment? What are the red flags? And also, as someone who has personal experience, what does multicultural affirming care also look like? And so this episode is going to be so deep and wonderful. Please enjoy it. Pre thank you so much for being here. You flew in from Minneapolis just to talk to me, and I’m so, so grateful. So tell us a little bit about yourself.
Dr. Priyanka Rao 2:44
Yeah. So I am a licensed psychologist. I live in Minneapolis with my husband and two kiddos and comically large dog, as you mentioned, I have my own practice called Asha mental health, and it’s a practice that’s focused on neuro diversity affirming and multi culturally inclusive care. So I just hired my first person. I’m expanding, which is very exciting, but we do therapy, so like individual, couples, family and then neuro diversity affirming autism and ADHD assessments for adults.
Kristen Carder 3:16
I can’t wait to get into all of that, because I know so many listeners are just trying to find people to assess them who are not
Dr. Priyanka Rao 3:28
assholes, so it’s literally about to say the same thing.
Kristen Carder 3:33
So I really do want to talk about that, but first I want to know a little bit more about you. So you were diagnosed later in life. What does that mean? How old were you? What was that process like for you?
Dr. Priyanka Rao 3:42
Yeah, I got diagnosed, I think it was only two and a half years ago. It was after my first kid, oh my gosh. I had a practicum, like a training experience when I was in graduate school where I worked at a clinic that did neurofeedback, and they did a brain scan and, like, like, just to kind of show me what it was like. And the psychologist I was working there was like, Hey, do you have ADHD? And I was like, now, ignored it. And then, like, you know, managed my way through school and things. And then, after my first kiddo was born, like the sheer mental load of all the things I was bouncing and juggling and keeping track of, I, like, felt like my brain was imploding. And so that’s what I was like, I think maybe I should actually get assessed, and I have a rock star therapist. And she was like, Yeah, you should probably do that. And so I did, and it sucked, but it was accurate, which was
Kristen Carder 4:30
helpful. What sucked? When you say it sucked, what do you mean by that? Yeah, it sucked in
Dr. Priyanka Rao 4:34
that, like, first of all, just caveat. As a psychologist, I have a pretty high bar for what I think an assessment should look like. Yes, it felt very half assed like, it felt like I was in there maybe an hour total. I don’t really feel like they asked a whole lot, or really got to know me at all. The report I got back was like, two pages and mostly tables, and so it didn’t really have a lot of like, useful information for me. So luckily, again, being a psychologist myself. Like, I already knew what I needed to know and I knew where to find more. Yeah. So it didn’t really impact me, but it did make it very clear to me, like, how lacking a lot of assessments can be, what not to do, yeah, which kind of sparked the interest in specializing in that myself
Kristen Carder 5:17
when you were diagnosed, what was the experience like for you? Of like receiving the diagnosis? Was that a relief? Did you feel badly about it? Did it make you feel better or worse? I guess is what I’m curious about. Yes,
Dr. Priyanka Rao 5:38
all of the above really validated, because I was like, okay, so this is hard, because it’s hard, um, made a lot of things make sense, and then I started learning more and more, and had so many of those, like, that’s ADHD too moments, um, and then it was also, like, sad. There was a lot of grief for like, Oh my goodness. What could I have done had I known this sooner, especially the first time I took meds, and my brain felt like it turned on, and then I remember being like, devastated that night, because I was like, What would grad school have felt like? What would college have felt like? What would managing my like newborn have looked like? Had I known this stuff sooner? So definitely the Mixed Bag roller coaster scenario, what
Kristen Carder 6:18
did grad school feel like for you as an unmedicated, undiagnosed person with ADHD,
Dr. Priyanka Rao 6:26
it was like chaotic is probably the best word in that. I’ve always been a good student. I care deeply about school. That’s the Indian in me. So I always got good grades. But procrastination to Max, I somehow made it through most of college without ever doing an all nighter. And I was starting to do all nighters to get assignments done in grad school, because I would wait until way too late, and the scope was just way bigger, keeping track of, like, all the things I needed to do, because there was a lot that I had to do on my own time, and a lot that was due concurrently. I mean, I’ve managed that in college and grad school just felt like a Tish harder, because then we also start working part time for all the training experiences. So I just like it was a lot of procrastinate, scramble, pull it off, crash, do it again. Yeah. Oh, that.
Kristen Carder 7:15
I feel like we could make like a visual, like an Instagramable visual, procrastinate. What did you say? Procrastinate, scramble, pull it
Dr. Priyanka Rao 7:25
off, yeah, crash, do it again, dang, yeah.
Kristen Carder 7:29
It’s so interesting because you’re obviously, like, highly intelligent, a hard worker. You said you care deeply about school, so you did have everything going for you, as far as, like, maybe never being diagnosed. Yes, because you were like, these are things that you were already doing and you were caring about school. But what was the tipping point that just made it like too much for you?
Dr. Priyanka Rao 7:55
It was, like, I said after my son was born, yeah, I was like, in a constant state of overwhelm. Like in grad school, I would hit pockets of overwhelm, but then we’d push through the deadline, and then I’d be fine again. In motherhood, there’s no like deadline to push through, ever, ever, and then the sleep deprivation. So I was, like, perpetually overwhelmed. And like many other women, like, I thought generalized anxiety, but that also didn’t quite fit for me. Like, I think that was probably my diagnosis at some point in time. But I’m not generalized in my anxiety. It’s purely about the sheer volume of stuff floating around in my head that I’m trying to keep track of and trying to get, like, any task done ever. And so that like difference between generally anxious about the world versus, like overwhelmed with all the things in my head. Was what kind of pushed me into, yeah, finally getting assessed. So
Kristen Carder 8:50
I think you just described the experience of many people, especially women, yes, who are often so misdiagnosed, under, diagnosed, not diagnosed, overlooked, dismissed, blah, blah, can you talk about, can you talk about women and ADHD? Like, Why are women so often not diagnosed or misdiagnosed?
Dr. Priyanka Rao 9:15
I think it’s because when we think of ADHD, most people think of like the young boy in school bouncing out of his chair all the time. So you’re thinking disruptive, you’re thinking loud, you’re thinking taking up a lot of space and never getting stuff done, and being kind of like a tornado. And women, we’re socialized to like follow the rules differently. We’re socialized to contain our shit. And so for women, the ADHD is a lot more internal, and so it gets missed, or it gets called anxiety, because they’re pretty close, but they’re slightly different. And so I think women get missed because we are more like contained. Yeah, we don’t tend to verbalize as often when we are struggling, and then we tend to get dismissed. Just, I think a lot of the narrative narratives around, like the the load of motherhood, like the mental load, is so validating, and also you can call that level of overwhelm, like just being a mom today, sure. And so I think some people, like, dismiss the level of struggle that they’re having, because, like, yes, all moms are struggling because there’s so much shit we’re managing, yeah. So I think that’s like a piece that gets missed too, and then, yeah, I think we just, like, we hold it in, we struggle internally, and we don’t talk about it the same way, yeah, and we’re just like, written off as, like, being high strung or being overly perfectionistic versus I actually have like, executive dysfunctions that are causing me to struggle with the thing that I’m struggling with. Yeah,
Kristen Carder 10:40
whenever I think about or talk about ADHD, especially in women, what I always like to come back to is like, Okay, you may have accomplished the thing. You may have gone through college, you may have gone through grad school, you may have a newborn that you’re attending to, but at what cost? Yes, like, what is the behind the scenes like? Because that’s what we need to compare, not the outcome necessarily, like, not necessarily your grades versus your peers, grades that can sometimes give good information, but for somebody like you, who’s intelligent and driven and who’s always loved school, that’s probably not going to be a very good evaluation of whether or not ADHD is present. It’s what’s the behind the scenes, like, compared to your peers? Do you have experiences or like any stories or any knowledge of it being more chaotic for you behind the scenes, or were your peers also pulling all nighters all the time? And, like, living in chaos? It
Dr. Priyanka Rao 11:47
was probably a mix. So I definitely, I would say, like, 100% of things, I waited until the last minute. I think other people would like procrastinate some stuff, but get it like I was the person that would like do the math and work in the way outside the classroom before it was due, and it was done, and it was right, but it was done, like, right at the last second
Kristen Carder 12:06
while your heart is beating and your pits are sweating, and you’re just like, don’t talk to me under my hammer. Yes, exactly.
Dr. Priyanka Rao 12:12
And then, like, I think I had one assignment in high school I, like, actually did not pull off the procrastination on and that was, like, utterly devastating for me. But because I was a straight A student across the board, like I got the leeway to make that okay. For me, it looked like being always late, which, to be fair, like I’m Indian. We run on Indian Standard Time. We’ve never been on time to anything in our lives. However, I also think that’s because, like, I am probably most of my family has ADHD, and so that doesn’t help with the timeline, totally. So I was the person that would, like, accrue all we had like, a demerit system at my high school. So I accrue, like, daily demerits for being late. But then, because I was a teacher’s pet and a good student, some teacher would give me, like, tell me to, like, grade papers or something, and I would wipe them out. I get married merits and wipe them out. And so I never had like consequences. And then I talk too much like, that’s where it shows up. I’m like, I’m just a social, chatty human and so if you look back on my report cards, like every report card from elementary school, it’s like, Priya is such a delight to have. She’s such a great student. She does distract her classmates with talking too much, but she because she’s already done and they’re still working, every report card said that, and that’s just like me being bubbly versus, like, disruptive in the way that people think of so, like, for sure, for my family, that didn’t, like, set off any red flags because they knew I talked a lot, and they were like, Okay, that’s just your personality.
Kristen Carder 13:30
Okay. So this is a great transition for how are the in what ways does ADHD look a little bit different in women? And I think we can put like, talking, you know, in that category. But what else would you add? How can a woman or anyone listening like, maybe you have a daughter, maybe you have a sister, like, how should we be on the lookout for ADHD in women? Yeah,
Dr. Priyanka Rao 13:58
so I think some pieces of that are around, like, what’s happening in your brain? What is the sheer volume of stuff that you’re juggling, and does it feel like you’re juggling it in a way that’s actually workable for you, or are you perpetually overwhelmed and feeling like you’re dropping the ball everywhere? So that could be like, over scheduling, what you think you can do in a day with your kids and all the activities that you plan, because you’ve got all the best intentions, but you have no time management skills. Maybe that’s a little harsh. You struggle with time management. And so then you’re, like, continuously running around all the time. Like, I had the feeling of, like, the saying, like running around like a chicken with her head off, like that was, where did that thing? I don’t even know. I don’t want to picture it. That seems really gross.
Kristen Carder 14:42
My mom would always say that, though, and so then I started saying and then I’m like, Oh my gosh. Why am I saying this? It’s so funny.
Dr. Priyanka Rao 14:47
Yeah, not, not the best mental image, but it was just like, that chaos all the time. So I think it’s like, Is your brain ever quiet? Do you ever get to, like, take a breather? Do you feel like. You can implement a system for organizing yourself and stick with it. So like, I’m queen of, like, the planner graveyard, where I’ll get a planner and I’ll use it beautifully for like, two or three weeks, and then I will completely forget that it exists. And so then I drop all those skills that I had for those three weeks, or I’ll meal plan really well for two weeks, and then, like, forget about that. And then we’re eating a lot of takeout, because you can’t plan ahead. Um, so I think it looks like you try to implement systems, you try to get everything together, and you feel like good for like, a minute, and then you can’t maintain it. Um, it’s I especially for, like, mothers, it’s the over stimulation from the kids. Like, kids are overstimulating, but like, this level of like, all my nerves are on fire. Is like, pretty common with ADHD and women, of like, just, I can’t think it was
Kristen Carder 15:48
something I knew as a young mama. I really do. I think I would have taken so much better care of myself and my kids if I if someone had just been like, the reason you’re feeling this way is because you’re overstimulated, and the reason that you’re overstimulated is because you have
Dr. Priyanka Rao 16:06
ADHD, right? Versus I’m just bad at momming, yeah? And apparently I
Kristen Carder 16:11
hate my kids, like, that’s how I felt. Was just like, ah, get away from me. And it had nothing to do with them, like, they’re amazing, but I I judged myself so much for it, because I was like, what kind of mom is like, wanting to constantly get away from her children, right? And so, yeah, but,
Dr. Priyanka Rao 16:33
but is it a human one? Yeah,
Kristen Carder 16:37
definitely neuro divergent one, yes, for sure, right? Yeah? Just that feeling of just like, I can’t hear one more
Dr. Priyanka Rao 16:43
thing. Yeah? For me, it gets me at the end of the day when, like, one kid wants to watch something on TV, the other kid, who’s a toddler, is just screaming because they want something that I can’t pick out, and I’m trying to cook dinner, so the fan is running, and my brain’s just, like, ready to implode. So I think a lot of us don’t realize that, like, not everybody feels that way when there’s six sounds going on, and so they don’t catch that as like, oh, this might be an indication of something. Yes, I’m
Kristen Carder 17:08
so glad you said that, because I think that the experience for a lot of women, especially is everyone feels this way. I’m just really bad at handling it. Yes, I’m just the only one that’s freaking out, or I’m the only one that’s yelling at my kids, or I’m the only like everyone feels exactly like me. I’m just handling it worse than my peers, and I do not think that is true.
Dr. Priyanka Rao 17:33
No, yeah. I mean, I think one good thing about social media is that people are getting more of the like, exposure to other moms, validating that it can be hard and like, if that is happening in multiple settings, if it’s not just with your kids, but you’re also overwhelmed at work, or you’re also forgetting things in your car, or you poured a cup of coffee and left it on the counter as you walked out the door, because it like fell out of your brain in that time period, those are kind of the indications that maybe it’s worth looking at where ADHD could fit into the picture, especially another one that I think a lot of women don’t realize is how bad PMDD can be, and the play between, like, hormones and ADHD. Yeah.
Kristen Carder 18:09
Okay, so what is PMDD? If you could just kind of give us a brief overview,
Dr. Priyanka Rao 18:14
yeah. So PMDD is premenstrual dysphoric disorder, which is a very fancy pants way of saying really, really, really bad. PMS, yeah. And so like, PMS, I mean, every woman I’m sure knows, yeah, sucks. And PMDD is, like, totally dialed up. So you are extra dysregulated, you are extra anxious. You have a really hard time relationally in those moments. So you’re finding yourself in a lot of, like, random fights you can’t make sense of it’s just like a wild hormone swing. And we’re finally doing some more research on hormones and ADHD and the play between the two and how much they get influenced. So I think a lot of women who have that, like, really intense, like, hormonal pattern are also often neurodivergent, like, there’s, like, just a lot of overlap between the two. Can’t tell you the stats on that, but I know that, um, they’re doing more research on like, how that fits, which is also why a lot of women are getting diagnosed in perimenopause or menopause, because, again, the like estrogen changes are exacerbating the ADHD. But of course, because we’re women, that hasn’t been well researched, and so it’s brand new information for everybody. This
Kristen Carder 19:21
is brand new information. So annoying. Oh my gosh. Okay, so that’s just like another fun facet of being a woman with ADHD. Is there anything else that you feel like is kind of specific to the experience of a woman with ADHD. So we talked about, like, talking a lot, the internal experience, the the mental load, but like, times a million, the hormonal swings. Is there anything that we’ve left out? I.
Dr. Priyanka Rao 20:00
I think, again, anecdotally, I don’t know that I could back that up with a stat, but I think women tend to lean really hard into the perfectionism and to feel that rejection sensitivity pretty intensely too, because we’re socialized to be very socially agreeable, yeah, and especially in the workplace, like we are up against a lot of biases and misconceptions and things. And so the perfectionism kicks into like, super high gear. So these are the people that are, like, continuously trying to people please and trying to, like, mitigate any mistakes, and are doing like the most and then some for what they need to be doing. And so I think we, like, hyper fixate a little bit on some of the social pieces in a way that’s different from how men do with ADHD, yeah, yeah. Not to say that they don’t experience the same struggles or the same rejection sensitivity, but when I’m, like, talking to women who are later diagnosed, that’s what I’m hearing a lot of, is I’m so anxious at work because, like, I’m managing people, but I don’t want anyone to be upset at me, or I have to, like, absolutely get this thing right. And so I’m, like, checking and checking and checking and making sure that I’ve got it, like, exactly perfect, because I have to prove, yeah. And I think that’s part of why it’s hard to catch, because, like, imposter syndrome is real, and there’s so many societal, like, differences around the expectations for women and the like biases that we’re working against in the workplace. And then those just play with the ADHD so that it becomes that much harder to catch that, like what we’re doing is dialed up, yes.
Kristen Carder 21:26
So how can women do a good job of advocating for themselves? There’s just, I know there’s so many women listening who have already been for a diagnosis or evaluations assessments, and just feel like they’ve been dismissed, they haven’t been heard, maybe they’ve been misdiagnosed. And I’m just curious if you have some words of wisdom as far as, like, how can a woman advocate well for herself in the assessment process?
Speaker 1 22:01
Yeah. So one I would recommend asking if you’re doing like, an initial consult, or talking to somebody, or looking to the website to see, like, are they speaking to women? Can they actually articulate how women are different with ADHD? So I’ve had people ask me, which I’m so glad that they do. Like, hey, how do you work with women? Tell me what that looks like. Where is that different? And then you’re listening to see if that person actually has a decent answer, or if they tell you something like, well, ADHD is neurological and in the brain, and therefore there’s no difference. And then you say, Okay, thank you. Bye, yeah, yep. So you you can ask explicitly, you also should, like, feel heard. If you have somebody that’s like, yes, but to everything you’re saying or dismissing you as like, just being dramatic, like, Screw them. Go somewhere else because they’re not listening to you. Like a good assessment, you should feel like really understood and heard and validated at the end of it. And if you don’t, you didn’t get a good assessment. Because even if you say you don’t meet criteria for a diagnosis, you should still learn something about yourself. You should about yourself, you should still feel heard. You should still get something from that process.
Kristen Carder 23:06
Yes, yes. Okay, so I’m so glad you said that, because I’ve said often, okay, like, I don’t know if you have a ADHD listener or person sitting across me, that’s not my job to know. I’m I’m not someone who does evaluations or assessments, but what I do know is that, like, you’re not okay. So let’s figure out what’s going on. Like, maybe it’s not ADHD, maybe it’s something else, but there should be an answer. It shouldn’t just be like, No, you’re perfect. You’re like, well, I don’t feel perfect. Like there’s something going on. And so I’m really glad that you said that, like, even if you don’t meet the criteria for a specific diagnosis, you should still learn more. You should still have, like, a next step,
Dr. Priyanka Rao 23:49
yes, 100% and if you aren’t getting more, if you just get, like, a Nope, this isn’t it. Bye. Like, that was a shit assessment, yeah. So yeah, you should definitely be able to learn about, like your executive functioning skills and where like growth edges are, or where you could learn more about things. I think a lot of times, what happens is women will go into an assessment, and the assessor will take behavioral observations or collateral information, like your partner fills out a survey for you, and if like behaviorally, you seem put together and calm or together, like, on it, and then your partner says, like, no, they’re fine. They’re just, you know, doing a lot. The non affirming providers are the ones that like, aren’t well versed in what women looks like. They’re gonna say, like, sorry, you you were able to stay focused. You could do this one test just fine, and therefore you can’t have ADHD. And that’s bullshit, because when you’re being tested, you’re gonna pay attention better, and when you’re a woman, you’re gonna contain yourself differently, or maybe not. Maybe you are all over the place, some of us are, but like, just because somebody else doesn’t see it doesn’t mean it’s not happening. And I feel like that is where most women get, like, discounted, because, like. For me. Like, I can sit still, I can have a conversation, I can stay focused on something I care about. And then, like, if you gave me a test, I would do really well because it matters. And so like, people would look at me and I got a doctorate, people look at me and be like, she can’t have ADHD because she’s like, doing okay. And in my brain, it’s like squirrels running around in there. Yeah. Like the the way to advocate for yourself is to ensure that the person is paying attention to your internal experience and believing that over what somebody else might see externally.
Kristen Carder 25:33
That was it right there, making sure the person assessing you is paying attention to your internal experience. Huge, huge, huge, huge, oh my gosh. Thank you so much for that. That was like, that was it? That was so good. Okay, so let’s transition a little bit here, because I know that you work with people who are getting assessed for autism, yes, and there’s a lot of overlap between autism and ADHD. And I just wanted to hear your thoughts about that. Like, what are the similarities? What are some similarities, and what are some differences between autism and ADHD? Yeah.
Dr. Priyanka Rao 26:14
So there is a lot of overlap. And, like, distinction between the two can be a little bit tricky. So where things are the same. You often see executive dysfunction with both. So struggles with time management, organization, planning, working memory, etc. You can have sensory sensitivities in both. Usually the degree of like distress or disruption from it is higher with autism. But I mean, both can be pretty hard. Um, you can see relational impacts, um, in both. So, like, some ADHD ers have, like, a hard time with reining in the impulsivity. And then, like, want to talk about the things they’re hyper fixated on, and then it gets a little bit, um, like, annoying for some of the people around them from time to time, if there isn’t that self awareness. And so you can see some social differences with both. But the key differences, I think, are in like, how that feels internally. And so for autistic folks, like, they just have differences in how they communicate, and differences in like, what kinds of social interactions feel really good to them. And so it’s, it’s usually less about like reining in impulsivity, and more about like, feeling out of sync with people until they find their people. So it’s a lot of, like, I hear a lot of folks mentioning things like, I feel like people got a rule book for what they’re supposed to do in a context. And like, I just didn’t get that rule book, so I had to learn it. And that right there is, again, where, like, the experience matters more than the observation. Because, like, if you’re an adult who hasn’t been diagnosed yet, you’re probably pretty high masking, which means you probably have learned to do pretty well in social situations. From an external perspective, but internally, it’s so exhausting, and it’s so much active thought. And you’re maintaining the eye contact, but you’re thinking about, okay, how long have I been making this eye contact? Is it too long? Is it too intense? Do I look away? Do I need to look at you again? And it’s all this, like, active thought. So like, I think one of the good distinguishing factors is, like, how much active mental effort is it taking to do some of those social pieces that for neurotypicals, or allistic meaning non autistic people is more like a automatic, implicit process, yeah, so they’re not putting the same thought to it. So I think that’s one of the distinguishing factors with autism. You usually see a little bit more of the like sensory sensitivities being like disruptive and exhausting can still happen with ADHD, though, so that’s kind of a fine line, and then a lot more preference for like sameness and routine ADHD, or brains like do really well with sameness, not sameness with routine, yeah, because we need that structure. The sameness part is a little less appealing to us, because we’re always like dopamine seeking. We always like dopamine seeking. We always heard like, the next shiny thing for autistic brains, like, their brains are processing so much information all the time that they’re on overload. And so routines and sameness, like provide some mental relief. And so that preference for the sameness, which like gets pathologized as being like rigid, is actually like trying to give your brain a break. If you know exactly what something’s gonna taste like, you don’t have to put like, brain cells towards that, and you get to, like, breathe a little
Kristen Carder 29:28
okay. So this is so interesting. I have a son who was recently diagnosed with autism, and one of the things that he said in recent years, as he’s gotten older and just had more language to express himself, he’ll he wants things to remain the same, even when it’s not necessarily a good thing. And he’ll say, like, I just want it to stay the same. And I’m like, but it’s not working. And he’s like, I don’t care. It doesn’t matter. And. Like, for example, he goes to bed at a certain time, no matter how tired he is, no matter how well he slept the night before, no matter, like, no matter what the circumstance, no matter what time he has to get up the next it’s the same bedtime. And I’m just like, well, like, you could go to bed earlier because, like, you’re tired. And he’s like, No, I go to bed at this time. I’m just like, I don’t assume. So that’s actually really, really helpful to hear you say that, because I’ve learned so much about his experience from him, but that is something that he hasn’t been able to verbalize. Is like it being the same is actually like a relief, and it makes it so that I don’t have to put brain cells toward. I wonder what time I should go to bed. It’s like, I go to bed at this time every night, no matter what is happening. It’s fascinating.
Dr. Priyanka Rao 30:49
Yeah, I think that’s one of the like, when we’re talking about, like, misconceptions around these diagnoses and like more, like ableist or judgmental like interpretations of that like, yeah, what you hear is like, they’re unnecessarily rigid, they’re really stubborn. They won’t change. They’re only focused on what they need. And that’s so unfair, because they aren’t. They just like, need a brain break. And so, like, when something is predictable and the same and follows the same pathway, it’s easier, it’s less draining. It is, like, one more thing in a world that is continuously overwhelming and unpredictable that they’ve got like, a handle on. Yes,
Kristen Carder 31:28
wow, I just that was really helpful for me. That’s really, really beautiful. Did you know that most ADHD ers are perfectionists? In fact, Dr Russell Ramsey, with his team at UPenn, found that perfectionism is the most common thought distortion for adults with ADHD isn’t that shocking. I mean, of all of the wild thoughts that we struggle with, perfectionism is the most common for ADHD ers. Now you might be thinking, How is it possible that I’m a perfectionist? I mean, I’m a mess and I do absolutely nothing perfectly. But what Ramsey found in his research, and what I’ve seen in my experience coaching 1000s of adults with ADHD, is that the desire to get things right and the fear of failure lead to avoidance, procrastination and paralysis. And I know as someone with ADHD, you struggle with avoidance, procrastination and paralysis. So ADHD, or I put together a four part course for you for free that will help you to understand your perfectionistic tendencies and overcome them in an ADHD friendly way so that you can get shit done. I mean, that’s what we all want, right? So click the link in the show notes for this totally free course. It’s a four part video series that I’ve already taken my ADHD clients through. So we know it’s tested and it works. And listen, it doesn’t suck. We have a good time. So click the link in the show notes to check it out for you. As someone who is assessing people who are coming in and they’re just like, is it autism? Is it ADHD? Is it both? I don’t know. What are, how do you unpick that? How do you like, because there’s so much overlap between it, yeah, so I don’t know if you’re allowed to say, because I know there’s like, test security and stuff like that. But like, how do you as someone who is sitting face to face with a neurodivergent person trying to help them to figure out, like, is this autism? Is it? ADHD, is it both? How do you figure that out?
Dr. Priyanka Rao 33:27
It takes a lot of time and, like, conversation and digging into things, and so that’s why, like, if somebody is doing an autism assessment that takes an hour, like, There’s no way.
Kristen Carder 33:37
Oh, you mean, if someone goes for an assessment, it’s just like, Bada bing bada, boom. Like, no, yeah,
Dr. Priyanka Rao 33:42
no. Because, like, how, like, I can’t even talk to you for an hour. How am I gonna cover your whole life and all the things that’s so true. The best way to do it in a way that’s affirming as well, versus coming from, like, a medicalized, deficit based model, yeah, is to, like, really dig into, like, the different parts of their life and how they’re showing up in different ways. So there’s, like, so there’s, like, a lot of great measures out there that are more affirming in nature, that are kind of more like structured, semi structured interview style. And so they’re going to tease apart the parts where it’s like, is this like seeking, new stimulation? Is this like the dopamine seeking? Is this the like to just like executive functioning, or are we seeing some of the other like social differences and preferences around sameness and some more of the stemming behaviors and those kinds of things. And so you kind of have to look at it all. It’s really hard to just look at one and not the other. And because the CO occurrence rates are so high between the two, it very well could be both. And when you have both, you often feel like there’s two parts of you that are at war with each other. There’s the part of you that, like, wants the sameness and the rest, and the part of you that really wants to try the new shiny thing. And so you try the new shiny thing, and then you crash. And so you’re kind of like, always, like, it’s tough, like, because the two different parts of you kind of crave different things. And. I, like, honestly, out of my like, assessment experience, like most folks that have come to me have have had both. There’s some that don’t obviously, but the prevalence rates between the two are, like, really high. So I like, I think a good assessment for ADHD, well, should always include a screener for autism, because, like, it’s just, like, smart, I think, to look for both. Because, like, what if? What if? Like, it’s another one of those things where you just figured everybody struggled in the same way that you did, or that you were just different somehow, but you weren’t quite sure why. Um, so my hope is that, like, everybody’s including a screener, at least in an ADHD eval and vice versa, like, if you’re doing an autism email, you’d also be screening for ADHD,
Kristen Carder 35:44
wow, I don’t think that’s happening. Yeah, probably okay. I’m glad that you are doing it. I’m really glad you’re saying it on here. I know we have a lot of clinical psychologists that that listen to the podcast and and I’m glad that you’re saying it, because, yeah, there should be. There’s such a high prevalence of overlap like that just makes sense.
Dr. Priyanka Rao 36:07
So a lot of people come to me after they’ve had an assessment and they get, say, an ADHD diagnosis, but then they feel like a big chunk of their experience doesn’t quite get explained with that. So they still feel like something’s there that’s being missed, or folks have gone for an autism assessment, been told, No, you’re not autistic. And then, like, they read their report and they’re like, Are you sure? Because it kind of looks like I might be, and that kind of makes sense for me. And what’s really like, interesting is, like, in the Autistic community, like self diagnosis is completely valid. Like, if you have questions and you’re reading the things, and you feel like it fits for you, awesome. That’s valid. And sometimes people either need the documentation for something or, like, just want somebody else to validate that they’re on the right track, and so then they’ll come for an assessment. But in my experience, and I think a lot of like, psychologists will agree with this, if somebody comes to you and says, I think I might be autistic, they probably are, wow. Like, there’s not a whole lot of allistic people that are wondering if they’re autistic, and if there’s something that you found out there that is really resonated with you, like you’re probably onto something, but you’re so used to being discounted, and so used to not trusting your own experience and being told you’re wrong or dramatic or sensitive, sure that, like, you just assume you can’t possibly be right? And so, yeah, I mean, like, I think we’ve just, everybody should look at both. I
Kristen Carder 37:29
just love that. I just love and I also really love that you said, like, if you think that you’re autistic, there’s a high chance, like, pull that thread. Yeah, for sure. For sure. Why is the Autistic community so accepting of self diagnosis? Because I think that is so beautiful, because
Dr. Priyanka Rao 37:51
it’s so fucking hard to get a diagnosis. One we are not well trained for this, so we are operating off of a lot of misconceptions. When you say we, as in psychologists, okay, so, and that’s true of ADHD, too. So like, talk about that a
Kristen Carder 38:08
little bit. Yeah, when you say that, what do you mean? Yeah, what does it mean that? Like, you’re not well trained in that.
Dr. Priyanka Rao 38:14
I have a doctorate in clinical psychology. I should probably know what I’m talking about. I did not know anything about ADHD and autism, I want to stop, yeah,
Kristen Carder 38:24
you didn’t have a course on it. I
Dr. Priyanka Rao 38:26
had, I think, one hour in a course that covered both as neurodevelopmental, that covered both correct and I did not get specific training on those assessments unless I went to a training site that happened to do those assessments.
Kristen Carder 38:41
So as a clinical psychologist, you had one hour of one class that was dedicated to neurodevelopmental disabilities, and it covered both
Dr. Priyanka Rao 38:52
correct unless I was a specialist in like, neuropsychology, okay, there wouldn’t have been more coursework on it. It was just kind of like the footnote in a course. And so, like, when I got diagnosed with ADHD, I did my, like, hyper focused thing, and did the deep dive on it, and I was astounded by how much I did not know, and like, how much learning I had to do, and how much, like, how much the assessments are really flawed if you’re not really well versed in what autism, or, sorry, ADHD looks like in in women and adults. Yeah. Because yeah, like, if you’re going to a psychologist that thinks you just do the computerized clicky test and that if you pass that, therefore you can’t have ADHD, like, that is inaccurate, yep. Or if you’re going off of behavioral observations, inaccurate. And then my son is autistic, and he just got diagnosed last year. And when he got diagnosed, I did my deep dive again on autism as we do, as we do, and I was again, like astounded by how little I knew. And I had so many like light bulb moments for like clients I’d worked with in the past that I got stuck on because I missed that they were autistic because we i. The picture I had in my head was like, either, like, the young boy playing with the trains and like, that being the thing they’re obsessed with, or like Sheldon from Big Bang Theory, yes. Um, gosh, who they claim is not autistic, but let’s be real. Um, what? Yeah, like, I didn’t know they claim that. I’m pretty sure the writers said that, like he wasn’t meant to be autistic, but like, he’s absolutely autistic 100% and
Kristen Carder 40:19
so is young Sheldon, obviously, yes, gosh, that’s funny. But
Dr. Priyanka Rao 40:23
I mean, like, that was what was in in my head, too. And again, psychologists here, like, I should be better versed in the average human and so then, like, learning more about what autism actually looks like, and learning about it from, like, a neuro diversity affirming lens, as in, these aren’t like deficits and problems and disorders. These are just like your brain is wired differently, and so you need different things. And when you’re in a context that matches that, you do just fine, like you’re not doomed.
Kristen Carder 40:51
Is that how we know that it’s not a deficit is if we’re in the right environment, we’re actually just fine? Yes,
Dr. Priyanka Rao 41:01
which, like, I mean, a lot of ADHD too. Like, when you’ve got the right supports in place, like, you can be okay, yep, yep, but yeah, for like, the autistic folks of the world, like, I think we live in a society that is very unfriendly, agreed. For like, an autistic neurotype, agreed. And so like, no wonder you’re struggling, no wonder you’re struggling. But like, if I could give you sensory breaks in the middle of your day, if you’re possible that you work remote so you’re at home, if we just told your friends to be cool with like, you disappearing off the grid for a bit when you’re burnt out, and then coming back and talking about, like, your area of interest, awesome? Like, we’d be good, awesome. Yeah, yeah. So I again, like, I said I was just so sounded by how ignorant I was as I was learning about it. And so it became like, really, like, personally important to me, because, like, I want my kid to grow up in a world where people are affirming and that people are understanding of like, the awesome shit he can do. And then also, like, professionally, I was so, like, saddened to see how few people are well versed on, like, what an autism diagnostic, diagnostic process looks like. Yeah, that. I was like, All right, well, this is where I’m going to channel online my learning, because I don’t work with kids, and so I’m going to do it with the adults. Yeah, and like, the need is so high. So this was a very long way to get back to your question of, like, why are people accepting of so people accepting a self diagnosis? Put 282 years in a room together? Love it. But like, people are accepting a self diagnosis because, like, finding providers that are well versed on it is really fucking hard getting, like, access. It’s expensive to get assessed, and many of us either don’t take insurance or limit how many insurance spots we have, because insurance, like, is such a horrible system that’s so underpays and puts so many like, administrative hurdles in place. And so like, access, from that perspective, is really hard. So you’re gonna get like, invalidated. They’re gonna go off of like, old info, and then it’s gonna cost you a fucking fortune. And so people have been doing their own research, and people have been finding it for themselves. And people have been like, yep, this resonates for me, and I’m gonna, like, act accordingly. And yeah, that’s valid. 100% you are the best judge of your own experience. Yeah, I love that so
Kristen Carder 43:14
much. Let’s talk for a moment about neuro diversity, affirming care, and just, like, why that’s so important to you, and what is it even mean? Yeah, so let’s just start with, like, what is neuro diversity affirming care? What does that mean to you? Yeah,
Dr. Priyanka Rao 43:33
so it’s operating off the basis, or, like, the concept of, like, neuro divergence, which means there’s a lot of different ways for brains to be, all great, all valid, versus there’s a right way for your brain to be, and that’s like the right functioning, and then everything else is like a deficit or a problem or a disorder of said functioning. And so like, when you look at ADHD brains, autistic brains, OCD brains, like, they are quite literally, like, wired and structured differently. They’re, like, hyper connected in certain ways, and they process information differently. And that’s why, like, the fun example I have is like, when, when a non autistic person looks at a forest, they see the forest, and then they might zoom in on a handful of trees, and then they find, like, the one tree in the front that’s got like, the cool bark, and they look at that an autistic person is probably gonna go in reverse. They’re gonna see the bark. They’re going to see the bark first, and then they’re going to go, oh, that’s on like, this tree. And then, oh, check that out. There’s lots of trees around there. And then here’s the forest. So they’re processing information in a different order, yeah, and they’re taking in more detail because of the brain being hyper connected than non autistic people. And so they’re like, they’re processing at a different pace because they’re processing a greater volume. And so, like those kinds of understandings is based on the idea that like that brain is, like equally legit to the ADHD brain, which is equally legit compared to the like a neurotypical brain. And that, like, if biodiversity is important from like a biological. Important. Why wouldn’t neuro diversity be and so neuro diversity affirming care is recognizing that it’s like, holding that at like, the core of how you’re looking at somebody. You’re not looking for deficits. You’re looking for like, differences. You’re not helping people understand where they’re like, problematic. But instead asking them like, how would you like to be? Like, it’s not inherently problematic to not be a social human. No, if you’re content there, cool, stay there, yeah. But like, if you’re not neuro diversity affirming, you’re gonna be like, well, you have to, like, socialize in X, Y, Z ways. You have to learn to make eye contact. You have to learn how to do small talk. Why? Who decided that was the best? I’ll talk the fucking worst. Yeah,
Kristen Carder 45:37
it is the worst.
Dr. Priyanka Rao 45:40
So I think when you’re talking about neuro diversity affirming, it’s become a really big buzzword right now, and that’s been like driving me bonkers, because everybody wants to put it on their website and say that they’re neuro diversity affirming, and then you go to look at their stuff and they’re not, because they just picked up the buzz word.
Kristen Carder 45:56
So what are the red flags? How can we figure out if somebody is or isn’t neuro diversity affirming? Yeah, look
Dr. Priyanka Rao 46:03
at how they are talking about assessment and like diagnosis. So like all of us have, should have websites that talk about what we’re doing and what we’re assessing for now, are they framing it in like, deficit language? Are they talking about all the things you can’t do? Are they like naming some of the questions you have or some of the feelings that you have, and so in a way that you feel heard, if they have a puzzle piece, they’re not affirming. Oh my gosh. Let me just put that out there. If the puzzle piece icon is there, go another direction. Puzzle Pieces are out. Y’all, yes, don’t, don’t do it. Yeah, um, if they’re saying person with autism instead of autistic person, they’re not affirming. And so, and if they’re, if, if you’re talking with them about their assessment process, and they’re talking about requiring a collateral interview versus asking if you’d like one, that’s not very affirming, because for a lot of people, it’s not safe, or everybody in their life discounts them. And so if you’re going to believe that collateral report over what I’m telling you, I’m struggling with totally you’re not being very affirming. Yeah, um, love it some other like, maybe green flags versus like a red flag is if places are asking you, like, if they’re offering, like, telehealth, that can be really neurodiversity affirming for people that get really overwhelmed in new spaces or traveling to places, or sensory input so they can be in their own environment. That could be a sign, if they are asking you about like sensory needs, scheduling needs, love so, like, in my assessment process, every client gets a like, a specific form that says, like, Do you have any concerns about, like, the duration of the appointment and whether that would be comfortable for you? Do you have any like, sensory sensitivities I can be aware of. Please dress comfortably, because I really don’t care how professional you look, I’ll open everyone being like you can wander around. You can fidget with stuff. I have a box of fidgets that I take with me, like you don’t have to look at me ever. How do you answer questions best? Do you need to talk it through? Do you want to write something to me? Do you want to send me a voicemail? Like, what is it that can help us make this dream accessible for you? Because, just because I communicate one way doesn’t mean you do, and to assume that you should is, is like, ableist in nature, yeah, yeah.
Kristen Carder 48:13
Can you describe what ableist even means for somebody listening who’s like, I don’t understand what that
Dr. Priyanka Rao 48:19
is. Yeah. So ableism is kind of like, based on the idea that neurotypical ways of being and acting, and neuro like non disabled bodies are the gold standard, and everybody else should change to match that, or work within that. And so that, again, means like, if you can’t do this, there’s a problem for you versus there’s a difference there, and they’re both equally valid. Or you, you can see it with like, physical disabilities too. Like, if you have spaces that don’t allow for access to different bodies, then that’s ableist, because you’re assuming that, like, people should fit in this little narrow box, and anything else is less than Yeah. And so in like, the neuro diversity world, it’s around like people should learn social skills training, because they should know how to socialize like me, which is bullshit, because there’s a lot of research now on the double empathy problem, which is that, like, autistic people communicate differently than non autistic people. And the autistic folks, yeah, have a hard time understanding the neurotypical norms, which is what we’ve always said, right? Like, the stereotype used to be that autistic folks don’t have empathy, which is utter bullshit, but it happens in the other direction too. So the neurotypical folks can’t understand how the autistic folks work, and so it’s a double empathy problem. It’s not like the notes, the neurotypical folks understand everybody and the autistic folks don’t. Yeah, it’s in both directions. And when you put people in the same grouping, like the same neurotype, like everybody clicks, and everybody can communicate just fine and connect just fine. Yes? So it’s a it’s a matter of context versus a matter of inherent problem or deficit. Yeah, yeah.
Kristen Carder 50:00
I love, I just love the theme, like coming back to in the right context, we do just fine, yeah, and that’s that that goes for ADHD, years that goes for autistic folks. It’s like, when you’re well supported, when you’re doing something that you love to do. I’m talking about like my experience of ADHD, yeah, when I have medication support, when I feel safe, and when I am doing something that I like to do, let’s just say, like, this space right here. Like, I am focused, I am on, I am like, so present, and my brain is not wandering, and I don’t feel like there’s squirrels, like, I’m just like, here. But it’s because it’s the perfect context for me to thrive, right? And so if we can just help people to find what context is right for them and stay in that, obviously we can’t be in there 24/7, but like as much as possible, I just we would all be so much happier.
Dr. Priyanka Rao 50:56
Agreed, totally like the folks who are disabled or disabled because the context they’re in doesn’t work for them. Yeah? And so, like, Yes, you are disabled in that context because the world wasn’t built for that, and so you’re at like, a disadvantage, or certain things are feeling harder for you, sure. And if we change that, if we put you in an environment that was like, sensory friendly for you, if we let you dress in a way that felt good on your body and wasn’t scratchy, itchy, tight, yeah, if we dropped the expectation of eye contact and still thought you were like an awesome social human, like then you you would experience that really differently. You wouldn’t feel disabled in that context. You would feel seen and valid and understood. And so that’s kind of the that’s the heart of what like being neuro diversity affirming is, is like helping people see that, yes, things are hard for you. I’m not team like, this is a superpower, because the world makes it really hard. Yeah, and like, just because you’re different doesn’t mean you’re less than or that there’s, like, a huge problem here. We just need to help you build your life so that it works better for you, so you don’t get burnt out as often, or so that you don’t feel like totally overwhelmed and drained in certain contexts, and you give yourself permission to do the things that are helpful. Because I think that is where a lot of us huge struggle, where, like, we should be able to, I don’t know, remember what to do without having to write it down immediately upon doing it, we should be able to, like, for me, the example I love using with my clients is, like, around medication. I have an alarm on my phone for medication. It’s in the same spot of my house, so in theory, I should take it same time every day when I’m there. And I have learned that I cannot turn off that alarm until that medicine is in my body. Oh, I cannot turn it off as I’m heading up the stairs to get the medicine. I’ve got to wait till it’s in my body, because if I turn it off at the bottom of the bottom of the stairs, I’ll forget by the time I get to the top. And you always say this, and I fucking love it, and I started using it with my clients. So thank you. The drama, the drama around I should have been able to do that. I should have been able to remember. I should have insert anything here like that is where all the distress comes from. But if I lean into like, no, that should be hard for me. So I should just snooze the alarm for two hours until I can take my med. It drops all the drama. I don’t have to feel shitty about it, and now I’ve got the supports I need to, like, be able to do the shit I need to do. So good, yeah. Oh, so thank you for that, because a lot of my clients have heard that drama
Kristen Carder 53:13
line before we go. I absolutely want to ask you, tell me about the experience of being an Indian woman with ADHD, yeah, if you don’t mind and why it’s so important to you to be really, like, multi culturally affirming in your practice. Do you mind talking about that for a little bit? Totally.
Dr. Priyanka Rao 53:33
Okay, okay, so Indians are not super well known for their mental health literacy. I remember early on, when I was in like, undergrad studying psychology. No, sorry, this was grad school, so I was becoming a psychologist. There was an Indian family member who, like, could not wrap her head around, like, what that meant, and she asked me if that meant I could read minds to be a psychologist, correct. Oh, bless. And it’s, and it’s not like a ill intentioned question. It was just like, it was like, so discounted. And I remember, like, even my parents, like, talk about, like, freaking out. Your Indian parents tell them, you want to be a psychologist when you go to school. Initially, they were like, What does that even mean? And then they saw the classes I was taking and the neuroscience stuff and the statistics and all that, and then they were like, Oh, this is awesome, yeah. But what they grew up around was that that was all made up. And so there’s a lot of like stigma in a lot of minority communities around, like, what mental health means, and then there’s a lot of like cultural expectations around, like, who do you talk to? What appearances mean? Like, what’s what stays within you, and what is allowed to stay in your family unit, and then what’s allowed to be spoken outside of that. So it’s like a combo of, like, there’s a lot of stigma, and then there’s a lot of, like, just lack of awareness. And so I remember when I told my mom that I had ADHD, she was like, No, you don’t. And I was like, no, but like, I really do. And also, like my brother definitely does. And also I think my dad might, and. So if you’re listening, sorry. But she was like, There’s no way, like you’re a good student and you’ve got your shit together. Like, how could you possibly and it’s just because, like, a lack of awareness around what that means. And that happened like for me too, where I remember, when I got tested, I had that computerized, I don’t know if you had to do one of those, but yeah, the computerized test, the continuous performance test, performance test, so they show you like, shapes or numbers, and you have to click every time you see it. It is the worst fucking thing in the world, but it’s effective in helping you figure out what your attention problems are. And I took that and I was like, I nailed that. They’re gonna tell me that I don’t have ADHD, that I’m being dramatic, that I should nail that like I crushed that. There’s no way that that’s going to show ADHD. And I went to my results session, and the feedback was, I was in the 99th percentile for hyperactivity. Oh, you got an A. I got an A. And so it was, again, like, just so many misconceptions and lack of awareness. And so, um, yeah, I think, like, that’s part of being in that community. And then there’s not a lot of models around, like, how to talk about mental health related things and so and that ADHD like misconception, the autism misconception, is like, global, and then it just gets tightened with the cultural factors that makes sense. So being culturally, like, inclusive and affirming means understanding that the American, white way of doing things is not the only way of interpreting information, the only way of having boundaries, the only way of doing like engaging with mental health care. And I think, like the field has gotten a little wonky around the concept of cultural competence, because I think, like all of us have cultural competence requirements in our licensure exams and in for our continuing education credits. But like, how the hell are you ever going to be competent in another like that implies an end destination to
Kristen Carder 56:50
me, like I am officially competent. I did
Dr. Priyanka Rao 56:53
it. I know all the things about all the people, yes, and then I think some people also lean too far into like, asking questions like, teach me and like, it’s not a minority person’s job to teach you, but you can ask questions within appropriate boundaries. You want to put all the label on them so culture inclusive care means like, recognizing that people have different contexts, asking them what’s important to them, asking them what their values are, and then not judging them if they’re problematic or great based on our cultural norms? Yeah, here huge. So you see this a lot with like, Indian and other Asian families, like, boundaries are going to look different with parents. Expectations around responsibility to your parents are going to look different. That doesn’t then make that pathologizing problem. That means you need to work in that context and help that person find the right like zone for them. So it’s kind of keeping those factors in mind, understanding that like, again, all cultures, all ways of wanting to be, are valid. You’re helping somebody feel good about the life that they’re living, the way they’re living it, versus the way you think you should they should live it, yeah,
Kristen Carder 57:57
oh, it’s so good. That’s really, really helpful to me personally, and I’m curious, actually, you said, before we got rolling that like you’re kind of a magnet for all, like the brown people in your area. And I just like that must be so wonderful for you as the recipient of just being able to support people, but then also, like, for the consumer, for the person going to you, it just must feel different and good. And I just, I just think that’s so beautiful. Thanks.
Dr. Priyanka Rao 58:30
Yeah, I’ve had clients appreciate that they there’s certain, especially the Indian ones, like, there’s certain things that they just don’t have to explain or justify. And the biggest one comes around boundaries with family, because so many therapists will tell them they need to, like, stop responding to their parents, or stop taking care of them in X way, or, like, set better boundaries. And like, yes, that’s probably true in some degree, but not to the degree that that person might imagine. Whereas, like, with me, if you say that, I’m like, okay, cool. So you have to do what your parents said. What are we going to do about that? Like, how do we how do we how do we feel good about that? And so it’s just like, we get to skip some conversations. And, like, there’s a boatload of Indians. I don’t know jack shit about most of them, totally. So, like, yes, I’ve got some baseline understanding. And what I’ll do is I’ll say, like, okay, so this is how I look at this. Is that, like, how you’re looking at it, too, or am I missing something? So it’s some of that, like humility I think is really important around like, Yeah, I know some stuff, and maybe not all the stuff I
Kristen Carder 59:28
just you’re really inspiring me to use more nuance in my own coaching. So I appreciate that you just are even willing to talk about it, because I am one of those people when I talk about relationships and boundaries, that I am very black and white in that area. No pun intended. Why did I even have to say that? I think that it’s really important for me knowing that I coach people from all over the world, you know, and in such different contexts culturally, to be a little bit. More inclusive there. So I just really appreciate you sharing that. That’s awesome. So my dear, how can people work with you? Because I want everyone to know I’m looking right at the camera, making awkward eye contact with you. Like, Priyanka, Dr Rao, she can assess you and like, How amazing would that be? Oh, he’s so great. I want you to like, I want every single listener to just like, find you do the side pack thing and like, 100% get assessed by you. Because I just, I feel such a safety with you that I don’t with everyone where I I really, truly feel like you have you create such a safe environment relationally. So thank you for that, and I can just imagine what that must be like for a client on the other end of that. So how can everyone who’s listening to this podcast work with you? Yeah,
Dr. Priyanka Rao 1:00:54
so if you’re looking for assessment, like the adult ADHD autism assessment that’s through my practice, Asha mental health. So that’s Asha mh.com I am psypact licensed, so what that means is you can look up the map online, but there’s like, a whole slew of states where I can do telehealth assessments. So that would be how to work with me for assessment. Asha mh.com and then I’m also working on building out some like, coaching and support groups for late diagnosed folks through, like, my coaching practice. So that’s Asha coaching.com so I’m working figuring out how to, like, kind of make the space in my calendar for both the assessing and then, like, the support after.
Kristen Carder 1:01:33
And that’s the ADHD struggle, yes, right there.
Dr. Priyanka Rao 1:01:37
What do I work on? First, I totally
Kristen Carder 1:01:39
understand that. Do you work primarily with women, or do you work with men also? I work with men
Dr. Priyanka Rao 1:01:44
also. So I work with all adults. I do think I, like, have a particular specialty area in women, especially on the ADHD side. But I think high maskers in general, ie the folks that have learned to kind of fake it and put all this energy into, like, holding it together and then kind of crash like, that’s been my like, actual specialty zone across genders.
Kristen Carder 1:02:04
I love that. Thank you so much for being here. I appreciate you. It was so fun. We will link all of that in the show notes and just make sure that people can get in touch with you easily. And I truly it. This was so much fun. I really appreciate you. Appreciate you too. A few years ago, I went looking for help. I wanted to find someone to teach me how to feel better about myself and to help me improve my organization, productivity, time management, emotional regulation. You know, all the things that we adults with ADHD struggle with, I couldn’t find anything, so I researched and I studied and I hired coaches and I figured it out, and then I created focused for you. Focused is my monthly coaching membership where I teach educated professional adults how to accept their ADHD brain and hijack their ability to get stuff done. Hundreds of people from all over the world are already benefiting from this program, and I’m confident that you will too go to Ihaveadhd.com/focused for all details.