Kristen Carder 0:05
Kristen, 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 Christine Carter, and you’ve tuned into the I have ADHD podcast. I am medicated, caffeinated, regulated and so ready to roll. Thanks for being here with me today. This is going to be a great conversation. We are getting back to the basics of ADHD. What does it mean to have ADHD? What should we be looking out for? Whether you are a seasoned ADHD vet and you know all of the things, or you’re just kind of exploring the concept of, like, what is this ADHD thing that I keep hearing about because I kind of have been seeing tiktoks that I really resonate with, and it makes me a little bit uncomfortable. This episode is for you. With me today is Dr Marcy Caldwell. She’s a psychologist, a writer, Illustrator, and proud wife and mother in a family full of ADHD with over 20 years of experience, she’s a passionate advocate for those with neurodiverse brains, focusing on helping craft systems and environments that nurture unique strengths. As the founder and the director of the Center for ADHD, one of the nation’s leading ADHD clinics, which, by the way, is right here in Philadelphia. Dr Marcy is committed to making a difference in the lives of those impacted by neurodiversity, a nationally recognized speaker, consultant and educator, Dr Marcy shares her insights with Fortune 500 companies and prestigious publications like The New York Times and HuffPost, championing awareness and advocacy for the ADHD community. She is the perfect guest for us to be talking about all of the fundamental aspects of ADHD. You are going to learn so much from this conversation. I can’t wait to get started. Marcy, thank you so much for being here.

Dr. Marcy Caldwell 2:19
Thank you for having me. It’s a pleasure to be here. So you live in the area. Tell us a little bit about yourself. Yeah. So I’m a clinical psychologist. I’m also the mom of two, two little boys, ages eight and 11. And see what else love to travel. We spend our summers abroad, which is super fun.

Kristen Carder 2:41
What are some of the places that you’ve been so recent years,

Speaker 1 2:44
recent years, we spent two summers in Switzerland, and last summer, we were primarily in France. And we send our kids to camp, and we work while we’re abroad, but we send our kids to day camps, and so they now have friends all over the world. We rent our house out, so it kind of pays for the whole experience. That

Kristen Carder 3:07
is so awesome. Wow. That is total ADHD vibes, by the way. So well, yeah, right. You in your intro, I read that you are from a family full of ADHD ers. Would you mind telling us a little bit about your ADHD experience for yourself? Yeah.

Dr. Marcy Caldwell 3:27
So I started out as a psychologist, thinking, I don’t even know what I was thinking in terms of what I wanted to do exactly. I just wanted to help people, and I was working in college counseling. At the time, I also had a small practice where I was doing assessment, so I was kind of testing adults, and in that practice, I was testing a lot of folks with ADHD. That’s one of the things that people want to get tested, right? And I would often recommend that they go on for therapy. And the thing about that kind of testing back then, it was super extensive, right? It would take 10 to 12 hours. It would tell me their whole life story over and over again. And oftentimes folks would say, I don’t want to have to go through that again, like you now, know all of me, can I just stay here? Um, and eventually, I kind of started to develop this practice that was full of folks with ADHD at the time. I then met my husband, who has ADHD, and I was like, my whole world is about ADHD all of a sudden. And so I, I went out and looked for some more training and and I, you know, went to some conferences. I approached Ari Tuckman to

Kristen Carder 4:52
supervise prior to your own diagnosis.

Dr. Marcy Caldwell 4:55
So I have not been diagnosed,

Kristen Carder 4:59
actually. And. Oh, and sorry, that’s fine. Okay, so your family. ADHD, I

Dr. Marcy Caldwell 5:05
personally, I call myself in the messy middle. I am and I so it’s tricky when you’re a psychologist and this is what you do. I can’t really be tested. I know all of the measures right? There’s kind of no way to objectively assess me. There are things that I very much relate to, and there are things that I don’t relate to, which you know it’s true of anybody with ADHD, and I am definitely not neurotypical. We’ll just go with that, okay? And I am somewhere in the middle in the messiness of it all, and that used to be really uncomfortable for me. And then the truth is, I’ve kind of, I’m okay with it now, right? Like I know how my personal brain works. I know what works for me. I know what I need. I know how to create the systems that work for me. And that’s kind of the important part. That’s often what we’re getting to with the diagnosis, right? The diagnosis is just a step on the path to that so that I can’t get an answer as to, like, where do I fit? Which box do I fit into? Is kind of okay with me now.

Kristen Carder 6:26
I so appreciate you sharing that. And again, I apologize. I made an assumption, but hearing you say that you’re in the messy middle, that there’s really not a place where you would be able to be objectively assessed because of all of your knowledge. I mean, all of that makes so much sense. Yeah, and I completely agree with you that most of the time, the diagnosis is a means to an end. The end being I want to understand myself. I want to know what works for me. I want to make sure that I’m setting myself up for success, that I’m understanding my brain and knowing like, how to proceed in ways that work with my brain and not against it, and so that makes so much sense to me. Yeah,

Dr. Marcy Caldwell 7:13
yeah. It’s been a journey, yeah, as it is for everyone, right? Yeah, absolutely.

Kristen Carder 7:18
So you’ve spent how long working with people with ADHD? You have years and years, yeah, some brands,

Dr. Marcy Caldwell 7:27
I’ve been working with folks with ADHD basically since 2008 Okay, and in a more focused way, since about 2012 and I love it. Why do you love it? I mean that I’m married to a man with ADHD might indicate I love ADHD brains. I love the energy that often comes for the ADHD brain. I love kind of the spontaneity, the creative problem solving and I just, I just find it fun. I also find the process of kind of system engineering really fun, and, you know, and I know that this is often really frustrating for folks, the fact that we have to kind of rebuild systems over and over again, but I also find that kind of fun and and, you know, realizing what we’ve learned in the process and putting together new systems and iterating, I I just think it’s a blast. And, and there is something that works really well with whatever it is. The way that my brain works works really well with folks with ADHD. So

Kristen Carder 8:47
that’s so great. So we’ve done several episodes. As I’ve mentioned already, we’ve done several episodes on the fundamentals of ADHD, but about every 100 episodes, and we’re at, I don’t know, three and change right now, it’s so important, I believe, for us to revisit just the fundamentals. Like, there are a ton of podcast listeners that kind of come in and out and are listening to different episodes, and some of our listeners are starting at the very beginning, like, Oh, I’m just kind of waking up to this, and I’m seeing like, reels or Tiktok that I’m relating to, and that makes me feel a little bit uncomfortable, and I don’t really know what to do. And for better or worse, ADHD is kind of trending right now, and I think there are good things about that and really obnoxious things about that too, but let’s kind of get to some fundamental aspects of ADHD. So I think it’s pretty widely known that, like distractibility, impulsivity, are typical traits of someone with ADHD. What other kinds of things, if we’re talking in terms of adults, what other kinds of symptoms do we need to be aware of when it relates to ADHD?

Dr. Marcy Caldwell 9:59
Yeah. So and I’m so glad that you’re doing this, because I think oftentimes in the ADHD world, we can kind of talk about so many of the far reaches of ADHD, and we often miss that, that basic stuff that is so foundational. And so I really think of ADHD and kind of the core difference of an ADHD brain being regulation based within regulation, right? And so if, and the way I often describe this to folks, is that if you think of a neurotypical brain as being like a mixing board in like a fancy Sound Studio. Okay, right? So you have tons of different switches, but they’re all dimmer switches, and so we can get the just right level of everything right, just enough attention, just enough energy, just enough motivation. So we still have some left for later, but we had just enough to kind of get this task done and all of our brains operating is on this board. So there’s a lot of things on there, including, like the volume of our voice, right? And so a neurotical brain has that with all these dimmer switches, ADHD brain has just as many switches, but they’re on off switches, right? And so they go all in and they go all out, and it’s much harder to kind of balance somewhere in the middle. It’s possible, but it takes a lot of energy, and which is why oftentimes that regulation is easier earlier in the day, yes, when you have some energy to kind of try to balance it somewhere in the middle, then later on the day, when we’ve spent all that energy and it’s like, sorry, I’m all in, or I’m all out, that’s that’s where you’re Gonna get me. Um, so this creates these kind of all in all out experiences across the board. And so that can be about the motion, yes, it can be attention and energy level, but it can also be, as I said, the volume of your voice, right? Like this is a typical one that we get a lot with kids that kids with ADHD get in trouble in class because they’re like, they’re whispering, but they can’t whisper. I actually had this with my husband just this morning. I was like, Yeah, we’re talking about something with my son. And I was like, Can you keep your voice down?

Kristen Carder 12:37
He’s like, he’s like, around

Dr. Marcy Caldwell 12:42
so you know, everything that our brain does needs to be regulated, and so that’s really the core difference. Yes, we see it the most with attention. We see it the most with hyperactivity, but it’s going to be all the things and and it’s going to be this kind of all in, all out sensation.

Kristen Carder 13:01
I don’t think I’ve ever heard it explained better, thanks, which is a huge compliment, because I’ve heard it explained 100,000 times, and so kudos to you for that analogy, because that makes complete sense. I fully understand the concept of a neurotypical having the ability to, kind of, and I can see the sound mixing board in my brain, and having the ability to kind of AMP up a little bit and then pull back a little bit, whereas for an ADHD or it’s on or off, and that is my the experience of my life. I’m either on and and when I’m on, it is like, feels good, but I can immediately feel the switch off. And there is a very distinct difference between Kristen Carter sitting in this podcast studio being on, and Kristen Carter sitting on the couch with the messy bun and the like the hood over my head, my my husband calls it a cone head, because I have, like, the big, huge bun of hair, and then I have the hood over top. I, like, pull it over my head, and I’m just like, nobody talk to me. I’m off. Like, it’s just like, I’ve spent it for the day. I have nothing left. So sorry. No more to give. Yep. Yeah, dang. So how does regulation, how does the inability to regulate affect a human so Barkley says, Dr Russell Barkley often refers, or referred to ADHD as a disorder of self regulation. And I agree with you. I think that this is just the primary aspect of ADHD, because it’s not necessarily just all attention. It’s not all impulsivity. It’s like the fact that we struggle to regulate that dimmer switch that up and down and moving it appropriately for the appropriate settings. How does that affect an adult, just like a basic adult, what is that. Look like for for us.

Dr. Marcy Caldwell 15:01
So it’s gonna show up in the world in lots of different ways. And it’s part of I think what’s so confusing about ADHD for so many people is that it can be all in and it can be all out, and sometimes it can be somewhere in the middle. And so it is going to show up in different ways, in different settings, in different circumstances, for different people, right? Because some things are going to activate the brain and draw the brain into that kind of all in setting, and some things aren’t. And if there’s enough energy in the system, enough regulatory energy in the system, that’s okay, we can kind of force it, but if there’s not, then too bad it’s not going to happen. And so it’s going to show up as things like procrastination, right? Because ADHD brains tend to be motivated by four things, novelty, competition, interest and pressure. And if something isn’t providing one of those things is not going to kind of turn that brain on right. And so we’re going to have to just wait until time passes and pressure builds up, and then that pressure builds up, and all of a sudden it kind of slips the switch from OFF to ON, from off to on. And now I can go and now I’m going to go hard and I’m going to be all in right, and it’s going to look like a tornado, but I’m probably going to get way more done than I could have that whole time beforehand when my switch was off, right? So that’s one of the things lateness kind of happens in the same sort of way, right? Then enough time passes, and then it’s like, oh, switch turned on, and now I have to go. And now I will go, but I have, but it took a while for that switch to turn on,

Kristen Carder 17:03
get myself to move right before that moment where I realized, if I don’t get my ass off, off the couch right now, I’m gonna get in trouble. Exactly. Yeah, there’s gonna be hell to pay in some way. Yep, yep.

Dr. Marcy Caldwell 17:16
Um, messy houses. Yeah, right, because nothing is there to kind of, so if you think about what’s needed to kind of keep a house in order, right, you have to put the bag where the bag’s supposed to go. You have to put the keys where the keys are supposed to go, right. And in order to do that, I have to have just a little bit of attention running that whole time of like, what do I have on my body? Where is it supposed to go as I walk in the house? And so it’s just a little bit of attention, just a little bit of memory, right? And when I’m saying just a little we’re talking about regulation. We’re talking about that, that knob being somewhere in between, all in and all out. And so that’s not going to happen, usually, and particularly not with a lot of queuing and a lot of effort. And usually, when the messes are created, it’s usually in the afternoon and evening, right as we’re coming in, and we’re just like throwing our stuff all over the house. That’s when the mess gets created after

Kristen Carder 18:24
a long day of work, or a long day of school, or long day of self regulating and keeping things in order in places where there’s more accountability, maybe, like, there’s more there’s more eyes on you at work, yep, so maybe you’re working a little bit harder because you feel the eyes on you. Or there’s, like, actual consequences if you don’t, you know, do it right? Yep. And then you get home, and it’s your safe place, and you’re just like, yeah, I struggle to even take my stuff out of the car. When I get home, I pull into the garage if I don’t get stuck in the garage, which I usually do right on my phone, or just like, trying to get myself to transition from the car to the home, because now I’m I’m switching off, like, work, Mom work person mode, professional person mode, into like, what I call second shift, which is like my mom mode right now. I’m like, the Uber and I’m the cook and the chef, and then clean whatever. So I get stuck in my car, but then I even struggle, like it is such a Herculean effort for me to just even grab my work bag, my lunch box, just to, like, bring it back into the house, let alone put it

away. Like, when I get home, maybe they make me do it, yeah? I just want to plop it,

Dr. Marcy Caldwell 19:40
yeah, yeah,

Kristen Carder 19:43
yes. I feel it. I feel it because by that time my switch is off,

Dr. Marcy Caldwell 19:47
yeah. And the other thing that’s coming into play there too, is an initiation hurdle, yes, right? Because you stopped, you got in the car and you stopped moving if you walk. From the studio to your house, and walked in the house, you probably wouldn’t feel as much struggle with it, right? That’s so true, because you didn’t stop the stopping in mobile I’m sitting in my car, and then you have to go again. And that initiation hurdle is a hurdle that requires more energy to get over than it would to just kind of walk through it if it weren’t there, right? And this is another one of those things that’s so frustrating to folks, because it’s like, why is this so hard? Why is it so hard for me to get out of the car? Like it’s just getting out of the car because, because there’s initi, there’s a hurdle in front of you, and that hurdle is hard to get over, particularly the longer the day goes on, and the more that you had to expend your energy resources during the day and so forth.

Kristen Carder 20:53
And also for me, like when my kids were younger, like what I anticipate the chaos being like, inside of my home, yeah? Like, I would rather just

sit and

not go into the chaos that I know is about to ensue. Yeah. Task initiation is one of those symptoms of ADHD that I think is not very well known. I’m gonna read some of what I believe to be like the most well known symptoms of ADHD. And then I’m going to ask you to add anything to that. So obviously, and this is from my website. I have adhd.com I compiled it from a bunch of different psychologists that I talked to about the ADHD symptoms. So impulsivity, distractibility, restlessness, like this, internal Chugga, chugga, chugga, whether it is externalized, hyperactively or not, maybe I’m just keeping it to an internal thing, the chase for dopamine. So like wanting the novel, the new, the exciting, working memory issues that include like time blindness. Like time blindness, I think, is just a huge one, and a huge way that people who maybe don’t identify as being ADHD can kind of clock like, Hmm, maybe there’s something more going on here. Emotional regulation, poor working memory, struggle with self reflection and so like making the same mistakes over and over and over difficulty with priors, prioritization and organization and planning, like that cluster group. And then what you just talked about like initiation, task initiation, and then on the other end of that completion, what would you add to that? Are there any that are kind of like, either missing or like little known symptoms that maybe the lay person wouldn’t even know about. So

Dr. Marcy Caldwell 22:48
this is a pretty comprehensive list. I think one thing that I might add in there is this masking, and maybe that’s not quite as symptom, but what if we’re talking about, kind of the ADHD experience? I think we always have to be, kind of be talking about masking, and which, you know, for those that don’t know, is really just this, this feeling, and often need, like, very real need to pretend as if, and the reason why I’m noting it is that I think that is a huge part of what drains that regulatory battery, and is part of what makes it so much harder in the afternoon and evening, because it’s a pretending throughout your

Kristen Carder 23:40
day. You describe that a little bit, pretending to what?

Dr. Marcy Caldwell 23:45
Pretending to be neurotypical. Yeah, that’s

Kristen Carder 23:46
exactly it. That’s so true. Pretending,

Dr. Marcy Caldwell 23:49
pretending to have it together, yeah, pretending to not want to interrupt all the time, pretending to, you know, be able to see time, pretending to show up places where you’re you know when and how you’re supposed to show up, as

Kristen Carder 24:06
it’s not hard, yeah, exactly. Like, as if, like, I’m just like, you walked in here. Yeah, I’m on a health kick right now, and my kids are so annoyed at me. I’ve changed the type of rice and pasta and bread that we eat at home. I’ve even eliminated all breakfast cereals from the house. No more Captain Crunch or cinnamon toast crunch to be found in the Carter home. It’s a true ADHD hyper focus for me right now. But one thing that I’ve stuck with, and I don’t think I’ll ever stop taking, is ag one i Kristen Carter, an adult with ADHD have been able to be consistent with taking ag one every single day for a long time. It’s the first thing I do when I wake up the morning, before coffee, before anything. It literally takes me about 60 to 90 seconds to just scoop it into some cold water, shake it up and drink it. It really is so easy. It, and I’m traveling with my family to Indiana for the holidays. Will be staying in hotel, eating out for a lot of our meals, and generally partaking in lots of non healthy activities, which is fine, because balance. You know what I’m saying, and I know that I can stay consistent with ag one thanks to their travel packs. I’m just going to pop six travel packs into my shaker, slip that baby into my travel bag, and done. It’s so simple I don’t even have to think about it. So I encourage you this new year, if you want to do one thing to improve your health as an adult with ADHD, try aging one for yourself. It’s the perfect time to start a new healthy habit, and that’s why I’ve been partnering with aging one for so long. And listen to this. AG, one is offering new subscribers a free $76 gift. When you sign up, you’ll get a welcome kit, a bottle of d3, k2, and five free travel packs, just like I’m going to be using over the holidays. You’ll get all of that in your first box. So make sure to check out drink. AG, one.com/i have ADHD to get this offer that’s drink. AG, one.com/i have ADHD to start your new year on a healthier note. For me, one of the most draining things is like pretending to be interested in something that I’m not interested in. Yeah, so like, smiling and nodding. I was in a meeting the other day for my company, and there’s like, a couple people involved, and this woman was doing a presentation. I was just like, I do not I don’t care. I do not care. And it drained by the end of that meeting. I was like, not able to function. I had a meeting right after, and I canceled it. I was like, I’m out. I am my brain is no longer available.

Dr. Marcy Caldwell 26:45
Yeah, yeah, yeah. And I think that actually gets to another important one, is that for folks with ADHD, there’s a very narrow band of what I call optimal simulation. So all, as Ari always says, right, like ADHD doesn’t invent any new problems. This is true for all folks that that we have a band of optimal simulation where we work our best, right, where there’s enough going on we’re interested and engaged, but not so much that we’re overwhelmed. So everyone has that band. It kind of looks like a normal curve, like a little hump for ADHD brains, it tends to be much more narrow, so that still a hump, but it’s like a very narrow hump, and it tends to happen a little higher up on on the scale, right? So it tends to require more stimulation and but it’s a very narrow thing before it flips over into too much simulation,

Kristen Carder 27:43
and you never know, yeah, when that’s just gonna go a little bit too far? Yeah?

Dr. Marcy Caldwell 27:48
So that, that tendency to feel really bored, and that boredom to actually be painful. And when we see, we see fMRI scans, that boredom actually does light up pain centers for ADHD brains, wait, say it again. That’s so important, yeah, so fMRI scans show that lack of stimulation actually does initiate the same sort of brain and, you know, and we have to be careful, because just because we see something on a brain scan doesn’t mean that it functions in the exact same way that we think it does, but we are presuming that, because it’s lighting up the same kind of pain centers the it is actually painful for an ADHD brain to be bored. Okay, can

Kristen Carder 28:33
we pause just for a second? Yeah, that is so validating. I lead a very large community of people with ADHD. And we talk about boredom a lot. And we talk about, I always say, and this is maybe taking it too far, but I always say, it feels like death. It feels like death in my body, like I have got to get out of the situation or I’m going to die like it. I feel physical pain with boredom. And so the fact that that is seen on fMRI imaging is so validating, because I actually I did not know that I’m so appreciative of that information. Yeah,

Dr. Marcy Caldwell 29:10
wow. And then on the flip side of that is overstimulation, right? And that’s one thing that wasn’t on that list, is that ADHD brains tend to have this kind of filterless sensory processing with that doesn’t kind of keep out extraneous information. I often like to think of it as like, the difference between like a VIP dance club and like Coachella. It’s like all the things are coming in, some of that’s fantastic, and can lead to a really cool vibe. And it also means that it can get rained out, and, you know, be a mud fast, right? And so people with ADHD tend to get very over. Are stimulated by certain things, like really loud, sudden noises can be really, really painful. My husband responds really viscerally and negatively to the dog barking and and a baby crying, right? Like all those kinds of noises can be really painful. Tags, right, any kind of sensory information for a neurotypical brain, often, it’ll experience that, for sure, but it’ll attenuate to it, and it’ll kind of normalize it is attenuate, so it’ll so for example, wearing a watch, right? When you put a watch on, you feel it at first, and then a couple of minutes later you stop feeling it. Yeah. First of all, for some folks with ADHD, they never stop feeling it right. And so

Kristen Carder 30:54
it’s like your body is saying to you constantly, you’re wearing a watch, you’re wearing a watch, you’re wearing a watch. And then multiply that by everything you’re wearing, everything you’re hearing, everything you’re seeing, everything you’re touching, everything you’re experiencing your body’s like, this is happening. This is happening instead of kind of blocking out. It’s almost like a mute button that’s missing, Yep,

Dr. Marcy Caldwell 31:12
exactly. And that then puts our sensory system into overdrive, right? And why is our sensory system there to protect us? So a sensory system that goes into overdrive kicks off that fight or flight response, and so an ADHD brain is much more likely to kind of kick over into that, that that kind of extreme fight or flight, because it’s often already almost there, wow, right? And it doesn’t take very much, and this is part of what happens with emotional regulation for folks, is it doesn’t take much to flip that over, right? When you’re already kind of at your max, because you’re just being bombarded by all the sensory information, and it’s not getting muted, it’s not kind of getting pushed away. Then what else are you gonna do? Wow. Gosh, that

Kristen Carder 32:13
is fascinating. And again, it feels really validating to hear you saying it because it it puts language. It puts words to the experience, to my own personal experience, of like it just feels like everything is a lot, yeah? Just feels like everything is a lot, yeah. So let’s transition a little bit here, and I would just love for you to take a minute or two to talk about, is there any difference in the way that women display ADHD symptoms? We know that women are typically diagnosed later in life. The last stat that I heard, and maybe you have some updates on this, but the last set that I heard was the median age for women being diagnosed female diagnosis is 38 which is pretty late. Yeah, I was lucky enough to be diagnosed early, at 21 so like, that’s really early for a woman, and I’m so grateful for that. But what are some of the key characteristics or qualities of ADHD symptoms displaying in women?

Dr. Marcy Caldwell 33:30
So, yeah, so women and girls do tend to manifest ADHD differently. That doesn’t mean they always all

Kristen Carder 33:37
the time. Yeah, every person,

Dr. Marcy Caldwell 33:40
they tend to be more likely to be have an attentive type, less likely to have impulsivity and hyperactivity. They tend to internalize symptoms more, and so what that means is tend to a try to mask them, which tends to show up as a lot of people pleasing perfectionism, and also leads to a lot of shame, right? Um, and, and, and that is then amplified by the later diagnosis, because the longer you go without understanding what makes you different, just the way our psychology is built as humans, when we are different, because that is not optimal for kind of survival and evolution, we then assume that we’re wrong and that we’re Bad, right? And so the longer you go without knowing why you’re different and how you’re different, the longer you go with this internal belief of, I’m wrong, I’m bad. And the longer you go, the harder it is to shake. So we see more symptoms. Symptoms of anxiety, depression, eating disorders and self mutilation, self harm, all kinds of things happen for women, in part because of this later diagnosis and this kind of internalized shame. Also have to think that, what do we expect for women, we expect them to show up. We expect them to handle social situations gracefully, right? We expect them to, you know, make phone calls and and bring over quiches, maybe not Keisha. Think about birthdays and, you know, and keep a clean house and stay organized and send in the permission slips and like do all these things that are all executive functioning nightmares. And so we have this very high expectation for women, and that’s hard for any woman to maintain. But then when executive functionally that is extra challenging, it really kind of creates this like, Well, who am I? What good am I? And how you know, how do I relate to this label of woman, even, let alone woman with ADHD. So it creates this very tricky identity issue. And the other thing that I see with kind of a late diagnosis is a lot of grief comes along with it, right of, kind of like what could have been if only I had known and and, you know, almost all of the women in my practice that have a late diagnosis, this is a big part of what we work on. It’s a like, what could have been, you know, what degrees could I have gotten? What, what pursuits could I have followed? You know, who would I have been if I didn’t have to feel like I was broken this whole time.

Kristen Carder 37:05
It makes me think of like our mothers, our grandmothers, our great grandmothers, who were never privy to a diagnosis. I mean, it obviously runs in families. I am positive that it’s in my family. And just thinking of the generations of women, excuse me, that came before me that just never had the luxury, the privilege of a diagnosis. And when, when I talk about diagnosis on this platform, I’m always so adamant that being diagnosed is such a privilege. Like, yes, there’s a lot that can come with that, and it can be hard to kind of grapple with, but to even have that information is like, gosh, we’re so lucky. Like, I feel so lucky to know this about myself. Because prior to this understanding, I just thought I was a bad person. I just thought I just like, I just couldn’t get it right. And even, to be honest with you, the diagnosis didn’t change that, because my doctor didn’t tell me anything about ADHD, really. So it took me learning about ADHD and the symptoms, and then being like, Excuse me, everything that I hate about myself is actually related somehow to ADHD, so maybe it’s not me. Maybe if I get a handle on these symptoms, I can, I can stop hating myself. Yeah, and that like to speak about the journey of the female ADHD experience. It is so it is a roller coaster, but it can be so healing to just know that about yourself. Yeah,

Dr. Marcy Caldwell 38:41
yeah. I’ve, I have, in recent years, been kind of tracking the progression of folks, kind of through their diagnosis and kind of their identity in relationship to the diagnosis. And we’ve been doing this in the practice, and we have kind of developed a model of what, how people kind of go through that journey. And, of course, it’s ADHD, so it’s not, it’s not linear, and people kind of move in and out of of the processes, but that, that oftentimes, you know, we come to a diagnosis, not knowing, right, and kind of thinking like I’m just like everybody else, the things that are different about me are bad, right, and are about who I am as a person, and then a diagnosis kind of pops that bubble. It’s kind of hard to go back to that stage, though, we can do all kinds of crazy things in our heads so we can and and then it kind of becomes a like, oh, there’s something wrong with me. There’s like, a problem, right? It’s been identified. Let’s fix it. And there’s a lot of energy in that. I. And this is when people tend to come into treatment and

Kristen Carder 40:02
they’re kind of like, Come on, let’s do it, yeah,

Dr. Marcy Caldwell 40:06
which is great. And like, harnessing that energy is fantastic. But within that is also like, there’s something wrong with me, right? And then there tends to be a stage where people go into kind of a depression, right? Of a like, there’s something wrong with me, and it’s not going away. Like, I tried a whole bunch of things and, yeah, this hurts, and I did all the things all the experts told me to do, and I’m

Kristen Carder 40:35
still didn’t fix me growing up, yeah, yeah, yeah.

Dr. Marcy Caldwell 40:39
I’m still showing up in the world in the same way, and and people tend to get really low at that point. And at some point, people tend to move out of that, and often it’s because of community, yes, and they start to kind of learn more people that have ADHD, they maybe do a lot, even more education. They get involved in a community like yours, or they go to an ADHD conference or something like that. And then they’re like, Oh, it is. She’s really cool. Yeah, right? I like these people. This is my tribe, right? And they can get very excited and and this is where some, like, toxic positivity can come in too. And, but it’s kind of a like, ADHD is amazing, right? And, and there’s a lot of great stuff in that, in that stage as well. And then we see kind of people move into this. Like, yes, I have ADHD. It gives, you know, some real challenges. There are also some things that I really love about it. And everybody on the street also has things that are challenging and that are wonderful. And like, how can we work together, right? How can I help you with your challenge? How can you help me with my challenge? People tend to be more willing to kind of walk into places and say, like, this is what I need. Yes, here’s what I have to offer. Right? With equal confidence in both of those things. And so we’ve seen people kind of make this progression. I got us off on us.

Kristen Carder 42:22
I absolutely love it. And I think that’s so helpful to the listener, to hear like, where do you find yourself in that progression? I think would be a really interesting question to ask, like, are you at the very beginning where you’re like, oh my gosh, there’s a problem. Are you at the kind of the toxic positivity where you’re like, Hey, she’s my superpower, like, where, where do you find yourself? Hopefully, no matter how long it takes, it ends with some sort of, like, acceptance, like I am a full person. I am flawed and I’m amazing. There are great things and terrible things about me, just like there are with every other person on the planet. And this is the challenge that I am facing. So what are the tools that I use exactly to help? Yeah, that’s so good. So we can’t have a podcast about, like, the fundamentals of ADHD without talking about some of the myths. And I love to ask this question, like, what are the most annoying myths to you, like, what are the ones that just like, grind your gears that you roll your eyes at that you’re just like, oh my gosh, these people are so annoying. Maybe you don’t identify as someone who loves to call people annoying, but as someone with ADHD, my on switch turns on, and I get annoyed immediately, and so I’m, like, scrolling on social media, or I’m reading the latest ADHD news, and sometimes it’s great, and sometimes I’m just like, oh my word. So what are some of the like myths that annoy you the most?

Dr. Marcy Caldwell 43:52
So everybody has ADHD is a big one.

Kristen Carder 44:00
I mean, everyone’s a little. ADHD, right? Yeah, like we all, we are little bit. ADHD,

Dr. Marcy Caldwell 44:07
no, we’re not.

Kristen Carder 44:10
We’re not.

Dr. Marcy Caldwell 44:12
I get where, you know, every myth has an origin story, right? Like, I get where that comes from, and it comes from as I was saying, what Ari always says, right? ADHD doesn’t invent new problems. So yes, we all have problems with the things that folks with ADHD have bigger problems with. It’s the extent of the problem and the larger constellation of the problem, right, and the universality of the problem. So that’s a big one. I think also the like, it’s taken on a new tone lately, which is the like, well, everyone has ADHD now,

Kristen Carder 44:48
oh, right. Like, it’s a new phenomenon, yeah, it’s overly diagnosed, right?

Dr. Marcy Caldwell 44:53
Yeah, which I think is particularly pernicious because it calls into question. In anybody who has ADHD and again, that has a real origin story, there has been an increase in diagnosis because there’s an increase in awareness right there is still statistically an under diagnosis, particularly in populations like women and girls and African American populations and there, there are lots of kind of pockets where it is still very much under diagnosed. Are there pockets of the world where it might be over diagnosed? Probably, yeah, and but the thing is that the more we talk about it, the more people are like, huh, that sounds a little like me. Maybe I’ll go see if this, if this fits, it, is a spectrum, right? And human beings exist on a spectrum where we draw the line is a somewhat arbitrary and b a little muddy, and so that’s where that possible over diagnosis might happen, is in that kind of muddy, messy middle, and that’s, that’s okay, that’s, that’s part of the that’s part of life, that’s part of diagnosis, that’s just kind of what happens. But we don’t want to have all the people that are being under diagnosed not be able to access that, just because there might be a couple people that are in that messy middle, that maybe are on one side of the line, but we’re calling on the other right. And so all of that talk just kind of leads into an under diagnosis and a stigma. I think that really is unfair for a lot of people. The other thing that I’ll say about that is that So Margaret Sibley is research out of University of Washington that looked at ADHD across a lifespan, right? And this was really new, really exciting research, because it looked at folks from birth, maybe not quite birth, like five or six, sure, early childhood, and they’re still following them, and it’s been, don’t quote me on this, like, 30 years. Okay, there are adults now, yeah. And so we have this kind of research, this longitude of research. Usually we do test them once at the beginning and once at the end. This time they tested all along the way, and what they found was that ADHD persists through life and but that it persists in this kind of waxing and waning sort of way, and that tends to the symptoms tend to increase around major Life changes. Well, guess what happened five years ago? Every single person had a major life event, right? So that we have this huge surge in diagnosis is also in part due to that, yes, that normally, our major life events are all happening at different times, right? And so, you know, somebody’s having kind of a surge in symptoms and being like, Oh, this is really hard. I need to go figure out what’s going on at a different time than somebody else. But in 2020 everybody had the exact same thing happen that caused everyone to go into crisis and everyone to come get diagnosed. So I do think that that needs to kind of be factored in when we’re talking about this increase in diagnosis, because it’s a very real thing that happened, and it did result in a whole bunch more diagnoses.

Kristen Carder 48:54
Absolutely, I’m so glad you brought that up, and I want to add to that for the first time maybe ever, we had that, you know, big life event happening for everyone at the same time. And we also had so much access to information, access to medical care via zoom or Skype that we never had had previously. So all of these, like new technology that we have access to, I think made it easier for people to access care, yeah, and get the diagnosis that they that, that they needed. I love that you brought that up, and yet there’s still a segment of the population walking around, you know, thinking that they’re just bad people because they just can’t function the way that everyone else does, and that’s why we record episodes like this, because we want to make sure, first of all, that people with ADHD have a really solid understanding of what it means to have ADHD. So many of us, myself included, were diagnosed gay. Given a prescription and sent on our way. I had no idea what it meant to have ADHD, I believe. I mean, I was a long time ago, and my memory sucks, but I believe it was something like, yep, you have ADHD, and this was before the internet. This was before, so what you’re in there? Like, not before the internet, but before we were googling everything. Do you know what I’m saying? So it was like, late 90s, early 2000s and so I didn’t, I didn’t just go do a Google. It was like, Dr Ned hallowell’s book is what my dad read. And then he was like, Oh my gosh, I have ADHD. And they was like, Kristen, you definitely have ADHD. And I was like, whatever, Dad, you don’t know anything. But I didn’t. I didn’t read the book. I didn’t know what it meant. I didn’t my doctor didn’t tell me anything, and so I spent a decade or more being medicated for ADHD, still struggling, of course, because pills don’t teach skills and they don’t fix everything, thinking like I was so flawed. My character was flawed. I was a selfish person, I guess. I guess I don’t really care about my friends because I don’t remember their birthdays. So that must mean that I don’t care. I guess I’m really narcissistic, because I arrive late everywhere and like, no matter how hard I try, I’m just always late. So I guess that I’m super like, all I can think about is myself, you know, things like that, that I would accuse myself of because I just didn’t know what it meant. And so recording an episode like this is so important. I’m so so grateful to you. Really, thank you for being here. Truly, it’s been a pleasure. Tell me about the work that you do and how people can get in touch with you. So if anyone is listening and they’re like this. Dr, Marcy woman sounds fantastic. I need more of her in my life. How can people find you

Dr. Marcy Caldwell 51:46
Sure? So I have a group practice called the Center for ADHD. You can find us at the Center for adhd.com and if you want to work with us clinically, that’s the spot to go. If you’re looking for kind of more of my writing and kind of thinking on things. I have a blog called adapt.org That’s add E, P, t.org, and I have a digital course as well for emotional regulation for ADHD and yeah, and then I’m around speaking and so forth, and have a book coming out sometime, hopefully,

Kristen Carder 52:23
sometime, hopefully, oh my gosh, that is so real. I love it. We’ll link all of that in the show notes, so anybody listening or watching on YouTube all of that will be there in the show notes. I so appreciate you. Thanks for being here. This is great.

Dr. Marcy Caldwell 52:36
Thanks for having me. It’s been fun.

Kristen Carder 52:40
If you’re being treated for your ADHD, but you still don’t feel like you’re reaching your potential, you’ve got to join focus. It’s my monthly coaching membership where I teach you how to tame your wild thoughts and create the life that you’ve always wanted, no matter what season of life you’re in or where you are in the world. Focused is for you. All. Materials and call recordings are stored in the site for you to access at your convenience. Go to I have adhd.com/focused, for all the info you.