About the Hosts

Christy Wilkie provides therapy for children and adolescents, ages 5-25, who have complex behavioral health issues. She combines her extensive clinical expertise with a belief in kids, and has a unique ability to find and develop their strengths. She works hard to be an ideal therapist for her clients, doing what is best to fit their needs.

Lucas Mitzel provides therapy for children, adolescents, and adults, ages 5 - 30. He believes building relationships with clients is the most important piece of successful therapy. He loves what he does because it allows him to walk next to people he would never have met had he chosen a different profession, as they work to make amazing life changes. He has the honor of meeting people at their worst, all while watching them grow into the people they’ve always wanted to be.

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Transcript
Exploring ADHD

Featuring Christy Wilkie, LCSW, and Lucas Mitzel, LCSW, Dakota Family Services

Announcer:

This episode of, is It Just Me, is brought to you by Dakota Family Services, your trusted partner in mental and behavioral health, whether you need in-person or virtual care, the team of professionals at Dakota Family Services is dedicated to supporting children, adolescents, and adults in their journey to better mental health.

Christy:

Disrupting life patterns and life routines that aren't serving you.

Lucas:

It's how we feel that keeps us going.

Christy:

You can be a masterpiece in a work of art all at the same time.

Lucas:

Hey everyone, I'm Lucas.

Christy:

Ans I'm Christy.

Lucas:

And you're listening to the Is It Just Me podcast.

Christy:

Where we aim to provide education, decrease the stigma, and expel some myths around mental health.

Lucas:

Christy, is it just me or does everybody seem to be talking about ADHD lately?

Christy:

It is not just you, it is a hot topic.

Lucas:

Why do you think that is?

Christy:

Well, my experience currently is that TikTok has gotten a lot of people more aware of maybe some symptomology that they just didn't really think of as being a symptom. And they're like, I do that. I do that. Oh my gosh, I must have ADHD. And sometimes it's good and bad, right?   Like sometimes you do, but sometimes you don't.

Lucas:

ADHD talk is huge  right now. And I think it's one of the main subjects that often gets brought into my office of people. Like, I watched a TikTok, I think I have ADHD, what do you think? Yep. And then we explore that. 

Christy:

It is something not at all that way.

Lucas:

Way. Well, so I, I think that there's a lot of misinformation when it comes to ADHD. There's a lot of really good information that people are really well aware of. One thing that I think deserves some clarification that I often see is the confusion between ADD and ADHD. Yes. because it used to be delineated between those two diagnoses, and now it's just kind of smashed into one big diagnosis with different specifiers. And that's clinical talk for things that really don't matter.  

Christy:

 Well, they, they matter. But,

Lucas:

So ADHD is what's considered a neurodevelopmental disorder. And that's where a person is essentially born with this because their brain just developed differently. And there's a bunch of different types of neurodevelopmental disorders such as autism.   is another one. But, so this usually happens when you're born and you, you see it when they're really young. However, some people can go undiagnosed for quite a while. We'll talk about that a little bit later.

Christy:

It doesn't mean it wasn't always there.   It just means you didn't know about it.

Lucas:

Exactly. And so sometimes it can seem like it just appeared outta nowhere, but that might be because they had skills to manage it. And so it was more hidden.   And then once the stressors, environmental stressors supersede the skill level, you start to notice it a little bit more. Another thing about is that your ADHD can kind of like ebb and flow throughout the day.   It's not just like this constant level of hyperactivity or inattentiveness. It's, it can, I will often say like my ADHD's on fire when it's like a bad, a rough day. And

Christy:

It is. I mean, you can, I can tell that.

Lucas:

Right? Like currently   it, it is. I'm trying currently.

Christy:

Currently Lucas is having a day  It is,

Lucas:

It's been a, it's something guys, but we're making it through.

Christy:

We are, we're gonna do it. What a, what a better day to do a podcast than when you're ADHD is just like

Lucas:

Talking about ADHD, a really big component of ADHD specifically is that the brain has a lack of dopamine.  And what is dopamine? Christy?

Christy:

Dopamine is the stuff that makes you feel good. It's the stuff that makes you enjoy things. It's like, it's a feel good chemical. We talked about, I think in our last podcast we talked about dopamine chasing.   Which is very much that, and I think that's something that people with ADHD who are unmedicated will frequently do. Not that you have any experience

Lucas:

With that. I know nothing about that  

Christy:

 , but they do. 'cause You're, you're, you're trying to make up for the, for the loss of that chemical in your brain by doing things that organically create that. But that often will cause you to do some behaviors sometimes that aren't super helpful.   Or healthy.

Lucas:

Yes.  , stop looking at me like that  .

Christy:

I'm not looking at you like anything.

Lucas:

  So a lot of times people with ADHD, we'll start going into the symptoms here. They'll do something called hyper fixation. And people with ADHD will often have these hobbies that they will super focus on, and they'll be all in 100% of the time. And they, that's like all they can talk about. And then all of a sudden out of nowhere, it just stops.   And they're not interested in it. And maybe they dumped a ton of money in it, or they just collected a bunch of things and then all of a sudden it just sits there for months. Mm-Hmm   And they're onto something new.   There's always something new because they're chasing that dopamine.

Christy:

And I think that often comes across as, 'cause we hear this all the time   Where it's like, well, I can't have a ADHD because I could, I can play video games for eight hours a day.   Or I can go do a puzzle for hours at a time. And that has, I have no problem doing that. And so I think, and the hyper fixation, I think, falls into that too, where it, it can appear that you're just really focusing on something. So if you have the ability to focus on something, that, that must mean that you don't have ADHD. And that's just not the case.

Lucas:

No. Because if you put yourself in a non-preferred activity, I'm guessing it's a lot more difficult to pay attention. Perhaps you're doodling on a notepad or you're fidgeting with your hands, or you're tapping a pencil or making noises with your mouth or having to like get up constantly.   That's what happens.

Christy:

So a lot of people, I mean kids in particular because most adults like aren't in school anymore. But reading tends to be really, really difficult for kids with ADHD because it does require a sustained effort. And so a lot of times kids will just think that they're bad readers and that they're terrible at English when really it's just, it takes a lot if they're not, 'cause we're often told to read books that we're not interested in too when we're in school. And so it's like getting through war and peace is probably a struggle. But like reading something like Harry Potter or whatever somebody's interested in, they can sit and read something for a long time that they're interested in.   But you kind of get this false idea that you're bad at something just because it requires sustained intent, which just isn't true. Your brain just is lacking what it needs to do to do that thing that everybody else's brain just does.

Lucas:

  And how this can look, speaking for myself specifically, is I can read a paragraph and not know anything that was in that paragraph. Then I have to keep rereading it,  maybe like three or four times because I keep getting distracted or my brain starts thinking about something else.   And it is one of the most frustrating things ever, especially when you're trying to like study or   You really want to do well on this reading assignment and you just can't, or you really do just wanna read whatever this thing is   because you need to for work or whatever, and you just, you can't get through it.   And it takes so much longer to get it done.

Christy:

The same I think happens with people when they're binging shows. Like if you're on Netflix and you're watching and all of a sudden you're like, I have no idea what just happened in the last five minutes of this show. I mean, it was on, and you were probably looking at it and watching it, but it just was not going in. And you're like, oh, crap. I have to go back and rewind it over and over and over. Yep. That is typically is a sign that maybe there's a, there's a focus and attention issue.  

Lucas:

So there's three types of ADHD presentations. The first one is inattentive type, second one is hyperactive. And then the third one is combined. Yes. Which is you have both of them and they're having a party.   And so they just smashed it all together. Now it's just ADHD inattentive type or hyperactive type or combined type. I personally have more of the inattentive type. And people with ADHD can have symptoms of both and not fully fall into that.   So you might have some mixture there, but I think it would be beneficial to go through some of the symptoms that we see quite often and how, what that might look like for people.   So for both kids and adults   Because they do look different.

Christy:

They look, they look very different. And for a long time they really thought that it was a, like a child and adolescent problem.   And people weren't looking at adults. They're like, adults can figure it out. And it's like, no. And, and I think that our generation is doing a really great job of bringing some attention to the fact that attention to the fact that's funny.

Lucas:

Oh, that was good.  

Christy:

Unintentional. That maybe that there were struggles this whole time and that life could have been a little bit easier if we just would've known what it was.  

Lucas:

We don't have to do life on hard mode, guys.

Christy:

No, no. Easy mode, please.

Lucas:

Always.

Christy:

Or easier.

Lucas:

Easier mode.   That'd be nice. So the first one we're gonna start with inattention is often fails to give close attention to details or makes careless mistakes. When I am typing something or writing down stuff, I will accidentally misspell words or I'm just going too fast and I like miss a whole letter, or miss a word, or I get things all mixed up maybe.   Or I will, as I'm talking, I might like say the wrong thing or like jumble up my words and it feels really dumb.   when you do it. And it's very easy to judge yourself. And I see kids doing this all the time where they're like, I know the answer.   And if they just slow down, it would be really easy. Or even just playing a game.   Like playing Jenga. They know what the right move was to do, but they were just too fast. And then they made a, a mistake. And they're like so frustrated that they did that because after they do it, they're like, oh, I could have, I knew what to do and I didn't do it.

Christy:

Well, and I think it's important to, to note how you feel when you make mistakes like that. Because I think especially in children, 'cause you're a grown adult-ish kind of sorta, I mean, age-wise,

Lucas:

I'm cosplaying as one.  

Christy:

 Exactly. Look at you. I'm so proud of you.

Lucas:

You can Google what cosplay is later, guys.

Christy:

 That's a whole other issue that you probably do. Do you cosplay?

Lucas:

I don't.

Christy:

That was okay.   That would've been a really good rabbit hole for an ADHD conversation. That would've been any who did. But, when you think about, and I mean Lucas is obviously aware that he has ADHD too, so he's an aware person that he has it and he knows that he is making mistakes and he still feels like an idiot every time he does something. That is a mistake. Now think about if you're a child or you're an adult who doesn't understand that that's what you have. And when people do something wrong, what do people do? They correct it. Or they think that there's a learning disability, or they think that you're just hustling or that you're, you're being careless or lazy or whatever. And it's like those people are so hard on themselves when they make a a mistake that to just be aware that coming down on somebody for making a careless mistake like that is just, that's, it's not helpful.

Lucas:

  Another thing that can happen, and this kind of mixes with some of the other symptoms as well, but people with ADHD are very impulsive.   And so they might impulsively say something that isn't true or a mistake, and then they get called a liar.   And get in a lot of trouble for that, when really it was just an ADHD thing. It was just a mistake.   And if we allow, we have to allow them to, to recover from those things. Yes. Without judgment,

Christy:

Without judgment is the key there.   Impulsivity in general can look like it's something very different.   And we often label it something different.

Lucas:

Another one that gets people really upset or at least annoyed, is that people with ADHD will often seem like they're not listening when they're being spoken directly to kids do this. I've done it to people and I am listening, but it definitely does not look like I am   And it maybe that's because I'm fidgeting, or like if I'm watching a show, I might have something going on on my phone at the same time, but I'm totally paying attention.   It's allowing me to pay attention.

Christy:

I've had full on conversations with you when your face has been in your phone. Absolutely. But I know that you're listening to me because every word I say is important to you.  

Lucas:

Every single, I hang on to every word.

Christy:

But, but, but we know that, I know that about you and I know that about and you're always like, I'm listening. Just so you know. I'm like, I don't care what you do.  The more busy you are, the more I know that you're trying to focus on what I have to say. So that's fine.   But I think it, it is just a misconception that if they're, if they're doing something else, that they're not paying attention, or I get this a lot in my office where kids will come in and I've got, my office is an ADHD, either nightmare or dream. I don't really know.

Lucas:

It really depends, but there's

Christy:

A lot going on in there is what I'm saying. And so I'll have kids come in and they automatically start fidgeting with something and the parents will be like, no, you have to listen. You have to listen to, to what Christy's saying. And I was like, they're listening better when they're doing something than if you're gonna sit there and make them listen to me.   Like, I don't have any problem with them doing that because that's what they're doing in order to engage with me, even though it doesn't look like it.  

Lucas:

I'll often, like, I've a huge bucket of Legos in my office, and that's one of the things that a lot of times kids are drawn to. And I will just ask like, can you hear what I'm saying? And they're like, yep, we're good. I'm like, cool.   So, I mean, I don't care what you're doing as long as you can hear what I'm saying. So just double checking that. Let's not just assume that they can't, but it is, it drives parents nuts.

Christy:

It does. But I mean, there's been studies conducted where they'll take like a group of kids and make them like sit and listen to what, in, in the way that we traditionally think that kids should sit and listen and then, then another group of kids that are just able to play and do whatever, and they're presented the same information. And the, and the kids that are able to play when they're, get the information have better recall. And they have, they do better on like the testing of the information that they're provided, trying to get a kid with ADHD to sit still, then they're, that's all they're focusing on is sitting still and they can't focus on anything else.   But sitting still.

Lucas:

  And it is really hard to sit still when you have ADHD   So another thing people struggle with is that they struggle to follow through with instructions or finishing things.

Christy:

Oh my Gosh. This drives people nuts.

Lucas:

It drives me nuts.   For myself. So I will, some people listening to this could probably relate, but I will start on, let's say, doing the laundry and five minutes into doing the laundry, I'm doing the dishes.  What? I don't know how I got here, but here we are.   Just something clicked in my brain and we had to, now we're doing dishes. Did the laundry get done? No.   It's like half done.   and the reason this happens is that when you are born, when your brain is developing and you have ADHD, you don't have enough white matter in your brain. And white matter is essentially the lubricant between all the neurons that allows for an electrical impulse to travel smoothly.

Christy:

Ah. there's, there's the nerdiness that I was looking for. It always comes. I know. I was just, was waiting for you to drop it.

Lucas:

So if we don't have enough white matter and we don't have that lubricant between the neurons, what can happen is that an impulse can get caught on another neuron and it'll get, it'll fire down something else. And you find yourself doing that thing.  A really funny example that I love to share with my clients is pre medications and treatment for this, I would be doing a note for work.   And all of a sudden, I, I don't even remember it happening. I find myself in the hallway. I don't know what I'm doing in the hallway. And I turn around to go to my note and I'm literally mid-sentence, and I don't know what happened. I don't know how I got here. It was like, I teleported, but I don't know what's going on.   And so then I go back and I'm like, why did I get up? Like there's not even a period. It's like mid thought. And I'm walking down the hallway empty-handed nowhere to go.   I just got up and I moved.

Christy:

I have seen you on a number of occasions be like, oh, I gotta go finish that note. Oh, I gotta go finish that note in the middle of a conversation that we're having. I'm like, okay. Okay. whatever. Whatever you gotta do, bro.    

Lucas:
It just fired.   

Christy:

And it just, it just, it just went. And then I'll see you and let you get your note done. You're like, oh my note.  I gotta do that thing.

Lucas:

There's been many times where I've like been mid-conversation and I'll just leave because something fired in my brain.   And then I'm like, walk halfway walking. I'm like, well, I can't turn around now.      Because that's even more awkward.

Christy:

Well, and so that I, to that point, I talk to a lot of people because with ADHD, multi-tiered instructions are very, very difficult. Very difficult. So you can't be like, I'm gonna clean my go clean your room and put your clothes away and clean your bathroom. Like no. You have to be like, Hey, will you go get that one pair of shoes and bring them down here? Okay. Next thing. Like, because giving anybody a whole bunch of things to do at one time is nearly impossible. We talk about that with school too, with kids that have ADHD instead of giving them a whole worksheet full of things to do, and like a syllabus that has because their brain shuts off. It's like, that's too, that is too many things. Give them one thing at a time.

Lucas:

Yes.

Christy:

And let them experience mastery with the one thing and then move on to the next thing. Yep. Otherwise it's just,

Lucas:

And you have to, there's a balance here because you can't give them multiple steps, but then you also have to kind of break it down. Mm-Hmm. Because they're going to get distracted. Or what happens is, I feel like everybody who has ADHD has the exact same thought process.   But if it seems or feels like it's going to take a long time, the brain's like, no, we're not doing this today. Yes. And or they say, I'll just do it later.   And then they forget.   And this is because we with people with ADHD will avoid or are or dislike activities that require anything that's sustained mental effort.   do we know how long it is going to, like, what the threshold is? No. If it just feels like it's gonna take a while, I don't wanna do it.

Christy:

But You also don't have a really great concept of time. I say, I say you as I'm just talking to you, but people with ADHD don't have a great concept of time. I had a, I had a kid who needed to do end of the year stuff.   And so that one week there seems like there's a lot of things going on. And so he's just, I was like, well, how long do you think it's gonna take you to do this? Like, literally write a paragraph. He goes, three hours. I'm like, why is it gonna write you? Because in his head he's like that. That's how hard it is to me. This is a three hour long problem. It's three hours long hard.

Lucas:

Three hours long, hard.

Christy:

So he was like, I'm like, oh buddy. No. Let's like, let's break that down. Like it's not gonna take you three hours. And in his head though, he was very committed to the bit.

Lucas:

 I've just to prove a point to people who were maybe in a little bit of a denial that they had ADHD. I've asked them that question of like, how long do you think we've been in the office together?   And they're like, like three minutes. I'm like, it's been 20. 

Christy:

Time blindness.

Lucas:

Which leads to a lot of issues for people, like people are late to things with who have ADHD. They will often take on more tasks than they maybe should because, because they think they have enough time to do it.   Kids will get really upset when they're told to get off of a preferred activity because you told them they have 20 minutes and to them that's a million years.   So, and now that it's ending, that was too soon.   

Christy:

And you lied to them.

Lucas:

And you lied to them, even though it's all accurate. So it's just, it's really hard when your brain is distracted by everything or hyper fixated or focused on something to manage time.   It's just this abstract concept that doesn't make any sense.

Christy:

It will make people in your life feel like you're not a priority if you're late to showing up to something, or you, let's say you're going on a date and all of a sudden you weren't supposed to be there at seven and you can't get there till seven 20. I mean, already made a terrible first impression.   And it makes you feel, it makes the other person feel like their time, like you don't care about their time. Do you not care that my life is impacted by how slow you go  And it feels very personal and it's just not  

Lucas:

Other things that they struggle with just briefly. We could talk about there's a lot of symptoms of ADHD   Disorganization, forgetting things. Obviously easily distracted. We've talked about that a bunch. But losing things, I don't know if I said that. I might have just forgot that I said that.

Christy:

Well, forgetting things and losing things are a big one.   because that's, that's also something that people will get mad at people for. It's like you are always forgetting your hockey bag. You are always, we are on your seventh baseball glove. Can you not keep your shoes in your bag? Like, what is wrong with you? That you cannot put everything together in one place and walk out of the locker room with all of your stuff? That is so common.  Or their keys.

Lucas:

Oh my gosh, my keys.

Christy:

We have a colleague that loses their keys all of the time. Yes. Bless her heart. But man, and you know where she found them last time? In her desk.

Lucas:

Oh my gosh.

Christy:

She thought she'd lost them for a week.

Lucas:

They were gone for a week.

Christy:

Well, I think it was about that. That's impressive. Doug is shaking his head because he was a part of this because they had to let her into her office every day. That's amazing. And she was like, they're literally in her office. I love that. In her desk.  

Lucas:

Oh my goodness. I have to put my keys in a very specific location or else I do not know where they went.   And my three-year-old loves to play little tricks on me and take my keys. So I have to put them in a spot where he cannot reach them. And he's huge, by the way. So Yes. There's not very many places I can put it. Same thing though. If I don't put it in that exact same spot, I have no idea where went.

Christy:

And it's frustrating to people who don't understand that you aren't trying to be an idiot. You just, it, your brain literally does not work like that.

Lucas:

  Moving on to the hyperactivity aspect, and this is probably the more well-known symptoms.   It's just, it's more in your face.

Christy:

It's what you commonly think of when you think of ADHD.

Lucas:

This is where we have the hyperactivity part.   So they're fidgeting or tapping their hands or squirming. They get up in situations. They're supposed to be seated. They might run around or climb on things where it's inappropriate and it just, it's almost humorous to watch if you're not, if you can make yourself not frustrated by it. Because they don't even know what they're doing.

Christy:

 No. It's a, I I've always heard it say like, when they, when it looks like, when it feels like they're driven by a motor.   Which that they're going, going, going, going, going, going, going, going up, down, up, down, left   All the way. Oh my gosh. Like bouncing off the walls. I mean, and I think that those are the kids that are more commonly, it's easier to diagnose when they have the hyperactive symptoms because it's like, it's just so in your face.   And, and those kids can also be aggressive verbally and physically. Those are huge things where, you know, they're, a lot of times people just be like, well, that's just a bad kid. Which I don't believe that there are any bad kids.

Lucas:

Nope.

Christy:

But I think that's a common thought is like, ugh, they're just trouble. That kid is just trouble. They're not No. His brain needs help. Help!

Lucas:

 It's kind of dopamine deficiency.    

Christy:

Give him what it needs.

Lucas:

They just, they often get in trouble more often in school. Right?   And so with inattentive type, like it's more internal, and so you can't really see what's going on in the brain. Like   They're distracted, but they, a lot of people can fake that. If I just stare off into space in the general direction of a teacher, they're not gonna know that I'm not paying attention. I'm not, I have no experience doing that, by the way, but somebody with more of the hyperactive aspect is going to blurt out answers, is going to insert themselves in conversations that they shouldn't be doing, is going to be getting up out of their seat when they're supposed to be sitting seating sitting down.

Christy:

Stop making stupid mistakes Lucas

Lucas:

So it's just, it's a lot easier to diagnose that part of it. And it often is the one that gets people in more trouble. Older kids or even adults might even accidentally get into legal trouble.   because of the things they might do, they might impulsively put something in their pocket and then forget about it.  And then now they shoplifted.

Christy:

For example,

Lucas:

For example, or might find themselves speeding when they didn't mean to speed   or saying something inappropriate in a conversation that just impulsively came to their head  'cause they don't have a filter.   It's just, it's more in your face. It's a lot easier to see.

Christy:

Which is why the, the, the inattentive type can go a very long time without being noticed. Because we didn't even talk about procrastination, I don't think. But procrastination is huge in the inattentive type. And, but they'll, they'll get it done. And I think females more often have the inattentive type. And they also are, they tend to be more, they color in the lines more like they know that they have to be good. They can't be loud, they can't, I mean, just societally speaking, those messages are given to girls very differently than they're given to boys. And so they can keep it together. Like they can hold it together all through school. They can perform well in school, but it is taking them so much work and effort and they can procrastinate something to the last minute and put it off and they can, and then they hyperfocus on it.   And they get it done and they hand it in and it's perfect. It's great. It's super well done. So nobody ever notices that there's ever a learning problem because they're getting everything done and they're not, they're not a behavior problem in class. And so it's like, oh, if there's no behavior, then it's fine. They're fine, everything's fine. But it's not fine.

Lucas:

It's not. And like you said, nobody knows that this is going on because in school things are just getting turned in on time. Parents might know about it because they're staying up until 3:00 AM helping them do their homework.   Or if they're a teenager, maybe they're not getting enough sleep that way. But   It is really hard to diagnose the inattentive aspect until you are talking about things, and especially when it's ADHD and anxiety.  That can be really difficult too, because they mirror very similarly. There's a concentration issue when it comes to anxiety. Yep. And when you're, a lot of times, especially the girls that I see who are anxious perfectionists with the ADHD, it goes super unnoticed because they're, like you said, they're coloring in the lines, they're getting everything done. But, and then they have that concentration problem that people just explain away with anxiety, except the anxiety medication and the treatment for anxiety not helping.

Christy:

  I think it, the other thing that I've seen quite a bit is with really smart people, and not even really smart, but like decently smart people, kids can go through high school and it's not ever really challenging enough for all of these symptoms to kind of flourish where you can see them. You know, there's, I mean, if you know that that's what it is, you can pick apart, like going back retrospectively, you're like, oh, I did that. That was probably, that was probably an attention thing. Or that was, I wasn't supposed to be losing stuff all the time.   But then they get into college and it's, there's more demand on their brain, there's more stress, there's more whatever. And then they figure out, it's like, why can I not do this work that always came easily to me. It's like, well, you were able to cope and figure out skills to do that when you were, when there wasn't like a huge stressor. You put a stressor on it or you put more demand on your brain and it's like, ah. It's just like haywire. It's haywire.

Lucas:

 And for people who are really high performing, a lot of times they can develop coping skills to kind of mask  their symptoms. And I have a lot of parents that might come in whose who they experience a lot of the same symptoms their kids did, but they just figured it out in air quotes.  And so why do they need, why can't they just figure it out?   Well, number one, everybody's different.   So just because you had similar symptoms doesn't mean it's the same. But number two, like what if you didn't have to figure it out?   What if we could have just made it better with some medicine? Or figuring out just a little bit of different skills to make it just a little bit easier.

Christy:

Well and people don't realize sometimes either the, the impact that, that having untreated ADHD has on a child specifically because their brain is still developing. You have kids with ADHD they're told, stop, don't quit it. You're bad. All I mean, all of those messages. And so that if you don't treat the ADHD, they start getting these messages that they're, that they're bad. That they, because most of the time kids want adults to like them.   They don't want to not be liked.   And so when they're doing all these things and they're really wanting to please a teacher or please a parent, or please a who, whatever. And they literally can't do it, they start to feel like, why can't I do this thing that everybody else is doing? And that sends so many negative messages about who they are as a person, because they're like, I why am I so bad? And then that can lead to anxiety and depression because it's like, I'm gonna go to school and I'm gonna mess up today. I know it, I know I'm gonna, I know I'm gonna make somebody mad today. I know I'm gonna, I know I'm gonna make my mom mad 'cause I I'm not gonna be able to do the thing that she wants me to do. And that has such a huge impact on self-esteem on mental health. So you have to be really careful about that too.

Lucas:

  And eventually they just stop trying.   Because it's, they just feel like they, there's no other choice.   And when you, it's frustrating for a lot of providers and parents, teachers, whatever, when they talk to kids like, who are struggling with ADHD that's unmedicated or untreated that, 'cause they'll ask, well, why did you do that?   And their answer is always, I don't know.  And it's true.   They don't know why they did that.

Christy:

It seems so defiant.  

Lucas:

It's not, I don't know why I got off my computer and walked down the hallway. I just did.  So it's just impulsive   and there's no reason behind it. I think when we talk about impulsivity, I often like to think of a, that we're all born with like these filters, right?   So we all have these thoughts, ideas, these things that we maybe wanna say these urges.   And a normal brain has a pretty good filter that stops some of those things from going out or like checks it before it leaves the brain   And comes out of your mouth. Or is like your hands or feet or whatever.  People with ADHD don't have that.   It's, in some cases it seems like it's just gone. And in other places it's just a bigger strainer. So like more things can kind of just like come out. I know that when I am unmedicated, like if I forgot my meds one day which nobody wants that by the way. No. I, I can get myself in trouble sometimes. Or I'll say things and Christy's like, you need nope, stop talking, stop talking right now.

Christy:

This is a no-mad day in this.

Lucas:

Yeah, no, you just need to be quiet.

Christy:

We gotta use your skills today, boy,

Lucas:

Christy:

Or keep your mouth shut

Lucas:

And it's, I'll say something, I'll be like, I can see it leave my mouth. And I'm like trying to take it back immediately as it as it leaves. But I don't have necessarily a reason that I said it, it just kind of came out.   And I think that we need to be really patient with, especially kids, but ourselves and other adults who we know maybe are struggling with this because it's not their fault. If they could choose to just not have these issues. they would've done it. 'cause Nobody wants to get in trouble. Nobody wants to do bad. No.

Christy:

But it, like you said, it's sometimes it's just easier to, to give up. And I say this a million times to people where it's like, sometimes it's easier to not try and fail than it's to try really hard and still fail. And so people just be like, I, I keep trying. I keep trying, I keep trying, but then I keep failing doing all these things. So then it's like I'm gonna convince myself that I don't care because it's embarrassing.

Lucas:

It can be super embarrassing.   Especially when you don't understand what's going on. Even when I do understand what's going on and I can tell that my ADHD like impacted something or made I get embarrassed.   By that. Like if I said something that I wouldn't have liked to say or said it in a way I didn't want say like, I feel really bad about that.   Even though I know I understand it and I know that what happened or whatever. So to not understand it and have those experiences is really, really hard. Especially when you're getting in trouble for it from teachers or from other family members or it's harming relationships, that sort of a thing.

Christy:

  So we talk about like ADHD and anxiety kind of mirroring each other. We kind of put a foot in there. What does that mean to you? Because for a long time, I'm, this is just the Lucas show today, but like for a long time you just thought you were really, really anxious.   And I'm not saying that you're not anxious, but

Lucas:

I definitely am.

Christy:

That is the thing. But, but, but ADHD figuring out that that was in that was maybe contributing to the anxiety was kind of a game changer for you.

Lucas:

It was huge. I realized that my thoughts were running really, really fast and I was having, they were just really fast thoughts with an anxious theme.  And I noticed that as I was learning more and more about ADHD and diagnosing people with it. And talking to a bunch of people who have ADHD, I'm like you're describing me.  This is why therapists also need therapistsBecause we're not, we not as necessarily insightful towards our own stuff.

Christy:

Not at all.

Lucas:

Actually,  it's way easier to help other people than it is to help ourselves. But yeah, when I started noticing that, like I was getting up and walking out randomly or I was like, man, I go, I have to like go and get a drink of water. Really? Like a lot.   Or one thing I noticed is that when I drink coffee or I have caffeine, I don't get hyper. I get tired.  And for people who don't know, one of the primary treatments for ADHD is a stimulant, which seems very backwards because we're taking somebody who's hyperactive and giving them something that's gonna make them hyperactive. But in very, like, in layman's terms, what it kind of does is it makes the brain go too hyper. And then, like I call it an emergency break gets pulled and then it calms 'em down. I'm sure if our psychiatrist is reading is listening to this, he's gonna be like, oh my gosh, that was not how it actually works.  But I'm sorry Dr. Martinsen.

Christy:

 But I talk a lot about, you know, I wish you could see my hands, but a normal brain functions at like a normal, like a normal stimulate rate.     And people with ADHD are below that. And so what they're doing is they're trying to get their brain up to where everybody else is functioning. And when their brain doesn't do that, naturally, they're using everything around them to get to this point. So they're like, the movement in the stimulation that you're, that they're creating is what's helping them get to the point where they're able to focus.   And so that's when like all the movement and the hyperactivity and all the stuff that they do, it looks like they're being distracted, but that's what they're doing to stimulate their brain to get to the point where it can engage in anything.

Lucas:

Yes. And a lot of people will they present that differently? So I have, I have no like, research to back up this observation that I have so take it with a grain of salt here. But I've noticed that there's really like two different kinds of people who have ADHD when it comes to stimulation. There's people who seek it and there's people who avoid it. I'm an avoider. And so the way that that looks is that in a, in an environment where there's a bunch of stimulation, my brain explodes and I cannot do it. So like in a meeting, if I'm listening to somebody talk or in a classroom and there's a side conversation going on right next to me, my brain tries to listen to both at the exact same time. And I cannot do that. And so I just, I get very uncomfortable. Like physically. And I like have to, I wanna like get up and leave.

Christy:

Well, because I, I think it also makes you angry.  

Lucas:

It does

Christy:

Irrationally. So like irrationally annoyed and angry where it's like, I need you to shut up    I just need to focus on this one thing. But you're decently put together as a human.

Lucas:

That was the nicest thing you've ever said

Christy:

You know, don't get used to it. But like, if you don't have those skills, like how hard is it to not get angry? So you look at these kids that get super angry at school, or even if you're a person at work that just gets annoyed with people all of the time, it maybe isn't a stimulation thing.  

Lucas:

You know? Absolutely. I know that when I'm like watching a TV show and my fiance talks to me while I'm watching this show, I can't, do I have to turn the show off?   Or she has to stop talking 'cause I can't do both.   And I will often like tune out 'cause the TV is typically on first.   And then she starts talking about the show. And I am not able to do that so that my brain just shuts that part off.   Or I'll try to listen and then I find myself getting very distracted by the TV. This is why I don't do well in like sports bars or something like that where there are TVs all over the place. 'cause I'm in the middle of a conversation. All of a sudden I'm watching like tennis, which I don't watch, but now I'm like really invested in tennis.

Christy:

  But being for just always listen to the fiance. I mean, I would choose that first.

Lucas:

Oh absolutely.   

Christy:

That's a good choice.  

Lucas:

I try my best.

Christy:

I know you do. Yeah, I know

Lucas:

The other way though is where people are stimulation seeking.   So they need all of that. They thrive in that environment. Because they're getting that. They need that stimulation to function.   And so sometimes going back to my fiance, she also has ADHD, but the other type. So then I, my

Christy:

 They're a delight together.  

Lucas:

It’s great. And so I like, I've come home and it's been, there's like music blasting a TV going and she's like singing and there's all sorts of stuff going on. And maybe there's like a mess that she, 'cause she started doing something and is doing something else now. And I, I walk in and I'm just like, I'm, I can't do this    But it helps her get stuff done that way.   So you just gotta know what's best for, you know, what's best for your kid or your partner or whatever. And, and just help them and just be understanding that this isn't this, this isn't their fault. They're trying to function because their brain just can't handle it any other way.

Christy:

I think a very common thing that people experience is with, if you are a person who, and you're driving in your car and you have the music on, and then you have to do something else, like you have to follow the directions or you have to like make a turn and they're like, I have to turn the music down. It's like, why? Why?

Lucas:

That’s me.

Christy:

Why do you have to? But so many people do that and it's like, I can't, I can't drive and listen to music at the same time.  

Lucas:

I need my hands.  

Christy:

  That's because your hands are attached to your ears. I don't know. But that, I think that is a, maybe a telltale sign that there is also an attention issue.

Lucas:

Absolutely.  There very well could be. So there's a lot of different diagnoses that can kind of simulate or look like ADHD or ADHD can look like something else, which is why it's important to come and get assessed.   And that could just be talking to a therapist. But also psych testing can rule out whether or not you have ADHD. And I think there's a lot, a lot of doctors will recommend psych testing because it is a, it is a stimulant. It's a controlled substance that they would use to medicate that or treat that. You don't have to go a medication route, by the way, if you don't want to. Although that is definitely easier.   and you're gonna see fast results with that. But a lot of people don't want to and that's totally fine.   You can, there are skills that you can do to manage, manage this as well. One really good one is reminders because we forget.   And so setting alarms on your phone or for your kids and making sure that they're aware as to like what time, like in the morning, I have an alarm at seven just to tell me that it's seven .

Lucas:

That's not a joke. I wake up at six, I have an alarm at seven. It's just let me know, Hey, it's seven o'clock and then I have another alarm to tell me it's time to take medicine. And then I go on with my day.  But if I don't have that, I am a disaster.

Christy:

 I do think it's important too to either audio, like audio reminders or visual reminders. I mean, the reminders kind of gotta slap you in the face.

Lucas:

 They do. They have to be loud.

Christy:

I mean, they have to be loud and you have to be able to see them, especially with, with kids. Otherwise that's just because like we talk about timers is another one. Like, because time blindness is a real thing. I was talking to another colleague and he was like, I could play video games for 13 hours and have no idea that that 13 hours have passed.   And so, and like we talked about before, 30 minutes to somebody with ADHD does not feel the same as 30 minutes to somebody without ADHD. And so you need a visual timer to like show like, so they can see the countdown to, to where it is. And audio reminders say, okay, you got five minutes. Oh you got 10 minutes. And it might feel like you are being overbearing, but that is usually not the case. Like they need the reminders.

Lucas:

They really do. And giving people those progressive reminders are super helpful, especially kids.  But if you're an adult listening to this and you're like, oh my gosh, you're describing me to a T. Do it for yourself too.  

Lucas:

Absolutely. I do, as I just described, it's great. But if you tell a kid like, they only have 20 minutes for a video game or an hour or something like that, they need reminders that it's almost ending. And if you suddenly tell somebody to get off of a video game who maybe struggles with some dysregulation, you're just asking for a fight. So allow them some time to transition out of that.   And the best way to do that is with some of those reminders.   Just checking in. We also do this thing where we will just respond to people because that's the socially appropriate thing. So make sure that if we're working with like parent child right now  that they look at you quick, make sure that we understand, ask them what you just said. Yep. Make sure that they, it clicked. I can't tell you how many times I've agreed to something and I have no idea what I agreed with because that's a socially acceptable response.  

Christy:

So yeah, I would say that the, the hardest times that I've heard, especially with kids, but also with adults that I work with, with ADHD mornings and evenings, a morning routine to get out the door is always really difficult. And then the nighttime routine to get themselves to bed is also very difficult. They're just very difficult times. 'cause It's like when you wake up, there's a lot of things you have to do in the morning. You have to get up, you have to take a shower, you have to brush your teeth. You have to remember to put shampoo in your hair because sometimes people forget to do that. You have to, you know, there you have to put your shoes on. You have to pick an outfit. Oh my gosh. Picking an outfit alone sometimes for people with ADHD is like, so we always say let's pick out our clothes the night before. Because that's just, it's just better so you know what you're wearing the next day because there's so many options. Or if you're a parent to say, do you want this one or this one? Yes. And let's give them two options instead of a whole closet. Because that's way easier.

Lucas:

Make sure the options are ones that you are winning no matter what they pick.

Christy:

  And then you have to get in the car and then you have to go to school. Which maybe is or isn't a preferred place for them to be. So I mean, if you're looking at, at an ADHD pain, just the stuff that I just said that is overwhelming, that is a lot of things to get done in a day. Getting their shoes on. I mean, I have had so many conversations with people getting shoes on or getting into the shower.  Like, how can I get my kid into the shower because

Lucas:

The shower's gonna take too long and I have fun things that I wanna do. I know.

Christy:

  And then, and then, and then once they get in the shower, they won't get out of the shower.  

Lucas:

'Cause it feels good.

Christy:

Because it feels good.  Oh my goodness. And they don't have a whole lot of control over that. And the same as with a nighttime routine. Because you have to, you have to get ready for bed and brush your teeth again and you know, whatever it is that you do. And then wind down and, and usually at night, typically speaking, is when people do the, the brunt of their preferred activities. You're winding down, you're watching tv, you're maybe have some screen time, you're doing a puzzle, you're doing, you're playing with your sibling, you're playing with your dog. Like all things that are technically stimulating. And then you're moving from a, from a preferred activity to going to sleep. Which sounds lame and boring. Nobody wants to do that. No. And so it's, and it's just, it's so hard. And so we, we talk about having a good sleep hygiene routine to go to bed and like I always say land your plane. Because it's like people in general.   We all start and we gotta take off and our planes gotta go. And most people's planes kind of descend on their own. And it's just a, it's just, it's tougher with people with ADHD, like you have to help them co-regulate to get their plane to land safely. Yep. Instead of just like, keep going around the world, you gotta land.

Lucas:

And if, if you're medicated for your ADHD, this, you can even notice this even more because in the morning you're unmedicated.  And it typically takes about an hour for the meds to kick in once you take them and then the school gets them if you’re a child or work gets you medicated. And then you come home and like maybe like seven or eight, it starts to go back down and now it's not in your system anymore because it only stays in there for less than a day. And depending on what type of med you take, so then the difference that you're going to see in your kid or your partner or yourself is much more drastic than maybe somebody who isn't medicated.   Because that would just be all day then. But be patient with that as somebody who has ADHD and is medicated, I will tell you that sometimes that the coming off of the med at night can be uncomfortable especially if you are just starting out and you're getting used to that, there's something called a stimulant crash that occurs and it's where you get really tired. You might even have a little bit of a headache or just you just don't feel like you and you just, if as an adult it can be dysregulating. I can't imagine what it's like for like a little kid.   That goes away as you get used to the medication just like a lot of side effects do with medications, but it's a new experience and so just be aware of that.   Something else to be aware too is that people with ADHD struggle with insomnia, much higher rates than other people.   And that might have something to do with our brains don't shut off.

Lucas:

So there's always something that we feel like we need to get done and we need to do it now and we just get distracted and we're thinking about a million things all at once. It's hard to sleep. We might wake up a bunch, be patient with yourself, talk to somebody and get some new ideas as to maybe how to fix that 'cause it can get better.  

Christy:

But we do, I mean, as far as skills go, we, I mean, I think I say the word stop, think and choose a lot. 'cause It's quick. Kids can remember it and it's like, we just don't want them to, we need to give them just like, just even a three second buffer to just stop for the thing comes out of your mouth. Stop. Think, think about what you're doing and how it's gonna impact other people. And then make your choice based off of those two things. And I think the other thing too is like when you're working with somebody who is impulsive and they, this happens all the time and even like with lying, kids have ADHD and, and they tend to lie because someone says something to them and they just respond back without thinking. And so they're just trying to get out of trouble.

Or if they just, their response is curt or it's mean or it's in inappropriate, instead of saying that's inappropriate, just be like, do you wanna take a second and just think about that and then, and then answer it again. Give them a little grace. Because in order for them to learn impulse control, someone has to allow them to make the mistake and be like, okay, we gotta work on that. That was a time when maybe we gotta, you know, but to not always go straight to getting somebody in trouble when they do or say something that we don't, don't think they should do or say.

Lucas:

And a nice activity that I like to do with, with kids in my office, and you can do this at home too, if you have any kids that are struggling with ADHD, is to play a game where going fast is going to lead to more mistakes.  Jenga for example, is a really is. But you could, with some kids, it's any game. But what you can do is you can have them slow down and explain why they're doing each step and they will, you're gonna see that they're improving in their game. And then really connect that improvement to the fact that they slowed down.   And then if you want to be, have fun, put a timer on every turn.  So like, you only get a second to make your turn or else you lose your turn.   And watch how many mistakes are made and then connect those things.  

Christy:

 And I think the thing with, with games we use, we, we use a lot of games in therapy and there's, they're meant to generalize the skill into a different setting. So like, if you can learn how to do that with Jenga, you can learn how to do that with math. So like, if you slow down and you don't make, you learn to not make so many careless mistakes and then you get this positive reinforcement that you're, that the same thing that you get in Jenga. It's kind of, you can just take those and generalize them to whatever it is that, that you're struggling with or whatever area you're struggling with.

Lucas:

  And positive reinforcement is huge for kids with ADHD, remember it's a dopamine deficiency.   And so a positive reinforcement is like candy to them. And it doesn't have to be a toy, it doesn't have to be anything that costs money. Telling my kids that I see that have ADHD, if I just tell them I'm so proud of them and I give them a high five, they are over the moon.   And they just respond so well to those things. Because typically what they hear is the no don't stop.   Those things. So if we can really focus on that positive reinforcement when they are doing something well that's really helpful. we can also manufacture positive experiences. An example of this is if we're walking through a door and they open the door

Christy:

I was gonna say the, is the door open or are we like literally walking through the door?

Lucas:

We're gonna open the door Christy.

Christy:

Okay. Got it.

Lucas:

That was blurting. So the kid opens the door and had no intention of letting you through first, but you bolt through and then you turn around and say, thank you so much for holding that door for me. That shows a lot of responsibility and respect. you just created a success for them.   And if we can do that in other situations, like, Hey, I need you to get ready for bed. And then they start moving, oh my gosh, thank you for listening right away.   They may not have had any intention of doing that, but you just made that happen.   And so now they're way more likely to actually go do it. There's a chance that it's not actually gonna work and they're impulsively gonna say no.  And then we can deal with that. But this sort of style works really well with kids who have ADHD because it's feeding that dopamine deficiency that they have.

Christy:

And like you said, it depends, I mean, everything in mental health is on a spectrum.  So there's, there are some ADHD that is very severe and then there's some that isn't as severe. So when we're talking about coping skills, I mean for most mental health stuff, the combination of medication with therapy is like chef's kiss. Yes. Like that's, that's just proven to be the most beneficial. Like we said, we know that some people are weary of putting their, their kids on medication or they don't wanna take them themselves because they either don't believe in it or they're worried about the side effects. And I would really encourage people to talk to their providers or talk to a therapist and kind of go through what that really looks like. Because there are also a, I mean the internet is a very big place like we talked about in our last podcast, right?

Christy:

And you can find information that supports, or that says that if you take medication for ADHD, that you're gonna grow seven ears. You know, like you can find, you can find that information on the internet and a lot of it is just not true. Yep. So to not get worried about reading one bad article, but go to an actual provider. There's a book that I've had parents recommend to me that's called ADHD 2.0.   That apparently has a lot of great information in it and I've recommended it to other parents. And they have also, they've, they've felt that they've maybe understood the process and their child a little bit better by reading it. So I mean, just to kind of get all the information before you, like make knee jerk reaction. One article that is like, medication is evil.

Lucas:

  You know, and there's nonstimulant options as well. There are,

Christy:

  There's,

Lucas:

It just depends on what's best for you and your family.   And just go ask questions. It doesn't hurt to ask the question.   They can't force you to be on a medication. No.

Christy:

So I always tell people, medication is not a prison sentence.  You can always talk. You are, you are responsible for what you put in your body. You have, you have control over that.

Lucas:

I think we would be mistaken if we did not talk about the importance of exercise with ADHD.

Christy:

Oh  

Lucas:

And what I always think about when it comes to exercise is this concept called an afterschool restraint collapse with kids who, especially who have ADHD. 'cause They're putting, they're holding everything together and they become like a stretch rubber band. And then they come home and we ask 'em, okay, time to do homework and they just explode. Or it's time to do a chore and they just lose it.   And that's because they were holding it together all day, being their best little selves that they can be. We come home, they feel safe and comfortable. Mom and dad will love me no matter what. And so they just let it rip.

Lucas:

One thing that's really been helpful for a lot of families is to let them have some space after school where they're allowed to go run around, go play, you know, decompress that, that rubber band so that they can just feel better.   And then after dinner maybe they are more compliant with wanting to do some homework or more willing to do that for adults. We can do the exact same thing. I know that after work, I just need a minute.  Like, just give me 10 minutes to just decompress for a second and then we can go do whatever. Exercise is one of those things that's super helpful for me.   I like to work out at night because of that, because I just feel like a stretched-out rubber band and at night I can decompress with the exercise and then allows me to actually sleep.   So it's, we all gotta figure out our own ways to handle that and for our kids and stuff, but exercise is one of the best ways to manage ADHD. And we do it naturally when we have ADHD by fidgeting and moving around and getting up. So if we can, if we can exercise, put that in a, as like a routine, it's gonna start feeling a lot better.

Christy:

You know, when you were, when you were saying that, 'cause I, I always think I, I have this thought frequently that we always expect more out of children than we do of adults. And I don't always know why that's the case.   But like, if I had a day of work and it is five o'clock and I went home and someone said that I had to do more work, that I would not like that. That would not, I would not appreciate, I wouldn't appreciate that sentiment. But that's what we're asking kids to do all the time. Like they're gonna keep it together and not just kids with ADHD, but just like in general, they come home and then we're asking them to do more homework right after they got done working all day. And then we're gonna ask them to do more and then also help with the dishes and then get your stuff cleaned up and get ready for tomorrow. It's like, it's just, or go to go to a sport or do what I mean, there's just, there's just a lot of nonstop action with kids that I think we expect a lot out of that we don't necessarily expect a lot out of adults. You know what I'm saying?

Lucas:

It's a Yeah, absolutely.

Christy:

Because I don't wanna go home and do more therapy. Nope. No  I'm done. I love it. I love it.

Lucas:

Absolutely wouldn't trade it for the world, but, but

Christy:

When five o'clock rolls around, it's like my brain just knows. It's just like, okay, you've done, you've, you have done your duty. It's time. Oh my goodness. Time to log off.

Lucas:

Oh man. So we always want to encourage you to ask the question, is it just me? You're likely not alone. And there's always a way to help. If anything we have talked about today resonates with you, please reach out.

Christy:

Do you have a topic you'd like us to talk about? Message us. We'd love to hear from you. Our email address is, is it just me@dakotaranch.org? Or if you know me personally, shoot me a dm. Yeah, same. I've gotten great suggestions from people about topics and so we're hoping to get to some of those and they're just like, wow, those were really good ideas.

Lucas:

Super good. Way better than I could ever think of.

Christy:

Same.

Lucas:

And don't forget to share us with your friends and family.

Announcer:

Thanks for listening to today's episode of Is It Just Me? To learn more or make an appointment for psychiatric or mental health services at Dakota Family Services, go to Dakota Family Services.org or call 1 800 201 6495.

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