Today we highlight a few common ADHD traps. Learn more about phenotypes. Learn about depression and anxiety comorbidities. How do stimulants, meditation, and CBT effects this phenotype?
- (00:40) First big common trap and how it affects people on the spectrum
- (16:50) The second trap and its affect
- (28:39) How Dr. D works with his patients
(33:48) Give us feedback on today’s episode by dropping a comment below.
Devon: [00:00:00] Welcome to the podcast, Dr. D on ADHD, a place where we chat about ADHD. My name is Devon and I’m the host and I will be talking with Dr Samuel Dismond. Together we run the show and we also operate his private practice where we treat ADHD. Dr D, how’s it going?
Dr. D: [00:00:24] It’s going well, Devon.
Devon: [00:00:26] That’s good to hear. We are a rolling out our third episode right now, and I wanted to talk to you about ADHD traps.
What do you notice regarding common traps that people with ADHD may fall into?
Dr. D: [00:00:46] The feeling that a person with this phenotype, the “$10 scientific word” meaning the outward expression of DNA. So, people with this phenotype, aren’t aware of the latest perspectives on who they are and the things that will work for them as individuals are not included in the choices offered by our culture. It’s like, Boom! We come into the world and I’m borrowing a term that I’ve heard other people use, they call them the “Factory defaults” of our culture and it’s the, you know, the options for making a living. It’s like “I’m a doctor, I’m a lawyer, I’m a this, I’m a that”.
“What do you want to do when you grow up?” It’s a this or that. And these boxes are very small with very high walls and they don’t fit the big round, sensitive nervous system of people with this phenotype. And so, the choices that they make aren’t like, “Oh yeah, that fits me great. It’s like, well, I guess I’ll give this a shot. It seems to be the, you know, the best of the alternatives, I think.” like that’s the energy of the decision making, and so that’s a bad setup to begin with. Okay, That’s number one.
[00:02:41] Before that happens. Before that even happens there. Actually, these folks are actually making choices. Bless their hearts about what they want to do as their “career”, as their “profession”. Since a little bit before puberty, the fact that they have this very special phenotype. That once upon a time was viewed by the other humans as literally a superpower. But, nowadays in this very square, compartmentalized way, we as a society, Western society, think about things. From that perspective, these kids, they’re different. And you know, especially in this day and age, it’s really obvious. We treat different as a “them” as an enemy, and we try to get them “them” to be like us, to be the same as us. So, the fact that they have this very distinct, very special outward expression of their nervous system. Because they have this, they do and say things that are different from everybody else.
Two thirds of the people in the room their age. And the adults have a a typical “them”, “Why don’t, why can’t you sit down? Why can’t you do this? Why can’t you act like us? Why are you with them?” That message is really corrosive and erosive. It’s like, “why am I being me not good enough?”
Rarely does a child just passing through puberty, which is rough enough. Rarely do they have someone who takes them aside and explains to them in a way they can understand that they’re okay. Explained to them the dynamics of what’s happening. This is a very primitive Paleolithic reflex. It’s an old evolutionary trick that doesn’t match our modern developed young brain. This middle-aged part of our brains has this reaction to something different to the other.
[00:05:22] And, folks who are in the big two thirds, that is the average. They have this very primitive reaction to kids who are different. And nobody pulls him aside to say that. So, as they’re developing, they get this slow, corrosive drip. Cultural acid drip on their tender hearts and souls, that’s, “why can’t you? You’re not good enough as you are”. Compound that as they get older with limited choices. It’s like, “You must be one of the square boxes if you are going to make a living and survive.” Compound that with getting into one of these boxes. And it’s just so hard when you are a round to fit in a square. It’s just difficult from the moment you get up to the moment you go to bed, it’s all square, square, square, square, square.
[00:06:28] “Now’s the time for this. Now you must stay on this because it’s the time for this.” These round sensitive nervous systems just don’t operate that way. So, the expectations of being in the box, start to be corrosive and there’s no place to go inside myself if I’m this kind of person, if I have this phenotype, it’s like, “Well, shit, I chose this, so it must be me. The problem must be me.” This is all leading up to the fact that, many people with this, “Phenomenally” special phenotype have a low level of depression.
[00:07:19] And when they meet medical professionals and they talk about their feelings, not even knowing that they have this phenotype, they’ll be told they’re depressed, okay. And that they have that the depression is the primary thing.
[00:07:36] And when they talk about, well, you know, the conversation drifts into topics that suggest they have this phenotype. The medical professional will say, “Oh yeah, you can’t focus cause you’re depressed.” They treat the person as if depression is a disease and that’s all there is. And so, it’s very difficult because it started the drip, the corrosive drip started so early and it’s been there all the time. There’s no information about the fact that they even have this phenotype. And then when they discover this phenotype one way or the other, most people talk about it as if it’s a disease, as if there’s something wrong with them. And in a very quick review of history will reveal, “Oh no, that’s not the case, this is an entirely culturally defined phenomenon.”
[00:08:41] Okay. And so, they will almost fight against any other notion that there’s something else going on because this depressed feeling, this feeling of failure, micro failures. You know, people talk about microaggressions and I say that’s a bunch of hooey for people with this phenotype. Micro failures is a very real thing. And so the trap that a lot of people have, is that, that depressed feeling, which is secondary, is something that they can change by meditating, you know, cognitive behavioral therapy. They can change their thinking that will fix the depression and then everything will be okay. That’s the trap. And it’s not. The data show this, and it’s my clinical experience that first, people with this phenotype have to understand who they are and it’s not a disease. It’s circumstance.
[00:09:47] Second, stimulants have been overwhelmingly demonstrated when properly used, when the person with the phenotype has the opportunity to experiment and figure it out for themselves what works with guidance, of course, with guidance, but they have the opportunity to figure it out for themselves, make the adjustments for themselves. When those things happen, the light goes on. It really goes on, and then the result, the depression, the result of the constant drip is seen for what it is.
The drip is removed. There’s a sense of control. I hate that word, but it’s most appropriate. They, these folks have now have a sense of control. They understand that they can use a stimulant when they need it and not use it when they don’t. And that’s really a good thing. Boom. All that stuff goes away. All that depression goes away.
[00:10:50] By itself, without therapy, without meditating or anything, it just goes away. And sometimes when the trauma is significant and it’s really trapped in memory. Yeah. Cognitive behavioral therapy after getting on stimulant therapy works really well. The data show that first a stimulant and for really stuck emotions, cognitive behavioral therapy, that works. But cognitive behavioral therapy by itself or treatment for depression by itself. Nah, it’s not going to help very much. So to bring it on back and answer your question directly again, the trap is feeling depressed and focusing on that depressed feeling. That’s the trap.
Devon: [00:11:39] So, if somebody was, born and raised in a way that was really nurturing and healthy for their ADHD, what would that person look like if they were to skip over the way that society makes them feel? Say they were…
Dr. D: the erosion.
Devon: Yeah. If that, if that part wasn’t there, what would that human look like as an adult?
Dr. D: [00:12:06] I’m going to venture to say that first of all, there wouldn’t be the corroded result, the depressed feeling, which is hugely valuable, and they would understand that, so-called “career choices” have to fit their phenotype.
[00:12:26] That these are not going to be off the shelf. They’re going to be customized and that they should look there.
And in the course of getting close to what the ideal situation is, they will find there are periods of time when, there’s no escaping the square box. There’s just no escape in it. Like I gotta do my taxes, and even with the accounting and helping me do my taxes, I still have to organize the stuff.
[00:12:55] So, the person, first of all, who was raised and made aware of who they are from a young age, would skip all that, those bad feelings. And they would have in the back of their mind that “I have to make choices that fit my neuro special-ness” and that they’re going to, they’re not going to be off the shelf.
And, and thirdly, that, there may be times when “I need a stimulant and that’s okay. I’m not going to take it all the time. It doesn’t make me a bad person. I’m not going to get addicted. It’s not a bad thing. My nervous system, because it’s different from everybody else’s, actually metabolizes stimulants in a different way.”
So I have this confidence in that “I’m in the world and I’m in my right place at my right time. Not that I’m some freak that doesn’t fit.” So there will be this air of comfort and confidence that comes when somebody is in a place that’s familiar. That’s what they’ll look like. Somebody who is comfortable in their place. Does it make sense.
Devon: [00:14:06] Yeah. Yeah. That’s great. Thanks for answering. That was a really nice long answer. It, it’s not, uh, it it just doesn’t seem like it. Is it all what, um, what, I notice a lot of the communities. See ADHD or ADHD treatment as…
Dr. D: [00:14:26] I’ve noticed that in general. Um, and I’ve noticed it in my practice. I have to work hard to be a good storyteller. I understand that, it’s really easy to get lost in these explanations. I try very hard to engage people in a question -answer way. When I’m trying to explain a concept, I ask people to guess what they think this is just to engage them.
[00:14:54] But that’s part of it. Uh, there. Unfortunately. It seems like there could be a quick answer, but there’s not, that’s true for a lot of life. There just is not a quick answer. And so there’s a place for, um, I’ve had to learn how to do it and I think everybody should learn how to do it if they have something they want to share.
It’s not about me feeling good just running my gums. I have to learn how to be a good storyteller to engage. This is for the the listener. It’s not for me. And so that’s a challenge. I think many times, you know, in our culture there’s this, “I got the mic thing and I’m talking, so it’s all about me.” That’s absolutely cannot be the case with folks with this phenotype.
[00:15:41] They have to be addressed in a way that suits them. They have to be engaged. The content has to jump around a lot in interesting ways, just like in his story.
So that’s, that’s just me reflecting on what you just said about, about the short answers and that why I’d give long answers. I recognize that and I try to keep it, I try to tell a good story.
I really work on it. I ask people if they understand. I try to get feedback. I ask for suggestions. I try to sense when somebody drifting off and and shake them up a little bit.
Devon: [00:16:21] Yeah, and you’re saying there’s, there’s really just one trap you’re describing just one.
Dr. D: [00:16:31] That’s just one of them. There’s more than one, but that’s the biggest one I see.
Devon: [00:16:35] I see. Yeah, so that’s the biggest one. It’s not like everything funnels through that trap or anything.
Dr. D: No. No. That’s the biggest one that I see.
Devon: Yeah. Do you have any other traps that you could talk about?
Dr. D: [00:16:50] Yeah. Another trap is, it’s kind of a. Um, I guess the word and anxiety seems too strong of a word, but it’s in that neighborhood of feeling, and it is about being alone. It’s this, this, this, it’s almost like a battle of should I be alone or shouldn’t I be alone? If I’m alone and it feels good. I might be just making what I think is a problem worse. But if I’m in the thick of things, it’s just, especially in places like cities, it’s just too much. It’s just too much. So the trap is bouncing back and forth, making it an “either or” thing. That either have to be out of it or in it, and that, that like kind of like a worry creates a kind of anxiety and that’s a trap.
And it, and it’s about, and it kind of infects all kinds of choices. It’s hard to decide one thing or another because it, it subtly gets painted in this, “am I alone or am am I in a crowd?” And it’s very difficult to find, a middle ground. And so that’s the other kind of trap is that this anxious feeling from that. Does that make sense?
Devon: [00:18:21] somewhat. Yeah. What would, uh,
I have ADHD and I started to. I mean, it’s hard to continue to, to stay tuned through these long descriptions sometimes. I got lost when you started talking about the city, and I was literally, I was thinking about..
Dr. D: [00:18:43] You got lost when talking about what now? Which one?
Devon: [00:18:46] About the city.
I just started remembering when I lived in the city and I was just like, what was it like? And I, I mean, I’m a person, who deals with this. So I, I want to know more about, about that. Like that example of the person that’s in the city, in the stimulus of the city that I feel like is a really strong example that I’d like to unpack a bit and understand more.
Dr. D: [00:19:17] sure. So there’s that. There’s a phenomenon that happens when, it happens for all humans. It’s when, when something comes up that I really don’t want to see, that’s when I drift off. That’s when I get hooked by something that was said and I will follow that rabbit hole.
[00:19:44] It’s because I really don’t want to think about the bigger context of what that thing is. So that happens with everybody. And I think it’s more challenging for people who have this phenotype. I can be more challenging. Because the threshold for looking at something else is low. So, looking at something else can happen quickly or there’s something that’s uncomfortable and, and one of the ways to tell the difference is it’s kind of like this little sleepiness.
[00:20:22] It’s like, it’s like this little thing happens when I make the switch and start going down the rabbit hole. That’s when I’m essentially running away. But, and that’s part of the trap that I’m, that I’m trying to describe. About being alone or being in the, in the city cause fun fundamentally. Um, just on paper that the, all the stimuli in the city on a day to day basis it’s pretty toxic for everybody and especially toxic for people who have this phenotype. It’s like the nervous, our nervous system is screaming “Danger! You know, “This is not good. This is not good.”
Devon: [00:21:14] I don’t know if this feeling of guilt was a positive or not, but w when I lived in the city, I felt like I could distract myself with the city all day and I felt bad about it. I felt like. I did feel like I could go and entertain myself and walk around the block and like get a smoothie and talk to the barista.
And I felt engaged in like, there was a sense of community, but I always felt guilty at how that countered my productivity and my potential output. But at the same time felt like I am like feeding and getting something that I’m wanting, and it seems harder to satisfy that, that want outside of the city with the less things to grab you by, you know.
Dr. D: [00:22:15] That’s a really good point. And, a lot of that is conditioning. The concerns are, that’s, that’s kind of the, the concerns are kind of what I was talking about with the anxiety. You described it in another way and I appreciate that. Giving a personal, using, you’re being generous with your personal experience to say that, um. So, the things that attract you in the city are the functioning of your phenotype.
[00:22:58]So, imagine yourself in a postmodern state, and you, you are, you are the lookout. You’re the century. So of course, you’re always, wandering around the space where your group currently is and you’re checking in with people. And it doesn’t take long. And while you’re checking in, you’re looking around, looking at their hut, looking for any changes, looking for danger, looking for, advantages. And as you move around, that fits your phenotype.
[00:23:32] And, and I dare say that’s probably why it feels so good to do it. I’m gonna venture a guest that, you’re fortunate if you can make a living doing that. Uh, a lot of people who have your phenotype end up doing things like biz development, biz dev or, recruiting because it’s essentially that that’s feeding their phenotype like their day to day tasks. A lot of them love it because they’re just, that’s what it is.
[00:24:00] They’re going around checking their sources. And seeing how new hires are doing, seeing, looking for new business, et cetera, et cetera, feeds that. But for many people, uh, like making a living off of that is just not an option.
[00:24:17] And there are aspects of growth that can only happen by oneself. We all know this. We hate to admit it, but it’s true. They’re all, there are aspects of being by oneself. So there’s that truth that you may know more or less. It’s in the back of your mind or the front of your mind, plus the conditioning. “Well, how can you make a living doing that? Just going around and talking to people all day, and you don’t see anything on the horizon.” So you feel like you’re burnt. You’re a consumer and not a producer being productive.
[00:24:57] And then, there’s another piece to this, which is, also the result of culture. It’s, most people don’t know how to use their sensory ability in a different context. So taking the basic, tools, cognitive tools, you know, how your brain things, how my body works in a city and apply that to nature, And then learn to have communication more or less with different aspects of nature.
so that can be a limitation that looks like being alone, but it isn’t, it’s not really being alone. It’s just being unfamiliar with this new way of interacting in a new place.
Dr. D: [00:25:56] And so there’s that.
Devon: [00:25:58] What does it look like in nature? What does that look like for somebody or, an example, or what could it look like, I guess?
Dr. D: [00:26:10] I can only speak about my experiences. So I take a lot of walks when I can. It’s difficult for me to do that these days. But when I do, I don’t have to go very far. I will just sit and enjoy the sunshine. I’ll sit on a curb or if there’s a stone fence in somebody’s yard, I’ll sit there and after a few minutes, a cat comes by and I love cats. And so I’m having a, I befriend this cat and it’s, she is now part of my routine. She, you know, if I’m roughly walking around the same time of the day, she’s there and I have a conversation with the cat. And then there’s this spot where these purple flowers, and I’m very fond of bumblebees, and I’ll sit and the bees will come and check me out. And I swear to God, some of the bees look familiar, you know, and I look at them and watch what they’re doing and watch how they do things. And it’s like that. It’s kind of like that. And I get to know, I get to have a feel for this other than human and, um, critters in my environment and I learn how to interact with them, observe them, and I gain information from them. And, I dare say, I can only imagine that for somebody with this unique phenotype that’s really bringing it home, like learning how to reengage that. That is from where I dare say the phenotype comes.
Devon: [00:27:49] What do you mean? That’s where it comes?
Dr. D: [00:27:52] It’s like before, before civilization, we evolved to be sensitive to. Uh, it wasn’t buildings and the barista, and it was bees and flowers and other critters. And you know, those are the entities with whom we had conversations in our rounds. If we are this phenotype in our rounds, checking out the environment, doing our big radar dish sweep of our area, that’s, you know, a vast amount of our history was that. And so I can’t help but think are our evolutionary evolutionary produced biology was about that. And it’s just a matter of re-engaging that.
Devon: [00:28:41] Do you ever incorporate these types of things into treatment or anything with, with patients did telling people to go outside or to go wander around?
Dr. D: [00:28:54] only when they ask, only when they ask. When I find myself doing it, like, I hate sounding like a broken record with people who want my help. And so he gets like, you know, “Quit smoking”. It’s like, how many times have I said that? So now I, I just don’t, I don’t volunteer stuff unless I’m asked. People eventually, do they, you know, I, um, our practice, as you know, it’s an opportunity for people to be extremely personal.
[00:29:27]Um, it’s easier to be personal using the messaging system and they offer things. And so they’ll ask me, “what did you do?” And I reciprocate. I tell them things that I did. And then they’ll like, “wow, I never thought of doing that. Tell me more.” And I’ll say, “Oh, sure” In a phone conversation or when they come for the logistics visit. I scheduled 30 minutes.
[00:29:50] They’re rarely clinical. We just shoot the shit, you know? And it’s just talking. So questions like that will come up and they’ll be like, wow, I never thought of that. And they say, how do I try that? And then I offer, but I stopped, you know, doing the preachy thing. Cause like I can’t stand hearing myself say the same thing over and over again. I just can’t stand it. And I imagine. You know, people can feel that, like, I’m reading a script. I was like, nah, Nope. So, and people have, you know, people have asked me and a few people have actually, uh made a change and done different things because of it. And it’s eyeopening.
Devon: [00:30:38] Yeah.
Dr. D: [00:30:40] I’m grateful. I’m really grateful when they do, try things and, and it works out for the better. I don’t feel like, “ah, see, I told you so. Ha ha, I’m so smart.” It’s like, no, I, I’m just really grateful that, you know, somebody tries something and it’s, it’s positive.
Like we swim in so much negativity and fractiousness these days, it’s like try something and it’s positive. Thank you.
Devon: [00:31:07] and I mean, there was a time when there were no Stimulant medications, and I mean, it was just trying all kinds of things. And I’m sure that you had to do before there was a solution.
Dr. D: [00:31:25] See, interestingly, the, the time, it’s interesting because the time when there were no stimulants. There wasn’t a need for it.
Right. All right.
The people, we forget, this is like what we’re living in right now. It’s, it’s so new. We have no idea whether a lot of this setup that we’re doing is good for us or not. Cause it’s so new. It takes like four, five, six generations. People forget a generation starts at 25 years old, and you know like when your peak reproduction, but you don’t finish a generation for another 50 years.
[00:32:12] So talking in terms of people lifetimes, that’s 80 years. So three people ago is like 250 years. That’s just three people. 250 years. Yeah. And this thing we’re living in now didn’t kick in until the 1950s that was post world war II. This thing we’ve created is, it’s like a blink in terms of human development.
[00:32:44] And, and before that time, Oh, no, no, no, no, no, no, no. Things weren’t so. You know, that’s like, yeah. People with this phenotype were highly valued, highly, highly valued. There was no need for stimulant.
Devon: [00:33:03] That’s really interesting. I appreciate the breakdown. we, uh. I think we’ve wrapped this, this one up nicely.
Dr. D: [00:33:18] Yeah. I feel good. I mean, I know, it’s like, I can go on quite awhile. I know it’s like 50 minutes we’ve been talking, so something like that. So I appreciate anybody that follows along. You can always pause it and come back to it.
Devon: [00:33:35] So, thanks for breaking that down. “Most common traps” is where we started and..
Dr. D: [00:33:44] Yes. We covered two big ones.
Devon: [00:33:45] we did. We did.
Dr. D: [00:33:47] Thanks for listening to Devin and me, Dr D on ADHD. If you have any feedback, episode ideas or questions that you would like us to explore in an episode, please email your thoughts to firstname.lastname@example.org that’s email@example.com. You can find links and references in our show notes over Norcaladhd.com/podcast.
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