BEYOND Basics - ADHD

Pen leads a discussion with Harvey on ADHD, including basic information, symptoms that aren't usually talked about, and their own personal experience.

Featuring: Our favorite French listener; the 2 degrees of separation between you and ADHD; spaghetti sauce, spaghetti sauce, spaghetti sauce; agonists: Adderall, antagonists: Fire Lord Ozai; Oops! All Antipsychotics.

Referenced/Related Links from this episode:

• ADHD Basics: https://www.additudemag.com/what-is-adhd-symptoms-causes-treatments/
• ADHD vs. ADD: https://www.additudemag.com/slideshows/add-vs-adhd/#:~:text=ADHD%20is%20the%20official%2C%20medical,lack%20of%20focus%2C%20and%20forgetfulness.
• CDC List of Symptoms: https://www.cdc.gov/ncbddd/adhd/diagnosis.htm
• Rejection Sensitive Dysphoria (RSD): https://www.additudemag.com/rejection-sensitive-dysphoria-and-adhd/

Suicide Hotline & Resources for Trans People: 

https://translifeline.org/

USA Suicide Prevention: 

https://suicidepreventionlifeline.org/

Internation Suicide Hotlines: 

https://www.opencounseling.com/suicide-hotlines

Suicide Hotline & Resources for LGBTQ+ Young People: 

https://www.thetrevorproject.org/


Ways to support Black Lives Matter and find anti-racism resources:

https://linktr.ee/blacklivesmatte

Resources to support AAPI (Asian-American & Pacific Islander) communities:

https://www.advancingjustice-aajc.org/

https://stopaapihate.org/

Resources for US Immigrants:

https://www.informedimmigrant.com/

Resources to Support Undocumented Immigrants in the US:

https://immigrationjustice.u

Transcript

Pen: 0:11

Hello and welcome to Beyond Introspection: a podcast where we talk about mental health, neurodivergence, and how it impacts our lives in literally every way.

Harvey: 0:18

All of them.

Pen: 0:19

I'm Pen.

Harvey: 0:20

And I'm Harvey.

Pen: 0:21

Today we're going to be talking about ADHD, which is--which is great.

Harvey: And some exciting news: 0:26

we are considering this the official start of season two of Beyond Introspection.

Pen: 0:30

Oh, right, yeah. I was going to mention that and then I promptly forgot, which is why we're talking about ADHD today. Because I have it, as you can tell.

Harvey: 0:38

You know, there's something that I've been meaning to share with our listeners.

Pen: 0:42

What's--what is it?

Harvey: 0:42

I made it sound like I was about to come out. Anyway...[laughter].

Pen: 0:47

Harvey's gay.

Harvey: 0:48

As if we didn't know that one already. So, we--I don't know how often Pen checks it, but on the website where we host our podcast we can see sort of the different locations that people are listening from. We have noticed that we have a consistent listener from France.

Pen: 1:06

Yeah, from, like, the start.

Harvey: 1:08

Yeah. From the very first episode, without a doubt, they've showed up on every single episode. So hey, whoever you are, Godspeed.

Pen: 1:16

Thank you very much. Also, just from, like, all of our listeners in general, I would love for them to like email or tweet at us or Instagram...

Harvey: 1:27

You can send us a DM on Instagram.

Pen: 1:29

Thank you, Harvey. Just, like, I would love to interact more with our listeners...

Harvey: 1:32

Yeah!

Pen: 1:33

...and have like--like, episode suggestions, or just feedback in general, whatever it might be. But in particular, whoever you are from France, like, you have--we have noticed you since the beginning.

Harvey: 1:44

You have been there from the start.

Pen: 1:46

And we love--we love that so much. I have no idea who you are.

Harvey: 1:50

Turns out we are also number 74 in Society and Culture in Namibia of all places.

Pen: 1:56

And I--we have--once we get someone from South America, we will have been listened to on every populated continent, right?

Harvey: 2:03

Yes. Which is--we're missing South America.

Pen: 2:07

And all of this, and we have no idea how any of it--and it's not even, like, we don't have a huge listenershi, judging from, like, downloads and things.

Harvey: 2:17

No, we--you know, on a good episode, we get maybe 20 to 30.

Pen: 2:21

Which is like that's okay,'cause we're just starting out. But like...

Harvey: 2:24

France?

Pen: 2:25

France? Namibia?

Harvey: 2:26

Namibia?

Pen: 2:29

Ah. So on to the actual content of the episode.

Harvey: 2:32

Sorry for the brief aside.

Pen: 2:34

Oh, Harvey, his is what we do. This is how we do it. It's our charming personalities. A discussion-based--they did a big cheesy wink. A big, cheesy wink, folks.

Harvey: 2:46

Yeah!

Pen: 2:47

it was good. It was great.

Harvey: 2:48

Wahoo!

Pen: 2:48

Wahoo!

Harvey: 2:51

I'm gonna have to transcribe that.

Pen: 2:54

Harvey started saying'wahoo.' in that little voice just for fun.

Harvey: 2:57

I did.

Pen: 2:57

And I'm--I'm charmed by it. And we'll end up mimicking them, and that's what neurodivergence is. So, yes, we're going to talk about ADHD, which means I'm going to have--I have notes. which is kind of funny. I have--

Harvey: 3:12

is that the first time you've taken notes since the second episode?

Pen: 3:15

Uh, might be, might be. Bo, I took some notes on the one where we did it separately. I wrote down the answers and things, but that only like kind of counts, because that was, you know, like, the fundamental way we're gonna end up...

Harvey: 3:27

Right.

Pen: 3:28

Anyway... Well, no, no, my version of taking notes in that was just writing it in a notebook. So I didn't have to switch screens. So, no, I didn't actually.

Harvey: 3:36

I talked. I just talked. I didn't--I just went for it.

Pen: 3:40

That's a big mood.

Harvey: 3:42

But anyway, yes, we're talking about ADHD [pronounced phonetically.]

Pen: 3:45

ADHD [pronunced phonetically], which is a complex brain disorder. I'd never heard it described as that until, like, maybe a month ago, I think.

Harvey: 3:53

Yeah, neither have I. That's a--that's a good descriptor for it, just because like, ADHD cannot be neatly categorized into much of anything.

Pen: 4:03

It's, like, the first time I saw it like that, I realized, like, okay, one, it sounds so much more like a thing, like, that people would take seriously, because I feel like a lot of the time when people talk about ADHD, one, they, like, just think about, like, the stereotype of a little kid who's just, like, bouncing around a lot and can't sit still. And by a little kid I mean, like, people think of it as being a little boy.

Harvey: 4:29

Yeah.

Pen: 4:31

And very, very likely, a young, AMAB boy. Which--God, we've probably said AMAB--AMAB and AFAB before. But folks, just so you know, that's assigned male at birth and assigned female at birth.

Harvey: 4:44

Yeah.

Pen: 4:46

So--so we're not just saying, like, boy and girl and not referencing, like--because it does change, genuinely.

Harvey: 4:52

And we would be doing a disservice to ourselves.

Pen: 4:55

Yes, very much so.

Harvey: 4:56

We are both nonbinary.

Pen: 4:57

We are trans, though.

Harvey: 5:00

We do be trans, though.

Pen: 5:01

So when people think about ADHD, a lot of the time, I think that's what they think about. And that doesn't seem like a serious thing, and it often gets kind of lumped in with, like, learning disabilities and such--and such learning disorders.

Harvey: 5:15

Yeah, to the point where I actually thought until pretty recently that ADHD was a learning disability.

Pen: 5:20

Which it is not.

Harvey: 5:21

Surprisingly to me, it's not.

Pen: 5:23

It's, um--it can be comorbid with them, it can be comorbid, with a lot of things. Typically, people who have ADHD have at least one other diagnosis.

Harvey: 5:30

That's true. And specifically on comorbidities, I remember looking this up, something like a third of people with ADHD also have autism.

Pen: 5:38

That makes sense. Yeah--

Harvey: 5:39

Gighly, highly, comorbid.

Pen: 5:41

Depression and anxiety, I believe, are also highly comorbid. Bipolar disorder is fairly comorbid. And that doesn't surprise me, because there's actually, like--bipolar disorder, and ADHD can be mistaken for each other very easily, as I learned in 2020, when I realized like, oh, shoot my--my diagnosis of bipolar type II is actually inaccurate. It's just ADHD, and I had no idea.

Harvey: 6:10

Yeah. A brief aside for definitions. If you're not familiar with the term comorbid it's just a fancy way of saying that two disorders commonly occur together.

Pen: 6:19

Yes.

Harvey: 6:20

So depression and anxiety, we see them occur together a lot of the time, we call them comorbid.

Pen: 6:25

Yes, yes. So ADHD is a complex brain disorder. And that's, it is--it is interesting, it sounds much more serious, and more like a thing, and I think that's important. And also, it gets to the root of what ADHD is, and what causes it, which is a deficiency of dopamine, it--not that--so the research on ADHD, kind of spotty, sort of.

Harvey: 6:52

There's really not a lot of it.

Pen: 6:54

And what there is, is like, relatively inconclusive. Like, researchers are--like, they can come down on, like, okay, so it's a deficiency of dopamine, which--dopamine, if y'all don't know, very important little chemical.

Harvey: 7:10

Yeah, dopamine--if you don't mind...

Pen: 7:12

Please do.

Harvey: 7:12

Dopamine is implicated in a lot of our reward centers, so you know, you may--so just as an example, eating food is often an example of a--of something that triggers a reward center, especially if you're eating something sweet. You eat it something in your brain says, oh, I like that, and then it triggers the release of dopamine, which encourages you to keep doing that thing that gave you that burst of dopamine. It makes you happy.

Pen: 7:40

Yes. Dopamine is important. in focus, and concentration, it's important in motivation, it's important in emotional regulation. I didn't actually look up a whole list of things that dopamine is relevant in, but it's like, very--it's very, very important in the function of your life.

Harvey: 8:01

Yeah. And you'll notice that the commonality among all of those is that they are dependent on some kind of reinforcement.

Pen: 8:07

Yes, that is that is a major thing with ADHD, is that our--people who have ADHD, our reward centers are screwed up.

Harvey: 8:17

Diminished, yeah.

Pen: 8:18

Yeah. It's--in order to do a thing, we need to have that reward, which is not, like, unusual. Like, that's, that's how it works, yeah?

Harvey: 8:26

Yeah, Law of Effect. This is the--I think one of the only laws in psychology. We have a lot of theories, very few laws. The Law of Effect states that if you are rewarded for doing something, you're more likely to do it again.

Pen: 8:38

And I actually didn't know that eating was one of the common examples. But I think that really, like, gets to the point of why it matters so much that, for people who have ADHD, that reward system is--is broken, is that--it's not just that we only want to do things that we like doing, it's, we genuinely cannot do something if our brain does not find it compelling, which means we run into a lot of issues where it's, like, something that we might enjoy doing more like our hobbies is easier for our brain to do because it's, like, directly--more directly able to be rewarded, as opposed to something like eating or doing your work or getting out of bed. If we don't have a reward going on for that, it's genuinely harder, if not sometimes impossible for us to do.

Harvey: 9:32

Yeah. You know, sort of--from my perspective, as somebody who doesn't have ADHD, as far as I know. I don't think I do,

Pen: 9:41

From what I know, and what I've observed, and I have looked into ADHD a lot, uh, yeah.

Harvey: 9:48

Yeah. So I'll try not to get too technical into this, but when--in the release of neurotransmitters, there's something involved called an action potential. And this is basically just--an impulse has to be--some kind of stimulus has to be strong enough to cause the cells in your brain, neurons, to go, oh, that's important, you know, we should send this out. And, you know, like I said, action potentials have to reach a certain threshold. So for somebody like me who doesn't have ADHD, while maybe I don't like to do my homework, that stimulus, especially when I complete, it is still rewarding enough for my brain to trigger that action potential and give me dopamine, because completing the homework is a natural reinforcer. But for somebody like Pen, whose--whose reward centers are a bit more resistant to dopamine, that may not be rewarding enough to trigger the release of dopamine.

Pen: 10:42

Which means that there's not--my brain does not have a significant enough motivator to begin the task.

Harvey: 10:49

Right.

Pen: 10:50

And it's--it's a very complex thing, because there are ways to work on like, behavior and cognitive therapy that can make that easier. I'm able to sometimes, just, like, knowing consciously that once I finished the thing, I will feel good, and I'll feel proud of myself, that can be the motivator that I need to do it, or it can help it along. But it's an imperfect system, because it's still like, the chemicals in my brain are still not doing it on the level that they're supposed to be.

Harvey: 11:21

Yeah, there's actually a word for that. That's called chaining.

Pen: 11:23

Chaining. Oh, yay! Words. I love that. But yeah, it's--it is a complicated thing, and it's--so the research into it, like, we know that it's dopamine deficiency. Suspect that there is a genetic link, not 100% on that. Know that dopamine deficiencies in a lot of different areas of the brain correlate to symptoms of ADHD. Not consistency necessarily on the research for which areas are, like, the root cause of ADHD. From brain scans, they can tell that people who have ADHD and people who don't, like, the brain genuinely looks different. But there's, like--there are a lot of holes of, like, well, we know this thing, but we're not totally sure.

Harvey: 12:15

Yeah. You know, I'm trying to think of--I have to imagine--I'm not a psychologist, not a not a licensed one. I'm a--I am a student. But if I had to guess it's probably mostly areas in the frontal lobe, which have to do with emotion regulation and motivation.

Pen: 12:32

Yeah, emotion regulation. I had not known before that that was such a big thing for people who have ADHD, but, genuinely, emotional regulation is very hard for us. And it--it runs into those bumps like motivation does, where it's--it just doesn't process correctly, which is why ADHD and bipolar disorder, in particular, can look like each other. Because bipolar disorder, emotional dysregulation is a huge component of that.

Harvey: 13:01

Right.

Pen: 13:02

Um, let's see, I have actually have a note on that. Oh, yeah. Specifically, one of the big ways that that manifests for people with ADHD is rejection sensitive dysphoria, or RSD, which I had not heard of, for most of my life, and then hearing it was like, ohhh. I have a quote from ADDitude, which I think I've mentioned before.

Harvey: 13:25

Oh, we love AD--ADDitude.

Pen: 13:27

I do, I do! I have several links from them, and I'm going to put them in the episode description, including this article on rejection sensitive dysphoria. This is a quote, it's honestly, it's like the little summary at the top, but it was, like, really helpful."For people with ADHD or ADD, rejection sensitive dysphoria can mean extreme emotional sensitivity and emotional pain, and it may imitate mood disorders with suicidal ideation and manifest as instantaneous rage at the person responsible for causing the pain." So that's, like, the more formal way of doing it. Essentially, what rejection sensitive dysphoria is is like, when you feel rejected or hurt, your immediate response is very, very intense. Can be anger, can be, like, really deep sadness, or just, like, the hurt is not... what's the word? Doesn't typically correlate properly. Like, it's not...

Harvey: 14:25

Yeah, they--there's kind of some kind of discrepancy between the action itself and the reaction.

Pen: 14:31

It's--it's a--it's typically what seems like a very inappropriate reaction, or, like, a much more intense reaction than the situation would normally cause. And that's just how the brain works. It's not 100% of the time. It's not an always thing, and it's something that certainly, like, therapy can help with. But yeah, that's something I didn't know for most of my life. And so I--well, frankly, I assumed I was a bad person, really when it comes down to it. It was--it was kind of confusing, like, I am so hurt by this thing, or I'm so sensitive to rejection. Even for me, one of the huge things, and I'm still dealing with this now is when people would, like, anticipate what I was going to do. Or like, I remember one time, I was talking about this boy from school, and my mom was like, "Oh, you like him, don't you?" And I was like--like, it bothered me so much that she could tell, and I didn't know why. But it was just like, I was--I was hurt by it, and I was so self conscious, and it's things like that, where people can, like, you know, maybe tell what I'm feeling or what I was going to do. And it just--it bothers me. I'm like, oh, no, I don't want to be predictable, and I want to be known, but I also don't want people to know anything about me, and it's just--it gets all tangled up. and I get defensive when people I care about know things about me. And it doesn't make any sense at all, and I'd get rid of it if I could, but that's I think one of the ways that RSD has has impacted me throughout my life.

Harvey: 16:03

Yeah, and if this sort of description is resonating with you, and you don't have ADHD, you are not alone. RSD--there is some evidence to suggest that is actually not exclusive to ADHD. It's most commonly associated with ADHD, but we also see RSD in anxiety and autism.

Pen: 16:21

Which makes a lot of sense. Like, I don't--I think it's pretty--it seems to me that it would be fairly rare that a symptom or a manifestation of especially a psychological disorder or condition would be exclusive to that one thing. Like, brains are--brains are weird.

Harvey: 16:40

Yeah, there are a handful of symptoms that are specific to certain mental--mental illnesses, but the more specific ones you start tending to see in, like, personality disorders. A lot--specific symptoms are more common there. But I can--I could also talk a little bit about how RSD affects me.

Pen: 17:00

Yeah, sure.

Harvey: 17:02

I don't really have the anger response quite as much. Really, just because I don't--it doesn't--I don't get angry very often. It's--it's not an emotion I like to feel.

Pen: 17:13

I typically don't get very angry either...

Harvey: 17:15

Yeah.

Pen: 17:16

...as a general rule.

Harvey: 17:17

Sorry, I was trying to imply that you did.

Pen: 17:19

No, no, I just mean, like, as an example of, like, how RSD can differ from your usual emotional responses. It can be, like, almost polar opposite, like complete 180.

Harvey: 17:29

Yeah, yeah.

Pen: 17:30

But anyway, yes, please continue.

Harvey: 17:31

Um, you know, yeah, like, really minor conflicts, particularly interpersonal conflicts feel so much larger to me than they do to the other person most of the time. And a lot of the time, this very directly results in suicidal ideation, and--and sometimes, like, real, acted-upon self harm, more than once. And it was part of that that actually made me think that I had BPD for a short period.

Pen: 17:59

I also had--had that experience.

Harvey: 18:02

Then I was like, shoot, this is just RSD, isn't it?

Pen: 18:05

But it's like, it's because we don't know about these things. We aren't taught these things, and so we have to come across them in the wild, like lions and face masks. And if you don't know what I'm talking about, or referencing, I would recommend our episode INTRO to Self-Care.

Harvey: 18:18

That's a good one.

Pen: 18:20

Yeah, yeah. So that is one of the big things with ADHD, that especially is not typically understood about it. That emotional dysregulation is a huge component, and particularly can impact people in ways like RSD. So here's a--here's a few, like, kind of quick facts about ADHD.

Harvey: 18:43

Go, go, go!

Pen: 18:44

I took real notes. According to the CDC, in 2017, in the US, it affects approximately 11% of children and 5% of adults.

Harvey: 18:53

Oh, wow.

Pen: 18:55

Because percentages never mean anything to me, that's about 8,107,000 children and approximately 12,570,000 adults.

Harvey: 19:05

Yeah, that's--that is quite--that is quite remarkable numbers.

Pen: 19:08

Yeah, that's--it's pretty big. And you know, there's fewer children than adults in the US. So that's why those those numbers differ in the way that they do. But I've definitely noticed, when I talk about ADHD, more people than I would think are like, "Oh, yeah, I also have ADHD." Like, the place I just started working at, two of my coworkers' husbands have ADHD, and one of my coworkers has ADHD herself. And that's just, like, the three other people that I've met so far, and there's at least one other person working there, and I have no--like, I haven't brought that up with her. But out of five people working there. That's, like, pretty significant.

Harvey: 19:55

Yeah, you know, odds are you know, somebody with ADHD or you know somebody who knows somebody with ADHD.

Pen: 20:03

Oh! Another big--another big thing with ADHD, and that I think is really important to talk about with it, ADHD versus ADD. So, the biggest thing about that is that, as of I think the DSM-5, ADD is just not used anymore.

Harvey: 20:22

ADD is not present in the DSM-5.

Pen: 20:23

Yeah, it's used to be, you know, the distinction, essentially, between whether or not that hyperactivity existed. But these days, it is categorized in different ways that I think are actually really, really useful. Like, shockingly, I actually like this from the DSM, and that doesn't usually happen.

Harvey: 20:40

Sometimes simplification is good.

Pen: 20:43

So the diagnosis is just Attention Deficit-Hyperactive Disorder. And then the way that they will go at it from there is that it'll be classified in three different ways that it usually presents. And for all three of them, it's, like, totally expected and normal for that to change over time, and they're classified as like primarily presenting in this way. And it's totally normal for a person to have, like, symptoms between them. And that kind of flexibility and understanding that like, this is just kind of how it looks, and it can change over time. I actually really like. I think that's a much more useful way of distinguishing.

Harvey: 21:24

I actually didn't know they changed.

Pen: 21:25

Yeah, yeah. Yeah, they can change over time. And I think, especially when it comes to diagnosing children versus diagnosing adults, that can be very, very significant.

Harvey: 21:35

ADHD in the way it presents in children and the way it presents in adults is vastly different.

Pen: 21:40

And I think it can be very hugely impacted by when you are diagnosed. Like, if you're diagnosed as a child, and you know these things about yourself, versus if you're diagnosed as an adult, and you've been suppressing these behaviors, then your symptoms aren't going to show up in the same way.

Harvey: 21:55

That's called masking.

Pen: 21:56

Yes, it is. It's bad.

Harvey: 21:58

It sucks.

Pen: 22:00

Particularly when you're doing it because you feel broken and wrong. Which I have a lot of experience with. But let's talk about the three ways that ADHD presents.

Harvey: 22:09

Yes, go on.

Pen: 22:10

There is primarily inattentive, primarily hyperactive-impulsive and combined. So yes, I have a list of some of the--the typical symptoms of them. In order to be classified as any of them, you have to have--if you are under 16, it has to be--let's see--six in a relative category. For 17+, it's five. And then if you are combined, you need to have either five or six in each of them.

Harvey: 22:44

Hmm.

Pen: 22:44

Yeah, that's--I mean, that's the thing is--so for combined, it'--it's, like, pretty significant for you to be classified that way, but it's also totally normal for someone who's classified as, say, inattentive to have, like, four symptoms in hyperactive-impulsive, because, like, it's a complex disorder that manifests in a lot of different ways. But it's still very useful to have that classification, because, like, meds-wise, I don't think it changes anything, but in the way that, like, behaviorally and in therapy, and with, like, tips and tricks that's going to impact it in hugely different ways.

Harvey: 23:20

Oh, yes.

Pen: 23:21

Like, if you're the kind of person who has, like, a lot of excess energy versus the kind of person who just gets distracted a lot, like, these are totally different ways of dealing with it.

Harvey: 23:30

Yeah.

Pen: 23:31

So, yes, I got a list of symptoms and things from the CDC. I'm going to be linking that as well in the description in case people are curious. I know that I always am. Deeply so. So I am--I'm almost 100% positive that two years ago when I was diagnosed--it was two years ago. Isn't that weird?

Harvey: 23:51

Oh, my God.

Pen: 23:52

Right?

Harvey: 23:52

Oh...

Pen: 23:53

I was diagnosed about two years ago. It would have been January 2019, I'm almost positive.

Harvey: 23:57

Oh, wow. That was--that was around--that was, like, six months after we met, which is why it's weird.

Pen: 24:03

Yes. And then I got medicated with Adderall, I think in that February. My psychiatrist started me--tried out an antidepressant on me to see if it would work, because you know, fewer side effects than a stimulant, but it did nothing for me. So now I have artificial dopamine.

Harvey: 24:25

Not necessarily artificial dopamine. Artificially-produced dopamine.

Pen: 24:28

Yes, artificially-produced dopamine, and also even higher heart rate, so...

Harvey: 24:32

Uh oh!

Pen: 24:34

Kind of wish the antidepressant had worked, but here we are. So I'm--I was classified as primarily inattentive, but I present several hyperactive-impulsive and even--and even more of them I presented as a child, which I think is probably very, very typical.

Harvey: 24:51

Yes. Very, very typical, especially if you are not diagnosed as a child.

Pen: 24:56

Yeah, so like, that's one of the ways that it's just naturally going to change over time.

Harvey: 24:59

Yeah, no, that makes sense.

Pen: 25:01

Particularly because some of the ways that the symptoms are described have to do with, like, a classroom setting, typically. Which, you know, some of that can translate into work settings as an adult, and some of them just can't.

Harvey: 25:13

But this is--

Pen: 25:13

Not one-to-one.

Harvey: 25:14

This is really illustrating how the way that we define mental illnesses is based on some very stringent criteria.

Pen: 25:21

Yeah, definitely. Like, some of the criteria for diagnosis with ADHD requires these symptoms to be present before age 12. And when it comes to things like that, one of the things that I always think about is like, sometimes the symptoms are present, but they're not noticed, or it's something that's hard to like, look back and be certain of. Especially like, I was diagnosed at age 20, so my relative certainty on how things were, and whether or not I was like, holding them back when I was nine is like, way harder to judge.

Harvey: 25:55

Yeah, that was 11 years ago.

Pen: 25:57

Yeah. But, so--here's some of my, like, my primary symptoms. For inattentive I have all but one of them, I think. Yeah, and that one is, often seems to not be listening when spoken to directly. I don't think I present like that.

Harvey: 26:17

I don't think so.

Pen: 26:18

But that's the only one.

Harvey: 26:19

I think between the two of us, I do more of that. But that's because I hate making eye contact.

Pen: 26:25

So there's, "often fails to give close attention to detail or makes careless mistakes in schoolwork at work or with other activities." That was something that I had much more as a kid than I do now. But things, like, I always refused to look back at my tests, like after I finished them, because there was absolutely no reward in my brain for doing so. I had already completed it once and there was just zero internal motivation for me to do it again. Which meant that sometimes, like, on math tests, I would get a lower grade, even though I totally understood the problem, because I made like--like, I misread one number or just wrote it down wrong because I have ADHD. And I totally would have caught it if I went back over it. But it was so hard for me to do that."Often has trouble holding attention on tasks or play activities." That almost feels--it feels funny to see that listed because it's like, oh, trouble paying attention for inattentive presentation? Wow!

Harvey: 27:20

Well, what caught me actually was play activities. Was like, oh, okay, so I need to--need to dangle, like, my cat teaser in front of--in front of Pen, and see how long they pay--

Pen: 27:29

That works.

Harvey: 27:30

Oh, God, you're right.

Pen: 27:32

It works on me.

Harvey: 27:32

I did it once when I adopted my cat.

Pen: 27:36

And laser lights work on me also.

Harvey: 27:38

Okay, that--I mean, both of those are charming, though.

Pen: 27:41

And so they, like--stimulation enters my playing field, and I'm like, give it to me.

Harvey: 27:47

Oh, my God, stimulus?[Harvey taps the microphone]

Pen: 27:52

It's--it can be very convenient for me. It can also be very embarrassing sometimes. But luckily, I'm very comfortable around you, and I don't mind that cat toys work on me.

Harvey: 28:00

You're around friends who love you very much.

Pen: 28:03

I mean, I'm a cheap date. Just put a little bell in front of me. And I'm like, oh-ho-ho-ho!

Harvey: 28:09

You have stimulated me.

Pen: 28:10

Oh, I can hit this, and it makes sound!

Harvey: 28:14

But continue.

Pen: 28:16

"Often does not follow through on instructions. Fails to finish schoolwork, chores, or duties in the workplace.

Example: 28:20

loses focus, gets sidetracked." I absolutely get sidetracked and lose focus. I think I usually come back around and finish a thing. But I--being able to just sit down and complete a task from start to finish, I can count, I think, times that that happens versus times that it doesn't. It typically doesn't. I remember the first time it happened for me, I think, like, ever in my life, and it was after I started taking Adderall, and I went into my dorm room to work on my Spanish homework. I sat down. I did most if not all of it, I got up, briefly went out to talk to you, some of the people in the commons, came back, sat down, and finished it with no loss of focus or concentration the whole time, and it was one of the most surreal experiences of my entire life.

Harvey: 29:14

Yeah, I remember that being really remarkable for you.

Pen: 29:17

I was like, wait, is this what you all can do? What?

Harvey: 29:21

It's--it's very funny for me. In our friend group, I am the only one without ADHD. So--I'm also really insecure with my work ethic. So every now and then at, like, in, like, the

Pen: Like, okay, one: 29:31

Absolutely, of course, like take middle of the afternoon. I'm like, hey, guys, I've been working on stuff since like--for like seven hours. Is it okay for me to stop? And all of y'all are like, Oh my God, yes. And then also, how do you do that, Harvey care of yourself. It's perfectly reasonable and, like, encouraged to take breaks. And it's like, yeah, of course you can. Two: What do you mean you just worked for seven hours straight? Like, I can do that but only if I'm hyperfocusing. And like, that's totally different. I can't get up to stop. I can't get up to get more water to drink.

Harvey: 30:05

No, yeah, see, I can do that. So...

Pen: 30:07

I don't--Anyway, "often has trouble organizing tasks and activities." Yeah, yeah, I can do it. That is the exception."Often avoids dislikes, or is reluctant to do tasks that require mental effort over a long period of time, such as schoolwork or homework."

Harvey: 30:29

That's really funny wording. I'm so sorry.

Pen: 30:31

It is--it's very funny wording. And it's

Harvey: 30:32

Ruh-roh, Raggy. like--it--like, come down to it, it's like, yeah, like we were

Pen: 30:34

Yeah. But, yeah. So she'd be like, "Hey, can you go get talking about earlier, the reward center uby brain is like, why on earth would you do this? I don't understand. "Is often easily distracted and is often forgetful in daily activities." And that one reminds me of when I would--as a kid, my mom would be like, "Hey, can you go downstairs and get the, like, the spaghetti sauce?" And I would be like, "Yeah, sure.: And the jar of spaghetti sauce?" or something, and I'd be like, "Oh, yeah, sure." And I was even more distractable as a kid than I a I go down to the basement, and I would be, like, you know, now. And so I would, like-- talked to myself a lot. And was always lost in like, fantas worlds and things, in par, because I read a lot, and n part, because I was using po r coping mechanisms for childho d trauma, but you know... thinking about things and talking about it. And I would go, and I would stand in front of the shelf, and I would be looking at the shelf, and then I would go back upstairs without having anything. And she'd be like, "Where's the jar of sauce?" And I was like, "Oh, right." And like--so what I got the habit of doing was, like, saying the word, like,"spaghetti sauce, spaghetti sauce, spaghetti sauce, spaghetti sauce," like, while I'm there, so that when I stopped and looked at it--and then I had to tune into what I was saying, because I stopped noticing what the words were. And this was all in the course of, like, it took like 30 seconds to walk down the stairs. So then I had to, like, tune into what I was saying, because I was just doing it on autopilot and be like, "spaghetti sauce, okay, okay." And then, like, take that extra minute or two for my brain to comprehend what I'm saying and why, and then what the next step is. And then I would see the spaghetti sauce, and then I would process that I'm seeing the spaghetti sauce, and then I would process that I need it, and that's why I'm saying it. And then I would grab it. And then I would go back upstairs and have to, like, also sometimes focus on not putting it down somewhere else because I got distracted. So this simple task of going down the stairs to the basement to grab a jar of spaghetti sauce and coming back upstairs, required, like, a checklist of mental activities and focus things that were--I had to do actively. Which, when looked at retroactively, because that was just my life, so I didn't realize that that was you know, anything. And then, like, some time when I was looking back, I was like, oh, that's not how things usually are, is it?

Harvey: 33:02

No.

Pen: 33:03

That's not--oh, people don't have to do that, do they?

Harvey: 33:06

Like, I'm a pretty forgetful person, but I forget things over long periods of time. Like, if my mom, for example, says at, like, 12pm like, "Hey, can you defrost the shrimp before I come home?" I'll be like, "Sure," and then several hours later, I'll forget. I don't forget things in the span of 30 seconds.

Pen: 33:23

It's--it's because it just doesn't stick.

Harvey: 33:27

Yeah. No, there's some kind of issue with encoding it to your short term memory.

Pen: 33:30

Yeah. And that's--that's actually one of the things with ADHD. And I know I'm getting off track here with, like, the symptoms and whatnot, but--oh, I do want to mention, one of the ways that I have learned a lot about ADHD, and that's been very affirming is comics that are made by a person who goes by ADHD Alien.

Harvey: 33:49

Oh, yeah, you've sent some of those in our Discord.

Pen: 33:51

Yeah, yeah, and they're on, like, Twitter, and other places. So if you look them up, you'll find some really, like, very cute drawn comics, but also that explain a lot of things and have metaphors that are super useful.

Harvey: 34:03

They're great.

Pen: 34:03

And that is where I learned about some things where like, from short term to long term memory, usually, you know, they just, like, go one to the other in a neurotypical brain, and it just works. But with ADHD, like, things get dropped.

Harvey: 34:17

Oh, yeah.

Pen: 34:19

A metaphor that I think I might have gotten[unintelligible] that I've used with you before, and this is for more than just memory, but it's, like--like, let's say, for people who don't have ADHD, and there's gonna be, like, some folks who this will resonate with, for like different disorders and whatnot, too. But for people who don't have ADHD, it's like--like, imagine that all the things for, like, being able to focus on a task and move something from short term to long term memory, getting the motivation to do something, all of these are like little balls. And for people who don't have ADHD, you have a bag that you can hold all these little balls. And you can, like, reach it, and you can get it when you need it, and then you can put it back, and then you have it. For people who have ADHD, there's no bag. We have to hold it in our hands and our arms. And if we're looking for one, then we have to look through all of them, and we might drop another one, or it might be that we're given one and our hands are already full, and it's just there and it just falls at it doesn't--we don't have it. And for me being medicated with Adderall is like having a bag with a hole in it. And that was, I remember when we--we were talking about it, and kind of came up with that metaphor of, like, the bag with a hole in it, because sometimes I would notice that I was still exhibiting symptoms. And I was like, "Well, what--like, are the meds not working? Like, is there something wrong? Do I not really have ADHD? Like, what is it?" And then got to realizing like, yeah, I'm medicated, but it doesn't make my brain neurotypical. And so it's like--it's a complicated thing, where it's like, okay, so this is better than it would be otherwise, but my brain's just never going to work like it's"supposed to."

Harvey: 36:00

Right.

Pen: 36:02

And I think the most effective metaphor I've had for that is a bag with a hole in it, where it's like, hey, this is much better than holding it in my hands. Things fall. They're going to keep falling. This is--and I think--I think one important thing, when talking about ADHD in particular, like treatments and things, this is not a curable condition.

Harvey: 36:19

No.

Pen: 36:22

Like autism, this is just something--like, this is how my brain is. This is how my brain is going to be for my whole life. Differently than autism, there are, like, medications and things that can impact ADHD and--and help with--with coping, and improvement, and, in the case of Adderall and other stimulants, artificially introduced ways for my brain to have dopamine to do a thing. But there is no way to just cure ADHD.

Harvey: 36:52

And I think that is sort of the crux of the difference between mental illness and neurodivergence.

Pen: 36:59

Which I know we've talked about before, but like, I think it's important to reiterate.

Harvey: 37:01

Yeah, mental illness can last a lifetime, but the thing about mental illnesses is that they often can be cured. You can have anxiety for a period of time and then not have it anymore after treatment. Neurodivergence is kind of necessarily your entire life.

Pen: 37:18

Yeah, it's like, I was born with my brain being this way, I will die with my brain being this way. There are things I can do over the course of my life to make things easier, like taking Adderall and recognizing my own symptoms, and being in therapy, and having stim toys and jewelry to help with my focus, things like that. But I'm never going to be able to change that base level I-have-a-dopamine-deficiency. Ooh! Fun fact about dopamine and medication and how it's useful

for ADHD: 37:51

one of my favorite things about ADHD medication is that typically, one of the most common ways that is treated is with a stimulant. And that's--that's the way people usually know like Adderall or Ritalin, that kind of thing.

Harvey: Street name: 38:04

Speed.

Pen: 38:05

Yes. It's, uh--sometimes it's just a component in--in a party drug or a street drug.

Harvey: 38:13

Yes. I'm oversimplifying it.

Pen: 38:16

no, but like, That is the thing, is--the thing that's very, very funny to me, is one of the ways that you can figure out whether or not you have ADHD, and this is not something I'm recommending this is something that just happens to be true, is that if I take a stimulant, like Adderall, I'm not going to get high. That means I have ADHD.

Harvey: 38:42

So if, for whatever reason you have recreationally taken Adderall...

Pen: 38:48

Which is not a suggestion that we are making.

Harvey: 38:50

Don't do that.

Pen: 38:51

No please--oh, my--please don't. Please don't I have to--my drug is federally regulated, I have to have more psychiatry appointments than I would have to otherwise, because people abuse Adderall. Please don't abuse prescription drugs, if you have any way to help it. Anyway..

Harvey: 39:08

If you've ever taken Adderall recreationally, and it just didn't do anything for you, you might have ADHD.

Pen: 39:16

There are very good odds you do. And this is--and Harvey's better at, like, the more detailed descriptions of it, but it's essentially because, like we've said, ADHD means I have a dopamine deficiency. Adderall artificially creates more dopamine. So if you have the normal amount of dopamine, and then you add more, you get high.

Harvey: 39:40

Yeah, it's--it's overloading those reward centers in your brain. Yeah, Adderall is what is called an agonist. There are two kinds of drugs. Basically, there's an agonist and antagonist. An agonist, in one way or another, promotes the production of a neurotransmitter. And this can happen several ways. SSRIs are actually agonists by blocking reuptake. But also in the case of Adderall, they can just promote neurotransmitter production.

Pen: 40:09

Yeah, and Adderall is, like, different from SSRIs in that Adderall is, like, you will know the date you take it whether or not it is doing the thing for you.

Harvey: 40:18

The mechanism of action is very, very different.

Pen: 40:22

And an antagonist is like Fire Lord Ozai from Avatar: the Last Airbender.

Harvey: 40:27

Eh... sure!

Pen: 40:29

In a very different context. In the context of psych meds, that is not what it is.

Harvey: 40:34

No. An antagonist is something that diminishes the--the availability of a certain neurotransmitter. So actually, in schizophrenia--unusually high amounts of dopamine is actually involved in schizophrenia, which is why sometimes we have to be careful with Adderall because we might start seeing symptoms of psychosis.

Pen: 40:57

Yes.

Harvey: 40:57

So sometimes they do--uh, antipsychotics are often dopamine antagonists.

Pen: 41:02

That makes--that make sense. I'm--yeah--and that's--I think that's one of the things though, like, I know, antipsychotics are not always prescribed for bipolar disorder, but...

Harvey: 41:13

No. Sometimes, though.

Pen: 41:14

Yeah. And so when you have the overlap in diagnosis, and also, like, the overlap in symptomology, and possible misdiagnosis of bipolar and ADHD, you could be medicated completely incorrectly in a way that could go very, very bad or could just be like, okay, so I've been taking this med for--Oh, my God, I used to be on an antipsychotic.

Harvey: 41:35

Oh, that's right.

Pen: 41:36

I forgot. It was the one that that horrible psychiatrist didn't actually tell me the proper side effects of and didn't give me blood tests. He put me on an antipsychotic.

Harvey: 41:45

Yikes. Damn. Anyway, anyone else in this thread smoke weed?

Pen: 41:49

That would have been worse than ineffective.

Harvey: 41:53

I think we're gonna have to cut out that weed bit, but...

Pen: 41:56

No, that's--

Harvey: 41:58

Oh, wowza.

Pen: 41:59

Yeah. So that's--that's one. But yeah, that's--got kind of off track there, which is pretty typical for us, but these are some things about ADHD and my personal experience. And also, I tried to focus on some things that are not commonly known or understood about ADHD, because I think that's one of the most important things for me when I talk about it. Because it took me 20 years to realize, oh, I have ADHD. Even though if it were more properly recognized, and psychiatrists weren't also part of the problem that it stereotyped into a very specific form of recognition, but, like, if I had known when I was younger, so much could have been different for me, but I didn't know it could look like this. Like I do. Uh, yeah. Do you have--do you have any thoughts, Harvey? I usually ask me first, but I have said everything.

Harvey: 42:48

Yeah. I don't know if I have thoughts, because I don't have ADHD, but I can tell you, I learned that the way that ADHD presents can change over time, which I had no idea about. So that was fun to learn.

Pen: 43:03

And I know we've had conversations, several conversations where we've talked about, like, my behavior or behavior of some of the other people we know who have ADHD. And you've been frustrated, which has been, like, reasonable. And I've said, oh, that's like, it's reasonable you're frustrated. So, that is actually something that can be how ADHD manifests. And...

Harvey: 43:20

And, inevitably, I'm like, ohhhhh.

Pen: 43:22

Which doesn't change that the behavior can be frustrating or impact people. But I think having that understanding can be very impactful. Like, oh! Oh, you're not just being inconsiderate. Your brain doesn't know how to do this.

Harvey: 43:37

That makes sense.

Pen: 43:39

And that's actually very useful in that one of the ways to solve that problem for people with ADHD is outside motivation. Someone just reminding us to do it or starting a task with us, then we can do it. So if you know that a person you know who has ADHD has that issue, you could just be like, here, stand up and do this thing. They're like, oh, okay, I can do it now. That's not like 100% of the time, but it does work for me, legit.

Harvey: 44:05

Yeah.

Pen: 44:07

But yeah, yeah, that's--

Harvey: 44:09

Thank you for sharing, Pen.

Pen: 44:11

Yes, it was a delight.

Harvey: 44:12

Make sure to tune in in a few weeks. We will be releasing an episode about autism next. And I'm basically going to be doing what Pen did.

Pen: 44:19

Yes. It'll be my turn to not talk very much. I'll try so hard, Harvey. I'll try so hard.

Harvey: 44:27

I know this, and I love you.

Pen: 44:28

Thank you.

Harvey: 44:29

Alright, stick around for just a few more moments, and we'll tell you a little bit more about how this podcast is run, and our Patreon.

Pen: 44:36

Woo! Say 'wahoo.'

Harvey: 44:37

Wahoo!

Pen: 44:39

Yay!

Harvey: 44:42

Beyond Introspection is an independently-run podcast by Pen Novus and Harvey LaFord. Music by girl Lloyd. You can find us on Twitter and Instagram at ByndPodcast or you can email us at beyonddotpodcast@gmail.com. That's beyond d-o-t podcast, no spaces. We publish on Buzzsprout, iTunes, Spotify or wherever you get your podcasts. You can find the links to our social media and email in the podcast description.

Pen: 45:07

We also have a Patreon. You can find us at patreon.com/beyondintrospection. That's all one word. We also have links to it on our site and on our social media. Our podcast is entirely independent, so we pay for hosting fees and transcript service subscriptions out of pocket. This is a passion project that we're really happy to do, and any support you're able to give us would really make a difference. On our

Patreon there are four tiers: 45:27

$2, which gives you access to test audio and other bloopers;$5 which will give you access to bonus episodes that will make in the future, on topics like how angry we are Freud, our frustrations with our respective fields of studies and even guest episodes; $10 will get you a direct line and priority access to request episode topics and new bonus content; and $15, which will give you access to monthly AMAs--that's ask me anything for those who don't know--where we can answer questions ranging from the podcast process and we figure out what to record, more in depth questions about our neurodivergences, and more. All of those tiers will include benefits from lower tiers of course. And also just to note, unlike our regular episodes, Patreon bonus content is likely to include swearing, so if that's not your vibe, please know that ahead of time. We'd also love it if you're able to share this podcast with people you know. Our only advertising is word of mouth and we want to reach as many people as possible.

Harvey: 46:23

Got feedback for us? Want to request an episode topic? Just feel like saying hello? Feel free to reach out on social media, or via email. We'd love to hear from everyone. Take care of yourselves.