Transcript
Speaker: Hello everyone and welcome back to the ADHD UK podcast. My name's Lauren. I'm Max. And I'm Jamie. So today we will be talking about the programme, The Great ADHD Myth that took place on Channel 4 last week.
Speaker: And usually with the ADHD UK podcast, Max will kick us off. But obviously, I don't sound like Max. I'm not Max. Max, if you could please reintroduce yourself and tell everyone what you're doing on the podcast today.
Speaker: What am I doing? Well, I'm not necessarily hosting because we want to talk about this documentary and we want to bring in some of my, um dare I say, expertise. So I just want to, I sort of hide it. I'm not usually here as an expert, but I am today. So I,
Speaker: have run treated ADHD for 20 years I run an ADHD service in my local area um i have ADHD and I'm trusty and co-finder of ADHD UK and all and have lots of members of my family with ADHD as well so I'm kind of marinated in the world of ADHD it's fair to say Yeah, I think that is fair to say. I think that's fair to say. Now, I guess, you know, like, for me, one of the biggest issues with the documentary was, is they took a very sort of complicated area of a complicated subject, speaking about how there are no identifiable changes in the ADHD brain. Now, I'm not an expert, but I'm by no mean lay, and I struggle to get my head around that and
Speaker: If I struggle to get my head around that, I think the average audience will probably struggle with that as well. I don't know if you want to sort of speak about that a little bit for the benefit of the audience, Max. So let's let's kick off with what it said about diagnosis. and and And many of our listeners and viewers would have seen this documentary and some will not have. So I think it's worth saying they make the point...
Speaker: that ADHD doesn't fit with what often we think of as what a medical condition is. We think of a medical condition as something that we can see on an x-ray, like a broken bone, or in a scan, like a tumour something like that.
Speaker: And ADHD isn't that... um there is no single thing that we can find on a brain scan that will tell us yes this is adhd there are findings particularly if you take a more sophisticated approach in a kind of computational approach there are findings that will give you a good indicator on um on m MRI and and and other imaging give you a good indicator of ADHD, but currently imaging is not necessary or sufficient to make a diagnosis. And this is true
Speaker: um was made the point was made by Katya Rubio as one of the um experts who was... ah enlisted into the program, but it would make the point that Katya Rubio has basically said that they distorted what she said and um basically truncated her her remarks to make it look like she was supporting their argument, which she doesn't support.
Speaker: Because although there is not a single thing, there is lots of biological evidence that ADHD brains and ADHD people are different. It's just that there is no single difference. So take genetics, for example, which the program almost ignored.
Speaker: Partly because, i mean, they could make the point there's no single ADHD gene, but there's no single gene for so many conditions. That doesn't mean anything. Most conditions these days we know are not single gene conditions.
Speaker: So that doesn't matter. that doesn't There's no's no single gene for depression. There's no single gene for epilepsy. That doesn't make any difference. Although certain forms of epilepsy are monogenetic. It doesn't matter. Because it's polygenic, therefore you can't do a genetic test for it. But that doesn't mean that genetics aren't important.
Speaker: We know that if you if if you look at the chances of someone having ADHD, the contribution of genetics is about 80%. So there is a genetic, there's a huge genetic component here. It's just that we can't pinpoint and say, look, it's that, that's the thing that's giving you ADHD. And that's a completely trite argument that they're making that because we can't point to so a specific thing, that there's no, there's no biology involved here. It's total nonsense.
Speaker: Wow. Yeah. I mean, thank you very much for that explanation. um I guess... I mean,
Speaker: ah guess we're speaking here as if we assume that everybody's seen it. um I think you know there might be some people who won't have um who wouldn't have seen it. don't know Lauren or Max wants to, you know, explain in arguments.
Speaker: I'll just find you quickly what the programme was about. So for six weeks, we followed, well, in the programme, they followed a journey of one young boy's um journey of coming off of ADHD medication. And for throughout those six weeks, and we tried different things, such as coming off of the phones and laptops, going into the woods and spending more time of his family, et cetera. And throughout that time, you know, ah he was going to school and we had some feedback from from teachers as well to say that, you know, and he was getting on better with his classmates, but also he was and not doing so well with his work.
Speaker: At the end of that programme, for 30 seconds, we see that he's back on ADHD medication. So one of the questions I actually have for you, Max, is obviously in within the programme, they spoke about one type of medication that was used for Mason, who was the child in in the documentary. and Can i ask you about sort of different different medications for ADHD and what you think as well about about the program and then talking about just that one type of of medication?
Speaker: I think there's a lot of problems with drawing any conclusion from a single person
Speaker: and what we would call an N equals one experiment, because the whole point about ADHD and all the research that underpins it is it's based on thousands and thousands of children and averaging their response over this time.
Speaker: I think the section on treatment, so essentially what happened is he was on treatment and... He wasn't that happy on his treatment and it he felt like it was taking his personality away while he was um on it and he he didn't like it. And I think often this happens. we We have conversations like this with young boys and girls all the time in clinic.
Speaker: Sometimes it's to do with a specific symptom, like it might take away their appetite. or gives a headache or something. And sometimes it's just that they don't want to take something because they don't want to be different, particularly at his age. He's a little boy in year six. you know Identity and being different and being other is really hard, particularly at that age. We think of it in in teenagers that they don't want to be different, but actually it starts much earlier. Yeah.
Speaker: So there's all it there's all that in the mix um often. But there is also at the core of it a dilemma. You know, you would like to have the full fat person. You'd like to have all of the fun, all of the um creativity, all of the jokes, all of the liveliness that you get from a child with ADHD. You want that.
Speaker: And you want that while also being able to focus and and cope in school. Now, we can come back and circle back to whether the school system is suited to these kids.
Speaker: Fine. But ultimately, when you're giving someone medication, you're trying to give them just enough so that they can cope, but not so much that they lose what it is ah to to be them. One of the first things they talked about is how actually when he...
Speaker: when he when the medication wears off, he goes back to... He he has all of these out these outbursts, which is what he had before he had the medication. So I don't understand why that's a knock on the medication. I mean, withdrawal at the end of the day, or sort of rebound, what we would call it, not withdrawal.
Speaker: um Rebound effects are common as well. So there's all of these interesting conversations that we can have about, is he on too much? Does he need to take it every day? Does he need to take it at the weekend? Maybe he can have the weekends off, and then he can go and run around in the woods. Brilliant, fine.
Speaker: All of this stuff... is conversations that you can have. But what the program presented was either you are on, I think it was 40 milligrams of Lisdex and amphetamine, or you're nothing.
Speaker: And those are the two choices. The other false dichotomy it gave is either... you do yoga and running around in the woods and, ah you know, spending lots of time doing art and being sociable with your family or you're on medication. And then you basically just on on your iPad all day and you don't go out ever.
Speaker: And I'm like, well, that's also nonsense because you can do both. You can be on medication and then, You know, when your medication wears off at the end of the day, you can run around in the woods for an hour. And that's a perfectly valid way of doing it. I don't that there's so many false dichotomies that they set up between these two ways of approaching it. um Because the first line and this is a really important point, the first line for children for ADHD treatment is not medication. The first line is environmental modification, i.e. reasonable adjustments in school, increasing exercise like they did in the show, improving and optimizing sleep, looking at their mental health, which is closely bound up with their relationships. So building those relationships, improving their behavior, improving their behavior
Speaker: The way to improve someone's behavior is to improve their relationships. There's no magic bullet to someone who's being aggressive. You have to build relationships by spending time with them and and them experiencing positivity from them from you. So of course you have to do all of those things, particularly with somebody who is prior to treatment,
Speaker: causing a lot, you know, getting quite aggressive, getting kind of having lots of outbursts. You have to do all of those things. And they are the first line. At no point during this documentary did they make that point.
Speaker: Yeah, no, I mean, 100% agree. And I think another thing that I found to be quite and disingenuous was the idea that, and you know, we're just, everybody who walks into the doctors is just getting this medication. You know, as we know, ADHD medication is strong medication. It's considered to be a controlled drug. Yeah.
Speaker: You know, and there may be good reason for that. Now, i could see ah could see why there would be concern if people were going into the doctors with anxiety and coming out with Ritalin. But, you know, we we know that that's not the case. And in fact, if anything, really, it is much harder to get medication than it should be. I mean, if you think about the shortages of 2023,
Speaker: You know, put people weren't rationing their medication, going without it for weeks and all these kind of things. it's It's, you know, it's not... is is It's not just freely available, you know, I don't know if you have any thoughts on that. Well, I think I just come back to the ADHD task force, which and the Department of Health and commissioned and which came up with a very sensible report about a year ago, which states there is no, you know, we're not over treating ADHD as a whole. We're not.
Speaker: um You know, probably fewer people are getting ADHD medication than would benefit from it overall. So I don't think they explicitly said that it was...
Speaker: um It is too easy to get hold of medication, but there's an there's a a suggestion that he just got hold of some. I think it's worth looking at how he got hold of some medication. Firstly, of course, he went through the private sector, and we can circle back to whether there are problems there.
Speaker: The other thing is um that he basically he gave a load of ADHD traits, which probably he does have. I don't want to speak for him, but he says he gave um honest responses. And sounds like I've also read his Daily Mail article about this.
Speaker: um and he said you know He gave all sorts of examples of clear ADHD traits, but the point he made after the assessment to to camera, which is a good point, is that he's not impaired, he's not he's not actually disabled by any of these features, they have no impact on his life.
Speaker: So why should he get take medication? And he's correct about that. What he should have had is a section of the assessment that where somebody asks him about impairment as to whether his symptoms lead to and a significant impairment in his life. Now, either that didn't happen, which I think is plausible because people do get a little bit casual about that sometimes, particularly if everyone who comes to you is saying that they're impaired and almost as a private provider,
Speaker: yeah People aren't necessarily... Why are people going to come to you if they're not impaired by their symptoms? So it's understandable. It's bad practice. But it's understandable that you might go, clearly they're all got impairment because that's why would they be here?
Speaker: Unless they're a journalist trying to make a point, basically. That's the answer. um so So, but I do think so i do think there's a Nestled within all the nonsense of this, there's a point that we need to make sure that people are experiencing impairment as part of their symptoms. And that is a line that we need to hold. Otherwise, we are pathologizing normal behavior, which which they are accusing us of doing. So I think within that, there's there's there's ah there's a point. But then, of course, he got hold of the medication because in the private sector, you don't have to then wait for the medication. You can just get it. And that is unfair in lots of ways, but that's part of the way that our system is set up. So I think, you know, given that he'd bought and um
Speaker: a diagnos bought an assessment, effectively bought a diagnosis, um ah I don't think it's shocking that he got hold of the medication immediately because that's more a ah problem with the NHS versus private division within the health system.
Speaker: Yeah, I mean, you you know you make a good point there, actually. And while we're on that subject, um I mean, I've heard a lot of people say things about the private sector and say how they give out a diagnosis too easily. i don't I don't know if you have thoughts on that, Max. or i mean, I know that, like Henry always says, that And the the private clinics are held to the same standards as the and NHS clinics. And I've also heard people say that it's really easy to get a diagnosis privately. I'd love you to maybe clarify that for the audience.
Speaker: Yeah, I think. um The. evidence seems to suggest that pretty much all ADHD clinics, dedicated ADHD clinics have a pretty high diagnosis rate, because you basically triage people, you sort of make sure before they come to that assessment that they probably have the condition. Otherwise, why do the assessment? So our NHS clinic, the NHS clinic I lead, has something like a 96, 98% diagnosis rate. And that's of autism or ADHD. But it's very high. so And that's NHS. So I don't think we have evidence that there's there's a systematic difference between the private sector and the and NHS.
Speaker: And there was a Panorama um documentary a couple of years ago that tried to make that case. And I don't think they really made it convincingly. Is there a concern? Yes, there is a concern that people who come wanting a diagnosis, paying money for a diagnosis, it does take a bit of gumption to say, well, actually, I don't think you have this diagnosis. But, you know, a lot of the time...
Speaker: All right. there If you do start handing out dodgy diagnosis, there is a very real threat that you'll get in trouble. Because they are Henry's right to say that private sector is um governed by exactly the same ah agency, the CQC, as the the NHS. There's no difference. So... ah I think I can see why people worry that we have there's a bit of a fuzzy boundary between a bit ADHD but not quite impairing enough or a bit ADHD and other stuff going on. It is fuzzy at the edges. um
Speaker: But that's true in the and NHS as much as it's true in in private sector. And I speak of someone who works in both sectors. okay Could I just add on to that about the ADHD UK's website? So if anyone listening, because obviously if anyone listening wants to go to the ADHD UK website, you can actually see the list of providers on the ADHD UK website if you are, if wanting to. Yes, that's right to choose providers. Yeah.
Speaker: Yeah, that is there. If you want to to look up, if you're interested in pursuing this for yourself, that's definitely true. Perfect, perfect.
Speaker: but by By the end of the programme, obviously Mason does end up going and back onto his ADHD medication. And as well, at the end of the programme, we hear a little bit about Dr Max explaining that he believes that ADHD is a social construct.
Speaker: Now, the way that it was explained made it feel like this was explicitly, you know, this is what he obviously believes. But to a lot people watching that who already don't really understand what ADHD is, that can cause myths in itself. And it's quite interesting how it's called the great ADHD myth because I feel like it's now caused, you know, myth around what ADHD is to a lot people that maybe don't know what it is from either an individual experience or from someone, you know, they may that they may know um so just wanted to know both of your thoughts on this really um for myself I feel like calling ADHD a social construct was so damaging to a lot to a lot of people you know because we especially having ADHD ourselves we understand um you know each each and every day is different but been through a lot my own personal life you know
Speaker: that I know ADHD as well from my lived experience, but i would like to know from both of your lived experience and from you, what you think about this. I mean, that's ah um Max is probably a bit more and qualified or will be able to articulate and answer better to this than me. But, you know, to me,
Speaker: um
Speaker: I mean, a lot of people say things like this, even you know even even people within our own community. And um
Speaker: I don't know, again, it goes goes back to the whole whole thing that the they took a very complicated and subject matter and sort of stripped of context and added to an already debate.
Speaker: um
Speaker: Yeah, I don't know if... umm Max, you have anything to say? I mean, i it's not a social construct. I mean, I think we can very so very straightforwardly say that that is just wrong. So let me explain. Because they didn't actually explain what they meant by social construct, which I thought was one of the many dishonest things that they did in that in the in in the documentary.
Speaker: So what a social construct is, let's say I'm going to use a sort of geographical analogy. So the relevant to yourself, Jamie, that the border between England and Scotland okay is a social construct.
Speaker: As in, there is nothing on the ground, like at least before we of form the border, there's nothing on the ground which tells you that there's something radically different about Scottish grass versus English grass.
Speaker: I know you will say that Scottish grass is better, but let let us believe that to one side for one moment. Um... But so that's a social construct. The water is better. Yeah. So England is a social construct. I can kind of accept that. There's nothing there's nothing kind of inherent about in the in the world about England. or you know All of these things are social constructs. I get that.
Speaker: But ADHD is not something that's made up independent of the physical world of course of course what adhd is more like the difference between a hill and a mountain so let me explain you've got these pointy bits around you know around you particularly in scotland i have to say obviously um and at some point you go from calling them a hill to calling them a mountain okay so you can argue and there have been arguments and there's reclassifications about what's a hill what's a mountain Fine.
Speaker: But none of those, it's a bit fuzzy, or maybe it's a hill, maybe it's a mountain. We we can argue about definitions. you know Does it need to be steep? Does it need to be you know how far above ground level versus sea level, block you know whatever?
Speaker: but None of that means that mountains doesn't don't exist. yeah And that's the argument they're making. It's hard to define, and it's hard to see in the world that therefore it doesn't exist. And that's complete nonsense.
Speaker: yeah There is a material reality to ADHD, which isn't easy to see in the talk with the tools that we have now. But there is a material reality. We know we have decades of research backing up the fact that there's a material reality. That doesn't take away the difficult questions, and the difficult problems about where we draw the line. What is the role of...
Speaker: environment such as poverty such as trauma such as all of these things that we talk about on this podcast all the time none of that means all of that's important but none of it means that the thing we're talking about does not also exist yeah exactly and i mean i I mean, what it did get right was that schools, you know, aren't particularly suitable for people with ADHD. And at the end of the documentary, it talked about how maybe, you know, we just need to change the society around us and everything would be a little bit better. But it's far more complicated than that, you know? I think it is.
Speaker: Yeah. yeah sorry No, it's far more complicated than that, like, for sure. Yeah. And I think... Yes, there should be as many adjustments as is possible to make for these young people.
Speaker: Absolutely. And I push for that all the time. And I'm very, very keen on that. One of the problems, though, is that what suits an ADHD child might not suit other kids. And they're all in the same space. And unless we suddenly have cart class sizes of 12 or 6 in our mainstream schools, which is not going to happen,
Speaker: We're not going to be able to have, oh, well, we're going to stream these children and they're all the lively ones and they can all sit in this room. And these are all the ones that need quiet and get, you know, find it really difficult when get overwhelmed when things are too much. And here are the ones who you know, with other needs, you can't do this endless streaming. So you have to have,
Speaker: A little bit of push and little bit of give and take about that. And there's also the other thing that and sort of was a bit annoying. I mean, i I thought the most annoying bit of this whole documentary were the talking heads because none of them are experts in ADHD.
Speaker: You know, they're they're all kind of retired mainly retired people or people who have a professional, a financial interest in denying ADHD. So, ah you know, when i talk about financial interest, we need to look at that as well.
Speaker: um or at least denying ADHD treatment. Anyway, we'll talk about them in detail in a bit. but um But yeah, I mean, I think, you know, this one of the most annoying things was when she's when Iona Heath, who's the former ah head of the Royal College of GPs, who was very respected in her time, but it's been... um retired for more than 10 years now said oh well what we should do is we just should just we should just make um the curriculum much more creative much more sport much more creative subjects I'm someone who grew up with ADHD I hated sport at school and I wasn't very good at because I'm also quite dyspraxic so I'm not I wasn't that good at creative subjects either so actually i would have hated that thanks Iona and all but also what do you lose if you just everyone is and I'm not a sort of Michael Gove
Speaker: back to basics kind of educationalist but we are in a we are competing with other countries and if they're miles ahead on reading writing and and the basics how are we setting kids up because we're spending all of our time doing other things so there's there's just tensions and there's difficulties within the school system which this program one was not interested in at all it certainly wasn't the best person on the education system was his teacher just like the best person on treatment was his mum i i think we should have had this documentary should have just spoken to primary school teachers and mums and it would have been a lot better but that would be fun isn't that funny that part of lived experience sorry what were you saying
Speaker: Oh, sorry, i say isn't that funny that it's, you've got, you know, the specialist sort of speakers, but then you've also got people with' lived experience that know Mason, that have have been around Mason. So lived experience, you know, yeah does really make an impact when when we do speak about it. It's lived experience, but it's,
Speaker: But it's also curiosity and doubt. So both mum and his teacher said, I'm not sure about this. I don't know about this. His teacher was like, you know, he's getting on better with his kit with his friends off medication, but he's really hard to handle in class. And I don't know what the right answer. And I was like, wow, that's so refreshing after all these people popping up with this absolute, you know, well the absolute belief that this is not a thing. And and I suppose I could be, a I could be,
Speaker: guilty of that as well but the difference is i'm in this and i have the data to back it up yeah Exactly that. I mean, were they not, I can't remember who was, but one of them was, I think it might have been Pemberton, but they were talking to the teacher and they were saying, do you think, or something about like, is it easier to teach kids with medication or whatever? And I'm pretty sure the teacher was like, well, I mean, it is easier to, you know, to teach this kid with medication. They can't speak for everybody or something. Yeah, it's a very good answer. She was great.
Speaker: Yeah, she was very she was she was she was one of the best. Him and Mason's mum, they were good. i think Mason's mum was also good because she was very much focusing and centering him. And she was like, I just don't know what to do. And this is dilemma. And I felt i felt for her because actually this is a conversation she should be having with her own doctor, not with ah a journalist.
Speaker: Because he's a journalist he's he's doing this as a journalist. he's not doing this as a doctor, he should She should be having this conversation with the doctor who looks after Mason. If she's not able to do that, I think that's a shame. But this is it's a valid conversation to have.
Speaker: Yeah, I guess it's a separate um yeah perce debate, a separate problem.
Speaker: Another question, actually. So for anyone that has watched a documentary that was thinking about, you know, seeking help for ADHD themselves, um but have seen the documentary maybe has now a different view of what, you know,
Speaker: ADHD is just from this documentary alone. Would you have any advice, Max, on on seeking help? Because I feel like this documentary may make people be a bit anxious about that. So I just wanted to ask what you Yeah, think the ADHD UTA website is is the best place to go. And I say that not just because of my position within it. ah i I think it's becoming the go-to. Lots and lots of people are are referring people to it. There is a page that we built for ADHD doubters, you know, that you can show to somebody who doubts the the evidence for ADHD.
Speaker: um And there's also there's there's lots of resources on there. And also there's support. you Join one of our groups. Talk about how the documentary upset you or effect affected you.
Speaker: um I think... I think just to reassure people, I really don't think that this is going to lead to change in policy. i don't think this is In six months' time, yes, there will still be kind of people saying, oh, this this was on the telly. In six months' time, this is not going to change what the what the situation is. this because it's Partly because it's really badly done.
Speaker: Partly because, actually, the one of the things that's cheered me about this whole episode has been how unanimous the professional response has been to it outside of the few non-experts that they interviewed. Because to re to reiterate, the people they they they interviewed, the talking heads, are not experts on ADHD.
Speaker: um every Everyone has come out with one voice and said, this is shoddy, this is not right. So I don't think it's actually going to change things. It might make it easier for a government to to not take action about ADHD, who don't want to take action, fine.
Speaker: But it's not going to, I don't think it's going to change the weather as a population as a whole, because it's so badly done and and its flaws are so obvious. Like 100%. I mean, like, I don't know if I'm in my own echo chamber, but I haven't seen um one article that's been in support of it.
Speaker: And, of you know, I was looking at my feed the other day and appreciate every single post and was about the documentary. So, yeah. And I think i think it is there's a part of me that thinks it's a shame that it's been done so badly, because I think there is an interesting documentary in there about things like the fuzziness around diagnosis, the role of the private sector, raising some questions and having some debates about To what extent medication is the right answer versus some of the environmental stuff?
Speaker: um You know, to what extent we should address poverty? It doesn't really talk about poverty. It's a very difficult thing to talk about. And I don't want to speculate on Mason's particular situation. but He was in a very little house and there was lots of them in there. And of course, of course that's not an easy environment to be in. um And we do know that poverty is associated with higher rates of ADHD um diagnosis. Now, I would say that that's often related to the fact that people from um poorer families are subject to other stresses and therefore their behavior is going to be more difficult and therefore their ADHD traits will become more obvious. So classically, it's the boy who is smashing up year three or four who comes to clinic earlier or gets on the waiting list earlier. um Whereas the woman, the the young woman who is sitting in the back with just as much ADHD is not coming to it not coming to anyone's attention until she has some kind of mental health crisis later on. It may be that you wanted to talk about that a bit, Lauren, because I know you wanted to to bring that that side of things.
Speaker: Thank you. i really wanted to talk about this because as a woman, I did not feel you know represented within that programme whatsoever. and If anything, it really did... um make me annoyed to be honest because as someone that was diagnosed in their mid-20s and I know a lot of women you know are diagnosed um even a lot um later as well as a as a in general um I did not feel represented all at all and also I feel like for me I have hyperactive ADHD um and inattentive ADHD, so combined. And I didn't represent like that when I was a young person, you know. And I feel like that's a very similar aspect for a lot of women. You know, it does represent different in in individual people, but especially in women, because a lot of the time hyper hyperactivity can actually be in the mind. My mind is like a motor. It is consistently going and going and going. And you wouldn't be able to see that because I don't express that, you know, the same way that maybe the young boy in the program did. So it does put a lot of, want to say, and speculation and a lot of misunderstanding back onto the table for women. And I just want anyone that is you know a woman listening that may be feeling distressed by this documentary, please and do go to ADHG UK's website because we do have support groups. And also, if you do want to put your views across on how you felt, ah please complete the ADHG UK survey that is on our website.
Speaker: Yeah, and we'll link to that in the show notes. That's a really good point. We've already got, I think, north of 4,000 responses and there's some preliminary results which basically show that it's been very upsetting to the the community. And I think I've talked a lot about the evidence and and been quite kind of objective about it, but I do want to say I'm not not blind to that, I was upset by the documentary because it was just really very badly done and so biased and the the the the the so-called experts they brought on were just totally irresponsible the way that they conducted themselves.
Speaker: And it isnt it's very enraging. um And I think it devalues people's identities. Now, we there is this whole thing about whether ADHD is an identity or whether it's a a diagnosis. i And they sort of brought a bit of that in, I think, as well. People are kind of self-identifying and therefore it's only a social construct. That's not right.
Speaker: Self-identification is fine as terms of in terms of understanding that you have traits, but a diagnosis requires you to go to a doctor or a psychologist and get a proper diagnosis.
Speaker: They are overlapping, of course, but they are distinct categories. And I think muddying them up, as the as the um documentary did, was another thing that they did, that was which was very unfair, particularly.
Speaker: I'm very i'm very very relaxed about people self-identifying as ADHD, but in order to get the reasonable adjustments from places like schools or employees, we have to have that gatekeep of a kind a clinician saying you these features that you have, which you almost always do have, ah not are not the reason why your impairment is happening or you don't have enough impairment from them, and so therefore we're not giving you diagnosis. You have to have that.
Speaker: And to pretend that that doesn't, that isn't happening is, ah is, is just, it's just wrong. is. My experience is that it is happening. It's what we do. Yeah. No, Just quickly say, just if it's right, if I just go back to women with ADHD and all actually everyone with ADHD, you know, and it feels like,
Speaker: For a lot of people, we felt marginalised for some time, and it feels like this programme is marginalised in the already marginalised. Yeah. and So i can I can understand why, you know, especially in within the media over the past few weeks, it has been a very tough time for...
Speaker: thought around neurodivergence, you know, and and hearing different things within the media. There's the whole autism thing, isn't it? The Yuta Frith stuff, where she's sort of going around denying people's established autism diagnoses. it's' it's That's mad. Yes.
Speaker: Yes. I think as a woman you're more marginalized, partly due to so patriarchal kind of the patriarchy basically, and partly due to the fact that historically you know the the attention has been on boys and men in terms of this diagnosis. So that's definitely true.
Speaker: I think one of the things that that the way there's the documentary contributed to that marginalization was by basically saying, said it a few times sort of in passing. Oh, of course, some people do have a lot of impairment from this and do need treatment, but not these people, not these people who are not smashing up the place and who are not really that distressed. And actually, and it's not not said out loud, but I think what it feels like is, well, if you're not falling apart completely, if you're able to do a job, if you're colding it in, as women often do, if you're internalizing your distress, as we would call it, keeping it inside and until you can't anymore, then well then it doesn't really count because you're not this kind of very distressed person. You're not this this kind of um just disruptive influence that we we recognize that kind of ADHD, but not all these other newer kinds of ADHD because that's overdiagnosis.
Speaker: The commonest way, though, that that that in my experience that young women, are obviously a work in child and adolescent practice, get a diagnosis of ADHD is that they have a mental health crisis.
Speaker: of another, what looks like another kind, and somebody has the curiosity to go, huh hang on you look a bit like you might have ADHD. And it's not that they're presenting primarily with ADHD, it's just that the ADHD has led to struggles, which have eventually led to a collapse of of some kind or another.
Speaker: I can actually talk about that because when I was ah in my teenage years, I had a um i went to and went to a psychiatrist and I had BPD with question mark. Yeah. So that they couldn't really put me into, i want to say, that box. But then obviously years later, I realised...
Speaker: this is this is ADHD so we didn't really know about what as much information as we do now about women with ADHD but we have a lot I know for a lot of us we feel like we've been you know misrepresented and misunderstood for such a long time that now we are you know finding out about ADHD how it does impact our everyday life and are going to find out more you know by by going for an ADHD assessment so to any woman listening please do continue to seek help.
Speaker: yeah absolutely um you know your experience is valid um like 100 so have we have we gutted this particular fish enough i've got i've got probably one or two other things to say that i think are important but Yeah. come Please do. I think, I think one of the things is, ah is the way that the medication was represented. I just want to be absolutely clear. One of the the worst things that was said was by one of this woman, Sarah Worley, she runs a private clinic, which essentially gives people supplements and yeah, which don't have any evidence base for them. And she just, so, and so whatever, um,
Speaker: Okay, so one of the things that was said in the um documentary is that this is slow release, the medication that we give for ADHD is slow release cocaine. And it was mentioned a couple of times that it was amphetamine based, which is true, but That only means that there is some structural similarity between the amphetamines that you might take in a club and these medications. But in terms of their effect, there's really no similarity hardly at all. They are stimulants in the same way that caffeine is a stimulant. so it's it' it's And in fact, it's I often think of it as it's a less addictive.
Speaker: It's similar to caffeine, but but less addictive. So i just i just don I think this is really irresponsible messaging. Yeah, absolutely. you want hear a joke? Yes, very much. Okay, so, right, two scientists walk into a bar, all right?
Speaker: One asks for a glass of H2O. Yeah. yeah The other asks for a glass of H2O. Right. And then he dies. Oh. H2O is disinfectant. Yes.
Speaker: We're partly laughing because it's a good joke and partly because it's maybe the, yeah, we've had a few few runs of that.
Speaker: Both of us. um So, yeah. um The other thing I was going to say was um the other thing that the Medicaid, that they suggested about medication was if you take medication, it means you don't have to make a change in your life. Yeah.
Speaker: If you take medication, it means that the problem is in the child or the problem is in the person and they don't have to make a change and they don't have to ah do all of those things like sleep better, exercise more, look after their mental health um and they don't have to try and seek better treatment within the ah school system or within an employee or something like that. And that's complete nonsense.
Speaker: There's another of these dichotomies. There's no evidence that giving someone medication makes them less mindful of these other things because you've got to get the balance right. And part of getting the balance right is paying attention to these things alongside the medication.
Speaker: That's why, for children at least, ah environmental stuff or environmental stuff is first line. um So that's the sort of thing. I think they are really misrepresenting the treatment, misrepresenting the condition, and and painting this cons conspiratorial idea that we are as a profession drugging children ah you know for our own benefit or to to keep them quiet and nothing could be further from the case no one who i know who's in adhd practice has any interest in keeping kids quiet they want them to thrive and what we try to do is is to get the balance of treatment right so that they are able to thrive
Speaker: Yeah, absolutely. i think um that's a good way of putting it. um Conspiratorial. I like that. Well, I think they are. They're peddling conspiracy theories. 100%, yeah. 100%.
Speaker: hundred percent You know what as well, oh as someone who takes ADHD medication, also going into nature, because they went into the woods, didn't they, within that that six-week period. Yeah. and like I feel like those two combined together, for me, make a huge difference. Being outside does make a complete difference, but also taking medication does obviously c support the everyday life of myself and many others as well. so and That's one of the things I wanted to put out there. It's not either or.
Speaker: um Exactly. I mean, I think i think i'm really I'm a big fan of exercise as a treatment for ADHD, well, as a that supportive thing for ADHD that might help.
Speaker: um It doesn't have to be in the woods if you can't get to the woods. The woods is great because actually you think about how much you move. soon as you get out of the car, you're moving, you're moving, moving, moving, moving all the time. It's much compared to the gym. You're actually moving a lot more, even though you might not burn so many calories, you're you're moving your body. And that's actually what really helps ADHD. It's not the calorie burn. um You know, swimming is also fantastic in that way because it is so, so movement based. So that's great. And that's fine. um But it doesn't have to be outside. It just help. It just happens that it is helpful to be outside because then of course you've got more space. So you're going to be moving more, but it's not,
Speaker: is there's this sort of almost kind of mythical thing that being in around trees or being in you know being in the open air has got some sort of magical effect i think it it can do but ah it's more about the movement that it promotes in your body oh interesting that in might that would my view and the other thing is that there's sort of quite a lot of chat about yoga um if you like yoga great do yoga And if it helps you, great, do do that. It's one of those many things that I always say pet to people, yeah, if you try it, great.
Speaker: But if it doesn't work for you, don't do it because you think it's good. i love yoga. Great, it's good. But I tell you, I tell you, like my yoga. think it's Like the person who teaches me yoga, like I actually need my medication to be able to follow him.
Speaker: like Oh, that's such a good example. I really do. He's like, yeah, it's it's a community center class that it like or local health center class. But oh, my God, I feel like I'm I feel like I retreat sometimes.
Speaker: And yeah, if if I didn't have my medication, I wouldn't be able to follow his instructions. or tell you that. Exactly. And such a great example of the fact that, yes, yoga helps you, but you need your medication in order to access it. And you've got both the benefits of both. I think that's such a that's a great, great example.
Speaker: Is there anything else that you wanted go over, Max? No, i've I've kind of covered all of the things that I wanted to go through. um i just i think i just think we should put a lid on it, really, and and say this was a bad documentary. was not well made. Its conclusions were not valid.
Speaker: I think we should just move on. Yeah. We'll talk about it today and we'll put it to rest, but I think that's it now. Concentrate on the conference. Yes, the ADHD UK conference, which is coming up in about six weeks time, I think.
Speaker: Yeah, the conference. It's the first week of October, Thursday and Friday, and the first week of October. Yeah, so everyone should come to that. Is this another good opportunity to explain some of the great things that ADHD UK does, like um the parent support groups,
Speaker: um the drop-in advice clinics every Friday d um all of the things that are done with um you know off the back of your donations yeah so it would be quite nice if if you could donate to us we really do make your money work so hard it's astonishing um and I you know I'm biased to say this but I I'm continually amazed at how how much we do with so little So it if you could yeah if you if you want were minded to to to to throw us some money, then you would absolutely be doing a huge amount for the community as a whole.
Speaker: um but you looking Just the conference, the point about the conference is that it's online, it's free. And you get an amazing selection of speakers from all around the world. It goes on for, I think, is it 27 hours? 28. 28 hours. this every year Every year it gets longer. So it's 28 hours continuous. So I'm not suggesting that you go to all 28 hours because I prioritize sleep as part of people's. um well-being but all of the talks then get put on the website on the youtube channel so it's an astonishing i i mean i've been to lots of conferences i've i've done loads of these things i think it's an astonishing thing that we do um i think it's one of the best things we do and i i think we should continue you know absolutely and so so love it yeah i mean with it being you know with it being accessible from youtube like you know
Speaker: you know, there's no, there's not really any cost barriers or anything to it. Everybody can access it. Yeah, exactly. And that's one of our, one of the things that we want to connect. We want to connect people with expertise with a low barrier.
Speaker: I'd say we do an okay job at that, I think. Well, we are going to put this on YouTube, which is, I think is, ah I think is the ADHD UK podcast debut on YouTube. So we'll see how that goes.
Speaker: Nice. we'll see it goes yeah yeah okay all right i think that wraps us up for today what do you think lauren yeah i think so um jamie did you want to do the outro or it's up to you if you want me to do it instead don't mind yeah okay i'll do that so thank you everyone for listening to and the adhd uk podcast i've been jamie i'm lauren and i've been max all right goodbye see you later
