Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
ADHD science episode 16: Q&A part 2
654 Plays4 months ago
The long-awaited second instalment of our Q&A epic!
Relationships, decision making, memory, perfectionism, self-harm, hormones and sleep. Max and Tess cover it all in 45 action-packed minutes. Also, we have all the weather.
Recommended
Transcript
Introduction: Hosts and Their ADHD Connection
00:00:10
Speaker
Hello. Hello. Welcome back to the ADHD Science Podcast, now in video. Now in video form. So my name's Max Davey. I am, what am I, a paediatrician. I am a host of this podcast. I help to run the ADHD UK um charity and I have ADHD. So I'm quite, quite ums embedded in the ADHD world. yeah Also your dad. Also he's my dad. um I'm Tess Davies, same surname. Crazy that. Yeah. um I'm just like a regular guy.
00:00:45
Speaker
Yeah. um I also have ADHD, so I'm less qualified to talk about this kind of thing, but I'm still very interested. Although you have just done your A levels, which is exciting. Finish them. Well done. Everyone wish me happy birthday. Yeah, very, very, very few days. We're not saying when, but very few days until test is birthday. Probably actually you will be 18 by the time this come out. Unless you edit this very quickly. I'm not editing at this one. oh sorry Lovely Anna's doing it this one.
Addressing Viewer Questions on ADHD
00:01:11
Speaker
okay so um What going to do today, Tess? We are going to answer some viewer questions. We don't have a guest. You're the guest. you you you You're the guest. We're answering your questions here on this lovely little bit of paper. No leaks, no spoilers. no um so Should we just jump right into it? Let's just jump right into it, Tess.
ADHD and Its Impact on Social Relationships
00:01:31
Speaker
okay so How does ADHD affect your relationships with others?
00:01:37
Speaker
I mean, one of the things I say when I make a diagnosis of ADHD in clinic is that it's not easy to hear, but your social relationships are very, very likely to be affected by your ADHD. And the first reason I think why this is, is is I mean, I'm going to assume that you have ADHD and not autism. And we can talk about separately why autism causes problems with your social relations. But broadly speaking, it causes problems with your social relations if you're autistic, if other people are not autistic. That's the main problem. um But with a with ADHD, the point is that you often with ADHD, you will have some but not all features of autism. So you don't quite get to the criteria for autism, but you will have some bits and pieces. so There's a lot of overlap between the conditions. Absolutely. So for instance, there's some recent data suggesting that um in ADHD, the recognition of facial emotions is impaired compared to the general population.
00:02:33
Speaker
And obviously that's relevant when you're trying to make a connection with somebody if you can't really work out how they feel. um So there's various things like that. And I think if you look around, you know, in ADHD, there's less cognitive flexibility, which is really important when you're negotiating or making deals or... Okay. is that Would that just be the definition of clock know about cognitive flexibility? Cognitive flexibility is the ability to cope with change and uncertainty and to, I think it's also to do with, you know what, have you ever heard of the term fuzzy thinking, fuzzy logic? I think I can figure it out. So it's kind of rather than this is or this isn't, this is probably this, it's kind of that and you know that kind of equivocation is difficult for people with
00:03:19
Speaker
an autistic spectrum condition and also for a lot of people with ADHD. okay So I suppose, I mean, I'm always a little bit wary of the term black and white thinking because I just think I'm not sure it's aged that well. But it is a bit like that, that kind of categorical thinking, things are either right or they're wrong. And in a relationship, be it a friendship or a romantic relationship, that's not always easy. yeah Will that make sense? And then, of course, there's the ah the side that is the ADHD itself, which is the attention deficit, hyperactivity. yeah um So not being able to focus... um This is just me jumping on insumption. I mean, I don't... Again, go for it no qualification. Go with your life. um Go with my life. Go for your life, rather. I'm going to get out of it. Go with your life.
00:04:04
Speaker
ah yeah well yeah Great. So, um not being able to focus during long, like, speeches from other people, yeah which, you know, that can be a problem because usually when someone's giving you like a long, long, like, less feel, they're talking about something that's important to them. And so you don't, it feels quite rude to not be able to fully pay attention to that, especially when they can do the same for you, which can often cause a lot of imbalance in relationships, I think. But it's, it's something that people with ADHD naturally will struggle with. And the same with the hyperactivity. um I think the way that we've discussed this before briefly, but the way that ADHD people like show that they're listening is very different to people who don't have the condition. So if you're watching this video, you've probably noticed that while my dad's been talking, I've been
00:04:52
Speaker
looking all over the room doing little dances with my hands but i'm listening i am listening but if if somebody doesn't have that understanding they're gonna be like god this this bitch can you pay attention i'm trying to tell you something you know i mean but like but you know we're listening and so that can affect your relationships so people don't have that understanding Yeah, and that's the second reason I would say is that you just don't have the attention for people. You don't have to to kind of give them space and time to to sort of be themselves because your brain is always just a wandering off. Yeah. um And that can be difficult. Yeah. And when you when you feel like you do have to um act as though act like in a way that would be
00:05:33
Speaker
proper for when you're paying attention you know putting on like a like doing a lot of nodding and a lot of yeah yeah yeah yeah you spend so much time thinking about doing that but you don't hear what they're saying oh and yeah then if they feel like you're listening yeah then you actually weren't exactly because she was focusing on making them feel comfortable so either you actually listen and look like you're not listening or you don't listen and look like you are listening that's the choice guys it's So I think obviously that can have a big influence on your relationships. Yeah, and I think the third thing that has an impact on your relationship is that over the course of your childhood very often, not always, but often in ADHD, your self-esteem has suffered. You've been told that you're rubbish and a failure.
00:06:17
Speaker
And then you have to go and make relationships with other adults with all of that baggage and all of that. I mean, you could even say trauma of you know being rejected, being kind of ah not getting what you want, being told that you're rubbish and useless and lazy and all of those things. And that just impairs your ability to to be april you know any kind of relationship because you sort of need to love yourself a little bit and it's hard. create You do, you do. I mean, you you have to do that in a friendship or any kind of meaningful relationship. You you know, a lot of the time people would actually end up
00:06:54
Speaker
kind of performing relationships because they don't feel confident to be themselves. Do you see what I mean? That's very deep. but i I have no relation to this. But do you know what I mean? You're not being yourself, you're trying to be the person that that person wants you to be. Right. I mean, again, it's like the active listening thing. Yeah, yeah exactly. You're putting on this, that this appearance to like please the other person, but you don't really yeah you're not really paying attention to how like how you're actually engaging with it. yeah I mean in autism there's a lot of talk about sort of passing for normal and and that's not really talked about much in ADHD but I think it is a thing. o i think I mean this is always related to what we said before but i think I think it does affect you because you're constantly trying to kind of fit in in a way that doesn't come naturally to you necessarily.
00:07:41
Speaker
Unless you're with other ADHD people, in which case, woohoo! Yeah. All right, is that question one covered? I think so. I mean, I guess the only other thing to say is that obviously it's not going to be different. It's not going to be different. It's not going to be the same for everyone. Sure. I mean, I think that goes for all of our questions. Yeah, but it's just a clarification I feel like we need to make. Absolutely. Absolutely. Our experiences will not necessarily reflect your experiences. your experiences might be completely different from what we described. And if so, I'm very sorry, we've tried. Well done. In which case, you know, if you haven't had problems with your relationship from your ADHD, well done. Well done. Congratulations. Congrats. um Okay, question number two.
Decision-Making and Executive Function in ADHD
00:08:20
Speaker
How, ah but how does ADHD affect decision making and executive function? So it's really interesting. We've talked a lot about executive function on the podcast. So if you kind of dip back into our
00:08:32
Speaker
um archives, pretty much, you know, it's it's mentioned pretty much every episode, isn't it, more or less? Yeah, I mean, it's very important. Yeah. So basically, it's getting stuff done. It's the ability to get stuff done. It's that X factor that lays upon your intelligence that makes your intelligence actually effective in the world. Right, yes. Isn't that fair? Yeah. um And a lot of people at HD really struggle with it, it's fair to say. um So, but I think in both of these things and the different things, decision-making and executive function are two separate things psychologically in in terms of kind of measurements. So i I want to treat them differently. And I think in both cases, you can tell two different stories. You can tell the story of like deficit of how how difficult it is to have ADHD, but you can also tell a positive story. And I think I want to tell the positive story as well. ah So in terms of executive function, if you are actually given
00:09:28
Speaker
And maybe I'm sort of showing my own colors here a little bit. But if you're actually given the autonomy to make your decision, you're just given where you want to need to get to, a person with ADHD will very often find a quite direct and often unusual route to get there. Right. And often, not always, it will be the most efficient route and often they would just get on with it, use a bit of hyper focus and then get it done really quickly. Um, not necessarily perfectly, but you know, very well. So I think it's not all bad when it comes to executive function. I think where ADHD people struggle is where you have to either follow a kind of maybe a little bit, someone else's process. And what do you mean? So somebody has said, we need to do this and you need to do that, then that, and that, and that, and that, and that, not just where you need to get to, but how you need to get there. They've laid how you need to get there. They've laid out the steps. Right.
00:10:22
Speaker
And I think that can be quite difficult for people with ADHD. Now, all of this is a bit, you know, again, we're generalizing, but I think if you are, it's that I think that's one reason why in school when you're always enough given that much. um
00:10:42
Speaker
ah You're not giving you're not you don't making your own decisions. You're not given that much autonomy. um Executive function can be a real struggle to get things started, your project started. Right. Okay. Could you give us like an example? Because I think I'm still struggling to. So for example, if you if you have, if you're just discussing something in a classroom, your idea is to convince, you know, maybe the purpose is to convince someone of what it is that you think. Okay. Often people with ADHD are really good at that. Okay, because they know, they take the, you know, the shortcut is to just come out with all the right, or all the right arguments, say it really clearly, say it really, you know, well. If you then sit down to write an essay about the same topic, you're then given
00:11:29
Speaker
this huge kind of structure that you then also, as well as actually just saying what you need to say, you they tell you how to say it. They give you all of these, you know, different sort of sentence structures and paragraph structures, and you have to put this in, you have to put that in. oh And that becomes overwhelming. Right. Okay, that makes a lot of sense. Does that make sense? makes That makes more sense. Okay, good. um And does executive function also refer to like, I'm sat on the sofa, I really want to put my clothes away. but right now I'm sat on the sofa and I can't get up. Does that refer to that as well? Or is that like a separate thing? Yeah, I think to an extent it does. And I think...
00:12:07
Speaker
I mean, I think that's a mixture of executive function and and and energy, of course, and we talk about fatigue a bit later. But um yes, I mean, sometimes things are just too boring. And it being you know, being you know, you're going to be bored doing this this project on this process, even if it's a tiny thing like putting the washing away, yeah it is going to be boring for the duration of you doing that. And you know, we both do it. We're both but if we know we're going to do a boring task, we'll put our headphones in and start playing music. Yeah, but is it like, I don't think it's always necessarily that because people talk about like feeling like you're stuck, like no matter how much you want to get up, you can't.
00:12:46
Speaker
Yeah and so there's sort of ah ADHD freeze isn't it? Yeah there was a term for it but I've forgotten. Yeah I mean I think we've got to look a little bit more, I don't think we've got the evidence for that, I don't think we've got the data for that as yet. right So I think sort of watch this space, I mean it'd be really interesting to find a paper about it. ah Yes that space right there. go um but But I But I think, again, you can't just think about ADHD on its own. And I think, can we come back to that when we talk about, there's this question about perfectionionism hold it put perfectionism and burnout later. And I think that comes under that okay rather than strict object objective function. But just to give a quick update, just to give a quick story about decision making, I think that's another area where actually ADHD people have huge advantages.
00:13:35
Speaker
There's quite good evidence that that people with ADHD are natural leaders, and one of the reasons you're a natural leader, and this is possibly, is that you are able to look at a large amount of information, pick out the relevant parts very quickly, and make a rapid decision. Now, not everyone with ADHD has this ability, but a lot of ADHD people do have that ability to just go, all right, this is the way to go, bang. And they will usually be right. the problem being the people with ADHD are not typically meticulous so if you are then asked well why is that the right answer then it can be difficult to a kind of show you're working as it were. See the problem with you saying these things is that I completely relate to them yeah I don't want to agree because I don't know if people without ADHD have this experience as well like I want to be like oh yeah that happens to me all the time but that doesn't necessarily mean like it's like it's just an ADHD thing Sure, but I think it's more an ADHD than a non-ADHD thing. yeah so that sort of you know Those kind of leadership qualities are more common in ADHD people. Decision-making is faster in ADHD and sometimes a quick instinctive decision is what you want. yeah um The problem is sometimes, and very often I have to say in kind of modern workplaces and schools,
00:14:51
Speaker
They don't want a quick decision. They want the meticulous, pedantic, working your way through, show your working stuff, which is which is annoying because actually in the real world, a quick, you know, let's just get on with it. Decision is often the right way. But anyway, to my cost, I've learned that that's not always acceptable to the as always acceptable to the hierarchy. Shall we just leave it there? um All right. So, i you know, ah basically in in essence, in And often it can look like people with ADHD just can't get stuff done, but actually we can, we just need the right environment and we need to be trusted in our decisions yeah and supported. We can do what you want us to do as long as you let us decide how
Memory Challenges with ADHD
00:15:33
Speaker
we want to do it. Also, if you let us think it's us, our idea. That's very important.
00:15:41
Speaker
okay basically sign over all control to me give me control of your company let me lead the school and i will do my homework if you make me the headmaster i'll do my homework yeah i'm not quite saying that but yeah that'll do it okay should we move on yeah i'm not really sure what we got out of that question but i'm sure the audience know i'm sorry decision making an executive function it affects it because let's just let's do a little summary just to refresh my memory a bit Okay, so decision making, decision making in ADHD is different. So a person with ADHD will tend to make a decision quicker on the basis of a few data points and ping off you go. And it will usually be the right one. It's good decision making unless what you prize about decision making is being meticulous, working through things one after another, after another, after another, after another and boring yourself to death until you come to the decision.
00:16:38
Speaker
that's bad. The ADHD people are not good at that kind of decision making. Right. That's a good little summary. Okay. I understand. Good. We'll move on. Shall we? up Speaking of actually, how does ADHD affect memory? Okay, I'll give me fairly brief about this because memories are really, you've done psychology A level, you know that memory is a really heavily complex area. There's all sorts of different classifications of memory. It's really complex. It's really, you know, it's, it's kind of mad. The main thing that I wanted to say about memory is that certain sorts of memory in ADHD tend to be worse and certain sorts are either better or the same than the general population. So the sorts that are worse are things what we call working memory. Okay.
00:17:25
Speaker
So working memory is broadly remembering what it is you came into the kitchen to do. It's remembering the thing that you should be doing right now. It's remembering it's kind of it's almost having you know it's almost your your working memory is almost your your rolling to-do list. And people with ADHD find that very, very difficult to hold stuff in their brains. So sometimes that's obviously a bit of a silly example, but obviously something that people talk about a lot is you walk into a room and you've no idea why you've walked in there because you've become distracted. um the But also it's relevant for things like if you're trying to sit down and do a maths problem and you've got to keep everything in your head and just too much for your working members. And then you lose some of the numbers.
00:18:08
Speaker
And they just go, some of the numbers are not, obviously not important enough, because they just feel it again. That's why I'm not a maths teacher. I think there's a lot of reasons why I'm not a maths teacher. Lots of reasons why I'm not a maths teacher is a good point. Because this is what you're good at. Didn't do maths A level, famously.
00:18:25
Speaker
um but So so that pin of that kind of memory is, in most people with ADHD, worse than the general population, which is yeah really difficult and impairing because a lot of the time, particularly in school, it's really interesting because in ad for an adult with ADHD, you can just so just you know grab your phone, make yourself and an alarm and then it'll go off when you need to do it and you do it. that Unless you then snooze the alarm and then kind of forget to do it, but that's okay. It's better. At school, of course, often you're not allowed to use things like that. so but And yet the demands on your working memory at school are massive, but you're not allowed to help yourself, which is why it's kind of unfair. Yeah, I find that it affects me a lot of work, actually. um I work in a pub, and quite often I'll start doing something in the bar, go into the kitchen to do something else, yeah and then forget what I was doing in the bar. Exactly. Great answer. And that's left you a bit of overflow sometimes of drinks. I forgot to get my coworker, Heidi, the drink she asked for, for about maybe an hour. Eventually, she didn't want to remind me because she thought it was mean, but I had just forgotten. Yeah, yeah. Yeah, can we cut that bit out? I didn't actually want it.
00:19:33
Speaker
wellll what We'll think about it. What was I even saying? So you were saying about working memory and how your working memory can be impaired. Yeah, I would describe um it like... oh forgotten how I would describe it. Yes. Okay. This is, this is exactly what I'm talking about. It's like if everyone's brain is a sieve yeah and our sieves just have bigger our holes in them. Absolutely right. You put information there and it just falls right back out. Absolutely. So that's why so um we have to cut this, um, this podcast so much because I will have this great point and it'll be so wise and so intelligent, so well thought out. And then I'll finally, finally, ahll finally find the opportunity to like slip it into conversation. Yeah.
00:20:14
Speaker
Gone. Fully gone. Gone. Absolutely gone. Which is why I've started having my little notebook. The number of amazing ideas that Tess has just not put on the podcast at all is just, I mean, it's phenomenal. I invented Heelys actually. let's say it yeah when i was When I was five. Yeah, that's true. I'm going to get a pencil. Right. We've now both got pencils now. So now this, this podcast will become much more professional, professional. pencilinel um okay so But on the other hand, the other sorts of memory in ADHD are intact. So things like i mean like ADHD people have good memories for facts, for things that happened, episodic memory. So we did this on this day. You've got an excellent memory for things that happened a very, very long time ago, yeah but not for what it is you should be doing right now. And that's classic ADHD. That's the end of the question that this dis section on memory.
00:21:07
Speaker
Yeah, so how does ADHD affect memory?
ADHD, Anxiety, and Overthinking
00:21:10
Speaker
ah We can't remember things when we're just holding them in our brain. Yeah, but we can when they happened five years ago. Awesome. Moving on. What is the relationship between ADHD and overthinking perfectionism and fatigue? So i'm going to take the lot this is a really interesting question and I apologise to our listeners because we never quite worked we never quite recorded who you answer asked all the questions, which is a bit rude. But actually some of these are some of these were asked in lots of different ways in different by different people and I've just kind of amalgamated them into a single question. But this was a unique one and I'm afraid I can't remember who who asked it.
00:21:46
Speaker
I think underneath, so I'm going to take i'm going to talk to i'll talk about the last one first. So fatigue, one of the things that's not talked about enough in ADHD is how tiring it is. So if you think about what we talked about a little bit earlier, um where if you're supposed to be listening, you're supposed to be showing particular behaviours, and the classic example is in a classroom, they talk about listening behaviour. So you have to sit, you have to look at the teacher, you have to nod, do all of those sorts of things to show them that you are listening. That requires mental energy.
00:22:22
Speaker
Yes. And although people with ADHD are often thought to have boundless energy, so that you know so we move all the time, we always be kind of have lots of kind of kinetic movement or ideas and pinging everywhere, we don't have infinite mental energy. We can crash. when we've had When we've used up all of the mental energy we have, partly to do what it is that we're doing, but also to pass for normal, to to to you know to show the kind of behaviours that people want us to do, to kind of get you know to not get in trouble for things. Sometimes you just run out of that of that mental energy. And that's one reason why often people are
00:23:07
Speaker
kind of relatively okay in one setting so either at school or at work and then when they come home they just completely fall apart their ADHD becomes wild. Do you think it's particularly linked to like certain activities like what we just talked about working memory taking more effort? Yeah. and yeah ah So if you want to remember what you went to the kitchen for and instead of just thinking oh I'm going to grab this You have to be like, I'm going to grab this, I'm going to grab this, I'm going to grab this, I'm going to grab this. And each of those go in there each of those is a tiny drain on your, on your, on your mental energy. And you only have a certain, I mean, this is obviously a, this is obviously something of a simplification, but let's say you only have a certain amount of mental energy per day. Okay. And that could be improved by sleep and by.
00:23:52
Speaker
know various different things but um you know and by having good mental health and that brings me to this the sort of the first two things that the person said which was ah perfectionism and overthink overthinking. So one of the things that's not talked about enough in ADHD is how many people have ADHD and anxiety which is a very nasty combination. Often it's under diagnosed because people see it as just just the ADHD or often, particularly in boys and and young men, it will not present as, oh, I'm worried about things. It will present as anger or aggression. That's quite common. um So I think, but I think, so what you're talking about with overthinking, it's not just the ADHD because on its own, ADHD doesn't lead to overthinking. In fact, it probably leads to underthinking. Do you see what I mean?
00:24:45
Speaker
but okay Make a decision off you go. Unless you also have anxiety, in which case you will sometimes get yourself into a very rapid cycle of what we would call rumination. Do you know what rumination is? ah Isn't that the class that they take in Hogwarts where they don't have crystal pools? Very good. That was terrible. Divination. Divination. Rumination is actually what cows do when they ruminate. When they when they you know how cows will swallow some grass and then they will kind of churn it around in the sun? Is it like reflection? No, it's not as, because reflection is kind of a positive thing, it's like thinking about your own thoughts. Rumination is where a thought is going around and around and around in your head and you're not really in control of it and you can't stop it and it's getting more and more powerful and it's dominating more and more of your mental space. Right. And it is,
00:25:39
Speaker
I think if you don't have anxiety, you you're not going to ruminate in ADHD, but if you do have anxiety and ADHD, your rumination becomes very powerful because of hyper focus and because of how fast your brain works. You can quite often get to a very negative conclusion quite quickly. So is that often things to do with like self-esteem? What does that look like? Yeah quite often it'll be I mean it could be anything so this person talked about overthinking but you know maybe and we talked a little bit earlier about ADHD freeze which is where I was thinking. Now I don't know I think I think it can mean lots of different things for different people but very often people talk about it as a sort of mixture of
00:26:22
Speaker
oh this is going to be really hard work so I just I'm going to find it really hard so I'm sort of don't know if I can do it plus I think I might do it badly I think I might not get it right because you know partly because you actually genuinely might find it difficult and also you've spent your whole life being told you've got things wrong and you've screwed it up and you you're not careful enough and all of those sorts of things. You didn't show your work. You didn't show your work and all of those things so I think ADHD freeze I think is it is not very well defined, but where I think it's most useful to use is this mixture of your ADHD difficulties with your anxiety. And perfectionism, which is the other thing the person talked about, is an andt is is anxiety. I mean, that it is it is it has to be perfect or it's wrong. And do you think that contributes a lot to ADHD freeze? Because um I mean, again, thinking I'm not going to be able to do this because I won't do it right. Yeah. And also because of that, the tasks that you have to do because the perfectionism becomes so much bigger. Yeah. Which can make the ADHD freeze worse, because then instead of like,
00:27:32
Speaker
I have to do this piece of homework. It becomes I have to do this piece of homework and then I have to do it again. And then I have to edit it to make sure it's perfect. And then I have to send it off. And you know, I don't know. Do you think that No, I think that's really true. The only thing I would add to it is, of course, we talked earlier about the the link with having some a some autism traits. And if you are a little bit rigid and a bit black and white in your thinking, things ah you know then it can very quickly slip into it's either perfect or it's rubbish in terms of know doing a piece of work or completing a task of any kind. So I think that's i so i think that's the answer is if you are ADHD and you find that you are
00:28:10
Speaker
really struggling with overthinking imperfectionism it probably it is your ADHD but also anxiety and the advice would be to to to talk to whoever looks after your ADHD about your anxiety because a lot of ADHD clinics don't really think about anxiety that much they just honestly particularly for adults they will kind of just say well well how much medicine do you want this this one um rather than looking more deeply into into into what's going on for the person underneath Hmm.
ADHD and Risk of Self-Harm
00:28:38
Speaker
Yes. I don't have anything to add to that. So I think so. I think it's time to move on What is The relationship between ADHD and self-violence so I wasn't really sure what self-violence means which isn't just self-harm, right? so um Basically, we don't need to dwell on this particularly but there is a relationship between ADHD and self-harm so I think
00:29:06
Speaker
there The relationship is driven a lot by the things that we've been talking about, about self-esteem and being told that you're rubbish all the time and therefore sort of feeling out of control and feeling unhappy, but also there's impulsivity. Yeah. Yeah. So people are able with ADHD are at more risk of self-harm. And obviously if you are somebody who is experiencing urge to self-harm or is self-harming yourself at the moment, the only advice that we can give is to go to seek advice, go to a website, NHS website's got some good advice about self-harm and talk to whoever looks after you, um because you know it's all fine to to for us to sit here and and talk in academic terms about why the connection is, but if that's happening to you, you need to get some help. The end.
00:29:59
Speaker
Treat yourself as you would treat a friend. If your friend was going through what you were going through now, what would you tell them to do? Exactly. Thank you. Right. Yes, happy with that. ah Okay.
Teenage Years and Hormonal Influences on ADHD
00:30:11
Speaker
Right. ah How do teenage hormones affect ADHD? So I find this question really, really, really interesting because there underneath it is kind of the assumption that puberty is about hormones. that how a 14-year-old sits is partly.
00:30:30
Speaker
guy and which is partly um There's a self assumption that the reason why a 14 and 15 year old might behave in a certain way is because of their hormones. But I don't think that that's quite right. Now, the hormones are important. What they do is they trigger the way that the the brain matures. But actually, if you think about people who have um either early or late puberty, so puberty is the change where the ah the the the the pattern, it's actually hailing. It's July and it's actually hailing. It's hailing. Brilliant. we love We love the British weather as well. Yes.
00:31:10
Speaker
the hail yeah um so um So puberty is when your body converts from a child to a more adult pattern of hormone secretion. That can happen early, that can happen late, but actually it does have some effect on how your brain matures, but It's not that much actually. coming home! What the A lot of it hell? is just uh it's also suit like and there's like lightning and um a lot of it i'm gonna carry on because i'm a professional okay we're gonna keep going um a lot of it is just the passage of time it just happens with time i'm just gonna go for a run no i wouldn't go for a run right now
00:31:55
Speaker
um A lot of it was is the passion pattern is the the passage of time. right So your yes, your brain is maturing in a in a process which is partly hormone dependent. That is true. And that that process, tends to what it tends to do is it tends to, in the longer term, improve your ADHD, which is often kind of counterintuitive because often in the short term, ADHD behaviour becomes more difficult during the teenage years. But in the longer term, if you look at it, people become less hyperactive and impulsive and their executive function improves over this period over that process of puberty. But it's so a lot of zigzagging in the middle. Exactly. So what's going on in the middle is a few things. For boys, particularly for males, I should say, the surges of testosterone which occur in early to mid puberty are associated with increased aggression. So your ADHD could be getting better, but if you're getting more aggressive, it looks like it's getting worse.
00:33:01
Speaker
So that's one thing. And the other thing that's really, really important is that being a teenager, even if even if there wasn't any of this change or anything like that, it's really hard. You are in this position where you're given much more kind of responsibility. Like you have to go to all of these different lessons. You've got to behave in this completely different way. and In a primary school, you're kind of get you're kind of allowed to be a child. Whereas at secondary, you have to be like a young person. well need the the The expectations are very different. yeah so I'm with you, I'm with you.
00:33:37
Speaker
And so you have this massive shift in expectations. You have all this responsibility. You don't have any control. You have all these demands made of you. And you've got all of this teenage stuff happening, like, I don't know, boys and girls and drugs and smoking and stuff like that. All of that stuff is happening around you. okay And it's just kind of very hard. And so it's not massively surprising that people are having problems. So is what you're getting at that puberty of being a teenager affects people with ADHD in the same way that it affects people without ADHD. It's just the manifestations of it are different because of those symptoms. Exactly right. Okay. Exactly right. That makes sense to me. Exactly right. But the good news is by the end of puberty slash the teenage years, you
00:34:25
Speaker
got a good chance of ending up in a better place than when you started those years. The trick is to get through those middle periods without losing it. Would you say? I think I did lose it. No, but you're okay now. I'm pretty cool. It's how much you lose it. 99% of people say that Tess is cool, and the remaining 1% are being hunted down. The remaining 1% is in that one. Oh yeah, you got it. That's true. ah yeah He's not being hunted down, he's playing the PlayStation.
00:34:57
Speaker
Right.
00:35:00
Speaker
Okay. Good
Menstrual Cycle's Impact on ADHD Symptoms
00:35:01
Speaker
parenting, Max. Ooh, interesting thing. How do female hormones affect ADHD? Maxwell? Female hormones, which is a very nice kind of lady problem. It's a bit euphemistic. You're talking about the menstrual cycle, okay? Okay. So how does the menstrual cycle affect ADHD? And the interesting thing is that we don't know enough about it yet. Now, one of our very first... Because science doesn't care about women. but but And science also doesn't care about ADHD. Broadly true. those Both of those things are broadly true. And one of the first people we ever um interviewed, who's actually got back in touch and wants to come back, Anna Maria Batura, ah who is amazing, is going to do some um research on exactly this. And she said, there's very little. So anecdotally, we know that immediately before the period ADHD symptoms are worse.
00:35:50
Speaker
People tend to have worse executive function. They seem to find that their emotions are more up and down. Their emotional regulation, which is a symptom of ADHD, is less good. And we don't mean it's probably to do with the balance of estrogen, progesterone, pro progesterone, all of that sort of stuff. we We need to know an awful lot more about it. But one thing that I think is really important is that people are understood and believed when they say that their menstrual cycle affects their ADHD. And then that's all I can say about it at this point, because we only have anecdotal data, but it is so overwhelming and we're overwhelmingly universal that there is an effect that all we can say is that people just need to be listened to about it. I don't know what you think about it.
00:36:36
Speaker
i mean
00:36:39
Speaker
i I can relate to that. okay But again, i don't i don't I don't know if that's just me. I have, again, no qualifications. All I can really say is that that does reflect what I have heard from other people who are who have periods and also ADHD. Yeah, exactly. So essentially the answer to this question is it has an effect We're not sure what, exactly. We're not really sure what. No. We're gonna find out soon, hopefully. Yeah. I mean, there's research there's research going on about this now, but it's it's massively overdue. Yeah. And that is because of the bias against women in in science. That is why, that is why. I love science.
00:37:23
Speaker
Okay.
Sleep Issues and ADHD
00:37:24
Speaker
Okay. Final question. Yes, final question of this episode. Guys, it's almost over. We've been rushing through these. he Well, you know, we're gonna be snappy.
00:37:33
Speaker
Go bare some armpit, guys. Okay. oh How sleep patterns affect ADHD? So they hugely do. I mean, sleep is another thing that I think has come up all the time in our episodes, if you go back through the episodes. But broadly speaking, so I'm just going to talk about how sleep affects ADHD, not how ADHD affects. Yeah, I was going to say, because they do very much have a two-way interaction. Bi-directional relationship. Bi-directional. Bi-directional. That's funny. This is so weird. Monkey's wedding. Is that what they call it? Congratulations, monkey.
00:38:07
Speaker
What? You know they call it What? When it's raining and sunny. Really? I thought so. That is excellent. That's an excellent fact. Even if it's not a fact, it's an excellent thing. So let's keep it. Congratulations monkey. we have made We have made it happen. um Sleep patterns do affect your ADHD. Now, they don't actually make your hyperactivity, impulsivity and poor concentration necessarily worse or better. Okay. Okay. So it is not true that treating, getting more sleep will make your ADHD go away. Does that make sense? yeah well It will make it, it will definitely, if you are sleep deprived, you will definitely find it harder
00:38:57
Speaker
So what I mean is, if you look in the laboratory conditions when you're kind of trying to do things and you're sleep deprived, actually with ADHD, it doesn't make a huge difference to your high your core symptoms. okay But what it will do is it will make effectively and functionally, it'll make it much harder for you to get stuff done. Right. More executive dysfunction problems? yeah part i mean Depends on the degree of of sleep deprivation, but very often, particularly when you get very sleepy in the afternoon, in fact, what you're doing is distracting yourself. Which is happening to me now. When you're not sleep deprived, um what what will happen is that the um is that you will almost be distracting yourself by the effort that you require to not fall asleep. Right.
00:39:50
Speaker
So yeah, being very sleepy will make you effectively less you're less effective in getting stuff done. And that is exaggerated for people with ADHD. I mean, my understanding of it is very basic. um And it's that a lack of sleep affects ADHD people in the same way it affects non ADHD people. but it's just has what, you know, like the the symptoms are the same that you gain, but because people with ADHD already have those symptoms, it's more, you know what I mean? Because it's combined what you originally had with what is happening because of the sleep deprivation, it just becomes one big lack of attention. Yeah. You know what I mean? Yeah, I think that's right. um But and I think it's, I think it exaggerates the effects of of the sleep deprivation.
00:40:40
Speaker
Yes, that's what i because you know there's we're starting at a ah different point, and then the sleep deprivation adds to both of them, and the people with ADHD are higher up. Does that make sense? I think it does make sense, yeah. Again, I don't have any scientific knowledge. No, I think you've probably explained it better than I have, actually. um And I think the other thing that... Should we switch seats? What's over there? Well, this isn't a special seat. I don't think it's quite a nice seat. um He's got a spinny chair. I've got a kids i've got a dining room chair. Spinny chair. Look at that. Scam. One of us has. I know, you we've both got jobs, actually. I've got jobs. I'm employed. You're employed. Part of the workforce. The other thing that sleep deprivation definitely does for your ADHD, and I think in a way this is almost more relevant, is that it it will have a direct effect on how well you control your emotions. So when you are sleep deprived, even if you're not having those sleepy moments of being distracted by sleepiness,
00:41:32
Speaker
you are still going to be have shorter temper. You're going to be able to control your sadness or anger, very much less. And so in terms of your effectiveness, you're actually either giving into all of those emotions and getting in trouble, getting in fights and arguments and stuff. or you're spending that precious mental energy on controlling your emotions, which again takes i'm sorry takes away energy that you could be doing on on getting stuff done. So I think i think in in summary, sleep patterns do affect your ADHD symptoms.
00:42:12
Speaker
but there but the but but only in a kind of indirect way, um by basically by magnifying the effect of of other sleep problems. Just a little um just little caveat to that because sometimes people go, well, you know, I've got the wrong sleep pattern because someone on the internet told me I should be getting nine hours a night and my sleep pattern's awful because I only get seven. But actually, and That might be enough for you. The amount of sleep that people actually need and when they need to sleep is wildly variable. Yeah. What do you think about the concept of sleep debt? I don't know if you if you know about this. and you know You know sleep debt. So it's the concept that if you don't get enough sleep one night, the effect of that, they don't go away over it like the course. so If you don't catch up those few hours that you missed, they build up. Do you think that that is like a thing?
00:43:04
Speaker
i mean i think i'm a bit skeptical of it in a longer term way but i think if you are chronically sleep deprived you almost because you're constantly kind of stressed you can't you you secrete what a lot of cortisol that kind of cortisol which is a stress hormone that kind of keeps you going and keeps you kind of vaguely alert and then if you then have a good night's sleep very often the next day you'll still be tired. You'll be more tired ah because you're not having that kind of cortisol slash adrenaline thing to keep you going. Now this may not be as scientific as I'm making it sound and I think I'm stepping slightly into the realm of a kind of oversimplification but broadly speaking I think it does seem like after you have you have a period of sleep deprivation and then a good night's sleep you often then feel very very very tired the next day and it takes a little while for you then to get back into
00:43:56
Speaker
kind of I think that can be quite confusing for some people. I know it's confusing for me when I get a good night's sleep and I'm still exhausted, but it's because I haven't been sleeping well the nights before that, you know? Yeah, yeah, yeah. And I don't think it's quite a sleep debt. I just think that you're... I don't think it's as simple as that. No, you're as tired as you need to be. You're as tired as as as the the amount of sleep you've been getting lately should make you.
Conclusion and Advice
00:44:20
Speaker
It's just that you're not compensating anymore because your body's like, hey! Yeah. But anyway, I think we need to look into more into this in more in more detail and maybe sort of come back yeah to this on and at a later date.
00:44:33
Speaker
yeah So those were our questions for today. The takeaways are stay tuned, seek help if you need help. Yes. Be nice to yourself. Yes. And working memory is a thing that you should now know. Yes. Thank you very much for listening. And now it's the nicest weather we've had in weeks. Yeah. It's lovely now. so Enjoy. that enjoy us Get out there, have an ice cream. So we'll be back with another episode of Q and&A in a few weeks. um And do um like and subscribe. I don't know. Go to your podcast provider of choice and subscribe to the ADHD Science Podcast, yeah where you can get more of us, but also other people yes who come to talk to us. And if you can't love yourself, how the hell are you going to love somebody else? Can I get an amen? Amen.
00:45:27
Speaker
Enjoy the weather. Thank you. Bye.