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Sasha Hamdani (on ADHD)

About this episode

Sasha Hamdani (Too Sensitive: Rejection, Resilience, and the Science of Feeling Deeply) is a board-certified psychiatrist and ADHD clinical specialist. Sasha joins the Armchair Expert to discuss the classroom insurrection she started which led to her ADHD diagnosis, how her residency rebuilt the confidence that medical school degraded, and that symptoms known today as ADHD first showed up in the 1700s. Sasha and Dax talk about her beef with diagnostic labels and how often trauma is misdiagnosed as ADHD, how liberating it was to understand the way her brain functions, and neurological reasons why grief is so destabilizing for someone with ADHD. Sasha explains the importance of being able to emotionally regulate before conflict, her hot take on self-diagnosis, and non-stimulant, skills-based approaches that work well to treat ADHD.

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Sasha Hamdani (on ADHD)

Armchair Expert with Dax Shepard

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Armchair Expert with Dax ShepardSasha Hamdani (on ADHD). Machine-transcribed; use the interactive transcript above to jump the player to any line.

0:00Welcome, welcome, welcome to arm chair expert experts on expert. I'm Dan Shepherd, and I'm joined by Monica mouse. Hi Today we have Sasha Hamdani on Long time coming. We've been talking about ADHD ad nauseam. I think we've even maybe lost listeners over it But we finally have brought in an expert to either correct confirm who knows just explore this topic that we are obsessed with That's the fun thing about this show we get to talk about something that we know very little about and then get real answers It is awesome Sasha is an MD she's a board certified psychiatrist specializing in ADHD RSD and emotional regulation Her books include self care for people with ADHD and an upcoming book comes out in October Look forward to when when people start serving pumpkin lot spice lattes and dressing and Halloween costumes Too sensitive rejection resilience and the science of feeling deeply

1:01Oh, I love this. This is a great episode. Yeah, please enjoy Sasha Hamdani This episode of arm chair expert is presented by apple tv the new us home of formula one Starting March 7th you can watch complete all access live coverage of every gram pre including practice qualifying and sprints all in one place Watch every race live only on apple tv We are supported by quince. There's something to be said for clothes that just work Not trendy not flashy just well-made pieces that hold up day after day That's what quince gets right they make every day essentials with premium materials organic cotton sweaters polos lighter jackets The kind of stuff that looks good season after season and here's the thing They cut out the middleman by working directly with top factories So you're not paying brand markup. You're just paying for quality. I really love quince It's becoming startling. I've been walking around. I asked people if I like they're close sure

2:03You got to put yourself out there and nine times out at 10 these days. It's from quince Yeah, I just got asked by the fashionista herself Nicole what size I work. She's getting her husband something from quince Quince only partners with factories that meet rigorous standards for craftsmanship and ethical production These pieces are built for daily wear the kind of clothing that becomes part of your routine because it's reliable Refresh your wardrobe with quince go to quince.com slash stacks for free shipping on your order and 365 day returns now available in Canada too That's q-u-i-n-c-e dot com slash dacks free shipping and 365 day returns quince dot com slash dacks This podcast is brought to you by square space the all-in-one website platform designed to help you stand out and succeed online When we were building the armchair expert website rob actually use square space to get it up and running Which was a smart choice because they've got everything you need in one place to create something that actually looks professional What really stands out is their blueprint a i feature

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4:07I'm nervous to be too out there But we had a microbiome expert on who has a probiotic that actually is real And I've been on it for like I think two weeks And probably not even probably like a week or something and I was in Detroit and I cheated on my diet sure And I had gluten and sugar And I didn't have any rash and my joints didn't hurt and I'm like Is it fix my leaky gut and Miss all of that fast maybe Like maybe that with that exclusionary diet. Yes, because I've been gluten for over five years because of this you have sorry Yeah, you do. Don't you think it's the sexiest auto Oh, it's so good like I walk around like I could feel like it's cold outside How long have you had it or been diagnosed with it? So I was diagnosed with psoriasis in Bip the grade. Oh, well, okay, but it didn't affect my joints until I got out of medical school

5:08And I was like, what is this? Why am I elderly? I did my residency in Phoenix And it was warm and nice and I didn't really notice things and then I moved back to hand city where it was cold I was like something is wrong with me. It was horrific And then I was like, okay, well, let me just up Pilates or up something else that's gonna help me My ball Brian must need to do more. Okay, and then I went I got the full work up And I also have horrible rashes all over my actual joints. Oh, and then they're like, well Yeah, I have to point out we're all wearing blue Yeah, that's really nice. And we're wearing basically the same outfit black pants and a blue top And you also both have the most beautiful skin tone and hair tone My god, long-lost twins You could bridge the divide between Pakistan and India That's what I'm doing. That's what I'm doing. That's what I'm doing. That's what we're here to do We'll be here. That'll be solved

6:09But I am curious because you must experience this bit of dissonance right where you've gone to medical school And then things are happening to you, but you're somehow not using the same criteria or it's hard to apply to yourself What you already know, right? And also I'm a psychiatrist So anything with the body Okay, you're from Santa Barbara. I once lived there and what part of Santa Barbara did you live in? Monocedo, okay, so what a mom and dad you feel guilty right? We just had a guest who currently lives in Monocedo and he said Santa Barbara and I said Monocedo and he said yeah Do you go to that amazing bookstore godmothers? Do you know about it? No, what maybe it's after you're gone. I mean gone for a while. Okay For like 18 years. Okay, so it's changed a lot But my mom still lives there so we're and I was able to like Come to the podcast and then we had a sleepover last night

7:09And there's a huge ice-throwing Kansas City. My flight has already been canceled. Oh no Okay, I guess I'll have to go be in Monocedo for a couple of days. Oh my god. Well go to godmothers It's very very cute. How do I not where is it? It's on a really cute street There's only that one main street a parallel to the train press state street. It's not there. It's not lily avenue lily it's on lily thing to you. I know Little man. I know this closest summer land beach. That doesn't count. It does not Monocedo Okay, it is because Because we went to lunch in Monocedo and it was like 10 minutes away or nine 10 minutes away could be carpenteria Oh Three blocks long. Yeah, it's so picky. We lived there. I think that's what it is Okay, that's fine. So drive the 10 minutes. We'll see What did mom and dad do in Santa Barbara? It's a funny story because my mom and dad got married and they were from

8:14Pakistan my dad applies all over the US for a job Doesn't get anywhere the first job that gave him an opening as an engineer was in St. Barbara. He's like sweet. Yeah, so we go there. My mom's in training because she is a pediatrician So she's still going through a residency and then I came out And then we just kind of lived and grew up there. You didn't grow up there. No, it's a weird word text It was weird when I got there from Detroit. I was like this is a very weird. It's a weird microphone Please pinpoint the things that you thought were because I have my own specific so growing up there It is this weird mix of people That have been there for a million generations and are just trickled down and they're on level a thousand of their trust fund Yeah, they're not really engaged. Yes, and humanity or No concept of work or motivation to like some people in my high school currently right now They have the same jobs that they had in high school

9:15But they're just working until their parent dies and that they can move upstairs Yeah, I'm delighted that we have the same observation because I got there and I started meeting I remember this girl at a coffee shop and she was Shooting math and she was also very interesting and pretty and I went to her house And it was this very nice house in my seat. Oh, and there are other Children of rich kids that were just completely neglected There's like this whole cadre of rich and neglected kids there That I thought was so freaky and weird. It's weird. I'm so curious. Hold your I'm 39 Okay, 39 very close-in-age. Yeah, very very close. We're the same basically the same but I am 38. I just I'm sorry I am you've had a very similar trajectory in that you two were trying to very much hide from your culture I Had purple context for a while I wanted them. I wanted them

10:16Yes, yes, I wanted them The irony you guys are both such babes That you would be trying to become you're going through that in your formative years and you're already feeling othered Yes, and so you really do whatever and when I'm saying other From a physical like in ninth grade I show up to public school coming from private school So I didn't really know anybody. I'm a violent context. I've had gear during the day. Oh boy. Yeah, not even nocturnal We could have taken a fucking break for six hours. Oh, I get two periods into that school. I was like this goes You're a survivor if you know No, you can't you don't make it out. You don't make it out and I was like wrong Let me deal with the palette issues and the overbite. I'll deal with it. Yeah, yeah, different times Yeah, that's right Okay, but you're kind of a vunderkin and you get diagnosed with ADHD at nine years old which that's the beginning of these diagnoses Yeah, maybe the uptick in these that's early. Well, it depends where you're at probably also gender for boys Typical age of diagnosis is between five and seven or women. Do you know what it is?

11:2140 35 years old Age usually they've had their own kids. They're like this is weird They go to the doctor the kid gets diagnosed and then the mom gets diagnosed Yeah, okay, so you do get a diagnosis and then that's immediately helpful Yeah, in that you get medication that starts working Yes, I'm hesitating because it's a weird story Okay Okay, so fourth grade I was pretty boisterous as a kid substitute teacher comes along I create an insurrection in the classroom. I got everyone to stand up on their desk start chanting to get And like that's horrifying. I can't imagine treating a teacher or a substitute like that ever But I was just the person who did that within an hour of that happening the substitute calls my teacher my teacher calls from a doctor's appointment. She calls my parents and she's like do something And so then my parents got me my mom was a pediatrician So I got in with a physician. I got diagnosed and I got treated But it was so stigmatized at that time. They didn't tell me my diagnosis

12:24And that's why I like I feel like I was diagnosed twice because it was on medication Hugely helpful. My parents were like okay take this vitamin and I was like whoa this vitamin is Working so much beats the shit out of Flintstones It was so chalky and discussed So I could sit through class. I could pay attention. I wasn't getting in trouble and school wasn't painful for me It was never hard for me before but I was so bored. I was like I can't sit here and do this So it became very manageable and that kind of propelled me through this stupid vitamin And then I did well enough throughout my schooling through high school that I got into a combined Undergraduate program. So I started medical school at 18. It's like I condensed to a six-year program University of Missouri, Kansas City. I was like that one there You shut up right? Yes, he did He really he did before he went to check

13:25Shokes in the mix here really? Yeah, his sim is in the mix right now Okay, it's very proud of us Yeah So I went there and that was the first time I'd been away from my parents That was the first time I'd been by myself I'm like there's so much stuff and freedom and also laundry and all of this other stuff that I've never had to worry about Because my mom would do it. I don't know how to feed myself. No Your mom waited on you I did my laundry starting from age like eight. Oh, okay. Okay. My mom tried could you screen make me a milkshake from the bottom of the stairs And she would make you on now that's nowadays Now you're thinking of the wrong story I was making a milkshake in the basically the middle of the night And she was like calling from her room like stop. There is a blender going and I was asleep And she was like what are you doing?

14:25So I was making Sorry, I probably could yell Amazing She did try to instill skills and I just was uninterested in high school I was playing sports and I was doing all this other stuff and if you had told me your laundry's not going to get done I'd be like, okay, I'll just wear my park at a school. It's fine. I don't care about that stuff And I still kind of don't care about that stuff So there's a lot going on and I went from being one of the smart kids in my school to all of a sudden being quite literally the Bottom of my class when I realized something was wrong and I brought it up to my parents is I did this Neuro test so neuroanatomy and I stayed up really tried to focus and I was like I know this brain Inside out. It was really interesting to me and I was visual and I was like I got this. This is so easy Go into the test. I'm like this is amazing. I'm getting all of them This is perfect I'm the first one out of that test and then they had this thing where they would like post your grades with your ID number

15:30So like the next day. I'm like showing up. I'm still looking for my ID number And you're looking at all of these grades and you're like 90, 80, whatever and I was like there is some loser If we got a third or two and I was like that's me Yeah, what a disconnect. I didn't flip over. Oh, oh You just did half of the test. I got a hundred percent. I didn't flip it over Okay, you think the perfect. Oh, you would think I went and I was like please This is going to break my self-esteem and I was like I'll be on the other side of the room You can give it to me orally just read me the questions. I will tell you the answers The guy was like you're either going to learn from this or you're not and I was like Okay, well, I guess I'm not So I remember telling my parents like, well, are you taking your vitamin? I was like respectfully. I don't even know where that is I don't know what you still thought it was a vitamin and right up college. It was a vitamin Okay, so I have a little I have a little beef with your parents This is an ongoing beef you also could have been told that nine years old that this notion that there's all these things We can't tell kids is so silly. I don't understand

16:31It was a different time though. It's a little terribly different. I mean because it's pretty young No, no, no, even like when my brother was little which is eight years below me ADD was if you have that you're problematic sure But there's no reason that the child couldn't understand that they have ADHD and explain what limitations and what other things are gonna Becoming their way so they have an expectation and some tolerance. They can understand that I think that could have happened But I also think I don't thought about this a ton since I'm a parent now How would I handle that differently in that time? It was so stigmatized there was a kid who had ADHD a couple grades above me in that Private school and that kid got expelled for putting fireworks in a toilet And they were like this kid is nothing We don't know what to do with him He can't be at school anymore and all the room parents were talking about it I was just very highly aware of this And then I was also the only brown kid in this sea of white children

17:32I already felt weird So I think my parents probably were doing at that point what they thought was the best They were trying to intervene. They think they're protecting you. Yes But I don't think lack of information is ever protection personally Not wrong. They redeem themselves big because I'll tell you what they did that was correct So after that so I'm like yeah, I don't know where my backman is Next topic And they're like okay heads up Vitamin is actually ADHD medication you have ADHD. I was like no, I don't I've been medicated against my will I feel really angry about to see yes, and so I was like let's just start over So then I really tried to apply myself in school. I would wake up at 5 30 in the morning I would start studying I would study for like 12 hours a day I'd be so into it that I would get into periods where I was like I should probably go eat and I was like No, no, I got to finish this chapter. I was just Trashing my body to get those results and I took another exam and after my best efforts. I still got a 60 percent

18:32Why? Because I was so tired the day before the test and so run down that I was foggy and I couldn't think at that time And I was like previously when I was on this vitamin. I never had those problems. I don't understand what's happening And so then my dad was like listen You might Yeah, come home who cares? Let's learn about your brain He brings me back to California and we go to library straight up old school library pulling out textbooks Both of us were just sitting on the floor He is reading textbooks about ADHD and he's like this sounds like you and I'm like that does sound like me And so we learned so much and I thought it was handled in such a curious and open way It came and my mom both were like We wish that we had that verbiage to tell you we didn't know And you were under our care for so long We didn't know what a fracturing there would be when you left and you were out of that environment So then truly I had to like scrape it and claw to get out of that hole

19:33But eventually I tried a bunch of different medications and some of them wouldn't let me eat and some would let me sleep There were some there were a disaster But then it was the combination of finding a good medication and finding the right therapeutic things And I don't think I truly figured it out until I got into Residency so after med school I was just surrounded by psychiatrists and therapists This is my happy place Great because med school it was so Hard the entirety of med school. It was like all of my attendings I don't know whether I was already pegged as a problem But I had an episode where there was an attending who came to my office I didn't do very well on a test and he had been kind of rough on me the whole time But he's like don't worry about it. You know what we're gonna do But then we have these little cubicle offices And he just brings like a box of them and he starts packing up my office And he's like you can just go home you came there for a reason Maybe you'll meet your husband here and I was like oh wow Oh my god So especially now as a mom of a girl I was like if anyone spoke to my girl like that

20:34I would be fair all in that moment. You're so embarrassed and you're so confused Like why is someone who's supposed to be helping me through my educational steps doing this You just don't do anything and so I just carried that yeah And so but then I feel like residency just reversed all of that because I felt traumatized in med school And then in residency all those pieces got rebuilt and they were like this is what you're good at Lead with that yeah, and then we'll work on the back end Okay, so you have become specialized in ADHD. I'm taking off my shoes. Yeah do it You can dump the socks too whatever you want no one's ready for that. Okay. I would love to know The historical understanding of ADHD as a condition I'd love to start with when maybe first enters the DSM or when does it appear and what did we think it was then and how would we now define it today? So the problem with that is it has had such an evolving course and it has had so many different names When it was first noticed it was in 1700s

21:35We had a patient who was extremely restless and that's what we're describing now as fidgeting or a sign of like that physical impulsivity And then as it moved on it got the name a hyperkinetic condition That was an interesting kind of segue because it really dialed down on the hyperactive component Then as we progressed we didn't get into formal ADD Territory which is not called anymore until the 80s. I believe that's when I was introduced to this concept. It was ADD ADD yeah, and that's what I was diagnosed with initially that came Later and then just recently in the DSM-5. I got beef with the DSM-5 Well, there's a lot of beef to be had with the DSM in general So now what are standing diagnosis is is ADHD is attention deficit hyperactivity disorder It's broken into three subtype. So if you have ADHD It's always called ADHD, but you can have the inattentive presentation You can have the hyperactive presentation or you can have the combined type which is kind of like a combination of both a huge problem Is people sometimes are like I can't have 80s soup because I'm not hyperactive

22:37Because it's in the name right Yeah, I don't like that. It's too wide of an umbrella. We would say maybe It's too wide, but it's also too Nero it focuses so so so stringently on just the focus components and it doesn't touch at all on Other areas of regulation because I think ADHD at its base. It's a dopamine dysregulation error So you have dopamine dysregulation when it comes to attention You have dopamine dysregulation when it comes to impulsivity. You have dopamine dysregulation Sleep with appetite with emotions all of that is so huge But we'd never really touch on it with the emotional side of things in particular if we don't change that with ADHD This is why people are going to get misdiagnosed with anxiety and depression for a million billion years Yeah, I guess currently though it is Diagnosed through Symptoms yeah, you're reporting symptoms Yeah, if a Phil's enough criteria that we would say you have it my curiosity is Are we approaching or do you believe we'll get to a point where there will be different diagnostic tools

23:41DNA markers where we'll go. Oh, we see this clumping of this here. Would it be FMRI brain scam where we would see Something that would let us know is there going to be a day where we can read The actual percentages of neurotransmitters and say oh you have this exact cocktail that ends up to this like Are we approaching any kind of diagnostic tool that's not just symptom related? No Okay, let me tell you why on all of those fronts I think about that all the time if there was something tangible We could grab onto and check a level of something that would be amazing So with the levels of dopamine dopamine serotonin you can usually check those There are a lot of things floating around with like a urine test where you pee and then they check your levels The reason why those are Incredibly unreliable is because sometimes It's not truly that you don't have enough dopamine It's just not present in the spot where you needed to be at the right time. Right. It's a dysregulation So what happens if I come to you and I'm like, okay, I think I have it. What do you ask?

24:43So there's a couple of other things the thing that makes a good ADHD Diagnostic interview is that not only are you checking for symptoms But you are simultaneously ruling out other things and I think that's what makes it such a complicated thing to do because I have Patients who have come in and they're like I went online for an assessment and says I definitely have it And I'm like yeah, and I understand the thing about ADHD that I know because I have it When you are right in the middle of trying to navigate a brain that feels so overly chaotic for you You are willing to point yourself in any direction to fix it. Yes. That's right. You're desperate That population is a vulnerable population because they are the people desperate to want help So I understand why people are taking tests online. It's just not a super valid test because it's capturing you In a very subjective manner. It's not giving good timelines. It's not ruling out any other things So it's giving this very skewed kind of thing with ADHD when you're looking at the criteria You're screening for both the inattentive symptoms the hyperactive symptoms and then obviously you'll get if it's combined from both those

25:50You want to check timeline see if these symptoms presented before 12 when you're assessing for an adult That can get tricky because if you're asking them to recall retroactive data That's hard a lot of people don't remember and a lot of people have spent so much time During their childhood where their parents have masked covered up fix kind of symptomology that it's hard to assess So that's difficult you have to really dig back to get good criteria And then when you're asking questions like for example with the inattentiveness you're asking is it hard to stay engaged with a task Do you feel like it's difficulty to organize things do you feel like you get Distracted halfway through the conversation. You're asking things about focus and focus adjacent topics But you also have to ask is this present during a depressive episode? Is this present when there's substances involved? Did you notice this before or after you got on thyroid medication? You're asking all of these things while you're doing a simultaneous screening for other things

26:51So it becomes Pretty complicated. It's so dynamic. You're doing a comprehensive medical rule out It's confusing from a psychiatric perspective like is this bipolar? Is this ADHD? Is this depression? Is this anxiety? Is this trauma? There are all things that overlap Really beautifully and can mimic it So you need to be able to kind of pull from the diagnosis what the patient is saying ask the right questions to get to where you're going And I'll tell you a lot of people come to me a hundred percent dead said I have ADHD And by the time we're done with the interview it's like no you didn't I mean this was trauma This is what was causing it yeah, and so it takes someone who's been trained To be able to discern that over a protracted period of time as well I would imagine this isn't something you're doing in five minutes You really need to learn quite a bit before you learn a lot and then we probably get into the other issue Which is I'm sure it is a spectrum condition So what do we say that 79% of these symptoms equals it or 71% or whatever you know

27:54When is it a disorder when are you one deviation below a disorder you can still be Suffering a lot of the symptoms before you're Chronically in as yeah, formally or pathologically in this condition And it doesn't mean that's irrelevant that you're just a step before it So my great curiosity is so what are the inattentive symptoms and I also want to talk about How it manifests differently in men and women and boys and girls to your point my hunch is the DSM was originally Just assembled with the boy symptoms correct and so I imagine they really present differently emails and females So how do they and what are those symptoms so with inattentive you're looking at difficulty with Starting a task staying engaged in a task completing tasks having difficulty with disorganization You're looking at issues with executive function the skills that are required for Processing and getting a goal done goal oriented behaviors done those are kind of more the inattentive Symptomology hyperactive you're thinking more like physical and verbal impulsivity

28:58These are the kids and adults who have difficulty staying in their chair. They're constantly fidgeting They're blurting out things. They're Interrupting Also we should say Dax is looking for a diagnosis by the Can I just tell you one second how I got interested. He must know Gabar Mate. Yeah I'm walking him to his car and he says to me Have you ever been And I just went that's a weird thing for him to say and he's an expert on it So I just went like oh, that's really interesting. He sat down and then I too my algorithm became like everyone else's And I start seeing these different things. I interview a friend who's been diagnosed and he was a kidney tells me that ADHD Folks have an outsize sense of justice and I want to know if that in fact is one I definitely suffer So, you know, I'm just not oblivious to a lot of these things do sound a lot like me here's deal I I'm not gonna diagnose you. Yeah, I don't want you to know. I'm actually not looking for that. I don't care if I do or I don't have it Well, you should I think that there is nothing more liberating than understanding your brain

30:01You deserve to have a good diagnosis and to know how your brain works when I went from not knowing what was going on And then I sat with my dad and then we actually went back to a physician And he explained like these are the things that are going on in your brain And this is why you might have difficulty with this. I gave myself So much number one grace about things that I beat myself up about for years and years. Right, right The self-flagulation which is again is I understand one of the conditions emotional regulation needs to be as part of that For example, so my dad asked last Year in April of Sorry, yeah, yeah, we found out he had lung cancer We found out he had the spot and they were like it's annoying But we'll get it treated whatever so we go we get it treated He goes through the chemo he goes to the radiation He calls me one day and he's like I just don't feel great So I avoid a flight I go over and like you look awful. I take him to the hospital Everyone's like no, we can't do a pet scan. It's too soon. I was like do it We don't care if insurance doesn't cover he's something's wrong It was at Brewer and he died 13 days later. What 13 days? Oh my god

31:0613 days, but what I noticed I think this is probably why I feel so passionately about the emotional regulation part is that the colliding of Brief and ADHD Was so destabilizing for me. It was like my brain exploded the brain fog was so and grief Terrific for everybody, but I think for someone with ADHD who's experiencing that emotional Disregulation already I had no idea how I was ever going to get through coping with those big emotions I was like this is too much for my brain. I can't parent. I can't get through a work day And see these patients without just losing it So when I was going through all of that and I had a really tough time with that Because I knew I had ADHD I mean, it was hard because I was like this is tremendous. I felt like I was completely Broken down and starting from scratch. I was like because I know how my brain works I need to create systems that are very low lift for me right now and find a way to rebuild that way If I didn't have a diagnosis or an understanding of my brain like this actually makes sense to me or this is what I believe is going on

32:12I think I would have just kept trying to do what everyone else told me to do which didn't work. Yeah Stay tuned for more armchair expert if you dare Thank you to our presenting sponsor apple tv the new us home of formula one You can now watch complete all excess live coverage of every gram pre including practice qualifying and sprints all in one place I will be consuming all of those things Monica. I know you will I kill for Friday to start watching practice one Following and on a sprint weekend. Oh my gosh two races And this season brings a ton of new energy to the sport new teams like Cadillac and Audi just joining the grid new driver stepping into major seats Landon Norris defending his first world drivers championship and all eyes on Lewis Hamilton in a second season with Ferrari and a brand new circuit in Madrid Plus a new us home for formula one you can watch every race live only on apple tv Watch on apple devices android devices smart tv streaming devices gaming consoles or on the web at tv.apple.com

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36:34I'll tell you after he Past I don't drink. I don't really do anything super interesting. I was just like my brain is so loud I wanted to be quiet right now Yeah, it's easier for me to be quiet And I was just like what can I do? I knew at that point It was my emotional regulation and I was looking for a way to medicate this. Yes, you needed relief Yeah, and I was like that isn't something that I can medicate my brain is having a really hard time with things that are really big And so I need to find Safety to get through these kind of moments and my husband is mom passed because of brain cancer years before So he was really well first and supported all of us through it He kind of saw what I needed and helped me through that moment But I think if I didn't know about ADHD, I would have ended up in a really weird spot. Yeah. Yeah I believe that that makes a lot of sense Okay, now back to the male female differences in my hunch was that the original criteria is probably just addressing the boy issues

37:37And you thought you agreed. So how did they express differently going back to like boys getting diagnosed way earlier than females Typically boys Present with more of the hyperactive symptomology. So they're the ones who are causing problems in the classroom They are disruptive. They're getting up in the class. They're bothering others Which is probably why you got diagnosed early because you were behaving like that Yeah Absolutely and I think about that a lot and I'm like I'm actually pretty grateful Yeah, that presentation because it got picked up but Girls on the other hand are mostly inattentive. They're like the daydreamers that are spacing out in class and they're doodling So those girls are pleasures to have in class. They're not bothering anybody They're getting passed along and then what happens is as The external pressures rise and as they're doing harder things as they're doing more adult things like getting into relationships They're starting families your needs exponentially Increase and what is demanded of you increases and you just aren't able

38:38To cope anymore and then it feels very much like a breaking point two other reasons that people assigned female at birth Don't get diagnosed Number one is a hormonal part of all of this when women are going through hormonal shifts when your estrogen is dropping Your dopamine drops also your symptoms get worse now These women or girls who are going through their first periods or things like that their ADHD symptoms are 10 out of 10 horrible and they're going through all of these attentional issues They're also going through emotional dysregulation because they're like what do I do my dopamine's all off? And that's when they're like she's bitchy because of her period. Right. Oh you want your period? Well, yeah, I saw posted viewers that was like 30% PMS symptoms for ADHD girls versus 10% for the general pop Significant wait, you feel at 30% more is that what you're saying? It's more common PMDD is significantly more common in the ADHD population It sucks because you're in a situation where you're like, okay, well my mood is already

39:42Garbage around that time before my period, but now I can't focus and I can't do the things I want to do And it's even harder for me to emotionally deal with it like that doesn't seem fair So that's another huge one And then the last one is quite literally just I'm not trying to get political here But it's not even political, but there's a societal difference in expectations for females So females are expected to kind of tow the line and mask So what is acceptable for a boy to be doing class? It's very unacceptable for a girl So the girl now learns to hide that behavior. So then what happens is that this High achieving very capable student or child Goes through life They are now getting applauded for masking their stuff And so when at times it becomes overwhelming and they can't People are like what's wrong with you? Why are you so emotional? What's happening? Why are things falling apart? Why are you breaking down at work? It feels like such a huge shift in their baseline functioning

40:45But really they're just Busting their ass trying to feel and look normal. Yeah Okay, I want to ask if these things I've heard anecdotally or around the digital campfire Are in fact people to ADHD over index in so there's a rejection Sensitive dysphoria. Yeah, tell me about that. I would love to tell you about that So I've become obsessed with that since my dad was sick I mean, I was just like what's happening? Why am I so sensitive to certain things? So rejection sensitive dysphoria is the very very real Emotional sometimes physical pain that comes from real or perceived rejection or criticism So someone criticized you or reject you or you think that that's happening And all of a sudden you can't stop thinking about it. You're beating yourself up about it No one likes getting rejected. That's not it. I have told my husband It is like someone Sucked the air out of my lungs. It feels that significant to me rejection sensitive dysphoria

41:46I think it's so important to recognize and to know about because it's so hard for the person who's experiencing It's also so hard for the people around that person. Oh, yeah, the relationship toe around them. Oh my god So when my husband and I get into fights I'm so sensitive that if I know we're kind of beefing with each other He'll look at me and I will just start crying and then I will chase him around the house and I'm like and another thing And another thing is show out Because I feel like this urgency that I have to resolve this so that this feeling goes away. This is the email right Yes, so what we do I'm not an effective communicator when I'm in that state. I'm emotional and I'm Angry and I'm scared and I'm sad and all of the things all at once and it's too much right in that moment So what I do is I literally write an email And I draft it and I draft it and usually take three or four passes because I'm like that's not what I want to say So already by the end of it I've come down pretty significantly We've regulated a bit. Yeah, because I've had this like safe place

42:46The safety of my laptop This is my happy place. I can write this down and I could take as many tries as they want to make it sound the way I want Then I send it off to him and we have a whole folder of this usually I'll send him a text message and like I said you something He'll read it and then he will think about it and process it and usually by that time I'm like I'm gonna just go somewhere else like I also go sit in my closet or I'll go sit in the car We're all going hang out with the kids. I don't want to be around him because I'm looking for as he's reading at what it's face is doing And so then what he'll do is he'll respond to it And he'll make pizza rolls And he'll put it out and then we'll have like a fun snack and we'll talk about it and then we'll be done And it's the best system we've ever had I loved reading that because I guess we need jerk this exists in my relationship And my knee jerk is we are good enough communicators and we are smart enough and we've all done enough work That we can sit down and talk about this that's where I come from it feels like a failure that we would have to be texting each other or emailing but then hearing you say that I was like I also must admit

43:51It does go smoother if those couple steps happen before we confront something verbally I'm happy to be relieved of the shame of us failing and being great at talking immediately I don't know how people do talk immediately Whether it's ADHD or not, I think time is kind of important Time in giving yourself that space to regulate before you come into and like try to resolve the situation Because otherwise this is so messed up But I think I'm realizing now that if I come off of an argument and I want to address it right away I want to show him how hurt I feel and how badly that hurt and it's not about resolving Exactly It's about wallowing and then I get angry or it matters I mean, it's pause when I agitated it's the whole thing Yeah How about this inflated sense of justice or this inflated discomfort within justice So it's not a clinical term You see it a lot in autism as well But it has to do with like rigidity Being very rigid and having a set expectation in your brain

44:51And then having it not come to fruition in the way that you planned I think that's kind of where it stems from And so they're looking at like a huge gamut of presentations of ADHD So there's some people who in order to maintain their ADHD They have become very rigid about things They have built these structures for themselves Where it's like this is how it has to be Because this is how I can function Right That's where I can have compassion for it You're very easily dysregulated You somehow learn this about yourself Whether you're conscious of it or not And yes, the more things that you can map out and plan out And control the less chance you'll have at dysregulation So I'm sympathetic to it My thing is like the airport All my character defects come out at the airport Because I mean as to cooperate with the TSA To do things that I think are illogical or make no sense I'm powerless People are taking photos of us I don't like that They might be taking pictures of my kids The big storm of things And I do a pretty effective job of controlling my day

45:54You know, normally And so yes, I have learned that Before we leave to the airport for the best outcome I have to have that expectation That helps me enormously to just go like Okay, we're going to get there And some guys going to tell you to hold your pants up And also hold your hands over your head at the same time Which you know is impossible People are going to take pictures, they're curious Get over that But if I walk in It'll prepare it or unprepared for what's going to happen That's when some massive dysregulation happens pretty quickly Yeah, we're all trying to get by There's some brains that are just More sensitive to these things than others Do you ever spend any of your time or focus Thinking about the evolutionary aspect of it Do wonder if this would even be a quote condition Without the incredible amount of stimulation What do you think about that There's been some thought about If we're looking at ADG Just from evolutionary perspective And we're looking at hunters versus gathers ADC people are the people who are going off And they're hunting And they're doing these things that involve risk

46:55And adaptation and impulsivity to some degree Not only seeking Yeah, and they're great at that And now we're putting that same group of people That would thrive in that environment In a new environment And I don't necessarily think it is Well, maybe it is due to all the stimulation But I think it is just society adapts and evolves Based on what its needs are And the needs are There is just a much larger neurotypical population And so the world is built for a neurotypical Now you're expecting this population of people Whose brains are wired differently To occupy space in a world that just wasn't built for them And a really easy example of that Is for ADG day A lot of people have delayed melatonin onset So their brains don't feel a normal I feel sleepy at 10 And then I'm going to wake up at 7 There's are like I want to go to sleep at 1 And I would love to wake up at 10 am But that's not where society runs You've missed three hours of meetings already Yeah You're right, there was a lot of different outlets

47:56For a lot of different types of brains Before But we have really homogenized the work experiences You go to a box, you sit in a chair You do this thing There's not like Oh yeah, why don't you go explore it over that other peak Will we the baskets? We're more apt to sit here and we've these baskets You know, everyone has a bit of an outlet Now it's like, no, no, everyone's supposed to wake up at 6 Everyone's supposed to do this and that So you have funneling it's all into the same thing There's going to be a lot of tension there I think it's tough because you are expecting people As you're growing up to function and learn skills In an environment that's not built for them So you're already kind of starting off at a deficit And then you know, you hit adulthood And they're like, okay, you've been for yourself You haven't really had time to build good skills Unless you've actually really dialed down Understanding ADHD Learn how to make accommodations for yourself It's kind of like you're going through this environment That you never really figured out with schooling You never really grabbed hold of it And then now you're an adult And you have to figure out what to do with it

48:57But you don't have any of those foundational skills sets What do you think about the fact that so many people Especially from social media and stuff are self-diagnosing I have a problem with that And this comes up a lot on the show That's partly what we were so excited to have you But I think it's a problem That so many people are walking around saying I have ADHD when they don't know if they have it Or they think they have it based on what they've seen Because for me, I'm like, well, what about the people who really have it To me that takes away from it is something happening in your brain In our developmental condition Right, what are your thoughts on that So I kind of have a hot take on that And my hot take is that I think self-diagnosis is actually good to a point And the reason for that And I'll tell you what the point is too I think that it is incredibly valid To have someone learn about what is happening in their brain Find things out on social media Or in books or in literature

49:58Or research that looks like them And grab hold of that And start learning verbiage of how to describe their own internal environment I think that's a wonderful thing And I think that that can be a wonderful stepping stone To accessing care And I know that's not an accessible step for a lot of people But that next step I have problems with it When it moves from self-diagnosis to the medication standpoint That's really where I start to draw the line Because when you start trying to treat yourself You haven't done the exclusionary kind of thing To figure out what else is going on And medications of any type They're not without risk You're doing things that could potentially impact other things in big ways So if you think you have ADHD And you want to learn behavioral strategies That help an ADHD brain Go for it, man My hunch, Veronica, is that your issue is much more The person who says I have ADHD so deal with this Using it as an excuse I don't think you would ever have a problem with someone going

50:58I think I have ADHD So while I should explore these tools That have been shown to work really well with ADHD Let me try them Great, these are helping I think your fear is probably more like I proclaimed I'm missing You have to lower your expectations of me now Yeah, exactly Obviously if someone's like Oh, I think I have it I'm going to do research and learn about it And figure out how to help myself That's amazing That's what I would want for everyone But that to me is not what's happening I think people are saying I have it And so I'm late And I think the reason I don't have an issue with it Is I come from a background Where alcoholic self-diagnosis That is the full premise No one can tell you're an alcoholic You have to tell yourself you're an alcoholic And then you have these steps That you're disposed of If you want to try this And no one's declaring I'm an alcoholic So deal with the fact that I didn't come to work So for me the association with the self-diagnosis Is very positive I think you're right If you're using ADHD as an excuse And if you're saying I can't do this And you don't have a formal diagnosis For someone who does have ADHD

51:59That can be extremely irritating Yeah And I've been guilty of that Where people have said that And I'm like You don't want to slug You can't possibly know like I do At the end of the day I have no way of knowing that I have no way of knowing what's going on there When they're failing Yeah, you don't know What their dysfunction is I don't know So I've tried to Peel that back and figure out And look at Why is this bothering me so much But using self-diagnosis As a tool To Get steps to get a formal diagnosis Or get more access to knowledge about things And research about things So you can learn about your internal environment I think that there is a huge space For lived experience of talking about that Yeah, you're fear someone will be like I am ADHD, I have time Blindness Don't ever expect me to be on time Yeah, and that happens And it's like Guys, I don't want to be on time either But I think it should be more like I have ADHD Yeah, I think I relate to this time blindness thing What are the three best tools Because I know I do have to be on time places

52:59We all have stuff And we have to figure out how to live in this world You know, we're not islands That's why I'm going to just quickly say Neuro-typicals bullshit as well It's the same reason the DSM is fucked up Because it has some premise of normal Which simply doesn't exist There might be eight people Who don't have something going on There's zero people We're all variable And I think the neurodivergent terminology It was like a psychological turn that came out in the 90s And it was really this umbrella term To talk about autism and ADHD And all of these other things And the neuro-typical was just kind of like a byproduct What's the opposite of this Yeah, DSM has problems Yeah Yeah How do stimulants work? Why is that an effective medication? This is a weird Area of medicine Because it's not this cut and dried mechanism So basically where A majority of that deficit happens Is that frontal lobe So directly underneath your forehead That's where all that executive function Judgment processing happens So what a stimulant does from

54:01Just like a very rudimentary perspective If your brain has a million different things going on Going different times Because of that underlying dopamine In Europe and effort and dysregulation So everything is just floating Had an incredible space You can take a stimulant A riddle and derivative Something in that family And it actually works A little bit counterintuitively Because it slows things down And really it's not that it's slowing things down It just speeds everything up To match what's going on with your brain It like synchronizes it almost Yeah, it is very counterintuitive I very much feel like I would benefit But I also know I can't be on that Oh my god, there's so many better things Then being on a stimulant Yeah Oh okay, so here's the deal If you're trading ADHD You could do it behaviorally Or you could do it Medicinally, right And with medicine For ADHD They're stimulants And they're non-stimulants And so the stimulants are what everyone thinks of

55:01And they're our gold standard right now Because they work well They work reliably And you could tell Pretty quickly Is this going to work or is this not going to work Those are things like Adderall derivatives Riddle and derivatives Those are all part of that class But for a lot of people with ADHD Stimulants even the long-acting ones They'll give you like a six to eight hour coverage But ADHD exists outside of that six to eight hours So then it's like what are we doing for the rest of that So non-stimulants, a lot of them give you a 24 hour coverage For the great majority They're either fall under the category of an antidepressant Or a blood pressure medication Or some other class Interesting And you are getting additional benefits So for those people who have ADHD Who are also anxious Here's a medication It's my health with ADHD Well, it is a blood pressure medication There's long-acting formulations of blood pressure medications That can help with anxiety and ADHD Or you're doing an antidepressant Which is going to help with depression And anxiety and ADHD Or you can do something long-acting

56:03That people take for shift work disorder So it really depends On what you need And what you're looking for And what else is happening at the same time But for a lot of people When they're coming to the doctor They're assuming If I have ADHD I need to be on a stimulant I need to be on five ants I need to be on Adderall I need to be on Riddlet And 90% of the time That's not the direction we're starting at Because I always tell people We need to build skills So we need to work on that If that's not possible Because your ADHD is dysregulating everything We need to give a medication That's going to give 24 hour coverage As much as possible So that you have a chance To kind of see and build There's some people who Just that diagnosis Immediately lifts them It gives them the permission To study and make changes And do those things That they don't need to be on medication So it's not like an absolute You have to be on medication To treat your ADHD But there are a lot of people That in order to build and cement those habits They need to be on medication

57:03And that's also incredibly valid It just depends on how your brain is wired So your first book Self-care for people with ADHD You have over a hundred tips It's fast-moving It's foreign ADHD brain to read this book Just little page long blips I could tell you my favorite one in that book And it's do a headstand That's not the one that's going to work the best or anything It's just the weirdest one But there is something about that change One, you're doing something weird How I figure this out is When I was in medical school that was studying For organic chemistry It was just so boring to me I was like, I can't do this anymore My mom would be like Just do something to change your position Or just do something to distract yourself A little bit And it was that inversion of a headstand That's hilarious Not necessarily the most impactful But that's one If you're bored in the middle of stuff Another one I think that is important So the book is broken up into separate areas And it breaks it down In terms of emotional self-care Physical self-care Professional self-care All of those other things I think if I were to

58:04Pick from those Because some of that book Is also things like giving yourself permission To grieve if you haven't gotten a diagnosis Because a lot of these people are coming to a diagnosis Late in life I'm done with the career portion of my life I'm done with the child-roaring portion I missed on so much And now I'm having to grieve this diagnosis I bet there's a feeling of Oh man, I could of blank Which is heartbreaking It's hard, but you know what I tell patients Who are in that position Is that This whole time You have been building skills You have been building structures You have had this brain this whole time And so now It's what you do with it And it's what you make of it With this new opportunity And so you wouldn't have built those skills That you needed if things were different Potentially Another very, very important one Is just making time for physical activity I feel like such a hypocrite Because I hate exercise I think it sucks It's so boring And it's so hard for me to motivate myself But it truly does make my brain work better

59:04Let's talk about the forthcoming book That will be out That's called Too sensitive Too sensitive rejection Resilience and the science of feeling deeply I like this So it's exclusively ADHD Because it feels like this could encompass More than just ADHD No, it's not Exclusively But you know the thing about Like we were talking my rejection Says it was for you Almost a hundred percent of people with ADHD Have rejections I feel like I have ADHD now I have to have hypocontria I really have all this for me yet I know that I don't have to I'm diagnosed No I'm not, I'm not, I'm not But I do have that So the concept of rejection sensitive is for you I started writing this book When I was all dysregulated with my dad It came about during that time And I was like This is the worst part of my ADHD My emotional dysregulation This is the thing that will bring me to my knees every time If I can't focus or if I can't do things I'll make a hack around it Or I'll delegate I can't delegate So I want to take care of my emotions And so I'm like there has to be a better way

1:00:05To think about this And learn about it And talk about it And I think that's why I have so much beef with the DSM By the way Europe changed their criteria in 2019 To include emotional dysregulation As part of a core component We haven't And so I look at it like Say your diabetes So bad That you started to lose your vision Now instead of someone being like Oh okay Well let's fix your diabetes They're like No no Okay let's just give you glasses Let's treat anxiety and depression Instead of treating the underlying diabetes The underlying diabetes is ADHD And the anxiety and the depression And the rejection sensitivity And the emotional dysregulation That's what's causing the vision loss Right It's a symptom not the cause It's a core part of it It's not a separate diagnosis And so if we don't get on top of this What happens And I've seen it so many times Is that for women in particular I'm seeing women who are On anti-depressant number six or seven

1:01:05They're coming to me And they're like I don't know what to do anymore I think I have ADHD Did you talk to someone about this? Yes I've talked to my doctor for years What did they say? First thing that they're going to hear Is they're going to say Well you're doing too well There's no way you could have ADHD The second thing they're going to hear Is No It's anxiety and depression Let's treat that first The third thing they're going to hear Is after there's six or seven antidepressants in Then they're going to say Listen These antidepressants aren't working Can I please look into ADHD They're going to be like We can't treat ADHD Until your anxiety and depression are clear These people aren't getting help And it's because emotional Disregulation is in the criteria I haven't loved one Who has come to this late in life And it's so fucking impressive Because they've done it without any help on their own But they said to me I finally realized That I'm processing everything different Than everyone else around me And I'm realizing that these Really Crazed states I am going through Are that thing

1:02:06Yeah And it has not fixed it But it has helped me go Oh, that thing's happening And no one else around you is really experiencing it So if I pop off now at work Or try to let everyone know A, they don't care because they're not experiencing it And this is without any help from anybody Just his ability to go Oh, that thing's happening Is incredibly powerful It really I feel like Takes a lot of the heft of it away It probably gives you a little bit more agency The way that this book Is set up The first part of it is truly just the science behind And a lot of the evolutionary perspective And just like the history of it How it came about The neurobiology What is actually happening What areas of the brain are being triggered That amygdala is being hyperactive Because it's assessing threats all the time Even though it's not appropriate And then the second part of the book Is how deeply do you feel So it's actually an assessment Where you can actually walk through And be like Is this me Where do I fall It's broken down into like You're probably in a spot

1:03:06Where emotional sensitivity isn't a huge issue You should read this If it applies to other people you love So you have better understanding Or this probably does apply to you Maybe it's not all the time Or This is probably you This is probably something that's pretty significant But you haven't had really all that much verbiage for it Because we don't talk about it And then it goes into the tools you use There's just 12 tools that you use And then the last part of the book Which is my favorite A real world examples of how you get triggered So it's a quote And then it is what's happening in your brain And then how you get out of that moment So when I was researching I was pulling from all these different psychological principles And like what actually does work So this is just an amalgamation of all of those principles Together to actually help with this select thing Yeah, I mean I can immediately think of Several people I can't wait to buy it for Which will be triggering But then Well good, I can't decide on the covers You guys can help me with that Oh

1:04:07When you see it on your and I stand Don't be triggered Well Sasha, this has been a blast You have a very popular Instagram account That would be very fun for people to go through Because I think a lot of stuff would feel Quite familiar as you describe it Oh, there was one last thing selfishly I wanted you to talk about And that is parenting with ADHD What can you tell me about that It's hard It's hard Parenting with ADHD is a huge expansion Of what your needs are Because not only are you having to manage your own brain You're having to manage and guide little people's brains as well Help them regulate That's really your job Yes And model good behavior And from the logistical standpoint It feels like it's just a lot to do My kids are in two separate classes Which is two different class party schedules And two different field trip schedules And two different teachers And end of school things

1:05:08And parent teacher conferences And that probably doesn't sound super overwhelming But that's so hard for me to keep track of it Which one is this? Which one is this? And like you have to really create good systems around that And I think the most most vital thing That I could tell anybody Who is parenting with an ADHD brain Give yourself grace Let yourself mess up And have a hard time Because when I got pregnant I had numerous Pinterest boards Of the kind of parent I wanted to be Like what I wanted their nursery to look like Immediately you have this kid You're sleep deprived You have breast milk everywhere This is not what you thought it was And that goes out the window And you're just like This is probably going to be harder than what I thought And one of the best things that we've done as a family Is work through moments that are hard and difficult Kind of together As a team and problem solving So there are times this literally happened two days ago Where I was just like This is hard for mom Because there is so much

1:06:09So when you give me a show and tell Bag and you're like I have to do this by tomorrow And it's 830 at night Right before you're going to bed You run downstairs And you're like I forgot to do this And I have to bring it in the morning That's hard for me And I'll do that But this is why I snapped at that Or this is why I don't have a hard time And then when I tell my kids When we have conversations like that Like any idea is a good idea Come up with solutions And let's talk about it And so they were rubs And they're like Well He could have turned in his bag You earlier today Well, he could have figured out What he wanted to put in there And siblings are great at coming up With that news for the other siblings I know what he could have done There's so many good ideas But not great at figuring out What they should have done But boy They can see right through the problem And there's a sister Yeah, I think it's just giving yourself grace And when you mess up Use it as a learning opportunity for everybody I think I was so focused on hiding Parts of myself from them Where I'm like What am I doing? I don't know what their brain is going to play

1:07:10Well, again, your asymmetric rejection reaction You can feel rejected from your family You can feel rejected Yeah, yeah Getting burned by my five-year-old I feel like here we are Okay, well, this was lovely Cannot wait for the new book Currently, though, you could start with Self-care for people with ADHD And then look for two sensitive rejection resilience And the science of feeling deeply I hope you come back This was a blast Hey! Stay tuned for more armchair expert If you dare Thank you to our presenting sponsor Apple TV The new US home of Formula One You can now watch Complete all access Live coverage of every grand pre-including practice Qualifying and sprints all in one place I will be consuming all of those things, Monica I know you will I kill for Friday To start watching practice one Following in on a sprint weekend Oh my gosh, two races And this season brings a ton of new energy To the sport new teams like Cadillac and Audi

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1:11:14So we're in March which means it's a moment to celebrate women And I want to take a second to acknowledge some incredible women in my life My family of course And Monica obviously who I get to work with every day The women on our team The women in this industry who are constantly juggling a million things at once They carry so much They're managing work, relationships, family dynamics And about a thousand invisible responsibilities that nobody sees or acknowledges And here's what I've learned Taking care of everyone else is exhausting Setting boundaries, creating balance, making space for yourself That's not selfish, that's necessary And therapy can be a really powerful tool for that It's a space to work through the pressures, the expectations, the roles we all play BetterHelp makes it easier to get started They match you with a license therapist based on your needs And if it's not the right fit, you can switch anytime Your emotional well-being matters Find support and feel lighter in therapy Sign up and get 10% off at betterhelp.com slash tax That's betterHELP.com slash tax

1:12:17We hope you enjoyed this episode Unfortunately, they made some mistakes I have to say I'm only three days into no dairy And I'm already noticing Oh, that's good Well, that's good I was saying last night I almost would rather have a runny nose all the time You have to Yeah, decide, I guess So worse when you know, it's better to live in a branch Just go, I'm just someone with the runny nose I know Well, then you can pick like if there's something you really want With cheese and you just know what you're getting yourself into Just go, okay, I'm going to cough I'm going to cough for a day Yeah, exactly I'm going to blow my nose a lot Exactly And that's going to be that Yeah, well, but also Good If you know you don't want to be coughing If you have a big thing to do If you have something to do on stage If I'm going to be like talking For a living For a living Yeah, yeah, yeah Someone's got to edit around your coffee

1:13:18And into a clearing Sure, sure, that's good to know I would never I mean, never say never If I had to, I guess I would But I could never give up cheese And it's my favorite food It's so good And it makes it can make something that's virtually tasteless Like a macaroni noodle on its own In a box of crap, macarons cheese You're not going to eat that You add that cheese to it Now you've got one of nature's greatest offerings Best, best, best Okay, I wanted to tell you that In a very fun way Lincoln has now kind of joined a little bit into our Sim Talk In so far as we were laying in bed Couple nights ago And she was telling a story about A girl in class had a caterpillar on her shoulder Okay And apparently There's like a season for this And there's caterpillars all over the trees at school And they're dripping down on people Ooh, okay, that just made me feel gross And then we were just talking about caterpillars

1:14:19And not all of a sudden I just had this thought And I said You know, Lincoln, when we die And we wake up in like a medical room And they go, you were in a simulation I think one of the things they're going to say is And by the way You thought that there was a tiny little sleeve of mayonnaise And that that little sleeve of mayonnaise went into a dark cloth And came out as a butterfly And you bought it You don't want it at all Oh god That's what it is A caterpillar is just a little tube of mayonnaise And we have bought into the idea that that thing Friends into a butt Somehow goes into a dark cloth And comes out as a butterfly Is preposterous When we're talking about like the bus maybe is proof of the sim I now think the caterpillar butterfly metamorphosis Story we've been told Is insane How would it go from mayonnaise to a butterfly Well, how would a seed This small

1:15:21Turn into you Oh, the like the embryo Yeah, it starts as a sesame seed size I know that's crazy That is crazy But I don't think his nuts is like a little tube of goo Goes into a cloth And is now a flying Most beautiful colorful structure Where's it all coming from That mayonnaise Don't call it that It is So nasty Oh my god So then we're having a lot of fun with what else they were going to say to us Like you guys He's not an octopus could swim over An environment And immediately become that environment Without even looking Their eyes are looking up at the surface of the water And then they they just hover over some coral And then their whole body immediately is the color of the coral Oh camouflage Get real Look Get real Beings are very impressive Is there anyone you want to add to this one So right now it's like Leading the charges like butterflies We're going to feel so stupid that we bought into that

1:16:23And then and then for us the octopi Camouflage means it's if you watched it recently It's in pot Monica could it could swim over your face and it would just be your face What are we talking about Wait really Yes The camouflage Is that what you mean The bioluminescence or whatever the thing it's called It's identical to whatever it's swimming over No way It's not an LCD tv It is We're telling us it is Also tv I mean all of it It's all It's TV I'm fine with No A TV This is the prehistoric globagoo Globagoo Well Okay you're fine with it I'm still I mean I just think humans is that's a bigger To me that's a bigger leap from going from a sesame seed to you Is bigger to me than the mayonnaise god But at least the thing is cell dividing and it's taking on Building blocks through nutrition to create the new cells And you can just see the course of action

1:17:23It's like it's doubling every time it divides It's very trackable This sesame seed With no eye nothing It becomes a human Yeah It's wild It's wild But again this gooey slug enters a cloth And then it flies away Okay Okay yeah You're not as perplexed by it But I just think it's one of the It's it's a miracle It's one of the hardest to believe Things that happens in nature Yeah I mean there's some things like ladybugs That I don't like but have grown to like a little more Okay What are they doing that's so startling Really just the way they look It's like wow Or like same with fruits Or like the pineapple It's like nature made this Nature made this pineapple This thing with spikes and this hat on it And and this sweeten it like I know but I'm struggling Okay but you're not letting me The gap between these two organisms

1:18:25If you were to like you just look at all in nature And we didn't know that those were the same things They'd be two of the last things you ever even put in a category A caterpillar in a butterfly It's like a elephant going under a cloth And coming out as a rattlesnake Yeah You don't like my examples Or not my examples There are just things that I find like Wild about the world Yeah you're you're really blown away with growth Yeah and like um the ladybug doesn't grow It just is very It's just how is it read with polka It like nature made polka dots Like perfect polka dots That is astounding On top like on on an on an insect Like what that doesn't even make sense It is crazy and then if it turned into a screwdriver at some point Sure You'll be like hold hold on I just yeah I don't have that I'm not that I'll be wildered by metamorphosis

1:19:25One animal turning into another animal Yeah because because of the seed turning into you Like I'm primed with that and that Yeah my distinction is like it was one thing and now it's another At least the seed was always a human you know Well the butterfly was always a caterpillar at It's just trying to tell us That's what they want us to believe Um yeah I mean yes Sim the sim is crazy Mm-hmm It is I mean what about magic What about magic We're gonna feel foolish You're gonna feel foolish because you're gonna be like They're gonna be like no that was magic Like those tricks that David Blended Aren't tricks that's magic And like you spent so much time trying to figure out What what were the tricks since there are no tricks Yeah I mean as you know I spent no time trying to figure it out Because I know I can't figure it out And I know it's not magic Yeah but you're gonna find out it's magic Oh we were playing uh 32 questions last night at dinner Oh And Delta really stumbled upon one

1:20:26Now it was I would argue that she was wrong on both fronts But one of the questions was Is it man-made? Oh okay Or is it from nature Okay I like that Yeah and so it wasn't man-made We figured that out early And then later on the line There's not from nature And then so I kind of bailed out of the game So I'm like well if it's not man-made And it's not from nature then it can't be anything Okay Right There's no there's nothing that's neither of those things Let me think Not man-made And not from nature And not from nature Did she mean like Cotton or something That is nature But like I could see her think like Well what it was was weirdly It was both nature and man-made Which is maybe why she didn't think it was either An eyelash Oh So that's both nature and man-made That feels like she stumbled upon a riddle Oh That is a good riddle Yeah what's man-made

1:21:27And man-made and Nate from nature And eyelash Although she said it was neither So yeah she meant both But I can understand why she said neither Is it man-made No At that moment she was like no no The body made it Nature made it Right And then Is it from nature is like No it's human-made Sure Sure Well yeah Yeah Interesting That's a fun game Yeah it was It's fun for a while I bow out pretty early My My attrition for 30 questions is Brief Okay Once we like I guess what I just I lose I lose Hope Again when I heard it's not man-made And it's not from nature Like well then I can't continue to get I'm doing running the fool's errand now Oh wow Because there's nothing that is Not either one of those things Okay Okay Yeah Comment if you can think of something That's neither That's a riddle Well it's not really a riddle It's just a hard question Would we say like Thoughts Or man-made Well I guess it depends on how we're

1:22:29How we're saying man-made If we're saying They can't exist without a human Hmm Okay Like a wrench doesn't exist in nature Yeah exactly That's But a man didn't can So like Guess construct thoughts But it's more abstract than that They didn't invent thoughts I think it's an example of It's both in that case Because it is the human thought Like what's Is human thought man-made or nature made Yeah And it's both Or neither Or I'll play with Delta Stay tuned for more Armchair expert If you dare We are supported by Empower See you've always wanted to take that bucket list safari trip Where you hop in a Jeep at sunrise And cruise the Saring Getty Here's the thing If you invest well You could do things like that With Empower You can get your money working for you So you can go out and live a little

1:23:29Isn't that why we work so hard To splurge at certain moments Maybe it's those concert seats That don't require binoculars Or taking that trip to Athens In Greece Not Georgian notice respect money So use Empower to help you get good at money So you can be a little bad Join their 19 million customers today at Empower.com Not an Empower client paid or sponsored Let's play Play There are two questions Why don't you want to play Okay, you have something No, you have to do it No Oh, okay Think of something Um Okay I have it Is it manmade? Yes Would it be sold at Walmart? Yes Is it smaller than a microwave? Yes Is it for personal hygiene? No Do you plug it in? No Okay It's smaller than a microwave You don't plug it in They sell it at Walmart

1:24:32Is this where you give up? We're getting close to where I would give up Okay Rob, do you have any questions? Is it food related? No No Okay, so we're not eating it It's smaller than a microwave Is it bigger than an iPhone? No Wow, okay great We just really got So it's kind of microscopic But they sell it They sell it It's smaller than an iPhone It's not Personal hygiene and it's not electric Is it a pen? No Is it home improvement related? No Would it be in your living room? Um, I would say no Like Would it be in your kitchen? Not traditionally Would it be in your bathroom? No Would it be in your closet? It could be in your closet Could be in your closet Your nightstand? Yeah I'd probably put it in my nightstand Wow

1:25:33Not electric Well, not plugged in Is it battery powered? I think It's not plugged in And But it's But it's not It has an electronic It's electronic Is it electronic? Yeah Is it a vibrator? No We were led there Yeah Nightstand Yeah It has a battery Smaller than an iPhone These days you do plug in your vibrators For a period They're not tethered Right Correct If you've got one that's tethered I tip my hat to you Like you need that kind of voltage Yeah Um A remote Um No It's not a remote But You're kind of in They're in the right zone Is In the nightstand Not a remote Not a vibrator Is electric I mean I don't know if it's I don't know if it's the one It's the one

1:26:34Okay Can be It can be Oh wow Non-pitchering a nightstand drawer I mean don't get so stuck in the nightstand It just it could be there Okay And you said it is or is an electric It can be It can be Batteries Let's say it has battery Does it tell time Uh Um Is it a watch Uh Close Very Very close And some would say it's a kind of An apple watch No Like one of those fucking rings you wear Like a Or a health monitoring Think a little more archaic Stopwatch Stopwatch Good job A stopwatch Yeah Do you have a stopwatch I have one in my nightstand You see okay You have a stopwatch I don't No a stopwatch um

1:27:34What made you think of a stopwatch Because there's a stopwatch We're using in at the Sag Awards Uh Top of mind as you would say Top of mind Okay Okay I mean I feel like I keep it in the nightstand Or I keep it um You know Yeah and the garage toolbox I'm going to meditate on why the game for me Gets Frustrating Okay Probably just because I don't know and I don't like not knowing Sure Probably Calvin likes and it's frustrating for me too Yeah it's hard right It's but especially when you I'm not sure he's always answering correctly I have the same and as it's a male thing I'm like suspicious that either they forgot or Yeah like Vinnie we can't play with Because he's got to change it Yeah yeah That's the other thing You catch these kids changing it Like if you guess it too quick They don't like that Yep Sure And it's what what should happen As it should be written down on a piece of paper To keep everything Above board Well I mean playing with kids is different Than playing with the dolls

1:28:35Like I think if you play with kids Sure It could be a little like Are they switching it Are they what are they I mean a lot of the time like This is a long game Yeah And I'm sure if they remember Sure But if you're playing within a doll And you don't trust it Uh-huh That's On you Uh-huh Okay Adults know what they're doing Yeah whether or not they would change it Is another thing There is some legion of people that would change it Sure But if they don't know the answers Like that's like a little like You know It was very easy when they were tiny children Yeah Because you knew it was something they could see in the room Of course Yeah Oh yeah yeah You would like You could narrow down pretty quick Yeah Is it a light switch You know That's because they look at it immediately too And then say they have it Wow Every time you ask Is it brown No Yeah I know So cute See a little caterpillars Turning into butterflies Mm-hmm

1:29:35All over the place All right, should we do some facts Yeah, let's do some facts Okay I didn't bring it up in the interview Although I was tempted to What You know Sasha holds a very dear Oh There's a very important name to me It is That's who you had to act with Oh yeah That's your first girlfriend That's definitely not Say that to Sasha Was that That was your first girlfriend Or the first thing you had to crush on We're getting close It's so relevant to my therapist Remember her name Is this because she had the sound Oh no No, that was That was Randy That was later Okay, so Elementary school could not No, no girls like me And I like so many girls I was just telling Dale to this the other day I was like, I like so many girls No, no, no, I'm like me I got to sixth grade with my new look That my brother did Right, right, right And the most popular girl in the whole junior high Yeah Sasha Cross it Okay, yeah Who was an eighth grader Yeah, I knew she was an eighth Came up and gave me a note in the hallway In the sixth grade hall Okay And I took it into my science class And I opened it up And it said, will you go with me So you dated Yeah, yeah, yeah

1:30:35But she wasn't your first girlfriend I had it I got to be careful Well, this is I'm going to call her Frank Frank I had it I had like a pay on time once It was Aw Wait, what happened I had a I don't know if you'd call her a girlfriend I had a girl who I think Yeah, a little bit And I think I think on bail time say Maybe I gave her something Maybe she gave I think why does she gave me some Some fudge or something But I Yeah, I do remember her name The reason it's so important is It is a transition from no girls like me To the most popular girl in the world I know This was a humongous The biggest 180 of my life That's huge I also think I was Kind of right in saying your first girlfriend Because I'm not counting this girl That's fine That's fine Yeah, we made out We made out so hot We would make out in front of the buses Wow, Dean, you didn't make out with fudge No, no, no, no Yeah, she was your first girlfriend So I'm right Yes And I guess I'm impressed you didn't bring it up

1:31:37Because It's really important We have an interview to Sasha No, we have it No, I have only met one Sasha since then Sasha Baron Colin I guess too Thank you for pointing that out The other was Is a Russian dude I knew Oh, sure I know Um, all right Well Godmother's bookstore You know, I was like, it's in Monacito And then you guys were like, oh, Son, I'm Monacito We're from there Yeah, yeah And Is it Santa Barbara, right Okay, which I think Rob said Summerland Summerland Oh, okay And everyone was like, yeah, that's not Monacito Okay, which is fine But then when I googled I said Where is Godmother's bookstore It said Godmother's bookstore is located 2280 Lily Av I think Rob had said that Because you said, Lily, that's her middle name Um, Summerland, California Founded by Jennifer Rudolf, Walsh And Victoria Jackson in 2024 Oh, it's pretty new I'll say It is situated in a restored 1920s bar

1:32:40Victoria Jackson, the performer from setting a life Victoria Jackson Who's that? A beautiful blonde cast mate in the late 80s Oh, I don't know, I see her SNL I don't know It's a different Victoria Jackson It's a Cosmetics mogul Cosmetics mogul Okay, great With the renowned literary agent Oh, well, it's situated in a restored 1920s barn Often described as a cozy curated space Nier Monacito It says that Nier Monacito, it does Open daily You're having a hard time with this one You're in a real hard time Taking another swing at it It said it though I didn't even say I said where is it And it even included Monacito It's such a cute bookstore Oh, my god, I could live there Oh, brand new too This point here It feels old Yeah, timeless I love it Okay Now You know how I was on D Suited up a different

1:33:40Thank you Which is meth Precursor Does meth eat alcohol Just said He used to make it like A Pac-Man And it was like the meth would eat The alcohol Yeah Doesn't It doesn't eat alcohol But it gets you high Which offsets the inebriated effects of alcohol Okay Because alcohol is such a depressant So if you imagine you took a Xanax And then you took an Adderall The Adderall would lift you out of the Xanax Oh, interesting And this is why people do speedballs Coke and heroin, they're opposites So you're kind of leveling off both sides Oh Both downsides of the drug Interesting A heavy heroin does your nodding off It's not ideal Coke your two edgy Nine on your face You know So I think that's what he means Is it right-sized as an ebriation I don't think it metabolizes the alcohol It's faster Okay So cocaine does the same thing Got it All right

1:34:42What was the most popular Flintstones vitamin flavor Based on nostalgic discussions The orange Flintstones vitamin Was widely considered That's what I think of Really I'm I was a red I'm a red She liked it great I think they made orange really front center in the ads Shusha It says purple And in some cases The iron fortified versions were less popular due to tays With some users describing purple as Yuck Shush Wow Purple was my favorite Oh You and Sasha could have shared vitamin Oh valentines That's cute God, I loved them Says nothing about red Uh-huh I'm going to give you credit for something So you've been saying for a while That Gabor Mate is an expert in ADHD And every time you say it I have to stop myself from saying Is that true I don't remember that

1:35:42I know he is like a trauma expert But I don't remember ADHD So I thought this was my inn Yeah, to correct Yes Gabor Mate is a Canadian physician and author He has worked in family practices And specializes in childhood development and trauma Including long-term effects on physical and mental health Such as autoimmune diseases Cancer ADHD and addiction So it's in there Yeah It's in there Yet his circuitous path is If you remember when we interviewed him Started working with the addicts and skid row there Yes That wasn't his thing But that became his thing Yeah, exactly Kind of like Sapolsky being a fucking primatologist As a hobby Oh yeah I think his addiction Trauma stuff more was his hobby Right But now he's really known for that Yeah Yeah, he's written five books exploring topics Such as ADHD, stress, developmental psychology And addiction Now if you guys miss that episode You really should go back That is such a great episode We did with him Oh, I guess I'd like to say one thing too Eric died, my friend

1:36:43Oh yeah, I'm sorry He was such a beautiful dude And I think it would You're a game Eric Dane Yeah, I think it would be a lovely episode To listen to If you're curious about What kind of spirit Eric had Yeah I'm sorry, how are you doing Um While I was talking to Lincoln about it And I said I Well first I go straight to like gratitude Right Like I had a lot of I was When you hear someone as ALS Worst nightmare of that would be I have lock-in syndrome And although he was very very diminished physically At the end, he couldn't Move much of his body If at all He could talk So he avoided that phase So I just immediately In the same way when my dad died I felt grateful Like it didn't get gruesome So I was grateful for that I know how many people were around That made me grateful And then the sadness I think for me takes a minute And I was talking last night to Lincoln

1:37:44I said I don't know Imagine you came home from school today And mom said Dad died today Don't Could you comprehend that And she's like No I'm like yeah wouldn't it take you A long time If you'd be like No, that's not That's not true That's not right And then months later You'd be like Oh wow, that really is true That's So I think I'm in that phase Where it's like Is it no Yeah I mean Intellectual I know But also No I think that's Totally normal I think that's Yeah, how most people processing It takes a minute I feel guilty about that Like I see people In real life and in movies They hear bad news And then they are Immediately devastated And I'm so protective I think I have so much Like Well-worn, neural pathways That I'm like I have so much shit That just engages right away To prevent me From feeling terrible Yeah And I think it takes a while For me to To be willing to let that in Yeah I think You shouldn't feel guilty about that

1:38:44I think It's totally normal And what's the problem But there's nothing wrong with it No, other than I think Well, my fear would be like Let's say I had been standing at the hospital And they pronounced my dad dead And then all of his friends were then And they start crying And I don't And now I appear to be sociable You know, like a sociable That's like the fear probably Or That's on that I watch these fucking date lines And the cop show up And I've witnessed something terrible And I'm kind of stable And they interpret that as guilt Like these are the crazy thoughts I have about like Yes, but that's But you're supposed to act People expect you to act A certain way And if you don't They start filling in Explanations As to why You're not reacting the way they do I know, but that's on other people That's on those people Who are deciding that Everyone should be Reacting the way they react Yeah And I think it takes a long time To process All of these things Yeah And Yeah And I'm sorry

1:39:45It's really sad Loss is hard Yeah, when I some Two weeks ago There's lots of laughing Yeah, that's good That's good Yeah Okay, sorry, I interrupted that fact check for that But I had forgotten that I wanted to say Yeah Well, let's just end on that Well, do you have another one? You can have another one if I can Well, it was just about PMDD It was PMDD It was really bad PMS All right, people People with ADHD You get PMS sometimes worse Yeah, and I have I'm pretty sure I have PMDD Okay And so then I was PMDD Are you complaining things? God I do think I have it And then I was like I also have that rejection thing Maybe I have ADHD Yay For you Talk about a 180 No, I don't, I don't think I do

1:40:45But um But it's all spectrum, you know It is, it is So that's All right, love you Love you You

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