ADHD - Back to basics with Whitney Kost, PA-C

In this February episode of Thriving With ADHD, we’re going back to basics - unpacking what ADHD really is, how it’s diagnosed, what’s happening in the ADHD brain, and what actually helps.

Joining Nada is Whitney Kost, PA-C, physician assistant at Animo Sano Psychiatry, who brings clinical insight and practical experience from working closely with adults navigating ADHD and other mental health challenges.

Together, they explore:

• What ADHD diagnostic criteria actually involve
• The difference between ADD and ADHD
• Types of ADHD and how they show up in daily life
• Symptom overlap with anxiety, depression, and mood disorders
• Common everyday struggles adults report
• What’s happening neurologically in the ADHD brain
• Treatment options - medication, therapy, coaching, and lifestyle supports
• Persistent myths and misconceptions about ADHD

Whether you’re newly diagnosed, supporting someone with ADHD, or simply looking for a clearer understanding, this episode offers grounded, reassuring education without overwhelm.

Thriving With ADHD is brought to you by Animo Sano Psychiatry, a behavioral health practice with a specialist ADHD clinic based in North Carolina.

Thank you for listening to Thriving with ADHD. This show is produced by Animo Sano Psychiatry. For more information about our clinic, please visit animosanopsychiatry.com.

Animo Sano Psychiatry has introduced new services for enhancement of our patients' mental health - ASP Concierge and Health & Wellness Program. Please visit our website to learn more.

Animo Sano Psychiatry is constantly looking for the talent in behavioral health. If you are a psychiatrist, nurse practitioner, physician assistant, or mental health therapist, we'd love to hear from you. Visit our Careers pages to learn more about the available positions. https://animosanopsychiatry.com/careers/

Transcript

Welcome to Thriving With ADHD, a podcast where we share everyday practical tips to help adults thrive with ADHD. This podcast is brought to you by Animo Sano Psychiatry, a behavioral health practice with a specialist ADHD clinic based in North Carolina. I’m your host, Nada Pupovac.

Hello everyone and welcome back to Thriving With ADHD. I’m really glad you’re here for this February episode because today we’re going back to basics — talking about ADHD in a clear, grounded way that’s helpful whether you’re newly diagnosed, supporting someone with ADHD, or simply looking to better understand this condition.

Joining me today is Whitney Kost, PA-C, a physician assistant at Animo Sano Psychiatry. Whitney works closely with patients navigating ADHD and other mental health challenges, and she brings both clinical expertise and a compassionate, practical perspective to this conversation.

Today we’ll cover what ADHD really is, how it’s diagnosed, the different types, how it shows up in everyday life, what’s happening in the ADHD brain, treatment options, and more. Our goal is simple: clarity, understanding, and reassurance.

Whitney, welcome to Thriving With ADHD. I’m so happy to have you here.

Thank you so much. I’m really excited to be chatting with you. It feels like a long time coming.

Absolutely. Let’s start with the basics: diagnostic criteria for ADHD. Can you share some of those with us?

Absolutely. Many people have a general understanding of ADHD or may even suspect they have it, but defining it clinically is important. ADHD is a neurodevelopmental disorder. Clinically, we look at patterns like difficulty following instructions, starting or completing tasks, restlessness, fidgeting, interrupting, and similar symptoms.

What I emphasize to patients is that many people struggle with these occasionally, but that alone doesn’t mean ADHD. The symptoms must be chronic — present for months or years — and they must have been present before age 12. They also need to affect multiple areas of life, such as school, work, home, or social settings, and reduce functioning in those areas.

That’s really helpful, especially for clearing misconceptions. From a clinical perspective, what’s happening in the ADHD brain?

We focus a lot on the prefrontal cortex — the area involved in planning, organizing, time management, prioritizing tasks, and decision-making. Research suggests individuals with ADHD may have lower levels of neurotransmitters like dopamine and norepinephrine in this area. Dopamine, especially, relates to reward and motivation, which helps explain challenges with focus and task initiation.

Many people also hear the terms ADD and ADHD. Are they the same?

Good question. ADD is an older term. Today we use ADHD for all presentations. The DSM-5 — our diagnostic manual from the American Psychiatric Association — recognizes three ADHD presentations: inattentive, hyperactive/impulsive, and combined type.

Could you briefly describe those types?

Sure. Inattentive type includes difficulties starting or finishing tasks, forgetfulness, distractibility, and poor attention to detail. Hyperactive/impulsive type involves restlessness, interrupting, difficulty waiting turns, talkativeness, or feeling constantly “on the go.” Combined type meets criteria for both.

There’s also overlap between ADHD symptoms and other psychiatric conditions, right?

Yes. Anxiety, depression, mood disorders, and ADHD can coexist. Impulsivity, for example, can appear in ADHD but also in mood disorders or manic states. That’s why careful assessment is important — we want to identify what’s truly ADHD versus what may stem from another condition.

Exactly — diagnosis isn’t about labels but about improving functioning and quality of life.

Absolutely. Diagnosis helps guide treatment and improve day-to-day functioning.

Speaking of functioning, what are common struggles your ADHD patients report?

Motivation is a big one. ADHD affects dopamine pathways, which influence motivation and reward. We also see overlap with depression, where motivation drops due to anhedonia — reduced enjoyment in activities. Distinguishing the cause helps guide treatment. Improving sleep, managing anxiety, addressing depression, and reducing substance use are all part of clarifying the picture.

Let’s talk myths. What misconceptions do you wish would disappear?

One is the continued use of ADD instead of ADHD. Another is the idea of “adult-onset ADHD.” ADHD must show symptoms before age 12, though many people are diagnosed later because symptoms were missed, often in women or individuals with inattentive presentations.

Also, ADHD doesn’t reflect intelligence. Many individuals with ADHD are high-achieving and develop coping strategies, sometimes masking symptoms until demands increase — for example in graduate school or demanding careers.

That’s such an important point. Now let’s talk treatment options.

Stimulant medications are typically first-line and often very effective, improving focus and motivation by affecting dopamine and norepinephrine pathways. There are also non-stimulant medications, depending on individual needs.

Equally important are behavioral strategies — therapy, ADHD coaching, organizational tools, reminders, body doubling, and lifestyle adjustments. Medication plus skills support often yields the best outcomes.

Before we wrap up, what’s one takeaway you’d like listeners to remember?

An ADHD diagnosis is a tool — it helps guide treatment and improve quality of life, but it doesn’t define who you are. Also, it’s important to look at the bigger picture: sleep, anxiety, depression, substance use, caffeine intake — all can influence symptoms. Honest self-reflection helps ensure the most accurate diagnosis and effective treatment.

Whitney, thank you so much for sharing your expertise today.

Thank you — I really enjoyed this conversation and would love to come back.

Thank you for listening to Thriving With ADHD. This show is produced by Animo Sano Psychiatry. Please follow, rate, and share the podcast on Spotify, Apple Podcasts, or your preferred platform.

For more information about Animo Sano Psychiatry, visit animosanopsychiatry.com.