Before You Cut Bangs
Hosted by Laura Quick and Claire Fierman, “Before You Cut Bangs” is full of hilarious conversations about real life, common and uncommon crises, and possible cosmetic errors that come along with it. Through storytelling and therapeutic wisdom, Claire and Laura share how to NOT fuck up your hair (and life) while walking through similar situations,
Produced by Will Lochamy
Before You Cut Bangs
25. Your ADHD and Adderall Questions Answered (by an expert) pt.1
Ever wonder if your pile of unread texts and emails is more than just procrastination? Laura, Claire, and Will are joined by special guest, Dr. Rachel Fargason from UAB to answer listener questions concerning all things ADHD. Dr. Fargason brings her expert insights, debunks myths about ADHD, and sheds light on the relief and understanding that a proper diagnosis brings.
Welcome to, before you Cut Bangs. I'm Laura Quick and I'm Claire Fehrman. I am a professional storyteller and I'm currently working on my first book.
Speaker 2:I have worked in mental health for many years in lots of capacities and this is a really important time to tell you our big disclaimer this is not therapy. We are not your therapists or coaches or anything like that.
Speaker 1:Yeah, I mean you shouldn't really trust us very much at all, unless you want to and it turns out well, then you can trust us, that's great.
Speaker 2:What are you chuckling?
Speaker 3:about Texting while we're doing this, work stuff and friend stuff, and all this Obviously Very timely with what we're talking about. My friend just said, as we're just talking about something else, he's like hey, by the way, you have 524 unread text messages, which just plays right into it.
Speaker 1:You have 524 unread text messages. I have 11,000 emails.
Speaker 3:Oh God, emails, Don't even get me started.
Speaker 1:At least 122 text messages. I have 40,462 unread emails All right, I have 5,671 emails and I have 133 text messages.
Speaker 3:Are we boring you, Claire?
Speaker 2:Yeah, Claire, you good. I'm really tired. I think I need protein or something.
Speaker 3:I bet you it would be shocking if we went and looked at how many texts I've received this morning. We are recording this still in the morning.
Speaker 2:I bet you it's close to 40, 50 maybe oh gosh, I don't care for that at all yes, I have.
Speaker 1:You don't have any beef jerky do you?
Speaker 2:I don't.
Speaker 1:You want a little snack? You want a little snack, need a snack? I brought you something.
Speaker 2:I'm sorry, I didn't know, I was hungry and then I got here and it hit really hard. The yogurt and granola wore off.
Speaker 3:I feel like we're having trouble focusing here.
Speaker 1:Oh, we're supposed to be like doing the opening. Claire said I'll handle it, and then she's like oh, I'm hungry. Do you have beef jerky?
Speaker 2:Anyways, this episode is gold, gold.
Speaker 3:And we know that because we've already recorded the meat of this episode.
Speaker 2:Yeah. I'm coming in post. So after we recorded ADHD episode number one, as a clinician, like we have a scope of practice, it is not my niche to be ADHD specialist, I only know about it because I have it. That's it. And so after we recorded that and y'all had sent in just like killer questions, we decided we needed somebody smarter than us. And boy did we find her. Now y'all can unzip. You know, start flapping your gums.
Speaker 1:Okay, got it, got it, we're ready. I love Dr ADHD. She was great, the good doctor. I wanted to put her in my pocket, take her with me everywhere, to have her pat me on the back and be like you're doing a great job, you're fine, you just have ADHD, y'all.
Speaker 2:I loved her Validating helpful and she answered the questions we couldn't.
Speaker 3:Yes, and luckily she said she'd come back, because even though this is going to be two episodes of her answering y'all's questions and our questions, it could be like four more episodes. So we're going to have more questions and we're going to take her on her word and have her back.
Speaker 2:Yeah, we're changing the name of the podcast.
Speaker 1:Actually we're retiring. Before you cut bangs and now it's going to be called, now that we all have ADHD.
Speaker 2:Yeah, and then we're only asking questions about ADHD with experts, okay, great.
Speaker 3:Let's hear it. Okay. So I've told you guys before that I'm pretty obsessed with the podcast Science Versus. I love it. I was just introduced to it, maybe a year ago, but I've gone back and listened to who knows how many episodes and, with Birmingham Mountain Radio stuff, a lot of times we have doctors from UAB come on UAB will reach out and say, hey, would you have this doctor and talk about the study we're doing or whatever, which I always love. And then I always love hearing those doctors, usually on science versus, like that's a show out of Australia and it's one of the most popular podcasts in the world millions and millions of listeners and they tap into UAB constantly. And so, uh, you know, having ADHD, as I do and we've talked about I was very interested in that episode and was very pleased to hear, uh, the expert on the show was from UAB again. So Dr Rachel Ferguson joins us now. Thank you so much for being here.
Speaker 4:Thanks for having me.
Speaker 3:Well, of course, yeah, and thanks for making me feel validated with. This is true. When I listened to your interview, I thought like, yeah, see, that's what, that's how I feel, and I really told my family. I was like I want you guys to listen to this doctor's interview because it explains me. It explains so much of me and my why I am the way I am, which is which I think is fine, by the way, but but, either way, it was really great. So thanks for being here with us.
Speaker 4:You're welcome. It's interesting you say that Will, because a lot of people have symptoms of ADHD and they don't. They don't have an explanation for it. Why am I not achieving it? What seems to be my intellectual level, like what is the problem here? And so they tell that if they're without a diagnosis, they tell themselves stories like well, maybe I'm just lazy, or maybe I just don't try hard enough, or maybe I'm not so bright as I think I am. And once they get a diagnosis that they have this more circumscribed problem which is an attention disorder, then it's like the lights come on it and so it's really fun to treat. And that's how I got interested in treating ADHD.
Speaker 3:Yeah, and I've told this before, but like my brother and I test IQ-wise the same right, but he is known as like this brilliant, you know teacher in like you know Dean's List, I mean just like perfect 4.0 all the time, never even has to think about it, and just and read. You know like 160 something books last year and all this and I was like, oh, I read a book three years ago, yeah like.
Speaker 1:I mean, I remember that one book I read, he certainly doesn't understand.
Speaker 3:he's always like, well, why can't you just do this and I? It's hard for me to explain, but I think you did a good job of kind of helping me through that, and we've got a lot of questions actually that came in from listeners.
Speaker 2:We do, and actually what you just said is why we have so many questions, because a lot of I mean we had people men and women responding, but a lot of women saying that they felt stigmatized or misunderstood or they really wanted some relief or they were married to someone with ADHD. So, in no particular order, I'm just going to hit some highlights of questions that I think really stood out to us, and this one. Several versions of this question came through, but here's one. I quit taking medication because of the stigma and I really need to get back on them. I had people saying things like oh, you're just taking them to lose weight or I take it to hyper focus. However, I take it to not hyper focus. So what would you say to someone around stigma or what blocks people from getting properly treated for ADHD? It's a great question, claire People.
Speaker 4:First of all, adhd is both underdiagnosed and overdiagnosed. It's a very interesting phenomenon. There are pill mills out there that the state of Alabama has really put the kibosh on these, but there are bad actors out there who will give medication to anybody who asks, and that has done a lot of damage to legitimate people who have a true psychiatric disorder. So I'm an academic psychiatrist and I came to treating ADHD 30 years ago when it was still believed that ADHD didn't extend into adulthood. But yet I kept having these patients come to me and say yeah, it was a really hyperactive kid. I'm not so hyperactive anymore, but now I still have trouble focusing and I just don't seem to be able to accomplish what my brother, who I'm just as smart as.
Speaker 4:So what I would say to the person who's worried about stigma, I would say this is a real condition. It's documented by science. It shows up on brain scans, and what I always tell people is you have a perfectly normal brain. If we did a brain scan on you, your brain would look normal. What is different is that your command and control center, your prefrontal cortex, is a little sluggish doing mundane activities. Now, when there's a lot of pressure on you or you've got a deadline, your brain wakes up and does everything it's supposed to.
Speaker 1:These three people could do anything if we've got pressure on us.
Speaker 4:In fact, I think people with ADHD actually do better under pressure. I actually think it's somewhat of a variant how I've become who I am today Same.
Speaker 2:I have only accomplished these things because of all the pressure I put on myself, so let me add a part B because last time this is part two of our ADHD series and someone had asked last time if we felt like it was overdiagnosed and I would love to hear more about it's both over and underdiagnosed.
Speaker 4:Okay, great. So first of all, in like population studies they found that and this was before COVID that only about 11% of adults with ADHD were actually in treatment, so it is still undertreated. Again, there have been some like telemedicine companies that have come and they've pressured nurse practitioners to just globally prescribe anybody who came to them and said I want stimulants. And that is not making a diagnosis of the problem, but I want to throw in back. Going back to the stigma issue, so it's a real condition, just because it so happens that the medication that treats ADHD is something that, at much, much, much higher doses, is abused. I think that's where the stigma comes.
Speaker 4:And, by the way, to your reader's point, stimulants are terrible weight loss drugs. They're not very good weight loss drugs at all. Most people complain to me like how come my appetite isn't suppressed? You know, they'll say once I start treating someone with ADHD, they say, oh, my focus is so much better, my concentration, my productivity is great, but my appetite's still good. Some people get a little appetite suppression. So it's really not that good an appetite suppressant and it's, by the way, not a very good cognitive enhancer for people who don't have ADHD.
Speaker 3:And that is something I learned from hearing you on Science Versus which because people you know, like I remember, in college somebody stole my medicine.
Speaker 1:Yes, yeah, In college it was like a known hype drug right Like this was like the counter to cocaine.
Speaker 2:Cocaine really Like. You drank a lot.
Speaker 1:You keep drinking if you took an Adderall, just pop an Addy, let's go.
Speaker 3:And they would describe it as like well, it's just speed, like you're just taking speed right. What do you say about that?
Speaker 4:Well, I would say that at therapeutic doses it's in head-to-head study. So, yes, I would say that at therapeutic doses it's in head-to-head study. So, yes, if you take a high enough dose, you're going to have a little speed trip and you might speed up and do a lot of things, although you could overshoot it and not be able to concentrate it at all. So I personally think it's kind of dangerous for people who don't have a diagnosis of ADHD and a credible prescriber just taking it, because they could really mess up their grades.
Speaker 3:Why does the correct schedule help me so much, but if someone who doesn't have ADHD takes that same schedule, it does not help them. As far as focusing, what's the difference in like what's happening in our brains?
Speaker 4:Okay. So I mean, if I was going to sum the theory up very simplistically? I mean, if I was going to sum the theory up very simplistically, someone with ADHD like you has sluggish dopamine receptors in your prefrontal cortex, so you need just a little dopamine. It's like a battery it charges your brain and then your brain works like it's supposed to. Well, somebody who has adequate dopamine in their brain all it's going to do is and this is what the head-to-head studies show there are studies that compare modafinil, which is a wakefulness agent, with stimulants prescription stimulants with other like phenylephrine, which is like a weight loss drug, and caffeine, and they were about similar, they really. So, really, what I'm saying is is, if you don't have ADHD, taking Adderall is probably not much different than taking a good cup of coffee from Starbucks. Probably a lot more risky too.
Speaker 3:Yeah, I've tried to explain to people that it makes me feel normal, like right.
Speaker 2:Like it doesn't make me just makes me like, oh OK, now I. Now I feel kind of normal, all right, I'm going rogue off the listeners questions because now I have a question. I do too Like we need you all day.
Speaker 2:So can you describe the difference in sensation of anxiety versus ADHD, that like sense of urgency of I have to get this thing done so I'll feel better, because that's something that I've seen a lot of? There's a hard separation for people. They don't know the difference, and this is ADHD symptomology, or maybe I'm just an anxious person and can't focus.
Speaker 4:Okay, very good question. So first of all, let me say that 50% of people with true ADHD, diagnosed, properly diagnosed ADHD, meet criterion for generalized anxiety.
Speaker 2:Except Will Lockamy. We're going to be really clear. He's like a Labrador retriever with ADHD, but yes agreed.
Speaker 4:Well, he's in the other 50%, that's right. Okay, so there are people who have both, so there can be both. However, the restlessness that goes with the hyperactive, impulsive form of ADHD can feel like anxiety, and sometimes people can confuse the two, like they feel hyper or restless. You know, adults aren't like hyperactive. You know hyperactive kids. They're not running around the room and under my table, you know, and on the chair, um, what, what? What hyperactive adults do is they move a lot, they talk a lot, they, they, they do a lot of mixed activities, like talking to you while they're texting and writing and maybe doing a few other things at the same time, so that. So restlessness can look a lot like anxiety, that's incredibly helpful.
Speaker 2:Laura, you can have a turn. I'm sorry.
Speaker 1:Yeah, I was thinking about even just some friends that I've had recently telling me about their anxiety or their ADHD being diagnosed first as anxiety, only to uncover that it was actually ADHD. Talk to us a little bit about that journey. Is there a proper way to go and get a diagnosis?
Speaker 4:Yes, Thank you, because this is a pet interest of mine and I've, I've, I'm make. The people in my department give grand rounds on this periodically. So a lot of people call our clinic and say I need testing for ADHD, which makes my psychologist crazy because they're like the test is a clinical diagnosis, so it's not a testing, it's not a paper and pencil test. I mean that can support.
Speaker 1:It's not like you failed.
Speaker 4:Yeah Well, what can happen is you know somebody smart like you might go and sit in front of a psychologist and, while the psychologist is standing over you and giving you attention, tasks, laura, you might do very very well, I love to achieve.
Speaker 1:Thank you for noticing that about me. Yes, but you know when?
Speaker 4:you later. You got to go write up a report or something, and you'd much rather be doing something else. Your mind might drift because there's nobody holding you accountable oh, I love when someone's staring at me.
Speaker 1:I can get. It's literally something I do regularly. I have sarah who works with me. I was like let's just meet at a coffee shop and you tell me the 20 things you need me to get done and I'll get them done like boom, boom, boom boom. But to left my own devices. There's just so many options of things that I can get or I might be able to get accomplished and then only to maybe get one or two of them done. So the proper diagnosis looks like.
Speaker 4:It's a clinical diagnosis. So what that means is make an appointment with a psychiatrist or there are some family practice and general medicine doctors and even a few neurologists in town who are willing and comfortable making the diagnosis and let them ask you questions. Um. There's some scales. People can um go online. There's the adhd rs scale, which is a nice screener. People can look it up and see if they feel like they meet criterion.
Speaker 2:That's so good I'm going to go back to a listener question. Um, this is for the people. So the listener that wrote in does not have ADHD, but her husband and child both do. So I forgot about those people that just live with us and have to deal. So one of her questions is how do I live with an ADHD spouse and or child and not lose my mind? I'm just going to read all of it and you can kind of pick and choose where to answer and not lose my mind.
Speaker 2:I'm just going to read all of it and you can kind of pick and choose where to answer how to get equitable share adulting responsibilities with someone with ADHD. How to deal with the supply chain issues that seem to constantly affect ADHD meds. How to communicate compassionately with someone struggling with ADHD. So we'll wait on the supply chain on meds, but it sounds like I know what I have to do to get through a day and it can probably frustrate other people and I think she's the other people we're talking about. So what advice would you give to spouses or mothers or fathers of someone with ADHD?
Speaker 4:OK, it's a really great question and there are a lot of things one can do. First of all, communication has to be really excellent and there are a lot of things that the individual who does not have ADHD in the relationship can do to help the person with ADHD. But the person with ADHD has to also be receptive, so both things have to be occurring. So I'll just give you some examples. So if a husband is married to a wife with ADHD and he wants her to do three things and he tells her in the morning she's going to remember one of them and the other two aren't going to get done. So I've seen husbands do really creative things, like he would stick sticky notes on her steering wheel of her car so when she got in the car she would see all those things. Because a lot of people with ADHD say to me out of sight, out of mind, and so they, you know, so it's there as a reminder. I mean, you can do these things on, you know on the phone too, but you have to remember to look at your phone. So I like things that are in front of your face.
Speaker 4:So communication the other thing about sharing tasks I think is a really important point and that person who asked that question. She's going to have to accept that she's going to be the home executive, she's going to plan and organize things, but what she needs to do is give them tasks. So she says, honey, your job is to take out the garbage every day, and if he doesn't do it, then she needs to remind him again. And if he's really not doing it, instead of getting frustrated, then they need to have like a little family meeting and maybe figure out is that not a good task for you? You know I need you to help her. What are you good at? What would you like?
Speaker 4:Usually, there's things that the person with ADHD are really good at because they have so much energy I mean their, their energy and that little bit of hyperactivity is a superpower, and so maybe that you know the husband can go out and play with the kids while she cooks dinner or something so, but but she's got to give him a test. So I always say give him a test in the short, like right now we're trying to leave the house. Honey, I need you to do X. Give him one thing when he comes back and then come back. Now, honey, can you put the suitcases in the car.
Speaker 1:And then come back. Right, right, it does sound like you're describing a parent-child relationship, though.
Speaker 2:Well, I think that a huge piece that I would say to this listener, who I totally adore, um, is you. It sounds like you have to have a pretty high level of acceptance and tolerance for that spouse with ADHD, because I could easily see resentment coming in of like I mean, here's a an example. I'm getting married next week and I told Bobby, um, I've planned every last detail and I said I need you just to order the speakers for Bluetooth. And he's like, not a problem, remind me. And my head almost exploded. But he's also ADHD and he really meant that. Can you remind me? But in my mind I'm like you should make your own sticky notes. So there's this part of us that, like we do get to choose acceptance and work through that resentment of like it takes a lot of brain power to remember these things and putting in a system to prevent some of the resentment.
Speaker 4:I think Systems are really really good. And I'm not saying it's not frustrating. I mean because it can be frustrating. But on the other hand, if you're expecting somebody to do something that they're not, if he's not going to remember, then that's on me, not him. Then. Or maybe you could get him to put a reminder in his phone in two weeks or something, or in one week.
Speaker 2:Well, I want to give him credit. He got two speakers. He did a great job.
Speaker 1:So but Good job Bob.
Speaker 2:Bobby I think that's what this person on here is describing is like why do I have to do all of these things to manage this other person?
Speaker 4:But I want to come back to your. Is that a parent-child relationship? Because that's a very important piece to it. So it's not a dependency. You're the organizer, okay, I mean.
Speaker 1:So a reframe would be I'm the executive of my home and I do think, like I, my husband and I have a very like. He's like the visionary and I'm the implementer. I like make shit happen in our house and he's like what if we built this amazing thing? It's like can you write all these checks to these people to make that happen? And I, you know, either have to acquiesce to that and understand that's my role in the project or he and I are butting heads all the time. Right, and that's not helpful at all. So I like that reframe of like you're the, you're the executive of the home and I think sometimes a narrative I feel like I know some of my female friends would say is like I'm just so tired of running shit. Yeah, I'm just so tired of being in charge, and it's like well, but if the reframe is, you're the CEO you know I love being a CEO, let's go.
Speaker 3:Which I've told the story before. But what happened recently or last summer was my wife's like we need a new back deck, like we need to take out all of the floor slabs and we need to put in new railing as well and do this. And I was like what? I was like, no, no, are you kidding me so much, I can't do all that. And then she's like all right, how about this? Let's just take up the flooring and put in new slabs. I was like, okay, cool, and went and did that. And as soon as I was done, she's like all right, cool, now let's do new railing. I was like, all right, got it.
Speaker 1:And so I daniel is also a gangster teacher who knows what's up.
Speaker 3:She teaches kindergarteners. So yeah, so anyway, once the deck was broken up into one task at a time, I was able to rebuild the deck, but when it was all at once I was like I can't do that. So once the tasks were split up, it worked.
Speaker 4:That's a very important point. One of the symptoms of ADHD is difficulty breaking down big tasks. That's why I say probably the other spouse is going to end up being the executor, and so what your wife did is she broke the task down into pieces and it felt totally doable and you're happy to go and do that one thing and then it's done, and then you know what's next, because you know, people with ADHD don't relax the way other people do. They relax actively.
Speaker 3:I see we told you it was fantastic and there's more because that was only like half of the questions.
Speaker 1:I'll be honest, I'm already just so blown away and I love how clearly she answered the questions. It was so helpful and I feel like it just gives you the like breathing room to know that, if you're walking around struggling with ADHD or living with someone who's struggling with ADHD, one, that we're just not alone. And two, that there are real resources and tools out there that make a lot of sense for people like us.
Speaker 3:Yeah, hey. So next episode we're going to do it again, More with Dr Rachel Fargeson from UAB on the next.
Speaker 2:Before you Cut Bangs All right, thanks for listening to Before you Cut Bangs, and we'll see you next time.
Speaker 1:Before you Cut Bangs is hosted by Laura Quick and Claire Fehrman and produced by Will Lockamy. Follow along with us everywhere. Please subscribe to the podcast. Find us on Instagram. We're constantly doing polls. We want to know what you think, and I know that you probably know this, but reviewing us and giving us five stars matters more than anything, and we are so grateful to have you here.
