Episode 79 - We Don’t Suddenly Get ADHD at 60 - We’re Finally Becoming Aware a conversation with Dr. David Goodman

Episode Summary
In this powerful episode of Grandma Has ADHD, Jami Shapiro sits down with internationally recognized ADHD expert Dr. David W. Goodman to explore one of the most overlooked conversations in mental health: ADHD in older adults.

For decades, ADHD was believed to be something children simply “outgrew.” Dr. Goodman has spent over 40 years researching and treating adult ADHD, challenging that myth and helping the medical community understand that ADHD is a lifelong neurodevelopmental condition.

Together, Jami and Dr. Goodman unpack why so many adults—especially women—are only now discovering their ADHD later in life, how it can be mistaken for memory loss or dementia, and why diagnosis can be deeply healing even in later years.

This episode is filled with insight, compassion, and hope for anyone who has ever wondered:

"Why has my brain always worked differently?"

What You’ll Learn in This Episode

✅ Why ADHD often goes undiagnosed until adulthood or later in life
✅ The surprising ways ADHD symptoms can mimic dementia or cognitive decline
✅ Why women and older adults are historically underdiagnosed
✅ How ADHD symptoms stay relatively stable, but life demands change how impairments appear
✅ Why many physicians still miss ADHD in older adults
✅ The emotional impact of discovering ADHD later in life
✅ How diagnosis can bring relief, healing, and restored relationships

About the Guest

Dr. David W. Goodman is an Assistant Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and Director of the Adult Attention Deficit Disorder Center of Maryland.

He is one of the world’s leading experts on adult ADHD, having:

• Delivered 750+ lectures worldwide
• Published 35+ peer-reviewed scientific papers
• Led major adult ADHD clinical trials
• Authored The Black Book of ADHD

His expertise has been featured in major outlets including CNN, ABC World News, The New York Times, and The Wall Street Journal.

Key Conversation Highlights

ADHD Doesn’t Disappear With Age
Research now shows ADHD is a lifelong neuropsychiatric condition, not something people grow out of.

Many adults are simply getting diagnosed for the first time later in life due to increased awareness.

ADHD vs Dementia
Older adults with ADHD may experience symptoms like:

• forgetfulness
• difficulty focusing
• losing track of tasks

These symptoms can sometimes be misinterpreted as early dementia, which is why proper evaluation is so important.

Why Women Are Diagnosed Later
For generations, ADHD was primarily associated with hyperactive boys.

Many girls showed inattentive symptoms instead, which were often overlooked. As a result, countless women have spent decades believing they were:

• lazy
• disorganized
• “too much”
• not trying hard enough

When in reality, they had undiagnosed ADHD.

The Impact of Awareness

A diagnosis later in life can bring a powerful shift:

• understanding past struggles
• releasing years of shame
• improving relationships with family
• developing strategies that actually work

As Dr. Goodman explains, the goal is helping people understand the difference between:

“what you have” vs “who you are.”

A Powerful Personal Moment

Jami shares the emotional story of discovering that her own mother had ADHD after decades of struggle.

That realization transformed their relationship from frustration to understanding, bringing compassion, healing, and peace later in life.

Featured Resource

📘 Book: This Explains So Much by Jami Shapiro

A powerful exploration of undiagnosed ADHD in women and how understanding it can

Thank you for joining us for this episode of Grandma Has ADHD! We hope Jami's journey and insights into ADHD shed light on the unique challenges faced by older adults. Stay tuned for more episodes where we’ll explore helpful resources, share personal stories, and provide guidance for those navigating ADHD. Don’t forget to subscribe and share this podcast with friends who might benefit. Remember, Make the rest of your life the best of your life.

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Transcript

[00:00:15] Speaker 6: Hi, I'm Jami Shapiro and welcome to [00:00:20] Grandma has ADHD. I'm a certified senior move manager and owner of Silver Linings Transitions, where I help people navigate life's big transitions. [00:00:30] But here's the thing, I spent years helping families move through change while completely missing the pattern that was running through my own life.

[00:00:38] Speaker 6: I'm the daughter of [00:00:40] two ADHD parents, the mother of three ADHD children, and yep, I have ADHD two. For years, I didn't have the language or [00:00:50] understanding for what that meant, but becoming an ADHD coach and specialist, that's been absolutely game changing, not just for how I work with my clients. But for [00:01:00] how I relate to my family and honestly for how I understand myself.

[00:01:04] Speaker 6: I even wrote a book about it called This Explains So Much. This podcast is for [00:01:10] all of us who are discovering ADHD later in life. Each week I bring new conversations with industry experts and people sharing their own ADHD journeys. [00:01:20] Real stories, real strategies, and often a little too much information.

[00:01:25] Speaker 6: If you're loving what you're hearing, please share this podcast. Leave us a review [00:01:30] and find me@Jamishapiro.me. That's J-A-M-I-S-H-A-P-I-R-O.me, whether you're over 50 [00:01:40] and just getting diagnosed or you're recognizing patterns you've lived with your whole life. This is your space to navigate ADHD with others who get [00:01:50] it.

[00:01:50] Speaker 6: So grab your coffee and get comfortable and let's dive in.

[00:01:55] Speaker 7: Hey, here's a quick heads up before we dive in. You [00:02:00] may hear me mention the Sparkler Society in this episode, talking about it. It's happening right now. And here's the truth. My ADHD brain got so excited [00:02:10] about this community that I may have jumped a little bit enthusiastically, a lot enthusiastically before everything was actually ready.

[00:02:18] Speaker 7: Classic A DH, D [00:02:20] move, right? We know what that's like. So here's what's actually happening. We've hit pause to make sure the Sparkler Society launches the right way because [00:02:30] this is going to change lives, and I want it to be everything you deserve from day one. We're officially launching in July of 2026, and here's what you can look [00:02:40] forward to.

[00:02:41] Speaker 7: Live group sessions every week, including support around decluttering and downsizing, body doubling, and ADHD group [00:02:50] coaching. We are also addressing some of the big challenges of ADHD, worrying over spending and starting crafts only to lose steam. Membership in the Sparkler Society [00:03:00] is going to save you from paying the ADHD tax.

[00:03:03] Speaker 7: We're talking real dollars back in your pocket, and most importantly, we are building a [00:03:10] community of women who want to get their shit together. Together. Here's the exciting part. We're starting a wait list right now@Jamishapiro.me. [00:03:20] That's J-A-M-I-S-H-A-P-I-R-O.me and the VIPs who join early will get free access to [00:03:30] shape the community before we officially launch in July.

[00:03:33] Speaker 7: You'll help us build this thing together. So if you hear me talking about the Sparkler Society, it's happening [00:03:40] tomorrow. Just know it's coming in July. And it's going to be worth the wait. Let's get to today's episode.

[00:03:47] Speaker 8: I [00:03:50] am very excited because today's guest is someone I have been following since I began my own ADHD discovery journey. He is so knowledgeable. I quoted [00:04:00] him in my book. This explains so much. You don't suddenly get ADHD for the first time at 60. It's getting caught for the first time in older adults because of increased [00:04:10] awareness.

[00:04:10] Speaker 8: That is exactly what we are doing here. So if it felt only, so it felt only right to have the man himself join us. Dr. David W. Goodman is an [00:04:20] assistant professor of psychiatry and Behavioral Sciences at the John Hopkins University. School of Medicine and the director of the Adult Attention Deficit Disorder Center [00:04:30] of Maryland.

[00:04:30] Speaker 8: He is an internationally recognized expert on adult ADHD, who has delivered over 750 lectures to medical professionals [00:04:40] around the world. From Amsterdam to Sydney to Washington DC. He has authored or co-authored more than 35 peer reviewed scientific publications, [00:04:50] led some of the largest adult ADHD clinical trials ever published.

[00:04:54] Speaker 8: And written the Black book of ADHD. His expertise has been featured everywhere from [00:05:00] CNN and A BC World News to the New York Times and the Wall Street Journal. He has even served as an ADHD consultant to Major League Baseball, the [00:05:10] NFL and the World Anti-Doping Agency. But what I love most is that behind all of those credentials is someone who truly gets it.

[00:05:19] Speaker 8: Someone who [00:05:20] understands that there are millions of adults and especially women who spent decades being told they were too scattered, too forgetful, too much, when [00:05:30] really they were just undiagnosed. Dr. Goodman, welcome to the Grandma, has ADHD podcast. I am so grateful and glad to have you today. [00:05:40] 

[00:05:40] Speaker 9: Uh, Jami, thank you for inviting me.

[00:05:43] Speaker 9: It's a, a pleasure. I'm, I'm grateful to have the opportunity to share what I know with your, your listeners, your [00:05:50] viewers, so that everybody gets accurate information about ADHD. And they can, they can address it themselves. They can address it in their friends, their family members. Let's, let's miss, [00:06:00] let's, uh, let's get the mis information off the internet and get credible information like you offer to your viewers.

[00:06:07] Speaker 8: I I love that. And you know, one of the things that I've [00:06:10] been saying, and, and not to brag, but you know, starting to talk about a DH ADHD and older adults isn't, isn't what the mainstream is talking about a lot of. And you've been out there [00:06:20] for I don't know how long, because that's how I even started to learn.

[00:06:23] Speaker 8: So how did you even, you know, get started in the ADHD space and, and, and be such a pioneer? [00:06:30] 

[00:06:31] Speaker 9: So when I was a resident in the mid 1980s, uh, nobody talked about adult ADHD. There was no training, there was no focus. [00:06:40] Nobody believed in it. I finished residency in 86, so I've been doing this for 40 years of direct.

[00:06:46] Speaker 9: Patient care and private practice in addition to [00:06:50] clinical research and education and lecturing and um, and writing. So in 1988, there was a study that came outta Canada that followed children for [00:07:00] seven or eight years, and it showed that ADHD was not going away into adolescents and early adulthood. And given the decades of research in ADHD, [00:07:10] I assumed that this was actually a legitimate study.

[00:07:13] Speaker 9: And started identifying patients in my practice. Now again, this is in the late 1980s. The [00:07:20] patients got better. Uh, proof is in the pudding when you make a diagnosis. It's not the accuracy of the diagnosis, it's whether treatment actually works. And so these people got better. I got [00:07:30] involved with clinical research trials with pharmaceutical industry in the 1990s, so I was involved in a lot of the early medications that are currently approved in the mid [00:07:40] 1990s.

[00:07:40] Speaker 9: I had my colleagues tell me that. Um, I should be very careful because ADHD in adults doesn't exist, and if you're gonna write stimulant medications, the DA is gonna [00:07:50] yank your license sooner than later. And this is professional suicide. I thank them for their consideration, followed the research, continued to do clinical trials and [00:08:00] publish.

[00:08:00] Speaker 9: And so 40 years later, you know, uh, this is where I am the expert, is the guy who's been doing it the longest to. As the slides [00:08:10] and the peer review publications to demonstrate an expertise. Now, uh, if you say you don't believe in ADHD, it's as if you fell asleep and just woke [00:08:20] up after 30 years because the explosion of international research on ADHD makes it indisputable that ADHD is.

[00:08:27] Speaker 9: A real and legitimate [00:08:30] neuropsychiatric disorder. And so that's why I'm here. Um, I teach at two medical schools. I do CME lectures. Um. [00:08:40] A dozen times a year I speak internationally. And what's particularly interesting, and I'm glad to be involved in your, in your program here, is that for the last 10 or [00:08:50] 15 years, I've, uh, taken an interest in ADHD and older adults.

[00:08:54] Speaker 9: And why is that? Well, if you take care of people for 20 and 30 years, you age with your [00:09:00] patients. And those patients that I diagnosed in their forties now had ADHD in their sixties. And I knew this wasn't going away. There is such a paucity of research on [00:09:10] ADHD and older adults that we'll get to, but it really is a message that needs to get out because these folks are showing up and getting diagnosed with mild [00:09:20] cognitive impairment or early Alzheimer's, when in fact they have ADHD.

[00:09:26] Speaker 8: Yes. Uh, one of the things that I learned from Dr. Nado is that [00:09:30] only one in five memory care clinics, at least when I interviewed her two years ago, were even routinely asking questions about ADHD. Is that still the case? Or more [00:09:40] memory care clinics picking up on this? 

[00:09:43] Speaker 9: So that that data is from a study published now 13 years ago.

[00:09:49] Speaker 9: I would [00:09:50] like to believe that ADHD is now on the landscape for differentials. Diagnosis for older adults who present with cognitive complaints. But again, [00:10:00] there's now a, um, a lot of attention on Alzheimer's with the new blood biomarkers we have for Alzheimer's. There's a lot of medical education. [00:10:10] But what I find is that in their consideration in the evaluation for older adults with cognitive impairments, ADHD is not part of the [00:10:20] consideration.

[00:10:20] Speaker 9: So in. April of this year, I and my colleague will be giving a lecture on ADHD and dementia, and how to differentiate the two [00:10:30] at the American Academy for geriatric psychiatry because I want this to be part of the conversation and part of the consideration when older people show up for [00:10:40] cognitive complaints.

[00:10:42] Speaker 8: So I would, Ima Well, first of all, I would love for you to discuss the difference between the two. I have a friend, by the way, who was in his mid forties, [00:10:50] convinced he had early onset dementia, goes to the doctor, and I'm sure you know what the punchline is. Am I right? 

[00:10:58] Speaker 9: No, I'm not. Because it, the [00:11:00] punchline depends on the clinician.

[00:11:01] Speaker 8: See, he had a DH, adhd, he was diagnosed with ADHD, which, which was a relief, right? Um, and it's, it's funny, as, as I shared with you before we started the [00:11:10] podcast, one of the things that I, so I, I was diagnosed along with my child, um, more than 10 years ago at the age of 45. Uh, by my child [00:11:20] psychiatrist. And, you know, as I'm going through the evaluation, I'm answering more yeses for me and as, and that's, you know, what happens in a lot of families.

[00:11:28] Speaker 8: But I, I put [00:11:30] it away because at the time I had three children. I was going through a divorce, I was starting a business. I had graduated college with high honors. It was like, okay, I have [00:11:40] ADHD, and, and that was really. It until eight years later when my mom, who was about to turn 77, I realized that she had it [00:11:50] and then I was, and, and as a senior move manager going into seniors homes and seeing a lot of similarities, the conflict in families, the chronic [00:12:00] clutter, the feeling of being overwhelmed, I was like, wait a minute.

[00:12:03] Speaker 8: Th these people probably, again, not a doctor, they probably have ADHD as [00:12:10] well, which has then what became my new fixation, I became an ADHD coach. And, and, and here we are hosting the grandma has ADHD podcast. So first of all, I wanna acknowledge [00:12:20] you because you, you looked at your peers and said, I, I, you know, who, who were saying ADHD isn't a thing.

[00:12:27] Speaker 8: Well, okay. Thank you for your opinion and I'm gonna [00:12:30] do this anyway. So thank you. Thank you. First of all, 

[00:12:34] Speaker 9: you You're welcome. You're welcome. Um, it, it's not an easy thing to, to [00:12:40] stand in the desert and have people tell you, uh, it's never gonna rain. Uh, and then if you follow the science, so I, I wanna [00:12:50] make this very clear to your listeners.

[00:12:53] Speaker 9: My balance between clinical practice has always been weighed. [00:13:00] With research in mind, one of the issues with clinicians who don't read the research is that you can start to develop clinical opinions based on [00:13:10] your experience with patients that really are not consistent with what the research shows. And you'll often hear clinicians say, well, this is my [00:13:20] experience with patients and that's important, but does that experience.

[00:13:26] Speaker 9: Is that experience supported by the research. So [00:13:30] passion in an opinion doesn't make that opinion true or factual. Mm-hmm. And that's always been the pursuit in my [00:13:40] career. So I've straddled both the academic and the clinical arenas and my. My talent is trying to [00:13:50] translate research into clinical applicability for all the other clinicians who want to come up to speed.

[00:13:56] Speaker 9: The fact that your friend got diagnosed with ADHD in their [00:14:00] forties is a reflection that the clinician they went to see understands ADHD and what to look for. The punchline could have easily been [00:14:10] you have anxiety and let me put you on an antidepressant. So. The diagnoses often are reflective of what your [00:14:20] clinician and provider know and have been trained to see.

[00:14:23] Speaker 9: You can't see something you haven't been taught. 

[00:14:29] Speaker 8: Sure. [00:14:30] Okay. So one of the que, first of all, I wanna say, have you, have any of your peers come back to you and said, you were right? And, you know, could, [00:14:40] you know, have, have they acknowledged it or is it just like, I, I know I was right, and here we are. 

[00:14:46] Speaker 9: So a few of them have come back and said, [00:14:50] kudos to you for following.

[00:14:51] Speaker 9: This. Many though have complimented me indirectly. And what I mean by that is if you are now seeking [00:15:00] out education, if you are now diagnosing, if you are now treating patients, and it doesn't matter if I was right or wrong, what's important to me [00:15:10] is that you took the opportunity to learn something. That you hadn't been taught that is relevant for the patients who are showing up in your office.

[00:15:18] Speaker 9: A lot of this has been [00:15:20] prompted by public awareness. So in the last 20 years, public media has picked this up. The patients in public have become aware of, and they go [00:15:30] in and they ask their clinicians about it. Those who are unfamiliar and untrained shrug their shoulders and don't, and go, I don't know.

[00:15:36] Speaker 9: Well, after a period of embarrassment, they decide, you know what? [00:15:40] Maybe I should learn something about. About this and be able to evaluate and treat. There's so many continuing medical education lectures online now about [00:15:50] this, that it's easy to obtain this information so that you can apply it to your day-to-day office practice.

[00:15:57] Speaker 8: Okay, so there's more awareness now [00:16:00] in, in the, in the clinical field. And I'm probably not using the right word by the way. Uh, Dr. Goodman, I have ADHD, so sometimes I can't find the right word. Um, [00:16:10] but, uh, but what I was gonna ask you is how, what would you say of, because my audience is really, older adults really fit women [00:16:20] because.

[00:16:20] Speaker 8: Because women have, I would say were largely more underdiagnosed than, or girls were largely underdiagnosed compared to boys because we could see the [00:16:30] hyperactive little boy. And there might have been a tension called to it where that really wasn't the case for, for women that were, you know, gen X and older.

[00:16:39] Speaker 8: Um, [00:16:40] so what would you say is the, the percentage of awareness among physicians? That was the word. Um, now, nowadays. 

[00:16:49] Speaker 9: [00:16:50] So I think there's been an increasing awareness of ADHD amongst physicians, both, uh, not only in psychiatry, but amongst nurse practitioners, amongst primary [00:17:00] care physicians. Um, they're increasingly asked to, um, continue prescriptions after the patient's been [00:17:10] formally diagnosed.

[00:17:11] Speaker 9: And so there's an increasing awareness. It's better now than it was 20 years ago. It'll be better in 20 years from now than it is now. Um, but my [00:17:20] impression is that, that people are coming up to speed on this. Nurse practitioners, by the way, are the. Growing prescribers [00:17:30] for this disorder. And so there are a lot of lectures now geared towards nurse practitioners.

[00:17:36] Speaker 9: Remember that in most professional training [00:17:40] programs, whether it's psychiatric residencies, internal medicine, nurse practitioners, social workers, there is not. An ongoing focus on adult ADHD [00:17:50] in their training curriculum. This is especially evident though when we come to women and ADHD and older adults because we've been [00:18:00] focused on.

[00:18:01] Speaker 9: The growth of children into adolescents and adolescents into early adulthood, but there's only growing literature in the last 10 years [00:18:10] on the fact that this is a lifelong disorder for which it's useful to know what you have, how you manage that is entirely up to you, but [00:18:20] hopefully you're making that decision based on.

[00:18:23] Speaker 9: Accurate information. The amount of research we have on ADHD in older women [00:18:30] is, is a thimbleful. It's um, it's actually appalling how we have very little research on ADHD and hormonal changes in [00:18:40] women both around puberty, menses, pregnancy, lactation. Perimenopause. So a lot of that has to come [00:18:50] up to speed, and women are now getting diagnosed more frequently.

[00:18:54] Speaker 9: We see that in the prescription data out of the CDC, where [00:19:00] there's a larger percentage of prescriptions for ADHD medication in boys versus girls. But once you get across the 30 or 35 [00:19:10] year. Age, there's an equal amount of prescriptions for women and men. Now, that is [00:19:20] a testimonial to the fact that more women are being diagnosed, but one also has to keep in mind that women, more so than men, seek out mental health treatment.[00:19:30] 

[00:19:31] Speaker 9: And so I think women are coming up to speed just in their own awareness, and then going to clinicians and asking and inquiring about this. [00:19:40] 

[00:19:40] Speaker 8: To your point, I think a couple of things for women, why I, I believe one is that women are more likely to discuss issues with their friends. Um, and so, you [00:19:50] know, when you're like, this is, and, and I've found with me discovering my own ADHD is looking back at how many of my friends also had it.

[00:19:57] Speaker 8: And, you know, none of us knew because we weren't [00:20:00] diagnosing girls at the time. Um, and like attracts like, so I think. To me, that's one reason. But I also will say that, and I've heard this in my interviews, when I interview [00:20:10] people who have ADHD and you know, had parents with ADHD, it seems like the mother's ADHD had a greater impact on the family.

[00:20:18] Speaker 8: Then the, the [00:20:20] father's ADHD because she is the executive functioning of the house. That's exactly what happened for me. I have three children. I'm juggling my own [00:20:30] responsibilities and I'm juggling a household and three children. And I remember, like, I just felt like I could never get it together, but I didn't have the words at that time.

[00:20:39] Speaker 9: [00:20:40] You know, I think that's a very important distinction that if mom has ADHD untreated, the impact on the functioning of the household is worse than if [00:20:50] dad has it. And that's in a traditional family. 

[00:20:53] Speaker 8: Yes. Yes, yes. Um, 

[00:20:54] Speaker 9: the financial aspects though, if Dad has ADHD, the financial aspects [00:21:00] are going to be impacted by his impairment and his inability to sustain a regular.

[00:21:06] Speaker 9: Employment and growth of a career. [00:21:10] So that's a very interesting insight. I hadn't actually thought about that, but that's absolutely true. 

[00:21:15] Speaker 8: Oh, yay. I love it. That makes me feel good. You just, you just gave me the [00:21:20] re recognition, euphoria recognition, success, euphoria. Have you heard about, um, uh, Dr.

[00:21:26] Speaker 8: Hallowell's, you know, the opposite of rejection sensitivity [00:21:30] is that recognition. Um, okay. So a couple other things that you, you touched on that I think are really important. Um, number one is how does [00:21:40] ADHD change? You had mentioned that now you're seeing it in your patients who you've been treating since they were 40 and now you know they're retiring.

[00:21:47] Speaker 8: How, how are you seeing the [00:21:50] impact of ADHD changing with age? 

[00:21:54] Speaker 9: So the. The symptoms of ADHD are relatively [00:22:00] stable. What changes are the experience of impairments, which is a direct outgrowth of the demands of the environment. So the more you have to [00:22:10] do, the more impaired you're likely to be. 

[00:22:13] Speaker 8: Mm-hmm. 

[00:22:14] Speaker 9: If the demands are not high, then the impairments don't become evident.

[00:22:18] Speaker 9: So people often [00:22:20] say, well, do I have to be on medicine for this? I say, well, it depends on the nature of your day if you're gonna sell. Hot dogs on a Caribbean beach and you're single, well, [00:22:30] maybe you don't need to be on medication, but if you're gonna function in a full-time job and you have a family and kids, uh, your impairments are gonna be quite noticeable to yourself and [00:22:40] to other people.

[00:22:41] Speaker 9: So over the course of time, the environmental demands change as we get older. Now, the mis, the [00:22:50] misconception is that older people and retired people have less to do because the kids are out of the house. But I can tell you at my age, uh, there's no less that I have to do. [00:23:00] What I have to do is different, but I still have to manage finances and family.

[00:23:05] Speaker 9: And medical issues and health of a spouse, et cetera, et cetera, [00:23:10] et cetera. So one finds that as you get older, the ADHD still causes impairments now, uh. The, the [00:23:20] challenge is when somebody is 60 and comes into the office and says, gee, I'm aware that my forgetfulness is worse, my intention is worse, and I'm losing track.[00:23:30] 

[00:23:30] Speaker 9: I can't necessarily ascribe all of that to ADHD, so ADHD doesn't get worse. As you get older, you may experience [00:23:40] as impairments as worse because of demands, but if your cognition has worsened and you're an older adult over the last two or three years, it may be that you have [00:23:50] ADHD and an additional.

[00:23:53] Speaker 9: Process that needs to be considered. So in the diagnosis, often people say, well, you have [00:24:00] this or you have that. But as you get older, the medical complexity increases. You can have this and you can have this simultaneously. And [00:24:10] then the challenge is how do you distinguish what cognitive symptoms are from ADHD, and what cognitive symptoms are occurring because you're in perimenopause and [00:24:20] your estrogen is declining.

[00:24:21] Speaker 9: Or because you may be having mild cognitive impairment, which is a precursor for many to [00:24:30] early Alzheimer's. Understanding how to make those differential diagnoses then leads you to figure out what the [00:24:40] pharmacologic sequence will be in order to help ameliorate those symptoms. Now, what I've just laid out quite clearly is a [00:24:50] very complex.

[00:24:51] Speaker 9: Clinical endeavor, and a lot of people simply have not been trained in doing this. The geriatric [00:25:00] psychiatry folks don't know much about ADHD in older adults. The adult psychiatrists don't know much about early dementia and ADHD, [00:25:10] and I'm trying to bridge the gap in this education by bringing this message and educational lectures to the annual and national conferences around the country.

[00:25:19] Speaker 8: Which is [00:25:20] no wonder that your life hasn't slowed down. I mean, really, this is the moment, right, that you, that, that, that's yours. I mean, it's, it's everywhere. You know? I, I don't know. [00:25:30] Just, I mean, so I'm gonna, you know. Say that when you have a DH ADHD and you go on social media, the A algorithms know that you click on a, you know, ADHD.

[00:25:39] Speaker 8: [00:25:40] But I know, because I'm starting to hear from a lot of people that the Atlantic just ran a, a story and that people who haven't even been paying, been paying attention to ADHD. It's suddenly, you know, in the [00:25:50] news, uh, I was, uh, sharing with you before our podcast that Mel Robbins was just on, you know, Sunday morning and was sharing that she had ADHD and, and, you know, so.

[00:25:59] Speaker 8: [00:26:00] So, no wonder you're incredibly busy. Um, I want to take a pause for two reasons. Uh, number one, I always take a pause because what I, what [00:26:10] I share with people is that I do this podcast out of my love of, uh, educating people my passion about why it makes a difference. Um, but I have [00:26:20] to keep the lights on. So we go to a commercial where I, uh, let people know about Silver Linings transitions, which is my San Diego based.

[00:26:27] Speaker 8: Um. Move management and home [00:26:30] organizing company, which is how I even got into all of this when I started to see a lot of the clients who needed, you know, continuous organizing. And it never occurred to me why it continued to be a problem. [00:26:40] Um, and the other reason that we're gonna take a pause is that as I shared with you, Benji, my dog has figured out when I sit in my podcast seat that if he barks at me, [00:26:50] he's gonna get treats.

[00:26:51] Speaker 8: And I've run out of all of the treats, and now I'm not gonna have to refill the treats. Uh, I told you I was gonna keep it very real for you, Dr. Goodman. 'cause. Because when I'm me, then everybody else gets the [00:27:00] freedom to be them or who, whatever. I said that. Right. 

[00:27:03] Speaker 9: You know, I'm, I'm glad you highlight your business.

[00:27:05] Speaker 9: Um, it's very important that we in this space [00:27:10] get public and private funding to do our work. I have a foundation called the My ADHD Foundation. That is a non [00:27:20] Charit, a, a nonprofit charitable organization that funds my ability to continue to participate in conferences and pay for the [00:27:30] expenses involved in developing slide decks.

[00:27:31] Speaker 9: So, you know, kudos to you. We do need to generate funds for people who support our mission and, and getting this educational and [00:27:40] accurate information out to the general public. 

[00:27:43] Speaker 8: I appreciate that. So with that said, we're going to take a pause. Normally, Dr. Goodman, what I ask people is, [00:27:50] uh, I don't know if you were at the International conference for ADHD in 2024 when Pen Holderness was the keynote speaker.

[00:27:57] Speaker 8: Were you there? 

[00:27:59] Speaker 9: I was not. [00:28:00] 

[00:28:00] Speaker 8: Okay. So he, 

[00:28:01] Speaker 9: I, I was not, I did not see him. 

[00:28:03] Speaker 8: So he asks a question or he, he says something in his presentation, if you could push a button and not [00:28:10] have ADHD, you know, he, he says, you know, whether or not he would push the button. So normally when we take the pause, I ask my guest, you know, would you push the button?

[00:28:19] Speaker 8: Uh, what do you [00:28:20] think the percentages of people who I'm gonna, we're gonna leave a cliffhanger, by the way, when we come back. You're gonna give what you think the percentages of people who would push the button and not have ADHD. But then I [00:28:30] really wanna go into, um, the difference between dementia and ADHD.

[00:28:34] Speaker 8: I love that. Um, you're gonna be speaking about that in April. Um, and also why it even matters. [00:28:40] So, uh, we're gonna pause. I'm gonna take a sip of water, get Benji treats, you're hear a little word from our sponsor and we'll be right back.

[00:28:49] Speaker 10: [00:28:50] I used to [00:29:00] dread visiting my mother because of the clutter. The piles, the chaos. We all experienced clutter differently. For me, it was a source of [00:29:10] anxiety and stress. I'd try to help and she'd get defensive. We were both frustrated. It was destroying our relationship. [00:29:20] Then we discovered something that changed everything.

[00:29:23] Speaker 10: My mother had a DHD, and she'd been living with it undiagnosed for [00:29:30] over 76 years. Suddenly, it all made sense. The clutter wasn't laziness. The disorganization wasn't a choice. [00:29:40] Her brain was wired differently and no amount of willpower or traditional organizing advice was ever going to work. That [00:29:50] discovery became my life's work.

[00:29:51] Speaker 10: It's why I started. The grandma has a DHD podcast. It's why I became an A DHD coach and specialist, and [00:30:00] it's why I am so passionate about helping women like my mother and maybe like you. Because here's what I know, clutter affects us emotionally [00:30:10] and physically. It damages relationships. It creates shame, spirals, and the overwhelm of not knowing where to start keeps you frozen.

[00:30:19] Speaker 10: But [00:30:20] it's okay to ask for help. In fact, it's brave. If you are in the San Diego or Coachella Valley area, my team at Silver Linings [00:30:30] Transitions can come to your home. We'll help you tackle the clutter with compassion, not judgment. I also work with women virtually through [00:30:40] one-on-one A DHD coaching, and if you are overwhelmed with clutter.

[00:30:44] Speaker 10: I can connect you with trusted resources in your area. Visit Jami [00:30:50] shapiro.me to get started or grab my book. This explains so much on Amazon. My mother and I got our relationship back. You can get your piece back too. [00:31:00] That's J-A-M-I-S-H-A-P-I-R [00:31:10] o.me.

[00:31:14] Speaker 2: Moving can feel overwhelming. Whether you are downsizing, relocating, or helping a [00:31:20] loved one transition. There are so many decisions to make, details to handle and emotions to navigate. At silver linings, transitions, we believe every [00:31:30] move should be magical, not stressful. We are more than movers. We expertly guide you through the entire process and do our best to [00:31:40] alleviate your concerns.

[00:31:41] Speaker 2: From the moment we meet, you'll feel comfortable because we will listen to your needs and wants and work together to create a [00:31:50] personalized plan that honors your memories and your cherished belongings while helping you embrace your next chapter. We visit your new space and create a [00:32:00] detailed floor plan, ensuring your furniture and treasure belongings will fit safely.

[00:32:06] Speaker 2: We handle the logistics so you don't need to worry about anything [00:32:10] from sorting and packing to coordinating the sale and donation of unwanted items. Our professional team uses efficient, eco-friendly bins and handles [00:32:20] every detail with care. We coordinate with our vetted moving partners, oversee the logistics, and ensure nothing is left behind even packing your [00:32:30] refrigerator items.

[00:32:31] Speaker 2: Here's where the magic happens. We don't just unpack, we recreate the feeling of home using photos from your previous [00:32:40] space. We thoughtfully arrange your furniture, hang your pictures, and set up your kitchen and bathroom so everything feels familiar from day one. [00:32:50] When you walk into your new space, it's not just moved in it's home.

[00:32:54] Speaker 2: Your coffee pot is ready. Your favorite photos are perfectly placed, your bed is made, and your [00:33:00] new chapter begins with comfort and joy instead of chaos. This is how silver linings transitions, makes, moves magical. We handle the emotional [00:33:10] lifting and the logistics so you can focus on what matters most settling into your new home, because every move deserves a silver [00:33:20] lining.

[00:33:29] Speaker: [00:33:30] Hi, I'm Jami Shapiro. I am an A DHD coach and the founder [00:33:40] of Silver Linings Transitions, where we do home organizing and move management. And you know, I did not know that I had a DHD [00:33:50] for years, and I remember personally hiring an organizing company to come in and help me because I could just never get it together.

[00:33:58] Speaker: And it really wasn't [00:34:00] until I understood. A DHD and its impact that I realized why, and so I wrote a book. This explains so much understanding [00:34:10] undiagnosed A DHD, because I just feel like there's so many answers that people don't even know that they're looking for, especially generations of women [00:34:20] who. Grew up thinking that A DHD was just for the hyperactive little boy.

[00:34:24] Speaker: It turns out it's not only a body that can be hyperactive, but it can be a mind that's hyperactive. [00:34:30] So you can have a wonderful day and you can have something wonderful happen. And then that one negative thing that happens is gonna be that thing that takes you into that spiral and it's gonna be [00:34:40] keeping you up at night and you're gonna be ruminating on it.

[00:34:42] Speaker: And I think that, you know, we as women carry. So much shame and so much how it's supposed to be. I'm supposed to [00:34:50] have it together. And I remember that was the case for me. I, I remember how is it that all of these women have so much consistency and their kids get the sticker charts and everything seems to run [00:35:00] well and I'm the one that's missing parent teacher conferences and my house, you know, is always in chaos.

[00:35:05] Speaker: And, and then again, that negative self-talk. So I, my [00:35:10] mission is really to educate people who have no. Idea that A DHD has the impact that it does, and it's to connect you to other people who get [00:35:20] it and who will make you feel that you aren't alone. You're not crazy, you're not lazy, you're not stupid, you're not too much.

[00:35:27] Speaker: You just have a brain that was wired [00:35:30] differently and I can't wait for you to join me in the community that I'm building, the workshops that I'm creating. The book club that I'm hosting because I [00:35:40] know that I am going to make a profound difference in your life.

[00:35:45] Speaker 8: And we are back with Dr. David Goodman. Uh, we just took a pause [00:35:50] and I left you with a cliffhanger. Okay. Dr. Goodman. So if I've interviewed 80 people who have ADHD and have asked them if they could push a button and not have [00:36:00] it, what do you think the percentage of people who would push the button would be?

[00:36:05] Speaker 9: So like any academic, I'm gonna put some qualifiers on this. I think that the [00:36:10] people who are functioning well and satisfied with their functioning would say, I wouldn't change my ADHD. And those who are struggling and [00:36:20] have struggled for a long time would probably push the button and say, gee, I wish I didn't have this.

[00:36:25] Speaker 9: It also depends on whether you're getting treated or not. So I suspect the people are getting [00:36:30] treated. Would probably not push the button and say There are aspects of my ADHD that I like, and those people who are going untreated and still suffering would probably push the [00:36:40] button and say, I'd rather not have this.

[00:36:42] Speaker 9: So you tell me what's the answer. 

[00:36:45] Speaker 8: One person said he would push the button, and by the way, he works as an ADHD [00:36:50] coach. Okay. But I know that he had a history of job loss. Again, back to your point of the man, you know, he was carrying, and I typically interview women, [00:37:00] um, you know, but, but not always in cases, you know, like I, I tell people you don't have to be a grandma and you don't even have to, you know, be over 50 or a woman.

[00:37:09] Speaker 8: But, you know, [00:37:10] my audience is women. Generally, but I, I've definitely heard from people who are younger. Um, you know, there was another question that I was gonna ask you. Oh, I was gonna ask you to go into the [00:37:20] dementia and ADHD and how, what the distinction is. Um, but I also wanted to share something to your point.

[00:37:26] Speaker 8: I actually was the keynote speaker at the [00:37:30] Western Region Aging Life Care, um, aging life care conference. So for, um, aging life care managers, um. Like Jar gerontologist ish, kind of, you know, [00:37:40] people who are functioning as case managers. So, you know, I was really impressed that they did, you know, make me the keynote because they wanted to understand yeah, impact of [00:37:50] ADHD.

[00:37:50] Speaker 8: I've not been the keynote anywhere else yet, but the next day they had a session on anxiety in older adults. And do you know that ADHD was left [00:38:00] off the left out of the whole presentation? You're shaking your head, so you're, you're surprised. 

[00:38:07] Speaker 9: I'm, I'm not, I'm not surprised. It, it, it's [00:38:10] why you and me and so many others try to keep ADHD in the conversation because again, if you haven't been professionally trained on this, you can't see what you don't [00:38:20] know, and you don't know what you haven't been taught, and you haven't been taught because the teachers themselves didn't know.

[00:38:26] Speaker 9: So it's very important to just continue to keep [00:38:30] this campaign and message. Going so that people who have not learned and are not aware of ADHD as a consideration can start thinking [00:38:40] about it. The people in the mood disorders arena, uh, don't think about ADHD when they're treating depression [00:38:50] resistant.

[00:38:51] Speaker 9: Um, episodes and yet the comorbidity, the coexistence of ADHD with depression, coexistence of ADHD with [00:39:00] bipolar disorder, anxiety disorders is really quite high. And yet you're gonna treat the anxiety without acknowledging that the ADHD is [00:39:10] causing the impairments that provoke the anxiety, which is why patients who have coexisting ADHD and depression or coexisting anxiety will get [00:39:20] better somewhat with medication and treatment, but don't get as well as they could if both were treated simultaneously.[00:39:30] 

[00:39:30] Speaker 8: S Okay. So I, and again, just from my observation, I haven't met anybody with ADHD that didn't suffer from some anxiety. Um, [00:39:40] but I've heard it's only 50% that I don't know. I mean, again, I'm not a doctor. I'm not studying it. I 

[00:39:47] Speaker 9: correct. So when we say [00:39:50] that 50% of adults with ADHD suffer from an anxiety disorder.

[00:39:56] Speaker 9: That's not to say that ADHD individuals don't [00:40:00] suffer from anxiety. Okay? So there's a distinction between having an anxiety disorder and having anxiety. My experience with ADHD [00:40:10] individuals is that most of them suffer from the experience of anxiety, but it doesn't rise to the level of a disorder diagnosis.

[00:40:18] Speaker 8: Thank you because I'm [00:40:20] like, wait a minute. Okay. I love that. So, because I really don't know what's the difference between like anxiety, where I would say I have a general anxiety, I, [00:40:30] it doesn't debilitate, it doesn't keep me from living my life. But I have these thoughts, you know, these obtrusive thoughts and, and I'll try to dismiss them.

[00:40:38] Speaker 8: Like for instance, my two of my [00:40:40] children live, you know, in different states or in different parts of the country and you know, I don't hear from them and I immediately go to. I jump to something's wrong [00:40:50] or, you know, I, I, I'm just always breaking my back, jumping to, you know, whatever the conclusion is. But what's the difference between the kind of anxiety that [00:41:00] I have or like, I don't like to fly, but I will.

[00:41:02] Speaker 8: You know, 

[00:41:03] Speaker 9: so this is the broader concept here, is that we all, as a result of being human [00:41:10] beings, have emotional experiences. We get anxious, we get frightened, we get sad, we get demoralized. Those are normal human experiences on a [00:41:20] spectrum. A psychiatric disorder is specifically defined by a cluster of symptoms that cause impairment and distress.[00:41:30] 

[00:41:30] Speaker 9: So. There's a level of severity that one needs to reach in order to have a disorder. And when we talk about [00:41:40] ADHD, the parallel to ADHD is, again, we all have experiences of inattention, distractibility, forgetfulness, uh, [00:41:50] impulsive decisions. That doesn't mean you have A-D-H-D-A-D-H-D is a constellation of those symptoms that started in childhood.

[00:41:58] Speaker 9: Have continued rather [00:42:00] chronically with impairment over the course of several areas of your life. So this idea that everybody has a little ADHD is [00:42:10] is really a misnomer. It does a disservice to patients who suffer from ADHD and it minimizes a formal diagnosis that ought [00:42:20] to receive some form of treatment.

[00:42:23] Speaker 8: Okay. Um. So one of the things that you also brought up that I, that I, and I don't know if there's an answer to [00:42:30] this, but it's something that I've been curious, to your point, when I asked you about the button, you said that it would depend on the degree that somebody was impacted. And, and I say that as well in my podcast.

[00:42:39] Speaker 8: I mean, [00:42:40] I, I have figured out how to leverage my ADHD and use it as an advantage, and that's where my awareness has helped because I now [00:42:50] recognize. There are, you know, I'm having, I have deficiencies or, um, you know, impairments in my, my short-term memory. And so therefore if I put a load of [00:43:00] wash in, if I don't give myself some sort of cue, then the like, is that I'm, I'm going to leave it there for a couple of days.

[00:43:08] Speaker 8: Right. Um, [00:43:10] where, and I don't know if there's an answer here, but where is the difference between someone like me who's figured out how to leverage it? You know, I was able to graduate college with high honors. Um, versus the [00:43:20] person who, I mean, I call it an albatross. I think I mentioned it that way in my book, like where ADHD is, is a, a significant impairment is, do you, is there anything [00:43:30] you can say to that?

[00:43:32] Speaker 9: Oh, I can say a lot to that. I have a tendency to be able to say a lot about a lot of things. Doesn't necessarily mean I'm right, but I, I have [00:43:40] an opinion on everything and very few answers. Mm-hmm. Um, so let's break that down a little bit. If you are bright, if you have a high IQ and you [00:43:50] have ADHD, then you're likely to use your IQ to create compensatory skills.

[00:43:57] Speaker 9: It's why bright students in middle [00:44:00] school and high school don't get identified with ADHD because the teacher says, look, you're getting B plus pluses, you're getting a minuses. You're not disrupted in school. You can't possibly have [00:44:10] ADHD if you are a physician or an attorney. People often said, well, you can't have ADHD because you've gotten through a rigorous academic.

[00:44:19] Speaker 9: [00:44:20] Challenge. And if you had ADHD, you couldn't do that. That's actually not true. So you can be bright and have ADHD and get through what other people [00:44:30] think are accomplishments. But if you ask these folks their experience, they'll say they're working twice as hard as colleagues in order to keep it all together.

[00:44:39] Speaker 9: Mm-hmm. [00:44:40] Mm-hmm. 

[00:44:40] Speaker 8: Now, 

[00:44:41] Speaker 9: if you have ADHD and executive dysfunction. That is your inattentive, distractible, and disorganized [00:44:50] medication will help with the core symptoms of ADHD. But you may find the, uh, executive dysfunction doesn't improve. So you can focus, you can concentrate. You're not [00:45:00] distracted, but you still have problems with time management and sequencing a task that requires a behavioral approach.

[00:45:07] Speaker 9: So in that case, the executive [00:45:10] dysfunction then causes more of the impairments. Then the core ADHD, if you have ADHD and another psychiatric [00:45:20] condition, that accompanying psychiatric condition is gonna create impairments as well. Those impairments may be ascribed to ADHD, but may really be a [00:45:30] reflection of the alternative coexisting disorder.

[00:45:35] Speaker 9: Also self-awareness becomes an issue. If you're an ADHD [00:45:40] individual who knows you have ADHD, then there's a self-awareness of what your ADHD is doing to you during the course of the day. If you're someone with ADHD and haven't [00:45:50] been told you're have ADHD, then you just think, um, that the environment is.

[00:45:56] Speaker 9: Is right when they criticize you for being lazy or [00:46:00] stupid or not motivated, and then that becomes incorporated into your self-esteem. So we often talk about the impairments in functioning, but we don't talk about the [00:46:10] impact on self-esteem. And if you grow up with ADHD that's not been treated, and the teachers and your parents and your friends consider you.

[00:46:19] Speaker 9: Lazy [00:46:20] and stupid and not motivated. You come to believe that that's you as a person. One of the advantages of getting diagnosed with ADHD and then treated [00:46:30] and shown that you can function at a higher level is that I teach patients the difference between what you have ADHD versus who you are as a person.

[00:46:39] Speaker 9: So [00:46:40] we go back to people with ADHD. Some people with ADHD are quite successful. You have celebrities. You have billionaires who have [00:46:50] ADHD, but they have managed through their intellect and or their creative talent to capitalize on their positive attributes. If you are [00:47:00] not someone with those talents and skills, then you're gonna suffer more so with impairments in financial, occupational, [00:47:10] academic, and social.

[00:47:13] Speaker 9: And so it really is a complex, but you can. DI dissect this [00:47:20] down. And so when I was seeing patients, this is the complexity that I would bring to each and every patient because every patient's circumstances are different. Their [00:47:30] personality, their upbringing, their social scaffolding and support networks, their personality, their self-observation and insight.

[00:47:38] Speaker 9: Are all quite different [00:47:40] and treatment has to be tailored to where the patient is with a guidance to where they ought to go in order to maximize the potential. I, I know I tend [00:47:50] to speak a lot and my wife accuses me of, of rapid fire lectures, but. There's just so much information that I want people to understand in order to gain an [00:48:00] insight to the complexity of what this is, and to work with clinicians and therapists who really get this.

[00:48:06] Speaker 9: Because if you're working with somebody who doesn't get it, [00:48:10] um, they're gonna be well intended, but the treatment, uh, and recommendations may not be optimally effective for you. 

[00:48:19] Speaker 8: [00:48:20] Right. I love it. And by the way, there is no long-winded answer here because you could keep going and I'm just, you know, taking it all in and so appreciative.

[00:48:27] Speaker 8: Um, what do you see on the horizon? You know, [00:48:30] one of the things that happened with my mom, so I, I recognize that mom. I think you have ADHD. She's been treated for anxiety in her and depression her whole life. She sees a [00:48:40] psychiatrist, she sees a therapist, she sees a general practitioner. Again, she's in her late seventies.

[00:48:44] Speaker 8: Um, and, and they all, oh yeah, that, that, you know. Seems to be right. No one [00:48:50] caught it until, you know, her daughter, who, you know, just was, happened to be listening to a podcast on, um, ADHD and fibromyalgia and migraine headaches because my mom had suffered from [00:49:00] both. Um, but she was told by her doctor, oh, we don't give stimulant medications.

[00:49:05] Speaker 8: Um. What, what's on, first of all, what's on the [00:49:10] horizon and, and what is your what, what do you say to a doctor who, by the way, and I recognize that there are people who have different health concerns, they might have a heart [00:49:20] issue, right? So, so there may be reason that they can't take multiple drugs, but a generally healthy person in their seventies, you [00:49:30] know what, what do you say?

[00:49:33] Speaker 9: Right? Um. That's the question again. There's, uh, there's a lot [00:49:40] of bits and pieces to this question, so let's take on, let's take on clinical training and clinical prejudice. One is that in clinical [00:49:50] training, because ADHD medications mostly prescribed, are stimulant medications are C two, which means that they have a risk for abuse [00:50:00] and misuse and divergence and also.

[00:50:04] Speaker 9: In older people, they can have cardiovascular effects. That is elevations in blood [00:50:10] pressure, elevations in pulse. Often older adults have other medical issues including cardiac issues, and so we typically were trained. [00:50:20] You're not gonna use stimulant medications and older adults because of the side effect risk and whatever it is they have.

[00:50:27] Speaker 9: That stimulants might be helpful for. They've had it their [00:50:30] whole life, and why bother treating it now? So that's the clinical prejudice people bring to this. And if you don't wanna write a treatment, [00:50:40] then you don't make a diagnosis. Even if the person has ADHD, people will say, I'm not gonna assume the risk of writing a stimulant [00:50:50] medication if it's gonna lead to a heart attack or hypertension, or a stroke.

[00:50:56] Speaker 9: Now all of this is tremendously [00:51:00] overrated. There is a library full of cardiovascular research on stimulant medications, and although in. Five to [00:51:10] 15% of patients have elevations in blood pressure that require some clinical attention. Most patients are prescribed these medications without [00:51:20] significant risk.

[00:51:21] Speaker 9: If you're a person with a cardiac history, you probably have a cardiologist, and I would coordinate my prescription with the cardiologist and [00:51:30] say, look, person has ADHD. I'd like to prescribe this. Do you have any reservations in my area in Baltimore? Most of the cardiologists first response was. Wow, you're a [00:51:40] psychiatrist calling me.

[00:51:40] Speaker 9: I think you're the first one who's ever done that. And then B, they say, you sound like you're knowledgeable. Here are the things I would look for. And if there are any side effects or problems, [00:51:50] then have the person get back to me. Now, withholding stimulant medications from older people who have ADHD is a problem in not [00:52:00] treating what they have that's causing distress.

[00:52:03] Speaker 9: And if you treat them. They get significantly better. They can function during the course of the day. Their anxiety and [00:52:10] their depressed moods are reduced. Again, what's most important when you treat these people is they will tell me, [00:52:20] I would rather now know what I have so that I can appreciate that what I have lived with my whole life is not me, is a disorder that should [00:52:30] have been identified and should have been treated.

[00:52:32] Speaker 9: And so in psychotherapy for older adults, there is an element of going back in life [00:52:40] with the regrets and sadness of opportunities that have been missed, relationships that have been fractured, job pursuits that were terminated. [00:52:50] Uh, impulsive remarks in meetings that antagonize the boss. And there's a grief period of going through this.

[00:52:59] Speaker 9: But [00:53:00] if you go through the psychotherapy of grief of your, um, life with ADHD, people ultimately come to the [00:53:10] recognition that I'm glad I know what I have and I can relieve myself of the. Damnation of who [00:53:20] I was because that actually wasn't me and the environment just didn't see it. 

[00:53:26] Speaker 8: So I wanna share a personal anecdote with you, Dr.

[00:53:29] Speaker 8: Goodman. Um, [00:53:30] so as I shared with you, my mom has ADHD. Um, we had a strange relationship, majority of my life. Um, many, many reasons. Clutter [00:53:40] was one of them. I was constantly battling my mom's clutter, the emotional dysregulation, the rejection sensitivity. I mean, it was all there and I didn't think it was [00:53:50] possible for us to ever have a close relationship.

[00:53:52] Speaker 8: And since discovering that she has ADHD, I have a, a forgiveness and an empathy for my [00:54:00] mother because now I realize when she was quitting her jobs and she couldn't finish college, you know, we had a real reason for it. And, and I apologized to [00:54:10] her and realized that I had been shaming her the way that parents, you know, shame their children and teachers shame their children.

[00:54:16] Speaker 8: And honestly, I mean, part of my story and why I'm here [00:54:20] is that I, you know, our relationship has. Truly transformed. Uh, we just celebrated her 79th birthday. Um, and I'm her only child [00:54:30] and, you know, again, many, many birthdays of us not being close. She lives in Florida. I'm in California, but I asked her, you know, what was her best birthday?

[00:54:38] Speaker 8: And she said it was this one. [00:54:40] And that was only possible through our shared understanding. And I do want to mention something, um, that I learned when I was becoming a certified senior advisor. And that was the term, and you, [00:54:50] you actually mentioned it without saying it, JRO transcendence, which Eric Erickson defines as, you know, the ninth, well, he didn't define it, but when he was in his eighties and, you know, [00:55:00] he was a famous sociologist and talked about the eight stages of life, but he didn't go past his eighties because, you know, that was, and then.

[00:55:06] Speaker 8: When he and his contemporaries were getting into their eighties [00:55:10] and they, they realized that there is this period where you look backwards and you evaluate your life and you make peace with your past. And so to when people say, why does it matter? [00:55:20] You know, you've lived this many years with ADHD. Why does it matter if you find out now or you do anything about it?

[00:55:25] Speaker 8: And it's because you get to make peace with your story and the [00:55:30] relationships that were fractured and all of this stuff, 

[00:55:34] Speaker 9: you know, that's. This is why you do what you do. That that really is, that's a [00:55:40] beautiful, beautiful story of the transition from a disruptive dissatisfying relationship to an [00:55:50] understanding acceptance apology to an older parent.

[00:55:55] Speaker 9: Um. I mean, it's very, it's very touching. Let, let me [00:56:00] ask you though, when you, when you were growing up and you didn't know she had ADHD, what did you believe was the motivation behind what she was doing? 

[00:56:09] Speaker 8: Okay, [00:56:10] so I'll, I'll, I'll give you a little, you know, when I was about. Three or four years old. My, my parents divorced young.

[00:56:16] Speaker 8: My mom and dad both have ADHD. Again, none of it was diagnosed at the time. [00:56:20] Um, I remember at a very early age, my mother would, you know, share, overshare it with me. And so she was dumping her troubles onto me. And so from a very [00:56:30] young age, I felt a responsibility towards my mother. So I was a parentified child where I didn't feel like I had a mother that I could go to and rely on them with my safety net.

[00:56:39] Speaker 8: [00:56:40] Instead, I felt like it was a responsibility and then a burden as I am now having children and going through being a, you know, on my own. And then on also [00:56:50] because I am very driven. So, you know, I, I decided to, I want to do something and I do it. Um, and my mom was constantly quitting. It was just like, so she wasn't holding down [00:57:00] jobs and she had an opportunity.

[00:57:01] Speaker 8: And by the way, my mom is very bright, so I didn't understand when I'm like, mom, you, you know, your company will pay for tuition reimbursement. She's in her [00:57:10] early forties. Why don't you go back to school? And she would say, um, well, I, I can't focus, I can't concentrate. And I'm, and I just, I didn't, again, because it wasn't [00:57:20] my experience at the time.

[00:57:22] Speaker 8: Um, and, and of course now I see when it was, when there was a class that I didn't wanna do, I couldn't do it. You know, I, I, I like, almost [00:57:30] failed algebra. Um, my teacher out of sympathy gave me a grade that I did not. Mm-hmm. I did not get the grade for, but she saw that I was trying. Um, and so [00:57:40] I, I just, I wanted my mom to be the, the adult that you, that you look up to, that you know, is that role model for you.

[00:57:48] Speaker 8: And I didn't have that. [00:57:50] So does that answer your question? 

[00:57:52] Speaker 9: It does. It, it exemplifies the experience that people have with ADHD, and that is. When [00:58:00] you're, when you're interacting with somebody with ADHD and you don't know they have ADHD, uh, their behaviors get ascribed to motivation. So they're showing up late [00:58:10] because they don't care.

[00:58:11] Speaker 9: They're making careless errors because it's not important to them. They're making impulsive remarks because they're narcissistic, they're interrupting me in [00:58:20] conversations. Because they're more interested in themselves than than them. And so a motivation gets ascribed to these behaviors. That's [00:58:30] actually not true.

[00:58:32] Speaker 9: And then in your experience with your mom, as you came to understand she had ADHD, and this would then explain a lot of the experiences you had. [00:58:40] Of her as a parent when you were a child, it gave you a better understanding that she wasn't doing this to you. This was [00:58:50] something that she was suffering with.

[00:58:52] Speaker 9: Yes. And that unfortunately it was your experience, but you got older, you got more reflective, you understood your [00:59:00] ADHD. Understood. She had ADHD, and then understood that this was not her as a person. This was just her untreated, A DH, D. It's a remarkable [00:59:10] story. I mean, it really is impactful and kudos to you for, for wrapping your head around this gaining acceptance of your mom's limitations as a [00:59:20] parent, grieving over the parent that you wish you had but didn't have.

[00:59:24] Speaker 9: But now understanding that your mom loves you, well intended, um, and [00:59:30] you have so much closer relationship, it's very satisfying to her. And you gave her a gift. You gave her a gift. In her older years now where she's going [00:59:40] to die in comfort that she won't have regrets about how she was as a parent because she now has an adult child who understood [00:59:50] and forgives and loves her.

[00:59:52] Speaker 9: Uh, again, this is, this is an example of what therapy ought to do for people in the course of their [01:00:00] relationships with their loved ones. 

[01:00:02] Speaker 8: I, I wanna just take it one step further and, and share a little more about my mom. So when I, I, I shared with you that I quoted you in my book. The book, by the [01:00:10] way, is called This Explains So Much.

[01:00:13] Speaker 8: And, um, and then it's, you know, the subtitles, my oldest child designed it, by the way. So we really kept [01:00:20] it in the family. But you'll see on the bottom that my mother was, uh, it was with Vicki Armell. So my mom actually. Read the book, edited the book, added her [01:00:30] stories, but even more significantly, let me take pictures and video of her home in the clutter that no, most people are usually really embarrassed about.

[01:00:39] Speaker 8: And that clutter [01:00:40] keeps them, you know, from living and makes them socially isolate. They don't wanna have people over. And there's an embarrassment and, and my mom is now opening the [01:00:50] conversation in the door to say, Hey. Don't be embarrassed. My mom actually was sharing with me, she lives in a, a building 55 and over, and there was an artist and my mom's an artist, and the, [01:01:00] my mom wanted to see the woman's artwork and she said, well, you can't come to my house, you know, it's a mess.

[01:01:05] Speaker 8: And my mom's like, well, my, my mess is on, on a book, you know what I mean, in a book. [01:01:10] And so she was so brave and I said, mom, this is gonna be your legacy. Because had I not realized that she had ADHD, I probably wouldn't be where I am now. [01:01:20] So I just wanna brag. 

[01:01:22] Speaker 9: Um. No, you're right, you're right. Um, no, it's a, it's a, it's a wonderful story.

[01:01:29] Speaker 9: It, it's [01:01:30] really a wonderful story. And, and you then convey that to your children when you're raising them, you now become the parent to them. You wish your mom [01:01:40] had been to you. So with each generation, there is an increase in the psychological health of individuals, regardless [01:01:50] of the psychiatric. Disorder and disability you might have.

[01:01:56] Speaker 8: Yeah, 

[01:01:56] Speaker 9: you don't, these disorders are what you have, you know, [01:02:00] I, I'm sorry you have this disorder. Um, but now that you have it and it's been identified and you're aware of it, it's your job then to manage [01:02:10] it and take responsibility for it. And get therapy on how to navigate through the social relationships with people.

[01:02:18] Speaker 9: There will be some [01:02:20] people who roll their eyebrows, uh, roll their eyes and say, you know, are you just making excuses? Okay, so you walk away saying, this person just doesn't understand. I [01:02:30] can take the time to try to educate them if they're receptive, but if they're not receptive, this is not somebody who's gonna be helpful to you in your life.

[01:02:37] Speaker 8: Yeah, their loss. Okay. I do wanna, I, I [01:02:40] hate to do this, but I have to do this. It's like when, um, I'm, I work in the senior space and people call a senior community a facility, and I'm like, don't call it a facility. Um, it's a community unless they're in [01:02:50] memory care, you know, or skilled nursing. Um, I don't like the word disorder.

[01:02:54] Speaker 8: I like the word difference. Because I know that my brain thinks differently, and I [01:03:00] have to learn, and I know you're a doctor, but I just, I know that's like a, a, a trigger point. A lot of us in this space are like, we don't, we don't like the label disorder, so they're just, [01:03:10] 

[01:03:10] Speaker 9: yeah, no, this becomes a, um, I, I agree with you.

[01:03:16] Speaker 9: It, it becomes a bit of a contention over the [01:03:20] jargon that's used. Keep in mind though, we're talking about different models. So one model is a medical scientific model that [01:03:30] uses the vocabulary of science. The other is a vocabulary and jargon of social interaction [01:03:40] and therapeutic language. It's not one is better than the other.

[01:03:44] Speaker 9: Let's understand that we're using the vocabulary in a specific [01:03:50] model and that the two can coexist simultaneously. 

[01:03:55] Speaker 8: And, and that makes sense given your explanation for anxiety and anxiety disorder. So, so [01:04:00] thank you. I'm glad, I'm glad that you, you, you said the problem is, is then, you know this, that we have generations of people who stigmatize anything that's mental health, any issues.

[01:04:09] Speaker 8: And so therefore [01:04:10] you hear the word disorder and you shut it down because that can't be me. I don't have a disorder. There's nothing wrong with me. So that was sort of where I was going with that. 

[01:04:19] Speaker 9: Yeah. You know, it's [01:04:20] very interesting, and I'll take it to a a macro level. We don't have this discussion if you have hypertension or diabetes, but we have this discussion with psychiatric illnesses.

[01:04:29] Speaker 9: And [01:04:30] why is that? Because we believe that our psychological state is under willful control. What we fail to understand is that [01:04:40] willful control is based on your brain functioning, and if your brain is not functioning properly. Then [01:04:50] you're not under willful control. A very concrete example is if I give you three martinis, are you under willful control when you make an [01:05:00] impulsive decision that you later regret in the following morning during sobriety?

[01:05:05] Speaker 9: That's an example of how brain chemistry that's [01:05:10] disruptive robs you of conscious, willful decisions. And that's a very important psychiatric [01:05:20] concept. It's not let's allow a schizophrenic person to live the life they choose. Let's understand that schizophrenia robs this [01:05:30] person of conscious, willful autonomy that they would choose to make different decisions if they weren't hallucinating and delusional.[01:05:40] 

[01:05:41] Speaker 8: Yes. Okay. Yeah, and my mom has said that too, when we talked about, um, we talked about anxiety medication or whatever before the A DH [01:05:50] adhd, uh, when I, I had a period of my life. I was going through a divorce, starting a business, and my mom, I, I didn't wanna take, oh, when I, when I was going through cancer, actually, I had cancer 21 years ago, [01:06:00] and while I was waiting for pathology and all of that, my mom suggested I take something and I'm like, I'm not taking something.

[01:06:05] Speaker 8: And my mom said, if you, you know, if you had diabetes, wouldn't you take insulin? So, [01:06:10] sort of the same thing. Right. 

[01:06:13] Speaker 9: We have been discussing now this topic for an hour, and I'm sure that we could [01:06:20] spend another hour talking about this. I'm going to have to bring this to a close because of other considerations and commitments I have for today.[01:06:30] 

[01:06:30] Speaker 8: I understand. Um, uh, since we probably don't have to time to discuss the dementia and ADHD difference, where can I send my listeners? [01:06:40] To find more information on when it's dementia and when it's ADHD. 

[01:06:47] Speaker 9: And I should have some specific, [01:06:50] um, my, my immediate suggestion would be to type in my name and put in ADHD and older adults.

[01:06:58] Speaker 8: Okay. There 

[01:06:58] Speaker 9: are [01:07:00] lectures and webcasts that I've done. And they're probably online. And so you can pull up one or two lectures [01:07:10] and, and listen to that. 

[01:07:12] Speaker 8: Okay. That's great. So it's Dr. David Goodman, um, ADHD in older adults. Any, any parting words? I [01:07:20] appreciate that we did spill late. Like I said, I, I'm, I'm, you know, so appreciative.

[01:07:24] Speaker 8: I learned so much. This was such a good conversation. [01:07:30] 

[01:07:30] Speaker 9: No, I'm grateful just to have the opportunity whenever somebody's interested in this topic to get accurate information so that listeners can [01:07:40] make informed decisions for themselves. Whether you have ADHD and get treatment is entirely up to you. The first issue is [01:07:50] get an accurate diagnosis so you know what you have.

[01:07:53] Speaker 9: And you know what? You don't have, okay? This is not who you are as a person. It's not a character fault, and it's not bad parents. [01:08:00] It's just the way your brain got wired. 75% of the cause of ADHD is genetics. And boy, your family tree. Is, uh, is [01:08:10] punctuated with ADHD all over the place. So you don't wake up at, at, uh, 25 years old and say, I think I'll have ADHD for the rest of my life.

[01:08:17] Speaker 9: It doesn't work that way. So understanding [01:08:20] what you have, and then that allows you to seek out information for which you can develop compensatory skills. Work with your partner, inform a [01:08:30] colleague, a coworker, a boss who's receptive to this information. It just makes you function better in the world now.

[01:08:37] Speaker 9: The other issue is you will have to deal with [01:08:40] people who don't believe in it, don't believe you, or think that it's an excuse. And if those people are not receptive to new information, my recommendation [01:08:50] is stay friendly and respectful. But they are not in any way going to be a support system for you or provide accommodations and allowances and.[01:09:00] 

[01:09:01] Speaker 9: Get accurate information. I'll just cite a, a study that's been highly cited. There were a hundred videos, uh, a [01:09:10] hundred most videos looked at. Um, for ADHD, 54% were deemed to be misinformation. Wow. So over half of what people are [01:09:20] seeing on the internet when the algorithms are pushing information to you is inaccurate, and you have to go to reliable sources.

[01:09:28] Speaker 9: Like Chad, [01:09:30] children and adults with ADHD Association, or abs a, which is the, uh, American Professional Society for ADHD related [01:09:40] disorders or the CDC, go to vetted medical associations and grassroots associations for accurate information. Let's [01:09:50] not, let's not get our treatment from influencers on the internet who have a conflict of interest and are interested in self-promotion.

[01:09:59] Speaker 9: Uh, before accurate [01:10:00] education. 

[01:10:01] Speaker 8: Well, thank you. I am, I so, I'm so grateful for your time. I always like to end my podcast when, when people say, why does it matter, you know, at any age that you [01:10:10] understand it. And it's because, excuse me, I like to say, um, because I'm committed to, you know, people making the rest of their life the best of their life.

[01:10:18] Speaker 8: And when you [01:10:20] understand yourself better, um, it makes life easier. So thank you so much. Thank you so much. I'm gonna end the recording. 

[01:10:26] Speaker 9: You're welcome, Jami. 

[01:10:29] 

[01:10:30] Speaker 3: The opinions expressed on Grandma has a DHD podcast are those of our guests and hosts and are intended for informational and entertainment purposes only. [01:10:40] This podcast does not provide medical advice, diagnosis, or treatment. The content discussed in this episode is not a substitute for professional medical advice, [01:10:50] diagnosis, or treatment.

[01:10:52] Speaker 3: Always seek the advice of your physician, mental health, professional, or other qualified health provider with any questions you may have [01:11:00] regarding a medical condition or mental health concern. Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast.

[01:11:09] Speaker 3: [01:11:10] If you think you may have a medical e. Call your doctor or emergency services immediately. The host, guests and producers of Grandma has a DHD. Do [01:11:20] not assume any liability for the content of this podcast. Listen at your own discretion.