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ADHD Beyond the Buzz - ADHD facts, myths, understanding ADHD 'presentations' & a bonus!
Episode 1 • 3rd January 2024 • ADHD Powerful Possibilities: New and Late Diagnosis & Beyond • ADHD Coach Katherine Sanders
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ADHD Coach Katherine Sanders

ADHD Coach Katherine is back for 2024 with a new series that will take you through everything that you need for getting a great life with ADHD.

In this episode of ADHD: Powerful Possibilities, host Katherine explores the topic of ADHD and its different presentations. She discusses what ADHD is, how it shows up in everyday life, and debunks common myths surrounding ADHD. Katherine also shares her personal experiences. The episode concludes with a special announcement about a guide for understanding different presentations of ADHD.

Tune in for an engaging discussion on ADHD and discover powerful possibilities for managing it.

Connect with Katherine here:


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ADHD presentations & self-assessment - get your copy HERE
https://www.lightbulbadhd.com/adhd-presentations



UK diagnosis pathway (general)

https://adhdaware.org.uk/what-is-adhd/getting-nhs-diagnosis/


NHS diagnosis guidelines (NICE)

England & Wales https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/diagnosis/

Scotland

https://www.scottishadhdcoalition.org/wp-content/uploads/2019/07/Guide-to-adult-ADHD-assessment-July-2019.pdf


USA diagnosis guidelines

https://chadd.org/for-adults/diagnosis-of-adhd-in-adults/#:~:text=For%20adults%2C%20an%20ADHD%20diagnostic,physician)%20or%20clinical%20social%20workers.


Self assessment scale for adults

https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf


Self assessment for women

https://adhdrollercoaster.org/wp-content/uploads/2019/03/SASI.pdf

  

1.     Anxiety Disorders and ADHD:    

   - Reference: Sciberras, E., Mulraney, M., Silva, D., & Coghill, D. (2017). Prenatal Risk Factors and the Etiology of ADHD—Review of Existing Evidence.   Current Psychiatry Reports  , 19(1), 1-9. [Link to the paper](https://link.springer.com/article/10.1007/s11920-017-0753-2)


2.     Mood Disorders and ADHD:    

   - Reference: Skirrow, C., & Asherson, P. (2013). Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder.   Journal of Affective Disorders  , 147(1-3), 80-86. [Link to the paper](https://www.sciencedirect.com/science/article/abs/pii/S0165032712007700)


3.     Sleep Disorders and ADHD:    

   - Reference: Tsai, M. H., & Huang, Y. S. (2010). Attention-deficit/hyperactivity disorder and sleep disorders in children.   Medical Clinics of North America  , 94(3), 615-632. [Link to the paper](https://www.medical.theclinics.com/article/S0025-7125(10)00002-5/abstract)


4.     Learning Disabilities and ADHD:    

   - Reference: DuPaul, G. J., Gormley, M. J., & Laracy, S. D. (2013). Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment.   Journal of Learning Disabilities  , 46(1), 43-51. [Link to the paper](https://journals.sagepub.com/doi/abs/10.1177/0022219412464351)


5.     Substance Use and ADHD:    

   - Reference: Molina, B. S., & Pelham, W. E. (2003). Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD.   Journal of Abnormal Psychology  , 112(3), 497. [Link to the paper](https://psycnet.apa.org/record/2003-07722-016)


        References for Neurological Basis of ADHD:    


1.     Brain Structure and Function:    

   - Reference: Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D., ... & Rapoport, J. L. (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation.   Proceedings of the National Academy of Sciences  , 104(49), 19649-19654. [Link to the paper](https://www.pnas.org/content/104/49/19649.short)


2.     Neurotransmitter Systems:    

   - Reference: Del Campo, N., Chamberlain, S. R., Sahakian, B. J., & Robbins, T. W. (2011). The roles of dopamine and noradrenaline in the pathophysiology and treatment of attention-deficit/hyperactivity disorder.   Biological Psychiatry  , 69(12), e145-e157. [Link to the paper](https://www.biologicalpsychiatryjournal.com/article/S0006-3223(11)00145-1/abstract)


3.     Genetic Factors:    

   - Reference: Faraone, S. V., & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder.   Molecular Psychiatry  , 24(4), 562-575. [Link to the paper](https://www.nature.com/articles/s41380-018-0070-0)


4.     Exclusive ADHD Neurological Features:    

   - Reference: Cortese, S., Kelly, C., Chabernaud, C., Proal, E., Di Martino, A., Milham, M. P., & Castellanos, F. X. (2012). Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies.   American Journal of Psychiatry  , 169(10), 1038-1055. [Link to the paper](https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2012.11101521)

Transcripts

Speaker:

RODE NT-USB & Susan's iphone (work) Camera:

What's up my friend.

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Welcome back to ADHD.

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Powerful possibilities.

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ADHD coach Catherine.

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And this is the first

episode of season two.

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In 2024.

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I want to take you through a

real journey of understanding

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a lot more about your ADHD.

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And then we're going to look in more

detail in future episodes about how to

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take all the knowledge into everyday life.

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So that you can address the executive

function, challenges that come up for you.

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Whether you're at work at

college at university, running

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a family, running a business.

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We're going to cover all of that.

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And I just wanted to start

with a really nice episode.

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Looking at ADHD and the

different presentations.

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Of ADHD.

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RODE NT-USB & Susan's iphone (work) Camera-1:

I thought it would make sense for us to

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start by thinking about what is ADHD.

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What can we get confused with ADHD?

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And then have a think about

what are the impacts in everyday

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life of the parts of ADHD.

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We've just talked about.

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I'm going to try and

keep this really short.

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It's new year 20, 24.

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We've all heard a really intense 2023.

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So let's begin.

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And really dive in to what ADHD

is, what it's not, and how it

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shows up in your everyday life.

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And I've got some interesting

news at the end of the episode.

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Let me begin by saying welcome to

people that haven't been here before.

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And welcome back.

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If you have, I really appreciate all

the feedback positive and the negative.

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And.

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Really fantastic reviews that

people have been giving me.

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Either in messages or

ideally on apple podcast.

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What's lovely is to hear from you

and for you to ask me questions.

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So please send me your questions.

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You can send them by email.

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You can send them through messenger,

just get in touch and let's create

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a podcast that really works for you.

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This episode, I decided to call ADHD

beyond the buzz and into the spectrum.

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It's a bit controversial because

there's a lot of buzz about ADHD.

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And I see a lot of people who

have maybe worked in other areas,

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transitioning into working in ADHD

because Hey, people are aware.

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That they have ADHD traits.

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They need help and maybe they can help.

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There's a lot of misinformation,

especially online.

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And how can you find trustworthy

information is something that we

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will discuss in a couple of weeks.

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But also is it a spectrum.

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I think probably.

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In the same sense that autism is now

recognized as a spectrum condition.

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And it's basically because

it's a neurological difference.

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That can affect anybody at

any age, no matter their sex.

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If your brain fits a certain pattern.

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That means that you have ADHD.

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Let's begin with what ADHD is.

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Attention deficit, hyperactivity

disorder, the worst name possible ever.

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For what we know is not a

deficit of attention and does not

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always look like hyper activity.

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And lots of us would say it's

not necessarily a disorder.

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It does come with lots

of challenges though.

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So let's not pretend that it's some

kind of magical superpower for everyone.

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THere are serious implications

and your long-term health, your

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success, your relationships.

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That are affected by ADHD.

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If it's not recognized,

supported, and treated.

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According to the APA the

American psychiatric association.

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It's characterized.

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By a pattern of hyper

activity and or impulsivity.

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And in attention.

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That interferes with everyday

functioning and development.

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ADHD as a neurodevelopmental

condition means it's actually about

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how our brain grows and develops.

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And this is a real contrast to even

15, 20 years ago when people really

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thought it was a behavioral disorder.

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So that's probably where

the disorder comes from.

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It's not a behavior disorder.

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It's a neurological difference.

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And I've talked about this

before, but neurologically.

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There are areas of the brain

that are particularly affected

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in the ADHD condition.

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The ADHD difference.

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And those are the ones that control

things like attention planning.

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And of course impulse control.

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There are other executive

functions that we can describe

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from those three main areas.

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That's where it shows up for most of us.

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But studies show and these are

physical scans of human brains.

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Not just.

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No scale forums that

doctors fill in for you.

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These are physical

scans, MRIs of the brain.

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That she'll, there are functional and

structural differences in the ADHD brain.

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Most of these are in

the prefrontal cortex.

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And that is where most of our high level

decision-making and planning happens.

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And the prefrontal cortex is

crucial for our decision-making.

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Our behavior regulation, emotional

control, and of course planning.

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Although it's important to try

and get a diagnosis of ADHD.

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If you can.

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We know that's not possible

for many thousands of people.

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Let's have a look at the DSM five

criteria to give you an idea of

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what the doctors are looking for

when they're making that assessment.

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Inattention is the first one.

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Now that doesn't mean that

you can't pay attention.

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It means that for at least six months

or more, your level of ability to

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control, your attention and focus.

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Is not what would be expected

at your developmental level.

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And that could include being

inconsistent, making careless mistakes,

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not paying attention to detail.

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As well as having difficulty

organizing tasks and activities

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that have lots of steps.

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That you need to focus

on to put into order.

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The next thing they look at is

hyperactivity and impulsivity.

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Again, there are about six or more

symptoms or that come under this banner.

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Of hyperactivity.

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And again, we're looking

at least six months.

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And are we that interfered with your

actual focus or your daily life?

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And those are things like fidgeting.

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Leaving your seat when you're

supposed to stay in your seat.

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This is most obvious in younger

people, but I know lots of adults

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are struggling with this one as well.

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And of course talking a

lot talking excessively.

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Blurting out interrupting when

we don't mean to or when when

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it's socially inappropriate.

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They also look at the age

of onset at the moment.

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You have to be experiencing these things

from before the age of 12, because

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after 12 other things can happen that.

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Like ADHD.

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But are not.

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Final easy look at impairment.

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No, that means they need to be

present in at least two settings.

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So at home and at work home

and in school university.

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And there has to be clear

evidence that the experiences

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and the symptoms you're having.

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Or interfering with your home,

with your social, with your work.

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You with your academic life?

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One of the things that is

really important when we do try

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to get a diagnosis, is that.

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Somebody looks at your whole life

and not just the last six months.

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Especially if you're an adult.

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Let's look at some of the myths that

people still perpetuate about ADHD.

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The first is a only affects

children and people grow out of it.

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It is true.

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Some people grew up and they no

longer meet the diagnostics threshold.

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But they may have developed

coping strategies.

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They may have found a work

place that suits them.

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They may have a family life and a

structure that allows their ADHD.

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To thrive.

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It's not impairing them any longer.

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If that's the case.

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Brilliant.

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But are they still actually

having an ADHD brain who knows?

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We'd have to do FMRs over a long time.

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On their ethical issues around

that as well as financial ones.

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What we do know is that the over

fifties are the fastest growing group

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of people being diagnosed with ADHD.

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That's largely in my case,

because it doesn't exist.

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And if you were bright, if you were

capable, you were not given any

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indication that you might be ADHD.

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And nobody's really talking

to us about how we deal with

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the lifelong consequences.

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Of undiagnosed ADHD.

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There are some great researchers

and doctors in the states at Dr.

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Kathleen Nadeau, Dr

Patricia Quinn, for example.

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But this really matters.

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If you're over 50, it's

unlikely that you are

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settling i

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n for a nice quiet retirement.

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So we need to understand ADHD

in the context of being adults.

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With, let's say patchy past and how

do we focus and deal with our ADHD?

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While still juggling work and

home and kids and parents.

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Everything else.

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Another classic myth is that

ADHD is a lack of willpower.

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Surely ADHD is just a

lack of willpower, right?

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That's a really common misunderstanding

that I see a lot on the internet from

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people who don't really believe the

scientific evidence that ADHD exists.

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And what's really frustrating about that

is that people with ADHD try really hard.

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And they just can't do it.

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And the more we try, the more

frustrated we get, the more

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disappointed other people get.

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It feeds into really negative

narrative about ourselves.

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And before you knew it were burned.

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So ADHD is not about willpower.

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It's not about not wanting things.

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It's about a neurological difference

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and the last myth I'm

going to talk about today.

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is that we can't focus.

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That we have no attention.

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Anyone with ADHD will tell you we have

bucket loads of attention when something

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is engaging, when it's interesting.

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And that's because interest is an

emotion and it's a really powerful one.

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If you're interested in something, I

bet you can focus on it for a long time.

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If you're having problems,

focusing on something that you're

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passionate about and that you love.

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It may be that there are other demands

going on that you're not aware of and

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you're not taking care of yourself enough.

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But with the right support and strategies.

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People with ADHD have lots of

attention and we can learn to

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control where we shine that torch.

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Let's talk about a differential diagnosis

because this is a really key one.

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What is ADHD not, or what

can masquerade as ADHD.

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I want to make it very clear.

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ADHD can overlap.

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With any of these conditions?

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I am not a medical doctor, so they

don't take this as a diagnostic thing.

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But it means that if you're experiencing

things that feel like ADHD or look

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like it is worth getting checked out.

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As soon as you can.

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First up is anxiety disorders, feeling

restless, being unable to focus.

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Jittery, that being driven by a motor can

also be a symptom of an anxiety disorder.

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Second mood disorders.

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This is a big one.

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People with ADHD are three times more

likely to experience adult depression.

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But you can get a feeling

of ADHD like behavior.

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And be experiencing depression.

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Because depression affects our

attention our focus our energy.

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And there's a really strong

body of evidence that especially

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women with ADHD are often given

a diagnosis of bipolar disorder.

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First.

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Another thing that travels with ADHD,

but can also lead to symptoms that

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look like ADHD are sleep disorders.

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If you snore really heavily, you may find

that during the day you cannot focus.

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Your energy is down, but your

attention is all over the place.

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And you're grabbing.

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You're grabbing energy, rich snacks

and things to try and boost your focus.

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Sometimes learning difficulties

can look like ADHD.

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Sometimes academic

difficulties look like ADHD.

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For example, dyslexia.

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Even dysgraphia.

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But the learning difficulties that

we experienced can occur with ADHD.

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So it's really important if you

or your child has a diagnosis

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of dyslexia or you suspect it.

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Please ask for them to check

that there's not ADHD as well.

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A significant percentage of people

with dyslexia also have ADHD.

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And vice versa,

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and finally substance abuse.

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Whether that is something that's

illegal or something that is

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legal, but very not good for you.

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You can end up having difficulty focusing.

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You can become jittery, you can

become anxious and unable to focus.

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So there is a pool of conditions

that look like ADHD, but are not.

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But can sometimes occur with ADHD and

especially in the last one, we know

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that untreated adults with ADHD have

a higher likelihood of abusing either.

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Illegal substances or legal

ones like alcohol or, overeating

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to try and manage how we feel.

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What is different about the ADHD brain?

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First of all the structure and

function is different and ADHD.

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Things like our neuro-transmitters

that dopamine and norepinephrine are

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different in ADHD because our dopamine

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transporter cells are more efficient.

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And so the dopamine doesn't get to

fulfill its job before it's removed.

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There are something like 500 genes

that we believe are involved with ADHD.

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And it's a group of them altogether

functioning that creates the

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difference in your brain structure.

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And although a lot of these neurological

features that lead to executive

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function problems can be shared

with other neurological conditions.

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That are some specific ones

that are more common in ADHD.

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For example.

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The cortical, maturation in ADHD.

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Which means.

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How mature is your brain cortex?

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Is it the age appropriate

level of development?

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It's delayed in ADHD.

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And that ties in with what we believe.

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Is a three to five-year

lag in academic and social

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development for people with ADHD.

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We do eventually catch up, but it's

one of the reasons why people with ADHD

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often appear younger than their cohort.

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With autism, which quite often

overlaps with ADHD, you might

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expect to find areas where the

brain has peaked almost too soon.

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But then it plateaus.

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And just briefly, I want to cover.

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How you're diagnosed.

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This is something that comes up polo.

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Hello.

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How do you get diagnosed with ADHD?

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So looking briefly at the UK.

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You would, first of all, approach

your GP, your general practice doctor.

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Who would then make a referral

to a specialist clinic.

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there is a huge backlog in the

UK that are some parts of the UK

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where adults are no longer being

allowed to go for an NHS diagnosis.

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That is a huge problem because

of the effect on our life,

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which we'll talk about next.

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But it means that there's a level of

safety in terms of diagnosis, because you

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do have to see someone who is qualified.

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They use the NICE guidelines,

which are set out in a link that

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I will include in the show notes.

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They also want to know about your history.

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If you're an adult, they're going to want

some evidence from before the age of 12.

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If you're a young person they're

going to want school reports, they

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may send a form to your school

to fill in or your university.

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But in the states, there is quite a

big difference and a lot of variety.

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So in the states, again, you

might want to see a psychologist.

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Psychiatrist, they will

use the DSM five criteria.

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They might include neuro-psychological

testing deal include rating

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scales and things like that.

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And again, one of the problems

is access to diagnosis.

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By qualified individuals and both

countries, there is a real problem.

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And it's not helped by the kind of

populist media saying that everybody

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has ADHD and people claiming

that it's not holding them back.

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If it's not holding you back.

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Fantastic.

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But there are thousands and millions of

us where it is a real barrier to success.

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And I don't just mean academic success.

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Friendships.

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Relationships, your working life.

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Yeah.

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Quality of life, how you see

and relate to other people.

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So what's the real impact

of ADHD on daily life.

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In a way it's incredibly

personal and I can't standardize

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what other people experience.

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I'm going to share my story when I

was a kid, I was intensely dreaming.

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And I would go off for hours and

entertain myself in my own head.

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In school, I was described

as having a butterfly mind.

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And if I was any more laid

back, I'd be horizontal.

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In fact, my brain was running a

million miles an hour, but not in

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any direction that was relevant.

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Outside of school.

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I went to dance classes four nights

a week or all day on Saturday.

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So physically I was very active.

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And I remember as a child, my granddad

telling me to go and play outside because

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I was jumping up and down constantly.

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And frankly, driving him up the wall.

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After dropping at university in my early

twenties, because I could not cope.

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I didn't have the scaffolding in

place to manage a way from my.

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We from my home.

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I went back in my mid twenties

and then it went on to do a PhD

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and the PhD was frankly torture.

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I'd come out of a really

highly structured degree.

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MA Honours where I got first class award.

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And then the PhD and there was nothing.

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I was left in this limbo and that's when I

first experienced the jaded ADHD paralysis

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or a narrow HSA where, you've got stuff

to do and you just can't get started.

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And it wasn't because they

didn't know what to do.

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And it wasn't because I didn't care.

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And I wasn't interested.

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I just had no idea where to start.

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And one of the things I ended up

doing was looking for dopamine.

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Through food.

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And it's something that I still

struggle with to this day.

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Even with medication it's something I

have to be really intentional about.

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And with stress it's one

of the first areas to go.

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And that's because my dopamine

was way below where it needed to

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be for me to actually engage and

ignite and start doing things.

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At the same time, I've also

experienced intense hyper-focus.

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And one of the things that I

used to do was really get into a

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subject, learn everything about

it and then drop it completely.

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And that includes everything from.

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Medieval music and fashion.

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Victorian corsetry to.

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Medical herbalism, doll

making, you name it?

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I have done it.

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And I've got the evidence

in my cupboard to prove it.

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I became incredibly.

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Absorbed in a subject and it would be

like an inch wide, but a mile deep.

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And then we'd have this period

of intense passion and interest

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followed by a complete, inability

to even look at this thing again.

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And frankly, that was embarrassing

and it was exhausting.

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Because as an adult, I thought, oh, this

means I need to turn it into a business.

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And many of you will have lots

of domain names registered

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for these ideas that you have.

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Looking at sports people, Michelle

Carter, as a U S Olympian.

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And she found it when she took

ADHD medication, she was focusing

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too much on the everyday tasks

and her training suffered.

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So she chose not to be medicated.

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And what she says is that, although

our learning disabilities and our

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problems don't go away, we can

adapt and learn how to manage them.

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And that is where things like

coaching CBT, therapy come in.

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And importantly, she says you can do it.

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But do it differently.

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And one person I didn't realize

was ADHD is Trudi styler.

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Now you might know her as wife of Mr.

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Sting from the police, that she's a

really successful actress and filmmaker.

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And she had ADHD and it showed up

in her childhood when she had real

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trouble learning to read in school.

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Her passion for acting a led to completely

transform how she engaged with life.

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:

And she ended up going

on to direct many films.

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She went on to appear in many movies

and produce lots of TV and films.

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Physically she uses

yoga to help her focus.

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And that is a really fantastic

modality if you're able, and there

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are lots of kinds of yoga you can use.

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She describes it as clearing the traffic.

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That goes on in our chaotic

minds, which I adore.

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But when she needs to read scripts

and learn them, she finds that

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the medication helps her to focus.

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She says, when you're a kid, you want

to be normal and you obsess about it.

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but as you get older.

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It's not such a big thing.

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She says, celebrate who you are and

listen for that small voice that is going

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to nudge you in the right direction.

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And these are just three stories

about how ADHD can present very

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differently in three different women.

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All of whom manage ADHD

in a different way.

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I'm going to finish with letting

you know about something really

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special that I've just produced and

it's going to make a difference.

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I hope.

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It's a guide for you to work out,

which presentation of ADHD you have,

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and that's the topic of the next

podcast, understanding the different

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:

presentations and then how to manage

your particular combination of them.

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:

It describes or inattentive.

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:

Hyperactive and combined ADHD

are how you can understand them.

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:

And it's got an assessment

guide that you can complete.

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:

So you know where you are because at

least in the UK It's not always common

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for you to be told, which kind of

ADHD you have and strictly speaking.

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:

they vary.

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I know that Dr.

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Barkley has said that we

all have aspects of them.

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:

And even with inattentive ADHD our

hyperactivity can be internalized.

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:

So these aren't silos that you go

off into they crossover and there's a

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common thread of which is our brain.

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I'm inviting you to download the guide

to the different presentations of ADHD.

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:

And when you do, you will get a

discount code for the ebook, which is

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:

coming at the end of January, which

is a much more in-depth look at ADHD.

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:

And also accompanies a webinar

where we can sit, talk and discuss

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ADHD, how it's showing up for

you and what you can do about it.

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And we're going to say, is there such

a thing as boy, ADHD and girl ADHD?

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The short answer is no, but we

will get into that next week.

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So use the link below to sign

up and get your own quiz.

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:

Understand your presentation and

get a discount for the ebook.

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:

That's it for our episode.

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And I hope that the differential

diagnosis, where we looked at, what

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can look like ADHD and occur with

ADHD, but is not ADHD was useful.

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And that you're interested

in the presentation quiz.

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:

And the Ebook and webinar.

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We also looked at some of the

really common myths of ADHD.

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And I hope you understand though, that

they are exactly that make believe.

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If you enjoyed my story of how

ADHD completely threw me off

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course, a in my teens, twenties

and thirties, stick around.

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:

It's so wonderful to have you

with me, as we explore ADHD.

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:

Maybe you knew somebody in your life

who needs to understand ADHD more.

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:

And this podcast is something

that you can share with them.

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I'll be back next week, where we look

at ADHD presentations and I explore

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a bit more about the quiz that you

can download from the link below.

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:

Until we come back next week,

keep learning, keep exploring,

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keep being compassionate.

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And most of all,

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Think about what's possible.

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Not what you can't do.

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:

But what is possible?

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:

And explore things from a different angle.

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:

Thank you for listening to

ADHD, powerful possibilities.

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:

I'm going to see you next week, and

please get in touch with your questions.

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:

Thank you for joining us today on

Powerful Possibilities, Navigating

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:

ADHD from New Diagnosis and Beyond.

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. If you found value in this episode,

please subscribe and share it with

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:

someone else you know who might benefit

or who you want to understand you better.

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:

Remember, your journey with ADHD

is an ongoing journey of growth.

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:

But you're not alone anymore.

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:

Until next time, this is Catherine,

reminding you that with the

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right guidance, the possibilities

really are powerful and endless.

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:

Take care.

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