My ADHD and Me (Neuro-Spicy Month)

It's Neuro-Spicy Month here at Rethink Your Rules!

Jenny's gearing up to present about ADHD at a CME about neurodiversity next month. So it seems like the perfect time to revisit some prior RYR episodes about ADHD. (Especially since they are the most downloaded episodes ever!)

This week, hear how Jenny's later-in-life ADHD diagnosis allowed her to view her past in an entirely new light. She shares openly about some struggles and failures that, in retrospect, were likely due to ADHD.

Does this sound like you - or someone you love? Could it be undiagnosed ADHD?

Mentioned in this Episode:
Neurodiversity: A Conference About People Who Think Differently
Click HERE to register for this free virtual CME event, where you can hear Jenny speak, along with other physician experts in neurodiversity.

Adult ADHD: Resources for Physicians
Jenny's favorite evidence-based resources & simple ADHD self-assessments, curated for physicians.

Focus@will
Jenny's Favorite Music App for Focus (Not an affiliate link)

_________
Need help applying this to your life? Ready for more strategies like this, but personalized to YOU? Set up your free consult and let’s talk about your unique situation and how coaching can help:
https://getcoached.jennyhobbsmd.com/consult
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Everything on this podcast and website is for informational purposes only and should not be used as medical advice. Views are our own, and do not necessarily represent those of our past or present employers or colleagues.

Transcript

Kevin: 0:09

Welcome to Rethink your Rules with Jenny Hobbs MD. A fresh perspective on relationships, success and happiness for high achieving moms.

Jenny: 0:19

This week, I am actually going to be revisiting a topic that is near and dear to my heart, which is ADHD, and even more specifically, thinking about ADHD in women and physicians and in myself and my own journey, and I wanted to bring this topic up again now for a couple of reasons. A few reasons. The first one is that this is one of the most popular episodes when I look back at the downloads of my podcast. And the second reason is that there's some new faces here and you may not even realize that these episodes are buried there that have some really good information about ADHD. And the third reason, and maybe the most exciting, is that I'm actually in the middle of preparing for a really exciting conference where I will be speaking about ADHD in physicians, and I want to be sure that you know about this conference because, although it is a continuing medical education conference that is put on by physicians, and much of the target is physicians and those who work with physicians in the workplace, the conference is actually open to the general public, so anyone is welcome to listen in and, in fact, the topics are very relevant really to anyone who wants to learn more about neurodiversity. So I thought this is a great opportunity to bring back one of the most popular podcasts that I've had and make sure that you have an opportunity to hear it, if you haven't already, and then to also consider joining us for this really cool opportunity to get more information and go even more in depth on this topic. So before I replay the episode in mind, I do want to tell you a bit about this conference. It's kind of unique and kind of cool. It's actually called Neurodiversity a conference about people who think differently, and not only will there be talks on ADHD, like mine, but there also will be talks about autism spectrum disorder and other forms of neurodiversity, and it's a really cool group of physicians, many of whom are neurodiverse themselves, talking about ways that we can work with our neurodiversity strategies for sleep and procrastination and sensory overwhelm and things like that, and then also talking about how we can help our patients who may be neurodiverse. So it's really a very cool eclectic group of people with a lot of practical insight and personal experience.

Jenny: 2:46

And it's entirely virtual and it is actually free. So if you want to show up and watch the CME live from anywhere virtually, you can do that for free and you don't have to be a physician. Now, if you are a physician or someone in the medical field, you can actually apply for CME credits and things like that. It's a truly legit medical education conference and I know for me, the topics that I'm going to be sharing about are things I do speak at when I go to conferences that cost a lot more money than this, and people are there in person, right, and physicians are getting CME credits for it. So it's literally the same content that we would be providing at that type of conference, but it's in a format that is really fun and easily accessible for anyone to attend. So it's a really cool opportunity.

Jenny: 3:32

I'm so grateful that they asked me to be a part of this and I'll just give you the dates so that you're aware of when it's happening. It's going to be this coming June 5th through 7th 2024. And the time is in the evenings, so it can work really nicely around any schedule and, don't worry, I'll put a link in the show notes and everything if you want to check out more about it or register. But again, it's completely free and each evening there's going to be a few speakers and if you decide that you want to have recordings of those speaker talks or if you want to be able to attend a coffee chat with all of us the Saturday afterwards, you really get to know everyone better and explore this in more depth. You can always upgrade to that sort of VIP option.

Jenny: 4:11

That does cost some money, but assuming that you just want to come and get some great information and think more about how you can handle neurodiversity, maybe in yourself or your patients, if you're a clinician of some kind or if you're someone who works with physicians, you know if you're a clinician of some kind or if you're someone who works with physicians, you know. If you're in leadership working with physicians, this is a really great opportunity to get some insight into. You know, when someone's behaving in a certain way that maybe seems problematic or pathologic or frustrating, whether or not there might be an element of neurodiversity there that you would want to be aware of as their employer or someone working in physician leadership. So it's going to be a lot of fun. Again, it's June 5th through 7th 2024, and that's next month, and I'm going to put in the show notes a link that will take you directly to where you can register for that, and that actually is a an affiliate link for me. So I just want to disclose that that will actually offer me, you know kind of credit for you signing up, and if you end up purchasing the VIP thing, I would get a small amount of money for that. If you don't feel comfortable with that for any reason, you'll also be able to find, you know, the conference page and you can just sign up directly there. That's no problem.

Jenny: 5:13

The other thing I will put in the show notes is a link to my resources on ADHD which goes directly to my page and that will provide you a nice free download with lots of information to explore as well. So two different types of links you'll find in the show notes. One is going to be about this really awesome conference called Neurodiversity, a conference about people who think differently, coming up next month in June 2024. And the second link that you are going to see there is a link to my ADHD resources which you can obtain as a free download, and of course, there'll be all the info there to contact and reach out to me if you have any questions. And with that I am going to replay one of my most popular episodes, all about ADHD. So take a listen and I hope that you have as much fun exploring this as I do sharing it. Hey, there it's, jenny. Welcome back to another episode of Rethink your Rules.

Jenny: 6:02

Today is going to be a story podcast. People always love the story podcast. Today is going to be entitled my ADHD and Me, and it's going to be my life story. But don't worry, don't click away, I'm not going to make it super long and complicated and detailed, or at least I'm not going to try. I'm going to try not to.

Jenny: 6:26

What I want to talk about is looking at some experiences throughout my life, as I see them now, through the lens of my later in life ADHD diagnosis. Having this later in life diagnosis has really led me to look back at things that I thought were, you know, things to be ashamed of, or character flaws, or had completely misinterpreted in my life, and now I'm really realizing that likely they were signs of my ADHD. And I think that by putting myself out there and being vulnerable which is not easy, because I don't want you to think I'm a terrible person, as I share some of these things, but by putting myself out there, I hope that I can give you a gift too, because if you relate to this, maybe you do need to consider. If you have undiagnosed ADHD I suspect you do. If you're listening and you highly relate to me and even if not, maybe you can think of things you can look back on in your life with the same degree of like okay, I was doing the best I could with the resources I had at the time and you can use this as a model to really love and accept yourself and grow from there and recognize just like I have with my ADHD this is what I was doing at the time. This and recognize just like I have with my ADHD. This is what I was doing at the time. This is why this was challenging for me. I did the best I could and I'm going to love and accept and forgive myself for that and move forward from that place and try to improve right from that positive place versus a shameful, self-critical place, which is a work in progress. But I really do believe it's a gift.

Jenny: 7:44

And the other reason I want to talk about this too is that some of the symptoms of ADHD that you're going to hear about can overlap with things like PTSD, which I have been also diagnosed with, burnout and even perimenopause. So when you're in your 40s and 50s, as a woman, you can start having some of these symptoms which overlap a lot with ADHD, and so if you do resonate with any of this, you know, consider those things as well and consider, you know, evaluating those for various treatments and with therapists, et cetera. But all of those things so ADHD, ptsd, burnout, heading into perimenopause if you're experiencing these types of problematic symptoms from any of those reasons, the coaching that I do helps a lot, right, and it's actually probably the most beneficial thing. So, if you're resonating with any of this, these are the things that we can work on and we can do something about with coaching, even if it's not like a clear-cut diagnosis, as it is for some people. So I hope you enjoy this and, if nothing else, maybe it'll be entertaining and you can feel free, as always, to share this with people you know in your life who have maybe wondered this same thing about themselves.

Jenny: 8:50

So if we kind of think back to when I was a very young child, so my toddler years, the kind of family dynamic was that I was a troublemaker. I was always in trouble. My parents talk about how I was very, very smart and they felt like I was constantly outsmarting them. And I'll give you a few examples. I wanted to type on the typewriter that my mom was using one day, and so when she went out to the garage to change the laundry, I locked the door and wouldn't let her back in. And I was just sitting there typing.

Jenny: 9:22

And so if you think back to some of the episodes I've done about ADHD, right, that impulse control, that desire for that fun dopamine hit, and I'm going to do it, even if the consequences are bad later. I'm going to give into that impulse in the moment, right. I also one day was supposed to be taking a nap in my crib and my dad was outside mowing the lawn and he looks up. And I've apparently figured out how to like climb myself out of this high crib and I'm running around the house jumping on the couches. And then, when I was three or four, I was supposed to be taking a nap at my babysitter's house and I didn't want to. So I was jumping on the bed and actually fell and chipped like broke my front tooth on the headboard of the bed that I was sleeping on and actually was my baby tooth, and it was discolored. And it actually remained like a discolored, injured, dead baby tooth for a couple years until I lost the tooth.

Jenny: 10:18

So you can kind of see like this whole perspective of actually it was probably a very hyperactive kid, right, but no one was like she has ADHD, not in the 70s as a girl, right. It was more like in my hyper-religious family. It was just more like I was behaving badly, right, and I would also, you know, obviously throw lots of temper tantrums if I was told not to do something that I wanted to do. I remember I was like five years old and some boy in the Sunday school with me. We thought it'd be fun to like kiss each other and see what that was about. So we like had big trouble for kissing under the table. You know, it's just all that like impulsivity and spontaneity and doing what's fun versus what you're supposed to be doing, not being able to sit still and be quiet and respectful at church.

Jenny: 11:03

I also learned to read at a very early age, like three or four, and so this gets into like hyper-focusing. So I was really interested in reading and I figured it out and made the connections in a very unique way, which is again an ADHD thing. And then I became obsessed with reading and so I would read constantly from the time I was three or four and I got very, very good at reading. This is like this ADHD hyper-focus thing, um, like they ended up having me skip a grade and read to other classes and all this stuff. But what was also interesting is I would carry my book around everywhere I went. I did not want to be without a book, right, because again, when you have ADHD, you don't ever want to be bored and I was very sensitive to that, so I always had my book so I could escape, right.

Jenny: 11:43

And the other thing about reading as I got older and looking back now, I've always preferred reading to, say, watching a movie or something like that, because for me, when I'm reading a book, I can be 100% focused in and engaged, and it's one of the few times that I can shut out the whole world. If I'm watching TV, it's far too easy for me to like multitask with something in my hand or get distracted and miss something and come back to it. But in order to really be in a story, you have to be reading it and visualizing it. It takes my whole brain. I can't multitask reading, and so I've noticed that for me, I really need that in order to completely shut my brain off, more than other people.

Jenny: 12:21

The other thing about reading that's interesting is, as I would read, I would often skip, like if there was a big paragraph where someone was describing the color of the trees or the house or the dirt road or whatever, I would just skip all that and go to the action, what people were doing, what people were saying, because I just get so bored with that whole big chunk of text, right? So even though I loved reading, I did not want to sit there and visualize some tree blowing around. I wanted to get to something interesting and new and novel, right. As I've gotten older, I've learned a little bit more to appreciate it, but it has to be a very, very good reader for me to want to read the descriptions. I remember distinctly when I was in college I read a book by Barbara Kingsolver and it was the first time where I was like, oh, I actually enjoy the way she's describing these descriptive paragraphs she does, but it's very rare still for me to find something like that and I get bored and I just skip ahead.

Jenny: 13:11

The other thing that I used to do I would walk around with my book and I would always have like a cup of ice and I'd be crunching on ice cubes and reading my book and my mom thought something's wrong with me. She took me to the doctor. There's all these people talk about different iron deficiencies or whatever. Nothing was wrong and now, as I've gotten older, I've learned that part of ADHD is what they call body-focused repetitive behavior. So playing with your hair, biting your nails, crunching on ice would be an example. It's very stimulating and actually, in retrospect, my parents tell me from the time I was a little baby I was playing with my curls arm up still to this day. Incredibly hard for me not to do that and I also did. And so that ice crunching, oh. And then I bit my nails all the time when I was a little girl. I've gotten lots of trouble for that as well. And then I also, as I went into school, was the kid who was always talking to my friends, getting in trouble for talking after class was starting.

Jenny: 14:13

I was very verbally impulsive, so you know, if I got mad at someone I was easily frustrated, had this big emotional dysregulation that I've talked about a lot with ADHD, and my kids have this too and I would literally I would name, call people like terrible names or swear words or you know, one time I used a racial slur I didn't even know the meaning of on someone, because they made me mad in line at school and I, you know again, like I don't. These are not things that I would ever, ever do, even a few years older than that, but I think I was probably like eight or nine when I did a lot of these things and there was so much shame and regret afterward. But in the moment I just had such a hard time holding myself back and these things would pop in my head and they would just be out of my mouth before I would realize it. Top of my head and they would just be out of my mouth before I would realize it. I also was this kid who if I wasn't interested in something or I didn't see value in it, I just would not do it.

Jenny: 15:06

I was obviously quite good at school but I didn't like art and I thought it was kind of pointless and I wasn't good at it. And I remember in fourth grade my parents went to parent teacher conferences and they were like, well, here's Jenny's art drawer. And it was completely bare because I just was like I'm not doing this and I did totally fine in everything else, but I would not do my art. It just wouldn't happen. And this is a big thing with ADHD that I think I've mentioned before, where the ADHD brain is motivated differently. So the ADHD brain is motivated by things that it finds interesting, novel, urgent, exciting, whatever. The ADHD brain is not motivated by rewards as much as other brains, so it's not like oh, I know that if I do this, then down the line I will get a better grade, or my teacher will like me better, or my parents will be happy, right. Like the ADHD brain needs, like an immediate, like reward or punishment that's really big, or an urgency to it, or like they have to care about it, right. And I just could not make myself care about that.

Jenny: 16:10

And that came up a number of times, I think throughout my life I've had a number of authority figures who thought that I didn't respect them or wasn't listening to them or was frustrated with my sort of last-minute approach, or they would think something was important and I couldn't really act like it was important to me. And I still am not entirely sure all the reasons for that. But my theory is that, again, if I feel like something is boring or not important, it is physically nearly impossible for me to pretend that I think it's important or to think, okay, if I, you know, charm this teacher and really look at them and tell them how great and amazing this thing that they care about is. You know, like for lack of a better word like sucking up, like I'm just terrible at sucking up and I, I think again, I don't know because these people never told me why they didn't like me most of them, but I would come across people where I think I just wasn't able to give them this sense of like I'm looking at you, I'm fascinated about what you're saying. It's so interesting. Like in my brain it's like, if I'm bored of this, if I especially, you know, I think it overlapped with being fairly gifted, and if any of you have gifted kids, you know what I mean Like often my brain was already like multiple steps ahead of what was happening, and so a teacher would be explaining something and it was hard for me to sit there and be interested in it, because I was like, yeah, I know, like let's get to something that I actually don't know.

Jenny: 17:35

Right, and this was just a very like socially, came across as very disrespectful, which wasn't my intent. I just was like, okay, I'm bored, I'm looking out the window, I'm thinking about something else, and probably I was also restless in my chair and playing with my hair and you know all those things, and then turning in my assignments late or at the very last minute talking to my friends instead of working on it and then scrambling at the last minute, right, I think all of those things in retrospect likely did come across to teachers, like I had an attitude problem which you know I was probably so oblivious to at that point. Right, and it's interesting, went through the process of getting this diagnosis. I had to do a little interview with my parents and send all that into the diagnostic, the person doing the diagnostics, because they really want to know if ADHD symptoms start in childhood. And I remember my mom said you know she's like now looking back, I remember that you know she admitted that she herself had a hard time with me and the way I talked to her sometimes. And then she noticed like certain teachers, like every year or two I would have a teacher that just really disliked me and then others were completely fine and had no problem with me and she's like you know, in retrospect, I think what it really was was not that you had a problem with those teachers or with authority. It's just that, like some people had a problem with you and the way you were doing things. And then she said it occurred to me that we could have chosen to respond differently to you being you right, and I thought that was really insightful and wise for my mom to say that, because I think that is exactly a great way to describe responding to a child or another person who is neurodiverse. Describe responding to a child or another person who is neurodiverse right. It wasn't so much like I was the problem. It was like they had a problem with how I was, and that's, of course, a whole longer theoretical conversation about how we handle that. In a world that's built around neurotypical people and neurodiverse people have to figure out a way to be successful. But I thought that was really insightful, particularly because at that point my mom didn't really even know that they were considering neurodiversity as a diagnosis. It wasn't something she knew about, but I think that is a really good way to describe it.

Jenny: 19:46

The other thing that I look back on that is so funny to me was I would never, still to this day. This is true. I never do a test in order, and so if I'm looking at pages of questions even one page of questions I physically cannot just go down the list and do them one at a time in order. I have to skip around. And I've always joked about this with my friends because I have always presented to most people as being very organized and I'll talk about that in a minute, why that is. But so we would joke about how, even though I'm so organized, I would tell them like I'm supposed to be, like so linear and organized and perfectionistic, but like I cannot do a test in order. So I just need the I don't know I needed like the stimulation or the variety or something of jumping around. And you know I was lucky enough to do fairly well in school despite that. But I also can remember a couple of times where you know I think I probably missed some questions, because it's so hard for me to go back and check my work. It just feels incredibly boring.

Jenny: 20:46

I remember one time I was in a spelling bee and I'm a really good speller, but I need to be able to write it down and look at it and see it. And I remember I was asked to spell the word verbally. It was a spelling bee in the mall. I was standing there and the word was breathe and I know how to spell the word breathe, I knew it at the time. But I said you know B-R-E-A-T-H. And then I didn't say the E and I just kind of like did it. I kind of like rushed through it, said it and then I realized I'd forgotten the E. But I was like impulsive and spontaneous and I, you know I didn't go very far in the spelling bee, but it really in retrospect was probably my inability to like slow down and focus and like double check in my mind that I had it right. And I wonder sometimes how many other things I missed like that throughout life because of that.

Jenny: 21:33

Some other things that came up as I headed through childhood and into my teen years was this emotional eating and so I tended to have these big emotions. And then one of the things about ADHD is we're kind of impulsive and on that search for the dopamine hit of something sweet or sugary, right. So that was very tempting to me. And something I would always think was kind of strange about myself was if I was home alone so my family was gone for some reason and there was quiet I would immediately have to go, like eat some peanut butter out of the jar or something like that. And I realized in retrospect now, I think, what it was was.

Jenny: 22:07

I am very sensitive to being bored, I hate being bored, and I think I was kind of bored and alone and so I immediately needed some kind of stimulation from going and eating something. I think there was probably an element too of being free from my family and everything and wanting to do that. But I think really it was this feeling of boredom and I'm still that way. If I'm trying to do work, I do much better if I'm in a coffee shop with other people around or with a friend next to me, even if we're not talking, but like the presence of another person is just enough stimulation for me to not get totally bored and distracted. And if I'm at home and I'm not able to do that, then I might look for other things, like I might have to play some kind of stimulating music, no-transcript. And one of the things I just recently discovered was really interesting was for me, if I need to do some work.

Jenny: 23:18

I can't listen to the type of music that most people listen to to work, like this music with no words, that's very slow, and like zen, I don't know what. Do they call it, the blue noise or anyway, whatever it is. Or classical music oh my gosh, like it's actually distracting to me to have boring music playing. So most of the time what I do when I'm working is I will listen to kind of like something fun, like hip hop or something, and it seems bizarre, but I actually like enjoy having those words that I know that I can sing along to while I'm working. It makes it fun for me, and just recently I discovered this really cool app.

Jenny: 23:48

It's called Focus at Will at symbol and it is paid after a free trial. So you know your mileage may be you mileage. You can decide if it's worth it for you, but for me it was totally worth it because it's actually designed. It's music designed to help people with ADHD focus and they have different channels on there and what they've discovered is people with ADHD need a little bit more stimulation from their background music than other people and so they have options in there for different amounts of beats and things like that and you can actually find what fits for you. And so I'm kind of on the higher end of their options.

Jenny: 24:23

There's one in there that's just absolutely perfect and when I turn that on I can focus. It's just the right amount to drown out the distraction and the voice not the voices in my head, like I'm a crazy person, right, but like that running kind of thought that you have when you always have a lot of things in your mind that are hard to turn off. And the crazy thing is there's even people, apparently, who are even more significantly this way than I am and they literally have music in there that's like the most jarring loud, like screeching sounds. And he said there's a small percentage of people that are on this app, that that's the only way they can get any work done. And so in retrospect I realized that that was what was going on with me and kind of along the lines of that sort of running set of thoughts in our mind. Again, this is not to make myself sound crazy. This is actually something that they've shown is we all have sort of a part of our brain that is operating in kind of the background of life, and then most of us, most neurotypical people can turn that off and then really focus a different part of their brain on a task. But for people with ADHD, the background noise part doesn't turn off as well when you're doing a task.

Jenny: 25:30

And kind of somewhat related to this is the concept of hyperactivity. In women with ADHD, it tends to be more of hyperactivity of thoughts or verbal right, and so I talked about how I often was talking a lot with friends in class and getting in trouble after class started for that. But I also had this sort of mental hyperactivity where I always have lots of thoughts going on and in fact when we were dating Kevin and I, you know, at various times I'd ask him what he was thinking and he would sometimes be like nothing and I would tell him what are you talking about? Like I, literally, if you ever ask me any time of the day, like you wake me up in the middle of the night, I will always have something I'm thinking, like my brain is never just not thinking. There's a constant inner dialogue and I thought it was just like oh, some people are like that, some people aren't. But I've realized now that that's actually most likely was a symptom of my ADHD, where I just always have lots of thoughts going on at any given time and I have a harder time slowing those down. Let's see, I'm checking my list here.

Jenny: 26:30

The other thing that came up as I headed into college high school, college and then into medical school too was and this is one of the most common things just this intense procrastination. So I would literally have fun with my friends for weeks and then I would have to study all night long for a test, right, and I would just always cram everything in the last possible minute. I would get everything done like really quickly get a good grade, crash, repeat, and I used to work so hard during finals week and things like that and then come home and crash on my Christmas break at home and literally like get sick and just veg and do absolutely nothing. And I used to joke with people and I actually kind of liked that, how I actually liked that. I was like I like this, I like to be all or nothing, I like to be like really intensely involved in school and like cramming and all the things and get it done. And then just I would be on the couch and literally was going to not move for two weeks and could like the thought of even picking up a phone to call a friend was too much. And again, in retrospect I think that all or nothing is still kind of fundamental to my nature. I really like that. It's like why, like shift work in the hospital, I like to go in see patients, be there when they're intense and they're really sick and they need me, and everything has to be done right now and it's all encompassing, and then I want to clean it all up and go home and do absolutely nothing, right. And so again, that all or nothing personality style was something I just thought was like and honestly, in our capitalist society where people really praise consistency and having routines and everything, I think I thought often that that was a problem, that I should be more consistent, right, I started really buying into this idea rather than just going with the fact that, like, that's the way I work best is with that sort of dopamine rush at the moment when things are due and then having the really lots of space to do nothing, because it takes so much activation energy for me to overcome that.

Jenny: 28:16

Some other things that came up as I went into college and medical school was my difficulty with being late, as I've talked about before and I remember I would. I said to one of my friends in med school a comment about how I'm always late and she was like she's like, jenny, you're not late, you're just two minutes late. You're always two minutes late. And I was like it's so true, I'm not, I just would always not leave myself just quite enough time to get there, you know, early. It was always two minutes late and I would also have difficulty even.

Jenny: 28:49

I remember once I was going to a job interview or something and I thought I left myself enough time but there was a bunch of traffic and I was late. And then I did that job and I thought I would do a great job of it, but it required a lot of really boring time. It was like working with Drosophila flies lab, for those of you that know that, and you have to like move them to clean containers and I had such a hard time getting myself down there to do that job, working by myself. It was very boring and you know this is a great example of like the benefits of getting a good reference and working in this field when I wanted to become a doctor. It would have been immense, it would have been so good for me, right, but I couldn't overcome my boredom and like lack of interest in doing that task, even when I reminded myself that it was important for all these really good reasons that I understood intellectually right and I did not do well at that job and I left under kind of sad circumstances where they were really disappointed in me and I was so ashamed and I thought I'll just, you know, I'm never going to be successful.

Jenny: 29:45

And as I went into college, I have to say there were several you know professors. Again, it was kind of like what it was when I was in grade school There'd be totally fine and then every once in a while there'd just be a professor that just for whatever reason, didn't like me and they would sabotage me, right. Like they would go to the person who was in charge of letting us into med schools and say I don't think she's not a good person Because of, like, if I turned in an assignment late or they. I think again, I had friends who didn't do as well academically as me, but they were much better at sort of sucking up to the teacher or showing a lot of interest and like put a lot of interest into like making that person feel good, and I was just really bad at doing that and, as I've learned throughout my life, there are certain people who need a lot of that overt attention display, of making them feel like they're interesting and smart and fascinating. And I think for again, I don't know if this is all my ADHD, but I have a hard, I tend to have a hard time giving those people enough of those things. I think I'm just like a little bit too abrupt and I think probably some of my body language or something makes them and the fact that I turn things in late makes them think I don't care, I'm not interested, which, if you know anything about ADHD, it's actually not true. It's just that that's this weird way that my brain works. Even when I care about something I'm interested in, I don't do it on time, right, but so I would. Really.

Jenny: 31:07

I had a lot of people who I felt very misunderstood and sort of blindsided because of how viscerally they would respond to me and I didn't understand why and it really held me back a lot in trying to get ahead. And I actually remember one of my med school reference letters for residency my advisor, who's amazing and really understood me really well and I remember he wrote in there when I saw it said that I was not obsequious, which I had to look that word up, but it basically means not good at kissing up, and therefore her evaluations probably are an under-representation of how good she is at her work, and I think that's followed me through my entire career, which is that I have never been so good at playing the game and doing those things and I think my evaluations and, you know, likability have always suffered as a result, and I've only just now beginning to fully understand that and try to mitigate that, now beginning to fully understand that and try to mitigate that. Another thing that came up throughout these times was this problem with rejection sensitivity. So you know we've talked about with ADHD. You have this rejection sensitive dysphoria. That's really strong, and so what would happen is probably with good reason, I would, you know, would be impulsive or distracted or late with assignments or not good at showing people that I appreciated them or that I thought they were really smart and amazing teachers or whatever, and then I would get this harsh feedback and I would absolutely be crushed.

Jenny: 32:31

I can remember a few very key moments in my life where I literally cried all night long, eyes puffy all night long, could not stop so devastated. And it's this really tough mix, right? And I would even say to my friends and loved ones, like, do people not think I have feelings, like maybe because I'm just so like, I'm kind of like a direct and abrupt and quick talker, like maybe they think I'm like not also emotional and sensitive? And I think that's a big part of ADHD, right? Is you come across this way that people don't realize is not you trying to be a jerk to them? But actually it's a manifestation of your hurt and vulnerable self that comes out in this really strong way that people are then respond to, and then you just hit the depths of despair and you don't know what to do. Right, because you just hit the depths of despair and you don't know what to do, right, because you don't understand why it's happening and you don't know how to fix it.

Jenny: 33:23

I remember one really specific example of this when I was a medical student I was on my third year rotation, it was surgery. There was a very old school set of residents I was working with and I was presenting on rounds and I had read the nursing notes from the night before about my patient. And so, as I was working with and I was presenting on rounds and I had read the nursing notes from the night before about my patient, and so, as I was presenting, I said, oh, and according to the nursing notes, like this happened, dah, dah, dah and the senior resident made fun of me in front of everyone for reading the nursing notes and I started crying and I literally cried throughout the entire day and through the entire night and the next day I came back to a conference with my classmates and my eyes you know, I just have a terrible puffy face after I've cried like that and I looked absolutely terrible. People were like what is wrong with you? And it was all triggered. I mean, how ridiculous if you think about it, right, like he was totally being an asshole. But I was so wound, so tight, trying to be perfect and avoid any rejection and be successful, and after all those years of being misunderstood and feeling like I never knew what people were going to say and wanting to do all those things, I was just wound so tight and then that one thing, it just crushed me and my emotions were so strong I could not recover and I did that a number of times as a new attending as well, where I would start crying if someone was really mean to me, and you know it would often throw people off. They didn't know what to do with it and I always thought, you know, this is like a problem, so unprofessional makes people uncomfortable and in retrospect it was probably a lot of that was my ADHD. Right Along those lines, I think, and I want to talk more about this in the next ADHD podcast I do, where I talk a lot about ADHD and physicians.

Jenny: 35:02

There's a really great article. I want to go through it with you, but I just want to point out that I think one of the reasons people with ADHD do make great physicians is because of all this right. We are incredibly energetic. We work very hard. When we like something and it's interesting and novel and urgent and challenging, we will be your hardest workers. We will obsess about getting everything right. We are very, very sensitive and empathetic in many ways, right, and I think a lot of that is what makes me such a good doctor. I also can see connections very quickly. I can think things through and assimilate a lot of ideas and explain. I'm really verbal, so it's easy for me to explain things on the fly to my patients. I'm great in a crisis, right?

Jenny: 35:44

So many good things about having ADHD, even though it causes challenges, and I think this is why so many people with ADHD do end up in medicine. It's just that the flip side of that coin is some of this impulsivity and emotionality that people don't understand and the fact that we seem so inconsistent, right. So once we're bored by something and I'll talk more about this in the next one, because this is getting a little long, but after 13 years in my current job, I noticed things that used to be challenging and interesting and urgent for me, that kept me stimulated and hyper-focused. Now they've lost some of that, right, because now it's become routine and so I have to find a way to keep my brain engaged. That's a lot harder than it used to be when it was all new and interesting early on, right, even being a doctor at some point. The amount of challenge and novelty and urgency kind of decreases a bit with experience, right, and we'll talk more about that next week, but I think I wanted to mention it here, too.

Jenny: 36:40

The other thing that I noticed as I headed into adulthood was this problem with talking too fast, talking too loud. So I would sometimes be in like our team room in the hospital and my friend and I would be talking about all these things and like having this really interesting debate. And I remember some of the more neurotypical people. Literally one time this guy was like you guys are too much, I have to leave, like. And I remember feeling really embarrassed, like oh my gosh, like this is my fault, I'm yelling, I'm such a bad person, right. But no, I was like now I'm like, oh wait, we just neurodiverse and that's how we are. Like we're a lot of speeding tickets oh my gosh, like so many. And again, because sometimes I feel like I never did anything unsafe but I do like to get things places quickly, I'm always running late and to me, like speeding a little bit on an empty freeway at 5 o'clock in the morning is not that big of a deal, but obviously the police disagree about that that.

Jenny: 37:34

The other thing I think that comes up a lot for people, physicians and things like that is this ability to do a really good job when your work is really challenging and interesting, like seeing a new, complicated patient, but the minute you have to, you know, fill out a boring form for their insurance, or like you have to submit your project hours for something or whatever. You just cannot do it. And in fact we have a system in my group where, if you do administrative tasks, you record the hours. And so I would record the hours like months and months after I was supposed to, so let's say like a whole year of doing tons of work, and I literally have to go back through my calendar for a year and write down all the hours.

Jenny: 38:15

Now I'm sure you can tell me there are many ways I could have solved this problem for myself. I could have just done it in the moment, I could have had it sitting in front of me, I could record them on my phone, but I just never seemed to be able to get a good system in place and I could never make myself sit down regularly and do it. And so I used to joke with my boss like can I have a project hour? For was like a whole nother hour of my life that I was wasting because I just in the moment could not convince myself to do the really boring, monotonous task of recording those hours or doing the CME thing or, you know, logging the CME or whatever. So these are all just examples of, again, how the ADHD brain is wired, and it's motivated by interest more than sort of a logical reward of what makes the most sense right, and in the interest of time I am going to stop giving examples from work about that because I want to do that whole separate podcast on that, but you get the idea.

Jenny: 39:06

What I do want to make sure I talk about is a couple more things from my personal life as an adult with ADHD that really make a lot of sense.

Jenny: 39:14

I've talked before about how I sometimes get very overwhelmed, and I would say people who are chronically overwhelmed, there's a decent chance that they should look into whether they have ADHD, because it's one of the really prominent symptoms that we have, and the reason for that is we have such a hard time prioritizing and back even going 10 or more years, I would have this problem where I would write this whole list of everything that needed to be done and I would think it has to all be done right now.

Jenny: 39:39

So I was very unrealistic about my time right and I would think it all has to be done perfectly right, because I was worried about doing it wrong and getting rejected and whatever. And it all felt equally important right, because that's an executive function is being able to know what's important and what's not. And I kind of stumbled into a really good way to deal with this, which is I would write down my list and then I would go to my husband and I would say okay, like I'm feeling overwhelmed, I need your help, and my husband is much better at looking through the list and saying Jenny this does not have to be done today.

Jenny: 40:10

This can be done this day and he would literally help me stop thinking everything was equally important. He would help me prioritize and that helped me so much because I just needed that external cue of okay, that's right, that makes sense. I'm not going to say that these things have all gotten completely solved by medication and awareness and therapy and coaching, but I will say it's a lot better. The symptom is a lot better and now that I understand certain times in the month when I may have more difficulty with ADHD symptoms and I can be a little bit more self-accepting when I notice myself in this state, I am less overwhelmed by it because I understand it and I know that it won't last forever and I know that I, you know, I can ask for help and it's nothing to be ashamed of, right, but that has been a defining feature of my life for so long. Another thing that's really kind of interesting about ADHD, at least as it presented in me, is that my whole life I have appeared to be a very organized person. I don't like clutter. I'm always cleaning up clutter, getting things out of sight, out of mind. My room growing up was like the cleanest room in the house. I wanted everything to just be put away, just so, and I would spend hours planning, planning beautiful planners and color coding and planning out my schedule for every minute of the morning routine and all these things, planning ahead, color coding my notes. I always have had a certain place where I put my coat, I put my purse, I put my keys and I always would plan ahead the night before so everything was ready to go and I think that to most people that appeared like I was like very highly. I had really good executive function. But what I'm actually realizing, and I realized as I got diagnosed, was that the fact that I had to put so much effort into organizing and keeping clutter clear and keeping everything in the same place, the fact that that was a non-negotiable thing for me and it created so much anxiety if my systems got messed up was because of my ADHD right, because apparently this is what they tell me. Not knowing other people's brains, tell me if I'm wrong, but apparently a lot of people don't have that same level of concern about keeping everything in the same exact place, because it's more easy for them to just remember where they put it and not to lose it and other people. Having a specific, detailed schedule is maybe less of a big deal because they can naturally sort of prioritize and figure out the time and everything.

Jenny: 42:26

So and I've actually heard this from a few other people I think a lot of people with ADHD are very obsessed with schedules and planners and things like this and organizing, even if we don't always follow them, because it's like our attempt to make sure we don't mess something up, because we know that's our tendency and we've been burned so many times by messing things up. Right, it's almost like that's where this anxiety comes from, and I kind of. My personal theory is like people with ADHD go one of two ways. They either like I can't do any of this, it's too hard, and they just kind of avoid anything that's going to require them to be super organized and all that. You know these are the people that are maybe less professionally successful because they have a hard time in school and they have shame and they just give up. But then I think those of us that are, you know, maybe more gifted or from houses where we were really pushed to succeed and achieve, we go the other way, where we still think we should succeed and so we have to put all these things into place to make sure that our weaknesses don't keep us from success, right, which creates all this anxiety.

Jenny: 43:22

And it actually turns out that a lot of that was most likely leading to an emotional state that was more volatile, more likely to burn out, more likely to come across stressed out and upset with people, when I didn't mean to, because I was trying to overcompensate and make this perfectly organized life. That is never possible, right? And that I mean I'm starting to think now, even it's like maybe not even how I work best, right? Maybe I work better with a little bit less routine and less organization, and you know how do I acknowledge that, while also living in this world, right, that expects a certain amount of that. Or else they think that you're unprofessional and rude and disrespectful, right? So I think that's something to consider is, you know, if you're so obsessed that you're going to kind of like, lose your mind if something's not where you left it, or if, like, any kind of clutter that you see around is stressful to you because you're like, like for me, I walk in a room and I'm like what's that? What's that, what's that? I can't focus because the piles of stuff that my husband has out, right, and one of the things that happens with those with ADHD too is we like my husband's piles because I don't know what they're there for. They're like a trigger for my brain, like what is that? What is that? What is that? Right, but my piles that are there for a reason usually I won't forget, right, because I know if I put it out of sight it'll be out of mind, like my piles are fine. So he's like what's this double standard here? And I'm like, well, no, I know why my pile's there, but like, when your pile's there with no reason, it's just distracting me, you know. And so that inability to turn off noticing everything and stressing about things can often be a sign that you're coping with ADHD. All right, we are heading close to 40 minutes here, my friends, so we will wrap this up with just a couple little quick ones. I want to mention One thing I've recently learned is that people with ADHD are very justice-minded, and so we are, more than other people, very affected by injustice against us or against others.

Jenny: 45:10

And if you'll notice, I think during COVID and with a lot of the racial things that have been going on, the political things have been going on the last few years, you'll notice people with ADHD are very fired up about that. If you're those people you see that are on online posting all the things and like can't let things go, and you know really hard for them to back down when they're sure they're right about something and it just feels wrong and they're fired up and they're angry and they can't. They're not those people. They're like oh well, it'll work out. That is part of having ADHD. We feel things strongly and they don't know all the reasons for it. But there are actually studies about this and people with ADHD are much more affected by injustice and more fired up about fixing it. And again, I think this is one of the things that can make us great, because we get really obsessed with fixing this stuff. We have a lot of energy, we're stubborn, we don't back down, and that's what you need, to be honest, to make really important change in important areas of life. It's just that it also can lead to a lot of exhaustion and burnout if you don't learn how to manage your mind and your emotions and conserve your energy, which is really where for me, as I was in COVID times having a lot of difficulty with all this. I think that's why coaching was so useful for me, because with my undiagnosed ADHD, all of that was just leading to so much difficulty. And now that I learned to manage my mind around all that, I can channel those tendencies that I have from ADHD into better things in a more effective way of advocating for justice Right.

Jenny: 46:32

Another thing that is super common for people with ADHD is that they really like to have new, interesting things, and so another big key for my therapist when she realized I had it was. She was like you are a doctor who's like started a side business a few years ago and starting another side business and doing this and your schedule is like. When I would list my schedule, I'd be like, oh, I forgot, I'm also doing this, I'm also doing this. And she was like that is what people with ADHD do. Right, it's not enough to just have a career and two kids and a husband and all this stuff. It's just everything sounds like a good idea. You say yes to everything. You don't want to wait, you want to do it now, because you're kind of afraid, like, if I don't, you're like well, I need some other kind of stimulation I need to go into leadership or I need to go into teaching or I need to. You know, for me it was like become an entrepreneur. And so, again, if you find that you're just really motivated by new novel interests and they're very intense, and then after a certain number of months or years you're kind of done with them and on to the next thing, that's very typical of ADHD. And again, this is something that can be some people even construe as our superpower. This is how people with ADHD can be very successful, because we can be so excited about these things and we have all this energy. But again, sometimes it's a little too much energy for some people and it can lead to a lot of burnout if we don't recognize it and manage it.

Jenny: 47:55

And I just want to wrap up with one brief example of something my father-in-law said to me years ago, before either he or I suspected I had ADHD. And this example is kind of near and dear to my heart right now because he just passed away a couple of months ago and this memory came back to me as we were thinking about him and his gift of encouragement. He was really good at just listening to people and seeing them for who they were and what was interesting to them and supporting them and loving them. And he would actually even spend a lot of his time in social interactions, sort of doing his best to not share anything about himself and just to listen to other people. He really enjoyed doing that and a few years into being married to my husband, I remember my father-in-law observed of me that I love to be entertained, and he didn't say it with any sort of judgment or malice, it was just like a genuine observation of who I am, what I like, what makes me tick, and it was a very brief sentence and I remember I said you're right, I do, that's so true, and I would have never really articulated it that way to myself before he said it.

Jenny: 48:55

But's so true and I would have never really articulated it that way to myself before he said it, but it just resonated and I just love the way that example reminds me of something that was so core to who my father-in-law was and also his ability to see something that was so core to me that even I didn't fully recognize at the time. So anyway, I know this is really long If you've stuck with me this long, thank you, and I'm guessing, if you've stuck with me this long, you heard something here that you resonated with. So again, reach out to me if you want to chat about how you can figure out if you have ADHD, or work on some of these things and learn to accept and love yourself, no matter what, as I have been doing this past year. It's really amazing fun work to do, and I'd love to see you recognize all your strengths and the brilliance that you have to offer the world. And the first step of that is really recognizing that you've never been the problem, even if you're wired differently and people maybe have a problem with you. But that doesn't mean that you're the problem, and I want to help you let go of all that so that you can just have the badass career and life that you're meant to have. So if you want to reach out, I'm here.

Jenny: 50:05

If you want to share this with someone else who might need to hear it, I'm also here. If you want references about ADHD, I have plenty of stuff I can send you. I'll try to put some in the show notes and my next one will be shorter. I promise I'm going to go through this article with how ADHD specifically presents in doctors, and if you have other questions or topics you want me to cover, please let me know. I'll be recording a few podcasts up ahead of time so that I will be a little bit more consistent at getting those out to you. All right, I hope you have an amazing week and talk to you soon.

Kevin: 50:36

Hi friends, kevin here. Thanks for listening to one of Jenny's great episodes on ADHD. Don't forget to check out the show notes for links to register for the free virtual CME coming up on June 5th through 7th of this year, 2024. Also in the show notes you'll find links to access Jenny's free ADHD resources. We'll see you next week. Thanks for listening to Rethink your Rules with Jenny Hobbs MD. Would you like to learn more about how to apply this to your own life through personalized coaching with Jenny? Visit us on the web at JennyHobbsMDcom to schedule a free consultation. If you found value in what you heard today, please consider subscribing to the podcast and giving us a five-star rating so we can reach even more women like you.