Sasha Hamdani (on ADHD)

Welcome, welcome, welcome to our expert experts on expert. I'm Dan Chippert and I'm joined by Monica Mouse. Hi Today we have Sasha Hamdani on Long time coming. We've been talking about ADHD ad nauseam. I think we've even maybe lost listeners over it But we finally have brought in an expert to either correct confirm who knows it just explore this topic that we are obsessed with That's the fun thing about this show we get to talk about something that we know very little about and then get real answers It is awesome Sasha is an MD. She's a board certified psychiatrist specializing in ADHD RSD and emotional regulation Her books include self care for people with ADHD and an upcoming book comes out in October Look forward when when people start serving pumpkin lots spice lattes and dressing and Halloween costumes PSL two sensitive rejection resilience and the science of feeling deeply Oh, I love this. This is a great episode. Yeah, please enjoy Sasha Hamdani this episode of armchair expert is presented by apple tv the new us home of formula one Starting March 7th you can watch complete all access live coverage of every gram pre including practice qualifying and sprints All in one place watch every race live only on apple tv He's in a chance He's in a chance He's in a chance I'm nervous to be too optimistic, but we had a microbiome expert on who has a probiotic that actually is real Okay, and I've been on it for like I think two weeks And probably not even probably like a week or something and I was in Detroit and I cheated on my diet sure And I had gluten and sugar and I didn't have any rash and my joints didn't hurt and I'm like Is it fixed my leaky gut in Miss Oliver? That fast Maybe I mean That with that exclusionary diet. Yes, because I've been gluten for over five years because of this you have Sorry on a curthew. Yeah, you do don't you think it's the sexiest autoimmune So good like I walk around like I could feel like it's cold outside How long have you had it or been diagnosed with it? So I was diagnosed with psoriasis in Bip the grade. Oh, well, okay, long time, but it didn't affect my joints until I got out of medical school And I was like what is this? Why am I elderly? I did my residency in Phoenix and it was warm and nice and I didn't really Noticing and then I moved back to hand city where it was cold. I was like something is wrong with me It was horrific and then I was like, okay, well, let me just up Pilates or up something else that's gonna help you my fault Right, I must need to do more. Okay, and then I went I got the full work up And I also have horrible rashes all over my actual joints. Oh, and then they're like well Yeah, I have to point out we're all wearing blue Yeah, that's really nice. And we're wearing basically the same outfit black pants in a blue top And you also both have the most beautiful skin tone and hair tone Oh my god long-awaited twins You could bridge the divide between Pakistan and India That's what I'm doing You hear that'll be solved here, but I am curious because you must experience this bit of dissonance right where you've gone to medical school And then things are happening to you, but you're somehow not using the same criteria or it's hard to apply to yourself what you already know Right and also I'm a psychiatrist so anything with the body Okay, you're from Santa Barbara. I once lived there and what part of Santa Barbara did you live in? Monocedo, okay, so what a mom and dad do you feel guilty right? We just had a guest who currently lives in Monocedo and he said Santa Barbara and I said Monocedo and he said yeah Do you go to that amazing bookstore? Godmothers do you know about it? No, what maybe it's after you're gone for a while Okay, I've been trying it for like 18 years. Okay, so it's changed a lot But my mom still lives there so we're and I was able to like Come to the podcast and then we had a sleepover last night And there's a huge ice-throwman Kansas City my flight has already been canceled. Oh no, okay I guess I'll have to go be in Monocedo for a couple days. Oh my god. Well go to godmothers. It's very very cute How do I not where is it? It's on a really cute street Maybe a street a parallel to the train tracks state street It's not there. It's on Lily Avenue Lily it's on Lily Thing to you. I know Little middleman. I know it's closest summer land beach. That doesn't count. It does not Monocedo I think it is because Because we went to lunch in Monocedo and it was like 10 minutes away or nine 10 minutes away could be carpenteria. Oh Wow you guys you guys are Santa Barbara is like three blocks long. Yeah, it's like So picky we lived there. I think this is what I guess I think I know Okay, that's fine. So drive the 10 minutes. We'll see What did mom and dad do in Santa Barbara? It's a funny story because my mom and dad got married and they were from Box done my dad applies all over the US for a job Doesn't get anywhere the first job that gave him an opening as an engineer was in Santa Barbara. He's like sweet Yeah, so we go there my mom's in training because she is a pediatrician so she's still going through a residency and then I came out And then we just kind of lived and grew up there you didn't grow up there. No, it's a weird word text Oh, it was weird when I got there from Detroit. I was like this is a very weird. It's a weird microphone Please pinpoint the things that you thought were because I have my own specific so growing up there It is this weird mix of people That have been there for a million generations and are just trickled down and they're on level a thousand of their trust fund Yeah, they're not really engaged. Yes and humanity or No concept of work or motivation to like some people in my high school currently right now They have the same jobs that they had in high school But they're just working until their parent dies and then they can move upstairs Yeah, yeah, I'm delighted that we have the same observation because I got there and I started meeting I remember this girl at a coffee shop and she was shooting math and she was also very interesting and pretty and I went to her house and it was this very nice house Amasito and there are other Children of rich kids that were just completely neglected. There's like this whole cadre of rich neglected kids there That I thought was so freaky and weird. It's weird. I'm so curious. Hold your I'm 39 Okay, 39 very close-in-age very very close-in-age. We're the same basically the same but I am 38. I just I'm sorry About it you have to be on I have to be on it. I am I am you've had a very similar trajectory in that you two were trying to very much hide from your culture. I have a lot of this for you I had purple context for a while I wanted them I wanted them Yes, yes, I wanted them The irony you guys are both such babes Incredible that you would be trying to become you're going through that in your formative years and you're already feeling othered yes, and so you really do whatever and when I'm saying other From a physical like in ninth grade I show up to public school coming from private schools I didn't really know anybody in my violent contacts. I've had gear during the day. Oh boy. Yeah, not even nocturnal We could have taken a fucking break for six hours. Oh, I did two periods into that school. I was like this goes You're a survivor if you would know No, you can't you don't make it out. You don't make it out and I was like wrong Let me deal with the palette issues and the overbite. I'll deal with it. Yeah. Yeah, yeah Different times. Yeah, that's right. Okay, but you're kind of a vunderkin and you get diagnosed with ADHD at nine years old Which that's the beginning of these diagnoses. Yeah, maybe the uptick in these. That's early. Well, it depends where you're at probably also gender for boys Typical age of diagnosis is between five and seven for women. Do you know what it is? Never 35 years old 35 age usually if they've had their own kids They're like this is weird. They go to the doctor the kid gets diagnosed and then the mom gets diagnosed Yeah, okay, so you do get it diagnosis and then that's immediately helpful Yeah, in that you get medication that starts working. Yes. I'm hesitating because it's a weird story Okay, so fourth grade I was pretty boisterous as a kid Substitute teacher comes along. I create an insurrection in the classroom I got everyone to stand up on their desk start chanting to get and like that's horrifying I can't imagine treating a teacher or a substitute like that ever But I was just the person who did that within an hour of that happening the substitute calls my teacher my teacher calls from a doctor's appointment. She calls my parents and she's like do something and so then my Parents got me my mom was a pediatrician So I got in with a physician. I got diagnosed and I got treated But it was so stigmatized at that time. They didn't tell me my diagnosis That's why I like I feel like I was diagnosed twice because it was on medication hugely helpful my parents were like Okay, take this vitamin and I was like whoa this vitamin is Working so much beats the shit out of flinstones I was so chalky and discussed. Yeah, but I know but the son is challenging So I could sit through class. I could pay attention. I wasn't getting in trouble and school wasn't painful for me It was never hard for me before but I was so bored. I was like I can't sit here and do this So it became very manageable and that kind of propelled me through this stupid vitamin And then I did well enough throughout my schooling through high school that I got into a combined Undergraduate program. So I started medical school at 18. It's like I condensed to a six-year program. Yeah at University of Missouri Kansas City. Oh, I was like that one there He did you shut up right? Yes, he did He did the work he's happening a show in the mix here really yeah his sim is in the mix right Oh Stereo proud of us So I went there and that was the first time I'd been away from my parents That was the first time I'd been by myself I'm like there's so much stuff and freedom and also laundry and all of this other stuff that I've never had to worry about Because my mom would do it. I don't know how to feed myself. No All right, you're my mom waited on you hand. I did my laundry starting from age like eight. Oh, okay My mom tried could you screen make me a milkshake from the bottom of the stairs and she would make you on Now that's nowadays Now you're thinking of the wrong story I was making a milkshake in basically the middle of the night And she was like calling from her and like stop there is a blender going and I was asleep and she was like what are you doing? So I was making it Sorry, I probably could yell Amazing She did try to instill skills and I just was uninterested in high school I was playing sports and I was doing all this other stuff and if you had told me your laundry's not going to get done I'd be like okay, I'll just wear my park in a school. It's fine. I don't care about that stuff And I still kind of don't care about that stuff There was a lot going on and I went from being one of the smart kids in my school to all of a sudden being quite literally the Bottom of my class when I realized something was wrong and I brought it up to my parents is I did this Neuro test so neuro anatomy and they stayed up really tried to focus on I was like I know this brain inside out It was really interesting to me and I was visual that I was like I got this. This is so easy Go into the test. I'm like this is amazing. I'm getting all of them This is perfect I'm the first one out of that test and then they had this thing where they would like post your grades with your ID number Like the next day I'm like showing up. I'm still looking for my ID number And you're looking at all of these grades and you're like 90, 80, whatever and I was like there is some loser If we got a third of your two and I was like well, that's me Yeah, what a disconnect. I didn't flip over. Oh, oh You just did half of the test. I got a hundred percent. I didn't flip it over Okay, you think the perfect. Oh, you would think I went and I was like please This is going to break myself a steam and I was like I'll be on the other side of the room You can give it to me orally just read me the questions. I will tell you the answers The guy was like you're either gonna learn from this or you're not and I was like, oh, okay. Well, I guess I'm not So I remember telling my parents like well, are you taking your vitamin? I was like respectfully. I don't even know where that is You still thought it was a vitamin and right college it was a vitamin. Okay, so I have a little I have a little beef with your parents This is an ongoing beef you also could have been told that nine years old that there's a notion that there's all these things We can't tell kids is so silly. I don't understand. It was a different time though It's a terribly different I mean you guys pretty young no no even like when my brother was little which is eight years below me ADD was if you have that your problematic sure, but there's no reason that the child couldn't understand that they have ADHD and explain what limitations and what other things are gonna be coming their way So they have an expectation and some tolerance they can understand that I think that could have happened But I also think I don't thought about this a ton since I'm a parent now How would I handle that differently in that time? It was so stigmatized there was a kid who had ADHD a couple grades above me in that Private school that kid got expelled for putting fireworks in a toilet and they were like this kid is nothing We don't know what to do with him He can't be at school anymore and all the room parents were talking about it I was just very highly aware of this and then I was also the only brown kid in this Sea of white children. I already felt weird. So I think my parents probably were doing at that point What they thought was the best they were trying to intervene. They think they're protecting you. Yes But I don't think lack of information is ever protection personally Not wrong They redeem themselves big because I'll tell you what they did that was correct. So after that So I'm like, yeah, I don't know where my back of minutes Next topic Okay, heads up Vitamin is actually ADHD medication. Yeah, ADHD. I was like no, I don't I've been medicated against my will I feel really angry about deceived yes, and so I was like let's just start over So then I really tried to apply myself in school I would wake up at 5 30 in the morning I would start studying I would study for like 12 hours a day I'd be so into it that I would get into periods where I was like I should probably go eat and I was like no No, no, I got to finish this chapter. I was just trashing my body to get those results And I took another exam and it after my best efforts. I still got a 60% why? Because I was so tired the day before the test and so run down that I was foggy and I couldn't think at that time And I was like previously when I was on this vitamin. I never had those problems. I don't understand what's happening And so then my dad was like listen You might make it through medical school. Yeah, come home. Who cares? Let's learn about your brain He brings me back to California and we go to library straight of old school library pulling out textbooks both of us We're just sitting on the floor He is reading textbooks about ADHD and he's like this sounds like you and I'm like that does sound like me and so we learned So much and I thought it was handled in such a curious and open way It hit my mom both were like We wish that we had that verbiage to tell you we didn't know And you were under our care for so long we didn't know what a fracturing there would be when you left and you were out of that environment So then truly I had to like scrape and claw to get out of that hole But eventually I tried a bunch of different medications and some of them wouldn't let me eat and some would let me sleep There were some there were a disaster, but then it was a combination of finding a good medication and finding the right therapeutic things And I don't think I truly figured it out until I got into Residency so after med school. I was just surrounded by psychiatrists and therapists This is my happy place Great because med school it was so Hard the entirety of med school. It was like all of my attendings I don't know whether I was already pegged as a problem But I had an episode where there was an attending who came to my office I didn't do very well on a test and he had been kind of rough on me the whole time But he's like don't worry about it. You know what we're gonna do We had these little cubicle offices and it just brings like a box of them And he starts packing up my office and he's like you can just go home you came there for a reason Maybe you'll meet your husband here and I was like oh Oh my god Especially now as a mom of a girl I was like if anyone spoke to my girl like that I would be feral in that moment you're so embarrassed and you're so confused like Why is someone who's supposed to be helping me through my educational steps doing this? You just don't do anything and so I just carried that yeah And so but then I feel like residency just reversed all of that because I felt Traumatized in med school and then in residency all those pieces got rebuilt and they were like This is what you're good at lead with that and then we'll work on the back end Okay, so you've become Specialized in ADHD. I'm taking off my shoes. Oh, yeah, do it. You can dump the socks too whatever you want no one's ready for that Okay, I would love to know The historical understanding of ADHD as a condition I'd love to start with one maybe first enters the DSM or when does it appear and what do we think it was then and how would we now define it today? So the problem with that is It has had such an evolving course And it has had so many different names when it was first noticed it was in 1700s We had a patient who is extremely restless and that's what we're describing now as fidgeting or a sign of like that physical Impulsivity and then as it moved on it got the name a hyper kinetic condition That was an interesting kind of segue because it really dialed down on the hyperactive component then as we progressed We didn't get into formal ADD Territory which is not called anymore until the 80s I believe that's when I was introduced to this concept. It was ADD Yeah, and that's what I was diagnosed with initially that came Later and then just recently in the DSM 5 I got beef with the DSM 5 There's a lot of beef to be had with the DSM in general to now what are standing diagnosis is is ADHD is attention deficit Hyperactivity disorder. It's broken into three subtypes. So if you have ADHD It's always called ADHD, but you can have the inattentive presentation You can have the hyperactive presentation or you can have the combined type which is kind of like a combination of both a huge problem Is people sometimes are like I can't have ADD soup because I'm not hyperactive because it's in the name right Yeah, I don't like that. It's too wide of an umbrella. We would say maybe it's too wide, but it's also too Nero it focuses so so so stringently on just the focus components and it doesn't touch at all on Other areas of regulation because I think ADHD at its base. It's a dopamine dysregulation error So you have dopamine dysregulation when it comes to attention You have dopamine dysregulation when it comes to impulsivity. You have dopamine dysregulation Sleep with appetite with emotions all of that is so huge But we never really touch on it with the emotional side of things in particular if we don't change that with ADHD This is why people are going to get misdiagnosed with the anxiety and depression for a million billion years Yeah, I guess currently though it is Diagnosed through symptoms. Yeah, you're reporting symptoms Yeah, if it fills enough criteria, we would say you have it my curiosity is Are we approaching or do you believe we'll get to a point where there will be different diagnostic tools DNA markers Where we'll go? Oh, we see this clumping of this here would it be FMRI brain scam where we would see Something that would let us know is there going to be a day where we can read The actual percentages of neurotransmitters and say oh you have this exact cocktail that ends up to this like are we approaching any kind of diagnostic tool That's not just symptom related No Let me tell you why on all of those fronts I think about that all the time if there was something tangible we could grab onto and check a level of something that would be amazing So with the levels of dopamine dopamine serotonin you can usually check those there are a lot of things floating around with like a urine test where you P and then they check your levels the reason why those are Incredibly unreliable is because sometimes It's not truly that you don't have enough dopamine. It's just not present in the spot where you need it to be at the right time Right, it's a dysregulation. So what happens if I come to you and I'm like okay. I think I have it What do you ask? So there's a couple of other things the thing that makes A good 80 HD Diagnostic interview is that not only are you checking for symptoms But you are simultaneously ruling out other things and I think that's what makes it such a complicated thing to do because I have patients who come in and they're like I went online for an assessment and says I definitely have it and I'm like yeah And I understand the thing about 80 HD that I know because I have it When you are right in the middle of trying to navigate a brain that feels so overly chaotic for you You are willing to point yourself in any direction to fix it. Yes. That's right. You're desperate That population is a vulnerable population because they are the people desperate to want help So I understand why people are taking tests online It's just not a super valid test because it's capturing you In a very subjective manner. It's not giving good timelines. It's not ruling out any other things So it's giving this very skewed kind of thing with 80 HD when you're looking at the criteria You're screening for both the inattentive symptoms the hyperactive symptoms And then obviously you'll get if it's combined from both those You want to check timelines see if these symptoms presented before 12 when you're assessing for an adult That can get tricky because if you're asking them to recall retroactive data That's hard a lot of people don't remember and a lot of people have spent so much time During their childhood where their parents have masked covered up fix kind of symptomology that it's hard to assess So that's difficult you have to really dig back to get good criteria And then when you're asking questions like for example with the inattentiveness you're asking Is it hard to stay engaged with a task? Do you feel like it's difficulty to organize things? Do you feel like you get distracted halfway through the conversation? You're asking things about focus and focus adjacent topics But you also have to ask is this present during a depressive episode? Is this present when there's substances involved? Did you notice this before or after you got on thyroid medication? You're asking all of these things while you're doing a simultaneous screening for other things. So it becomes Pretty complicated. It's so dynamic. You're doing a comprehensive medical rule out. It's confusing from psychiatric perspective Like is this bipolar? Is this ADHD? Is this depression? Is this anxiety? Is this trauma? There are all things that overlap really beautifully and can mimic it So you need to be able to kind of pull from the diagnosis What the patient is saying ask the right questions to get to where you're going And I'll tell you a lot of people come to me 100% deadside. I have ADHD And by the time we're done with the interview it's like no you didn't I mean this was trauma. This is what was causing it Yeah And so it takes someone who's been trained to be able to discern that Over a protracted period of time as well. I would imagine this isn't something you're doing in five minutes You really need to learn quite a bit before you're there And then we probably get into the other issue which is I'm sure it is a spectrum condition So what do we say that 79% of these symptoms equals it or 71% or whatever You know when is it a disorder? When are you one deviation below a disorder? You could still be Suffering a lot of the symptoms before you're Chronically in as yeah formally or pathologically in this condition And it doesn't mean that's irrelevant that you're just a step before it So my great curiosity is so what are the inattentive symptoms? And I also want to talk about How it manifests differently in men and women and boys and girls to your point My hunch is the DSM was originally just assembled with the boy symptoms And so I imagine they really present differently Emails and females so how do they and what are those symptoms? So with inattentive you're looking at difficulty with Starting a task staying engaged in a task completing tasks having difficulty with disorganization You're looking at issues with executive function the skills that are required for Processing and getting a goal done goal oriented behaviors done those are kind of more the Inattentive symptomology hyperactive you're thinking more like physical and verbal impulsivity these are the Kids and adults who have difficulty staying in their chair. They're constantly Fidgeting they're blurting out things there are Are you interrupting interrupting Also we should say that's is looking for a diagnosis by the end of this Can I just tell you one second how I got interested he must know goodbye Mate yeah, I'm walking him to his car and he says to me Have you ever read? And I just went that's a weird thing for him to say and he's an expert on it So I just went like that's really interesting he said that and then I too my algorithm became like everyone else's And I start seeing these different things I interview a friend who's been diagnosed and he was a kidney tells me that ADHD folks have an Outside sense of justice and I wonder if that in fact is one I definitely suffer So you know, I'm just not oblivious to a lot of these things do sound a lot like me here's deal. I I'm not gonna diagnose you I'm actually not looking for that. I don't care if I do or I don't have it Well, you should I think that there is nothing more liberating than understanding your brain You deserve to have a good diagnosis and to know how your brain works when I went from not knowing what was going on And then I sat with my dad and then we actually went back to a physician And he explained like these are the things that are going on in your brain And this is why you might have difficulty with this I gave myself So much number one grace about things that I beat myself up about for years and years right right The self-fligulation which is again is I understand one of the conditions emotional regulation needs to be as part of that for example So my dad asked last Year in April of Sorry, yeah, yeah, we found out he had lung cancer We found out he had the spot and they were like it's annoying but we'll get it treated whatever so we go We get a treated he goes through the chemo he goes to radiation He calls me one day and he's like I just don't feel great So I have word of light I go over and like you look awful. I take him to the hospital Everyone's like no we can't do a pet scan. It's too soon. I was like do it We don't care if insurance doesn't cover you something's wrong It was at Brewer and he died 13 days later What? 13 days Oh my god 13 days But what I noticed I think this is probably why I feel so passionately about the emotional regulation part is that the colliding of Brief and ADHD was so destabilizing for me. It was like my brain exploded the brain fog was so but and grief Arrific for everybody, but I think for someone with ADHD who's experiencing that emotional Disregulation already I had no idea how I was ever gonna get through coping with those big emotions I was like this is too much for my brain. I can't parent. I can't get through a workday And see these patients without just losing it So when I was going through all of that and I had a really tough time with that Because I knew I had ADHD. I mean it was hard because I was like this is tremendous I felt like I was completely Broken down and starting from scratch. I was like because I know how my brain works I need to create systems that are very low lift for me right now and find a way to rebuild that way If I didn't have a diagnosis or an understanding of my brain like this actually makes sense to me or this is what I believe is going on I think I would have just kept trying to do what everyone else told me to do which didn't work. Yeah Stay tuned for more armchair expert If you dare Thank you to our presenting sponsor apple tv the new us home of formula one You can now watch complete all access live coverage of every gram pre including practice qualifying and sprints all in one place I will be consuming all of those things Monica I know you will I kill for friday to start watching practice one following and on a sprint weekend Oh my gosh two races And this season brings a ton of new energy to the sport new teams like Cadillac and Audi just joining the grid new driver stepping into major seats Landon Norris defending his first world drivers championship and all eyes on Lewis Hamilton in a second season with Ferrari and a brand new circuit in Madrid Plus a new us home for formula one you can watch every race live only on apple tv Watch on apple devices android devices smart tv streaming devices gaming consoles or on the web at tv.apple.com All part of one apple tv subscription alongside hundreds of exclusive shows and movies watch the formula one Australian gram pre live on Saturday March 7th at 11 p.m. Eastern or watch race replays on demand anytime only on apple tv The new us home of f1 We are supported by all state checking all state first could save you hundreds on car insurance That's smart Not checking your phone's battery before heading out that'll get you every time Of course your phone dies on the way to meet someone leaving you wandering around quietly panicking about being in the wrong spot Yeah, checking first is smart So check all state first for a quote that could save you hundreds You're in good hands with all state potential savings very subject to terms conditions and availability all state north american insurance Co and affiliates north brick yellow and oil We are supported by into it turbo tax a Pro 15th is coming up fast and if you're like most people you're probably dreading the whole tax thing You know the old way sitting in some waiting room for hours or sending over your tax docs and waiting and waiting for any kind of update You want something modern and tech forward But you also want that human connection and this year brings a major upgrade into it turbo tax now has in person locations Nationwide you can walk into a tech enabled turbo tax location near you and meet face-to-face with a real tax expert Drop off your documents in the store and see them uploaded to your turbo tax app instantly just like that You're done your new turbo tax expert stays back and works tirelessly to get you every dollar you deserve While you get real-time notifications as you go about your day Honestly, it feels like someone finally figured out what we've all been wanting It's not some sterile tax office from 1987 and it's not just an app where you're on your own It's both the human expertise with smart modern tech you drop off your stuff go about your day and get real-time updates as your expert works through everything That's the upgrade head to turbo tax.com to find a store location near you and get matched with a turbo tax expert with real-time updates in iOS app I'll tell you after he Past I don't drink. I don't really do anything super interesting. I was just like my brain is so loud I wanted to be quiet right now. Yeah, it's easier for me to be quiet And I was just like what can I do? I knew at that point It was my emotional regulation and I was looking for a way to medicate this. Yes. Yes. You need a relief Yeah, and I was like that isn't something that I can medicate my brain is having a really hard time with things that are really big And so I need to find Safety to get through these kind of moments and my husband his mom passed because of brain cancer years before So he was really well first and supported all of us through it He kind of saw what I needed and helped me through that moment But I think if I didn't know about ADHD, I would have ended up in a really weird spot. Yeah. Yeah I believe that that makes a lot of sense. Okay. Now back to the male female differences In my hunch was that the original criteria was probably just addressing the boy issues Yeah, and you thought you agreed. So how did they express differently going back to like boys getting diagnosed way earlier than females Typically boys present with more of the hyperactive symptomology So they're the ones who are causing problems in the classroom They are disruptive. They're getting up in the class. They're bothering others Which is probably why you got diagnosed early because you were behaving like that Like a boy. Yeah Absolutely, and I think about that a lot and I'm like I'm actually pretty grateful Yeah for that presentation because it got picked up but Girls on the other hand are mostly inattentive. They're like the daydreamers that are spacing out in class and they're doodling So those girls are pleasures to have in class. They're not bothering anybody They're getting passed along and then what happens is as The external pressures rise and as they're doing harder things as they're doing more adult things like getting into relationships They're starting families your needs exponentially Increase and what is demanded of you increases and you just aren't able To cope anymore and then it feels very much like a breaking point two other reasons that people assigned female at birth don't get Dignose number one is a hormonal part of all of this when women are going through hormonal shifts when your estrogen is dropping Your dopamine drops also your symptoms get worse now These women or girls who are going through their first periods or things like that their 80s two symptoms are 10 out of 10 Faribault and they're going through all of these attentional issues They're also going through emotional dysregulation because they're like what do I do my dopamine is all off and that's when they're like She's bitchy because of her period right? Oh you want your period? Well, yeah, I saw post-aviors that was like 30% PMS symptoms for ADHD girls versus 10% for the general pop it's significant yeah, wait You feel at 30% more is that what you're saying? It's more common PMDD is significantly more common in the 80s de population It sucks because you're in a situation where you're like okay, well my mood is already Garbage around that time before my period, but now I can't focus and I can't do the things I want to do And it's even harder for me to emotionally deal with it like that doesn't seem fair So that's another huge one and then the last one is quite literally just I'm not trying to get political here, but it's not even political But there is a societal difference in expectations for females The females are expected to kind of tow the line and mask So what is acceptable for a boy to be doing class is very unacceptable for a girl So the girl now learns to hide that behavior. So then what happens is that this high achieving very capable student or child Goes through life they are now getting applauded for masking their stuff And so when at times it becomes overwhelming and they can't People are like what's wrong with you? Why are you so emotional? What's happening? Why are things falling apart? Why are you breaking down at work? It feels like such a huge shift In their baseline functioning, but really they're just Busting their ass trying to feel and look normal. Yeah Okay, I want to ask if these things I've heard anecdotally or around the digital campfire are in fact people ADHD over index in so there's a rejection sensitive dysphoria. Yeah, tell me about that. I would love to tell you about that So I've become obsessed with that since my dad was sick I mean, I was just like what's happening? Why am I so sensitive to certain things? So rejection sensitive dysphoria is the very very real Emotional sometimes physical pain that comes from Real or perceived rejection or criticism So someone criticized you or reject you or you think that that's happening And all of a sudden you can't stop thinking about it. You're beating yourself up about it No one likes getting rejected. That's not it. I have told my husband 80s like someone Sucked the air out of my lungs. It feels that's To me rejection sensitive dysphoria. I think it's so important to recognize and to know about because it's so hard for the person who's experiencing So it's so hard for the people around that person. Oh, yeah, the relationship toe around them. Oh my god So when my husband and I get into fights I'm so sensitive that if I know we're kind of beefing with each other He'll look at me and I will just start crying and then I will chase him around the house and I'm like and another thing And another thing is show out because I feel like this urgency that I have to resolve this so that this feeling goes away This is the email right? Yes So what we do I'm not an effective communicator when I'm in that state. I'm emotional and I'm Angry and I'm scared and I'm sad and all of the things all at once and it's too much right in that moment So what I do is I literally Write an email and I draft it and I draft it and usually take three or four passes because I'm like that's not what I want to say So already by the end of it. I've come down pretty significantly. We've regulated a bit Yeah, because I've had this like safe place The safety of my laptop Like this is my happy place. I can write this down and I could take as many tries as I want to make it sound the way I want Then I send it off to him and we have a whole folder of this usually I'll send him a text message and like I said you something He'll read it and then he will think about it and process it and usually by that time I'm like I'm gonna just go somewhere else like I also go sit in my closet or I'll go sit in the car We're all going hang out with the kids. I don't want to be around him because I'm looking for as he's reading at what it's face is doing And so then what he'll do is he'll respond to it And he'll make pizza rolls And he'll put it out and then we'll have like a fun snack and we'll talk about it and then we'll be done And it's the best system we've ever had. I loved reading that because I guess we need jerk This exists in my relationship and my knee jerk is we are good enough communicators And we are smart enough and we've all done enough work that we can sit down and talk about this That's where I come from it feels like a failure that we would have to be texting Each other or emailing but then hearing you say that I was like I also must admit It does go smoother if those couple steps happen before we confront something verbally I'm happy to be relieved of the shame of us failing and being great at talking immediately I guess I don't know how people do talk immediately Whether it's ADHD or not I think time is kind of important Time in giving yourself that space to regulate before you come into and like try to resolve the situation because otherwise This is so messed up But I think I'm realizing now that if I come off of an argument and I want to address it right away I want to show him how hurt I feel and how badly that hurt and it's not about resolving it exactly It's about wallowing and then I get angrier and matter. I mean it's positive and agitated. It's the whole thing Yeah, how about this inflated sense of justice or this inflated discomfort within justice So it's not a clinical term you see it a lot in autism as well But it has to do with like rigidity being very rigid and having a set expectation in your brain And then having it not come to fruition in the way that you planned I think that's kind of where it stems from and so they're looking at like a huge gamut of presentations of ADHD So there's some people who in order to maintain their ADHD They have become very rigid about things they have built these structures for themselves where it's like this is how it has to be Because this is how I can function That's where I can have compassion for it is you're very easily dysregulated You somehow learn this about yourself whether you're conscious of it or not And yes, the more things that you can map out and plan out and control the less chance you'll have at dysregulation So I'm sympathetic to it my thing is like the airport all my character defects come out at the airport because I mean ask to cooperate With the TSA to do things that I think are illogical or make no sense I'm powerless people are taking photos of us. I don't like that. They might be taking pictures of my kids The big storm of things and I do a pretty effective job at controlling my day, you know normally And so yes, I have learned that Before we leave to the airport for the best outcome I have to have that expectation that helps me enormously to just go like okay We're gonna get there and some guys gonna tell you to hold your pants up and also hold your hands over your head at the same time What you know is impossible People are gonna take pictures. They're curious get over that but if I walk in It'll prepare to unprepared for what's gonna happen. That's when some massive dysregulation happens pretty quickly Yeah, we're all trying to get by there's some brains that are just More sensitive to these things than others. Do you ever spend any of your time or focus thinking about the evolutionary aspect of it? I do wonder if this would even be a quote condition Without the incredible amount of stimulation. What do you think about that? There's been some Thought about if we're looking at 80g just from evolutionary perspective and we're looking at hunters versus gathers 80g people are the people who are going off and they're hunting and they're doing these things that involve risk and adaptation and Impulsivity to some degree. No, we're seeking. Yeah, and they're great at that And now we're putting that same group of people that would thrive in that environment in a new environment And I don't necessarily think it is Well, maybe it is due to all the stimulation But I think it is just society adapts and it evolves based on what its needs are and the needs are there is just a much larger neuro-typical population And so the world is built for a neurotypical now you're expecting this population of people whose brains are wired differently To occupy space in a world that just wasn't built for them and a really easy example of that is for 80s day a lot of people have delayed melatonin onset So their brains don't feel a normal. I feel sleepy at 10 and then I'm gonna wake up at 7 There's are like I want to go to sleep at 1 and I would love to wake up at 10 a.m But that's not where society runs you miss three hours of meetings already. Yeah, you're right There was a lot of different outlets for a lot of different types of brains before But we have really homogenized the work experience which is you go to a box you sit in a chair You do this thing. There's not like oh, yeah, why don't you go explore it over that other peak Will weave the baskets? We're more apt to sit here and weave these baskets You know everyone has a bit of an outlet now. It's like no no everyone's supposed to wake up at 6 Yeah, everyone's supposed to do this and that so you had fun only it's all into the same thing There's going to be a lot of tension there. I think it's tough because you are expecting People as you're growing up to function and learn skills in environment that's not built for them So you're already kind of starting off at a deficit and then you know you hit adulthood and they're like okay Then for yourself you haven't really had time to build good skills unless you've actually really dialed down Under so to ADHD learn how to make accommodations for yourself It's kind of like you're going through this environment that you never really figured out with schooling You never really grabbed hold of it and then now you're an adult and you have to figure out what to do with it But you don't have any of those foundational skills sets. What do you think about the fact that so many people especially Social media and stuff are self-diagnosing. I have a problem with that And this comes up a lot on the show that's partly what we were so excited to have you But I think it's a problem that so many people are walking around saying I have ADHD when they don't know if they have it Or they think they have it based on what they've seen because for me I'm like well, what about the people who really have it to me that takes away From it is something happening in your brain. In our developmental condition. Right. What are your thoughts on that? So I kind of have a hot take on that and my hot take is that I think self-diagnosis is actually good to a point and the reason for that and I'll tell you what the point is too I think that it is incredibly valid to have someone Learn about what is happening in their brain find things out on social media or in books or in literature or research that looks like them And grab hold that and start learning verbiage of how to describe their own internal environment I think that's a wonderful thing and I think that that can be a wonderful stepping stone To accessing care and I know that's not an accessible step for a lot of people But that next step I have problems with it when it moves from self-diagnosis to the medication standpoint That's really where I start to draw the line because when you start trying to treat yourself You haven't done the exclusionary kind of thing to figure out what else is going on and Medications of any type they're not without risk. You're doing things that could potentially impact other things in big ways So if you think you have ADHD and you want to learn behavioral strategies that help an ADHD brain go forward man My hunchronica is that your issue is much more The person who says I have ADHD So deal with this using it as an excuse. I don't think you would ever have a problem with someone going I think I have ADHD So wow I should explore these tools that have been shown to work really well with ADHD. Let me try them great These are helping I think your fear is probably more like I proclaimed I'm missing you have to lower your expectations of me now. Yeah, exactly obviously if someone's like oh, I think I have it I'm gonna do research and learn about it and figure out how to help myself. That's amazing That's what I would want for everyone, but that to me is not what's happening I think people are saying I have it and so I'm late and I think the reason I don't have an issue with it is I come from a background where alcoholic self-diagnose that is the full premise No one can tell you're you're an alcoholic you have to tell yourself you're an alcoholic And then you have these steps that you're disposed of if you want to try this and no one's declaring I'm an alcoholic so deal with the fact that didn't come to work So for me the association with the self-diagnosis is very positive I think you're right if you're using ADHD as an excuse And if you're saying I can't do this and you don't have a formal diagnosis For someone who does have ADHD that can be extremely irritating Yeah And I've been guilty about where people have said that and I'm like you don't want to slug You can't possibly know like I do at the end of the day. I have no way of knowing that I have no way of knowing what's going on there failing Yeah, you don't know what their dysfunction is. I don't know So I've tried to peel that back and figure out and look at why is this bothering me so much But using self-diagnosis as a tool to get steps to get a formal diagnosis Or get more access to knowledge about things and research about things So you can learn about your internal environment I think that there is a huge space for lived experience of talking about that Yeah, you're fear someone will be like I am ADHD I have time, blindness Don't ever expect me to be on time. Yeah, and that happens and it's like guys I don't want to be on time either But I think it should be more like I have ADHD Yeah, I think I relate to this time blindness thing What are the three best tools? Yes Because I know I do have to be on time places We all have stuff and we have to figure out how to live in this world You know, we're not islands That's why I'm going to just quickly say neuro-typicals bullshit as well It's the same reason the DSM is fucked up because it has some premise of normal Which simply doesn't exist There might be eight people who don't have something going on There's zero people We're all variable And I think the neurodivergent terminology It was like a psychological turn that came out in the 90s And it was really this umbrella term to talk about autism and ADHD and all of these other things And the neurotypical was just kind of like a byproduct What's the opposite of this? You have DSM as problems Yeah How do stimulants work? Why is that an effective medication? This is a weird area of medicine because it's not this cut and dried mechanism So basically where a majority of that deficit happens is that frontal lobe So directly underneath your forehead That's where all that executive function judgment processing happens So what a stimulant does from just like a very rudimentary perspective If your brain has a million different things going on Going different times Because of that underlying dopamine and orp and effort and dysregulation So everything is just floating ahead in an incredible space You can take a stimulant, a riddle and derivative Something in that family And it actually works a little bit counterintuitively Because it slows things down And really it's not that it's slowing things down It just speeds everything up to match what's going on with your brain It like synchronizes it almost Yeah, it is very counterintuitive I very much feel like I would benefit but I also know I can't be on that Oh my god, there's so many better things Than being on a stimulant Yeah Oh tell me Okay, so here's the deal If you're treating ADHD you could do it behaviorally or you could do it medicinal Right And with medicine for ADHD There's stimulants And there are non-stimulants And so the stimulants are what everyone thinks of and they're our gold standard right now Because they work well, they work reliably And you could tell pretty quickly Is this going to work or is this not going to work Those are things like Adderall derivatives, Ritalin derivatives Those are all part of that class But for a lot of people with ADHD Stimulants even the long-acting ones They'll give you like a six to eight hour coverage But ADHD exists outside of that six to eight hours So then it's like what are we doing for the rest of that So non-stimulants, a lot of them give you a 24 hour coverage For the great majority, they either fall under the category of an antidepressant Or a blood pressure medication Or some other class Interesting And you are getting additional benefits So for those people who have ADHD Who are also anxious There's a medication that's going to help with ADHD Well, it is a blood pressure medication So there's long-acting formulations of blood pressure medications That can help with anxiety and ADHD Or you're doing an antidepressant which is going to help with depression And anxiety and ADHD Or you can do something long-acting that people take for shift work disorder So it really depends on what you need and what you're looking for And what else is happening at the same time But for a lot of people when they're coming to the doctor They're assuming if I have ADHD I need to be on a stimulant I need to be on five ants I need to be on Adderall I need to be on Ritalin and 90% of the time That's not the direction we're starting at Because I always tell people we need to build skills So we need to work on that If that's not possible because your ADHD is dysregulating everything We need to give a medication that's going to give 24-hour coverage as much as possible So that you have a chance to kind of see and build There's some people who just that diagnosis Immediately lifts them It gives them the permission to study and make changes And do those things that they don't need to be on medication So it's not like an absolute you have to be on medication to treat your ADHD But there are a lot of people that in order to build and cement those habits They need to be on medication And that's also incredibly valid It just depends on how your brain is wired So your first book self-care for people with ADHD You have over a hundred tips It's fast-moving, it's foreign ADHD brain to read this book Just little page long blitz I can tell you my favorite one in that book And it's do a headstand That's not the one that's going to work the best or anything It's just the weirdest one But there is something about that change One, you're doing something weird How I figure this out is when I was in medical school that was studying for organic chemistry It was just so boring to me I was like, I can't do this anymore My mom would be like, just do something to change your position Or just do something to distract yourself a little bit And it was that inversion of a headstand That's hilarious, not necessarily the most impactful But that's one, if you're bored in the middle of stuff Another one, I think that is important So the book is broken up into separate areas And it breaks it down in terms of emotional self-care, physical self-care, professional self-care All of those other things I think if I were to pick from those Because some of that book is also things like giving yourself permission To grieve if you haven't gotten a diagnosis Because a lot of these people are coming to a diagnosis late in life I'm done with the career portion of my life I'm done with the child-roaring portion I missed on so much and now I'm having to grieve this diagnosis I bet there's a feeling of, oh man, I could of blank Which is heartbreaking It's hard, but you know what I tell patients who are in that position Is that this whole time You have been building skills You have been building structures You have had this brain this whole time And so now it's what you do with it And it's what you make of it with this new opportunity And so you wouldn't have built those skills That you needed if things were different Potentially another very very important one Is just making time for physical activity I feel like such a hypocrite because I hate exercise I think it sucks It's so boring and it's so hard for me to motivate myself But it truly does make my brain work better Let's talk about the forthcoming book That will be out That's called "Too sensitive" "Too sensitive rejection, resilience, and the science of feeling deeply" I like this So is this exclusively ADHD because this feels like this could encompass more than just ADHD? No, it's not, exclusively But you know the thing about like we were talking about rejection Says it's for you Almost 100% of people with ADHD have rejections I feel like I have ADHD now I have that type of contraire I really have all this for me yet I know that I have that I don't have that I know No, I'm not, I'm not, I'm not But I do have that So the concept of rejection sensitive is for you I started writing this book when I was all dysregulated with my dad It came about during that time and I was like This is the worst part of my ADHD My emotional dysregulation This is the thing that will bring me to my knees every time If I can't focus or if I can't do things I'll make a hack around it or I'll delegate I can't delegate someone to take care of my emotions And so I'm like there has to be a better way to think about this And learn about it and talk about it And I think that's why I have so much beef with the DSM By the way Europe changed their criteria in 2019 to include emotional dysregulation as part of a core component We haven't And so I look at it like say your diabetes So bad That you started to lose your vision Now instead of someone being like Oh okay Well let's fix your diabetes They're like No, no Okay, let's just give you glasses Let's treat anxiety and depression Instead of treating the underlying diabetes The underlying diabetes is ADHD And the anxiety and the depression And the rejection sensitivity and the emotional dysregulation That's what's causing the vision loss Right It's a symptom not the cause It's a core part of it It's not a separate diagnosis And so if we don't get on top of this What happens And I've seen it so many times Is that for women in particular I'm seeing women who are On anti-depressant number six or seven They're coming to me And they're like I don't know what to do anymore I think I have ADHD Did you talk to someone about this? Yes I've talked to my doctor for years What did they say? First thing that they were going to hear Is they were going to say Well you're doing too well There's no way you could have ADHD The second thing they're going to hear Is No It's anxiety and depression Let's treat that first The third thing they're going to hear Is after they're six or seven Interdepressants in Then they're going to say Listen These antidepressants aren't working Can I please look into ADHD They're going to be like We can't treat ADHD Until your anxiety and depression are clear These people aren't getting help And it's because emotional dysregulation Is in the criteria I have a loved one who has come to this late in life And it's so fucking impressive Because they've done it without any help on their own But they said to me I finally realized That I'm processing everything different Than everyone else around me And I'm realizing that these really Crazed states I am going through Are that thing? Yeah And it has not fixed it But it has helped me go Oh that things happening And no one else around you is really experiencing it So if I pop off now at work Or try to let everyone know A, they don't care because they're not experiencing it And this is without any help from anybody Just his ability to go Oh that things happening Is incredibly powerful It really I feel like Takes a lot of the heft of it away It probably gives you a little bit more agency The way that this book is set up The first part of it is Truly just the science behind And a lot of that evolutionary perspective And just like the history of it How it came about The neurobiology What is actually happening What areas of the brain are being triggered That amygdala is being hyperactive Because it's assessing threats all the time Even though it's not appropriate And then the second part of the book Is how deeply do you feel So it's actually an assessment Where you can actually walk through And be like Is this me? Where do I fall? It's broken down into like You're probably in a spot where Emotional sensitivity isn't a huge issue You should read this If it applies to other people you love So you have better understanding Or this probably does apply to you Maybe it's not all the time Or this is probably you This is probably something that's pretty significant But you haven't had really all that much Verbage for it because we don't talk about it And then it goes into the tools you use There's just 12 tools that you use And then the last part of the book Which is my favorite Are real world examples of how you get triggered So it's a quote And then it is what's happening in your brain And then how you get out of that moment So when I was researching I was pulling from all these different Psychological principles And like what actually does work So this is just an amalgamation of all of those Principles together to actually help with this select thing Yeah I mean I can immediately think of Several people I can't wait to buy it for Which will be triggering but then Well good I can't decide on the covers You guys can help me with that Oh When you see it on your and I stand don't be triggered Well Sasha this has been a blast You have a very popular Instagram account That would be very fun for people to go through Because I think a lot of stuff would feel Quite familiar as you describe it Oh there was one last thing selfishly I wanted you to talk about it And that is parenting with ADHD What can you tell me about that? It's hard It's hard Parenting with ADHD is a huge expansion of What your needs are because not only are you having to manage your own brain You're having to manage and guide little people's brains as well Help them regulate that's really your job Yes and model good behavior And from the logistical standpoint It feels like it's just a lot to do My kids are in two separate classes Which is two different class party schedules Two different field trip schedules And two different teachers and end of school things And parent teacher conferences And that probably doesn't sound super overwhelming But that's so hard for me to keep track of it Which one is this? Which one is this? And like you have to really create good systems around that And I think the most most vital thing That I could tell anybody who is parenting with an ADHD brain Give yourself grace Let yourself mess up And have a hard time Because when I got pregnant I had numerous Pinterest boards of the kind of parent I wanted to be Like what I wanted their nursery to look like Immediately you have this kid, you're sleep deprived You have breast milk everywhere This is just not what you thought it was And that goes out the window And you're just like this is probably going to be harder than what I thought And one of the best things that we've done as a family Is work through moments that are hard and difficult kind of together As a team and problem solving So there are times this literally happened two days ago Where I was just like This is hard for mom Because there is so much So when you give me a show and tell bag And you're like I have to do this by tomorrow And it's 830 at night Right before you're going to bed You run downstairs And you're like I forgot to do this And I have to bring it in the morning That's hard for me And I'll do that But this is why I snapped at that Or this is why I had a hard time And then when I tell my kids when we have conversations like that Like any idea is a good idea Come up with solutions and let's talk about it And so like they were rubs I was like they're like Well He could have turned in his bags you earlier today Well he could have figured out what he wanted to put in there Yeah siblings are great at coming up with that It's for the other siblings I know what he could have done To put on any good ideas But not great at figuring out what they should have done But boy They can see right through the problem And there's sister Yeah I think it's just giving yourself grace When you mess up Use it as a learning opportunity for everybody I think I was so focused on hiding Parts of myself from them where I'm like What am I doing? I don't know what their brain is going to play Well again you're asymmetric rejection reaction You can feel rejected from your family You can feel rejected Yeah Getting burned by my five year old I feel like here we are Okay well this was lovely Cannot wait for the new book Currently though you could start with Self-care for people with ADHD And then look for two sensitive rejection resilience And the science of feeling deeply I hope you come back this was a blast Yay! Stay tuned for more armchair expert If you dare We hope you enjoyed this episode Unfortunately they made some mistakes I have to say I'm only three days into no dairy And I'm already noticing Oh that's good Well that's good I was saying last night I almost would rather have a runny nose all the time You have to Yeah decide I guess So where's when you know it's better to live in ignorance Just go I'm just someone with the runny nose I know Well then you can pick like if there's something you really want With cheese and you just know what you're getting yourself into Just go okay I'm gonna cough I'm gonna cough for a day Yeah exactly I'm gonna blow my nose a lot Exactly And that's gonna be that Yeah well but also Good If you know you don't want to be coughing If you have a big thing to do If you have something to do on stage If I'm gonna be like talking For a living For a living Yeah Someone's got to edit around your coffee and into a clearing Yeah Sure that that That's good to know I would never I mean never say never If I had to I guess I would But I could never give up cheese It's the it's my favorite food I'm so good And it makes it can make something that's virtually tasteless Like a macaroni noodle on its own In a box of crab macarons cheese You're not gonna eat that You add that cheese to it Now you've got one of nature's greatest offerings Best best best best Okay I wanted to tell you that in a very fun way Lincoln has now kind of joined a little bit into our Sim Talk Insofar as we were laying in bed Couple nights ago and she was telling a story about A girl in class had a caterpillar on her shoulder Okay And apparently There's like a season for this And there's caterpillars all over the trees at school And they're dripping down on people Oh Okay that just made me feel gross And then we were just talking about caterpillars And not all of a sudden I just had this thought And I said You know Lincoln when we die And we wake up in like a medical room And they go You were in a simulation I think one of the things they're going to say is And by the way You thought that there was a tiny little sleeve of mayonnaise And that little sleeve of mayonnaise went into a dark cloth And came out as a butterfly And you bought it into that Oh god That's what it is A caterpillar is just a little tube of mayonnaise And we have bought into the idea that that thing Turns into a butterfly Somehow goes into a dark cloth And comes out as a butterfly Is preposterous When we're talking about like the bus maybe is proof of the Sim I now think the caterpillar butterfly metamorphosis Story we've been told Is insane How would it go from mayonnaise to a butterfly Well how would a seed this small turn into you Oh the like the embryo Yeah It starts as a sesame seed size I know that's crazy That is crazy But I don't think his nuts is like a little tube of goo Goes into a cloth It is now a flying Most beautiful colorful structure Where's it all coming from That mayonnaise Don't call it that It is so nasty Oh my god So then when we're having a lot of fun with what else they are going to say to us Like you guys He's not an octopus could swim over an environment And immediately become that environment Without even looking Their eyes are looking up at the surface of the water And then they They just hover over some coral And then their whole body immediately is the color of the coral Oh camouflage Get real Look Get real These beings are very impressive Is there anyone you want to add to this one So right now it's like Leading the charges like butterflies We're going to feel so stupid that we bought into that And then for us the octopi Camouflage That's a big one If you watched it recently It's in Monica It could swim over your face and it would just be your face Really talking about Wait really It just can't be the camouflage Is that what you mean The bioluminescence Or whatever the thing it's called It's identical to whatever it's swimming over No way It's not an LCD TV It is Well they're telling us it is Also a TV I mean all of it It's all It's TV I'm fine with No A TV This is the prehistoric globogoo Globogoo Well Okay you're fine with it I'm still I mean I just think humans Is that's a bigger To me that's a bigger leap from going From a sesame seed to you Is bigger to me than the mayonnaise god But at least the thing is cell dividing And it's taking on Building blocks through nutrition To create the new cells And you can just see the course of action It's like it's double And you never time it divides It's very trackable This sesame seed With no eye Nothing It becomes a human Yeah It's wild It's wild But again This gooey slug enters a cloth And then it flies away Okay, yeah You're not as perplexed by it But I just think it's one of the It's a miracle It's one of the hardest to believe Things that happens in nature Yeah, I mean there's some things like ladybugs That I don't like But have grown to like a little more Okay What are they doing that's so startling Really just the way they look It's like wow Or like same with fruits Or like the pineapple It's like nature made this Nature made this pineapple This thing with spikes And this hat on it And and the sweet and it like I know but I'm struggling with it You're not letting me The gap between these two organisms If you were to like you just look at all in nature And we didn't know that those were the same things They'd be two of the last things you ever even Put in a category A caterpillar in a butterfly Sure It's like a elephant going under a cloth And coming out as a rattlesnake Yeah Okay You don't like my examples Or not my examples They're just things that I find like wild About the world Yeah, you're um You're really blown away with growth Yeah and like The ladybugs doesn't grow It just is very It's just how is it red with polka It like nature made polka dots Like perfect polka dots That is just sound On top Like On an on an insect Like what? That doesn't even make sense It is crazy And then if it turned into a screwdriver at some point Sure You'd be like hold on I guess yeah, I don't have that I'm not that Be wildered by metamorphosis One animal turning into another animal Yeah, because Because of the seed turning into you Like I'm primed with that and that Yeah, my distinction is like it was one thing and now it's another At least the seed was always a human You know Well the butterfly was always a caterpillar at It just I know it's what they're trying to tell us That's what they want us to believe Um Yeah, I mean yes Sim the sim is crazy Mm-hmm It is I mean what about magic What about magic We're gonna feel foolish You're gonna feel foolish Because you're gonna be like They're gonna be like No, that was magic Like those tricks that David blended Aren't tricks That's magic And like you spent so much time Trying to figure out What what were the tricks Since there are no tricks Yeah, I mean as you know I spent no time trying to figure that Because I know I can't figure it out And I know it's not magic Yeah, but you're gonna find out it's magic Oh, we were playing uh 32 questions last night at dinner Oh And Delta really stumbled upon one Now it was that I would argue that she was wrong on both fronts But one of the questions was Is it man-made Oh okay Or is it from nature Okay I like that Yeah, and so it wasn't man-made We figured that out early And then later on the line There's not from nature And then so I kind of bailed out of the game So I'm like well if it's not man-made And it's not from nature Then they can't be anything Okay Right There's no there's nothing that's neither of those things Let me think Not man-made It did And not from nature Did she mean like Cotton or something That is nature But like I could see her think like Well what it was was weirdly It was both nature and man-made Which is maybe why she didn't think it was either An eyelash Oh So that's both nature and man-made That feels like she stumbled upon a riddle Oh That is a good riddle What is man-made And Nate from nature From nature And eyelash Although she said it was neither So She meant both I can understand why she said neither Is it man-made No At that moment she was like no The body made it Nature made it Right And then Is it from nature And it's like no it's human-made Sure Sure Well yeah Yeah Interesting That's a fun game Yeah it was It's fun for a while I bow out pretty early My Attrition for 30 questions is brief Okay Once we I guess I lose I lose hope Again when I heard it's not man-made And it's not from nature I'm like well then I can't continue to get I'm doing running the fools air And now There's nothing that is Not either one of those things Okay Okay Yeah Comment if you can think of something That's neither That's a riddle Well it's not really a riddle It's just a hard question Would we say like Thoughts Or man-made Well I guess it depends on how we're How we're saying man-made If we're saying They can't exist without a human Hmm Okay Like a wrench doesn't exist in nature Yeah exactly But a man didn't can Like guess construct thoughts But it's more abstract than that They didn't invent thoughts I think it's an example of it's both in that case Because it is the human thought Like what's Is human thought man-made or nature-made Yeah And it's both Or neither Or I'll play with Delta Stay tuned for more armchair expert If you dare Let's play Play There are two questions Why don't you want to play Okay you have something No you have to do it No Oh okay Think of something Um Okay I have it Is it man-made? Yes Would it be sold at Walmart? Yes Is it smaller than a microwave? Yes Is it for personal hygiene? No Do you plug it in? No Okay It's smaller than a microwave You don't plug it in They sell it at Walmart Is this where you give up? We're getting close to where I would give up Okay Rob do you have any questions? Is it food related? No No Okay so we're not eating it It's smaller than a microwave Is it bigger than an iPhone? No Wow okay great We just really got So it's kind of microscopic But they sell it They sell it It's smaller than an iPhone It's not personal hygiene And it's not electric Is it a pen? No Is it home improvement related? No Would it be in your living room? Um I would say no Like it would be Would it be in your kitchen? Um Not traditionally Would it be in your bathroom? No Would it be in your closet? It could be in your closet Could be in your closet Your nightstand? Yeah I'd probably put it in my nightstand Wow Not electric Well don't plug in Is it battery powered? Um I think It's not plugged in And But it's But it has a mechanism It's electronic Is it electronic? Yeah Is it a vibrator? No We were led there Yeah Nightstand Yeah Yeah Has a battery Smaller than an iPhone These days you do plug in your vibrators For a period They're not tethered Right correct If you've got one that's tethered I tip my hat to you Like you need that tranna voltage Yeah Yeah Um A remote Um No It's not a remote But You're kind of in They're in the right zone Is In the nightstand Not a remote Not a vibrator Is electric I mean I don't know if it's It's a electric Okay Can be It can be Oh Wow Non-pitri and a nightstand drawer I mean Don't get so stuck in the nightstand It just it could be there Okay And you said it is or is an electric It can be And be Batteries Let's say it has battery Tell time Uh Um Is it a watch Close Very Very close And some would say it's a kind of An apple watch No Like one of those fucking rings you wear Like a Or a health monitoring Think a little more archaic Stopwatch Yes Good job A stopwatch Yeah Do you have a stopwatch I have one in my nightstand You see okay You have a stopwatch No, I don't No, a stopwatch Um What may do you think of a stopwatch Uh Because there's a stopwatch We're uh using in at the sag awards Uh Top of mind Did you would say that? Top of mind Okay Okay I mean I feel like I keep it in the nightstand Or I keep it um You know Yeah, and the garage toolbox I'm gonna meditate on why the game for me Gets frustrating Okay Probably just because I don't know And I don't like not knowing Sure, probably Calvin likes and it's frustrating for me too Yeah, it's hard, right? It's especially when you I'm not sure he's always answering correctly I have the same and as is a male thing I'm like suspicious that either they forgot or Yeah, like Vinnie we can't play with Because he's got to change it, right? Yeah That's the other thing You catch these kids changing it Like if you guess it too quick They don't like that Yep Sure And it's what should happen Is it should be written down on a piece of paper To keep everything above board Well, I mean playing with kids Is different than playing with the dolls Like I think if you play with kids Sure, they could be a little like Are they switching it? Are they what are they up to? Do they remember? I mean a lot of the time like It's a long game Yeah And I'm sure if they remember Sure But if you're playing with an adult And you don't trust it Uh-huh That's on you Uh-huh Okay Adults know what they're doing Yeah, whether or not they would change it Is another thing There is some legion of people that would change it Sure, but if they don't know the answers Like that's like a little like You know It was very easy when they were tiny children Yeah Because you knew it was something they could see in the room Of course Yeah Oh yeah, yeah, yeah, yeah You would like You could narrow down pretty quick Yeah Is it a light switch? You know That's because they look at it immediately too And then say they have it Wow Every time you ask Is it brown? No So yeah I know, so cute See a little caterpillars turning into butterflies All over the place All right, should we do some facts? Yeah, let's do some facts Okay I didn't bring it up in the interview Although I was tempted to What You know Sasha holds a very dear Oh It's a very important name to me It is That's who you had to spend with Oh yeah, that's your first girlfriend That's definitely not Say that to Sasha Was that That was your first girlfriend Or the first thing you had to crush on We're getting close It's so relevant that my therapist remembered her name Is this because she had the sound? No, that was That was Randy, that was later Okay, so elementary school could not No, no girls like me And I like so many girls I was just telling Delta this the other day I was like, I like so many girls No, no, no, I'm like me I got a sixth grade with my new look That my brother did Right, right, right And the most popular girl in the whole junior high Yeah, Sasha Cross it Okay, yeah It was an eighth grader Yeah, I knew she was an eighth Came up and gave me a note in the hallway In the sixth grade hall Okay And I took it into my science class And I opened it up And it said, will you go with me? So you dated Yeah, yeah, yeah But she wasn't your first girlfriend? I had a, I got to be careful Well, this is, I'm going to call her Frank Frank? I had, I had like a fangirl time Once it was Let's just leave it like that Wait, what happened? I had a, I don't know if you'd call her a girlfriend I had a girl who I think You could talk to her Yeah, a little bit And I think, I think on fangirl time say Maybe I gave her something Maybe she gave, I think Why does she gave me some Some fudge or something But I, yeah, I do remember her name The reason it's so important is it is a transition from No girls like me To the most popular girl in the world I know This was a humongous The biggest 180 of my wife That's huge I also think I was kind of right And saying your first girlfriend Because I'm not counting this fudge girl That's fine That's fine Yeah, we made out, we made out so hot We would make out in front of the buses Why? Dean, you didn't make out with fudge No, no, no, no Yeah, she was your first girl friend So I'm right Yes And I guess I'm impressed you didn't bring it up Because It's really important We have an interview to Sasha No, we have it No, I have only met one Sasha since then Sasha, I'm calling I guess too Thank you for pointing that out The other was Is a Russian dude I knew Oh sure I know All right Well Godmother's bookstore You know, I was like it's in Monocito And then You guys were like, it's not a Monocito, we're from there Yeah, yeah And then The Santa Barbara, right Okay, which I think Rob said Summerland, Summerland Oh, okay And everyone was like, yeah, that's not Monocito Okay, which is fine But then when I googled, I said Where has Godmother's bookstore It said Godmother's bookstore is located 2280 Lily Av I think Rob had said that Because you said, Lily, that's her middle name Summerland, California Founded by Jennifer Rudolph, Lash, and Victoria Jackson in 2024 Oh, it's pretty new I'll say It is situated in a restored 1920s bar Victoria Jackson, the performer from setting a life, Victoria Jackson Who's that? A beautiful blonde cast mate in the late 80s Oh, I don't know, I see her SNL Oh It's a different Victoria Jackson, it's a Cosmetics mogul Oh Cosmetics mogul Okay, great With the renowned literary agent Oh, well, it's situated in a restored 1920s barn Often described as a cozy curated space Near Monocito It says that Near Monocito, it does Open daily You're having a hard time with this one You're never really hard to take another swing at it It said it though I didn't even say I said where is it And it even included Monocito Yeah, yeah, yeah So, it's such a cute bookstore Oh my god, I could live there Oh, brand new too This is a point of year and a half old Yeah, timeless I love it Okay, now You know how I was on D Suited up a different Thank you, which is meth Precursor Does meth eat alcohol? Just said, he used to make it like a Pac-Man And it was like the meth would eat the alcohol Yeah, does it? It doesn't eat alcohol But it gets you high Which offsets the inebriated effects of alcohol Okay Like as alcohol is such a depressant So if you imagine you took a Xanax And then you took an Adderall The Adderall would lift you out of the Xanax It's really interesting And this is why people do speedballs Coke and heroin, they're opposites So you're kind of leveling off both sides Both downsides of the drug An interesting thing A heavy heroin does your nodding off It's not ideal Coke your two edgy Nogging on your face You know So I think that's what he means Is it right-sized as an ebriation I don't think it metabolizes the alcohol It's faster Okay So a cocaine does the same thing Got it All right What was the most popular Flintstones vitamin flavor Based on nostalgic discussions The orange Flintstones vitamin was widely considered That's what I think of Really I was a red, I'm a red She liked it great I think they made orange really front center in the ads She says purple And in some cases the iron fortified versions Were less popular due to tays With some users describing purple as Yuck Well Purple was my favorite Oh Oh You and Sasha could have shared vitamin Oh valentines That's cute God I loved them Says nothing about red Um I'm gonna give you credit For something So you've been saying for a while That Godbore Mate is a expert in ADHD And every time you say it I stop myself from saying Is that true? I don't remember that I know he is like a trauma expert But I don't remember ADHD So I thought this was my inn Yeah, to correct Yes Godbore Mate is a Canadian physician and author He has worked in family practices And specializes in childhood development and trauma Including long-term effects on physical and mental health Such as autoimmune diseases, cancer, ADHD and addiction So it's in there Yeah It's in there He had his circuitous path Is if you remember when we interviewed him Started working with the addicts and skid row there Yes That wasn't his thing But that became his thing Yeah exactly I found like Sapolsky being a fucking primatologist As a hobby You know I think his addiction And trauma stuff, some more was his hobby Right But now he's really known for that Yeah Yeah, he's written five books exploring topics Such as ADHD, stress, developmental psychology and addiction Now if you guys miss that episode You really should go back That is such a great episode we did with him Oh I guess I'd like to say one thing too Eric died, my friend Oh yeah And he was such a beautiful dude And I think it would You're a game Eric Dane Yeah, I think It would be a lovely episode to listen to It's curious about what kind of spirit Eric had Yeah I'm sorry, how are you doing? Um Well, I was talking to Lincoln about it And I said I Well first I go straight to like gratitude Right, like I had a lot of I was When you hear someone as ALS My worst nightmare of that would be I have lock-in syndrome And although he was very very diminished physically At the end he couldn't move much of his body If at all He could talk So he avoided that phase So I just immediately In the same way when my dad died I felt grateful Like it didn't get gruesome Yeah So I was grateful for that I know how many people were around That made me grateful And then the sadness I think for me Takes a minute and I was talking last night to Lincoln I said I don't know imagine you came home from school today And mom said Dad died today Don't Could you comprehend that And she's like no I'm like yeah wouldn't it take you A long time You'd be like no that's not that's not true That's not right And then monthly you'd be like oh wow that really is true That's So I think I'm in that phase where it's like is it no Yeah I mean intellectually I know but also Yeah I think that's totally normal I think that's not Yeah how most people processing It takes a minute I feel guilty about that Like I see people In real life and in movies They hear bad news and then they are immediately devastated And I'm so protective I think I have so much like Yeah Well worn neural pathways I'm like I have so much shit that just engage Just right away to prevent me from feeling terrible Yeah And I think it takes a while for me to Be willing to let that in Yeah I think you shouldn't feel guilty about that I think It's totally normal And what's the problem But there's nothing wrong with it No other than I think Well my fear would be like let's say I had been standing at the hospital And they pronounced my dad dead And then all of his friends were then And they start crying and I don't And now I appear to be associated up But you know Like associated with That's like the fear problem Right Or That's on there I watch these fucking date lines And the cop show up And I've witnessed something terrible And I'm kind of stable and they interpret that as guilt Right Like these are the crazy thoughts I have about like Of course, yes But that's But you're supposed to act as certain People expect you to act as certain way And if you don't, they start filling in explanations As to why you're not reacting the way they do I know, but that's the key That's on other people That's on those people who are deciding that Everyone should be reacting the way they react Yeah And I think it takes a long time To process all of these things Yeah And Yeah, and I'm sorry It's really sad Loss is hard Yeah, when I some two weeks ago There's lots of laughing Yeah, that's good That's good Okay, sorry, I interrupted that fact check for that But I had forgotten that I wanted to say Yeah Well, let's just end on that Well, do you have another one? Well, it's just about PMDD It's just really bad PMS All right, people People they DHD get PMS sometimes worse Yeah, and I have I'm pretty sure I have PMDD Okay And so then I was PMD Are you sure you can flamin' things? God I do think I have it And then I was like I also have that rejection thing Maybe I have ADHD Yay For you Talk about a 180 No No, I don't, I don't think I do But um But it's all spectrum, you know It is, it is So that's All right, love you Love you