Denise (00:07):
Myth magic medicine and everything in between... Two doctors talking...
Denise (00:13):
Welcome to Myth, Magic, Medicine. My guest today is Diana Mercado-Marmarosh, a family physician whose personal experience with ADHD has led her to a mission to help physicians and medical students create systems that support them at work and help reclaim their personal lives. Hi Diana.
Diana (00:36):
Hi, thank you so much, Denise, for having me. Uh, yes. So I'm a family medicine physician and I got diagnosed, during my first semester of medical school, with ADHD and actually I had no awareness. I didn't even know what ADHD was. I remember that I was struggling a little bit with my tests, which was, I mean, I always was the one who finished the test last, like that was never a question. I always took like the very, like, I would turn it in last, but [ when I ] got to college I started to struggle a little bit and I wasn't sure if it was because all of a sudden it was multiple choice instead of like writing out stuff. And so I was like, maybe it's just that and the way it was worded.
Denise (01:33):
Can I just ask a quick question though? So a lot of students struggle because all of a sudden they're responsible for their own behavior. You know, they've turned 18 it's on them now. So how, how did you, how did you feel your issues were different than other students that you were in class with?
Diana (01:49):
Well, again, I had no aware awareness. Okay. I just thought it was just the learning curve that it was just different, and be whatever it took, cuz I couldn't, I couldn't flunk out. I couldn't lose my scholarship because my, I came from humble beginning. So like my dad was a welder and you know, he would make $30,000 a year. So, I was attending a school that that's what it cost a semester. So of course I had to figure it out because I could only come if I had scholarships, right? Like that's how my mind worked. So what II did whatever I had to, meaning I had to get, or I didn't have to, I wanted to -on purpose, go get a tutor for every, every subject. And so to me at that point, I didn't realize that that was the most helpful thing because I could then talk to the experts and by talking to them, I figured out what was crucial on the test because to me, everything was a priority.
Diana (02:50):
I wanted to learn every single detail. And you could imagine that I wasn't getting the big picture of what was like important And so by having tutors, all of a sudden I could hone-in on, oh, this is a important concept. Oh, okay. And so I started to put it together, but at that point I had no idea that that's what I was doing. That was a way that was helping me to do it. And I think my, even, even though I struggled my first semester, in my first year, I was then, you know, slowly, all of a sudden I started getting Bs and then all As, but it was because a couple of things, I started, doing group studies, studying with people, maybe I wasn't talking to them, but I was in so many different activities. Like the NHS [National Hispanic Society] president,, you know, the Folkloric thing, the debate team, you know, I was in so many things and plus working. So I think I was pulled in so many different directions, but all that kept my dopamine levels up. Again, no awareness that I had an ADHD problem because my grades were good.
Diana (04:06):
But the point is that, I was never the best, standardized takeer, a skilled test taker, and I, was even surprised I got like a med school interview, even though I always put in the work, like I went and I did that six or eight week or whatever program you had to pay, you know, for Kaplan or whatever it was to help you.
Denise (04:31):
So at what point did you realize that, that there was something more than just, I need a better habit that there was an actual diagnosis?
Diana (04:39):
So again, I had no awareness. Like I was out-working myself, like I was working, studying 80 to a hundred hours, who knows how long, right? And so it was my classmate who said, Diana, there's something wrong here. Why are you studying like two to three times more than me?
Diana (05:02):
and yet, I don't know if you're just like so tired from studying that you're not retaining nothing or there's something wrong because you can tell me things, you can explain things, but then when you look at questions you're not following through,maybe you're not understanding the wording of the questions or maybe your English and your Spanish, ;ike it's messing you up or like, you know, because I learned English at 10.
Denise (05:33):
We, we definitely need to take a little sidebar on the validity of bilingual education. If anything, it was probably an advantage
Diana (05:43):
Yeah. But she was like, I don't know if it's that you don't understand the wording, like maybe they're asking double negatives. Yeah. Or like, or like, I don't know what it is. She's like, but something's going on. And at that time, my dad had been diagnosed with, colon cancer, sorry, stomach cancer and, so she's like, I don't know if you're just stressed and worried about that or maybe you're depressed or something else is going on. She's like, but just go get checked just to see if there's anything, because I would take my test and I would complete like 60% of it. And then everything else was C, C, C, C CCC all the way down, because I was out of time. Yeah. And had me do a formalevaluation. It's called a neuro-psych evaluation, which is an eight to nine hour test.
Diana (06:34):
So I got formally tested, and then they wrote up this like 20 page paper on me. and they said that it was not anxiety, that it was not depression, that it was ADHD. And that, that I had really strong visual skills. So that, that would be something that I should use to help myself. So they gave me examples on how I would function best. And so with that advice, I was then able, whenever I was making my notes, I would first go to the pictures in the book to try to understand and figure it out myself and make my own questions before I would even start to jump on the text. It was not until I started making my notes with pictures and like visually separating things, like saying, oh, all of these are lactose fermenters, all these are non-fermenters...
Diana (07:28):
Then in my, in my brain, when I was taking a quiz or a test or whatever, I could be like, oh yeah, these were on this side of the page. Yeah, No, No [gesturing] Okay. I have a 50/50 chance, but at the same time, it was really, that was helpful, but it was also kind of like the answers would just pop out and I wasn't trusting myself cuz I was like, "That was too easy!" And so it was like, I was almost, if I couldn't explain to you why, I didn't trust my intuition. And so it was like a mixture of stuff. So, but anyways, I learned to finally be like, well, if it came, it came, I'm just gonna put it down. And until I know for a fact another answer, I'm not gonna question myself.
Denise (08:12):
So once you had the diagnosis, did you have an ADHD coach? No.? They just said, okay, this is the diagnosis. Put these techniques in place.
Diana (08:21):
This is the diagnosis. Medicine
Denise (08:23):
Yes. Okay. So you were put on one of those
Diana (08:27):
Ritalin five milligrams
Diana (08:29):
And again, they didn't explain to me that it was in a short-acting. They didn't explain to me that this only lasts four hours or whatever. So you could imagine I was like self-hating myself, cuz I was...
Denise (08:42):
You hadn't done pharmacology yet.
Diana (08:43):
No, I was a first year. Right. So I had no idea how this medicine works. They just gave me five milligrams and they're like, good luck. Right. And they just said, take that once a day. And so you could imagine how I was like, well, and then I had to go back like feeling ashamed. And I was like, I'm so sorry. This is only working a few hours. And I'm trying and it's not working. And then they eventually changed it to 18 milligrams, extended release. And, but they never changed it. Like they always kept me at that same dose. They never said, oh, you might need a short-acting one, like when you're starting at night, like here's five milligrams. They never really adjusted it. They never asked me how it was working. It was like, here you go. This should be it. You don't need anything else. And, and this is where I think if, if they failed me or I didn't know any better because had they set
Denise (09:38):
Let's stop the shame business here Yes, you were a medical student, but you were a medical STUDENT, the patient, obviously patients can fail the doctors all the time. If you don't tell the doctor, you aren't taking the medicine or the medicine isn't working, there's no way for the physician to know this. But, but to just say, well, here's your problem toodle-off , go on your merry way. You're a lot younger than me. When, how long ago was this happening?
Diana (10:07):
Yeah. So, I started med school in 2004. Yeah. So it was in 2004.
Denise (10:14):
Yeah. So my frame of reference when I was in training, was in the eighties and I might have accepted that from somebody in the eighties. I could, I could see that happening, but by the two thousands, this was a well established phenomena and adult diagnosis was not unheard of. So that's a, that's a significant failure. Yeah. It's perhaps, it is perhaps, because we do have a tendency to assume that higher functioning people can kind of figure it out because they figured it out before. Yeah? But it's still failure of the system. We, this is this, this is a shout out for all holistic medicine. We need to put all the pieces in place for people so they can succeed.
Diana (10:56):
Yes. And, and I wish they would have told me, Hey, seek a therapist, Hey, seek a coach. Hey, like try different things. But again, maybe that's what I needed to go through to later on do what I'm doing now and be able to be like, Hey, medicine can do a part, but then you also need to understand yourself.
Denise (11:20):
Okay.
Diana (11:20):
[To understand] how you think. And, and you can try coaching, you can try therapy, you can try all kinds of stuff. Okay.
Denise (11:26):
So this is a good place to ask you. So what do you offer? You are an ADHD coach in addition to being a family medicine physician, you see children, I'm sure, who are labeled by their teachers and thought perhaps they have this. Can you, can you briefly, speak to the different presentation of a child starting school and finding a struggle and an adult starting higher education and finding it a struggle, with a little bit of a stop there. When I first went into practice, when I left my pediatrics fellowship, I went into general emergency room medicine. And for all the EM people who were having a heart attack at the idea of that, we were still grandfathering people in, there weren't that many places to train. So I used to see all the kids in the ER.
Denise (12:20):
But I remember very clearly a three year old coming in for stitches and I'm looking at her chart and I said, she's on Ritalin. Why is she on Ritalin? And, the mother said," Oh, she doesn't behave at the supermarket., I told her doctor and he put her on it" She wasn't tested. She was just put it was it, it was one of those diagnosis that was just, oh yeah, well it's that. which was pretty horrific, to me. But unfortunately as the ER attending, I didn't have a say in the matter. Yeah. So,can we speak to,the timeline of how these, these things sort of come, come to people's attention because a lot of kids never get diagnosed. They're just [labeled]troublemakers.
Diana (13:05):
Yes, exactly. Yeah. Yeah. So I think part of the delay for me getting my diagnosis is because I'm Mexican, I'm Mexican American, but I grew up in Mexico 'til I was 10. I was born here in Texas. My parents were immigrants and my mom just had me along the way on the way back to Mexico. So that's why I'm a Texan, but I grew up in Mexico and there, me and all my cousins, like we're just high energy kids. We probably might all have ADHD who knows. Right? But we didn't think anything of it because that was just the environment. And so I think that sometimes females can get missed and sometimes just kids can get missed in general because we assume that their high energy and creativity and stuff is just normal, which at some point it is to an extent. So
Denise (14:06):
The diagnosis is only made when their behaviors are inconvenient to the rest of society.
Diana (14:11):
Well, I mean sometimes right, because, or they're not doing their work, right. Like if, that's where it gets tricky because the stuff that I really love, like, of course I excelled. And like when I came from Mexico to over here, like math was this, I didn't have to understand it. Math and English. Right? Yeah. So I could like do multiplication and everything, even though they had to put me back a couple of grades over here, like I was fifth grade level over here when I was supposed to be like, if they just looked at that,[math] they're like, well, she's really smart. There's no way. Right. And then the stuff that I like that I love, like they kept giving me more and more work because I loved it. And the stuff that I didn't understand, they're just like, well, English is your second language is not a big deal.
Diana (15:02):
And so you could see how it, it can get jumbled. But the point is that nowadays you just don't say, okay, I can't control that. Like you do the standardized, I guess you could say standardized the Vanderbilt forms, that there's special screening things that is done by two, two to three, teachers. So they want to check like the whole school behavior environment. And then they're done by the parent. Right? And if the kid is kind of old enough, maybe 9, 10, 11, there's even one that they, themselves, could check out,like how they feel. Right. And so it's like taking different perspectives, instead of just saying, oh, Johnny is disrupting the whole class and not doing their work because they're not, you know, concentrating. And so sometimes girls can get missed because they tend to be more inattentive.
Diana (16:03):
So you could imagine the nice, friendly, quiet, shy girl in the back of the room, daydreaming. And they're not causing a hot mess. They're just not doing the work because they're in 10,000 ideas. Right? And so you could see that why she would not be picked up right away compared to Johnny who's like tearing up the room and you're like, oh my God, what are you doing? Right? And then there is something that happens if you are a female who is hyperactive, like Johnny, when we go through puberty, like we tend to calm down some again. So then you could miss us again there in high school, because we're not the screaming type all over the room. Right? And so when you get all the way to, high, I mean to college or to medical school, law school, something that requires your level of executive functioning to be superb and whatever you had been doing, those systems no longer work, working harder is not the right thing.
Diana (17:08):
It's like, you now have to learn how to prioritize, how to batch, how to do, you know, precheck lists and all these other things. And like you said, most of us, you can see when you were being taken care of, or have some safety nets that your parents were doing, the laundry for you, cooking for you, you know, all those things. And then all of a sudden you have to make your decisions for yourself. Meaning like, what classes am I taking? When am I studying? When am I doing my laundry, these tasks, executive tasks that become like a problem And then sometimes you don't realize that there is an emotional component to it. That is not really used to diagnose in the IS, but it is used in Europe. there's the emotional dysregulation piece. And
Denise (18:04):
I think they're beginning to realize that.
Diana (18:07):
Yeah. I think it's, it's slowly starting to become understood because, if you can imagine, we all have, this is how I describe executive function. It's like you wake up and you have a full battery. So that battery, or that energy making capacity, right. Comes down, comes down. The more decisions you have to make. Right? And so at one point you're kind of like trained and you aren't even aware. And so more input comes in and all of a sudden, you just explode because you don't even have the awareness. Yeah. You don't have the bandwidth. And so people look at you like, are you crazy? You just blew up or you just started screaming or, and you didn't even realize you're doing that. You don't have that two second delay between the prefrontal cortex and your amygdala. And like, that's enough, you blowing up was enough to like reset. But now you look very unprofessional around everybody else because they're like, what just happened?
Denise (19:11):
It seems disproportional.
Diana (19:12):
Yeah, exactly. Yeah. Anyways, the point is, that as you become an adult, because of the adulting task that you're supposed to be doing, like, paying your bills, right? Cleaning your house, meeting deadlines, imagine how it might just seem to some that, oh my God, they're being lazy because I can see how bright they are in this other area, and yet they can't do the dishes or they can't just pay their bills or they can't just open the mail. Right. And so you can see how, I call it the tortured musician. Like they might , they might have this Beethoven piece, but they have no insight that it's a Beethoven piece or they don't have the possibility to take it out into the world, so everybody else can see because they get 90% there and then they burn out or they start criticizing themselves.
Denise (20:13):
So when you are, when a physician, I, assume you,... do you work with other professionals or just doctors?
Diana (20:22):
So I have a 12 week group coaching program that is just for physicians. And I actually have another program that is just for medical students. I realized that they, you know, while we, we have same executive things, we are just focusing on different part of our lives. So for the physicians, we are wanting to leave work at work, wanting that work balance with their kids. Like we want to chart and do the in basket at work and be actually present at home. Right? And for the medical students, their pain point is yes, wanting to complete whatever work they want , completing their task or whatever. But they're more like board exams, board exams, board exams. So that's the bane of their existence versus for us. Yes, we had that, but now we've gone through that and we're at a different phase. So anyways, my group coaching is medical students and physicians, but I said they each have their own, but I am a guest coach in other programs that I sometimes go and support.
Denise (21:29):
When you were talking about, you have this full battery and you wake up, where do you think siestas might help with this? Since you're from a culture that certainly used to have them? My husband's from the Dominican Republic. And the siesta was very much part of the life there in the seventies and eighties. It's going away. It's, everything's open all day now. But many people, certainly professionals still stick to that. Do you think that helps? Is it, is it doable within certain...
Diana (22:01):
I think any time that you're able to take a pause throughout your day, whether it is five minutes of a tapping meditation or 10 minutes for you to enjoy your food without like having to chart and eat your food, right. At the same time or gulp it down. Right. I think any moment where you're not having to exercise your brain is helpful so I can see why taking a siesta or a nap would like unplugging you from the craziness. Right? And why then you could come back and be refreshed and be ready to go. So, like, that's one of the things that I really feel has pulled me out of burnout. Like every day I make sure I do, at lunchtime, I have like at least 10 minutes for me to eat without disruptions, without whatever, without me wanting to be on Facebook or wanting to like, do anything else, but just like being here, right here, right now.
Diana (23:13):
And then those three to five minute micro meditation daily has really like, helped me to get out of that like overwhelm feeling that I was having, because I always felt like, I was turning off fires instead of, I was always living from a place of reaction to whatever was coming my way, instead of a place of, no, I planned this on purpose. No, I know this is, look, I designed it this way, and of course life happens, right? You're a physician, life happens, but now I've learned how to decrease those distractions because I work 80% in the clinic and then [when] I'm on call for a whole week. We alternate, so when you're on call, you are doing the clinic plus being on call and you're on call from like 7:00 AM on Monday to like 5:00 PM on Friday. And sometimes you're on call that weekend. So then that means your whole week, it goes straight, right? It goes like 12 days straight that you're kind of on. And so knowing how to take care of you by taking those little breaks, when you feel like you're about to lose your stuff, makes a big difference.
Denise (24:39):
Okay. If somebody listening to this suspects, they may have some of these issues, what would be their first stop?
Diana (24:49):
So I, I wanna quickly point out how this could be seen in physicians in the workplace, because sometimes we don't even realize it ourselves, that we could be the one that has ADHD or that our colleagues could have ADHD. Yes. And having that awareness, I think will be life changing. Because again, ADHD just, I wish it only affected you, but unfortunately it does not. It affects the way you interact with your family. It affects the way you interact with your boss. It affects the way you do things or don't do things for your patients. So it affects everybody. So I want to share with you, there's actually a really cool article that maybe you could link.
Denise (25:36):
It will be there in the show notes, Yes.
Diana (25:38):
Yes. And it's the title is called " Understanding ADHD in physicians, workplace implications and management strategies",
Denise (25:50):
If you suspect that you have it, you should talk to your family doctor first?
Diana (25:57):
Primary care first, I think, first of all, if you think that you have it, or if somebody else thinks that their colleague might have it, I think...
New Speaker (26:08):
Ah, but see, I was going to ask you that one, second, because if you think it, then, then you've already decided you've made that first step. If you think a colleague has it, that's gonna be a very different conversation than one you had with yourself.
Diana (26:24):
Yeah. So if you think you, so if you suspect you have ADHD, I would start with going to your primary care doctor. Right. I would make sure that they screen me or screen you for anxiety, depression, or ADHD, like all three of them, because you'd be surprised how sometimes we get diagnosed with anxiety and depression, but you really had ADHD because you couldn't complete the task that you wanted to. You were so upset, which right. Which is depressing. You were so upset and you, and you couldn't imagine why you would have palpitations. If you feel like you're gonna get fired, because you can complete what you're wanting to complete. And you just can't right. And now don't get me wrong. It could be that you have all three things going on, which has happened. But again, if maybe you had ADHD and you were just never screened for it being treated for anxiety and depression is never gonna fully get you to where you want to be, because you don't, you never treated the root cause
Diana (27:32):
And so if you did have ADHD, then all of a sudden you'd be surprised how many people don't need to have their anxiety and depression medications, or if they do, they might need like a tiny dose just to, regulate you. Okay. So I would start there. I would start with a family medicine doctor. If their medical doctor is not comfortable making this diagnosis, go get a psychiatrist opinion. You know, I think it's worthwhile. If you think you are struggling and you didn't even realize you were struggling because you just thought this is the way it's always been. I really do feel like you need to get a second or third opinion or get somebody who's a specialist in that area because, making the diagnosis can be life-changing, life-altering, because understanding it could then make the world of difference because then now, you know, now, okay, so this is what I need to do. And so I think that's the first step getting the diagnosis because then you can start to peel the onion and start to see.
Denise (28:48):
But you, were told you'd outgrow it, you learnt skills to get around it. You don't outgrow it.
Diana (28:54):
Exactly.
Denise (28:55):
Okay.
Diana (28:56):
And, and so I was working myself to death, unaware that I was working myself to death charting 20 to 30 hours outside of work, uncompensated pay on top of doing everything else. But I didn't know if there was a better way. It was love-hate relationship because I loved my patients and I was gonna do whatever it took for them. But I was like, why do I have to write anything? I just had an amazing encounter with them. How come nobody was videotaping that? Right. Yeah. And so, but I understood that this is how they have to get paid. There has to be something in the chart. Right. So the point is I had to learn that [about] medicine. Then I started, ADHD coaching [for] myself. I finally, with the pandemic, it kind of got me to be like, okay, maybe there has to be a better way.
Diana (29:43):
You like are so tired. You're not having time for anything. And so I invested in ADHD Coaching, then I invested in Life Coaching. And then I decided that I needed to tell other physicians that there's ways of doing it, leaning into your strengths so that we all can get to practice medicine on our own terms. And, and so the point is of this whole talk is that if you have identified yourself with maybe not being the best in time management, or maybe not, being able to keep up with charts or different things like reconsider, like, where you're getting distracted, is there a systems issue? Becasue it could be that maybe you just don't have enough help and there's nothing wrong with you. Right?
Denise (30:33):
Right. And actually you don't have to be technically neuro-diverse to benefit from a lot of these things.
Diana (30:40):
Exactly. Yeah. And so in my coaching group, like I wanna say 80 to 90% of the physicians in there have ADHD, but the other 10 to 20%, they don't have ADHD. They just didn't realize they had to set up boundaries for self-care. They didn't realize, they didn't realize they could have systems. So of course they come in, they implement everything I say and boom, they're like, yeah, they're like, oh my God, I had never had a free weekend in the last 10 years, where I didn't open my computer, where I was present with my family. I didn't know that was possible. And again, it is trial and error. Only, you know how to set up your system, but it's not until you speak with somebody else who's gone through it that you're like, oh! So that's the beautiful thing about being in community because there's no judgment, we're all trying to do better for ourselves. We're all trying. And it comes with CME. So win-win - get your institution to prevent burnout and get effective charting and, and effective ways of managing yourself. And, you know, everything changes all of a sudden, not because you were wanting to be a better wife or a better doctor, a better whatever but it just kind of happens when you put your own oxygen first, it ripples, right?
Denise (32:04):
Yeah. For all of us dealing with self care issues. That's, that's huge. Do you have any advice for how to gently suggest to somebody who's clearly having issues that they might want to look at that?
Diana (32:16):
Yes. Again, I really think, I am so grateful and forever will be grateful,, that, you know, my roommate at that point said, Diana, like, something's going on? I just, ask. Right? So I think it's approaching it from a place of compassion, like coming up to this person and just saying, Hey, um, I see that you're struggling with X, Y Z tasks, right? Like labeling the task. Not that the person is wrong. It's not, the person is not saying that you are dumb or whatever. Right? But saying, "Hey, I see that, you know, I see that sometimes you appear like you have too much on your plate" or "Is there anything that is going on?" I mean, cuz it could be that somebody's dealing with their families, right? Like diabetes, there's so many reasons for something, right? Or somebody passed away andjust noticing and asking the physician, what their thoughts are on a potential..
Diana (33:25):
cause, and just saying, "Hey, I'm concerned. I wonder if you would benefit from talking to somebody" Or something like "I've noticed you've been distracted in the meeting. So you've been losing things around the office or you have difficulty organizing this is everything okay?" Seeing it in that way where you're not, again, you're pointing out the behavior. Not that they are like wrong for like being in chaos. Although we feel like chaos. Right? But just saying, "Hey, I've noticed X, Y, and Z is everything okay?" Or saying, "Hey, I'm concerned about your wellbeing. Are these tasks, you know, too much for you?" Or," Are they affecting you?" Or "Can we talk further about your thoughts or are you comfortable sharing anything?" Or you could literally say, "Hey, I read this cool article about ADHD and physicians. I wonder if, and I'm just wondering, you know, you could, I wonder if you would identify with any of these things, you know, I wonder if, if you're running behind like two hours late, if you just had somebody put a 10 minute timer, so they could come knock on your door to give you that external cue that maybe you should start wrapping it up."
Diana (34:48):
And then, and because, here's the thing, people think that the more time we give our patients, the more that they understand that we care, but you'd be surprised when you really listen and you really are present. It doesn't matter if you're present two minutes or 40 minutes. Like the interaction is the same, because you generally perceive, how you interact with them is the same, and, and it's not. And so when I do this timer thing, I joke around and I say,and I tell them now, now I tell them, now I'm comfortable talking to my patients. And I say, you know, I have ADHD. It's amazing for you, because you're the most important thing in my room, but it sucks when you're waiting for, because you're like, "Where is she?" And so I say, we're doing a quality improvement project. They're just keeping me on track. That's good. You know
Denise (35:45):
Yeah. And it's also being a little bit vulnerable to your patients that it helps with the know and trust.
Diana (35:54):
Yes. And, and then do it
Denise (35:56):
And it also normalizes that, this whole myth that, you know, doctors can't get sick, doctors can't have issues, but just remember the first few patients that walked up to you in the supermarket, amazed that you shop for food, it helps to break that barrier for them
Diana (36:13):
To realize. Yeah. And I also tell them, you know, um, just like you, I have, I wonder if I'm doing it right.
Diana (36:25):
Yeah. Like having those conversations where like, they feel like they're not the best parent or like, they feel so frustrated because like they went and they did everything at work. Right. And then they're so drained and they're like, well, I'm going to work to provide for my family, but then I'm home. And I'm so irritated with my family because again, my executive function is gone. Right? And then you're just starting your second shift. It's not like you get to say, oh no, like I don't wanna be a parent. I don't wanna be a wife. Like you, on purpose, decided that.
Denise (36:58):
Well, and then that's an extra thing. If, you've managed to put it, without realizing you have, this, apparently it's a disability, this neuro-diverse way of thinking, but you've managed to put in things in place for high school, you've gotten through medical school and you have a kid and now there's just another stressor. It might, that might be the straw there. There's a lot of different things that can, that can make it just suddenly impossible the dam breaks.
Diana (37:29):
Lot of females actually are not diagnosed until they get to college or they get to med school or law school or after the birth of their first child, again, because you were so used to you kinda winging it, but then, now you have this extra, beautiful, responsibility. Yes. That cannot afford you to kind of just wing it. Right? Then you throw in if you're breastfeeding or you throw in the lack of sleep. Right. Because if they're feeding every three hours perfect scenario for like, dang, what just happened? Everything that I had in place is no longer working because here's what happens with ADHD. Like most of us swear, we're never going to leave stuff to the last minute. Yeah. But we do. And, and then magically, boom, the deadline causes the stimuli enough for you to hyperfocus and you get that task done. But then you pay for, for the next two, right? Two days with the adrenal gland, just like, on way overdrive. Right? But imagine doing that every day with a newborn you can't, like, you can, but oh boy, do you pay for it? Right? Right? And, and so that's why females usually get diagnosed or, you know, like you said, your kids, all of a sudden get diagnosed and you're like, wait a minute. All those questionnaires. But, but I do
Denise (39:06):
That seems so familiar,
Diana (39:08):
But I, I wish I was the only like, the only unicorn, but we're all, it's a spectrum. Like with there's so many things with ADHD, like why do we bite our nails? Because it's a way to like, hyperfocus, why do we do different things? And you don't think , what you don't know, you don't know. But then if somebody is lucky enough to see something that maybe would help you get out of your own way and somebody can point it out to you because you don't know, this is the way you've been for how many years, you think this is the norm. You think it's the norm to lose your keys 40 times a day, you know, you think it's the norm that you've misplaced...like today, even today, I thought it was Friday. You're human.
Denise (39:58):
And just because you've lose track of the days of the week, when all three people in your household are now working from home. So every day looks the
Diana (40:07):
Same. Exactly.
Denise (40:08):
That doesn't mean necessarily you have ADHD. But if it is something that you are thinking, please look in the show notes for the article and for some suggestions and for some links to some helpful resources.
Diana (40:23):
Yes. And if you are a physician and you have identified with any of these things and you feel like you might benefit by working with me, please do reach out because, I don't want you to go through what I went through for the last years of ignoring myself, you know. Normalizing it and being in a room where this is just the norm, you know, helps you to be able to then turn around and help your colleagues who maybe they don't realize that it could be different. Right.
Denise (41:00):
Right. Okay. Thank you so much, Diana.
Denise (41:04):
Thank you for joining us at myth magic medicine. If you have found this episode useful, you can apply for free CME credit for the link provided in the transcript. If you're not a medical professional, please remember while we're physicians, we're not your physicians. So please consult with your own healthcare professional. If you think something you have heard might apply to you or a loved one until next time.
