ADHD Types and Hormones: The Unexpected Link You Need to Know | Ludovico Saint amour di Chanaz

Episode: 8 Duration: 1H36MPublished: ADHD

Listen on SpotifyListen on Apple PodcastsListen on YouTube

Are you ready to reimagine the way you think about ADHD, mental health, and the neurodivergent brain? Today, we’re diving deep into the science, personal experiences, and practical strategies to thrive in a world designed for the neurotypical. I’m joined by Ludovico, a brilliant PhD researcher and advocate who discovered his ADHD while in grad school. Together, we unpack the complex layers of neurodivergence, hormonal interplay, and how our environment shapes our mental health. If you’ve ever felt misunderstood, overwhelmed, or simply curious about what makes your brain tick, this episode is for you.

Discover These Surprising Insights from This Episode:
In this fascinating conversation, Ludovico and I explore the intricacies of ADHD and beyond. You’ll gain insight into topics like:

  • The science behind ADHD’s genetic origins—did you know traits date back 30,000 years?
  • Why ADHD isn’t just a modern phenomenon caused by technology.
  • The powerful influence of hormones on ADHD symptoms, especially for women.
  • How microplastics like BPA and environmental toxins may exacerbate neurodivergence.
  • The surprising link between bilingualism and brain plasticity.
  • Why ADHD symptoms often evolve with age and life stages like pregnancy or menopause.
  • The intersection of ADHD and emotional dysregulation—and how to manage it.
  • Tools to identify the early signs of burnout before it spirals.
  • Why melatonin myths could be holding you back from better sleep.
  • How to decode the three ADHD presentations and their impact on daily life.
  • The relationship between ADHD and anxiety, and why they're often mistaken for one another.
  • Practical strategies for creating a routine that sticks—even with an ADHD brain.

You'll Walk Away From This Conversation Knowing:

  • Why 49% of women with ADHD experience PMDD and what to do about it.
  • How ADHD increases your risk for postpartum depression and how to prepare.
  • What your environmental toxin load could be doing to your brain—and how to fight back.
  • The secret weapon to managing ADHD overwhelm (hint: it’s simple and actionable).
  • How delayed sleep phase syndrome might explain your insomnia.
  • Why women with ADHD are often misdiagnosed as “successful but scattered.”
  • The truth about ADHD and comorbid conditions like fibromyalgia, POTS, and autism.
  • How to use music as a therapeutic tool to focus and manage stress.
  • Why burnout cycles hit ADHD brains harder—and how to break free.
  • The unexpected ways testosterone and estrogen can shift ADHD symptoms.
  • Why neurodivergent brains may be better suited for entrepreneurship than 9-to-5 jobs.
  • How sleep apnea and ADHD might be sabotaging your energy levels.

This Episode is Brought to You By

Dr. Brighten Essentials use code POD15 for 15% off your order
Fygg Toothpaste: use code DRBRIGHTEN for 15% off

Transcript

Dr. Brighten: welcome back to the Dr. Brighton show. I'm your host, Dr. Jolene Brighton. I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist.

As always, I'm bringing you the latest, most up to date information to help you take charge of your health and take back your hormones. If you enjoy this kind of information, I invite you to visit my website, drbrighton. com, where I have a ton of free resources for you, including a newsletter that brings you some of the best information, including updates on this podcast.

Now, as always, this information is brought to you cost free. And because of that, I have to say thank you to my sponsors for making this possible. It's my aim to make sure that you can have all the tools and resources in your hands and that we end the gatekeeping. And in [00:02:00] order to do that, I do have to get support for this podcast.

Thank you so much for being here. I know your time is so valuable and so important, and it's not lost on me that you're sharing it with me right now. Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast get out to everyone who needs it. All right, let's dive in.

Ludovico, welcome to the Dr. Brayton show. 

Ludovico: Thank you. Thank you. I'm really delighted to be here. 

Dr. Brighten: I am so excited for this conversation. I came across you on threads. So online and you, uh, I don't, maybe you don't even remember this, but, um, you had reposted something that was similar to mine. Like you had like posted something similar to mine and people were like, Hey, you lifted Dr.

Brayton stuff. Uh, and you were like, Oh, I should have tagged her. I was inspired by her. And I just was like, that just shows such high quality character. And I want to know this person. And then I started digging into your [00:03:00] content and I was like, I'm so fascinated. We have to have a conversation. 

Ludovico: Thank you.

I remember actually the thread. I was like, yeah, you know, I don't want to make anyone feel bad about this. And I was just inspired because it was great content and I just wanted to kind of remodel it a bit. Um, so yeah. 

Dr. Brighten: Well, and I also feel like, um, I, I always give a lot of lead way because I feel like with the neurodivergent brain, sometimes I like pick up information everywhere and then it like gets compiled and six weeks later, it's like my own.

And I think it's an original thought. And then people are like, you were obviously inspired by this person. I'm like, Oh, I was, I forgot about them. I forgot they existed. 

Ludovico: Yeah. And also when we do content, especially about science at the end of the day, whenever there is converging information, because We're all going to be looking at science and papers at the end of the day, we're going to be making converging content as well, because that's, I don't know, it makes sense somehow.

Dr. Brighten: Totally. And that's something I think, um, people don't understand is that [00:04:00] when there is scientific consensus, we're all going to sound pretty similar. We're going to be saying the same things. 

Ludovico: Oh yeah. It's going to sound boring, but at the same time, this is what papers say. So we're not going to say something else.

Then there's the personal experience, which is going to be different in every person. Um, and then there's kind of the mix of both, which is what I'm trying to do. 

Dr. Brighten: Yeah. Well, I want to talk about the personal experience because You, my friend, are well credentialed, but you didn't find out you had ADHD until you were in your PhD program.

And I'm curious what that was like for you. 

Ludovico: It was not completely unexpected. Um, I've always had kind of that thought that I was different. You know, from how other people functioned. A very simple example of this is me in high school saying to everybody else, I study with music on because there's always a thousand thoughts in my brain.

But when I have music, there's only two, what I study and the music and no one could relate to that, right? [00:05:00] Um, and I learned about ADHD actually only when I was into my second years of masters. So really late into the process, and I started the process of diagnosis only when I was during my PhD, basically.

So it was really late, but it wasn't. That big of a surprise on one hand, on the other it just made a lot of sense with a lot of things in my life. Do 

Dr. Brighten: you feel like it would have been helpful to know earlier, like in terms of accommodations or helping you be more successful? 

Ludovico: It probably would have helped, uh, at least in terms of self awareness, because I kind of, always wondered why I was feeling exhausted, where everyone else was feeling fine.

So that would have helped at least to know where it comes from. It probably would have changed a lot in terms of what I ended up doing. Um, because I always was a hard worker that strived to [00:06:00] do a lot of things. Uh, and that hasn't changed much, even since my diagnosis, it's just probably would have made life easier in a lot of ways.

Dr. Brighten: Mm hmm. Yeah, I always wonder, you know, when people get diagnosed late, like how would have life, would it have looked differently at all, or would it have been the same? So I feel like even once you get diagnosed, you're like, well, now what? Like what, what actually do I do? And it takes many years to really figure out, okay, knowing this information, what actually changes for me.

Ludovico: Yeah. There's a process of grief that is going on because you have to, you know, you have to Come to terms with what being neurodivergent means, because up until that point, I think I always had that kind of thought that maybe I'm just like everyone else. I just I'm not trying in the right way, right? I just didn't find the answer.

And actually, when you get diagnosed, you're like, Oh, um, there is no answer. It's just your brain's different. So now you have to adapt to that. [00:07:00] And I think what it gave the diagnosis, there was definitely this process of grief, but at the end of it, there was a lot of acceptance and a lot of self love and a lot of guilt that went away from me not being able to do certain things that now instead I just delegate or I just don't focus on that much, whereas before I was desperately trying to conform to what everyone else was doing, um, of course, without any success.

And now instead I just focus on what I know I can do and I delegate what I know I can't. 

Dr. Brighten: That guilt piece that you just said, that is something I hear from so many people is the thing they're able to shed when they finally get the diagnosis. And I do think getting a formal diagnosis has utility. I also know within the United States.

There are a lot of barriers to that, whether it be cost, uh, whether it be time, you know, there's these factors that [00:08:00] go into healthcare that make it difficult, that definitely creates barriers. And so I think people learning about it online, learning through things like this podcast is really hopeful. And often people will say, well, what's the big deal?

Everyone's a little bit ADHD. As we know, that's not true. It's like anybody with ADHD, we always roll our eyes. I'm like, if you only knew the struggles, friend. Uh, but with that, that's the biggest thing I hear people are able to let go of is the guilt. Of feeling like, I'm not enough, I'm not doing enough, why is everybody else so successful and I'm not?

How come it's so easy for everybody else and it's not for me? And I feel like there's a lot of judgment, shame, stigma that's in, that we really internalize but also we cultivate sometimes. And that you're able to drop all of that once you have that diagnosis. I mean, not immediately. As you said, there's the grief phase.

There's like the, I feel like for myself, it was like, Oh, wait a [00:09:00] minute. This all makes sense now. And then it was like, oh gosh, like, My, the poor little girl who was treated so unkindly, unfairly, and also was so cruel to herself sometimes, um, you're able to really process that. 

Ludovico: Yeah. And then there's, uh, all the anger that goes out to the world as in, you know, why didn't anyone tell me before it would have been so easy.

And I mean, we go through all of the stages, honestly, it's, um, it's draining. Yeah. On one hand, but on the other, it's also very relieving at the end of the journey. I feel that it's a, it's a really great place to be, uh, at the end where you kind of just accepted that this is how you work. So you can now take some steps to get better, to heal.

And that also takes a while. 

Dr. Brighten: It does. And we're going to talk about some of that today, but before we get into that, you're fluent. in French, [00:10:00] Italian, and English. Are you also working on Spanish now? 

Ludovico: I am fluent in Spanish and also Greek, actually. 

Dr. Brighten: Okay, so there's five languages. I know that three of those was by age 18.

I'm curious, how did you do that? Because I think Some people who are neurodivergent, they really struggle with language altogether. I'm just curious, like, how were you able to achieve that? I think it's a huge achievement to be fluent in five languages, including Greek. I'm like, that's amazing. 

Ludovico: A lot of it, to be honest, is luck, right?

Because I was born out of a French mom and an Italian dad. So I started right off the bat with two languages. And 12, we moved to Athens in Greece and I just learned Greek because that's where I lived. Um, and then English in school because they teach you English and we had some amazing professors as well.

And, uh, in Greece, for example, so all the movies are in original language. You, you don't [00:11:00] really have a lot of translations except for kids. So you kind of just tend to also learn English right off the bat. Yeah. Um, and then Spanish. After living in Spain for six years, I kind of just Yeah, learned it quite well.

It's just, you know, living in places. 

Dr. Brighten: I, it is definitely something I thought I would move to Puerto Rico and I would like be able to work on my Spanish and pick it up is very different. Um, and even, uh, you know, in Mexico, which is where my family's originally from, they're like, Oh, okay. So, uh, Puerto Rican, completely different Spain, Spanish.

Like, it's different. Um, but I do think it is quite an accomplishment to be able to speak so many languages. Um, and yeah, that's why I was really curious. Like, how did you accomplish that? Immersion. Immersion. Uh, it's basically, you know, when people say like. You, you know, when you just like jump headfirst into the water, you're going to swim or you're going to die, [00:12:00] um, not so dramatic, but with the language, it's like, you just got thrown into it.

Ludovico: Yeah, basically. Yes. And I mean, now living in Barcelona, most of the people who live in this city are already bilingual as a minimum, because you have Catalan and Spanish, which are usually taught together. So if you learn English or you have a third language, because your parents are from somewhere else, then you grow up with three languages, minimum.

Dr. Brighten: Yeah. No, Catalin, when I was in Spain, that threw me. I was like getting by on my Spanish and then I was at a restaurant and I was like, what are the words coming out of your mouth? I 

Ludovico: don't understand. It sounds so different. It's kind of a weird mix between Italian, French and Spanish. It's really difficult to understand when you're not used to it.

Dr. Brighten: Yeah. Do you feel like ADHD was a hindrance in any way for you to be able to pick up new languages? 

Ludovico: For languages, not necessarily, because it's always been a part of kind of my experience and my identity, right? Growing up already with the languages [00:13:00] and learning more along the way. Even as a kid, uh, it's not something that I experienced was necessarily super difficult.

I've always loved learning languages as well. And probably, you know, also studies show that this might have given me some sort of advantage or compensated for my ADHD in some sort of way as well. Oh, 

Dr. Brighten: no, you have to say more on that. Well, I mean, 

Ludovico: especially in Barcelona, actually, because there's so much bilingualism, there's a lot of studies on people who are bilingual and actually shows that growing up with two languages increases brain plasticity and cognitive functions, such as executive functioning.

So it actually could have helped, right? But no, learning languages was not. I guess harder or easier for me than it would have been for anyone else, but also I grew into it. So I, I'm also very conscious of the privilege that I had regarding this. 

Dr. Brighten: Yeah. And it's interesting, you, you say growing up with two languages, the neuroplasticity, [00:14:00] my oldest son has ADHD and he picks up languages very easily.

So he speaks English and Spanish and now he's working on French. He pushes me. He's like, I want to learn Japanese, I want to learn this, I want to learn, I'm like one thing at a time. We're going to like go stepwise because it's that ADHD tendency, you know. You get really excited, you want to do all the things, then you burn out, and you do none of the things, and I'm like, let's just pace ourselves.

But, something that I found really interesting in the research as well, is that the language your mother speaks is what is highly influential, and if your mother's black, Bilingual, you're more likely to be bilingual. Um, as a mom, I kind of feel like a failure because I'm not, I'm not as fluent as I would like to be.

But I think that's something that's really interesting as well. You know, you having parents who spoke multiple languages and how that may have influenced you. 

Ludovico: Yeah, that might be the case as well. I mean, both of my parents spoke multiple languages, so I've always been [00:15:00] around this kind of environment that kind of pushed me and nurtured me.

into being curious, I guess, about learning more things. But also, I mean, to be honest, kids pick up languages super easily. So there's also that. When you learn languages when you're young, there's all the phonemes and all the tonalities and all the things that get into your brains so much more easily than when you're an adult.

If I were to learn a new language right now, it would be massively more complicated. 

Dr. Brighten: Yeah, well, I'm in my 40s. I'm I want to shift gears because, um, I want to talk more about ADHD. People say ADHD is a new phenomenon that humans, you know, only experienced it due to our current environment. So just in the last few generations, we're seeing this explosion of ADHD and it's all because of our current environment.

Can you tell us why that's false? 

Ludovico: So, um, it's, it's not a [00:16:00] hundred percent false. I'm going to start with that actually, which is maybe a weird stance to take, but first of all, it has always been around. It has always been around, right? There is especially one genetic study about a professor called Dr. Oscar Lau that actually works here in Barcelona.

And, uh, he has done a genetic study on. people who lived more than 30, 000 years ago, right? So on remains, anthropological archaeological remains, and they actually analyze the whole history of humanity, including Neanderthals until today, by trying to find biomarkers and genetic markers of ADHD. And what they actually did find is that the genetic underpinnings of ADHD were present already 30 to 40, 000 years ago.

So First of all, definitely something that was present way before TikTok, right? Then, yeah. Then we also have some descriptions [00:17:00] of ADHD in the medical field that date from 1775, with Dr. Mel Curidon always forget the surname, and also Dr, um, Sir Alexander Crichton, a Scottish doctor, so in 1798, who also described ADHD, so around the, the same time period, and they described it as this tendency to get distracted, to be very emotional, very sensitive, and very hyperactive, especially in children.

And these descriptions also were a lot earlier than TikTok or Instagram or Big Pharma or whatever. people think that ADHD is caused. from, right? Uh, so we have evidence that it existed way before today. Now, why would the environment also play a role? Because, well, ADHD is polygenic, so it's a very complex genotype.

It's a very complex phenotype, in general, in biological terms, which means that Can you break that 

Dr. Brighten: down? Oh, great. You're gonna break it down for people. 

Ludovico: Oh, right. Yeah. It's There [00:18:00] are several genes that are going to come into play when it comes to ADHD. So you can have ADHD, uh, because your dopamine system is understimulated, but that can come because some genes that code for the absorption of dopamine in the gut are disrupted.

Or maybe because some genes that code for, uh, receptors of dopamine in neurons are disrupted or for neuron formation or for that thing or for that other thing. So at the end of the day, you end up with a combination of 100 to 150 genes. Already that just these ones can explain ADHD. And then you have the mutations and the combination of all of that.

So it's a mess, right? Well, and 

Dr. Brighten: it's why it's so hard to diagnose genetically speaking, like people are like, you, why can't we just test the genes and no, and because it's very complex, hopefully in our lifetime, we'll understand more, but because of the complexity, I wouldn't be surprised if it's not. a few generations out before we really start to be able to dial it in.[00:19:00] 

Ludovico: Exactly. There's a recent study that actually identified 27 genes, but for example there was one that is dopamine receptor, another one is serotonin, another one is adrenaline. So, Each person may have a different origin of ADHD, but that has, at the end of the day, a convergent phenotype, which means that the result will be the same, but because of different stuff, right?

And then you have the environment that comes in, and that can influence this, and activate or deactivate certain genetic predispositions, and make it more likely that your brain is going to develop in certain ways. Um, to, to give a simple comparison, it's like you have people who have very white skin and people who have a bit of Mediterranean skin, if they both go under the sun, one of them is going to get burned in 10 minutes and the other not, right?

And it's not because only the environment is just a kind of weird interaction between the two things. 

Dr. Brighten: Yeah. And what you're talking about is epigenetics. So we've got the genes, [00:20:00] which are coded. And then we've got the way that the environment influences the genetic expression, how those genes are actually going to present, to show up, to express themselves.

And that's where I think it is an important conversation. So I'm glad that you said that. Cause I'm like, I definitely teed it up in that way because ADHD has always been around as far as we know. And yet. Our current environment isn't really compatible with the ADHD brain. I would love to hear more of that from you.

One thing I'll say is really the capitalistic drive of work eight hours straight through, or even you look at the school system. Sit all of this time. You only get breaks when we say you get breaks. That entire system is really set up for profitability. It benefits other people, not the individual. And it's an entire system that says.

This idea that neurotypical is the standard. Why is it the standard? Because [00:21:00] it's the one that makes the most profit in this society. And so that's just one example. I would love for you to speak more about how is our environment influencing our The ADHD brain. 

Ludovico: I mean, that's definitely a fascinating question because it's still being studied and it's still not very well understood.

But, uh, you know, for example, you talked about epigenetics, but besides epigenetics, it can be also just an interaction, right? You have a genetic predispositions that make certain traits more likely to appear. And then you have an environment that also makes certain traits more likely to appear. So if you have these traits being ADHD and they're up to a certain point.

And then you add the environment to that. Then you might go over the clinical threshold and you have the apparition of symptoms of ADHD, which get disruptive. Remove the environment and you don't have clinical ADHD, even though you have these traits. Remove genetics, but put the environment, you have the same that's happening.

Dr. Brighten: So 

Ludovico: you already have these kind of [00:22:00] interactions. What you say about the, the capitalistic society, the eight hours a day. I mean, humans were not meant for that, right? We have evolved as a species for 200, 000 years to be the most resilient hunters in the animal world, right? We managed to survive and to catch prey because we would manage to outlast them into long, running, um, things, right?

We're not as fast, but we can just run for much longer. We are made to be in movement. And today we get to a society where nobody is moving. Everyone is in front of a computer eight hours a day, and whoever you are, whether you have ADHD or not, that's not going to be fantastic for your mental health. It's just that When you have ADHD on top of this, or when you have certain genetic predispositions, these kind of environment will make everything so much more worse.

It will disproportionately affect you. And that's one, one part. The other part is that, for example, very, very recent studies actually showed that [00:23:00] microplastics in the form of bisphenol A, more specifically, can alter certain neurochemical pathways and induce more ADHD like symptoms by disrupting how neurons form themselves during critical periods such as in newborns or even in the womb.

So there's this kind of chemical environment, physical environment, social environment that are all nefarious for mental health that will increase the likelihood of having issues such as anxiety and depression and make life extremely harder for people who already are neurodivergent and who are not adapted to this way of working, which is crazy.

If you took a medieval peasant and you told him instead of working 150 days a year. You have to work 300 and do it for eight hours a day, seated down, without going out ever. They would tell you you're crazy. It's, you [00:24:00] know, it's. 

Dr. Brighten: Well, and I'm glad that you brought up the plastics, the environmental toxins.

We know that it's so crazy to me how there is, there's one camp that's like, you know, we're a hundred percent science and you know, we push back against that. And these, these things are not so bad. And yet we have to consider the totality of the exposure. So working in women's health, we know that women have a.

Huge exposure to environmental toxins through their personal care products. They're, you know, wearing like 10 to 13 products a day that may be, you know, over and over exposing them to the same chemical. No one's ever done that study. No one's ever looked at, okay, not just like the amount of phthalates or, you know, whatever, whatever the chemical that you're looking at, not just how much is actually in this product, but how much is in every single product.

And then you wear it over a period of time. And then. You continue to wear it while you're [00:25:00] also pregnant. And then there's all the other things in our environment that we cannot dodge, that we cannot avoid. And, you know, as you bring up micro, microplastics, BPA, there's the effect on the brain, then there's also the effect on the hormones.

And we know, I, I really, um, Dr. Mosconi, who's a great researcher in menopausal brains, she does great, uh, publications on that topic. You know, something that she said is that the biggest mistake we ever made is calling them sex hormones because they're not, they're just hormones and they're all over. And that's what she talks about in brain health is that because we call them sex hormones, we called them women's sex hormones.

It became all about the pelvis, all about the ovaries. Can you make a baby? Maybe the breasts get involved and we left behind the brain. And that I think is also important for people to understand because as women, it's. Who are neurodivergent, we are very, very sensitive to the hormonal changes across our menstrual cycle during perimenopause, pregnancy, postpartum, [00:26:00] as you enter menopause, we see a lot of changes happening, and so we also have to consider, what is the environment doing to our hormones, how is that interacting with our ADHD as well.

Ludovico: Absolutely. I mean, estrogen, uh, testosterone even plays a huge role into the expression of ADHD. You have studies showing that, uh, I think it was 49 percent of women with ADHD are prone to have PMDD, right? Uh, which is for, for listeners who don't know who, who that is, uh, it's a premenstrual dysphoric, uh, disorder, which is basically PMS, but bad, like really bad, really 

Dr. Brighten: bad.

Yeah, with 

Ludovico: suicidal thoughts, uh, with really, you know, low energy exhaustion, uh, you're feeling horrible. For certain days way worse than PMS and 49 percent of women with ADHD are prone to that more women with ADHD are prone to have postpartum depression a lot of women find out they have ADHD whenever they have [00:27:00] a child or whenever they hit menopause because that's when their hormones get lower, right?

So definitely the environment that affects hormones will also affect how ADHD symptoms express themselves and also how manageable they become. Because something that I really like to say is that you can have ADHD and, you know, having ADHD and suffering from ADHD are two different things. Yeah. You can have the symptoms, you can have the traits, but if they're managed, if they're accommodated, they don't necessarily make you suffer.

Suffering from it, it implies a whole other level of understanding with the interactions that it has on your body and mind. 

Dr. Brighten: Mm hmm. I want to just add to this conversation for people listening. PMDD, so PMS, we might experience three to five days before we get our period. PMDD is going to be a longer period of time.

So what we currently understand, and it's not complete, it's Truth for everyone is post ovulation. That is when progesterone [00:28:00] is rising. The only way to get progesterone is through ovulation. And when that spikes around five to seven days post ovulation, that's when the PMDD symptoms can heighten. So this might be more like a week and a half to even two weeks of your cycle.

And so for people to understand that you have to track your symptoms, If you are feeling emotional, you are raging, uh, you are, you know, finding that you are suicidal. If you have major joint pain, muscle aches, you feel like you have the flu. These kinds of symptoms are all important to write down because we have to see these symptoms consistently over several month period of time to make that diagnosis.

And often, Why I say it's not true for everybody is because often the therapy is to shut down ovulation by using hormonal birth control. However, hormonal birth control contains no progesterone, it contains progestin. We know that certain individuals, and the research has not been done to the extent it [00:29:00] should be for how long we've had the pill.

on who is most susceptible to developing depression, anxiety, suicidal ideation, which is the suicidal thoughts. Um, and yet I do see women with PMDD who also have ADHD or are autistic, autistic women are at even higher risk of PMDD, um, they'll be put on the pill and things get worse. So much worse. And I believe it's so much to do with that progestin as well.

So sometimes we have to play with the progesterone. There's different things that need to be done, but I want people to understand that if this is you do not delay getting that diagnosis, getting support, because as you said, you shouldn't have to suffer. You mentioned accommodations. What kind of accommodations have maybe helped you or that you found has helped your clients?

Ludovico: Uh, that's a very broad question. Could you, you know, maybe point that towards an area of life, like work, home, the relationships, because there's like so much to say. 

Dr. Brighten: There is so much to say, gosh, you know, as much as I [00:30:00] want, I want, okay. I want to start with relationships. Let's start there. I think that a lot of people are going to be interested in that.

Ludovico: I would say, um, this might sound like a very boring advice, but I swear it's going to get better to start with self awareness, right? When you're aware of how you react, of how you are, and of what makes you tick, what makes you tick. Get puts you into distress. It becomes a lot easier to navigate all sorts of relationship.

And the second step of course is Communicating these things and one very easy tip that I want to give everyone here, you know, feel free to use it saved a lot of Relationships around me is just to kind of monitor your internal state by just giving it a color, right? Just give it either green orange or red where green is you're fine, you're okay, everything is great, and you can even have some unexpected things happening and you're going to, you know, handle them fantastically.

Then you have [00:31:00] orange, which is you need to do the bare minimum. You can function, you can work, you can do your routines, but you don't need anything else more in your plate because otherwise you will either shut down or be overwhelmed or, you know, being deep distress. And then red is. Don't talk to me.

Don't do anything with me. Do not interact because I am being in complete distress right now, right? And these are kind of the three main levels. Then people can add, you know, yellow or whatever they want in there. But these are the three main ones. And whenever you start your day, kind of just, you know, do a short body scan and be like, okay, in which color am I in today?

And just by communicating that color with your partner or with your friends or with your family, it makes a lot of interactions a lot less painful. Because by then, if you know that I'm an orange day, You're not going to bring up a very heavy topic or something that will overwhelm me because you know that the conversation is not going to go well, so you'll just leave it on the side.

Uh, you know, [00:32:00] make sure that I am well hydrated and well fed and well rested, and then we'll talk about it in the morning. And usually that works very well. Just that one simple change creates a space where people first of all listen to each other, but are also aware of each other's limitations. So that's the one like biggest tip that will change a lot of interactions for sure.

Dr. Brighten: I love coming up with a color coded system. I'm going to implement that with my children. I think that is a really powerful way to communicate it with my oldest, who he's very verbal, very intellectual. Like he will say, I'm dysregulated right now. Like put a hint, I'm dysregulated. I'm like, okay. Move the body, space, just tell me what you need.

Like we have those kinds of conversations, but I think starting the day with assessing, like, what's the baseline. And if you already know your baseline is orange and then you hit high traffic, you know, or there's something else that like kind of pushes you [00:33:00] over the edge, the anticipation in, I don't want to say anticipation, but maybe the recognition that the possibility of red is lingering.

gives you an opportunity to give yourself permission to maybe take a 10 minute walk, to do a deep breathing session, um, you know, to maybe squeeze the hell out of your stress ball, like whatever it is for you that helps you, you know, to go back to what you were saying about, like, we were meant to run. We are hunters.

I think that is such a big, um, Evolutionary mismatch that we have right now in our society is that when we have these kind of big emotions or our nervous system is feeling dysregulated, we're in that fight or flight, so often it's like, just take a breath. Like there's socially acceptable ways, especially as women, I even do my like little prim and proper hands that we should process those things.

And I actually tell a patient sometimes like, maybe you want to do jump squats. Maybe you want to sprint down the hall in your office because what your body is saying is that in the fight or flight, it's a fight. flight [00:34:00] freeze. What do you want to do here? Because your body doesn't care that you're sitting in an office.

Your body doesn't care that you're in the carpool line. Your body doesn't care. Your body needs what it needs. How can we move that in an effective, positive way? 

Ludovico: Yeah. Your body needs release and it needs to release that nervous energy. That is absolutely a hundred percent sure. And something else also that can help a lot of people is music.

Dr. Brighten: Yeah. 

Ludovico: works super well with ADHD. Also a study on kids, right? Uh, so maybe not everyone, uh, as an adult will have the same experience, but studying kids showed that they, uh, people, children with ADHD actually read better and are better concentrated when they listen to music rather than when they don't have music.

And neurotypical children is the opposite. When there's silence, they can concentrate. When there's music, they can concentrate less. So just integrating music into your life can make a [00:35:00] huge change. It also channels your emotions. Um, and, and with ADHD, I've made a post about that recently about emotion contagion.

We tend to get attuned to the emotions of other people and with emotional dysregulation, you amplify them. So if everyone around you is feeling stressed, you may have a panic attack that doesn't even come from your own anxieties. And that can be very difficult to handle. If you have noise cancelling headphone and you pop on, I don't know, Taylor Swift song or heavy metal, then suddenly you're in your own bubble.

And that helps a lot with emotion regulation. 

Dr. Brighten: Mm hmm. It's one of my tricks for flying because so many people have anxiety about flying I have more anxiety about like is everybody gonna get in the line and are we gonna go? Single file and will everybody follow the rules of putting their back like there's rules and I'm like, that's what I'm I'm anxious about Like will everybody know that the rules and we and we can all move faster but I have to put on music because it's if the person next to me is like freaking out then I start freaking out and I'm like [00:36:00] and I always am like Is it me or is it them?

It's always them. And so music is absolutely something that I want to echo. The other thing is, uh, binaural beats that can be super helpful as well. Um, with my son, we, like when he was really young, uh, you know, we read to go to sleep, but sometimes he would have that nervous energy and sound bath is something that even now he'll still request, like, can we put that on?

Um, I love the music tip. And when you said about music and studying. I'm like, no, that was me. I actually, um, find that if I, and I will listen to the same song on repeat over and over and over, or for different sections that I'm studying. And then when I would go to take the test, I would just sing that song and I'd be able to recall it.

And my brain's like, there it is. We've got that for you. And when I would share that with people, they're like. You are such a freak. And I'm like a freak, a freak with an A. 

Ludovico: I did the same. I did the same. I had specific bands or albums that I would [00:37:00] associate to certain, um, yeah, to, to certain things. And then before the test, I would relisten again to that same album and I would ace the test.

Exactly the same. 

Dr. Brighten: So what were your bands? What were your albums? Cause I'm just curious. 

Ludovico: Uh, I think for biochemistry, it was a heavy metal album of Disturbed. I've listened to Linkin Park for, I think it was Animal Biology, and then I don't remember the others, but it was around the same kind of vibe. But yeah, I, I had specific bands for certain themes and, and that worked.

Dr. Brighten: Yeah, no, I did the same thing. Okay. So same, same. I love that. I, I've actually never heard anyone else say that. So I'm like really excited right now that I'm like, this is amazing. See, we were supposed to, we were supposed to talk. This is so great. I want to go a little bit further because we talked about, um, You know, you can be taking on somebody else's anxiety, you can be picking up someone else's emotions, but does [00:38:00] ADHD itself cause anxiety?

Is there an association with anxiety? 

Ludovico: There is an association with anxiety. So, more people with ADHD will have anxiety. Now, whether it's the ADHD itself that creates the anxiety, or it's because you're more prone to anxiety when you have ADHD, Right. It's still very unclear and the lab conditions to test that would be very unethical.

So we can't know, but probably the thing is that with ADHD, you have emotional dysregulation and then, you know, you're prone to distractions, to hyperactivity and to a lot more criticism. So it would make sense that someone who's constantly criticized more than other people would develop more anxiety than other people.

It's not surprising. 

Dr. Brighten: Yeah, I think that is something that's one of the things that often women will be diagnosed with is anxiety and when you unpack it, there's often ADHD underlying that. You brought up the hyperactivity though. I want to talk about that because [00:39:00] everybody thinks like, oh, if you have ADHD, you must be bouncing off the walls.

You must be like running around. You can't sit still. You're fidgeting all the time. Break that down for us. 

Ludovico: ADHD is more a difficulty of regulating things, right? It's a deficit in executive functions. And executive functions, they do regulate things like attention, which is why we have attention issues.

They regulate emotions, uh, they regulate, um, prioritization, organization, all this kind of stuff. Um, and also movement. And also how nervous you are. But how you will express this hyperactivity depends from person to person. It's been shown that males, for example, tend to express more of their hyperactive side when they become teenagers, because there's an increase in testosterone, you have an increase in energy, and so if you have more energy, you're going to move more.

But then there's also all the social pressures on girls, uh, even, you know, starting from babies, to sit still, to be quiet, to not make [00:40:00] waves. And so you kind of, yeah, exactly. And so you kind of just internalize all of those pressures and all of the hyperactivity and nervousness that you have inside of you can just push it deep down and you become inattentive.

And so the hyperactivity becomes mental. You just have incredible worlds inside of your mind that are absolutely immense. But then from the outside, you just look like this. Yeah. Perfectly still. And so the in intense activity that is going on inside your mind is never seen from the outside. The only thing that is seen is that you might not respond when people call you, or you might be getting a bit distracted, but it's actually because the brain is never stopping.

It's sending you all of the signals constantly, all of the time. So there's in general, right, to get back a bit to the basics, there's three presentations of ADHD inattentive. And then there's Which is what I just said, then there is hyperactive, which is people running around all the time and [00:41:00] being super physical, and then there's mixed presentation, which is the most predominant presentation for people.

70 percent will be mixed, and then you'll have about 15 and 15 percent of people who will be on each side of the spectrum. Um, and, and the thing is that this presentation could also change throughout life. if you become more energized or If you go through a burnout, right and maybe you were hyperactive you go through a burnout bam You become inattentive because you simply don't have the energy to move 

Dr. Brighten: Yeah 

Ludovico: It, it has a lot to do with energy, with hormones, as also you fantastically said before, uh, when you explained that whole thing, it was beautiful to listen to, honestly.

Well, thank you. No, but it's true, right? Uh, and, and the presentations can change. So it is a bit complex. You will have different presentations. Mm 

Dr. Brighten: hmm. 

Ludovico: I think I went out of my way to answer that, but that's fine. 

Dr. Brighten: No, I think it's great that you, you broke down how people typically present, knowing that mixed is [00:42:00] part of it.

And this is where I think women really face a challenge in getting a diagnosis is that there's a couple things that I often hear or I've read in other chart notes. Um, one is, Patient sits still the entire time, does not fidget, you know, that all of these things and it's like the doctor doesn't realize that this person is masking, they're performing, they are doing their best to give you exactly what you want, exactly what you want and behave accordingly.

Um, And then the other thing that often will come up is that, well, this person was able to finish their degree. This person has a PhD, therefore they could never have ADHD because they're successful. And so much of what you said, I think is going to resonate with people, but I would just love to have you speak to that piece as well.

Ludovico: Yeah. I mean, this kind of treatment by doctors is honestly always something that makes me a bit also because it resonates to my own experience and the experience of a [00:43:00] lot of. People who are close to me and who because of this kind of mistreatment have, you know, risked losing their life. So it's, it is definitely something that is very close to me.

No, you can definitely be successful with ADHD. It has nothing to do with that. And you can be successful because of a number of parameters or things. If you were born in a fantastic family with perfect education and everyone is rich and all your needs were always accommodated, then you can have ADHD and be perfectly fine and be extremely successful because all of the usual challenges will never be presented to you.

So for example, that can be just the environment. Uh, you can have a naturally high IQ. that will compensate for your ADHD symptoms. You're super smart. Everything that you learn, you immediately remember it. And so you need to pay attention to five minutes in class instead of 15. And that also works with ADHD, right?

Because you will pay attention for a bit of time. But if you imprint everything right away, you [00:44:00] can still be super successful at school without even doing any effort. There's people who I know who just worked three times harder than everyone else. And who have PhDs today, right? They just spent three hours during homework instead of one every day.

And so they just exhausted themselves to the point of burnout to get to that level. And I think that whenever you do that, whenever you work, whenever you overcome your ADHD in those ways, you end up, you know, even without wanting to learning tools That will help you whenever things get challenging so you can definitely come very far with ADHD Because you will use Overcompensatory mechanisms you have also other people that will self medicate with coffee or with tobacco You know smoking 40 cigarettes a day just to get by you can finish a degree but your lungs will be Gone.[00:45:00] 

Um, yeah, there's plenty of reasons why people with ADHD can be successful or even just because they have adapted their own life. You have studies showing that people with ADHD have a higher entrepreneurial profile. They're more likely to start their own companies and not more or less likely to fail or succeed.

Dr. Brighten: Yeah. 

Ludovico: Right. Uh, 

Dr. Brighten: I, yeah, it's funny because so many years ago I had said like, I, I just not, I don't Good at being someone else's employee. Like I'm just not good at that. Like I have to work for myself. Um, I also have the like problem of like, don't like to be told what to do. I'm like, if you sign my paycheck, okay, maybe.

Um, but you know, that's also something I think people with ADHD can really relate to is being oppositional and being a little combative sometimes when you feel like someone's being overly demanding on you. 

Ludovico: There's definitely that. Uh, there is, you know, lots of studies on the overlap between ADHD and [00:46:00] oppositional defiant disorder, just opposition behavior by itself, which makes sense.

Because whenever you have ADHD, most of your negative feedback will come from authority figures like teachers, parents, or whoever you have in front of you at that time. So having constant negative feedback from a type of position will not foster trust and love towards these kinds of positions. If you're constantly told that you're not good, that you're not enough, or you have opportunities that were barred to you by these kinds of figures, then you end up resenting them, you know, kind of just automatically because you learned that authority means danger.

You never learned that authority means trust or safety. You just learned that whoever is above you has the power to make your life miserable because that's what happened during your life. And so it becomes very difficult and some people take it to insane extremes, which is where oppositional defiant disorder comes in and [00:47:00] they refuse to get health treatments.

They cut ties with their parents, um, you know, not because of abuse or whatever, they just cut ties with their parents because that's it. And I don't know, it just creates a whole lot of problems once this goes out of control, but a lot of it is due to the environment. And if people were just a bit better educated about what ADHD is and how to treat children who have that, there would be a lot less opposition.

Dr. Brighten: Mm hmm. And when you talk about learning this, so many of us are learning this in childhood, which really gets ingrained. It's the way we start laying down our neurons as well. And so it's possible. We know the brain is amazing to unlearn these things, to make these changes. But if you're someone listening to this and you're like, yes, I get triggered in this way.

Awareness is really one of the first steps, wouldn't you say? 

Ludovico: It's absolutely one of the first step awareness for me, you know, the fact of learning that you have ADHD, even just self diagnosing [00:48:00] is a step towards awareness because it's a step towards understanding yourself. And once you have that kind of key in hand, everything becomes so much easier because especially with ADHD, we have trouble recognizing our emotions.

We have trouble recognizing even the signals of our bodies like thirst or hunger. And so being aware of what to look out for. goes a very long way into making life better. And this also applies, of course, to emotional scars or trauma. 

Dr. Brighten: Speak to why it is that people with ADHD have a hard time. staying, you know, aware of their need to drink water, to eat food, they often lose track of where they're at in the day in terms of caring for their body.

Ludovico: Right. So a lot of it, I think, comes to cognitive load. Uh, there is just a certain amount of information that your brain is able to process at a time. And when you have ADHD and you have a very wide array of [00:49:00] attention, tend to pick up all possible signals that are around you in your environment, but also all kinds of internal signals, which includes thoughts that can be about anything and signals that can also be about anything.

So, you know, uh, your shirt is a bit tight or your pants don't fit quite right, or your head is scratching. And, This comes to par with signals like I'm thirsty, I'm hungry, I'm tired, and then you have all of the thoughts, and you kind of have all of this passive information that comes into a small bottleneck, which is your working memory, and you can process really only seven to nine at a time of these signals, and When you have so much to filter through, the important information, which is, you know, hunger, thirst, and all the physiological signals, they kind of just get lost into it.

It's as if I put full volume, five televisions open right in your room, and then I told you to pay attention to what I'm saying, would be a lot harder. Some of it would come through. Most of it probably wouldn't. [00:50:00] 

Dr. Brighten: What can people do so that they can better nourish themselves, they can stay hydrated, they can stay on top of these body, body needs?

Ludovico: So I would say there's two main things that people can do. The first one is, uh, intentionally focusing their attention towards their bodies, you know, doing a two minute body scan per day. Um, you know, you just kind of sit on your chair or wherever you are you close your eyes like okay How am I feeling?

Am I tired? Am I hungry? Is you know, my stomach gurgling? Do I need to drink water? Do I need to lie down? Do I need to sleep? That's it. You know, just ask yourself these questions actively and consciously this will direct your attention towards these points in your body and you usually will find the answers.

Uh, or, you know, do I need to go to the bathroom? Lots of people, well, they usually have UTI because they forget to go to the bathroom. These kind of things. So actively focusing your attention. And the second thing that you can do is just implementing routines. [00:51:00] So if you have regular routines of bathroom or eating or drinking times, you kind of don't even need to go through that intentional awareness step because you know that you will have breakfast at this time, lunch at this time, dinner at this time.

So your body will be fed throughout the day and you will have had also your share of hydration throughout the day. And maybe a third kind of small tip that I could say is buy yourself a nice bottle that is shiny and that you'll like. Because that definitely helps a lot. 

Dr. Brighten: Facts. And I have to tell you that, um, so I'm like neurotic about like literally about tracking my water.

I won't even let my husband, if I have like a, um, um, bottle of sparkling water. I'm like, you can't, you can't have that. I have to know how many ounces, how many mils I got in, in a day. But the, the water bottle trick of a water bottle that you love, it's your new accessory. Just [00:52:00] keep it with you. And for some people, even getting one that has a straw, You need to clean this often, everyone.

You need to clean it often, please. But, um, the one with the straw will make it even easier for some people or adding in, uh, you know, electrolytes, um, berries, things that can flavor the water as well, things that make it fun, that switch it up. Because when I tell you water can be so boring, it is so boring.

You don't want to drink it. It's so boring. And so that's where I'm like, get fancy. You know, make your spa water at home. Like, it doesn't just have to be like the citrus fruit, like put strawberries in there, put cucumbers in there, like put melons, like, uh, you know, mix it up, make it so it's not boring.

Yeah, if you feel fancy, 

Ludovico: drink tea. 

Dr. Brighten: Yeah. If you feel fancy, you're in Europe. You're like, if you're British, if you feel fancy, drink some tea. Oh, um, so I do want to, I want to talk a little bit more about [00:53:00] comorbidities. And ADHD. We've talked about PMDD, we've talked about anxiety, um, but with the oh ho ho you just gave me, I think we have a lot more to unpack when it comes to the comorbidities of ADHD.

Break it down for us. 

Ludovico: Oh boy. Uh, that, that, that's a whole other Pandora's box to, uh, to go through, right? Um, so there's, there's a number of comorbidities. I think, you know, you have the, the physical ones, you, there, you will have a huge comorbidity with, uh, joints. joint issues like Ehlers Danlos syndrome or hypermobility.

So a lot of people with ADHD will have, you know, hyper, joint hypermobility. Then you will have also a lot of people with ADHD will have fibromyalgia, which is an immune system dysregulation. So that comes along with chronic pain, chronic fatigue, uh, with also dizziness when you stand up with POTS as well.

Um, I'm, I don't remember exactly what it is. you know, the, the, what the acronym means, but it was [00:54:00] complicated. And then you will have also a lot of, yeah, I'm sorry about that. 

Dr. Brighten: No, it's okay. Brainy scramble. 

Ludovico: It's, 

Dr. Brighten: it's okay. And most people just refer to it, uh, as POTS. And so I think what's more helpful is to understand the symptoms of POTS.

So you stand up, you get dizzy. You go, sometimes you as simply as walking to the bathroom and your heart rate elevates, you have exercise intolerance. Um, and that is something that we also see a lot with people who developed long COVID, which is interesting because there's a lot of crossover with some of these ADHD symptoms and long COVID.

And so I bring that up just because it's another one of those things that when you're like, I think I might have ADHD working with a knowledgeable practitioner can help you sort that out. It's no reason you can't have both. No one ever said you can't have multiple things going on at once. 

Ludovico: Yeah, yeah. You can definitely have a lot of things going on at once.

And uh, pause. Postural orthostatic tachycardia syndrome. It's basically when your heart goes bonkers whenever [00:55:00] you do something. Yes. Absolutely. And that is usually linked to widespread chronic inflammation. Which is also linked to ADHD, which is also linked to fibromyalgia, which is also linked to a number of other mental conditions and indeed to long COVID as well.

As you said, I love that you brought this subject because actually people with ADHD are also more likely to get long COVID and to suffer from it. And recently there's been some promising studies with interventions with ashwagandha, B12 and vagus nerve stimulation. for your attention. that all decrease the symptoms of lung COVID and also an enzyme called serra, serratiopeptidase that comes from the stomach of a silkworm and it's still very much difficult to extract, but they all brought, you know, promising results.

So if you're listening to that, go look into these, um, if you can. So I have 

Dr. Brighten: to share, uh, we're going to go more in core comorbidities, but I got COVID in [00:56:00] 2020 and I didn't really have any symptoms. I just one day couldn't breathe and passed out going to the bathroom. And it was a very, it was, I was an anomaly.

And then I ended up with lung COVID, and I spent four months on oxygen, I had POTS, I, um, trigeminal neuralgia, like, I mean, and majority of my symptoms were neurological and cardiovascular, never had a fever, never had a cough, um, my lungs, like, imaging after imaging, all perfectly clear, and it was interesting because people were either like, You're faking it or you're malingering.

And like all of these experts online, you know, cause like suddenly everybody was an expert on COVID, even though it like just stepped onto the scene. That was very laughable. I had medical doctors who were like, you, you either have diabetes or you had cardiovascular disease. I'm like, so my 2020 plan was to travel the world.

And so I had a complete workup just before I got COVID and everything was perfect. They were like, you look amazing. I'm like, [00:57:00] yay. And then I got. So, so sick. And it's something that I'm, as I go through the research, I'm like, there's being neurodivergent, there is having autoimmune disease, there's having endometriosis and all of these have a histamine component to them as well, which, you know, as, as we were talking about PMDD.

That can also have a histamine component and so it's fascinating to me how all of these things are connected and how we still don't even understand who all was affected by COVID and why they were affected, uh, so significantly, but also just, you know, even when we look at fibromyalgia, like who is most likely to get that, is that even the biggest the best diagnosis we could be giving someone?

Because is there anything else underlying that, that maybe you just haven't read the study on yet to be able to help that person? 

Ludovico: I just absolutely agree with everything you just said. It's just the research is so, so, so recent and so complicated that it's very difficult to come to conclusions. And at the end of the day, [00:58:00] whether it's ADHD or everything else, there's also a lot of categorization that is going on.

So at some point, if we discover something else, the categorization may change. 

Dr. Brighten: Yeah. 

Ludovico: So let's keep 

Dr. Brighten: going with comorbidities. We took a little detour, but there's so many comorbidities. I'm like, we're going to deviate and I'll, I'll bring us back in. 

Ludovico: I would say maybe the first and foremost that people should know about is likely sleep issues, insomnia, and just sleep problems overall with ADHD.

So 80 percent of people with ADHD report having sleep issues, uh, which is either not managing to sleep. Do you get, get to sleep at night, uh, you know, just staying in bed and tossing and turning for three hours and not being able to close your eyes or just waking up completely exhausted in the morning and not being able to get out of bed.

And that was me for a lot of years. And it turns out that a lot of people with ADHD have what is called delayed sleep phase syndrome. So just the hormones that normally react to sunlight, [00:59:00] like melatonin and cortisol, just basically onsets one hour to an hour and a half later than they normally should, just like teenagers, which is very interesting.

Yeah. Yeah. And, uh, then a lot of people also just generally have insomnia because the mental hyperactivity that you have all the time just prevents you to get into that kind of rest state to be able to sleep. And a lot of people with ADHD actually have sleep apnea. Which is something that not a lot of people know.

And so sleep apnea is basically when your, you can have obstructive sleep apnea or not obstructive, but most people with A DHD, it's obstructive, which means that your airways are obstructed by something, which can be something as simple as deviation of your septum or your tongue is too big, whatever, right?

But your airways are obstructed. That means that whenever you sleep at night, uh, you. micro suffocate at times. You can't manage to breathe. And so your brain wakes [01:00:00] you up to kind of make you breathe, but this also disrupts your sleep cycle. And since the moment during sleep, when you recover energies, slow wave sleep, you get out of slow wave constantly, and you don't get back there, which means that your sleep pressure is not relieved, that your memory consolidation is absolute crap.

And also probably that all the plasticity things that should be happening during slow wave, like activation of genes, like BDNF or ZIF 268 also get disrupted. which kind of just perpetuates the cycle. And that sucks, right? And the thing is that there are treatments available for sleep apnea. There are things that people can do.

And just by, you know, going to the doctor and getting tested for that, that can just cancel a lot of your problems with exhaustion, for example. 

Dr. Brighten: I want to go back, the genes you mentioned. What are they and why they're so important? 

Ludovico: Uh, so the 268, they're [01:01:00] usually implied in memory and especially in brain plasticity.

So they are the ones that are going to be responsible for the rearranging of neurons and synapses in the brain. They are the one that are going to make you able to be flexible in what you learn and in how you do things. When you will have less BDNF, your synapses become less flexible, which means that your network become more rigidified and you can have increased, for example, emotional responses.

You have a harder time learning things. You have a harder time consolidating memories. All of these things can happen with the decreased plasticity. And with the ZIF it's more or less the same. 

Dr. Brighten: This all sounds really bad. Let's give people some solutions. What can people do to start to improve their sleep?

Ludovico: So to improve their sleep, um, a couple of things that I've seen work in a lot of people is having a regular sleep schedule. And I know that sounds boring as hell for a lot of people with ADHD, but it, it works, right? Because it kind of [01:02:00] just, all the stuff 

Dr. Brighten: that works is boring. 

Ludovico: It's unfortunately it is, but it kind of just forces your body and your hormones to work.

To be, you know, to, to start rising at the appropriate times. So go to bed and wake up every day at the same time, just every day, even weekends, even holidays. And that does sound boring as hell, but after a couple of months, you start seeing changes and you start waking up more refreshed. Because just your body gets used to that rhythm.

And so what we call your sleep pressure cycle that is created by adenosine and your circadian rhythm become synchronized. Because when they are unsynchronized, instead what happens, and a lot of people are going to relate to this, is that you feel exhausted as hell during the day. You feel sleepy. The only thing you can think of is going to bed.

Then you go to bed, it's 10 and suddenly you're wide awake and you want to start 10, 000 projects. 

Dr. Brighten: This is 

Ludovico: what happens when they're unsynchronized. Synchronizing them makes sure that when you go to bed, you're sleepy. Second very easy [01:03:00] thing, only sleep in your bed. It's a very simple phenomenon called context dependent memory.

You tend to associate places with actions or things. So associate your bed with sleep. After a while, whenever you go to bed, you feel more sleepy. And the third thing that would advise is honestly just take melatonin. Jumpstarts the whole thing. It works very well and has very little side effects. 

Dr. Brighten: Okay. As a brain expert.

You gotta talk a little more about melatonin because there are people who are so afraid of it. Um, there, you know, I hear as well, people will say, like, if you are giving your child melatonin, it is child abuse. And this is something where I'm like, tell me you don't have a neurodivergent child without telling me.

Because sometimes children, um, you know, with, uh, ADHD, autism, pandas, uh, certain conditions, they need to have that melatonin. It's not just going to help them fall asleep, but it's also an antioxidant for the brain. It has a lot of utility. But [01:04:00] people are so afraid that they're going to become addicted to melatonin.

Can you speak to that? 

Ludovico: No, melatonin is just basically the hormones that make you fall asleep. It's the one that controls your circadian rhythm. And, and that's it, right? You cannot, you can, you cannot even overdose on melatonin. If you take too much of it, it just will have the opposite effects. You won't sleep.

That's it. You know, big deal. No offense. But 

Dr. Brighten: you're already not sleeping. But if you need sleep, maybe that is a big deal. 

Ludovico: The thing is that melatonin seems to be less effective in people who are autistic. Uh, in certain forms, because certain forms of autism, um, some people have an increased number of synapses.

increase brain activity. So in, in these forms of autism, people will have up to 30 to 40 percent more synapses, which means that the degree of melatonin that is required to put these neurons to sleep is increased, which is why whenever sleep experts prescribe melatonin to autistic people, they usually prescribe higher doses than they do to neurotypical [01:05:00] people.

It's not child abuse to give your child melatonin. It just will help them sleep better. That's it. It's just the sleep hormone. It's nothing weird. It's nothing fancy. I mean, it's it's just the sleep hormone 

Dr. Brighten: And it's something that I want people to understand. We always want to work on our sleep hygiene.

Like you were saying, you know, making sure that you go to bed on this at the same time, sleeping in a completely dark room, making sure your room is cool, making sure your sheets are comfortable. Um, the sensory processing issues can be real with like your bed, just being uncomfortable, like the sheets are scratchy, the pillow, you do have to tend to all of that.

And you may also need additional support. So I do like things like phosphatidylserine, uh, passionflower, and I think melatonin has utility as well because, um, you know, we use it often. So if you have endometriosis, if you are struggling with fertility, that's something that we may be using more like, you know, three, [01:06:00] six, 12 milligrams of melatonin.

If you're wanting to go to sleep, some people, they have 0. 5 milligrams of melatonin and they're like, I'm out and I'm out for the night. Um, and when it comes to children, it really is something that I don't, it's, it's, you don't want a paradoxical effect. More is not better. We do want to instill good sleep habits, but at the same time, if your child is neurotypical or has a different issue going on that's affecting their sleep, understand that the poor quality sleep is one of the most damaging things.

It, it really will inhibit your body's ability to heal. And so sometimes we do need to use it short term. Sometimes, you know, you're in a healing phase that is longer, that you're using it long term. I think really the slippery slope is when people are like, Yeah, we're not doing, you know, bedtime routine with our kid.

We're just gonna give him melatonin when we're done with him at the end of the day and call it a day. And that's a different conversation. And really, I haven't met. [01:07:00] any parents who are doing that. 

Ludovico: No, exactly. And also something you mentioned is that the environment needs to be also kind of tailored, right?

If, if you use melatonin, but I don't know, you live in a neighborhood and you have a train passing by your window every five minutes, then melatonin is not going to help because it's the environment that sucks. Um, getting a good mattress, having a good pillow, having good sheets, all of that is amazing advice.

And also something that is generally advised is also to sleep in a room that's slightly colder. Than what you would usually be in because your body decreases its temperature during the night and so you tend to feel warmer. if you're, the temperature of your room is, is too warm. And that can trigger other things like sleep paralysis, which is really not fun.

Dr. Brighten: Yeah. What is that? Explain that to people. 

Ludovico: Um, sleep paralysis is basically when you're awake, but you're dreaming at the same time. So whenever you dream, your brain area that's called the thalamus kind of paralyzes your [01:08:00] muscles. And when it doesn't, you sleepwalk. So it prevents you from moving during your dreams and the thing is that you become awake during this phase You're still paralyzed and you're still dreaming.

So you kind of have extremely weird hallucinations While you see your room, which is usually dark and since dreams often work by autocompleting What your emotions and consciousness sees, uh, you're scared, you're in a dark room, you're going to auto compete with nightmares. And so you basically see this kind of nightmarish hallucinations and demons that are coming to eat your soul.

But you're just sleeping. It's a really not fun experience. 

Dr. Brighten: I've lived it many times. I have also experienced this and it's the worst. It's also something too, that, uh, one time I just have to share that. Um, It was my husband cheating and I could not snap out of that. I could not snap out of that. I was like it happened I saw it [01:09:00] it happened and even though i'm like, I know it didn't really happen But like that my brain was really trying to like reconcile like what was going on.

Um And I do want to add, so people, whenever I share on social media that when I go to a hotel, I'll drop the temp of the room to like 64, uh, that's Fahrenheit. Um, people are like, that's crazy. Why would you do that? I'm like, because I already have a hard time sleeping in hotel rooms. And if I get it super cold and I go take a warm shower and then it's super cold when I come out and I get in bed, like my body will just be like, go to sleep.

You're done. 

Ludovico: Yeah. The temperature changes can help as well. Mm 

Dr. Brighten: hmm. Um, okay, so we've covered, we've covered, um, the hypermobility, we've covered POTS, we've covered, uh, sleep issues, PMDD, is there anything else that you think people should be aware of when it comes to comorbidities? 

Ludovico: Plenty of things, right? We have a lot to choose from.

Maybe you give us a 

Dr. Brighten: rapid fire list. We can pick the [01:10:00] best ones to pick apart. 

Ludovico: Uh, there's a higher rate of comorbidity with, of course, depression and anxiety. Uh, you know, you struggle your whole life. That makes sense. Then there is also higher comorbidity with autism. Uh, there's high comorbidity with bipolar disorder, with OCD.

Um, a bit higher with Tourette's. As well. So there's a comorbidity with a number of other issues and disorders, oppositional defined disorders as well, which I mentioned earlier. And yeah, those would be the main ones that come to mind. Oh, and eating disorders. 

Dr. Brighten: Mmm, yeah. Definitely. And I, the reason why I wanted to bring up this list is because if you're someone who has been diagnosed with these things and there's other aspects of ADHD that you're like, I wonder, it may be worth exploring and seeing, like, do you also have ADHD?

You brought up autism. And that is one that I think is a really good question. A high number of [01:11:00] autistics, like more than half, uh, in some of the research, maybe you have different statistics based on the research that you have been reading, also have ADHD. And that is something that I feel like we really aren't doing a good enough job of, of really, Separating who is truly just ADHD and who is autistic also with ADHD.

You know, you said it the opposite way of like, ADHD is the comorbidity of autism. Really? There's just like besties hanging out. They're just like hanging out together. What, you know, in terms of, you know, how many people do you think with ADHD are actually autistic that we're missing? 

Ludovico: So this is interesting and it will change a lot.

And as a function of how you formulate it. Right, around 50 percent of people with autism will meet the diagnostic criteria for specifically inattentive ADHD. And some studies say that a lot of that comes from the fact that there are just simply overlapping [01:12:00] criteria that if you're autistic and you struggle with social interactions or eye contact, then you might also come off as inattentive ADHD.

It doesn't necessarily mean you are though. So, a lot of that, at the end of the day, also comes to personal experience, and I will encourage people who are autistic or people who are ADHD to go and look at the lived experiences of patients who have been diagnosed with ADHD or who have been diagnosed with autism and see if they relate to any of that, because the diagnostic criteria are one thing, and they are sometimes quite far away from what the reality of the lived experience is.

And this I feel is a first quite important distinction. The second thing is that studies show that between 20 and 60 percent of people with ADHD also meet the criteria for autism. And the reason why it's such a huge difference is because as a function of the methods [01:13:00] the studies used, then you will have either the lower percentage or the higher one.

Dr. Brighten: Mm hmm. 

Ludovico: And so far there is still a lot of research ongoing on that. So it's very difficult to weigh on one way or another, but I would really encourage people to go and look at the lived experiences of people because it can teach you a lot about yourself. And you can find maybe struggles that you have that are not quite fully explained by ADHD.

So that's an interesting part. And. If at the end of the day, you don't relate, then that's fine. You will have learned something about someone else and probably will have more compassion towards them. So that's, you know, win win either way. 

Dr. Brighten: Yeah. Well, I love you saying look at the lived experiences because the data of living in your body and your own life is so, so valuable.

And I think there's not enough humility in medicine for practitioners to recognize that the research [01:14:00] on autism and ADHD is so far behind where it should be, especially when you look at those. Who had, who were born with ovaries, and how, and why I say that, people are always like, Why don't you just, you know, say woman?

Well, very specifically, if you have ovaries that are cyclical, Like, there is so, and what I mean by that is they're producing hormones cyclically, right? This is not menopause, we need research there. Although, Um, I think that one's a little bit easier because of where, where the hormones are in terms of being more matched to a male counterpart, but the majority of a woman's experience is not understood when, through the lens of autism and ADHD, and that is where, Knowing your own body, knowing your own data and understanding that you never need a research study to validate what is true for you, whatever your truth is, is absolutely your truth.

Ludovico: They're absolutely, first of all. And there are two main things to, [01:15:00] uh, you know, to underline here that I would like to respond to. The first one is that hormones can make a massive difference. I've had a lot of people over the years making my content, uh, transgender individuals saying that when they started.

Transitioning and they took hormones, the presentation of their symptoms of ADHD and autism did change. Yeah. They felt that their brain felt different, that their symptoms felt different. And there is an interaction with hormones. There is. There absolutely is. And this is something that needs to be addressed, that needs to be understood.

So that people who are born with a uterus or without it, who are cis or who are trans or whatever can better understand their own experience, uh, just, you know, Transitioning, for example, is just a hard enough thing. If on top of that, you have to adjust how your ADHD reacts, it becomes nightmarish. Yeah.

Just having a doctor that maybe can tell you, look, you know, you're going to take testosterone or estrogen. This, this, and this is what you might expect from your [01:16:00] ADHD symptoms. Cool. Thank you, doctor. I will make adjustment before this happens. Excellent. Right. Just this. The second thing is also that studies, research, medicine, all of that works statistically.

Which means that you take a hundred people, 60 of them will show these traits. That also means that 40 of them won't. And this is one question that I get again and again about medication, about people saying, but medication, right? Methylphenidate didn't work for me. Does that mean that I don't have ADHD?

No. Studies show that 70 percent of people respond well to medication. That means that you're going to have three people for each 10 that take it, that are simply. Either not going to respond at all or are going to have massive side effects. That doesn't mean that it doesn't work for everybody else. And that doesn't mean that it works for 100 percent of people, right?

The lived experiences is so valuable because it's not a statistic. When I do my [01:17:00] content, I try to base myself a lot on studies because at the end of the day, what is observable again and again and again, probably is true. But it's also true that again, it's statistical. So if you don't feel represented by a statistic, remember that this is a number and that you're actually represented by that number because you fall within the percentage of people who don't have that.

And that's okay. It doesn't make your experience any less valid. 

Dr. Brighten: Have you ever seen a study on trans individuals and ADHD or autism? 

Ludovico: I haven't seen a study about that yet, no. 

Dr. Brighten: I've never seen a study. That's why I was curious. And that's why, you know, when, so I focus in women's health. I used to work in transgender care, but I just wasn't seeing enough patients that I felt like there were better people I could refer them to, that that's all they were doing.

And, you know, working in women's health, I'm so careful now when [01:18:00] I speak about things because I will have trans individuals say, like, Well, why aren't you using more inclusive language? So for example, and I might be talking about an herb vitex. I'm like, I can't because I, the study is on, on women, women who, you know, uh, they were assigned female at birth.

Okay. For all intents and purposes, that's the definition here. And with that, I cannot just say people with Uh, you know, ovaries or menstruators or things like that because if you're on certain medications for that transition that may interfere and I am so, so careful and so sometimes people are like, you're not being inclusive enough and I'm like, I am purposefully not including people because the research, we don't have that research and to do that and to, and to speak in such a way that would be irresponsible.

Yeah. And so I want anybody listening to this to understand that like as we use [01:19:00] these terms and as we we talk about these things It's not It's not to exclude people purposely. It's that research has excluded people. And this is where, again, listening to your own body, being hyper aware of how your symptoms, and I mean that, being hyper aware, like paying way more attention that like, because even.

You know, if you are neurodivergent giving someone, we might say, okay, well this is the typical dose of estrogen that we would give. That may impact you differently. Giving someone testosterone, you know, there's a correlation. Those with polycystic ovarian syndrome have a higher incidence of being diagnosed with ADHD.

That's a hyper androgen state. There's also insulin dysregulation, there's inflammation components. So it's a lot more than just. Testosterone and other androgens being elevated, but it tells us that testosterone can play a significant role. And so I just bring this all up because I don't want, I don't want people to feel excluded.

And at the same time, I want them [01:20:00] to understand that like research is so lacking in the funding that they haven't been included there. And we can't just speak broadly about these things without risking doing harm in some instances. And so that's why I would always refer people back, meet with your practitioner, have a one on one conversation.

And they are very unlikely. Do you have expertise in any neurodivergent condition given what they're managing? So it is about advocating that you get the referral to the person who does. And there is a very like, you know, the, the number of people, Who are truly like autistic and ADHD friendly providers and very knowledgeable about it.

Uh, there's a lot of people out there marketing it. And then I have conversations with them and they're like, we can cure autism. And I'm like, I am walking out of this conversation because no. Um, but to find them, I feel like is, um, it's a little bit of a challenge sometimes, but then to find [01:21:00] those who have that skill, plus they understand the hormonal component is like finding.

So, with that, if you are one of those practitioners, could you comment and let us know how people can contact you below this? So, wherever you are in the world, because we have an international audience. Um, yeah, is there anything you want to add to that? I just kind of had a little No, 

Ludovico: I mean, I think, I think you said everything that it's also, uh, you know, on my mind and in my heart that research is exclusive.

It's, it does exclude certain populations because it's not trendy because it's not nice. And I mean, we probably will get there eventually. It's just that it's also that research is exclusive. It's painfully slow. It's painfully slow. It takes 20, 30 years to get something really confirmed. And so this is also what is really hard about this.

Yeah. Um, and this is also why I mentioned the thing about, you know, people transitioning who felt that their ADHD or autism was different because if there [01:22:00] is anyone here listening to this, that is also transitioning and is thinking to themselves, what the hell is happening to me? Maybe you'll have an answer.

Yeah. And you know, and if that helps even just one person, I'm happy about that. Yeah. Um, on the how to contact me and on the practice. So I've recently started ADHD coaching because as you said, I found it very difficult to find ADHD informed practitioners. And I've been spending the last two years and a half doing content on ADHD from the lived experience, but also massive amounts of research papers.

And I've just thought. I would love to help people. So I've got an out and it got a coaching certification. Uh, but I also have, you know, a day job, so I kind of just don't have a lot of time for that. It's just, if possible, I like to help people. People can contact me on my Instagram, on my TikTok, on my email.

Um, my accounts are brain. curiosities and from there, there's like my website and all of my links. So just feel free to go check them out. [01:23:00] 

Dr. Brighten: We will definitely, we'll be linking everything in the show notes so that people know. Um, all of that will be there and very easy to find. Um, before I let you go though, I got a couple more questions for you.

So I do want to go. Everything you want. There's, you talked about burnout, you brought up burnout multiple times. What is burnout? Why do people experience it? How can they avoid it? 

Ludovico: So burnout is a state of prolonged stress after which your body at some point just has enough and crashes. Um, your stress response, your immediate stress response driven by adrenaline, by cortisol, and by all of that funny stuff, is something that is supposed to get you out of dangerous situations.

You know, you're out in the wild, you meet a tiger, you run. Stress response. The stress response is supposed to go down afterwards, which makes you feel tired and exhausted. But if you have that sometimes, then that's fine. If you have the stress response [01:24:00] all the time. your body and brain will think that they are constantly in danger, which will increase how you respond to stress.

You will be increasingly sensitive to stress. And so everything going wrong, everything happening will make you completely lose your marbles. Right. This is a very scientific explanation. 

Dr. Brighten: Well, I think people, um, much prefer understanding what we're talking about than the full scientific. So I think you're in good company.

Ludovico: And burnout is usually described in five big stages. There were originally 12, but then like, Now that it's a bit more popular, it got reduced to five, which is the first one is the honeymoon phase. Uh, you get excited, you take on a lot of stuff. Then you have the onset of the stress phase. You start feeling stress, chronic stress.

You start having physical symptoms like back pain. Uh, you can't manage to sleep. You have, you know, digestive issues as well. You bring the stress home, you kind of snap at everybody. Then you have the burnout phase, which is characterized by [01:25:00] apathy. It's just basically your body crashing and telling you, now we don't care anymore.

We get eaten by the tiger. Cool. We drown in the river. Cool. I don't care. And then you have the chronic burnouts. It's just, it's, yeah, you just stop caring because it's too much for the body to handle. And then you have the chronic and habitual burnout, which is basically you cycling between stress.

resentment and anger and the apathy. So one day you're going to be super angry. And the other day you'll be like, Yeah, um, and this is burnout and people with ADHD are a lot more sensitive to burnout for multiple reasons, right? The first one is emotional dysregulation. You're more sensitive to stress. So you're more likely to go into the stress phases But also we are more impulsive and we like new shiny things So we're also a lot more likely to get into the honeymoon phase and take on a lot of stuff that becomes too much two days later.

Um, and understanding how burnout works, understanding how [01:26:00] ADHD works will help people maybe manage this better because they will know when they have a new exciting and shiny thing. Maybe not to say yes right away because that can lead to burnout. Again, awareness there is key because when you know how you function, when you know what to look out for, then things become a lot clearer.

Dr. Brighten: Yeah. Yeah. How can people know that they're, they're on the edge of burnout, like they're on that road on the way there? How can they cultivate that self awareness?

Ludovico: I mean, you know, a lot of it comes from doing these kind of body scans that we talked about before and understanding if you're feeling stressed, tired, exhausted, apathetic, angry, or excited in your day to day life. Most people with ADHD that I've met and that I've known honestly are already into some sort of burnout and they're cycling through these five stages [01:27:00] very fast.

There's been some preliminary evidence that people with ADHD cycle faster through burnout. So they get into burnout faster and then they, they resume the cycle again and again and again. Which makes things more difficult. But I would say, yeah, developing that awareness of yourself, of your internal states of your emotional states and also of your physiological states.

Because sometimes you feel exhausted because you haven't slept in three nights or because you haven't eaten or because you didn't drink any water today. So kind of just understanding where the tiredness comes from can be very helpful and also having the awareness of You know, getting into the honeymoon phase, because this is something that amazingly has stayed in the research during all of this years on burnouts.

And it always starts with a honeymoon phase with a phase of excitement and with a phase off, I'm going to get everything done. There is a problem, no issue. I'm going to get everything done. And whenever you get into that kind of excitement phase, [01:28:00] maybe put in place tools. to limit how much you do to not get into burnout.

That can be very helpful. 

Dr. Brighten: I love that. Yesterday I identified that I was getting into that honeymoon phase and I was talking to my assistant and I was like, and I got this done and I'm doing this and I'm going to take on this and da, da, da, da, da. And I was, I caught myself and I was like, You know what?

I'm going to go for a walk. I'm going to listen. I have this like, um, affirmations app where I listen to affirmations and some of them are about like filling your body and how's your body feeling? And I went for a walk and then I came back and I asked my assistant, like, how much do you think is reasonable?

And she's like, how about we just focus on one thing? And I'm like, thank you. I have to have that person there to check me. But it was something that, um, I definitely saw it coming and I was like, and I feel like part of it is like, I've done that enough times that I'm like, oh, I know you, I know where we're going, and that can be challenging [01:29:00] to have that awareness.

I definitely think when you're younger too, because you have more energy, you have more capacity. For me. Having two children, running a company, doing all this stuff. I'm like, I have to be stingy with my energy sometimes. And when I get really excited and I want to do all the things, I have to just really have that external check sometimes where I go outside, I do that work.

And I, I talked to my assistant. I talked to somebody about like, can you be a mirror? Can you be a mirror for me and just like, let me see what, what I'm doing right now. So that I can, cause it can be such a challenge. People who are in burnout right now who are like, I'm already there. I do not care. Any predator come take me away.

What can they do to start to come out of that? 

Ludovico: Um, so the first step, which seems very obvious again, is to recognize that you're in burnout. You're like, okay, I'm in, I'm in a burnout. So. Yeah. Now what? Um, the general advice is to, [01:30:00] you know, whenever you have a stressor to get away from the stressor, if you can take holidays, uh, take holidays.

If you can get a medical leave, get a medical leave. Honestly, I know that in the, in the U S it's extremely hard to do this because the system is messed up, but in Europe, there are a lot of countries where there is free healthcare and you can actually take medical leaves while you're sick. Continuing to be paid.

So if you're in one of those countries, just do that. Honestly, just take a medical leave and take care of your health, figure out what got you into burnout in the first place, and make sure that you change enough things in your life so that you don't get back into burnout. And one thing that you've mentioned, and that I would like to bounce off on is focus on one thing.

Especially with ADHD, especially when we're trying to heal, especially when we're trying to get better. We want to do everything and we want to do everything perfectly and we're like tomorrow I'm going to wake up at six and go to the gym and eat [01:31:00] healthy and get a new job and start a new project And you get overwhelmed and it doesn't happen right because it's too much Focus just on one thing and I'm I'm saying like the smallest possible thing when I started working on routines when I got diagnosed when a partner started working on routines three years and a half ago with a psychiatrist, the routine was taking a shower every day.

That was it, right? That is the minimum. minimal step that you can take the smallest thing that you can do today and feel confident about being able to maintain for six months, no matter how many things come your way, this is your starting point. And then you go to the next step and then you go to the next step, but focus on one thing.

If you try to change your nutrition, change your habits, change your gym routine, change everything. It's just, it's going to be too much too fast. So just one thing, that's it. And. [01:32:00] Honestly, it feels long and it is, but it's also solid because once you start implementing these changes little by little, it becomes part of your life.

It becomes part of who you are. It becomes even part of your small evening or morning rituals. And then they're solid. And then even when you're in a burnout, even when things go bad at work, even during a breakup, you're going to keep doing these things because they are solidified. And this is what we want to get to.

We want to have a new minimum. We want to make sure that your bad days in three years are not as bad as your bad days today. That's it. 

Dr. Brighten: I love that. And I think that's, that's actually perfect advice for anyone, especially, you know, in the new year, everybody's like, Oh, I want to hit, like, I'm going to change everything about my life.

And something I have said to my patients. Um, and I've heard this time and time again, and if you're listening, you've, you're probably like, we've heard this. [01:33:00] Um, is that I have almost never seen somebody change everything and take on everything in a treatment plan and actually be successful. And then they give up everything.

And what I find is so much more effective is even if you just work on three days, you could be three. I don't know why odd works better. Three, five, seven. That seems to work really well for people of like, you know what to like just today, as you were saying, taking a shower. Or going for a walk or maybe I'm going to add an extra serving of vegetable.

Even when I tell people, you know, we need to get up to like five to seven servings of fruits and vegetables a day, that sounds overwhelming. And I'm like, and we're going to start with one serving every day. If you're eating zero, one serving every day, if you're eating one, then it's two every day and you do that for a week.

And then the next week you add an additional one. It's the, and it seems so little, but I think so often about the analogy of like how [01:34:00] pyramids are built. They are built by a solid foundation and you set the solid foundation and you can reach great heights but only if the foundation is solid. 

Ludovico: And in a lot of these things it's often better to do it badly than not at all.

Dr. Brighten: I love that. Yes, give permission. Like, done is better than perfect. 

Ludovico: Do it badly. You know, if, if your struggle is eating every day, eat a snack. It's better than not eating, right? And there are so many messages about this food is good. This food is bad. This habit is good. This habit is bad. Get that out of your mind.

Doing it badly is better than not at all. The bare minimum will already be better than nothing. So just, you know, give yourself permission to exist as a human being because I mean, come on, it's unrealistic. No, no one gets seven serving of vegetables per day. I think in the United States, maybe only 15 percent of the [01:35:00] population does that or something along those lines.

It's crazy to think that we have to do everything perfectly. No one 

Dr. Brighten: does. And it's something that you're not going to do it right every single day either. And that is where, you know, I like on your good days. If you have gotten good sleep, if you have fed yourself well, then on the not so good days, you can be gentle with yourself, because you know that you, you already put into the pot, so to speak, and you can draw from some of that.

So I think the notion of You don't have to be perfect and giving yourself permission to do things in the best way that you can is a perfect place to wrap this. So I want to say thank you so much for your time. I know that you are, we are like opposite sides of the world right now. And you made time to come on and to share all of this valuable information with everybody, all of my listeners.

And so I'm just, I'm so grateful. Super, super grateful. Thank you for your time. 

Ludovico: Thank you for having me. This has been absolutely [01:36:00] fantastic. I've loved the conversation and I, I loved where we finished it because you know, yeah, it's, it's important to just remind people that being kind to yourself is just really, really important, especially when struggling with mental health, you know, we do what we can.

Dr. Brighten: Absolutely. Well, thank you again. And everybody listening, we will put all the links in the show notes. So if you would love to follow Ludovico and consume his content in the same way I have, then I will have that accessible for you. So thank you again. 

 

Ludovico: Thank you very, very much.