The Hidden Costs of People Pleasing: Why ADHD Women Struggle + How to Break Free | Meredith Carder

Meredith Carder: [00:00:00] People pleasing is a little bit selfish. Oftentimes, when we say yes to things that we truly want to say no to or we don't have the capacity to do, we aren't going to be able to show up as our best self. We might show up with resentment. So sometimes saying no is the empathetic choice. Masking is a, a defense mechanism.

It's a way to cope with your symptoms by being aware of them and trying to do the opposite of them. 

Dr. Brighten: Women can feel really guilty though in saying no and not showing off and doing everything for everyone and doing it perfectly. How can people start to deal with that guilt and process it in a healthy way?

Narrator: Meredith Carter is an A DHD coach, author, and community builder who helps adults with A DHD feel seen, supported, and empowered 

with a background in psychology and business and decades of lived experience. 

She's the creator of the Hummingbird Hive and author 

of it All. Makes sense now, people with a DHD, one of the things we really struggle [00:01:00] with is emotional regulation.

Meredith Carder: Sometimes we get very like closed off emotionally and emotional regulation is actually not part of the diagnostic criteria for A DHD. It used to be, and then it was taken out mainly because 

Dr. Brighten: the masking piece that you brought up. What's the connection between the masking and the people pleasing that we see people do?

Meredith Carder: I think there's a huge connection there. I think a lot of the time what's 

Dr. Brighten: happening is. Welcome to the Dr. Brighton Show, where we burn the BS in women's health to the ground. I'm your host, Dr. Jolene Brighton, and if you've ever been dismissed, told your symptoms are normal or just in your head or been told just to deal with it, this show is for you.

And if while listening to this, you decide you like this kind of content, I invite you to head over to dr brighton.com where you'll find free guides, twice weekly podcast releases, and a ton of resources to support you on your journey. Let's dive in. Why do [00:02:00] so many A DHD women become chronic people pleasers, and what can we do about it?

Meredith Carder: I think there's so many reasons that that can happen, but I think, uh, the main reason would be that most women with A DHD are diagnosed later in life. Uh, so they spent their whole childhood feeling like something's different and they don't know what it is. So they get a lot of feedback about their behavior and how they show up in the world, and over time they.

Start to try to overcorrect so much for their A DHD symptoms. So they begin over-delivering. They begin saying yes to everything, and they are really just trying to avoid the shame they felt their whole life for not understanding how their brain worked. Mm-hmm. 

Dr. Brighten: And so women getting diagnosed with a DH ADHD a lot later in life, was that true for you?

Yes, I was diagnosed, um, following 

Meredith Carder: my daughter's [00:03:00] diagnosis. Oh my gosh. It was my son. And then they're like, wait a minute. Yeah. Yeah. It's a common story and I think that what happens is we're filling out all these assessments and paperwork and hearing ourselves in these symptoms. So it's kind of like those light bulbs start going off.

Mm-hmm. 

Dr. Brighten: So for women who have been in this pattern of people pleasing. Most of their life, if not all of their life, how can they start to take steps to break free of that? I 

Meredith Carder: think the first step is really working on that self-awareness piece, understanding your A DHD symptoms and not just what they, those symptoms are, but how they're driving so many other behaviors in your life.

So first, it's that piece of noticing it more, and then once you start noticing it, you can develop strategies to pause before you say yes. To evaluate, uh, the true intention of the things that you are [00:04:00] committing to. And for me, that looks like, it looked like rehearsing language mm-hmm. That I could use to give myself, um, some space between the ask and the pressure to make the decision.

So I, I knew I needed to do that ahead of time. Um, I'm impulsive. I have the hyperactive type A D, HD, and so I knew that oftentimes that yes was gonna come out of my mouth. Mm-hmm. Almost immediately. So when I worked to try to unwind some of that behavior, I came up with some phrases I could say to give me myself some time to consider.

Dr. Brighten: Women can feel really guilty though, in saying no. Mm-hmm. And not showing up and doing everything for everyone and doing it perfectly. How can people start to deal with that guilt and process it in a healthy way? 

Meredith Carder: You know, as a game changer for me was realizing that sometimes people pleasing is a little bit selfish.

Oftentimes when we say yes to things that we truly want to say [00:05:00] no to or we don't have the capacity to do, we aren't going to be able to show up as our best self. We might show up with resentment and uh, that's gonna show through in our interactions. So if we're able to. Say no, that person can find someone to do that task or help them with that thing that is giving them a true yes, that really does want to take on that, that task.

So I've really tried to reframe it as sometimes saying no is the empathetic choice. 

Dr. Brighten: I love that. I love the reframe, and I think that's something you do really well in your book is taking people of like, this is what we're doing. These are the patterns, and here's, we can start to reframe what most of society has told us and look at it differently.

You talked about the hyperactive type of A DHD. Can you talk a little bit about the different types of A DHD, because I think this is what lends primarily to a lot of women being missed. In not getting the diagnosis when they should have. [00:06:00] 

Meredith Carder: Yeah. There are three subtypes of A DHD. There is a DHD, uh, primarily hyperactive, impulsive type.

There is a DHD, primarily inattentive type, which if you hear the, um, term A-D-D-A-D-D isn't a term that's used as a separate diagnosis anymore. It hasn't been since the eighties, but it's still used quite often to describe what is now called inattentive, A DHD subtype. Mm-hmm. Um, and then there's the third type, which is combined type.

And that means that you have, uh, enough symptoms that fall into the hyperactive, impulsive type and the inattentive type. 

Dr. Brighten: Mm-hmm. Can we give people who are new to this, just kind of like an example of each of these? So what is the archetype? Like, what is the, you know, the typical like textbook diagnosis of this person?

I say that with air quotes. Because as we expand our understanding of all neurodivergent conditions, we [00:07:00] start to understand much like everything else, nobody fits into a perfect textbook description. 

Meredith Carder: Yeah, I I'm so glad you added that piece 'cause it is so true. There's so much that, um, comes from our conditioning and how we may mask our symptoms.

Uh, but to give you a general overview, the hyperactive, impulsive type is, uh, really similar to how it sounds. So the symptoms that fall under that umbrella are, um, lots of times needing to move fidgeting. There is oftentimes, especially for women, it shows up as talking very quickly. Mm-hmm. I was called Meredith the mouth as a child.

Um, it also can show up as a need to be busy, like packing our schedule with a lot of things. So sometimes the people pleasing isn't about. Actually trying to please someone. It's just trying to like put as much on their calendar as we can. Uh, and then the impulsivity is just like, it sounds like we are, um, not having that pause between a thought and a decision and acting very [00:08:00] impulsively, uh, for inattentive type.

That is the struggle to direct our attention to what is most important in the moment. Um, oftentimes in school, that's the kid that's daydreaming as an adult, it's that person that is losing their focus at work that, uh, can't get through a meeting. Or you can probably see it in conversations you have with people with A DHD where you're like, oh, I think they're somewhere else right now.

Mm-hmm. Uh, so it is, is that struggle to keep attention, um, on the task. And then there's all these other symptoms that fall under both umbrellas. Uh, and most of those fall under, uh, struggles with executive functioning. So things like struggles with working memory. Uh, prioritization, pacing, self-regulation, uh, and there's self rem moreth that fall under that umbrella.

Mm-hmm. 

Dr. Brighten: Yeah. I think that's helpful for people to understand because most people who are unfamiliar with A DHD have it in their mind. That you're bouncing off the [00:09:00] walls, that you're somebody always fidgeting, shaking your legs like, you know, you are the person who can't sit still and you're failing in life in so many ways.

Um, and we can fail in life. In some ways it feels like failure, but not always necessarily true that it is. However. There's a lot of ways that A DHD can show up, and I think that's important for people to understand that it's not just that one picture of the small little boy who can't sit still in school, who you know is racing around at reassess.

It can show up in a lot of different ways. So I wanna ask you the masking piece that you brought up, what's the connection between the masking and the people pleasing that we see people do? 

Meredith Carder: I think there's a huge connection there. I think a lot of the time what's happening is, uh, girls are socialized to be the compliant little girl in class.

And if they are having to, you know, hear a lot of negative feedback early on, it doesn't take us long before [00:10:00] we start, um, really performing in the way we think society wants us. To show up. Mm-hmm. So oftentimes that looks like, um, saying yes to things that we probably don't even want to do or aren't prepared to do.

Uh, I think oftentimes we're trying to avoid that shame we feel when we have not, uh, been the person we think others expect us. 

Dr. Brighten: To be. Mm. I just realized I brought up masking. We both have brought up masking, but we haven't really defined that and I think for some people it might be the first time they're hearing that.

So can you explain what masking is? 

Meredith Carder: Masking isn't a, a defense mechanism. It's a way to cope with your symptoms by being aware of them and trying to do the opposite of them. Mm-hmm. So an example might be, uh, if you are having a need to move quite a bit and you know that that's distracting to your teacher and she's told you you didn't like that.

So instead you are defending all your focus, sitting in that [00:11:00] classroom and being aware of your body and thinking about only that. Mm-hmm. So you are literally putting on a mass. And covering up your symptoms so that others don't see them? Uh, oftentimes I see this in adults more like, um, I have a big friend group with a DHD, uh, and oftentimes we, we love connecting.

We love talking, and a lot of us are really self-monitoring because we know we interrupt, we know we talk too fast. So sometimes that will look like a person that, you know, that is quite charismatic, going quiet. Mm-hmm. Um, and oftentimes they've, they've had hit that moment where they're like, oh, I've talked too much.

I've gotta like walk it back. I'm gonna mask that need to connect in that way and not participate in the conversation. Mm-hmm. 

Dr. Brighten: You have a daughter with a DHD. Do you feel like, just from observing her and having worked with clients, does is it seem like pretty easy for her to pick up masking? Like she moves into it pretty easily because I know for you and I [00:12:00] like, we're high masking individuals.

Um, mm-hmm. Obviously, because we show up online, we're having a conversation right now. We're not interrupting each other. Um, but I just am curious from that perspective, and the reason why I ask this question is because I have a son and, uh, it is so clear to me that masking is just not intuitive to him at all.

Like, he doesn't pick up on the cues that like, oh, like I, I should start learning how to fit into this. And I look at that and I almost wonder like. I feel this is my intuition. Society gives him a lot more leadway mm-hmm. To misbehave, you know, and misbehave in terms of not following society's norms. And I feel like for girls, it becomes something that's, it's a lot easier to step into masking because of those societal pressures.

But I don't have a girl. I just was once a girl. 

Meredith Carder: Yeah. You know, I actually have a son that has a DH ADHD too. Oh. Um, my daughter was like, first, first. Um, yes, I do. I have. And like they present pretty differently, which is really [00:13:00] interesting. And I think that's such an interesting question that you bring up.

Um, I definitely had noticed, especially prior to her diagnosis. That she figured out masking quite early. Mm-hmm. Uh, it was actually, it took a while to, to land on a DHD with her, even though it seemed very clear to me because she masked so heavily at school. Yeah. Um, she was that stereotypical child that is like, oh, we don't have any behavior problems at school.

And then she would come home and it was like an emotional explosion every day. Yeah. And we were having a very hard time. Um, and you know what's really interesting about her at is when she got diagnosed and we started treating the A DH adhd and I started working with her and coaching her and helping her understand her brain and how to accommodate her symptoms versus mask her symptoms.

Mm-hmm. I don't think she masks as much anymore. Um, one thing she did that I found so fascinating is when, uh, COVID hit and school went online, one of the first. [00:14:00] Things she did when she set up her little workspace, she was a fifth grader at the time, is she took a little exercise band and put it on the, um, the legs of her chair.

Mm-hmm. And that was to bounce her feet on, uh, because she knew she needed to fidget. She knew she had had that accommodation at school and it really helped her. And it was less distracting to the teacher than her, like falling out of her chair or doing something that's noisy or something like that. So I think, um, because we've been able to work with her about self accommodating, I don't think she feels the need to mask.

She's actually a very confident girl now. She really, um, channels her hyperactivity in a really valuable way. She's. Captain on our cheer team and does a lot of really, um, she's very busy and is able to just kind of live her life in a way that makes sense for her. Uh, but she was, she was definitely masking, um, so much when she was younger that they were trying to understand if it was anxiety or a DHD.

Yeah. Um, and it, it really was a lot different with my [00:15:00] son. Uh, he leans more inattentive. He's a combined type, but his inattentive symptoms, I think show up quite a bit more for him. Um. But the more we've treated his ad, she, the more the hyperactive is shining through. So I think he was masking a little bit, but I think you're a hundred percent right that he just doesn't seem, um, to see his behaviors as a problem As much as my daughter did, uh, he sort of was like, well, I'm a boy, and he wasn't really getting the negative feedback that my daughter was early on.

And I think that, like you said, we just give boys a lot more leeway, um, and we don't ask them to cover it up quite 

Dr. Brighten: as much. Yeah. I wanna talk about, um, accommodations because I think this, this helps adults as much as it helps children as well. What I will say though about, you know, all of this conversation about masking that I find really interesting is that you're, you're like, we can accommodate, we can shift things so we're not masking, you know, with my son.

So we're A DHD and I find [00:16:00] often, so for people who don't know what that is, autism and A DHD, because my brain just. Likes to keep it interesting. Um, but with that, there's, there's times where I'm explaining to him social interactions and he's like, but why? Why do we have to do it like that? And I, I'm honestly like, I don't know, I just learned over time that this is how people are and I'm like, I don't, I don't actually understand it myself.

And it's so funny 'cause we'll turn to my husband, both of us, and be like, explain this to us 'cause like, we actually don't understand this. And so I think that's another layer. But we were talking about this concept of not having to mask. I wanna talk about the accommodation. How can we make it so that we're masking less?

However, I think people need to understand why masking is an issue because. There's a lot of people who are like, I'm high masking. I'm very successful. People like me, I have friends. Like I, this is a good thing. Why would I ever want to not mask? So can you talk a little bit about what I call the mask [00:17:00] tax or the toll you have to pay for masking?

Yeah, there 

Meredith Carder: is, uh, there's definitely a mask task. I haven't heard that before. There's, there's certainly costs to masking. Uh, I think we, it's such a nuanced conversation because we do have to mask at times. Um, every human does. At, at some point in their life have to not show up. It's their a hundred percent authentic self in every moment.

But, uh, when we are constantly masking so many things about us, we are directing all of our bandwidth to that. So if you're sitting in a meeting and all you can think about is how uncomfortable you are in that seat, but you won't let yourself get up and stand or find a way to fidget that's not distracting to others, uh, then you're not absorbing what you're supposed to be learning or, uh, you know, you, you can't participate as your full self.

So you are probably really tired after that meeting. Mm-hmm. And you probably also are gonna need to put some [00:18:00] additional work into like learning that information on your own or talking with someone to get, uh, the information that you miss. Um, there's physical costs to masking. I think oftentimes when we're just pushing through and thinking about how we're showing up all of the time, it's just exhausting.

So oftentimes as people get older and they get even more self-aware of other people's perceptions, um, we, we get better at masking, but we start paying even bigger costs. Mm-hmm. So a lot of times with adult women that cost is burnout. We get there quite a bit faster than someone that might be in I identical situation because we are directing so much mental bandwidth into those masking behaviors.

Dr. Brighten: Mm-hmm. And for anyone who's listening to this that is neurodivergent, that's like, oh, I've been in burnout before, or maybe what it was called was adrenal fatigue, or more scientifically accurate, is HP dysregulation. [00:19:00] That is the physical, hormonal toll that basking takes. So you can feel like. When people say adrenal fatigue or adrenal burnout it, well, it's not scientifically accurate.

If you've ever been there, it feels that's what it feels like. You're like, I just feel like my adrenal glands are not making cortisol. Doesn't spike doesn't wake me up in the morning, doesn't actually help me when I'm in a stressful situation or when I am in a stressful situation, I hit bottom even faster.

And you know, there was that interesting study that came out recently showing that women who are neurodivergent, A DHD specifically. They have a higher mortality risk and part of that. So there's a lot of factors that go into that. And we need to replicate research and we need to follow people around for a while.

But certainly burning burn burnout is part of that, and the masking is contributing to the burnout as well. So for people who are like this, okay, [00:20:00] masking not great. I, and I do wanna say, you said as a defense mechanism, I wanna add onto that, that it's also a survival mechanism. Mm-hmm. Because, um, I will see a lot of people on social media who are like, drop your masks, stop masking.

I mean, it's not always safe. It's not always safe not to mask. You could lose your job. Uh, because people are like, why'd you say the weird thing? Why are you doing this thing? Like, this is not how we expect and you're not doing anything necessarily wrong. You're still performing. You know, there's a lot of ways that it can be not safe for you.

Mm-hmm. So masking is also a way that we survive. Mm-hmm. And with that being said, though. I think it's great if you can take weekends where you don't have to mask. Um, my birthday this year, I was like, I'm not, I'm not masking today. I am not hanging out with anybody. I'm gonna do what I want. That's what I'm gonna gift myself for my birthday.

How can people start to drop the mask? And then I wanna start talking about accommodations as well. Yeah, 

Meredith Carder: I think it really starts with, um, understanding when you are masking [00:21:00] and being thoughtful about what would be the cost of dropping the mask. Oftentimes we just revert to masking everything, um, when we're masking things that don't necessarily have a big impact.

Uh, so thinking about that. First mm-hmm. Being like, what are, what are the masks? I really actually are protecting me that I, I probably need to keep using for a time. And then thinking about what are the safe spaces where I can unmask? So if you know that you are in the type of role at work where you feel like you're masking all day, uh, think about how you spend your time outside of your work hours.

Mm-hmm. Uh, it might, it might need to be a little bit different than what you're doing now. Think about how you're. Spending your lunch break if you get one, maybe. Uh, instead of networking with, uh, coworkers, you need to go sit outside and regulate, uh, and allow yourself to just be, so thinking about breaks from the mask mm-hmm.

I think is really [00:22:00] important. And just really doing that evaluation about like, is this. Is it important to mask this thing? Like, I think the fi I keep coming back to fidgeting today. Maybe it's because I'm sitting here like this, 

Dr. Brighten: don't move. It's the mics. I'm gonna tell everybody. It's the mics. And I, I am like, I need to find something else because I move a lot, but then I feel I have to have this regulated.

Yeah. I'm like, I need a different situation. I know, 

Meredith Carder: like the bike. Yes. Um, so I again, yes. So that fidgeting example is, it's like most of the time fidgeting really is not that big of a deal. Yes. It may send a message to someone like, oh, they're, they're moving around a lot. Maybe they're neurodivergent.

Usually it's people that are in the know. Uh, but if we just find a way to fidget and get that out that isn't noisy or loud, that can help a lot. So instead of like trying to just sit there like this. You know, like being so still and not moving, um, thinking about like, [00:23:00] what can I have in this meeting that's not quite as noticeable.

And there's, there's fidget rings. Some people really like those. 

Dr. Brighten: I'm wearing, well actually, this is not, um, this is a, uh, a Mexican jewelry designer. And when I came across her stuff, I was like, this is a perfect fidget. I have my little pinky ring that I'll play with as well. Mm-hmm. But they also have the rings that spin.

Mm-hmm. Um, there's, uh, the ones with the balls, so. Mm-hmm. There's. We should link to some on Amazon actually. Mm-hmm. And show people what we're talking about. Mm-hmm. But yeah, I always look for jewelry that I can play with that nobody is like noticing I'm playing. 

Meredith Carder: Yeah. So it's like, not as distracting. Like I know, um, for a long time I had a coworker and he clicked his pen all the time.

Oh. And like that is Doy and we noticed that. So, um, you know, I didn't know I was neuro at the time, but I I related to his need to move around because I, I was asking it. 

Dr. Brighten: Yeah. But before your period, you're like, click that one time. Yes. And you're gonna see the bad side 

Meredith Carder: of me. Exactly. I definitely, it's those [00:24:00] noises, our, our filtering systems in our brain pick up on so much.

So some of those things can, the things that we do can also drive us crazy mm-hmm. As well. And we can be very sensitive to them. So thinking about like. Can I fidget in a way instead of having to mask it and try to be perfectly still and direct. So much mental energy in that what can, what can be a way that's not gonna like draw attention to me and distract from, you know, the purpose of why I'm gathering with people.

That would be something to think about versus, um, like emotional regulation is a big struggle for a lot of people with a DHD. So sometimes we get like very like, closed off emotionally. Um, and at times that's one that you might not want to go totally unmasked at work. Yeah. Like losing our temper, like being able to, I.

Blurt something out before thinking about it that might be a, a mask that is actually helping us a little bit. So thinking about, okay, this is having a big toll. How can I find different ways to maybe regulate [00:25:00] myself so that I, I don't get as dysregulated and I don't have to mask as much, but I can't just let myself be full, authentic and say everything that pops into my brain because it might be hurtful and it might, you know, come back and hurt myself as well.

Mm-hmm. 

Dr. Brighten: You also talked about having the band on the chair for your daughter. Something that we've used with my son is taking, um, those adhesive Velcro crow strips and putting those underneath a workspace so that one side is scratchy, one side is soft, so there can be that sensory stimulation going on For a while we had, um.

A tub, like I had a plastic tub full of like those little plastic balls. Yes, they probably have phthalates and yes, it's not great, but, uh, they, we filled it with these balls and then he could put his feet in and just play with these balls or sometimes mm-hmm. Um, you know, there's an exercise for plantar fasciitis that we do with like a water bottle.

Um, and rolling a water bottle on the ground and lifting it up with your toes. And sometimes I would just put that on the ground and be like, you can play with that [00:26:00] while you're doing it. Mm-hmm. Are there other things that you use with clients that you're like, this helps so that they can fidget, that they can, you know, get some stimulation and get some energy out in some ways while they're working?

Meredith Carder: Yeah, I think oftentimes, um. You know, this was actually inspired by my daughter as well. Uh, she kind of figured out as she got farther into like junior high and high school that she didn't really like how obvious some of her accommodations were that were in her IAP. So she communicated to her teachers that if they needed the attendance, ran down to the office or they needed some kind of errand to run, like, please pick me if you can.

Uh, because that helped her get up and move. Mm-hmm. Uh, that was one of her accommodations is breaks, movement breaks, but it looks a little awkward when you're like, Hey, I need a movement break when you're a teenager. Yeah. So that communication can help. And how that I think can translate into, um, the workforce is if you work for yourself, give yourself those breaks.

That's easy. If you are self-employed and you are [00:27:00] in a role where you're working from home and you can get up and move and kind of recalibrate and get some of that hyperactivity out if you are not, um. Think about how can you communicate to the people leading meetings being like, Hey, you know, I know a lot of us have noticed that, um, these three hour meetings are really hard on our focus.

Can we take a couple of quick built-in breaks? Mm-hmm. Uh, and ask for accommodations that probably help everyone on your team. Um, and also thinking about if you're in a position at work to, uh, kind of direct what you're assigned. Say, Hey, these are my strengths. I really do well with these types of tasks.

And choose tasks that allow you some novelty and variety throughout your day. And opportunities to get up and move and talk to people in other departments and kind of naturally meet that need to move and, uh, kind of not be in that same spot. 

Dr. Brighten: Thinking about the same thing already. Yeah. As you're talking about this, I'm like, I, I don't know that the [00:28:00] tech.

Community is, you know, all neurodivergent. But I feel like there's gotta be enough neurodivergent there because when my husband, he, he's worked in several tech companies, there were, uh, ball chairs everywhere, walking desks everywhere. Ping pong table breaks were happening. Um, there was one place where he worked and there was actually an indoor basketball court.

And there were all of these things where people were always getting movement in their day. And I look at that and I'm like, these were all accommodations that every workplace could really use. And yet you see them specifically in the tech sector. 

Meredith Carder: I, I've noticed that too, and I don't know if it's because they are diving into the research a little bit more.

Maybe they're ahead of the curve for like organizational development. I used to work in training and development and um, tech companies did seem like they were considering. That a little bit more probably because it's linked to higher productivity for [00:29:00] everyone. Exactly. And it's beneficial and it helps their bottom line.

But if it's a win-win for everyone, I think that's so helpful to integrate those things. Um, and I think what's been interesting since COVID and a lot of those jobs have gone to remote is that oftentimes people were having those moments during the day and then they find themselves working from home in a role where they technically have more freedom, but they don't always build any of that in because it's just not intuitive anymore.

You're not looking at the ping pong table over there and thinking, oh, I'm gonna take this ping pong break. You're not thinking about those things quite as much. Mm-hmm. So often if you are one of those workers that, uh, used to have a very active environment, sometimes you have to think about how can you recreate that 

Dr. Brighten: in your new setting.

I wanna talk about time perception 'cause that's definitely an issue that a lot of a DH DERs struggle with. Why is time. So weird for the A 

Meredith Carder: DHD brain, you know, it falls under that executive function umbrella. We really [00:30:00] have a hard time perceiving, uh, hard time, perceiving time. Um, we really struggle with time knowing how long things will take.

We struggle with losing track of time and feeling time passing. Mm-hmm. So it's not always a like, oh, people with a DHD are always late. Uh, a lot of times I think people think it's a time management thing, like they're just not managing time well. Mm-hmm. But oftentimes they're just not, not feeling that, that time passing.

Often we get into hyper focus. Which is a state where we are very locked into what we're focused on and we can be there for hours. Mm-hmm. And a, a lot of people don't understand this about A DHD 'cause they're like attention deficit. What, like, how Yeah. How are people so focused with A DHD? But it is really, a, DHD is an issue with attention regulation.

Mm-hmm. So we can either be very, very locked in or struggling to pay attention at all. But [00:31:00] oftentimes that, that hyper focus plays into the issue with perceiving time. We also have struggles with, um, really being able to see an overview of how long a project will take or the components that are a part of that.

So that can mean that we might commit to a task thinking, okay, we have two weeks to do that. That's plenty of time, but there's all these pieces to the task that we didn't perceive and we just did not give ourselves. The, the time and bandwidth needed to be able to do that. 

Dr. Brighten: Mm-hmm. And even the concept of, of time and having to make an appointment on time and then work your way backwards and then use planning.

It's, it's more executive functions than just time. Mm-hmm. Itself. So I wanna ask you, if somebody feels like they're always rushing or they're constantly behind, what can they do to start to manage their time better? 

Meredith Carder: I think breaking down, um, [00:32:00] routines is really helpful. Having micro routines for. Times of day that seem to give you trouble with the time.

Mm-hmm. So if you're, you know, if that's getting out the door and you're always like, you get to the office on time, but you feel like you ran a marathon to get there because there was always some stressful thing you weren't anticipating. Try to really do everything you can to find a routine that's intuitive because then it takes the decision and the thinking out of the process.

Uh, oftentimes with that, that time and the executive function of decision making is tough too. So if we're in the morning having to pick out an outfit, we can lose track of time in our closet deciding between three things. And we feel like we've been in there for three minutes, but it's been 20 and then everything's behind.

So thinking about can I choose outfits the night before or can I have a more uniformed approach to how I dress? So it's a little more intuitive. So kind of reducing the number of decisions that need to happen in a routine can really help. Um, [00:33:00] oftentimes for things like, uh, not making it to meetings in time and things like that, I do a, a double alarm.

So I set an alarm about 20 or 30 minutes before and I hear that alarm and I think, okay, I'm gonna have to stop soon. So if I'm hyper-focused on something, it's like my brain gets a little warning. Mm-hmm. And then when that second alarm goes off, I'm less likely to ignore it or be like, oh, I gotta really wrap this up 'cause I'm already starting to wrap something up.

And then I'm able to transition into that meeting on time. Mm-hmm. Uh, so thinking about those pieces, I often find sometimes with time management we can overcorrect that big time. Yeah. That can be a people pleasing thing too, where I was that person that was always excessively early 'cause I got. So used to like that frazzled feeling of being on time, but showing up feeling like I, you know, was just really exhausted just getting there or the, the stress of being late.[00:34:00] 

So I would show up to things 20 or 30 minutes early and that cusses its own level of stress and you lose a lot of time in that. So not just asking the question around how can I be more on time, but think about how am I thinking about the, the time leading up to having to be somewhere or be in a space, and what can I do to kind of, um, find those stumbling blocks and make them a little easier for myself?

Dr. Brighten: Yeah. I, I know about the, the being early. So if I have to be somewhere at three 15, I tell my brain it's three o'clock. Mm-hmm. And I set everything by three o'clock. I also, I also have to say, I wonder if, uh, this is true for you, but I find this true for other, um. People with a DHD is that if the appointment is at 3 0 5 or it's at three 20, like that does not exist.

Mm-hmm. Like that is not a thing. You are either at three o'clock or you are at three 15, but these, these other things like that you're trying to schedule for me. So I will always be like, it, it has to be like three o'clock, 3 15, 3 30, somewhere in, you [00:35:00] know, the 15 increments. But my husband all say, oh, we have to be there by three.

And he'll be like, it's three 15. Like, why, why are you saying that? Look, it's three 15 on the calendar. I'm like, no, you just sabotaged my brain because odds are. If I say through clock, I'm making it at three 15, like that's what's gonna happen. And so I 

Meredith Carder: already know that we're not always building in that buffer.

I think it can be really helpful to you to have that external processing of time with someone. So if you're going to the airport and you know you want to be there at a certain time, talking it through with someone, or even ai, if you don't have that person to talk it through, I often forget, okay, how long is it gonna take to park?

How long is it gonna take to, you know, take the bus over from the economy lot? There's so many steps that I think we are only looking at like, okay, here's the drive time over to this place. We're not, we're not naturally putting those other steps in. So kind of sanity checking your plan with somebody can really help so that they're like, oh no, it's gonna take you at least [00:36:00] 15 minutes to walk in.

Or if it's a new place finding it, that's. Something I didn't do today and was a little bit late to this meeting. So, um, we can get better with it as when we practice it, but also just, um, allowing yourself a little bit of grace when, when it doesn't work out the way you need it to. Um, and just learning for next time.

But I always think of, for me, yes, other people are impacted by be being a little bit late here or there, but, um, I'm the one that's usually, mostly impacted because of the stress of that and how that feels to be late. So thinking about it as kind of like a service to yourself to, it's almost like self-care to take that extra time to kind of nail down those routines and set yourself up for success mm-hmm.

To, you know, be able to arrive on time a little more often. 

Dr. Brighten: Yeah. And I appreciate you saying, you know, leveraging ai, it's so interesting to me because. Oh, it's such a split right now. And people are like, oh, you [00:37:00] shouldn't use the ai. And yet I find both people who have a DHD and autism, they are leveraging AI in a way that's helping them support their lives that never existed.

Like saying to ai, this is my, you know, outline a morning routine. Okay, this is what I also do in my morning routine. Okay. Could you put a time estimate to that? Okay. Can you make it a PDF printout and then you can print it out and you can put that up. This is something, um, that I manually had to do because this before AI for my son of like, every morning we need to brush our teeth, we need to wash our face.

Like, then you need to go get clothes. And like, having those steps there and you know, for the average individual they might be like, oh, you know, that's like, why would you need that? And it's because it's easy to miss steps or it's easy to get distracted. Hyper-focused on something else. Especially as, you know, he's now a pre-teen boy and it's like, oh, if the remote's out, hmm, I could just turn on the tv.

And now it's like, we've forgotten that [00:38:00] anything else needs to be done. I wanna shift the conversation. You brought up emotional regulation earlier. What's something most people, uh, like are misunderstanding about emotional dysregulation when it comes to A DHD? 

Meredith Carder: You know, I think there's a lot that we don't, uh, really focus on, and part of that is because emotional regulation is actually not part of the diagnostic criteria for A DHD.

Mm-hmm. It used to be, and then it was taken out mo mainly because it was hard to measure and hard to quantify. I 

Dr. Brighten: wanna stop right there because I wanna highlight that the DSM. Mostly changed for the comfort and the ease of practice for the practitioner and not based on the experience of the individual.

And I think that's really important because people will say that's not in the DSM, so emotional dysregulation isn't real. Meredith, why are you talking about that with A DHD? That's not in the DSM. The DSM didn't even allow for the diagnosis of A DHD and autism. I believe it was like 2016 when they finally [00:39:00] allowed it.

And the whole reasoning why they never allowed it is because they thought it was too hard for the clinician to be able to differentiate these. So sorry to interrupt you, but I just really need people to understand that the DSM is for the practitioner and it is not encompassing the experience of the individual.

Meredith Carder: I am so glad you interrupted to share that because that is such a, such an important point. And that is I I think it's just the. Inequity of the system could be a whole nother conversation. Yeah. Uh, but bringing it back to the emotional regulation piece, uh, we don't talk about it enough because of that very reason.

And, uh, what's interesting though is, uh, working in this field and interacting with experts, many of them that are physicians and neuroscientists, uh, they all agree that it, it should be something that we are studying and understanding. And part of that diagnostic criteria, it's actually something the psychiatrists that, uh, evaluated my [00:40:00] daughter noticed in the appointment and, and pointed out to me before we knew any of that.

So, uh, people that understand A DHD understand that this is absolutely a huge part of A DHD. Again, it's under that umbrella of regulation. It's hard to regulate our attention. It's hard to regulate our emotions. Um, there's several. Studies that show that people that are neurodivergent have a smaller zone of tolerance.

So your zone of tolerance is that space where you are calm. Um, it's not that there's not stressors present, it's that you can navigate those stressors and that you're able to, um, stay just like it sounds regulated. Mm-hmm. And then we, we often are pushed out of that zone more easily, and our zone is just smaller.

So that sometimes looks like being really temperamental, like very extreme emotions, but it also can look like feeling more flat. It's al you can go up or you can [00:41:00] go down outside of that zone of regulation. Mm-hmm. So it's really important to talk about, because I give people strategies all of the time, but if you are chronically overwhelmed.

You're probably dysregulated. You're not gonna be able to do any of the strategies I give you when you're not in a state of regulation. So if we don't address that, none of the things that we give clients or we give ourselves to manage our symptoms are gonna be very helpful. Mm-hmm. 

Dr. Brighten: You know, it's interesting, that was one of the first things that was noticed about your daughter.

'cause in my son, that was the first sign for me is the extreme emotional dysregulation, the big feelings, the big outbursts. Um, and, and the small zone of tolerance. And that's when I was like, huh. We need to look into this. Like, there's something here, there's something going on. I wanna talk about that zone of tolerance.

If we know the zone of tolerance is small, what can we do about it? 

Meredith Carder: So there are everyday things that you can do to increase your [00:42:00] zone of tolerance. Uh, spending more time in nature. Mm-hmm. Exercise, uh, spending time in community, laughing. All of those things help us widen that zone of regulation. Those are those things that fall under that self-care umbrella.

There's so many of us. Have a really hard time finding time to fit in. Mm-hmm. Um, so thinking of those things that kind of build up your tolerance over time. And then you also want to build your library of skills to notice when you're moving out of that zone to, to catch it faster. Uh, 'cause usually there's signs, uh, oftentimes they're physical.

It's things like you start feeling hot or you start getting a little bit of a headache. Uh, noticing those things faster and having ways to down regulate. And then also noticing when you're in those patterns where you don't have enough stimulation to feel regulated, where you don't feel like you can initiate tasks when you're kind of feeling really low and having tools that kind of can bring you up into that [00:43:00] zone where you can focus and, and navigate things a little bit easier.

Mm-hmm. 

Dr. Brighten: Yeah, and I think, you know, the taking breaks is so important and as the top of this conversation, we talked about people pleasing and I think women. They forget to take breaks, they forget to take them, put themselves first. Maybe they don't forget, but they don't prioritize it. And it's certainly something that I think a lot of society likes to send women this message of like, you are inferior because of your hormones.

Like you can't keep up with men. Men are cycling their hormones on a, a day-to-day basis. Right. I like to call it the sun. It's up and it's down. It's pretty boring. So I don't work in men's health. Super boring, not in a stimulation. For me, uh, women, we are gonna be cycling roughly on that lunar cycle, so on the moon cycle.

So if you think about the moon phases, that's you, you have all of these phases that you go through and there's this message then. You know, during your luteal phase, you should suck it up. You should push through, like, and that is something [00:44:00] where, you know, my message to neurodivergent women is that this is a built-in for a break system like you, your hormones have you in go, go, go mode for the first half of the cycle.

And we are meant to take breaks as humans and as women we get gifted that time of like, yes, your emotional regulation's gonna be a little bit less and you're not gonna be able to multitask and do you know 50 things in your mind like you were doing two weeks ago? And that's permission to pause. That's not something is wrong with you.

But I think because we put, try to push through that and I say we, because I certainly, I can know all this and then I've fall into that trap again, but we try to push through, right? Or like sometimes life is happening and it's day 27 of your cycle and your period's coming and you're like, well, I still have to be at this meeting.

I still have to give this presentation. That's when we start to find ourselves really feeling like the pool of all of this. And I bring this up in the conversation of emotional [00:45:00] dysregulation because it's that PMS and even like the PMDD symptoms, you know, they feel so extreme and sometimes. Adding in. So this is not like all you have to do is go out in nature and do all the things that you're saying and you'll be fine.

It is adding those in by subtracting the thing, the things that don't really need your attention. Taking those out, that you can feel more regulated in that time and that. The medicine that doesn't have to happen in the doctor's office. 

Meredith Carder: Yeah. I think a lot of managing A DHD, especially in women, is understanding your patterns and making the shifts you can to honor your capacity because it is not the same every single day.

And we've been taught for so long living in a capitalistic society that we should be able to show up at work at the same time, work the same amount of hours, and just always be on. And we aren't designed that way. And if we have a DHD, we've got this extra set of struggles with that. Mm-hmm. So I think it's something that all women struggle [00:46:00] with.

Uh, but I think with a DHD, we have to really think about that and think about how we, uh, what, what, um. What, what kind of agency do we actually have with our job or our personal life and our family? To honor that a a little bit more, because I don't think most of us work, if we work for the corporate world, they're not gonna be like, okay, yeah, it's cool if you work, you know, half days during the second half of your cycle.

We get it. I, I think it would be wonderful if we got there, but thinking about if you have a little bit of control over your workload, like I am focused a lot on writing right now and my brain is not that great after I ovulate like it, it feels like I am a different person for those couple of weeks in a month.

So knowing that I try to structure most of my writing when I am earlier in my cycle and I feel more creative and I, it's just easier to initiate. So it takes a lot less bandwidth. I can write at other times than I [00:47:00] have, but when I. Have, when I'm not writing for a deadline, I try to move the creative projects there and then put the other things that are just requiring less brainpower and energy, um, in that second half of, of my cycle.

And I'm lucky that I have flexibility in my job to do that. But I think a lot of us can kind of look for ways, uh, we can think about that in our life and, and understand what our capacity is and not try to fight it so 

Dr. Brighten: much. Mm-hmm. I am, I feel this so hard right now 'cause I'm working on a book right now and there's deadlines and chapters due and I ovulate it and I'm like, great.

I don't feel, ah, like, and any, any time though, I do get the like, okay. I, I feel like writing, like I gotta go in on it. But one thing for, for people who are like, well, what do you do when you just have to do it? Is that so for writing, for example, yes. I'm writing this in my luteal phase, my brain, it's, it's more work, honestly.

It's more work. Things don't flow as well. I can always revisit it and edit. [00:48:00] Back in that follicular phase back when my estrogen is up. It's honestly something that where I was just like, man, I just feel like I should just take some estrogen so I can power through this. And I'm like, yeah, that would be great.

I'd love to see the fallout of doing that in your cycle. So nobody don't do that. And it was just my thought of like, oh, if I just had my estrogen ally, I would be doing so much better. I wanna talk to you about the, um. A DHD shame spiral because after you have a bout of emotional dysregulation, maybe you lash out to somebody, maybe you cry in front of people that can feel embarrassing.

You know that there can be this shame, like, I feel so ashamed. How do you coach people through that? A DHD shame spiral. 

Meredith Carder: Uh, that's a really hard one 'cause I think it, it really can be painful when our symptoms put us in a situation that we regret saying something or, or acting in a certain way. Um, I think it's Brene Brown that says shame dies in the light.

Mm-hmm. I think I, I really encourage people to find that safe person to talk about it [00:49:00] with. If you maybe have that coworker that was there, having that conversation versus ruminating on the interaction for weeks and days and months, getting things out into the open, I think is, uh, much better for our brains than keeping it internal.

Sometimes you might be surprised at the perception it might be, oh, I didn't even notice that you did that, or, oh, no, it actually made me feel good to see you have. Tears and emotions because I feel like I was suppressing that you might be surprised at the outcome or you might have a conversation that leads to a better way of interacting in the environment that, that triggered that reaction.

Uh, but I think we really have to talk about the fact that people with a DHD, one of the things we really struggle with is rumination. Mm-hmm. Which, if you're not familiar with that term, it's overthinking. Our, our brains tend to, um, stay kind of in that like thinking processing mode. Uh, there has actually [00:50:00] been studies that show that there's a network in the brain called the default mode network.

They often refer to it as the DMN. So all people have this network, but that's when we're kind of like at rest and we're thinking things. Through. And then there's this other, uh, network called the Task Positive Network, the TPN, that when we start doing a task and we're involved in something that the DMN turns down in like a neurotypical individual.

So with people with A DHD, our DMN doesn't turn down as much mm-hmm. When we're involved in a task. So that means that while we all can overthink and we can all ruminate, we're doing it much more often. Yeah. Um, and we're not getting that brain break when we're like, oh, I can just keep busy and do this.

Thing and kind of forget this ever happened. No, we're still thinking about it. Mm-hmm. So if we wanna break those cycles of rumination, oftentimes we do need to, you know, get it out in the open and talk to the people that we're involved in and, and try to repair in that way. Uh, [00:51:00] but our, our brain's gonna tell us that's not the solution that would, we should stay over here and keep ruminating.

So yeah, being aware of that tendency is really important. 

Dr. Brighten: Yeah. And, um, for, I talked about this. I did a, a episode on a DHD sleep issues specifically in perimenopause because it's like, you don't sleep because of, you know, delayed sleep phase syndrome here with A DHD, and then you add perimenopause hormones on it and now you're not sleeping even more.

But that rumination can be really problematic. And that's when, um, so many of my patients have said, like, when I'm falling asleep. My brain just won't shut off. What are you thinking about? Are you thinking about to-do list? No, I'm thinking about that thing that I did when I was six years old and I really wish I never did it.

And all I can think about and I'm like, Hey, I've been there. I know this. I know this well. And so it is something that I want people to know is really, it is really common experience and it is something to recognize that it's a huge drain on your energy. I don't think we talk [00:52:00] enough about how exhausting it is to live as a neurodivergent person in a neurotypical world.

And that's one of those reasons as well of like analyzing every action that you've ever done and how could you do it better? Mm-hmm. Um, I do wanna talk about the pause though, 'cause you brought that up earlier about pausing before, before you speak. But how do you help people who are having a hard time with overreacting or reacting quickly?

How can they take a pause? To not go into reactive mode first. 

Meredith Carder: I think it, it takes a lot of practice. I, you have to identify what your kind of exit strategy is before you need it. So if you know that there's certain things that trigger you at work or trigger these responses at home, thinking about that and thinking about how can I notice faster and have a.

Pause or, or have some language that allows for [00:53:00] that pause. Mm-hmm. So we use this a lot in our home with, uh, communication. 'cause you know, we've got five people and three of them have a DHD. So there's a lot of, you know, emotional regulation issues happening. And uh, our past pattern was everybody gets so hot and we continue trying to get our point across and yelling and it's just not good.

Mm-hmm. Right. So we've identified language being like, I feel like I need a break and I'll approach you when I feel more regulated and when you're regulated, please let me know as well so we can, we can have this discussion in a productive way. Uh, but do you guys actually get to say all of that? I mean, my kids are older, so I think that's, uh, important to know what 

Dr. Brighten: is, because we just have code word dysregulated.

Yeah. I mean, dysregulated, it doesn't always, if somebody in the house we're like. Give space, dysregulated, give space, like, and so it's like you actually are able to have that whole conversation. You guys have been practicing 

Meredith Carder: that. I mean, for a while. It doesn't, it sometimes works really well. Sometimes it looks more like I have to leave and sometimes there's just door being slammed to [00:54:00] make a point, you know?

Yeah. And I, I think sometimes too, it's like, you know, as a parent when, when the language isn't used by the child and it is more of like the walking away, slamming the door, I am able to. Just let that go because I know that she is really trying to do what's best for her in that moment, but she's just not at a point yet where she can like skip the door slam.

Uh, when I was a kid, I did a lot of door slamming and that was additional punishment and additional negative feedback for how I reacted instead of really getting to the root of the thing that you were trying to work through that was causing the dysregulation. Mm-hmm. So, yes, it's not perfect. I think if we practice those things ahead of time, oftentimes, um.

When I've worked with clients that are really struggling with that, they'll, they'll do that as like a morning routine. They'll do some gratitude work and then they will like rehearse language for conversations. [00:55:00] And as you practice these things in real life, it gets more natural. And you don't always have to have this like, canned speech, but if you never think about that language until you're in the moment, the language is not gonna be very kind.

So I, I think it's the pause starts to happen more the more you practice and the more you're aware that you need it. Um, and oftentimes I think that we struggle to, we're trying to regulate in the moment when we really need to kind of like be somewhere where the trigger is not for a time to, to get back into regulation.

Oftentimes people are like, don't, don't, you know, leave the conversation until things are resolved when sometimes we all need a break so that we can get back to a place where it's productive. 

Dr. Brighten: Yeah, I agree with that. I appreciate you saying that because, um. You hear that so often, and I know somebody once upon a time said like, if you wanna stay married, like never go to bed angry.

And I'm like, well, sometimes you're gonna go to bed angry because what do you, because that message [00:56:00] to me was always pushed down. Your emotions don't. Mm-hmm. Don't deal with your emotions because even when you still talk about things, you can start getting dysregulated again, and then you fill that in your system.

And then I think it's really easy. I mean, I feel like younger me was like, oh, I feel so guilty and I'm gonna ruin my marriage. And I'm not, I think I've been married like 15 years now, but I was like so paranoid because I'm like, no, but I still feel like I feel angry and it's like not even necessarily still angry with this person as much as like the feeling is still there.

Like it mm-hmm. Has to, and it's when, uh, as I matured, I learned like you have to let emotions run their course and run through your body. And I'm someone. So in our house we have the, like, I am dysregulated. It's often because, you know, I've modeled this, so this definitely comes from me because I'm in the kitchen and I'm cooking and I'm trying to do all the things, and then like I'm being talked to and someone's banging a pot and all this, and then I'm like, wait a minute.

It's upon me. I'm dysregulated and I, I have to leave and take this little break. Something [00:57:00] we do in our house. So with the, the older one, he's not so much cool with the trampoline, but the toddler is like, let's go bounce on the trampoline for, for a while. I'm someone that like, I gotta do jump squats. Like what, what, what I want people to understand, and this is what I explain to patients, is that.

When your nervous system gets into the sympathetic drive, fight, flight, freeze. Ask yourself like, what does it want? What does it want to do? And a lot of times it's like, I wanna fight, I wanna run away. Let's give your body what it needs. So it wants to actually move and move in that way, but I like, I really love that you guys have been working on it so long that your family can have that dialogue and actually get to that place of discussion.

I think that's like a really beautiful thing to be modeling to people of something that's possible. 

Meredith Carder: Yeah. I don't wanna put the image out there that we're perfect, that we don't fight. I didn't think that sense. Yeah. Yeah. I just wanna be clear here. Um, my teenage daughter will call me on [00:58:00] it and be like, no, we just got in a fight last week.

And to me it's not eliminating. These things happening, these things will happen. We will get dysregulated. We will say things that we regret saying, but understanding the root of it and giving ourselves more of a chance to have less of these situations and then knowing how to repair, uh, is really, really important.

Dr. Brighten: Yeah. And for people listening, uh, I will link to Dr. Ann Louise Lockhart's episode 'cause she talked about how bad it is to yell at your kids, how, you know, we know that physical, um, punishment is. Damaging to a child. So spankings, um, she talked about yelling and something we talked about in that is like, okay, well everybody's gonna lose it at some point, right?

Some people might be freezers, right? Mm-hmm. That's how their sympathetic nervous system works. So they just shut down, which is also damaging to a child, right? What can we not do right to the kid that that isn't something? Well, she gave tips and one of the things was like [00:59:00] showing them and modeling them.

When, when you feel like you've misbehaved and you've acted out of character from what, who you would like to show up in this world model to them, what an apology looks like, how redemption can be, can be achieved. And I thought that is just so powerful. I wanna shift the conversation to motivation. Um.

Because I think that's the other thing we often get labeled as like unmotivated, right? Unmotivated, lazy. No, I just don't wanna do the boring, meaningless stuff that I don't think has a point, right? That was me in school, like, what's the point of this? If you can't tell me why, why this is worth doing, then I'm not gonna do it.

Such, like if you have a child that's a troublemaker. Let me be an example of what troublemakers can look like when they grow up. What actually drives motivation in the A DHD brain and why is it sometimes that rewards will backfire? 

Meredith Carder: I think it's a, it's such a interesting conversation. We have such a complicated [01:00:00] relationship with motivation because oftentimes there are those things that we just really struggle to initiate and we get that label of lazy, but then we have this other side of us that is like so motivated to the things that we're interested in.

So what they, they think is happening in the A DHD brain is that we, uh, have. Uh, our dopamine receptors process dopamine much more quickly than a neurotypical brain. And dopamine is a neurotransmitter that's involved in a lot of things, but one of those things is motivation. Mm-hmm. So when we're thinking about a task that is kind of boring, like, you know, doing laundry or something like that, uh, a neurotypical person is gonna get some dopamine in their brain thinking, oh, it's gonna feel good to get this done, or I can check this off my list.

And that feels good, and that's enough dopamine for them to do the thing. Whereas an A DHD person that they might get that like little feeling of, oh, I wanna do my laundry, I wanna get it done. And then that dopamine is processed so fast before they can even initiate [01:01:00] that task. So they're having to be like, let me find a new podcast to listen to.

Or they're having to jump through all of these hoops to try to be motivated to things that are, it's much more, uh, intuitive for other people to be motivated towards. Uh, so that's, I think, where we get, are people 

Dr. Brighten: really motivated to do their laundry? I don't think 

Meredith Carder: anyone likes it, but I do think for some people it's just, they know it's something that needs to be done.

They see the importance of it. I often say that the trickiest thing about A DHD is our brains are not always motivated by importance. They're motivated by interest. So if we've got all of these tasks on our list, and we know that this one thing has, we really need to wear clothes tomorrow and we're on our last pair of shorts, like, why aren't we getting up and doing the laundry?

But we have this other task like researching a topic that we're really interested in. Our brain's gonna tell us, no, no, no. The, this is the important thing when it's really not in that moment what we need to be doing. Mm-hmm. Uh, so that, that can be really tough. And I think it's really tough with, [01:02:00] uh, people that are diagnosed later in life because they have these, like two parts of themselves where they're like, why can I be.

So motivated towards this one thing, but I can't keep my home functional or I can't submit my expense report. Uh, those things I think are really confusing. Uh, and I think oftentimes, uh, we oversimplify it like lazy is such an interesting term to me because it just doesn't apply to most people with A DHD because oftentimes too, we, like we do wanna be keeping our home cleaner.

We do want to like not be getting in trouble at work. We do wanna get reimbursed for that expense. Mm-hmm. Um, so we're having a hard time doing things we actually want to do. And if you're lazy, I think it's avoiding things that you just totally don't wanna 

Dr. Brighten: do. Right. Yeah. I, I just have to laugh because it's like, um, so the autistic part of me needs the house to be organized and everything in its place.

Like people, I, I cohabitate with many people. The, and the, the people moving the stuff in the pantry. Like [01:03:00] my husband will see it. I walk in there and I'm like, oh. And he's like, oh my gosh, okay. They, somebody moves stuff on you. I'm like, yeah, yeah. But then the A DHD side of me is like, I can, I can wash and I can dry clothes.

I can not get over the finish line. I've actually had to, it's interesting 'cause um, you know, there's the whole argument around autism and it's like, oh, well you're a low accommodations person. I'm like, well, am I, because I have to hire people to come into my house and help me. Like, I can't get cro across the finish line of like getting the CLO clothes folded and getting them put in drawers.

And, um, there's all of these tasks that happen in the house that I'm like, I. Can't get them done. Like it's, I and I have tried all of the watch tv. Will you, you fold clothes. But then I, I get really bored with TV and like, so it's, it is this, um, struggle. And you know, something else as you were talking that came up for me is how we hear these silly things that are like, successful people make their bed every [01:04:00] morning.

And I think for people with a DHD, they hear that and they think, well, I can't make my bed. I'm someone who's like. There's a fitted sheet and there's a comforter, and that is done. Okay. We can't do more than that. That people will hear that though. And they think, like, they hear these successful people say these things like they make their bed every morning.

Um, they always have like, you know, their clothes folded neatly. Like, and, and then you hear that and you think like, well then I can't be successful. And it's not true. Success looks really different. And I will tell you, I've met many. Very successful people who are like, sometimes, like they never roll in, in clothes that are not completely wrinkled.

And I see that and I'm like, friend. Same. Same. So I, I think, um, you know, this, this talk around motivation is helpful for people to understand how things can look differently for them. I wanna ask you the, what are the most effective tips you share with clients for [01:05:00] managing impulsivity? Um, and how, you know, how that gets in the way of their motivation.

Meredith Carder: Yeah. 

Dr. Brighten: I 

Meredith Carder: think it is really important to think about. Every day, like what your why is for that day because we will be governed by that impulsivity if our why isn't strong enough. Yeah. So you talked about being the kid that's like, I don't, I don't wanna do this thing if I don't know why I have to do it.

And thinking about the things like, you're bad. I am actually the same way where I'm like, I don't need to make my bed. My husband likes to make the bed, so I let him do it. And I've let go of the fact that like, if I were a better wife, that's something I'd be doing. It's important to him, it's not important to me.

So when he's outta town, I just kind of pull that comforter over and we move on. Uh, but thinking about like. Every day and thinking about what are my top priorities and why are these my top priorities, I think can help a lot with that impulsive need to just kind of like, follow what our brain wants to [01:06:00] do in the moment.

Mm-hmm. Uh, I really like a, a transition routine to transition me into my day and out of my day. And usually that looks like in the morning, um, thinking about, okay, what did I identify the night before as my priorities? Uh, so it's almost that double check if you are closing out your workday and thinking about, okay, tomorrow, what do I want?

You're building that vision and then you're revisiting it in the morning and it's gonna be easier to have a little more control over those impulses. Um, I also think sometimes. It's okay to follow your impulses every once in a while. I like to give myself a day where I don't have any deadlines and I, I am able to just follow what my heart tells me to do that day.

It feels really freeing. Um, I had a client that was kind of struggling with that where she was like, I know I do better with routines and plans, but then sometimes I just want to rebel. And she identified trying to fit in a half day each week that she [01:07:00] called her blah day. And she could just be like, blah, I'm just gonna do whatever I want.

I don't have to follow the rules. And she found herself, sometimes she would do the routines anyway 'cause she was craving it, but other days she let herself just kind of follow the impulses. And when it's. When you give yourself kind of like that little bit of a, a leeway, um, I think it's easier to, um, have some more control over them the rest of the time.

Dr. Brighten: Do you think that's a bit of pathological demand avoidance? Because sometimes it's like, I know I need to do these things. Like here's the routine and I definitely love routines and I get really, um, yeah, I dysregulated if routines get, uh, interrupted, but then sometimes if somebody's like, oh, you have to do this or you should do this, it like lights up and I can even do it to myself where I'm like, oh, you should do this and you should do that.

And then my brain's like, we're not gonna do it. We're not gonna do it, any of that. So I wonder if like those like permission about having the blah day is something that would work for people with PDA as well. 

Meredith Carder: Yeah, I do think with PDA we do have to have [01:08:00] time away from the demands. We can't have a demand all of the time.

We need some freedom within our routines to be able to have choice. Um, I think PDA can be really hard. I get like that too. As a kid I would just. Say, like, I just don't like being told what to do, even if that telling was something that was gonna be good for me and benefit me. Uh, so I think that, and again, I think we impulsively resist at times versus taking the pause and being like, okay, so the, I don't, maybe we didn't like how that demand was phrased by someone or from ourself.

Maybe we need to approach it from a different angle. I think it's easier in adults as kids because we can be a little more irrational than that. Mm-hmm. But, um, you know, I, I found that with exercise with myself as I was very into marathon running for a really long time, and I did really well with a very solid training plan until I didn't, until I got older and I needed more recovery than what the system, you know, was telling me I needed [01:09:00] to do for miles.

And when I took a break, it was like. I wanted to just do things my way. Mm-hmm. You know, and I, I, I just couldn't bring myself to have that structure again. And I, I had to slow down and be like, I was telling myself, just follow the plan, you know, but until I took the time to be like, why am I being so resistant to this?

And identify that, like, oh, that was, because that being so rigid on that hurt you in the past. So like, do that self collaboration where you find that answer. And I think if you're dealing with a kid that, um, shows the signs of that PDA profile, it, it is kind of like that collaboration versus always being a like, directive parent.

I think it, it helps a lot when we can get the buy-in from, from that person. Mm-hmm. And sometimes that person is ourselves that we have 

Dr. Brighten: to get that buy-in from. It's funny that you said like. You know, I don't like to be told what to do. Uh, before I was diagnosed, I would be like, what's the rule in the house?

[01:10:00] And my son, um, and my husband both knew, it was like, don't tell mom what to do. I'm like, yes. And, and I identified that early on that I'm like, if you tell me what to do, like my nervous system's, like you're attacking me and I'm angry. Is it rational? No, it's not rational. It's how my nervous system's wired.

But it was, that was one of our code things for them to reframe it. Of like, Hey, what do you think about doing this? Or Wouldn't it be nice if we had this? And just doing a reframe and then my nervous system's like, yeah, let's do it. Like, this is great. I'm like, this is so silly, but it's so real. It's such a reality.

Mm-hmm. So for, um, so for people listening, PDA pathological demand avoidance, this is where, just like we're saying, you tell someone what to do and their nervous system lights up and it's like, can't, won't, it's not even conscious. It's not something that they're deciding. It's what their entire existence is like.

Just, it's like one re. Rebellious nervous system against yourself as well. When somebody is struggling with that and they [01:11:00] know they have to get something done, what are some tips to help them? 

Meredith Carder: Uh, yeah, I think being aware of it and having language around it is absolutely important. Uh, we didn't really start talking about PDA until like the last couple of years.

Mm-hmm. So recognizing that is very important. Um, and then I think it is always coming back to the purpose. People that show that profile, uh, need to know the why big time. And if you can't identify a, a why, then you're not gonna be able to meet that demand. Um, sometimes we have to think about what is it about this demand that is feeling so uncomfortable to me?

Is it that I'm worried I'm not going to feel good? Like the, for an example I see a lot is my son is very demand dev avoidant, and it's so heartbreaking as a mom because he'll get invitations to play dates and things like that. Mm-hmm. He will almost immediately be like, no, I don't wanna do that. And he's very social, but oftentimes he's like, well, I'm worried I'll be [01:12:00] tired from school, or I already have football tonight and I don't wanna do this other thing.

It's like he has like a, a set amount of demands that he can tolerate. And once we kind of identified that and. Accepted that versus like packing things in. Uh, it's worked a lot better. I've noticed that with myself. Is that like when I'm going through a period of time where I have tons of meetings on my calendar and my time doesn't feel like I have much control over it, that's when I have to lessen demands elsewhere.

Like there's only so many demands that a lot of us are willing to tolerate. So thinking about, okay, why am I doing this? Getting back in touch with the benefit, you know, completing the task will give you. And also just looking at your kind of bandwidth to have those external demands, uh, and kind of shifting if there's just too much at a certain time.

Dr. Brighten: Mm-hmm. I love the, you know, cataloging, like, how many demands can I take in the [01:13:00] day? I think that's really important. I feel like it took me too long in life to realize that like if it's more than three big things I have to do outside of my house, like I'm gonna be completely wiped out. And so I know that it's like if I have to go to a doctor's appointment and I have to do the Costco trip and I'm gonna have to go to like a parent teacher conference, that's it.

Don't schedule any other big, going outside the house doing other things. Don't think like, oh, I can just stop by the pharmacy on the way or anything like that. And to say that it might not catch up with you that day. It might catch up with you a few days later. And this is the thing that's so tricky about being a human, is that the things that often are impacting have impacted how we're feeling in this current moment.

They already happened a week ago, a month ago, and here we are, and we don't think back to that and we just wonder like, well, what could possibly be wrong? So I love that tip of like, understand how many demands [01:14:00] like you can really take on in a day. I, I think the same is true with like decision fatigue. So you gave the great tip of like.

Before bed, pick out the outfits because Yeah, first thing in the morning you have to think about getting breakfast. You, you start thinking about all of these things and that's the, I feel like you can only make so many decisions in the day. And this is something that I will say to my team sometimes, like I.

I have made a lot of decisions today. I need, like this one, you have to come back to me tomorrow. 'cause I just feel like I'm gonna give you an answer and none of us are gonna be happy with it. So let's try again tomorrow when my brain is fresh and is actually has a little more capacity. Mm-hmm. I think just understanding that is so important and being able to communicate that.

Yeah. Well this has been a fantastic discussion. We are gonna link to where you coach, uh, ADHDers. We'll link to your book and all of your resources, but I wanna say thank you so much for sharing your expertise and taking the time to sit down with us today. It was great. I was so happy to be here. Thank you so much for joining the conversation.

 

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