Hi, everyone.

Welcome back to another episode of the ADHD Women's Wellbeing Wisdom.

This is where we drop those moments of wisdom from the series and we're able to offer you fantastic insights from amazing experts and specialists that many of us can't speak to or get hold of.

And today is no different.

We've got Dr.

Helen Reid on the podcast and now she is a consultant psychiatrist with over 30 years of experience in the NHS.

And she has many, many years of lived experience, but also professional experience with neurodiversity, both with adhd, with autism and many of their coexisting traits.

And she also has a special interest in rsd.

And I know that what this conversation will bring is so much more validation, but also understanding about medication and what works, how things work, how we can tweak our medication, medication with our hormone imbalances as well.

So it's really fascinating because Dr.

Reed also, she also has ADHD herself, as do her children.

And so her advice and her experience and her support is firsthand.

And so she understands it from her perspective.

And so when she helps her patients, she really gets into the depths of potentially how medication can help is hindering what's not working and really understanding it from that lived experience.

So here is a fascinating conversation with Dr.

Helen Reed.

In today's episode.

We are talking about ADHD and medication.

Now, today's guest, Dr.

Helen Reed, is a psychiatrist and she is able to prescribe ADHD medication and she talks about tweaking and changing the medication.

However, she is not your personal doctor.

So please, please listen to this episode as guidance and some help and support.

But if you are changing or tweaking your medication, this has to be done through your titrating prescriber, your doctor.

So I just wanted to flag that up before today's episode.

We are finding out in our 40s, 50s, 60s, that actually it's ADHD.

We're able to connect these dots and that sense of relief alongside the grief and the sadness is profound.

And I.

I've said this before, but I don't know of another clinical disorder, difference, whatever you want to call it, that ticks all those boxes the way ADHD and women does.

That's why I feel like it's so topical and why it's so profound when women, especially getting these diagnoses.

Do you.

Are you seeing that as well?

Absolutely.

I mean, if, if you would have said to me five years ago that, you know, I would have narrowed, you know, my focus from the whole of psychiatry to neurodiversity not that it really is narrow, but it sounds a bit narrower, doesn't it?

And if you would have said, well, you know, you'll be basically kind of diagnosing one thing, you'll be talking to people about one thing and you'll be doing it every day, year in, year out.

And, you know, although I've never got bored with patients, you know, I think it's something I noticed very much in the clinic that people are hyper focused.

We hyper focus on our clients, whoever they are, you know, and right through the clinic you've got people who are doing frontline stuff, helping stuff, reaching out to people.

And it's something I think that ADHD people are very, very good at.

And of course we will bring hyperfocus to that.

So, you know, But I would have wondered whether or not I might get bored to extent and want to sort of break it up with some other things.

Answer, no, I never get bored.

And the reason I never get bored is A, because it's fascinating, but B, because of the massive difference it makes to people.

And it's constantly wonderful, it's absolutely wonderful to be able to bring this to people, to have them sort of to validate their.

What they've often had, you know, when they booked the appointment, if you like, this sense of, my goodness, there's something here might finally explain, you know, the years of struggle, the pain that I've been through, the, you know, and of course we adhd, I don't think, well, we're not, probably not alone in this, but of course, our emotions being what they are, we will tend to blame ourselves when something doesn't work.

So, you know, you've had the drugs, they didn't work.

That's because you're rubbish.

You know, you've had the therapy, it didn't work.

Well, obviously you're rubbish, aren't you?

Because.

And I think it's very hard for us to think, well, actually it was the wrong thing, unless you get somebody who gives you permission to say, actually, that is you.

And more often than not, at the end of my consultations and, you know, they're in depth, you know, long two hour chats and I get a lot of information from people so that, you know, they're very detailed, but people still often want to check in before they go, are you absolutely sure that I've got it?

Are you absolutely sure that I'm not just lazy and it breaks your heart, but also it's the most wonderful thing to be able to bring that to people and it changes lives.

Yeah, couldn't agree more.

How can someone with a self diagnosis that hasn't had that validation from a doctor start to kind of change that self talk a little bit.

What do you say?

I mean, I do say to people in my clinic it's understandable that people will have this doubt.

And to be honest, you know, it doesn't sound true.

You know, I've got to say, if I'm listening to it with my logical ear, if I didn't live this stuff, if it wasn't my life, I would say, well, that's a bit preposterous, isn't it?

Like, are you really saying that, you know, 5% of the population have got this difference, which, you know, responds like nothing you've ever seen before to treatment, which I personally think is the most convincing thing about all of it.

But, you know, we're not talking about a sort of, you know, are you blue or are you red?

We're talking about symptoms that everybody has and they are, you know, continuously distributed through the population.

So, you know, we have all got a bit of adhd, but that is not to take away, you know, from the suffering of the people who are in the top 5%, which is where we currently have our man made, and I do mean man made cutoff point.

And if I was in charge of everything, I would probably bring that cutoff point down a bit.

And the reason I would do that is because of the massive effectiveness of medication in this condition.

And I know not everybody is on the medication journey and I don't want to talk about nothing else except medication, but from my point of view, it shrinks down the giant hamster wheel of a person's life.

And I think that it's, it's really important for people to have the pressure taken off them.

And you know, all our lives I think we've lived with so much pressure.

And part of it is that if you have this kind of brain, it's actually a lot more effortful to live in the world and to do the things that we're expected to do.

So I describe that for people as a hamster wheel.

You know, I feel that, you know, with untreated adhd, your hamster wheel is just a lot bigger than everybody else's.

And without exception, the people that come to Magdini are exhausted, overwhelmed, you know, flat on the floor.

They literally, they have tried everything, and I mean everything, and they don't know what to do next.

And so part of what I say to them is, you know, there's no prizes for doing it the hard way, really.

If we can find a way to make things easier, to accomplish these goals without killing ourselves with effort, then clearly that's going to be a good thing.

So, yes, I'm in a self diagnosis.

I think that if people understood more about the fact that the symptoms are continuous.

So if you do an online questionnaire and you answer honestly, as most people will obviously do, and if it tells you that you've got significant symptoms of adhd, well, that tells you that you're on that continuum, which we all are anyway.

It gives you an idea of where you are on the continuum.

And if the online thing says to you that you have quite a lot more of these symptoms than other people and you're struggling quite a lot more than other people, then you know that's true.

You know, and that's all the diagnosis is.

I mean, any mental health diagnosis is really.

Let's ask you about what the symptoms are like, let's ask you what effect that has on your life.

And, you know, we don't doubt that with depression.

You know, I, When I talk to groups of consultants about all of this, you can absolutely guarantee that somebody will put their hand up at some point and say, well, how do you know it's ADHD and not just someone who's a bit lazy?

And yet if I was going to talk about depression, you wouldn't get someone putting their hand up saying, well, how do you know that person's really got depression and not just a bit sad and miserable?

We know it's a matter it's not nature, it's degree.

If you have enough of these symptoms that they're holding you back, you know that you're doing your best, you're exhausting yourself, but somehow you seem to fail to achieve your potential.

Well, that is what we call impairment criteria.

And if you've got symptoms and impairment, that's where the diagnosis sits, really, you know, and it is actually as simple as that.

I mean, I wanted to ask you, you've got a.

An interest in rejection sensitive.

Rejection sensitivity, dysphoria, rsd.

And we do hear this term being talked about a lot.

And I know so many of us relate to it.

I mean, it almost seems kind of like I've never met someone with ADHD that doesn't suffer with some form of rejection sensitivity.

How do you help people with that?

Is it just a ability of being aware of, to be able, for people to be able to go, now I understand, now I understand why I'm so sensitive with Friendships and relationships and criticism and feedback, or is there anything else that people can be doing to help themselves?

Well, I do think awareness is important and I do agree with you that it's, you know, it's, to my mind, it should be on the diagnostic criteria for adhd.

Well, I think the thing is there's a lot of established psychiatric diagnoses that would be, you know, it would be a little bit difficult to argue for their separate existence if you, you allowed this thing to be a thing.

You know, where is the boundary between bipolar, emotionally unstable personality, you know, where does that sit?

And even are there.

I personally don't believe that those are actually real things.

I believe that all of that is likely to be ADHD and perhaps various other neurod sort of comorbid sort of things.

Like.

Yeah, I think ADHD makes you take a very dimensional view of all sorts of things that, you know, things can overlap.

You know, blue and blue and red can make purple, you know, but that doesn't mean that we need a separate category called purple.

It can be much easier for us to understand that it's an overlap.

It's a mixture of blue and red.

And I think the same thing with mental health diagnoses.

So what can we do?

Well, I think you're right.

Knowing that it's a thing, knowing that we have a slightly different kind of brain and that our emotions will be turned up much higher than other people's.

So we can know like cognitively that if I feel upset by something, the chances are that you may well not even have noticed this thing that I'm agonizing about.

If, if I think you hate and despise me, the chances are you haven't even considered whatever it was.

And it was a thing that mainly happened in my head.

Many things I've learned myself sleeping on it.

What a wonderful thing to do in the morning.

Things often look a lot better.

So I think realizing that we have a bit of a tornado machine in our head is a very helpful thing.

But in ADHD we see it everywhere.

And I always say to people, it's like you're on this trapdoor, you know, and however great the day is, however well you've done, you are always like one thought, one memory, one nothing at all from just like plunging into this place of self hatred and you can't talk yourself out of it.

You know, that just makes you feel worse because now you're this person who can't talk.

You know, you might know you're overthinking.

I think A lot of us do know that we're overreacting.

Doesn't mean you can say, okay, well, I'll just snap out of it then.

It does take time.

So I think ADHD medication does help a great deal with emotional dysregulation.

And in my clinic, what we tend to do is, because obviously stimulants last only a certain amount of time and then they stop working on the day.

They, they, they work for a number of hours, depending what we're taking, and then they stop working.

And of course, when you're thinking about emotional dysregulation, rejection sensitivity, stuff like that, that often feels like a crash.

And so people can say, well, that was great, but I had this terrible side effect because I was so allergic to this medication that I suddenly felt like, sh.

If she's my French, after about five hours, after taking the meds.

And of course, so I educate people in the clinic.

This stuff's time limited.

You want to keep an eye on how long it works for and what happens when it wears off.

Most people, especially most women, will get a crash after a few hours, and I tend to ask them.

And it can be a bit of an ask, given that people have had bad experiences, to just try adding in an antidepressant like Prozac, whatever your GP is giving you, anyway, if you're an antidepressant, don't have to change.

And although they don't work very well, in my opinion, in untreated adhd, to help with the problems that we have with mood there, once you've got a stimulant in place, if you add an antidepressant to that, it takes the crash away and it sort of regulates the sort of emotional balance over the 24 hours.

So pretty much everybody in my clinic will take a stimulant combined with an antidepressant by drugs, including me.

You know, I've never been depressed in my life, but I do add pros.

I take it only about once a week because, you know, of course, the whole point of these antidepressants is they stay in your body for a long time.

So, you know, one doesn't have to necessarily take them every day.

I mean, I think it depends on choice and, you know, how much we're battling.

Very helpful for PMS as well.

You know, once we've got a regime like that, if someone's got pms, they could perhaps take an extra one on those days and those kinds of sort of proactive, kind of, you know, using medication as a sort of Toolkit to help us with what we're going through on that day is very useful.

And, I mean, there are some other medications as well.

I don't know how much you want me to go into specifics, but there's one called clonidine, which Dr.

Dodson very much recommends on.

I use it extensively in my clinic.

This is one we take at night.

It helps with the sleep architecture, but it really helps with that sense that the world is a difficult, spiky place where we're just, you know, destined to fail and be attacked all the time.

So I think there's knowing about it, things we can do about it.

And of course, if you do manage to stop the juggernaut, if your life starts to get better, that gives you the sort of mental clarity and the space to do those things, perhaps to foster those relationships which make you feel good, you know, to have another think about the ones that don't make you feel so good.

We're more able to protect ourselves.

We're more able to think about ourselves.

There's so many ways in which having a smaller hamster wheel enables people to activate the stuff that we all know.

Like, I find everyone that I see knows exactly what they could do to make their life better, but they just can't do it, you know, because they're too overwhelmed is the thing.

So a little bit of mental space, a bit of clarity, and an understanding of what kind of brain we've got and how it actually works, I think, you know, really can go a long way.

And, of course, success breeds success, right?

Doesn't it?

As does failure breed failure.

So I tend to say to people, the bottom line is, do what makes you feel good.

If you're doing something and you feel like it's doing it good and you feel better and it's helping you, then obviously do more of it.

But if you're, you know, gritting your teeth and in tears and having panic attacks and in the hope that somehow or other doing this thing is going to make you feel better, strongly suggest you stop doing it and take some medication instead.

You know, very much, I think we.

It comes back to having that confidence to know whether something is good for you or not and to ask yourself those questions.

So I hope you enjoyed listening to this shorter episode of the ADHD Women's Wellbeing podcast.

I've called it the ADHD Women's Wellbeing Wisdom, because I believe there's so much wisdom in the guests that I have on and their insights.

So sometimes we just need that little bit of a reminder and I hope that has helped you today and look forward to seeing you back on the brand new episode on Thursday.

Have a good rest of your week.