Dr. Kathleen Nadeau: Adulting and aging with ADHD

Mar 18, 2024

 

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“One of the best ways to help women with ADHD is in groups. We heal each other by understanding each other, laughing together, and not expecting the same perfection that the outside world expects of us.”

Dr. Nadeau is a clinical psychologist and founder of The Chesapeake Center, as well as an internationally recognized authority on ADHD.

She is the author or co-author of over a dozen books related to ADHD across the lifespan, from her best-selling book for children, “Learning to Slow Down and Pay Attention”, to her latest book “Still Distracted After All These Years,” which addresses the many factors of growing older with ADHD (because as we all know, you do not outgrow ADHD).

We discuss some of the strategies laid out in Dr. Nadeau’s latest book, such as the importance of maintaining structure, connection, and support as we age. We also address some of the myths and misconceptions about stimulant medications for the over-60 population, and the need for better understanding and treatment of ADHD in older adults, as many healthcare professionals dismiss or minimize the struggles faced by this population.

And we talk about “failure to launch” in younger adults and how difficulties with early adulting skills might lead to a lot of anxiety around aging with ADHD.

Finally, we discuss her upcoming book, “A Clinician's Guide to Women with ADHD: Diagnosis and Treatment” which she is co-writing with Dr. Patricia Quinn, MD, and Dr. Michael Morse, MD. Although there are many books for and about women with ADHD, there is a great need for a clinician's guide to diagnosis and treatment. Women continue to have great difficulty finding knowledgeable physicians and therapists to treat them. This long-overdue book due to be published in 2025 will provide a very straightforward treatment guide for medical and mental health providers. 

Website: Chesapeakeadd.com

Instagram: @thechesapeakecenter

 

Links & Resources:

Still Distracted After All These Years: Help and Support for Older Adults with ADHD by Dr. Kathleen Nadeau

The Unmade Bed: The Messy Truth about Men and Women in the 21st Century by Stephen Marche

https://www.tiktok.com/@retirementhouse

Enjoy!

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Dr. Kathleen Nadeau 0:00
One of the best ways to help women with ADHD one of the best ways to treat women with ADHD is in groups that we help heal each other. We heal each other by understanding each other and supporting each other and laughing together and not expecting perfection from each other, as we feel the outside world expects of us.

Katy Weber 0:33
Hello, and welcome to the women and ADHD podcast. I'm your host, Katy Weber. I was diagnosed with ADHD at the age of 45. And it completely turned my world upside down. I've been looking back at so much of my life, school, jobs, my relationships, all of it with this new lens and it has been nothing short of overwhelming. I quickly discovered I was not the only woman to have this experience. And now I interview other women who like me discovered in adulthood they have ADHD and are finally feeling like they understand who they are and how to best lean into their strengths, both professionally and personally. Alrighty, righty before we begin, I would love to share with you this review from a listener named N. B. Cedar. It's entitled, my favorite ADHD podcast, the host, Katie has a great ability to cover a wide variety of areas with each guest while keeping things balanced and centered on the topic. The content is very practical. And each week, there's plenty of laughs and stories I can identify with when it comes to both ADHD and parenting. I love this podcast for its ability to touch on heavy topics while never feeling like we're digging too deep or making things uncomfortable. Thank you for making this podcast. Well, thank you very much and be one of the many gifts of women with ADHD is how we tend to get straight to the heart of the matter. We skip the small talk and get right to the trauma. I often call it sorting through the trash. And honestly, I wouldn't have it any other way. So thank you for appreciating that fact. And we're coming along for the ride. And of course, I really appreciate the time and effort it took to stop what you were doing and write that review. So thank you. And if you're out there listening to this podcast, and you have found these interviews to be helpful, a wonderful way to say thank you is to head to Apple podcasts or audible and leave a review. And you can now leave feedback on individual episodes on Spotify. And of course, if that feels like too much right now, and I totally get it. You could also just quickly hit those five stars. In fact, why don't you just pause right now and go do it and I promise we will wait for you. Okay, here we are at episode 179 in which I interviewed Dr. Kathleen Nadeau she likely needs no introduction for most of you but Dr. Nadeau is a clinical psychologist and the founder of the Chesapeake center. She's also an internationally recognized authority on ADHD. She is the author or co author of over a dozen books related to ADHD that address ADHD issues across the lifespan from her best selling book for children learning to slow down and pay attention to her latest book still distracted after all these years, which addresses the many factors of growing older with ADHD because as we all know, you do not outgrow ADHD. Dr. Nadeau and I discussed some of the strategies laid out in her book such as the importance of maintaining structure, connection and support as we age. We also address some of the myths and misconceptions about stimulant medications for the over 60 population as well as the need for better understanding and treatment of ADHD in older adults, as many healthcare professionals dismiss or minimize the struggles faced by this population especially. And we talk about failure to launch in younger ADHD adults and how difficulties with early adulting skills might lead to a lot of anxiety around aging with ADHD. And finally we discuss our upcoming book A clinicians guide to women with ADHD diagnosis and treatment which she is CO writing with Dr. Patricia Quinn and Dr. Michael Morse. Although there are many books for and about women with ADHD there is a great need for a clinicians guide to diagnosis and treatment. Women continue to have great difficulty finding knowledgeable physicians and therapists to treat them. This long overdue book is due to be published in 2025 and will provide a very straightforward treatment guide for medical and mental health providers. So stay tuned. And on that note, here is my interview with Dr. Nadeau Well, Dr. Nadeau, thank you so much for joining me today. I am thrilled to have an opportunity to chat with you. Well,

Dr. Kathleen Nadeau 4:46
it's my pleasure and I'm just so struck whenever I am being interviewed by someone about women with ADHD what what a community we have, you know, It just turns into a very engaged chat, because that's what we're like, right?

Katy Weber 5:06
I know, it never fails to amaze me. I've been doing this for three years. And I still, I feel like every person after one hour of conversation, it's like, my bestie, like, near and dear to my heart. And I will see, you know, I was just at the ADHD conference in November or the end of November in Baltimore. And I saw, you know, guests from two years or three years ago that I hadn't talked to, since then. And we just embraced each other, like long lost family. And it's so nice, because not only is it the friendliest community I've ever been a part of, but so many of us, myself included, really struggle with friendships and socializing, especially with other women. And so for me, just to be able to, like, be friends on our own term, in the way that we are friends, I think is is such a wonderful community to be a part of.

Dr. Kathleen Nadeau 5:58
But isn't that interesting that all of us women with ADHD, who may have felt throughout our lives, like we didn't quite fit in, just immediately click with one another. And there are so many of us that, you know, I think we just need to have some sort of tribal identification.

Katy Weber 6:27
I like that. Okay. So now, to get started, I would love to hear about your diagnosis journey, because you are not the first psychologist certainly not the first psychologist I've interviewed who was diagnosed after already working so much with the population, and but you weren't necessarily drawn to ADHD clients, you were kind of thrown into it? Isn't that correct? Working with children?

Dr. Kathleen Nadeau 6:53
Well, yes. And no, I was thrown into it in the sense that I had a general psychology practice. And then a very important public law was passed in 1978. They basically mandated that kids with an ADHD diagnosis had to be given accommodations in school. And suddenly, my phone was ringing off the hook. And that was so long ago that we still thought it was hyperactive little boys. It certainly wasn't a passion of mine, to spend my career working with hyperactive little boys. I mean, those who are just desperate moms calling me on the phone, of course, I wanted to help them. And I think what really hooked me was talking with all those moms. Because, of course, those were the days when we didn't really think girls have it, you know, there was an occasional outlier. That might but it was mostly boys. And it certainly wasn't adults. And we just didn't know much of anything about it. But from the very beginning, the minute I started talking about the moms, they started telling me how many of the same characteristics they had had as a child, and they didn't know if they really had ADHD or not, because, you know, in those days, it was all very skeptical. But I think it just kind of grew on me and, and it grew on me, because my family is certainly impacted by ADHD. My daughter, very unusually, was diagnosed just casually by her pediatrician at the age of four. And I took her in for a general physical and he said, Your daughter has ADHD. And I would watch and it was because she was this skinny little kid and she had tiny little bruises all over her legs, because she kept climbing trees and falling out of them and bumping into the corners of tables and, and she was swinging her legs and fidgeting around on the exam table just as your daughter has, has ADHD. And I knew that my younger brother did because he was he was the classic kid. I mean, he hated school. And he was rambunctious and impulsive, very lovable guy, but he in school just never meshed very much. And I was a good student and I liked school. So in those days, no one would have ever guessed, including myself, that I might have it do. What

Katy Weber 9:32
was it when you were talking to the some of the mothers about their journey or about their children? What was it that you saw in yourself that you started to recognize was that was ADHD and in how it presented in you?

Dr. Kathleen Nadeau 9:46
Well, I guess what I would say is that there was not an aha moment but just to gradual unfolding, because that was a time when I was really thinking not so much About women with ADHD or bet myself, but it just became so clear to me that we don't outgrow this thing. Because I'm working with all these parents, you know, who were telling me, I was just like that. And you know, I still am to a certain extent. And so that was my focus was adult ADHD. And I wasn't particularly focused on myself. But the more I worked with these families, the more I thought about my own family, then I started going back and looking. I mean, I'm exactly I was exactly the kind of girl that would never have been diagnosed. I wasn't a behavioral problem. I never got in trouble in school, I did my homework, I was a straight A student, you know, just the kind of girl that never gets diagnosed. But because I was a bright kid, I entered college, two years early into a special program that Emory University had. So I was 16 years old, when I started college. And then thinking back about once I was away from my family, and on my own, I was constantly misplacing things and constantly not remembering to fill out paperwork and turn it in. And looking back, I was going to school in Atlanta, and my roommate dropped me off at the airport to fly home for spring break. I've never flown by myself in my life at that point. And I thought, Oh, I'm gonna wander around the airport, you know, the Atlanta airport is massive. It's one of the biggest airports in the world, and buy some presents to take home. And I got involved in it completely lost track of the time and missed my plane, and had to spend the night in the Atlanta airport. It was the last play now. So I thought that's a sign that

Katy Weber 11:55
you know, it's it's fascinating to me how many women I've interviewed who were diagnosed in adulthood, but they had a sibling who was diagnosed, usually a brother, or even not diagnosed with ADHD, but it was diagnosed with maybe a learning disability and they adopted the identity of the easy sibling. You know, they were the ones who became the really good student. And you know, much of those qualities we see a lot in girls, which is very bright, doing well will really well behaved. But then suddenly, as they get into adulthood, realizing how much they've been white knuckling it how much perfectionism and anxiety have driven them in order to sort of be that good, girl, right? even into adulthood and how that was kind of how I recognize the ADHD. And my daughter was she didn't you know, she's very similar to many of the women I've interviewed. She's 16. Now, but you know, very bright always did really, really well in school. But it's the anxiety and the pressure to succeed that she puts on herself that I now recognize is such a common quality in women with ADHD. I was like, Oh, okay. That's also what it looks like.

Dr. Kathleen Nadeau 13:03
Exactly. Although I think I was so fortunate. That wasn't my story. And I didn't go through life with anxiety. I was between two brothers. So I wasn't the golden child, the smartest one. My older brother, literally was brilliant. I mean, he, they didn't know what to do with him. He was so smart. And so there was no pressure on me. I mean, I was just reasonably smart. He was boy genius. So that took the pressure off. I also had the very good fortune of having a very laid back mother. So she was not after me, you know, you forgot this or that. She wasn't that way at all. She I know she had been raised by a very strict mother, who had been a school teacher. And sort of she took her mothering job very much like she took her school teacher job and, and so she grew up determined, I'm not going to be that kind of mom. And I think I really benefited from it. So that I didn't go around worried that I was going to make a mistake. Although interestingly, this very non critical mother, I had the good fortune to be raised by when I was in my 30s. We were in my kitchen she was visiting, and we were just chatting. And she said just kind of quietly, you know, you've gotten a lot more organized. And she never told me I was disorganized. I mean, I wasn't good inside. You know, it was just as quiet observation. You know, you're sort of starting to get it together now.

Katy Weber 14:46
Oh, gosh, you know, it's funny. I had a very similar experience. And just in terms of having I had two older brothers, both of whom did very well in school, Ivy League scholarships, you know, straight A's, and I was kind of the middle felt that my mother didn't know what to do with. But my parents also, I think they felt like they lucked out with the other two. So they didn't really put pressure on me. They were kind of like, it's fine. And so I didn't feel a lot of pressure, and she's a girl. But oftentimes now looking back, I feel like that I was so lost, you know, I felt like, I was just really bad at adulting in my early 30s, which, you know, kind of makes me think about one of the things that really struck me in the still distracted, which is such a great book, I'll go back and properly introduce it. I mean, I know you've written a lot of books, but I do have most of my questions, I think are for aging with ADHD in the older generation. But one of the things you talked a lot about in the book was having adult children, and that failure to launch as an ADHD, you know, older generation, having adult children and some of the unique struggles that exist with having older children. And some of it just reminded me so much of myself in my 20s. And it was I had this real lightbulb moment thinking about how a lot of you know, I'm terrified of retiring, I'm terrified of getting old, a lot of the fears that I have about aging, I think relate very deeply, to whatever trauma I hold from my lack of adulting skills in my 20s, the fact that I was so bad at finances, the fact that I made so many impulsive mistakes, and all of the stuff that felt like, it's very ADHD in terms of how people stumble through experiential learning. I definitely made my mother cry a lot, you know, but I'm like, Oh, that makes perfect sense as to why so many of us are terrified of aging, and getting to that stage where we lose trust in ourselves as adults, when we have ADHD a lot of the time.

Dr. Kathleen Nadeau 16:55
Absolutely. And I wrote about this in the book, still distracted. But I, I think it's really important to think about that. One of the periods in which we struggle the most is very early adulthood, because we've been surrounded by some level of support and structure, because of school because of parents living at home. And then that gradually or suddenly goes away. And there's just so much to learn. If you think about it, it's like we didn't plan this very well, that we're supposed to figure out how to manage money and how to drive and how to feed ourselves, and how to maintain a household, and what to do for a living and how to get up on time and how to get to bed on time. So we can get up on time. And we need to change the oil in the car, and we need to pay the bill and it's all too much at once. And I've worked with so many parents advising them, let's do divide and conquer. Let's give your kiddo a gap year to learn adulting skills while they're still at home. And then let them go out into the wild blue yonder of what so often American college life is like, and be much better prepared. And, and sadly, I've worked with so many families where they went off as a freshman failed, came home with their tail between their legs, then learned the adulting skills, got a job, whatever, and went back and succeeded at college, there's just too much on our plate to learn all at the same time. And I think what happens as we face retirement is we are again facing the loss of support and structure. Most of us have a built in social life at work. Having work gives us a purpose and a structure to our day and a time to get up and a time to be there and time to come home. And all of that goes away. And at the same time we're going through interpersonal loss through death through illness, through people moving away. I mean, my husband and I are still in a house we've been in for a long time. But nevertheless, we are losing friends because they're moving to live near their adult children or they're moving south to warmer weather, or they're ill or they've died. And so even if you stay put your world is going to change a lot. And one of the things that I talked to so many older adults about is the whole concept of addition and subtraction, that life is going to subtract things from you. And you need to very consciously add things to your life so that you don't end up alone. and very isolated and, and structureless. And I think we're really at risk for social isolation and depression. And I've talked with far too many people living alone that are kind of living in chaos, you know, living on cheese and saltine crackers and staying up half the night because there's no reason to get up in the morning. And we need structure and support. That's the drive, I always beat structure and support at whatever stage of life. Yeah,

Katy Weber 20:32
that's something I feel like I definitely am trying to instill in my children, because I have a 16 year old and a 12 year old. And you know, not only are my husband and I kind of having in that panic mode of like, okay, we have to teach them everything they can possibly know about adulting before they leave the house, knowing full well both of them have ADHD. So I know that full well, they're not going to remember anything we say until they have to experience it themselves, right. So part of that is going to be falling down flat on their face a few times before they learned their lesson and that we will be there to help them and pick them up. But a lot of the time, it doesn't matter how many times you teach them something by explaining I feel like both of my kids are the type of people who really need to experience it. And that was definitely my I was exactly the person you were just explaining before I went to first year University as a freshman dropped out, said this is not for me, I can't do this when traveling and lived, took a gap year grew up in many ways. And then came back and got back into university. It was on the Dean's list for the next three years. But anyway, oh the add and subtract that was really interesting to me. Because I you know, I just turned 49 And I was just talking to my personal trainer about like, I'm at that age where physically emotionally like, there's so many things in my life where I'm like, do I fight this? Or do I accept it and lean in? And I really liked that philosophy of like, yes, things are gonna, my body's gonna be stopped gonna stop doing things and my body, you know, things are changing, obviously. But what can I focus on that I'm adding him as a result? So yeah, I like that. Okay, so let's backtrack a little bit to the book because I know you've written about a dozen books for women and children. Your most recent one still distracted after all these years really focuses on a the aging population with ADHD. So you reached out and interviewed how many 150 150 75

Dr. Kathleen Nadeau 22:25
Men 75 women, and attitude magazine was so helpful to me. And letting me publicize through talks I gave for attitude, through other venues through attitude that I'm looking for adults over the age of 60, that are already officially diagnosed, they don't just think they probably have it officially diagnosed because I wanted what I learned to really have credence to have legs that, you know, she didn't just talk to a bunch of old people who think they might kind of sort of have ADHD. And it was really interesting what I learned that great majority of them, take stimulant medication, the great majority and benefit from it, even though the great majority of psychiatrists that I come across, don't want to treat adults over age 60. They've got no training, they're worried about medication side effects. They don't know how to address the possible cardiac risk. Well, the way you address that is you send them to a cardiologist. And you know, make sure that you have the cardiologists okay, that you're going to put them on stimulants. And it's so ironic because if anybody knows about Geriatric Psychiatry, many, many very old people in nursing homes, take stimulants. Prescribed not because they're requesting them prescribed by their geriatric psychiatrist. Because it gives them energy, it gives them some focus, otherwise, they're just slumped in their chair in the day room of the nursing home all day long. So it's so ironic that there's this gap that if you're 87, will prescribe stimulants for you, not because of ADHD, but if you're 67 Oh, no, that's too dangerous.

Katy Weber 24:27
It feels like there are so many stereotypes around the medication. And the disparity between who you get as a clinician is, is so interesting, like your daughter had a pediatrician in I'm guessing, you know, the 70s or 80s, mid 70s to mid 70s. So she had a pediatrician who not only recognized ADHD in a girl, even in the set, I mean, even just recognizing it from from her physicality, right?

Dr. Kathleen Nadeau 24:55
It was shocking. That was just pure luck. Just pure luck. And so I'm

Katy Weber 24:59
always He's fascinated when I hear you know that I think the two things I hear the most from menopausal or postmenopausal women who are seeking a diagnosis is, you've made it this long, what's the point? That seems to be the most common response that they seem to get? Which is, well, who cares? You know, if you have it, or do you don't what's, what's the big deal, which I want to get to in a minute, but then the other one is just the lack of information and knowledge about stimulant medication, and just the immediate dismissal of like, No, we're not even going to try that, based solely on age.

Dr. Kathleen Nadeau 25:33
Think about it. Can you imagine a psychiatrist saying, Well, you've been depressed this long? What's the big deal? No, I'm not going to try to shoot for depression. Get over it. They would never say that. It's this complete lack of understanding about ADHD. And yes, we can live with ADHD without being diagnosed and treated for it. But if you look at the statistics that Russell Barclays research showed, we pay an enormously high price for untreated ADHD that, I think not enough people know this yet. But our lives are eight to 10 years shorter than the average person's if we have untreated ADHD. And the reason for that is twofold. One is that many people die a very untimely death when they're young because of impulsivity, because they drank too much and drove too fast. Because they decided it would be really fun to you know, ski the back bowl where there was an avalanche. I have a nephew with ADHD, who I'm sure has significant brain damage at this point, simply because he doesn't ask anybody to hold the ladder when he's climbing up on the roof. He I mean, he just isn't a careful person. And so our lives are shortened by impulsivity in the beginning of life. But even more importantly, our lives are shortened. Because it really takes a lot of planning and discipline and persistence. And you were talking about that in yourself as we get older, to get enough sleep, go to bed on time, exercise regularly eat a healthy diet, know how to manage our stress that what we're learning is that so many of the diseases, diseases, we die from our lifestyle diseases. And people with ADHD are more likely than the average American to lead an unhealthy lifestyle meaning eat too much struggle with obesity, disordered eating patterns, sleep problems are existing throughout life. And when we get older, and when we are overweight, then we're more likely to have sleep apnea and have very disrupted and under non restorative sleep. We don't get out there and exercise because everything hurts because we have inflammation in our body from eating too much starch and sugar and you know, all the unhealthy things that we tend to ingest. And it's a lot harder for us with ADHD because it takes a lot of learning and planning and follow through to shop for fruits and vegetables. I mean, my daughter jokes, you know, she throws out more than half of the fruits and vegetables she buys because she has great intentions, but you know, then it gets to the end of the day and I'm tired. And I'm going to order out and into the trash bin and go the good intentions. You

Katy Weber 29:04
know, I think one of the things that when you were talking about was we talked about this a lot on the podcast, I certainly experienced this in my life, which was this idea that like as women, I think clinicians dark, you know, usually it's our general practitioners, but there's that sense of saying, Well, this is just how life is right? You go to your doctor and you say I'm depressed, I'm struggling. You know, I need help and they put you on an antidepressant. They say you're depressed and they're like, Well, this is just motherhood right or you know, and the same thing happens in perimenopause, I, you know, I can't remember things and I'm, you know, really struggling and my emotional. I'm raging at everybody and they're like, Well, this is just perimenopause. Here's an antidepressant. And so I think so many of us had a really difficult time gauging whether or not our struggles were more or less than what should be expected of us, right.

Dr. Kathleen Nadeau 29:55
It's so interesting. I always try to capture little phrase is when I'm talking to people that, you know, just started the essence of part of the ADHD struggle. And I was being interviewed, I don't know, a couple of months ago, and it was a radio call in show and, and interestingly, almost everyone that called in was in their 60s or older. Even though that wasn't the topic, it was just general ADHD. And one woman was in her 70s. And she said, I have ADHD. I've been diagnosed, I've taken medication, it's really helped me, and my doctor retired. And now I cannot find another doctor, I'm in my 70s, who will prescribe to me. And they're saying the same thing that you turn that what's the problem? You're retired, you know, why do you need to take this stimulant medication, it's not good for your heart, and blah, blah, blah. And the phrase that just really struck me, which I thought was wonderful, that she said, you know, into the telephone, I need my brain. The battlecry I need my brain. I need my brain to function. And I think I think women's complaints get minimized and dismissed. I mean, we there are just countless studies for all kinds of medical issues, not just ADHD. But older people get dismissed. It really is. ageism, like, almost what do you need a brain for? You're retired, you're old, as if we don't lead lives. And I'm in my late 70s now, and I am very active and plan to stay very active. And I wouldn't appreciate anybody going well, what do you need to do that for? Just sit down and have some ice cream? Yeah.

Katy Weber 31:56
Yeah, absolutely. That, you know, another thing that I really, really struck me, in the book was was talking about the social isolation, as we age, and how deeply that can affect people with ADHD. Going back to what we were talking about earlier, you know, it is often difficult for us to make friends. And sometimes I have these moments where I'm like, God, if I, you know, if I have to be nice to people, this is such a neurodivergent thought, like, I have to be nice to people. Because if I'm not nice to people, nobody will come to my funeral. And then I'm like, Well, why do I care if anybody comes to my funeral, I won't be there. But this idea that, like, I have to make friends, like I have to have a lot of friends, it's been one of those things I've had to come to peace with as I've aged, which was like, I only have a very small handful of really, really close friends. And I'm fine with that. It's great. But there's like, I think, a lot of pressure on us to, you know, have a larger social network, especially as we get older. And so I'm always paranoid, or I'm always worried that you know, once my husband if my husband dies before me, or if he leaves me, you know, what am I going to do? How am I I'm going to feel so socially isolated. And you talk a lot about that in the book just in terms of ways to manage that with ADHD, especially for many of us were like retirement homes and some of those typical situations like even you know, the villages or those retirement place, you know, retirement communities, might fiscally just not be an option for a lot of us, ADHD or don't tend to retire with a lot of money in the bank

Dr. Kathleen Nadeau 33:34
makes a lot of money. Exactly.

Katy Weber 33:37
So can you talk a little bit about like, some of the strategies that you mentioned in the book when it comes to taking care of ourselves socially? Yes. And

Dr. Kathleen Nadeau 33:46
you know, I, I really feel and I, I'm always writing a book. So I'm working on another book, my writing partner, Pat Quinn, who also has ADHD. She's wonderful. So she and I and male author, amazingly, fella named Michael Morse, who is on the staff at my clinic, a psychiatrists are writing a new book on women with ADHD because our book came out over a quarter of a century ago, and boy, is it out of date. So the working title of our book is you don't know what it's like. And that is really the way so many women feel like you have no idea what it's like. I read a hilariously titled book, I don't know year or year and a half ago. It was written by a guy who's a writer, and his wife is some big wig TV personality in Canada. And so he followed his wife to Canada and he's Mr. Mom, and she's got the big career and he's fine with that. However, the title of his book which I loves is called the unmade bed. And he said, Okay, I'm willing to be home with the kids, but I'm not going to do it, I'm not even going to try to do it the way women try to do it, I don't care if the beds made, I don't care if I'm feeding kids peanut butter sandwiches six days a week, I just don't care. My self esteem is not tied up with having a tidy, tidy home and providing perfectly balanced meals. I'm just here, trying to keep everybody alive, while I write my book, The unmade bed. And I thought, what liberation, he feels in his role, because, of course, gender role expectations don't require him to send out the thank you notes, and you know, buy all the perfect gifts for the birthday parties that his children are invited to. Whereas I've known many women, perhaps you'd have to go to Whole Foods and buy something and put it in a pan as if they'd made it, to take it to the school, whatever, because they feel they're supposed to have made it. But getting back to what you're saying, I really think one of the best ways to help women with ADHD, one of the best ways to treat women with ADHD is in groups, that we help heal each other. We heal each other, by understanding each other and supporting each other and laughing together and not expecting perfection from each other. As we feel the outside world expects of us. It's crazy the way women are living. I mean, somebody did. And I'm not talking about women with ADHD, I'm just talking about women that in this generation and the generation before, women are expected to work full time. And they're expected to raise a family and they're expected to manage a household and I was the first generation of working women. So my mom, my mother and aunt, they were home full time they played bridge in the afternoon, they told us to go out and play. I mean, they they were not killing themselves. And then boom, we were liberated. I mean, not so sure if liberation is the right term for it. But societal expectations placed on us females today are ridiculous. And yet we buy into it. And yet we buy into it. You know, I have a wonderful woman who's worked at my clinic for six years now. And she just had her first child who is not even three months old yet. And she was calling apologetic that I know, I told you, I was going to come back after three months, but I'm not sure that I'm good. For God's sake, stay home as long as you're able to. I mean, please don't come back. If you don't have to come back two days a week, come back, you know, whatever is gonna work for you don't put that crazy pressure on yourself. And yet we do

Katy Weber 38:19
know, we don't have a lot of us don't really have that choice. Unfortunately, in the US, well, you

Dr. Kathleen Nadeau 38:25
know what? She and her husband, I think made a very smart decision. They lived in a tiny apartment. They were just a couple. And they talked about buying a townhouse and doing you know, getting ready for baby. And they just decided no, we're not going to do that. Because we don't want the financial pressure. So they didn't do all that hoopla of what we have to have because we have a baby, you know. And I think that's why she does feel that she has more wiggle room to not come back to work full time immediately with a three month old. But getting getting back to what do we women do as we get older. You know that my mantra is structure and support, structure and support. And I think that one of the best things that Chad or Adha or any national organization could do is to help women create a network of support groups. You know, if if you had your cohort of five or six women that you talk to online once a week, and could contact in between if you were really struggling. I'll tell you a story when COVID hit. We decided at my clinic that we were going to offer a whole bunch of online support groups just for free just if if you need it Help if you're home trying to figure out how in God's name am I supposed to work from home and have my children at home going to school and all that insanity that we all lived through. And so we started lots of online support groups. And I and my oldest colleagues started a support group for older adults with ADHD. So that was right at the beginning of the pandemic. And we met once a week, and that group still meet. And it's 2024. And it started in March of 2020. We ran it for about a year and a half. And I said, I'm so sorry. But I, you know, I've got many things pulling at me, and I can't continue to do this every week. But I really want to make it possible for you to continue. So let's talk about the logistics. And let's talk about what it would cost to get your own dedicated Zoom Room so that you're not in this crazy situation about my guidance gonna turn off in three minutes, because we've used that for 45 minutes. And one of the women in the group, wonderful woman, she was a retired college professor said, I'll take care of that. I can do that. You know, I've taught online, I've done things, and they're still meeting, they are still meeting because those women, interesting bunch of women, and interestingly, every one of them significantly creative, which we don't talk enough about in terms of ADHD. They were writers, they were painters, they were sculptures. I mean, it was remarkable. And they would come and show in the group online, what they've been working on, I was just amazed. They're still meeting and I bet they continue to meet for years because it gave them exactly what they needed, which is a place of humor and acceptance and encouragement, and information. I mean, they come to that group with Did anybody see this article? I'll share it with you. I mean, it was a real support group. And all the good meetings are the word and I think that's what we women with ADHD need is that place where we're okay.

Katy Weber 42:22
Absolutely, my favorite work to do is working in group coaching. And also, one of my favorite things I've done in this business is I've done virtual book clubs, where we study salary Solden, and Michelle Frank's book, The radical guide to women, for women with ADHD, and you know, there'll be like 5060, women in the Zoom rooms, and we'll go into the small group private rooms, and to see them when they come back from those private rooms, because a lot of these women is the very first time they've ever talked about ADHD, with anyone, much less other women with ADHD who get it right, and just to see them, everybody comes back, and they're all flushed, and they have these huge smiles on their faces. And it is the most rewarding thing to see, to be able to, like, bring those women together and and to make those connections and have them find each other. Right, it is so much about finding this community and embracing it. Well said. And yet,

Dr. Kathleen Nadeau 43:19
if you do research, which I do all the time, on studies about what are the most helpful treatments for ADHD, nobody's looking into that. Nobody's thinking about it. They're just talking about, you know, this type of therapy administered individually is that more effective than this type of therapy is that more effective than medication and going, we're missing the boat here.

Katy Weber 43:47
There's a tick tock account, they have millions, plural of millions of followers. And I don't know where they live, they live in the south somewhere. But there's like a senior house where it's like, they there's like six of them that all live together. And they make tic tock videos about fun life living together. And so that was I found that really great, you know, talking about this rise in, like, basically having roommates as a senior citizen with ADHD, it felt so perfect, just in terms of like, you know, how we can take care of ourselves, but not be left alone, like you said, as many of us tend to do, because I think a lot of us really struggle with like reaching out and remembering to keep in touch with people. And so one of the things that's great about those formalized groups is that it's being arranged. You know, even my my best friend from university, we've known each other for 25 years, and she's now living in Mexico and like we just have a schedule every two weeks. We check in with each other. We have a zoom call, and we know it's in the calendar and what it's like we book it before we get off the call. Because we both know that that's what we need, right? We can't we're not going to remember if I you know, it'll take us months to actually get touch with each other if we don't have this, like in the calendar. And so there is something that's really helpful about that formalized socialization to for us, I think. So I gotta, I gotta look up who that tic tock account is I'll put it in the, in the episode show notes. They're so funny. Oh, that's

Dr. Kathleen Nadeau 45:16
wonderful. And I would love to know, too, and I will be willing to bet you that several of those women have ADHD?

Katy Weber 45:24
Oh, of course, right? I mean, you know what to do in your free time, I'm gonna create a tic tock account and get millions of followers. Of course, they probably all do. Yeah.

Dr. Kathleen Nadeau 45:35
Yeah, exactly. And see, that's the side of ADHD that not nearly enough is written about. You know, and you were talking about the incredible energy that you feel when you go to conferences. I think that is universally true. But you won't hear a single researcher talking about that? Well, I

Katy Weber 45:59
think a lot of us feel shame around that playfulness, right, that childlike energy that so many of us have the childlike curiosity. I think so much of it. For me for a long time in my life, that was something to be ashamed of. I didn't feel like an adult. I think a lot of people with ADHD have that feeling like I'm not very good at adulting. There's something about me that is irresponsible, right? So we start to label a lot of that childlike energy as with negative labels, and that you know, and that's going back to what you said, like, I think that's why reframing is such a huge part of this diagnosis for us that we can actually feel so empowered, and why so few of us find an ADHD diagnosis to be pathological, you know, for for so many of us, it's, it's a wonderful identity to embrace.

Dr. Kathleen Nadeau 46:49
Absolutely, it is a type of a brain. And there's no type of brain that is wonderful at everything. So what is pathological depends on, you know, who's doing the defining of it. I gave a tongue in cheek lecture on attention surplus disorder. At a conference that I had discovered this new, crippling diagnostic entity called attention surplus disorder. And I developed a checklist, you know, I must keep all my ducks in a row. I enjoy sorting socks, just.

Katy Weber 47:32
Yeah, absolutely. Well, especially, you know, sometimes when we call that neurotypical, we're like, is it so neurotypical? I think, maybe there's, you know, I think there's more maybe there's borador Divergence out there that we ever want to admit.

Dr. Kathleen Nadeau 47:48
Well, years ago, when I was in graduate school, this very famous lecturer from MIT came down. I graduated from the University of Florida. I grew up in Florida and got my PhD there. And they have a excellent medical school. And this fellow was brought down to lecture to medical students, and that clinical psychology students that were being treated in the medical school, his name was Hans Lucas, Teuber. And he's really kind of the father of the field of learning disorders. In those days, there was no such thing as a learning disability. And we were just beginning to understand a little bit about dyslexia. Except we thought dyslexia meant seeing everything backwards, which, of course, is not what it is. But anyway, he came down, and I'll never forget his opening statement, because it I think it has framed the way I've worked in this field forever. And he said, our brains are as different as our faces. That we have two eyes, a nose and a mouth. But we all have a distinctive face. And we all have a distinctive brain. And I guess you could say there is a typical face mean, often a typical face, or desirable face is very, very balanced. It's a Barbie face in ways. But almost nobody has a Barbie face. And I don't want to look like Barbie. But I thought that was such a good way of putting it. Because I find especially because ADHD is defined as a medical condition. And the way we do medicine in the United States and in many countries, is medicine has to do with what's wrong with you. I think of ADHD as a type of a brain and not as a pathology. And I remember talking about this 25 years ago, at least at a conference. And being scolded by some of the biggest names in the field. Don't go around saying that if you say that it's not a disorder, then we're going to lose all the funding to study it. And we're going to lose all the funding to support these kids in school, it has, it is a pathology, it is a medical condition. And what I would say is that this thing we call ADHD, really isn't a categorical condition. It exists along a spectrum. Like everything, you can be very depressed or a tiny bit depressed, you can, I think everything exists along a continuum. And certainly there are people that struggle mightily and you know, practically, you know, can't find their head if it wasn't screwed onto their shoulders. But most of us with this thing called ADHD don't function that way. It exists along a continuum. And that's true for autism. There are some Autistics that are mute, that can't function without a constant caretaker. But the vast majority of people on the spectrum, lead very functional and sometimes highly, highly successful lives. I eat Bill Gates, he's uncertain, lots of very successful people are. And so we really need to get away from this pathological notion, it's a type of a brain and, and the characteristics are variable, and they exist on a continuum. And for, I think, for many of us, how we feel about ourselves really has to do with where we are planted, among whom we are living, what we're trying to do with our lives, I went to lecture, oh, I don't know, this must have been 10 or 12 years ago, in Switzerland. And a group of private schools in Switzerland wire me to come and talk to them about ADHD. The Swiss, if you can imagine, couldn't be a more ADHD intolerant culture. Other than the Japanese, I think of those two is the, you know, we value being hyper controlled at all time. So I was in the cultural museum in Zurich, I gave myself a couple of days to get the jetlag before my talks, and I walk into the cultural museum. And right in front of you, as you go in the door, are the Swiss national values. This is what you're supposed to be like if you are Swiss. And I created an acronym so I could remember it because I that this is brilliant. I love it. This is so related to why you don't want to live in Switzerland. If you have ADHD. And the acronym is P pod, precision, punctuality, order, and discipline. These are our national values. So I was contacted by this desperate couple, they had a teenage girl going to private school in Geneva. And she was just having the most miserable experience and they moved her from that school to a boarding school in the mountains. She was even more miserable. The father was American, and they just decided we've got to get her out of Switzerland. I mean, her life is so miserable here. And her godparents, close, close friends of her parents lived in the Washington DC area. And she'd known the daughters of her godparents who were her same age for her whole life, basically. And she went and finished high school living with her godparents in Arlington, Virginia. And that kiddo who was being criticized and excoriated up one side and down the other, goes to a very good competitive Public High School in Arlington, Virginia, becomes the class president, in her senior year has the lead role in the school play. I mean, she just, she could be herself. She could be expansive, and everything she wasn't supposed to be when she was in Switzerland and I, I tell that story because how we feel about ourselves has everything to do with how the world around us responds to us. And that it's it's so important, therefore, to not stay in toxic relationships and we don't get to pick who our family is. And sometimes our family wants us to be utterly different than we are. And I always say, I was so blessed to have the mother that I didn't. She was just, you know, you'll grow up eventually. So these women that are having such a good time, and, you know, being roommates, you know, in their later years, have created a world in which they can thrive. And I think to whatever extent any of us are able to do that, that that is one of the most important ways to live well, with this kind of a brain. Yeah,

Katy Weber 55:41
absolutely. Now, I quickly I wanted to ask you about the advanced training institute that you're working on now. Because I actually, I've gotten back to school for somebody who dropped out of university the first time around, I'm now back, I'm going back to school to become a mental health counselor, and wonderful, thank you. But what you know, it fascinates me how much ADHD is not talked about in the curriculum, and I feel like I see it everywhere every case. It's like, every case study, I'm like, well, has this person been screened for ADHD? Clearly, they seem to have it. And so it is amazing to me, not only how much I can bring to the conversation, in terms of, you know, what I'm able to sort of talk about in the classroom in the in the curriculum in terms of this other perspective that so many future clinicians just aren't getting out of the curriculum? They're not. So is this a typical certification like the CCCP? Or is this tell me about this Advanced Training Institute?

Dr. Kathleen Nadeau 56:43
I'm so glad you asked. It's something I've been thinking about for years. And I finally decided, this is what I want to do at the end of my long career is to be able to share what I've learned over all these years with other people, because our training is still abysmal, which is remarkable, because ADHD is so common. I mean, it's not a rarity, it's so common,

Katy Weber 57:15
especially when you're talking about clients with depression. You've

Dr. Kathleen Nadeau 57:18
got it. So I am starting the advanced ADHD Training Institute. And the reason I'm calling it advanced is I really want to work with people who are already working with people with ADHD, not people who don't know anything. And we're starting with going through the DSM diagnostic criteria. And I want it to evolve and grow and expand. Right now I am working on an introductory lecture series on diagnosing and treating ADHD. And the lecture series will be filmed starting in April, I'm working with a company that is providing us with an online platform that is used by a number of online universities. So it's, it's set up to sign up for courses and pay for courses online. And I think it's just going to evolve. I mean, obviously, it can't all be me doing the training, I'm going to certainly do training around older adults, because I'm the only one that seems to have done a lot of research in that. But I'm also going to bring in lots of people in the field that have a specific interest because ADHD is very complex. It impacts every aspect of our life. It exists with almost every other type of disorder you can think of. So we need to have training and ADHD and eating disorders, ADHD, and substance use disorders, ADHD and autism spectrum. mean, the intersection of ADHD is enormously complex with the statistics are and I bet they're low that 80% of adults with ADHD had at least one coexisting condition, if not several, and my bed is higher than that. I think it's extremely rare to have ADHD and not have a learning disorder or an eating disorder or anxiety or depression or or a criminal record or a criminal record. Absolutely. And so I'm starting the Training Institute and the beginning of it will be my introductory lecture series. And then we're going to develop tracks. And those tracks will focus on the treatment for example of children dividing it up between girls and boys because I think that The manifestations of ADHD and girls are different. And in many cases, the needs of girls are different. We're going to have a whole track on treating women, we're going to have a track on every major comorbidity, and invite people that really understand how to work with people that have ADHD, and disordered eating patterns and substance use problems. Because there's just such enormous lack of information out there. And I really want this to become something that just continues to grow. And yes, there will be certifications. Because it's cumbersome and costly. I'm not going to be offering continuing ed credits in the beginning, although we probably will offer them basically, you have to pay a lot of money to accompany that goes to all the trouble to keep updating the certifications, it's a cost matter. And I can't afford to do that until we've got students coming in. We've already got a lot of interest from people in many different countries. And of course, they're not concerned about continuing ed credits. That's what it is. And it's basically going to be advanced training and how to diagnose and work with these many, many folks. Wow,

Katy Weber 1:01:30
amazing. I mean, yeah, I'll be first in line, I will as soon as I graduate. I think about a case study we had recently in one of my courses, it was a woman who was a high school teacher who had recently retired and was having difficulty with lack of structure in her life and was getting depressed and crying and over, you know, doing the dishes. And I was like, it's everything about this case studies, screaming, ADHD. But it goes back to that idea of like you're saying of like, how important structure is in our lives. And so there are going to be certain times like babies, and our 20s, where that really gets in flux. And I think retirement is a huge time in our lives, where we're having to reevaluate our sense of self worth and our sense of purpose. And I think it's so important that you are putting a voice to this, and putting this research out here and speaking to a lot of a lot of these fears. But also, I mean, there's a lot of really, really helpful strategies in the book, too. So thank you so much. Thank you for sitting down and chatting with me. I really enjoyed this. Oh, I've

Dr. Kathleen Nadeau 1:02:34
enjoyed it tremendously. Thanks so much for inviting me and good luck with your studies. And I'd be delighted if you join us at the trading Institute. Wonderful. Thank you.

Katy Weber 1:02:51
There you have it. Thank you for listening. And I really hope you enjoyed this episode of the women and ADHD podcast. If you'd like to find out more about me and my coaching programs, head over to women and adhd.com. If you're a woman who was diagnosed with ADHD and you'd like to apply to be a guest on this podcast, visit women and adhd.com/podcast guest and you can find that link in the episode show notes. Also, you know, we ADHD ears crave feedback. And I would really appreciate hearing from you the listener, please take a moment to leave me a review on Apple podcasts or audible. And if that feels like too much, and I totally get it. Please just take a few seconds right now to give me a five star rating. Or share this episode on your own social media to help reach more women who maybe have yet to discover and lean into this gift of nerd of urgency. And they may be struggling and they don't even know why. I'll see you next week when I interview another amazing woman who discovered she's not lazy or crazy or broken. But she has ADHD and she's now on the path to understanding her neuro divergent mind and finally using this gift to her advantage. Take care till then