Beyond ADHD: A Physician’s Perspective: Recent Episodes
Dr. Diana Mercado-Marmarosh
My mission to help others develop systems that tap into their zone of genius to reclaim their personal lives back
Welcome back to a special dual episode of "Beyond ADHD: A Physician’s Perspective" hosted by Dr. Diana Mercado-Marmarosh. She is joined today by Dr. Matthea Rentea, an internal medicine and obesity medicine physician, to explore the intricate connections between ADHD, the brain, and metabolic health. This conversation aims to shed light on a topic that is rarely discussed—the intersection of ADHD with eating behaviors and metabolic conditions.
Introduction:
Dr. Diana Mercado-Marmarosh is a family medicine physician and an ADHD life coach, particularly for healthcare professionals. Her journey with ADHD was one of initial concealment, fearing professional judgment, but ultimately it became a crucial part of embracing her identity and capabilities. This newfound acceptance has been transformative not only for herself but also for those she coaches.
Dr. Matthea Rentea elaborates on her journey, highlighting parallels with Dr. Mercado-Marmarosh. As an internal and obesity medicine physician, Dr. Rentea has faced struggles with obesity, which fueled her passion for holistic weight management approaches that go beyond calorie counting and medication.
The common professional and personal challenges they share have driven both physicians to advocate for greater discussions around ADHD, executive function, and their implications on lifestyle habits, particularly eating behaviors.
Understanding ADHD and Its Overlapping Symptoms
A significant portion of Dr. Rentea's patients have ADHD, leading her to recognize patterns like emotional eating and impulse control challenges. ADHD, often misunderstood and mislabeled in females, is especially prone to being overlooked due to subtler symptoms like inattentiveness and internalized stress responses.
Dr. Mercado-Marmarosh enumerates key symptoms often associated with ADHD beyond the more commonly known impulsivity and hyperactivity. These include difficulties with executive functioning like emotional dysregulation and time blindness. Understanding these dysfunctions offers a window into ADHD's impacts on daily life, and suggests the importance of creating supportive systems rather than perceiving oneself as flawed.
Strategies for Managing ADHD and Enhancing Well-being
Dr. Mercado-Marmarosh emphasizes three core strategies which can benefit individuals with or without ADHD:
- Planning and Time Management: Proper planning can significantly boost productivity and reduce stress. Incorporating simple tools like calendering future appointments or using timers can mitigate issues with time blindness and scattered focus. She advises setting intentional time for tasks and establishing buffer times to accommodate the unpredictability that often accompanies ADHD.
- Task Initiation and Completion: She advocates for initiating tasks with the aid of timers or favorite playlists. The concept is to break down daunting tasks into manageable time slots, removing the dread and perceived enormity that prevents task initiation.
- Emotional Regulation: Developing emotional awareness and regulation is crucial. This involves acknowledging and interpreting emotions constructively rather than succumbing to reactive behaviors. Techniques such as mindfulness, deep breathing, and seeking external support through accountability partners or therapists can foster resilience and composure in day-to-day challenges.
Interrelation with Metabolic Health and Medication
The discussion transitions to how ADHD symptoms and their management, including medication, overlap significantly with metabolic health behaviors. Dr. Rentea notes how certain ADHD medications and GLP-1 receptor agonists can influence eating patterns and impulse control, often reducing cravings for ultra-processed foods. This inadvertently aids in managing obesity—a common comorbidity with ADHD.
Dr. Mercado-Marmarosh and Dr. Rentea reflect on their personal experiences, such as fluctuating weight and eating to sustain energy and focus, discussing how recognizing ADHD's role can lead to better health strategies.
Top Tips for Patients
Dr. Rentea leaves readers with practical advice:
- Conduct a Nutrition Audit: Understand your eating patterns without judgment to identify areas for improvement.
- Implement Small, Manageable Plans: Utilize timers and structure to prevent overwhelming hunger or impulsive eating.
- Stay Curious and Adaptable: Be willing to experiment with solutions, keeping changes simple and incremental.
Conclusion
Dr. Mercado-Marmarosh's closing thoughts encourage readers to observe their patterns, suggesting that community and self-awareness are powerful tools in managing ADHD. Both doctors emphasize the need for continued dialogue and self-advocacy, providing resources and strategies that go beyond conventional healthcare settings.
For further insights and support, Dr. Mercado-Marmarosh invites listeners to engage with her through various platforms and programs dedicated to ADHD coaching and physician wellness. Dr. Rentea, offering expertise in metabolic health, welcomes those interested in exploring their health journeys to reach out via her clinic and online resources [Rentea Metabolic Clinic].
This episode of collaboration is an invitation to join a broader conversation about health, self-discovery, and embracing one’s unique neurological makeup.
Parenting a child with ADHD can be both challenging and rewarding. In our recent episode of the Beyond ADHD Podcast, we had the pleasure of hosting Elaine Taylor-Klaus, a renowned author, educator, and co-founder of ImpactParents. Her new book, "Parenting ADHD Now," is a comprehensive guide aimed at helping parents navigate the complexities of raising children with ADHD.
Elaine's journey into this field began with her own experiences as a parent of children with ADHD. She understands the daily struggles parents face, from managing behavior to advocating for their children's needs in educational settings. Her approach emphasizes the importance of building a supportive community and seeking out resources that empower both parents and children.
One of the key themes Elaine discusses is the necessity of understanding ADHD not just as a disorder, but as a different way of experiencing the world. This perspective can transform the way parents interact with their children, fostering an environment of empathy and support. Elaine encourages parents to focus on their child's strengths and unique talents rather than solely on the challenges associated with ADHD.
In our conversation, Elaine shared practical strategies for effective parenting. These include establishing consistent routines, creating a structured environment, and employing positive reinforcement to encourage desired behaviors. She also highlights the significance of self-care for parents, as managing the demands of parenting with ADHD can be emotionally taxing.
Elaine’s book serves as a valuable resource, offering insights, practical tips, and encouragement for parents at every stage of their journey. It is designed to help families feel less isolated and more equipped to handle the challenges of ADHD.
For those looking to connect with Elaine Taylor-Klaus, you can find her on her website at ImpactParents.com and follow her on social media for ongoing support and resources.
As we wrap up this enlightening episode, we encourage all parents of children with ADHD to explore the resources available through Elaine’s work. Remember, you are not alone in this journey, and with the right tools and support, you can empower your child to thrive.
In this enlightening conversation, Farah Jamil, an executive ADHD coach, shares her personal journey of being diagnosed with ADHD as an adult. She goes in-depth on how she has learned to harness the realities of ADHD as a strength and advocates for more representation of diverse experiences within the discussion of ADHD. As an entrepreneur, she also discusses the intersectionality of ADHD, faith, and executive leadership. Farah offers valuable insights on self-awareness, self-empowerment, self-advocacy, and the importance of seeking appropriate support to thrive.
Guest Speaker: Farah Jamil
Meet Farah Jamil, Founder of Muslim ADHDers and a seasoned Health Executive. As a Certified Executive Coach, she empowers early- to mid-careerists to unleash their inner 'Super Leader' and 'ADHD Superpowers.' Farah hosted the 1st global Muslim ADHDers Virtual Summit, uniting 1,500+ registrants. With 15+ years of leadership experience, an Ivy League graduate, and a global presenter on 'Neurodiversity – Navigating ADHD in the Workplace,' Farah is making a significant impact as one of the 2020 INC 5000 Vision Conference's global Executive Coaches.
Remember to like, share, and subscribe for more insightful conversations and valuable content. Stay tuned for more episodes and join us in the quest for a more productive and balanced life!
Welcome to another insightful episode of the Exploring Minds Podcast! In today's conversation, we delve deep into the world of ADHD myths with the brilliant Dr. Randie Schacter. Join us as we debunk common misconceptions surrounding ADHD, anxiety, and depression, and gain a clearer understanding of these often misunderstood conditions.
Our esteemed guest, Dr. Randie Schacter, a seasoned psychiatrist and advocate for mental health awareness, shares her expertise on ADHD and sheds light on its multifaceted nature. With a focus on fostering community and creativity, Dr. Schacter discusses the challenges and strengths associated with ADHD, offering a fresh perspective that can inspire positive change.
In this thought-provoking interview, we explore the impact of COVID-19 on individuals dealing with ADHD, the importance of recognizing symptoms in both children and adults, and the power of creative outlets like pottery to enhance mental well-being. Dr. Schacter's passion for understanding the human mind shines through as she uncovers the dynamic connections between ADHD, anxiety, depression, and the role of self-care.
Join us in this captivating conversation as we challenge preconceived notions, provide actionable insights, and ignite a greater understanding of ADHD and its intricacies. If you're ready to gain a fresh perspective on mental health, ADHD, and the myths that surround them, hit that play button and let's dive in together!
🎙️ Guest Speaker: Dr. Randie Schacter
Dr. Randie Schacter is a board-certified psychiatrist specializing in holistic and individualized care. With expertise in General Psychiatry and Child and Adolescent Psychiatry, she treats individuals from childhood to adulthood. Dr. Schacter's approach is rooted in osteopathic philosophy, focusing on the whole person and empowering them to actively participate in their healing journey. She integrates education, therapy, and medication to create personalized treatment plans. Based in Matthews, she collaborates with patients, families, schools, and other contributors to develop comprehensive wellness strategies.
🌐 Website: silverspaces.org and silverpsychiatric.com
Welcome to another exciting episode!! In this episode, we delve into the world of productivity, technology hacks, and achieving a balanced lifestyle. Our special guest, Dr. Ann Tsung, MD MPH, is not only an emergency medicine and critical care physician, a full-time flight surgeon at NASA, a real estate investor, and a mom, but also a productivity guru who has mastered the art of optimizing time and energy.
Join us as we uncover Dr. Tsung's journey of managing her multi-faceted life and her mission to help others regain control of their time and focus. She shares her insights on the power of delegation, the magic of technology tools, and the importance of setting clear priorities. You'll learn valuable strategies to declutter your digital life, supercharge your focus, and achieve more while working less.
Dr. Tsung's unique perspective blends medical expertise, productivity wisdom, and real-life experiences, making this episode a must-watch for anyone seeking to enhance their productivity and reclaim their time. Whether you're a busy professional, an entrepreneur, a parent, or simply someone striving for a more balanced life, this episode has something special in store for you.
Tune in to discover practical tips, inspiring stories, and actionable advice that will empower you to take control of your schedule and reach new heights of productivity and fulfillment. Don't miss out – hit that play button now and embark on a journey towards unlocking your full potential!
Connect with Dr. Ann Tsung: Website: It'sNotRocketScienceShow.com Instagram: @AnnTsungMD Facebook: @AnnTsungMD
Ready to supercharge your productivity? Book a complimentary productivity call with Dr. Tsung to uncover customized strategies to save you time and boost your results: Book a Call
About Dr. Ann Tsung: Ann Tsung, MD, MPH is a dynamic figure blending roles as a NASA flight surgeon and part-time ER and ICU physician. She's also a real estate investor and host of the "It's Not Rocket Science Show" podcast. Driven by a transformative journey of self-discovery, she's achieved remarkable milestones like summiting Kilimanjaro, world travels, and real estate ventures. Her productivity philosophy emphasizes human optimization, mind-body connection, and skillful tools, inspiring others to take charge of their lives. Dr. Tsung's mission is to empower individuals to achieve more with less effort, enabling them to prioritize passions and meaningful connections.
Welcome to "Beyond ADHD, A Physician's Perspective" with Dr. Diana Mercado Marmarosh, a dedicated family medicine physician based in rural Texas. In this insightful podcast, we explore the transformative journey of understanding and embracing conditions like ADHD, anxiety, and depression. Today's guest, Craig Clawson, a seasoned journalist and podcast production expert, shares his personal experience with ADHD, revealing the challenges he faced before receiving a diagnosis at the age of 49.
Join us as we delve into the link between ADHD and its impact on daily life, family dynamics, and career trajectories. Discover how unlearning certain beliefs and habits, along with seeking professional guidance, can lead to a fulfilled life beyond these conditions. With candid conversations and actionable strategies, this podcast aims to shed light on the potential hidden within every individual living with ADHD.
If you're ready to unlock your true potential, gain insights from the perspective of a physician and a professional storyteller, then this episode is a must-watch. Don't miss this empowering conversation as we debunk myths, share personal stories, and inspire positive change in the way we view and cope with ADHD, anxiety, and depression. Join us on this incredible journey of self-discovery and growth.
Subscribe now to "Beyond ADHD, A Physician's Perspective" and never miss an episode that will transform your outlook on mental health and wellbeing. Let's navigate the challenges together and embrace the unique gift that lies within each of us.
Dr. Diana Mercado-Marmarosh: Hello. Hello. Welcome to Beyond A D H D A Physician's Perspective. I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my A D H D, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize, That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hey, did you hear that? That was the attention? So I just got back from Costa Rica like literally yesterday and. We spend an incredible week there and my tour guide, his name is Carlos and he's from the Mela tribe, and he gifted my husband a wonderful drum that he had. For himself for over 15 years and that's the sign for attention it.
Anyways, I wanted to grab your attention as I'm starting this and, uh, let you know that I will be, uh, Putting a hold on my group coaching for a month. I've decided I won't start again until June 19th. So, um, that gives you some time to start going through some of the modules that I already have there, and then when we come together, we can reconvene.
I am in Cloud 45 right now after such an amazing transformational ex. Experience that I was able to facilitate in Costa Rica and I wanna share all about it with you. Um, so June 19th, if you are considering the coaching group, you need to sign up now because of course spots are limited. And, uh, I really, really like my.
Groups to be small, private, and intimate. And of course there's already some physicians who are going to continue the level of membership and I'm glad to have them. And some of them have been with us for, for a while. But anyways, June 19th, put that in your calendar. Uh, you can come to the 11:00 AM class that I'll be having, or you could come to the 7:00 PM class that I will be having.
And so with that in mind, let me tell you about my most amazing week that I just had last week, and some takeaway points and some things that maybe will inspire you to consider it for the next time. What do I start? Uh, I was asked why Costa Rica? So first of all, in September when I went to experience Costa Rica myself, I booked that on a whim.
I, my husband and I had gone to Costa Rica for our honeymoon, and that was almost the 11 years ago prior to, uh, September. And in September we were gonna have our 11 year anniversary. So I decided to, um, Book a hotel and the flights and everything without telling my husband. Yeah, very A D H G impulsive.
Like I found this amazing hotel and I just could not wait. I didn't want it to be sold out. So I booked everything and then I went, I told my husband, Hey, um, in a month from now, we will be going to, uh, Costa Rica. To celebrate our, our 11 year anniversary. I hope you're coming cause I am going with or without you.
Cause this place is divine. And of course he came with and the rest is history. So when we went to uh, Costa Rica, I just. I fell in love with the hotel, with the atmosphere. It just felt like paradise. I love having my own private villa bungalow. It was so cool to hear all the birds, the frogs, uh, to see this logs, uh, in the hotel grounds.
And I felt like I needed to bring people to that place to experience it for themselves. And so the purpose of the retreat ended up being. A place where people could dis live behind all their troubles. They could like disconnect and just reevaluate and having fun along the way in doing such, and in a place where it would be non-judgmental and the place.
by the R N l um, volcano and the hot springs and the hanging bridges and the Safari River float. So I decided to. Also tap into the indigenous tribe that was around the area, which is called Maku. And I wanted to really learn more about them. Um, they are located near a town called San Rafael aso, which is about.
One hour from Launa where we were staying. There's about, uh, 600 people that live on that reserve and is one of the smaller tribe in Costa Rica. And so as luck would have it, when I attended in September, I. The tour guide that I met, his name was Carlos, and he and I met him on one of the tour guides where he was showing us the Safari River float.
And I just, in talking with him, I asked him if he knew. Any indigenous people that I was interested in, in maybe having like a coco, a blessing ceremony. And he got super excited because he told me that he was of that tribe and that he could help arrange that. And that was in September. And of course, uh, he probably thought that, you know, I was just this crazy girl having crazy thoughts, but I kept, um, Emailing him and sending him Zoom messages and zoom links and Instagram messages and letting him know that I would be coming May 1st through the sixth, so that I would be able to, to have this, uh, ceremony and, and, and have him as our tour guide to do the different things.
So everything came together and he became our tour guide and. You know, through the whole week it was a learning process for all of us. Um, I did not know all the details. I did not know the how, but I knew the why, why I was doing this. I was doing this to provide physicians and healthcare professionals with the way of reevaluating I.
Their current lifestyle situation and allowing them to walk away empowered with, uh, executive function tools, emotional regulation tools with ways to integrate their desires and their goals and creating them into a reality. And I really, really set the intention to have only people who were. Soul aligned, who were really ready for a transformation, who were really ready to put in the work that it required to help themselves succeed.
And so with that intention, we embarked in this beautiful journey, 12 people, 12 beautiful physicians in a total of 20 people, uh, attended my retreat. Uh, out of those 20 people, five were my support group, meaning my husband, my, uh, sister, my brother-in-law, um, my niece. And then of course myself, so that's five of us.
And then the other 12 positions, speakers were, you know, there for the, for the event. And I had some guest coaches and luck. And as luck would have it, I, the guest coaches ended up being amazing. And I even had a therapist who came and we complimented each other so well, uh, because we were doing coaching and having real talk.
And also she was, uh, helping us to talk about. Different things and from the therapy perspective, and she even offered to help process some of the things that came up. So yeah, it was really wonderful. So I'm saying all this to let you know that again, I'm in Cloud 45 right now. I, my cup is so beyond full.
Uh, we had such an amazing, amazing, amazing experience. It. Came out 10 times beyond what I expected. I'm sure you're gonna start to see all the pictures online. I didn't really post on social media, um, but I will start to, we were able to, Yeah, to see wonderful things like slots and monkeys and, uh, frogs and we were just able to be present with each other.
I even wrote the last day, I wrote together, uh, I wrote a poem that I gave them that I wanna read to you guys that I think really, really, um, Helped or really helped us to put all, every, all the themes that we were talking about. And so let me read it to you. I wrote, it's okay. It's okay if things don't turn out how you expected them to.
It's okay to adjust course and choose another path. It's okay if you don't have all the answers right now. It's okay to be a beginner and be clumsy when trying something you've never done before. It's okay if it takes some time. It's okay to feel your feelings, whatever they might be. It's okay if you don't always feel okay.
It's okay to ask for help. It's okay to rest even when there is a lot to do. It's okay to take a break from growing and just be, it's okay to let others share your burden. It's okay to say fuck this shit and it's okay to sign up for the next experience with team Deanna. So I'm laughing because a lot of these things came up and I'm laughing because some of these were inner jokes.
Um, I gave them a. A little swag bag. And in one of the, the key chains, it said, I had one that was, you know, not cursing, but I had another one that was, and the one that was cursing said, a wise woman said, fuck this shit, and lived happily ever after. Uh, and I'm laughing because, Sometimes we all have expectations of how something needs to go, and then we get mad that it didn't go that way.
But what if it also means that that's our flexibility or ability to read the room and modify. I allowed myself to see that we were kind of tired one day after enjoying a beautiful day at the hot springs and getting a massage that I, instead of going out to eat at a restaurant, I decided to change course and just to bring the food to us and to then decide to dance and just have an impromptu, uh, get together.
And so it's okay. If you don't have all the answers and it just kind of works out, like trusting the process that, you know, some of the areas that I had gone to. Uh, like the volcano, I had gone through another site where I had climbed it and it was like an hour of rocky, uh, lava. But our tour guide suggested that we go through this other site where they had a lake and you could actually go kayaking, and that was optional.
And some of us took advantage of the kayaking and took advantage of the paddle boating, and others could just chill. And you know, it was okay for people to decide to sit out in some, in some of the activities because of whatever they decided. Maybe they didn't wanna wake up or maybe their knee was hurting, or they just decided they wanted to skip out.
And it was okay for us to realize that we're not gonna have everything in that moment in time, that we sometimes want it, that it's okay to not. Feel like it's okay and it's okay to ask for help from those around us and to let us share your burden. So it was such a beautiful, beautiful retreat. Uh, we had amazing food.
I think like I was shared with you guys before, this is one of the places where, um, I ate everything I wanted and I still lost weight. And I think it was because we were so, so active. But today, What I wanted you to think about is that what is, what is okay for you? I want you to fill in your thing. It's okay for you to, what I want you to send me, um, a message through, uh, Instagram or a d h d dash life coach.com.
Comment box or send me an email@overachievewithadhd.com and let me know. Overachieve with ADHD gmail.com and let me know what is okay for you. And another poem that I've read to them is something that I always read to my, uh, coaching clients. And I think you should also hear this one. It's called Breaking Service by Mark Nepo, breaking Surface by Mark Nepo.
Let no one keep you from your journey. No rabbi or priest. No matter no mother who wants you to dig for treasure, she misplaced. No father who won't let one life be enough. No lover who measures their worth, but what? You might give up, no voice that tells you in the night that it can't be done. Let nothing dissuade you from seeing what you see or feeling the winds that make you want to dance alone.
Or go where no one has yet to go. You are the only explorer, your heart, the unreadable compass. You're so the sure of a promise too great to be ignored. So I wanna ask you that too. What is something that you might have been ignoring, what is something that you are maybe looking forward to doing? I think it's important that you really, really tap into that because the universe is here to support you.
You just have to make sure that you tap into that, and if you feel like it can't be done, come hang out with us. We are here to support you. My community is amazing and we are definitely here to support you. All right. Well, I just wanted to share my experience about Costa Rica. It was divined. Every single person there was amazing.
They helped us all grow. They helped us all be present in the moment. We definitely had a blast, and I will definitely be repeating this again and, um, I will let you know. I am thinking I'm gonna be doing two Costa Rica retreats, probably one with similar, what we did this time around. And then the second one might be the private one just for, uh, the people who have already gone at a different place.
But anyways, I just wanted to touch base. And let you know that I didn't forget about you while I was in Costa Rica. I was just fully present in the moment, and, and I hope that, you know, this week you guys had an amazing week and I can't wait to hear what you tell me that you know that it's okay to do so.
Let me read it again one last time. It's okay. It's okay if things don't turn out the way you expected them to. It's okay to adjust course and choose another path.
It's okay if you don't have all the answers right now. It's okay to be a beginner and be clumsy when trying something you've never done before. It's okay if it takes some time. It's okay to feel your feelings, whatever they might be.
It's okay if you don't always feel okay.
It's okay to ask for help. It's okay to rest even when there's a lot to do. It's okay to take a break from growing and just be,
it's okay to let others share your burden. It's okay to say, fuck this shit. And it's okay to sign up for the next experience with team Deanna. That last one was actually hold that I should add by Carlos, my tour guide. I was riding this. It's okay poem on the last day, which was Friday morning at breakfast and he saw me writing it and he told me, don't forget that part, because I signed up and I am all in in team Deanna.
So it's okay to listen to others and to welcome. All the positive things that they say about True. It's so easy for us to always be like, oh, we're messing this up, but it's okay to welcome compliments. Maybe that'll be my 14. It's okay to welcome all the compliments. But again, I am curious to learn what your It's okay statement will be.
We'll be in touch till next week. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happen.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave, work at work, and re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain so that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all. What kind of view you're gonna have after this conference? Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh, I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.
Hello. Hello. I am so excited to have a dear friend of mine here and an amazing person, Dr. Carolyn Lentzsch-Parcells, and we've been knowing each other for some years now. I'm gonna say two or three years. I don't know how long, but it feels like a pandemic sometime. Yeah, it feels like a lifetime, and it's been amazing because.
She is here in Texas and she is doing the work of encouraging young adults and teenagers and all the works to have better life. And it's an amazing, right? Yes. And it's an amazing journey that she's been on. And not only that, but she's a really solid advocate for A D H D using as a superpower.
Thank you. And she, At all the platforms and not just here and there, but like at the national level. She is been an amazing speaker at the a D conference and she's been there years and years. So anyways, I just wanna bring her today for her to share her story and for her to share a little bit about herself and so that we all can see that we can do wonderful things like.
Dr. Carolyn Lentzch-Parcells: Thank you, Diana. Like Diana said my, my full blown full doctorate name is Dr. Carolyn Lentzsch-Parcells. I'm a board certified pediatrician practicing adolescent medicine in Fort Worth, Texas. And as Diana said, I do, I take care of basically kids and teenagers and young adults, many of whom have a D H D learning disabilities.
Or other challenges. And of course myself am also A D H D, human and mom and business owner and all the things. Yeah, and I'm happy to be here. I got to meet Diana through our A D H D nurse and it's been really fun getting to know her. Awesome. So
Dr. Diana Mercado-Marmarosh: I know that your story is a little bit different from some of our stories in the sense that, yeah, some of us females tend to be diagnosed a little bit later in age.
Yeah. And I remember you telling I knew a little bit earlier. So would you mind sharing a little bit about
Dr. Carolyn Lentzch-Parcells: that? Yeah, I would love to I consider myself very lucky especially for a woman and especially for a woman of our generation because, like you said, so many of us slipped through the cracks until really recently.
And essentially what happened for me was my, my I had a family member who was a younger male and he was getting diagnosed cuz he had more kind of classic symptoms. And my parents looked at that and went, hold on a. That looks familiar and they had already advocated for me throughout my life.
My dad would read my summer reading to me because I also have a learning disability in reading, which we didn't know, but he still did that. They got me tutoring and they really supported me all the way through. And then this occurred when I was a junior in high school, so I had a full assessment done and was diagnosed with a D H D combined type and a learning disability and reading and written expression as a junior.
At a very rigorous, private all girl school. So that was interesting. But it explained a lot for me and for my folks. And what was interesting too, though at the time is, being 17 and therefore knowing everything I refused a lot of the help that was offered to me. I refused medication.
My parents were actually very supportive of medication. One of my mom's favorite phrases has always been, You know that this is like diabetes it's another condition. And if you were diabetic, would you not take your insulin? I don't think so. So that's again, something that's pretty unique from what I came from.
But I still refused medication at the time. For the same reasons. I had a lot of the same kind of, Concerns, misconceptions, what have you that a lot of folks have. I was worried about the side effects. I'd seen some family members have some negative side effects and that concerned me. I was worried about using my diagnosis or medication as a quote unquote crutch.
I had all those same kind of concerns that a lot of people have. I did very, I'm very glad in hindsight, except accom. And that was critical. That was absolutely critical. And then of course, over the years, just understanding more about H ADHD and about my brain was in and of. Really helpful.
Dr. Diana Mercado-Marmarosh: Would you mind sharing what kind of accommodations and was it like during college or was it already in medical school that you decided to type in Sure.
To dive into that? Sure. No, so it
Dr. Carolyn Lentzch-Parcells: started in high school when I was diagnosed. And actually one of the things that made me realize, oh, I guess the is a thing and I guess I really am different, was I had actually taken. The SATs and the SAT T two subject tests before my diagnosis, and then I retook them with accommodations after my diagnosis.
And on a 16 point scale, I went up over 200 points and, oh, I can do what was that? And I didn't think that I was stupid. I didn't think that I was lazy, it wasn't any of. I thought I had a very realistic view of what my capability was, and it turned out that my capability was actually quite above what I thought it was.
That testing. Of course, for better or for worse, that testing is critical, right? So that was one of the first times where I really went, oh wow, okay, this is the thing. And then I had accommodations. It was primarily testing accommodations, but also some note taking and things like that.
And I had those accommodations all the way through college on the mcm. All the way through medical school. Medical school for my medical school exams. But unfortunately, and this has actually changed a little bit since then cuz some of us fought. But at the time especially the U S M L E, the United States Licensing Medical Licensing exam is governed by the a d A laws.
Whereas the exams I had taken previously were governed by I D E A laws, so the educational laws versus the professional laws. And I fought and fought and fought and fought and was not able to get accommodations for the US m l e in time to take it. Clearly I passed because I am a licensed physician.
But what was really interesting about that one actually was when I came to the, there was also the first test that I ever took that was on a computer. Because I'm old. So yes, children, there were tests originally on paper and Scantron sheet, which as soon as I say Scantron gives anybody 35 or older, P T S D.
But anyway what was really fascinating though is because it was on the computer, there was actually a lot of accommodations. Built in, because I only saw one question at a time. The script was very large. I didn't have to transfer from a answer booklet to a Scantron. I just clicked a dot. I had headphones on.
I had, I was in one of those cubicles with the, I call 'em human blinders, right? Yeah. So there was a lot of things that actually turned out to be very accommodating for me. And so I did okay. I did fine. It was scary and it wasn't, But I did it. So that was interesting. But those were the accommodations.
Primarily had. Yeah.
Dr. Diana Mercado-Marmarosh: So it's, again, it's so good to become curious with how you learn and to make sure that, like you said, you don't miss maybe a learning disability on top of that or dyslexia or a number thing or something else, right? Input or output understanding, because, Yes, it can be a d h, adhd and that can be its spectrum in itself, but it can also be end something else.
And right when you're aware of that, then you can, like you said, you can advocate to have correct accommodations for that. And some people, when they think accommodations, all they think about is oh, maybe they just get a little bit extra time. And while that might be helpful, a little bit extra time can make a world of a difference for some of us.
What if there could be something else that could be done as you're learning how you learn or how you test or how you give information back
Dr. Carolyn Lentzch-Parcells: to people. No, yeah, that's exactly right. And I think for me anyway, and obviously everybody's different, but for me, the accommodations were really key for me to be able to show what I could really do.
And I think one of the things that people get hung up with on accommodations is but what about real life? What will that mean for somebody in real life? These are all things, I'm not taking a multiple choice test in real life. I don't take care of my patients. My patients don't walk in and hand me a multiple choice, question, answer for me to go, oh, it's this diagnosis and you don't have one minute to figure it out.
No, exactly. Exactly. I don't. And in fact, the fact that I take my. The fact that I listen, the fact that I notice details that other people may not notice, all of which can be part and parcel with my A D H D, right? Are all the reasons why I'm good at what I do. So the key to AC accommodations is not overly accommodating people or enabling, folks to not build skills.
It's to. It's to take away unnecessary barriers. It's not to, the analogy I like to use sometimes is if you've got a fence and someone's too short to hop over the fence, accommodations are not to catapult you over the fence. Accommodations are a step stool, so then you can grab the top and pull yourself up and get you up over it.
It's that kind of thing. There's the other thing too is there's accommodations these days. Like when I was a kid, I wish, there's times I'm glad we didn't have cell phones. There's also times I wish we had, because now the accommodations we had to fight for audiobooks, for dictation.
Software for those of us who have writing difficulties. All these things are now in our hands 24 7. I use dictation software on to do my charts because I still, writing is still not the easiest thing for me. These are all things that, that we do get to have moving into real life. So there's no reason to not allow our students to learn what resources they have and what assistive technologies are out there that they can use, that they'll be able to use their whole life.
Yeah.
Dr. Diana Mercado-Marmarosh: And it's so interesting, like you said that about the, that like in my mind, I used to have the thought, oh, I'm not a great writer because it takes me forever. But when I had, I got coached on they asked me, so which, did you get a F? And I was like no, they're like in English. I was like, no, they're like in Spanish.
I'm like, no. They're like, then where did you get this thought? You're not a good writer. And so many times because we have
Dr. Carolyn Lentzch-Parcells: a certain thought, it gets us stuck, right? But
Dr. Diana Mercado-Marmarosh: maybe that's not. The right thought, but maybe you do realize that takes you a little bit longer than other things. Maybe speaking is easier.
So like you said, you can click on your phone. There's a tab where it lets you record a voice to text message, and you could do that, or you could click on the tab and it literally just records your voice message and you send that, right? So it takes you two or three minutes to write that whole thing where it would've taken you like 20 minutes to.
Think about what the hell you're trying to type and I'm you saying it right. Are you thinking it? And so then we never even send it because we were thinking about it too long and then we got distracted somewhere.
Dr. Carolyn Lentzch-Parcells: And I see that happen with, a lot of my kiddos who have dysgraphia, or have dyslexia. I still use books on. Books on tape. Wow. I just aged myself again. Audible books on tape. Oh my gracious. I still use audio books. Thank you very much. And in fact, actually one of the, one of the coolest, I gotta give a shout out to my residency friends because when I was in residency, we, they decided to start a book.
And they were readers, several of them. And of course it was like every other book club, right? There was a book, but we didn't really discuss the book. It was just an excuse to get together, drink, wine, and vent. But there was a book chosen and every book they chose, they made sure was available on Audible so that I could listen to it if I wanted to.
Yeah. That was huge. Yeah.
Dr. Diana Mercado-Marmarosh: And that's huge. That's so important, right? Because that just doesn't talk about. Hey, let's get together. But that talks about inclusion. Yes. It talks about equality and having that possibility to actually accomplish whatever you say you're doing well and
Dr. Carolyn Lentzch-Parcells: this is where, so that's in Exactly.
That's where I wanted. So when we talk about, cuz there's so much conversation now, not just in the A D H D and LD world, but the all over on inclusion and accommodations and what does that mean and what should it mean? And that instance right there, I think is the, at least for me, illustrates the ideal.
It wasn't a big deal. It wasn't made a big deal. It's not like there was some big fanfare, Hey, look at us, we're doing this for you. And it also wasn't something that was a huge effort for them. It wasn't, it didn't take anything away from them. It was just, and again, nobody made a big deal out of it. It wasn't, it was a nonis.
Yeah. And I don't know that they even realized until I told them what that meant to me. Again, it just, it would just was, it just was, and that little thing to them was a huge thing to me. And that's, we, again, we get caught up in, the extremes of these things. And really it can be just the small day-to-day things.
And it doesn't have to be a big deal. It doesn't have to be a big fanfare. Yeah. My dad reading my summer reading books to me he didn't make a big deal of that one way or the other.
Dr. Diana Mercado-Marmarosh: And he used it as a way to bond with you. He used it as a way to spend time with you. So instead of, sometimes we all have 10,000 things as parents that we're doing, and then he could have chosen to think, oh my God, one more thing I have to do.
Or he could have chosen to think this is something we do together.
Dr. Carolyn Lentzch-Parcells: And actually the funny thing about that one is apparently I might have gotten diagnosed even younger. Because of what teachers had said, except my parents, my dad in particular, cuz he. Similar challenges was like, what?
It's just, I don't see just life. It's isn't this just what our family does? Our joke is that if you open up the DSM five criteria under A D H D, you're pretty much just gonna see my family tree. Yeah. It's just how we roll.
Dr. Diana Mercado-Marmarosh: We don't make a mean a thing.
Yeah. So tell me what are some of the things that you're up to nowadays? And I know we were talking about social media right before we started recording. Oh my goodness. But you're
Dr. Carolyn Lentzch-Parcells: welcome to share anything that you're up to. Oh, I appreciate that. I think, dude, it's hard these days.
Because the good news is we have all these opportunities. The bad news is we have all these opportunities. Oh my Lord. And I don't know how much of it is I was born with a horrible case of FOMO and or is it the A D H D or what? I don't know. I don't know. But I feel like I'm constantly, I know you and I have talked about this constantly trying to find the balance, whatever the heck that means between all the things I wanna do and all the things I need to do, right?
Yeah. And all the things other people. And want me to do. Yes. And and I do think some of that is the A D H D, because we are constantly chasing the dopamine man. Yeah. And I tell people all the time, I overcommit and say yes to too many things. Not because I'm a people pleaser, not because I feel like I have to say yes.
It's because I want to say yes to everything, because it all sounds. Yeah. And I think that's an issue whether you have ADHD or not, whether you're a mom, not a man mom, a woman, a man, whatever, whoever. I think we're all facing that these days. And again, it's it's cool because we've got opportunities to do other things, but then trying to not compare ourselves and trying to.
Weighed through what the options are. So Diana and I were talking before I popped on, I was asking her about how she started her podcast because I'm like, should I do a podcast? Should I just be a guest on podcasts? What do I wanna do with that? And right now I'm not doing that, but I am. I do have a practice, girls, women in Young Men's Health and Wellness, Fort Worth in Fort Worth, Texas, which like I said, we take care of.
Young adults and teenagers and kiddos in general. We do primary care, but we also do some mental behavioral health, obviously, things like a D H D. So I'm running that practice and we are building and growing, which is exciting, but whew. Stressful. Stressful at times. And then I kindly sorta finally, Spit the bullet at the behest of many and our of several of our friends and colleagues in the A D H D community and started doing the social media thing.
I I refer to myself as a reluctant social media poster. So you can follow me if you want. God, I still feel weird doing that though, and saying that the self-promotion thing just does. Come naturally. But anyway, Instagram, I'm the hd.md. Same on TikTok, Carolyn Lynch, Parcells on Facebook.
I think technically I'm the underscore h d underscore MD on Twitter, but I don't tweet a whole lot.
Dr. Diana Mercado-Marmarosh: I just, yeah,
Dr. Carolyn Lentzch-Parcells: I don't, I tell you what, I am such a visual person. I cannot stand the visual format of Twitter. Yeah, it confuses me and drives me crazy because I'm an old person. Just don't get it. Yeah. I'm mostly active on Instagram, but I am on the others too.
Yeah. So
Dr. Diana Mercado-Marmarosh: that's right. Doing, and we were just talking about like the overthinking and the good enough thinking whenever we're doing some of the social media. Yes.
Dr. Carolyn Lentzch-Parcells: And. Yeah, it's actually been, what is that about? Yeah, so it's been actually an interesting little growth experience for me because I love speaking, I love teaching.
I was a theater major. I was a pre-med theater major, also known as a sparkly unicorn, and so I thought it might be a nice little outlet for me to. Use some of my creative juices, but also to get some good information out there and some good education out there. And hopefully, brighten some people's days.
And what's interesting though is the whole short form thing. So first of all, I'm a theater kid, so for those of you who aren't theater kids, it is very different from film because theater, you go out there, you cannot see yourself. It is you and the audience. You get to feed off your audience and get that immediate feedback.
And oh, by the way, the show must go. So there is, it is once and you are done, right? You might have another show, but that one is done. It's in the can. You can't change anything. And this video thing, man, you can see yourself. You can do it multiple times. You can oh, not good for a perfectionist with adhd not good at all.
And the whole like 90 seconds or less. I can't have a conversation. I can't, oh, that's, no. Anybody who knows me knows. But that's like impossible. But I've had to figure it out. So like the first few videos I did. I almost completely gave up cuz it took me like, what, 24 something, whatever bazillion takes.
And I still wasn't totally happy with it and I don't know how to edit. So that was a whole thing. And then as I've gotten doing it more and more, I've gotten so much more comfortable with the fact that and I think it's really cool that what people want is not this highly curated, highly edited thing, even from a professional like myself.
Cause I do think sometimes as physicians we feel like we have. We almost have to mask a little bit more. And so it's cool that I've figured out, okay, what's the information that people really need? And take out all the extra junk, right? Or what's the point I really wanna make?
And let's just get to that. And then being a lot less perfectionistic about it, which is actually really cool. And just you know what? Yeah, that's good enough. We're posting it, eh, we'll see what happens. Yeah. So that part's been really cool. The not cool part. About the whole social media thing is like my whole life, Diana and I were talking about this, like when you're a physician, your entire life has been largely prescribed, and yes, pun intended, right?
It's four years of college, maybe three, maybe five, but it is college done. If you do that and you do it well enough and you get these scores, then you get to this next level, then you go to medical school. Four years, and as long as you don't screw up and you do well enough and you pass your exams, then you're a doctor, and then you do residency and then this and then that.
So the whole thing is very prescribed and the outcome is known as long as you do X, Y, and z for the most part. Obviously there's some variations, right? And this social media thing is you never know. You never know what videos are gonna hit. You don't know what's not gonna hit. You don't know when it does.
You don't necessarily know why. When it doesn't, you don't necessarily. And the other thing that I think is a little hard for me, again, when I'm doing something in front of a live audience, first of all, I often get immediate feedback by people talking to me or giving me either positive or negative feedback.
Usually positive. But even if they don't come up to me, I can see their face. So I have some idea as to the impact that I may or may not have made if people leave comments. Sure. And likes maybe, but I don't really know. Yeah. I don't get to really know how or if stuff is impacting people. Which, I keep to, I tell myself if it helps one person and it didn't take, and it was just a little bit of my time. Yeah. Then why not? Then it's worth it. Yeah. But it is time and it is. And you wanna make sure when your time is limited and your effort is limited, you wanna know that what you're doing and what you're putting out there is having the positive impact Yeah.
That you want it to have. Cause that's really the only reason for me to be doing it.
Dr. Diana Mercado-Marmarosh: Yeah. I know what you mean because when I am supposed to give lectures or do something, I'd rather do it to a live audience, like you said, because then I can see how it's landing or I can see how I'm pivoting.
And while I might not have everything, of course, on the slides, because then that's like word vomit, like it's all in my brain. And I'm like feeding off of what. Seen in the audience or where they need to go based on the audience. And so yeah, when I'm supposed to, Hit record to
Dr. Carolyn Lentzch-Parcells: A
Dr. Diana Mercado-Marmarosh: blind thing and just use my slides.
Oh my gosh.
Dr. Carolyn Lentzch-Parcells: I try it, but
Dr. Diana Mercado-Marmarosh: oh my God, I feel like I'm not in my zone because again, I'm like you just said, I'm not getting that feedback. So it's, yeah. So talking to you like this is amazing because like I can understand what we're doing. We're just having a conversation. It's not scripted or anything, so it totally goes
Dr. Carolyn Lentzch-Parcells: where it goes, that's why I love, honestly, like that's why I. Favorite absolute favorite things to do other than live talks is podcasts, right? Because it really is just I love to talk and I love to talk with my friends, and I love to have that like connection. And so whenever I do 'em in this format, which is part of why I've thought about doing my own, but I just, I love, like you said, I love the format.
I love that it's just a conversation and even if I don't get to see the reaction of the audience, I get to at least interact with one other human. Yeah. There's at least that may, maybe nobody else likes it or listens to it, but we're gonna have a good time doing it, and at least that was worth, the hour, whatever that we put into doing the recording.
Of course you're doing all kinds of work on the back end. My brother-in-law, I'm sorry, your brother-in-law, bless him. See, that's what I would need if I did something like this. I would need, I'd need another. Yeah, I would need a human who knows techie things cuz I do not know techie things. Yeah,
Dr. Diana Mercado-Marmarosh: And like sometimes, it is, like you just said, realizing that in life there's certain things, obviously
Dr. Carolyn Lentzch-Parcells: we've been taught.
Dr. Diana Mercado-Marmarosh: And drilled. Really, if you're talking medicine, we need to make sure we have some type of precision, but at the same time, it is called the practice of medicine. You need to have some wiggle room to be creative, wiggle room to explore wiggle room, to not just stay within the box that they're wanting us to stay in.
But at the same time, like you said, there's certain guidelines. There's certain guidelines, yeah. Where you know that if you went way south, okay. Everybody in recently would know you're really way south. But with social media, with an entrepreneurship, with anything that like. You don't have the prescription, like you said, and so you can easily go down some rabbit hole and be like, what?
What happened? And again, but at the same time, it lets you. Be creative enough and be willing, I wanna say the word fail faster, because again, you didn't know, but then that also makes you grow faster because now you have new data to change and modify and whatnot. But yeah, I still wanna rule book.
Yeah. But yes, we should. Honey, guys, we should have some guidelines though. I think that's why it's so good to surround yourself. Network of somebody who's a little bit ahead of you and maybe a little bit behind you. So that's, we can, we all can help each other. Keep going. That's exactly
Dr. Carolyn Lentzch-Parcells: right. To that point so some of the folks listening may have seen, and if you haven't, you really need to go take a look at Jessica Mc McCabes, how to A D H D YouTube videos.
She's one of the, one of the first of us, if you will, to really To really push out excellent content on A D H D. And I got to meet her through the conferences and we're now friends and she was one of the ones that kind of really encouraged me to do this. She's also one of the ones that helped me, that really taught me, because I did a video with her for her YouTube channel on medications.
What was that? October, 2020, I think. And, This was the first time I had ever recorded something on video and I had to do it, on my own, in my office. Next time I was like, I gotta have somebody else helping me with this because I just would get lost in the weeds. And I sent that poor woman, I think, and her team like, what, 34 clips.
I think that they miraculously managed to condense into five minutes of excellent material. That sounds like it was one take. I don't know how the hell they do it. They're good. But I told her afterwards, I was like, look, I already respected. Big time what you do, but holy crap, like I had no idea just how much time and effort and energy and editing and da.
Now it helps if you have somebody who isn't completely paranoid and takes 34 takes and sends you every single clip cuz they don't know what's good and what's not. I'm, it helps me get over that a little bit.
Dr. Diana Mercado-Marmarosh: But hey, that was the first time you did it right? And like you said, exactly. You wanted to make sure, and I think that's where it's exciting, but it can also be paralyzing because what you're trying to give out into the world is bigger than yourself.
Like it's bigger than your ego. It's you wanna make an impact because this is education that can really be like a trailblazer for people who. Otherwise might not have considered the possibility of medicine. And you and I know that like medicine is one of the tools when it works amazing.
When it doesn't, then it can be a little bit harder, but it doesn't mean impossible. And it should be medicine and plus everything else.
Dr. Carolyn Lentzch-Parcells: And I feel I. You and I both, we have unique perspectives, right? Because we have a D H D, but we're also physicians ourselves. So even though like our stories are unique from each other's, we also have this unique perspective of seeing both sides of it.
And for me, I also, again, I feel very lucky that I. Had the situation that I had. Not to say that it wasn't with, its without its challenges. It absolutely was. I still had to, deal with teachers and professors and other people who, and still do, who don't understand or don't, didn't understand the accommodations and all of that.
But I had so much support and so much. We're talking, I don't even wanna say how long ago it was, cuz, this was a long time ago that I had all, like 20 plus years ago. Long time. I, even my learning special, the learning specialist at my college who I had to meet with cause I was getting accommodations.
I will never forget this. This comes back to, it goes back to something you said earlier. She said I had to meet with her and she said, Carrie, tell me how you study and how you do your work. And I said I do it all wrong. And she goes, okay, tell me. And I told her, for example, I said, I highlight everything except for and the, and, but, and she goes, okay, why is that wrong?
And I go cuz I was told it was wrong because you're only supposed to highlight like the main points. And she goes, Carrie, you graduated from Haka Day, you are at Davidson College. Tell me again how that is wrong. And I was like, oh. And she goes, let me tell you what you're doing and why it's right for.
And she went on to explain to me how I was using the highlighter to track and to process and all of this. And she's like, when you do it that way, do you remember everything? I'm like yeah, sorta. And she's okay then if it ain't broke, don't fix it. And that was such, and this was over 20 years ago.
Okay. That was just such a game changer for me and in my own thought process, and I was so lucky to have all of, to have that and to have that support growing up, especially back then that I feel like, our family has always our leading ethos, if you will, what we've always been Taught and what's always led us is to who much is given, much is expected.
So for me, I feel like that's taking the experience I've had taking, but also combining that with the knowledge that I have, being able to put that into the world in a way that hopefully makes a difference, right? And hopefully pays forward some of what I was given and part of what I, some of what I had the privilege to.
Dr. Diana Mercado-Marmarosh: Thank you for sharing that. And I think it's also so important to realize, like you said, that you had opportunities. But you were brave enough to take those opportunities. Like some people, and Yes. You said as a teenager, maybe not all of them, but it is human. It is human nature, but at the same time, like that's okay,
Dr. Carolyn Lentzch-Parcells: we all wanna go have a conversation with our 17 year old self.
Exactly. Exactly.
Dr. Diana Mercado-Marmarosh: We shoulda could or would've done, but the point is that you were okay. You were comfortable enough and being curious to let me figure this out. Let me ask somebody else advice, but also let me. Resonates for me so that at the end of the day, you're not just. Okay, this is it.
But also curious enough to be like what if there could be more or not? But at least you go into that right sphere and like you were telling me like, you've been able to talk to your uncle who's like amazing at, that's his jam, right? Like in social media stuff and have friends who open up doors for you or explain different things and.
Most of us feel like they're gonna know I suck in this area. I don't wanna show them that I suck at this area. But it's in, again, it's not like it's, we all expect to start walking all of a sudden when we were just born. No. Like you have to learn different things. Exactly.
Dr. Carolyn Lentzch-Parcells: Yeah.
Dr. Diana Mercado-Marmarosh: And so it was such a blessing to have you when you were in my group, and then to turn around to come and give us the talk, to be the guest coach about medicine like that was. Again, like you don't realize how we all have our own gifts and our own Yeah. Way to enhance the group or the environment or the community
Dr. Carolyn Lentzch-Parcells: that we're in.
To that point, I'll be honest, when I did, your coaching group, I wasn't totally sure what all I would get out of it, right? Because I know so much about ADHD already, right? And. I've done coaching in the past for myself and I've done kind of all the things, but I'd never done the group coaching, the thing.
And I'd also never done coaching with other physicians. I knew other physicians, but there wasn't a ton of us. There are a ton of us, but there weren't a ton of us that knew each other. And that was one the things that I think was really cool. Yeah, I had the opportunity even as a member of the group to answer questions or to share my knowledge, but there were definitely.
Several times where other members of the group would just say something or something about something they experienced or some epiphany they had that made me go
Dr. Diana Mercado-Marmarosh: oh,
Dr. Carolyn Lentzch-Parcells: fabulous. Like brain capo like just brain blown. And I think that was really, I think that was really cool.
And just the camaraderie. Too, of just, and just being able to be like, Hey, we're not alone here. We're all having similar struggles we're having, we have some different stuff too. But we have some really similar stuff. Yeah. It's, we're not the only ones.
Dr. Diana Mercado-Marmarosh: And it's, so again, and that's what I mean by it's so important to have a community that kind of just gets you, and they might not get everything, but when you have.
Safe space where you can just come and be. It's so different than from feeling like, oh, I can't say that out loud because my coworker is gonna think that blah, blah, blah, blah, blah, because they have no problem here and therefore blah, blah, blah.
Dr. Carolyn Lentzch-Parcells: So that connection. Yeah. Con, we talk about connection a lot and resilience.
We talk about connection, and that's that connection that you get from having truly shared experiences. That is there's a lot of negatives to all the online stuff and all the social media stuff and all of that for sure. But that's one of the real positives Yeah. Is being able to actually form connections and community and that stuff's critical.
Dr. Diana Mercado-Marmarosh: And I think Covid made it such, where again, I didn't even know how to use Zoom like or anything. Really prior to this. Yeah. But Covid made it such that you could wonder, Hey, I can have a conversation with anybody anywhere in the world. Okay. That's cool. And it made it a norm to be able to have that instant connection because I know when I then finally met you in person, oh my God, it was like a
Dr. Carolyn Lentzch-Parcells: world of different, That was so funny because it was like at that conference.
So for those of you who don't know, we're referring to the international conference on A D H D, which happens every November. By the way, please keep your eyes open and your emails open. It is fabulous. Baltimore. It's coming up. Here we go, crabcakes. But it is, it's three days of. Communing and having just the most fun time as well as very informational and educational with 1500 of your bestie, A D H D humans.
But anywho, needless to say, for 2020 and 2021, we were virtual, which was still great. I'm glad we had it, but it just wasn't the same. And I met all these people like Diana and some of our other physician friends and other folks. And then when we finally all came back together, The conference this last November in 22.
It was the funniest thing cuz there were people who was like, oh my God, it's so glad to see you again. And they're like, we've never actually met. And then there were other people who I'd actually met right before the pandemic who I was like, I'm so glad to finally see you in person. They're like, Carrie met before.
And I'm like, alright. Our sense of time was just so messed up. But it was oh, it was so much. Yes. So much fun. And the party was awesome. If I do say so myself, oh yes,
Dr. Diana Mercado-Marmarosh: We party again. Oh my God. We party till like midnight or something crazy and yeah, we,
Dr. Carolyn Lentzch-Parcells: there's videos out there.
I, there are videos. They are posted online. Because yes, we are still responsible adults. There was nothing crazy. It was just a lot of fun. Feather boas and Elton John glasses. But there was, I, each night I went to bed later and later, I think the first night it was like 1:00 AM. Second night to I was like, I'm getting too old to stay up this late.
I was in so much pain by then. Yeah. But it was just, we were having so much fun finally being together and getting to see each other and Yeah. Talk about some deep stuff, but also just have fun and talk and chill and Yeah.
Dr. Diana Mercado-Marmarosh: Yeah. And again, that's what I mean about community. Come into the place where everybody just gets you.
Yeah. It was so funny to hear people be giving a presentation and then midway they stop and they're like, what was I saying? And everybody's laughing, oh, and yeah. And then they're like, no, I'm serious. I got lost. What
Dr. Carolyn Lentzch-Parcells: was, it's amazing. I love it because I don't, one of the things I've always said about that conference, and part of why I've stayed so involved is because the first year I went in 2018, it was honestly, The first time that I felt like I could be 100% completely and totally authentically myself, both as a professional and as carry the D h D human.
Because so many times at these conference, when these professional conference, I feel like I have to mask Yes. And compensate to be taken seriously. Yes. Because if I'm my full, if I'm on full volume, I will not be taken seriously and people will look at me like I'm being annoyed. And at this one, like the very first time I went, people were like coming up to me.
I wasn't presenting right. I was just, And would raise my hand or, make comments or answer questions and people would come up to me and go oh my God, I love your energy. I'm like, I'm sorry, you said what? And they're like, and they looked at me like I was the, some sparkly unicorn because I was a physician with a d h adhd.
And I was like, y'all do know there's a lot of us, right? This is a lot of us. Like probably half the doctors out there, but I'm just saying. But no, but it was. It was so cool and it was not being myself didn't take away from who I was as a professional. It gave me more credibility. Yeah.
And it was incredible. It was incredible. Yes. And and it's continued that way. And working with those folks again, it's great because it's like, deadlines are a funny thing when you're working with a whole bunch of ADHD people. People are very forgiving which is nice, but also you also have to hold to 'em really tight or nothing ever gets done, exactly. So yeah.
Dr. Diana Mercado-Marmarosh: Is that you? You should see me planning my Costa Rica retreat. You know when the deadline was? Oh my
Dr. Carolyn Lentzch-Parcells: gosh. Was it first,
Dr. Diana Mercado-Marmarosh: right? Oh yeah. Like it firsts was the deadline and I'm like still getting Oh, I just booked my flight yesterday and my mom's coming too, and I'm like, give it the details.
I'm trying to organize. Getting you to and fro, right? Yeah.
Dr. Carolyn Lentzch-Parcells: But again,
Dr. Diana Mercado-Marmarosh: To your point. I think we need to remember that our energy is important and that we need to protect it. But we also need to realize what enhances it so that we refill and recharge ourselves. Yeah. And like you said, we don't give it all away with the.
Things that you know, can distract us and if they were not really what was IMP would be important five years from now, then maybe that you could gauge it that way. But Okay. I'm gonna wrap this up cuz I know our time is valuable and I know you and I can talk for hours cuz we've done that before.
Dr. Carolyn Lentzch-Parcells: Yes ma'am. But in the interest of time
Dr. Diana Mercado-Marmarosh: You already told us where people couldn't find you, but just tell us one more time and then I'm gonna ask you one more question and
Dr. Carolyn Lentzch-Parcells: we'll wrap it up. Our website is www.gtwhealth.com. My clinic is in Fort Worth, but we also two other clinics in the Dallas Fort Worth area.
The social medias are instagram@thehd.md which is the same at TikTok, Carolyn Lynch, l e n t z s c h, Parcells at for Facebook and then Twitter, but. Whatever. Awesome. Not Twitter.
Dr. Diana Mercado-Marmarosh: If people just started tuning in, because we have wondering attention, what is the one takeaway point that you would want them to walk away with?
I
Dr. Carolyn Lentzch-Parcells: get asked that, of course whenever we do these and my always go-to takeaway is this, which is do not let. Whether you are an adult with D H D or a parent of someone with D H D or you love someone with d h d, don't let what other people say prevent you from advocating for and fighting for what you or the person you love needs.
Everyone will always have an opinion. There will always be opinions and there will be always be opinions that disagree with whatever you choose to do. It is not shame. It is not failure to ask for help and to fight for what you and the people you love.
Dr. Diana Mercado-Marmarosh: Preach. Awesome. Okay, the last question, I know I said it was only one.
What do you hope to do for fun in the next three to five years? I know you already have a lot of fun, but tell me, oh, tell me what are you
Dr. Carolyn Lentzch-Parcells: dreaming about in the next three to five years? Yeah, travel. Lots of travel where to Lots and lots of travel. Internationally, already checked off Italy. Wanna go back to Italy, London.
I do love me some tropic. I got a whole list of bucket list countries. Like I'm one of those people that wants to make it to just about every, continent or whatever. Yeah me too. I'm not a cold weather person, so some of those but yeah, a lot of travel. Awesome. I'm hoping to suggestion.
Dr. Diana Mercado-Marmarosh: Yeah. We were just looking into maybe doing a cruise cuz that would be amazing. Like a 10 or 12 day cruise. Yeah. Like Mediterranean, because then you just have to literally get yourself on the ship and then you get on and get off, get on, get off. And you have hotel taken care of for you.
Exactly. Yeah. And then it's actually a lot more affordable than you think, how you do all your connections and. Stuff. So yeah, I think cruises are amazing for our A D H D brain dude. And we need an A D H D
Dr. Carolyn Lentzch-Parcells: physician's cruise. Oh, that'd be so much fun.
Dr. Diana Mercado-Marmarosh: Yes. We gotta plan something.
Dr. Carolyn Lentzch-Parcells: Go team. Woohoo.
Dr. Diana Mercado-Marmarosh: Stay tuned guys. Stay tuned. This is coming up. Awesome. Thank you so much for spending your time here with me today and with everybody who's listening because like I always say, Time is our most valuable asset because unfortunately we don't know how much or how long we have a it.
So let's try to do our best to be present in the moment because we know that we like to dwell on whatever already happened, and we like to plan so far ahead that we forget, like right here, right now, don't know
Dr. Carolyn Lentzch-Parcells: what you're talking about. I have no idea. I have no idea what you're talking about. I don't do that over.
Dr. Diana Mercado-Marmarosh: So yes, thank you again for coming. It's been, I'd delight to have you.
Dr. Carolyn Lentzch-Parcells: Appreciate
Dr. Diana Mercado-Marmarosh: it, Diana. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh . I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs.
And some of my habits were just as important as learning the new set of skills. I am so excited about today's topic, which is the relationship between metabolic syndrome and A D H D. I see this in my practice every single day. People look at me like, oh my God, she's a genius. It's not that I'm a genius, it's that I have firsthand real life experience with it myself.
It, when you have that real life experience, you're able to pull it out and make connections that somebody else might not have. So again, let's go through what is D H D A? D H D is a neurological neurodevelopmental. Disorder that affects our executive function and our executive function is this mental task ability to complete tasks, right?
So most of us, when we think about D H D, we think about the usual things like attention. It affects attention, okay? We think about impulse control, we think about the hyperactivity. Many of us might not be aware that there's more than those three. There is 12 executive functions and all of them, or some of them could be affected and sometimes one day more than the other.
And so when we talk about that, it's. Important for you to know, because if you don't realize that task response response inhibition. Task switching. Task initiation task. Completion management of time planning, prioritizing emotional control, time awareness, all those metacognition. There's so many of them.
There's 12 of them that can get affected, and if you're not aware of that, you might be blaming yourself and thinking you have this character. Defect is part of your condition, and you'd be surprised how many times my clients have this aha moments and even my patients when I asked them, okay, gimme all the things that you love about yourself and gimme all the things that you dislike about yourself, and many times all the things they dislike about themselves.
Are part of those executive function, and there they are sitting thinking that they are broken and they have a character flaw because they can't seem to do X, Y, and Z, when in reality it's part of their condition. And why am I talking about this? I'm talking about this because metabolic syndrome a set of symptoms or a.
Things that come together. For example, if you have high blood pressure, if you have high blood sugar levels, if you have excess abdominal adipose tissue or fat around your waist, or you have any. Cholesterol levels that are elevated. All those four things put you at risk for developing metabolic syndrome.
And what people don't realize is that A D H D is a neurodevelopmental disorder that is, Affected how much dopamine levels are around. So usually your A D H D tends to be unfavorable when your dopamine levels are low, and you tend to do well with your A D H D when your dopamine levels are high.
And so certain things like food can really increase your dopamine levels. And so that makes sense why, three o'clock, two o'clock, you might be looking for candy or for something for you to use to help you enhance your dopamine levels, because they're probably a little bit low. So with that premise, I am explaining to you that many times your eating habits can be a response to your unmanaged.
And there is a link. Okay. You see what I mean? When a individuals with A D H D have a higher risk of developing this syndrome, because people with A D H D have higher rates of obesity, insulin resistance, and. That is concerning because if you're not aware that you're using food as a means to regulate your A D H D, you're not aware that the underlying cause is not that you're eating so much, but that you're using food as a way to increase your dopamine so that you can try to complete the task at hand.
If we were to treat and diagnose you with A D H D, then it would. Easier for you to not have to be overeating. You be surprised how many times I have diagnosed people with A D H D when they had been told that they were just depressed or they were just anxious or they just could not lose weight. And I would, we would sit down and go through the diagnostic criteria and then when, then we would do all the labs and everything, and then we would realize.
There was ADHD there and once they started, Getting treatment for D H D, they've lost 20, 40, 50, a hundred pounds because now they are now no longer using A D H D. They're not, they're no longer using the food to treat their D H D and, okay, so fine, whatever. We're a little, all a little bit overweight. What does that have?
Anything to do with anything. The reason I am talking about it today is because it has everything to do with everything. Why do I say that? Again, our current lifestyle. Sets us up for metabolic syndrome like most of us are living quick, busy lives. And that is ha that causes us to go through the drive-through to eat sugars to have diets that are high in sugars and probably cokes and caffeine is probably another way, or energy drinks is another way for us to increase dopamine, and most of us tend to be.
Like not exercising as much as we want, and most of us tend to actually even drink and smoke. And some of that is gonna increase our health concerns. And when you have all that things going on, It actually decreases or estimated life expectancy due to you using all those sources as a way to in, to help you with your A D H D.
It actually can diminish how much time we haven't deserved, like it can decrease our life expectancy by 10 to 15 years. So it is important to talk about it because you might not realize treating A D H D. Either with medication or with behavioral therapy, or with coaching or all of them together can help improve your impulse control and can encourage healthy habits.
So that might, now that you understand that you don't have that two second delay between the stimulus and response, That might help you enhance your response inhibition. You might set up a strategy to help you just take a deep breath before you answer or before you go grab the cookie and ask yourself, what do I really need in this moment?
So the important thing is to realize that if you're somebody who might have metabolic syndrome, it might be important for you to. Get curious enough to realize if you might have a D H D and whether you can treat A D H D, and that can help actually decrease your risks for being overweight, for developing heart disease for, having a stroke or diabetes.
Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happen.
Dr. DIana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs.
And some of my habits were just as important as learning the new set of skills. Hello. Hello. I am so excited about today's topic. It is called Unleashing the Power of A D H D, heroes and Healthcare. It is a topic that is obviously very dear to my heart because. I am one of those A D H D health providers and also I work with a D H D clients who are physicians who are healthcare providers.
I actually use that type of information to apply for a conference in Rome that I got selected to, to go speak about in July. So I'm super excited about that. But anyways, today, We wanna talk about why. I really think when we lean into those healthcare providers or physicians who have adhd, it is so important to do and again, we all know that when we step into a room where the community just gets us, it makes a world of a difference. It's having that real life experience that can really make a difference. Between how you handle whatever you're going through and how the other person handles whatever they're going through.
The A D H D hero has been in the trenches battling their own symptoms coming out on the top, and when they share their real life experience, it just, Becomes obvious that they have superpowers and strategies and they can use this to show others. They too are on a journey. A D H D is a lifelong condition and it can get easier if you know how to deal with it because you understand it firsthand.
I always tell my own patients just because I'm talking to them about it, it doesn't mean like I have all the answers and it doesn't mean I'm a hundred percent. Got it under control because it is a journey. One day you show up fully, a hundred percent charge. Another day you show up. 20% charge based on the task that you're having at hand is how you are going to deal with whatever comes your way.
But having real life experience makes a big difference because you can just almost tell them exactly what they're thinking because it's your brain that is so similar with theirs. But again I also wanna point out that there is a spectrum. So it's not like a hundred percent of everything that I tell you that I'm doing is you're gonna do.
I'm always very careful with that because it. It almost becomes like gaslighting, right? Instead, it's important to ask yourselves what usually works, what doesn't work, so you can start to create some insight with that. I don't know if you're aware or not, but the AMA released a survey in 2016. It actually stated that 30% of US medical students.
Had disclosed that they had H adhd. It is very likely in your healthcare team you have somebody with H adhd. So it's important to point them out if they want to, right? So that they too can relate to each other and come up with a community to support each other. Brain power, like they get to tap into their brain power with their ADHD brain.
These heroes are unique it that they have this unique perspective. And they have obviously a wealth of knowledge about the condition. They can see things from a di different angle and come up with creative solutions. It's so important to not only. Use the brain powers to help educate your patients, but it could also be used to help educate your colleagues and it can also be useful to help modify the current system that might not be supporting them or not supporting the whole flow.
So what do I mean by this? For example, in my practice we, we were the ones responsible for starting our own notes and I suggested what if the nurse or the ma preloads a template and they may be type in one word or one sentence explaining why the patient is there. Now the note is open. You have an easier way to start.
It seems obvious to do something like that, but it was not until one of us suggested it and the rest of the team was like, oh yeah, we should try it. And all of a sudden we weren't missing, not even having started a note on a patient. We could track it easier. So it's just coming up with more solutions and being creative.
And another thing why it's important to have this A D H D superheroes in your team is because. They can help to destigmatize this condition. They can show others how A D H D could be a superpower instead of a weakness. They can help not only the patients, but also the families come to understand.
There's nothing wrong with them, you know that. Just thinking differently and there's, it's like thinking right or left-handed. And so if you're naturally left-handed and you're trying to use your right hand, it's just a little harder to do that task. But when you understand that you are left-handed, then it's easier for you to.
Do something with it. Taking the stigma away from a condition that is genetic that you didn't choose, it makes a world of a difference. For me, this was the realization that finally got me to open up to others. When I was coached in October of 2020 by Sunny Smith and I was told, A D H D is a circumstance.
You get to decide how you want to. What do you wanna make of it? You can decide that it's the best thing in the world, or you can decide it's the worst thing in the world. You can decide it will benefit you or not. Like it's up to you. And she asked me like, how is the diagnosis of A D H D any different from high blood pressure or from cancer or from diabetes?
And in my mind it was, I was trying to make all kinds of justifications. I was, but then I came to realize that A D H D. Like you're born with it and it's probably been there all along, but you were not even aware of it because that was just your norm and. Once you get the diagnosis or once you come to understand that you, this is it, then you can start to work towards understanding it and using it as a superpower and.
Another reason why it's important to have an A D H D superhero in your team is that it can lead to more collaboration. It could lead to better teamwork, not just for you, but also for your patients. Like you can, because you understand it, you're able to. Find more resources for this individual. You're able to get them to the right people, like either a therapist or a coach or explaining to them that, they might.
Have iron deficiency that can make their D H D worse. Or you could look into vitamin D deficiency and that could supplementing, could enhance their A D H D. Or you have awareness that Sometimes P T S D can almost appear like a D H D. So it's important to be aware of these things because then it could help you enhance, be a patient's advocate, but it can also enhance their diagnosis management once you have identified it.
So I really think having an A D H D hero in your team could, can unleash the beauty of this relationship between management, understanding, and treatment that can really change a person's life. Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave work at work. And re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain. So that you can start to dream the life that you always wanted this year in 2023. I can't wait to, um, learn all about, uh, what kind of year you're gonna have after this conference. Take care. Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh I'm a family medicine physician practicing in
rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs. And some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited today. I have a dear friend of mine who has also actually been one of my coaches and, um, I have her here and I'm so excited. Uh, That we are gonna be talking about, uh, energy. We're gonna be talking about how sometimes we get so drained and we wonder like why we are so tired.
And this is, um, my physician friend. This is Dr. Oxana Ormonova. And I'm might have mispronounce that, but I'd like to call her Dr. Oxana Ormonova. So tell me a little bit about yourself, Dr. Oxana.
Dr. Oxana Ormonova: Well, um, thank you so much Janna, for having me here. It's such a treat, but, um, anyway, so I was born near Mongolia and I grew up in Siberia and I went to medical school in Siberia.
And since I was a child, I was very intuitive and I could see things that people could not perceive, right? Yes. And at the same time, I was very, very sensitive. I was sensitive to other people's emotions, um, other people's problems, what they were going through. And, uh, my mom was a physician and I used to make rounds with her, you know, in the hospital when I was four years old.
So, and I always wanted to help people and I always wanted to heal people. So naturally I went to medical school and. Even when I was in medical school, after my lectures, I will go to local clinic and I would put, um, I did hands-on healing where I will put hands-on, uh, people and they were getting better, so their pain was going away.
Uh, they were saying like, oh my God, what did you do? Right? Um, finally, I'm, I'm feeling better and I would go home and I would be just, You know, exhausted. I, I will be just go straight to bed. And I was not realizing back then that I was putting, you know, taking all the energy and absorbing all the emotions.
All the pain, and I was, um, taking it on. And then, um, also many years ago in my training, I was doing, um, rheumatology elective. And of course I was, uh, thinking, oh my God, it's going to be so easy. It's not a surgery rotation. Right. I can, um, get plenty of sleep. It's going to be like a, you know, uh, almost like a vacation, you know?
Right. And so after a few days working, and again with outpatient clinic in this rheumatology, Office office, I started feeling depressed. I was getting all the aches and pains, my joints were hurting, and I was young and I said, what's the heck, what's going on? And I was looking to, um, my attending and she said, oh, it's, it's okay.
I feel like that all the time. And she said, why don't you start taking, um, just. Small dose of antidepressant, you can just take half a pill of antidepressant. And I said, oh my God, I'm in the beginning of my medical training. If I start taking antidepressant now, what I'm looking down through, this is not a solution.
And so, um, and throughout my journey, journey, um, I've been on a, again, um, I tried a lot of different me meditations and, um, You know, I'm always been a seek of truth and so forth, so, and it's made me realize how much as a physicians, we are taken on and you and I see, you know, you are aware of that too. We taken our patients, uh, pain.
We are taking out patients suffering. We are trying to solve the problems and so it's interesting. When I start reflecting, uh, and again, I've worked as a hospitalist for, um, 20 years, almost 20 years, and I start reflecting. I was like, my God, um, why I am sometimes still feeling tired and when I start counting how many patients I've seen throughout my, you know, including med school residents and so forth, and ballpark was at least more than such a thousand patients.
And then I also. Okay. These physicians, we deal with pain and suffering on a daily basis. Um, sometimes we deal with most challenging cases, right? And so I also start thinking how many professions out there in the world who do something like that. It's really right. So it gives you perspective. Where you realize, oh my God, it's not very, something wrong with me.
It's not underachiever or loser or, um, not capable, but it makes you realize, oh my God, this is a lot what I'm dealing with. This make sense?
Dr. Diana Mercado-Marmarosh: Yes. Um, I think as physicians, we just assume that we're supposed to do everything for our patients and then some, right? Mm-hmm. And then we don't realize that sometimes like we have to be the most important patient in the room if we don't take care of us.
Like that could be very draining. But like you said, some of us, um, I'm gonna make a general statement, but usually females tend to. Be more in tune with what, uh, the oth the patient in the room is sharing. And sometimes we, yes, we take our time with them, but like you said, we feel like it's our duty to like solve all of their problems like so many times, like I.
I've been like getting onto good Rx to find the cheapest like medication at the cheapest store so that I could get to them. Like I'm pretty sure most physicians just write the prescription and walk out of the room, but I would put myself in their shoes. If I didn't have insurance, I would want somebody else to go the extra mile.
Mm-hmm. And, and again, it's not that, uh, it's good or bad, it's just that being aware. If you do that on top of whatever's already expected, like it can drain you even more and more and more because of the current system, the way it's set up. Mm-hmm. It's not meant to give you that flexibility to be able to do those kind of things.
Dr. Oxana Ormonova: Yes, and this is exactly what I was going to talk about too, because again, most of us, we go to medical school because we want to help people, we want to heal people. Just like you said, we put our heart and soul in trying to, um, help patients. And exactly what you said, it's not about just providing treatment, it's trying to find a placement, trying to find a nursing home, or, um, somebody's homeless, you know, you try to find place for them.
Right. And so, um, and because people, we are dealing. We're in so much fear. We're in emotional pain, we're in physical pain. And because of that, you, us as a physicians, we see us as like we we're trying to grab onto us, right? We are, we in survival. And so, um, and we're like, okay, this is a person who can help me, right?
And so it's, and, and I don't blame them because this is the way as I add. And so it's almost. When somebody is drowning and you're trying to save them, if you are not careful enough, they will drown you. Right? Because we panic, we an anxiety, they're grabbing onto you. And so it's almost energetically this is how it is.
And um, uh, this patients and in our me medical system, because also medical system is set on principle where patients come to the physician and they go. You are my doctor, fix me. And you probably heard it so many times, right? And we, it, the system said that, okay, patients give all the responsibilities for their health and we put it on a doctor's shoulder and so many of us against raw medical training, it's, it's expected.
We trained like sad and, but exactly what you said. You have to make yourself a priority even when you're on a plane. You know, if I go, okay, put oxygen mask first on yourself, and then put it on your child. Right? So at least you know, airlines got it. Right. So hopefully our, you know, our medical, you know, society and system get, you know, catch, catch up with it.
Yeah. And so, and what happened? As Einstein's, you know, you can't argue with Albert Einstein. He said, everything is energy. So our emotions, our feelings, our thoughts, our en vibrations of our, um, bodies, it's all energy. And so all of us, we are like radio stations. We absorb, um, everybody, you know, our, everybody else, emotions, thoughts.
So, and a lot of times people don't. That some of the feelings we're having, it's not even their own, they're picking it up from a loved one or, um, from their patients. From their clients. I, I work with a lot of coaches too. And so w you know, there is a lot of anxiety in the world right now and, uh, people don't realize, oh, the reason I'm feeling.
Because I'm tuning in and picking it up from what's going on in the world.
Dr. Diana Mercado-Marmarosh: Yeah. So how did you first start to realize that? Okay, so you, like you said, you realized that. All this world is is energy. We are energy. And most of us will always say we're depleted of energy. Mm-hmm. Most of us say, oh my God, I'm so drained, or, I'm so exhausted, I'm so tired.
Like how did you, during all those years, like how did you finally learn to like manage your energy or, or to be more mindful about it so that you wouldn't continue to allow yourself to be so depleted? Mm-hmm. That's a
Dr. Oxana Ormonova: great question. And again, it's. Many, many years of, uh, trying different meditation techniques and, um, practicing different, um, again, um, tools and so forth.
What I realized, oh wait, and it's actually, um, this is a great story. Two days ago I was, um, talking to Mel's physician and I was telling him, oh, I'm going to be, um, talking, uh, on a podcast about how to maintain. Energy boundaries, and so you're not picking up, uh, patient's energies. And, and he's retired and he said, oh, why would any physician want to learn that?
He said, physicians just build walls and this is what works, right? He said, oh, you know, we, we just built walls so we, we are not. Absorbing. Cause, you know, patients pain and emotions. Why would somebody want to learn something different? Isn't it amazing? Yeah. And, and I was just, oh my God. So this person saw that this is actually the way to, to go about it.
And, and I don't notice, notice again, a lot of us doing that. So I would say I'm noticed more male physicians maybe doing that compared to female physic. But again, it doesn't work in a long, in a long term. So let's say if you are running a code and you have to tune out everything around you, um, let's say yes, you are in, you know, in that space for whatever, 30 minutes, one hour.
But if you don't snap out of it and it keeps you, you carry it on for many years, um, days after days. Then it starts affecting your relationship with yourself, right? It's because you are not processing it. So you still, the building falls out of resistance, out of, again, trying to protect yourself. So, and then it starts affecting your own relationship with yourself.
And that's why, you know, there is so much suicide and oppositions with so much depression. It affects your relationship with your children. Um, your loved. So it's not a solution. Does this make sense? What,
Dr. Diana Mercado-Marmarosh: what? Yeah, yeah. Like energy is meant to be, emotions are meant to be like a compass. Like, uh, you know, to understand happiness, we have to understand pain.
Cause we need to understand one from the other, right? And yes, like you said, there's periods of time. It is beneficial to kind of turn ourselves off like in the middle of a code so that you become, quote, unquote objective in whatever you're doing. Mm-hmm. And you focus on that. But after the fact, if you don't reflect or even take two seconds to realize that you were dealing with life and debt situation, that you, that life is fragile, like, mm.
Like if you don't look at like, what if that would've been me on the table, or what if it would've been my family member or, or my husband, or whatever. Right. Like if you don't reflect the humanity of it. Mm-hmm. Like you could miss the opportunity of what you were in front of. And when we don't reflect on it, I mean, even though while you're going through it, it sucks.
Mm-hmm. If you don't reflect on like being grateful that you are still breathing, that you are still here, right? Then you miss the opportunity to process. Like what a beautiful gift you could have given to that person if you brought them back and now they had a chance of X, Y, Z for many years to come, right?
Mm-hmm. Or if you didn't bring them back, knowing that you did the best that you could in that moment in. Yeah. And so, uh, so I think in, in terms of that, I can see why it's a protective mechanism and I can see why it's helpful, but I can also see that if you do that one too many times without the reflection part of it, mm-hmm.
You can get lost.
Dr. Oxana Ormonova: Mm-hmm. Yes. And this is what I see in, again, in so many of my clients, they say, I feel disconnected, or I have a hard time forming connection with people or, and, and most importantly, um, having true connection with yourself. So with your own emotions, right? And so, And
Dr. Diana Mercado-Marmarosh: again, and I think Covid, sorry to interrupt you.
Mm-hmm. I think Covid did a number for all of us. Like yes, it ma it forced us to realize that maybe before we had a community we could tap into and like you felt like, oh, they can help me. They can help me. Mm-hmm. But then when everybody was functioning from a place of fear, from a place of like, oh my God, I'm gonna bring X, Y, Z to my nanny, or to mm-hmm.
Blah, blah, blah. To my elderly neighbor, I'm gonna be the one getting them sick. They're gonna die. You then kept away, right? We were no longer in community, and all of a sudden you were even more drained because you didn't have that extra help that you needed, and therefore you were even more depleted with your energy.
And again, we were functioning from a place of survival like you were just. Trying to survive. And then well, and, and for some people like that's primary care physicians, but I know some like specialists that were told like, we don't need you go sit down. They were like in heaven because they're like, Woohoo, I have to get one third of my patients.
Right. So like mm-hmm. But at the end of the day, I think it was tiring and draining for physicians because while everybody. Or were forced to take a stop and reflect, or not reflect, but at least take a stop. Like we were never given that freedom. Mm-hmm. To take a stop or like, unless you quit because you know you had some mobility or you felt like you couldn't handle whatever, or whatever your point was.
It's not that you couldn't handle, but you made a personal choice, right? Mm-hmm. So for the most part, I feel like in the last three years there's been a. Cultural, mental physician, mind awakening. Mm-hmm. Realizing that maybe being drained. I wasn't drained when I was at home. Maybe this is not the norm.
Maybe I shouldn't be drained all the time. Right.
Dr. Oxana Ormonova: Because it's, again, we, we are so used to it through medical training. Um, it's, it's like it almost becomes a norm. And I still remember when I was a resident and I would be like, oh my God, I'm on call every 36 hours. And some older physicians would say, oh, why are you complaining?
Um, when I was in my medical training, when I was a physician, I was on call every single day. Yeah. So it's was, and this was a standard, right? So this was, you know, expectation and it's. Interesting. You know, what I see with some of the, um, some of my clients who have a D H D, and again, I work, uh, with a a D G clients, so I, I see it on a different, um, again, on a different level.
So I, coming from perspective, looking at energy, um, again, being intuitive, um, being a spiritual healer and what I see, um, in a lot of people who have a d h. They have tremendous amount of creativity. They're super creative. Um, a lot of them have a lot of energy. And so what's happening is you, you again, especially, you know, when we are kids, right?
Our school system is trying to put everybody in a box. It's like a cookie cutter right system. And so a lot of those kids, they don't fit in. It's, you know, they have maybe more creativity that other kids have in, in, in the class. And so, and then we, you know, we get labeled you too much or, you know, get quiet or, um, don't, don't talk.
Right. And so, um, and another thing is, again, a lot of them I see they're very, very cap. But because through their life, again, even since, um, we were kids, we maybe were invalidated, we were criticized. So it's, you know, it starts, um, affecting them in a, in a, in the long ground. And sometimes I think about, um, little Mo.
You know, when he was a child and every, you know, and he was super creative. So I think if he was, um, you know, in present time and he was in school, he would be labeled a A D H D, right? So, because people, um, didn't know, would not know how to handle, handle him and handle his creativity. So, and another thing I noticed because.
ADHD people, a lot of them have a lot of creativity, so people around them, I mean, they recognize in some ways how capable the person is, and they go like, oh, why don't you do this? You have so much energy, or Why don't you do that? And then sometimes you taking it on and on and you end up with, you know, your, your plate is full.
So, You can't catch up with all those things on your plate. And then those people who gave you all those tasks start criticizing you. They're like, oh, you better time management. Or, um, but you didn't finish that. So, and like you said, learning, like what you're learning is how to maintain boundaries, right.
Or how to set boundaries and, um, which is so, so important.
Dr. Diana Mercado-Marmarosh: Yeah. So, uh, it's, it's coming to understand that you. There's certain executive functions and some of the, some of them we are better at than others. Like, you know, maybe you're good at planning. Mm-hmm. Maybe, but maybe you're not so good at task initiation.
Right. So you can plan, but you're not gonna ever start the task. Or you have a lack of awareness of how long it's gonna take you, you know? Mm-hmm. A time, uh, or you feel like, Have a month and then before you know it, it's like I have a week. Oh my God. You know? And, and so I think realizing that, why are we saying yes before looking at our calendar?
Like maybe we've been conditioned to say yes and we don't wanna feel like we're disappointing somebody. Yes. So that boundary there might not seem like a big deal. But if you just kind of said, Hey, let me look at my calendar and I'll get back to you. Like, it's gonna save you so much drama, because then you're gonna realize, oh, I was already overbooked.
Or you're gonna realize you were not even in town that week and you said yes to something. Right? And so I think we, we forget that part of these boundaries have to do with, again, the in. Realization that we wanna belong. And, and it's not that we're trying to people please, but we want them to like us. And of course we wanna say yes to everything.
Mm-hmm. But saying yes to everything you're, that you're saying no somewhere to something. And it's likely something to yourself that involves you and your self-care and your self rest. So, um, those boundaries, when you implement them, they're really meant to be there to protect your energy and.
Dr. Oxana Ormonova: Exactly what you said.
And, and another I want to add is because again, I see people with, uh, A D H D, they have a lot of creativity, a lot of creative energy is, uh, learning how to channel it. So, because when you have so much, right, you could do this and you could do that, and you can do, um, you're so capable, you can do 10 other things.
So choosing, um, again, what you were mentioning, prioritizing, so it's, oh, Or even when I see a lot of people have a lot of gifts, again, creative energy, it's all our self-expression. And so one thing you choose as, for example, you can choose as your career. Another thing you choose as your hobby. So another thing you choose, you know, as your second hobby, whatever it is.
So then it's you channel link your creative energy. You streamline in it, right? So then it's creates less that, um, it's like, oh my God, you know, I don't know what I wanna do. Um, and then sometimes you, um, maybe people don't accomplish, um, what they want to do. So, but again, I just want to validate, um, those people who have a D H D who are listening to this podcast, I want to validate them that, again, some of their.
What problems we're experiencing is because we have a lot of creativity, we have much more creative energies than, you know, maybe people around them. And we have a lot of energy because creative energy is, it's energy. So we just, uh, one types of
Dr. Diana Mercado-Marmarosh: energy. And I, and something that came up, um, and I can't remember if it came up during one of our coaching sessions when you were coaching my group or when you were coaching.
Oh, uh, when I went to one of your workshops was the, the fact that some strategies that are meant to protect us. Sometimes don't because we don't give ourselves the time to implement them. Like the sleep, right? The exercise, like, uh, the low carved diet, like sometimes we don't realize that those do play a role in there somewhere.
And then we wonder, why can't I focus long enough, right? Mm-hmm. And, and we don't realize that all those are affecting how we're showing up.
Dr. Oxana Ormonova: Absolutely. And. As we were talking, um, again about how we absorbing, um, others, our patients energies and so forth, it's, you know, first the key is awareness. Even recognizing that, validating yourself, going like, oh my God, I've seen in my life thousands and thousands of patients.
Um, how many people out there in the world even capable of doing what I'm doing? I. So many times my friends would say, I don't know how you do it. I would never be able to do what you do. And so, and given ourselves a break when let's say you are on your day off and you're beaten yourself up because you're like, oh my God, laundry's piling up and I have no energy to get to this, you know, pile of laundry.
So give yourself a break. Don't beat yourself up and realize. I am going through a lot. What I am dealing with is a lot. And so then you st instead of invalidating yourself, you start validating yourself. You start recognizing your power. You start recognizing your capabilities. And another thing, what I, uh, teach people might be helpful is when you start feeling, for example, sad or depressed, or you're feeling anxious, you can ask.
Wait a minute. What I'm experiencing right now are those my feelings or I'm picking it up from somebody else because majority people on the planet, we are not aware that we are constantly picking up other people's emotions and thoughts and including with thoughts. You know, if you're thinking something, um, you know, And your life is doing okay and all of a sudden you start, you know, having some weird thoughts.
You can ask yourself, okay, are those my thoughts? Or I'm picking it up from somebody else. So yeah, and then you can ask like just such simple think, you can ask your awareness and say, okay, my awareness, I want to be aware of my own feelings. Please, let's shift my own feeling. So, and again, everything starts with awareness.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. Everything does start with awareness because again, if we just assume that, that what I'm feeling or experiencing is because of something I did directly. Mm-hmm. Um, like we might miss that. You know, we, we can control our thoughts and feelings sometimes when we're aware, but if we're not aware, we, we feel like we're giving away all our energy to other people.
Right. Um, and, and we all have had those difficult patients sometimes where you just feel like exhausted and drained. Like they wanted 20,000 things. Then you're like, oh my God. And they're like, energy vampires. It's like, gimme back my energy. Take back your monkey. Like I don. I don't wanna keep your monkey, you know?
Um, but I think having tips and strategies to protect and refuel our energy would probably like be something that you guys can start to implement today. And it could be very, well be something like, um, Being mindful before you walk in the room, like making sure mm-hmm. That you know you're fully present and making sure that after so many patients, you're taking a break or you're for five minutes of meditation or just a water break, or just going outside, like something that is not like patient related.
That, I mean, just throughout the day, sometimes we charge your phones because it's dying. Like why wouldn't we recharge ourselves? Yes.
Dr. Oxana Ormonova: It's so important what you said. I love you. The analogy you said, we chat your forms. I was like, oh my God. This is, this is, um, such a great analogy. And also, um, you know, having this, like you, just exactly what you said, having a system in place where however it works for you, so is a, you have to have a, um, you know, After you see five patients or, um, whatever it is, or you have to after work, at least walk in nature for five minutes.
So, and also recognizing that we are all different and recognizing what works for you or what works for somebody else might not work for you. So for somebody seeing 25 patients a day, it's not a big deal, but maybe for you. Um, seeing 15 patients a day, this is your limit, right? So, um, after 15 patients, you, oh, 10 patients, whatever, whatever is the number.
And so not invalidating yourself because somebody else, um, achieving more or, um, seeing more patients, right? Because we are all, all very, very different. And when I'm teaching, uh, physicians and coaches about how maintain. Energy boundaries a lot of times, um, because it's exactly almost like, you know, built like this physician said, oh, we just built walls.
What's a big deal? Uh, but it's coming out of resistance, coming out of fear. And so when uh, people tell me like, oh, uh, how do I protect my energy? And I teach them it's not about protection. Because again, when we think about protect. They're coming out of like, we have to wall something off. And so I'm saying, oh, you're just learning how to maintain it.
How to maintain and replenish. So then you are not, again, you are not trying to, um, build like a, a wall wall or fortress around you because you phrase it.
Dr. Diana Mercado-Marmarosh: Um, yeah. So when we're asked to multitask, We might be able to do one or two things. Exactly. Then you throw like five things on there. Then you can quickly see why our brains become overwhelmed or anxious or mad.
Like we are like, you know, we don't wanna be bothered, and so, mm-hmm. I think those are the type of boundaries that you have to understand your own limits so that you don't get to the place where all of a sudden you look like you're just blowing off steam. Mm-hmm. Because you weren't even aware that.
What steps did I miss three decisions ago? Instead of just saying, no, I can't do this, or, no, let me do it this way, or let, or let me ask a clarifying question. What is the priority here? Is the priority seeing that patient right here in the clinic? Or is it seeing the patient in the hospital or is it writing this, uh, these orders that you just brought and you pulled me out of the room for like, what is the true priority here so that we can reach.
Whatever needs to be reached at the end of the day. Mm-hmm. Without feeling like you are the one who's depleted and then being labeled as, you know, misunderstood or not the team player. And then, uh, we get ourselves into trouble.
Dr. Oxana Ormonova: Yes, exactly. And you know, when I, one of the tricks I, I do, and sometimes I teach also, Physicians, it's, you know, after you see a patient and you get out of the, you know, came out of the room and you washing your hands, but while you're washing your hands, you can just imagine that any energy you picked up from the patient just drains down the sink, right?
You just washing it off, like you cleansing it all from your energy field. Um, all the pain, all the emotions, and just being, again, aware of it or being mindful about. And then you just go, oh, I just wanna feel my own energy. Um, I want to be rep. Replenish is my own vitality, my own life force. Um, so this is something what people can do.
And again, our system is built on. I don't know about your training, but when I went through my training, it's almost like you're supposed to feel your patient's. And I heard, and you probably heard too, from so many patients, um, I would try to cheer them up and I would be, okay, you know, let's make you feel better.
Let's, you know, get you home. Um, and they would be a, oh, you don't know what I'm feeling, so you don't know what I'm going through. You are not feeling my pain. And it's almost like accusation. So, and sometimes again, this is, um, how we trained. Oh, we have to, we have to do that, but it doesn't help our patient.
It doesn't help us. And this was again, what I teach, um, physicians. It's how do you, what's the difference between being in sympathy to somebody, being in sympathy to your patient versus, um, being in a state of compassion, which is very, very different. Yes, this is would be another great reminder.
Dr. Diana Mercado-Marmarosh: Yeah, those are amazing tools and tips there.
Okay, so if people wanna reach out to you, where can they find you? Uh, do you have an email to share or, um, should they just reach to me or how should we, where can they, you have a website you can share with us? Yes. They can find
Dr. Oxana Ormonova: me on, uh, my website and it's Divine Wellness MD dot. I'm also on Instagram, the same name, divine Wellness mg.com.
You can email me, uh, and my email is aana and divine wellness mg.com. And uh, I'm also Lincoln. So yes, would love to connect and I love your podcast and I love, um, how you're helping physicians with A D H D and. Yes, you are a trailblazer.
Dr. Diana Mercado-Marmarosh: Thank you. Now, if my physicians just started paying attention because we have wandering attention mm-hmm.
Um, what is one takeaway point you want them to have?
Dr. Oxana Ormonova: Well, is again, to recognize how capable they are to recognize that part of the label. The society labels them as a D H D. Because they have a lot of creative energy. They have a lot of energy and learning how to channel it in the right direction and use it to their advantage, instead its resume becomes like a destruction, right?
So, um, this would be take away, be besides what we already talked about. Talked
Dr. Diana Mercado-Marmarosh: about. Awesome. So what do you hope to do for fun in the next three? Oh,
Dr. Oxana Ormonova: well, um, I enjoy teaching. I enjoy teaching physicians and, uh, coaches and, um, doing my one-on-one coaching. So, and um, yes, building the practice, serving people, and, uh, it's my, my passion again after Any, any travel
Dr. Diana Mercado-Marmarosh: plans?
Oh,
Dr. Oxana Ormonova: always. I love to travel, so, and I love to travel to foreign. So, um, I love learning about different cultures and meet people from different parts of the world. Awesome. Yes, definitely.
Dr. Diana Mercado-Marmarosh: So, all right, well, thank you so much for your time and for your amazing advice. And there you have it. You, you guys have to start implementing some of those energy boundaries.
It could be as simple as remembering to allow all the energy that is not yours to be back to its source and you keep yours and. Being willing to, to ask yourself, what is draining me? What can I let go of and what is refueling me? What can I do more of? Because the things that are fueling you probably have really good dopamine for you, and you should do more of those so that you can show up better in the world.
Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free masterclass and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave, work at work, and re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain so that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all. What kind of view you're gonna have after this conference? Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in a personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits, We're just as important as learning the new set of skills.
Hello. Hello. How is everybody doing today? I have a very special friend with me today and I'm excited because I've been wanting to get more men to come to my podcast so that we can share all the resources. So I have a very special guest his name is Simon Arnold. And he comes all the way from Germany and isn't it exciting?
And he's here to talk to us about his journey with how he got diagnosed with A D H D, but also he's actually like changing the world. He has a book and it's called The 13 Hour Life Coach. And so I wanted to just bring him here and. Have him talk to us about why he wrote the book, and I will explain a little bit about his book a little bit later.
But first I wanna introduce you to him and hear how he came about. And I, some of this that I'm asking is in the book, so you gotta. Buy the book, but he will, he'll give us
Simon Arnold: a preview. Yeah, exactly. Thank you so much Diana, it's so nice to see you again. Really? So yeah, I'm the 13 hour life coach and I was diagnosed with a D H D Wow.
Three years ago now. And I went to a psychologist and he basically flipped his book through with what ADHD was and said, I think you're right. And I was like I'm right here. And I needed to help myself. There was really no. Help for adhd, certainly three years ago, and I wrote, I think about 107 strategies to help me live with A D H D.
And And I find them to be working. So yes, .
Dr. Diana Mercado-Marmarosh: Awesome. I'm gonna just read what the back of his book says, because this is gonna give us so much material to dive into the conversations of this book. Simon realized one day that the external life. Distractions had disappeared and that he could read and comprehend a book for the very first time.
And he came to face with his inner voice. We all know about that inner voice, right? He was recently diagnosed with a D H D and he labeled his inner voice or he Big Mo and Big Mo basically, Is able to add clarity to his life while he's on medication. So that's the key here. He feels like he's able to concentrate for about a full 13 hours while he's on medication and every da every day.
When Big Mo leaves, then he realizes that he's thrown into a world of confusion together. Big Mo and Simon. Learn to figure out a D H D in a unique way of using diaries. So he's able to understand himself through those moments of clarity. Not only does he do that, then he turns around and he creates a successful.
Group in his town in Germany so that he could, they could each help each other learn strategies every day. He has clarity and then confusion, but obviously a strong bond happens now here he is being a coach for others. So tell us what was it like to finally get
Simon Arnold: medicated? Okay, so I was, It was during my diagnosis process, really.
My son already had ADHD and was medicated for it. I was completely under doctor's orders, allowed to take a tablet just to see how it, worked in my body really. And I took it and I found that my outer distractions were all gone. Diana the sound of the trees, the chirping of the birds at the windowsill, the yeah the cars three, three roads away.
I would hear them on a daily basis and all of a sudden I just had clarity and that was really the first and we can go in into this later. I'd search for 34 years for this. And I got to where that I where I wanted to be since I was eight years old. I knew something was wrong with me from the age of eight years old and I was determined to find out what it was.
And it was a d h D really. Yeah, the, I could concentrate for about four hours, I think. I knew exactly how I was filing paperwork at the time and I was like, wow, that goes there and that goes there and that can go in the bin. And my inner voice came out and I call him Big Mo and we can go into this bit later.
Big for just the feeling I have when he's around and mo for the moments that he's here with me. So that's really the start of everyth.
Dr. Diana Mercado-Marmarosh: So when you were eight years old, you said you knew. What was it that you knew? What did you feel like? Did you look around and people concentrating? Or did you feel like you were daydreaming so much?
What did you knew? At the age of
Simon Arnold: eight, I can. I can go right back to the exact, not the exact day, but I can go right back to the moment in my mind, sitting on the on the red thick carpet in England, of course, where I grew up and yeah, I was eight and I just sat there and I thought, There's something different with me.
I'm different to everyone else. I had to go on belief in faith hope and faith, and, but I had to find out what hope and faith meant, to be honest, at the age of eight. So it took a few years to get there, but I had the, I always had the inner feeling without having the inner voice. That something was wrong and I was determined to find out what it was.
Dr. Diana Mercado-Marmarosh: That's good that you had enough insight there and that even if it took three decades , to finally get the diagnosis. When you did it finally made sense. And that's also a sign of like understanding that we are always on our journey and we're always gonna be life learners. And realizing if you're not at a place where you want to be, Or things are not exactly as you wish them to be.
Like you have the opportunity to change stuff. And in your book, I was kinda amazed by some opportunities that you took . Oh, thank you. . You decided you wanted to become a physical therapist, is that correct? And you decided I'm not gonna do it here in my hometown. Lemme just go to another country and see what that's like.
Can you tell us what that was about? ?
Simon Arnold: Oh my God I'll never forget that I was on the computer at home when we had dial up internet. It goes bing bing. And then, The, the sound, it takes forever. And my mother was in the living room and I said, yeah, I just I feel so great. And she goes, why'd you feel so great?
I said, I've just booked a course for physiotherapy at the Best Physiotherapy school in Australia. And she says, How much that cost and I showed her what it cost on my credit card statement online. It was 6,700 pounds that I paid straight off, and she nearly fell off the chair in amazement. ?
Dr. Diana Mercado-Marmarosh: Yeah.
So people with A D H D are risk takers, right? ? Yeah. You describe what I think most of us with A D H D in the book about having a dream and going for the dream, but sometimes, unfortunately, the dream doesn't always pan out like you wish it would. Would you tell us a little bit about. Yeah.
Simon Arnold: Wow. It was the dream to be a physiotherapist.
So in England, we say in English, we say in England we say physical therapist. You say physical therapist. That's right. I over I, I basically, When I paid for the course in Australia, I had, I knew no one in Australia. I didn't have any money, put it on the credit card, but somehow I came, and this is where it comes from this, I somehow run into people or they come into my lives and it's hey.
My parents live like 20 minutes from the schoolwork the university where you wanna study from, so I went to Australia and due to the executive functions and memory recall, really, I just didn't have a clue. And it, I can I describe it now as just having a mind that's like a siv.
And that, whatever information comes in, it just goes straight out. Nothing stays. So I re, over a long time I tried in Australia with no funds to go further. I didn't have any money for shoes. I had to phone up my father and get, yeah, that was hard. Brunelle in London first year, no idea.
Didn't have flu. And then in Berlin, As well. And bear in mind, I spent all my free time at a friend's private practice from the age of 17. So the first attempt for physio was about 2025, so I had a good five years of solid experience in the area and still didn't do, and still even today didn't pass it.
Dr. Diana Mercado-Marmarosh: Yeah. And so I bring that up because, I'm pretty sure if you had decided to practice physical therapy, like you would've been amazing because you picked it all up from experience, right? But again, you didn't know what you didn't know. You didn't know that your executive function, attention to detail organization, you name it, right?
Giving you the possibility or ability to only capture written stuff in a short window. And so you were picking up parts of it and your knowledge was not necessarily reflected on what you had learned in. The actual experience of being there and doing the things, and I'm sure everybody complimented you on your bedside manner and ability to, for you to optimize the treatment to each person because of how much you were so in tune with it.
But it was. The written part could have kept you out or maybe you didn't have enough time to finish test or different things like that, right? And so I bring that up because people always say, okay, they graduated from blah, blah, blah. As if the degree is what makes a person. Have the ability to quote, unquote, be labeled as success story.
But it's not that, and it's a, it's an understanding that you, there's so many different areas of knowledge and so many different things and all those, at the end of the day, while they might seem like filled experiences, their still experiences, that what I see. Got you to bet on yourself and bet on your dream and keep trying and trying.
Most people probably without a d h, ADHD would've given up after the first or second time , right? But. Not somebody who knows their why and what they want to do and so that is something that is to be admired. And all those experiences, they don't negate us. They actually propel us and they continue to help us because now you can relate to all your clients that you're teaching with a d h, ADHD because you understand exactly.
Drive and that almost stubbornness. But at the same time, it's excitement, right? Yeah. It's like a mixture of both. It's excitement for the unknown and, yeah. And I know like you're ready to move to a new country, right? Yeah. You wanna tell us about that, ?
Simon Arnold: Yes. I've wanted to move to Seattle for three years, so if anyone can help me out, please help me out.
And . It really starts in the morning with meditation and, just imagining being there and just using all different techniques possible. Yeah, just to be able to experience it. I think I said to you recently that, three years ago a and Seattle was really the A D H D hub.
Somehow, I'm not sure whether it is now, but it was really big on A D H D, which is strange because h d's coming out more now. It was different three years ago. Yeah, that's my goal. Pretty much everything at home here in Germany is pretty much sold and my goal is to land in Seattle with two suitcases at the end of September.
Dr. Diana Mercado-Marmarosh: Woohoo. That's around the corner. , how exciting. Let I wanna ask you about that group that you formed in Germany when you finally got diagnosed with A D H D. Like what were you thinking? What was propelling you? Like, why did you decide to make this group?
Simon Arnold: Okay, so I'd written the book. I actually launched the meet up h d in the , bay where I live in Southern Germany, the group.
And it ran for 13 months. Once a week I would go and either to a park where we could go for a walk or into the town 20 kilometers away. And a lot of the time, to be honest, I just turned up hoping that people come. To be honest, I had my little A for a D, H, D, not adhd. So everyone I go, Hey, oh my God, these are the weird guys.
I just wanted a, I just wanted the A, so it looks like maybe it's insignificant, right? Except to my group. I knew that other people needed help cuz I didn't get hit. That's why ,
Dr. Diana Mercado-Marmarosh: and how was it? What did you, I know you went with no expectations and I know you went because you didn't want others to go through what you went through.
What kind of friendships did you develop?
Simon Arnold: Here's the twister. Okay, so the meetup group ran for 13 months. People would continuously write to me and say, yes, I'll be there. And I turn up at the event. And there was one summer in particular. It was so busy for my d h d brain in a beer garden. It was so full.
The lady had given me a table in the middle of all of these hundreds of people, and no one turned up. Basically the characters like Riker in the story for the walking and everything else. That's really experiences of my own because A D H D didn't have the open following like it does now. I am really sad to say actually.
For 13 months, not one person turned up. And then three days after I canceled the course, I met the first person and just had the most amazing connection ever with our, with both of our inner voices. And and we helped each other. But that was hard. That was hard. So I basical. I all the stories in, the walking and the, and everything in the chapter, which I'm talking about.
They're all my experiences, but I real experiences, but I put them into different characters to explain it so much better.
Dr. Diana Mercado-Marmarosh: And that's the thing with a D H D, like sometimes we overcommit or sometimes. We are just not good at timing. . Yeah, true. We have the best intentions. Yeah. And so sometimes it just doesn't happen.
Or like you said, three years ago, label was not something necessarily to scream at the top of your lungs. Because even for me, you, we, you and I had this conversation. Three people knew I had a D h D three years ago. Yeah. Yeah. And now it's I say it like it's sky's blue type of thing.
Yeah. But it's because of the work that we have to do with the inner voice, like you said, because our mind might tell us that we are broken. And and it's a running thing and we don't want anybody to know that we're broken, and it's not true. It's just our mind is different. It's like being left-handed instead of right-handed.
And there's nothing wrong with that. It's just that you maybe weren't aware that your innate thing was this way and we being conditioned to do it the other way due to culture, due to society due to expectations of gender roles, you name it, and so again, that also shows your ability to keep showing up, right?
Like you kept showing up regardless. Yeah. And so all those seem like it's the bittersweetness of it, like you said, like when you decide, okay, screw this , and then you have the most basic conversation. It's almost like society's okay, fine. I guess the universe will conspire against you to make it work.
Yeah. Thing is, like you said, you're getting closer to the A D H D hub in Seattle, and hopefully in November we can meet in person at the chat conference. That'll be great. . Yeah, like there you will see like your tribe, like every single person in the room, just picture like 2000 people a, d, adhd.
, and they're giving like lectures and they'll be giving the lecture and then halfway they're. What was I saying? And everybody's laughing. They're he, and they're like, no, I'm serious. I lost my train of thought.
Simon Arnold: Where was I? . Yeah, exactly. It went out that way. . Yeah.
Dr. Diana Mercado-Marmarosh: And so it's like the norm.
And it's funny, and it, and you don't have to explain it because people just know and yeah. So I think that your book. So good at explaining some of those cultural cha like some things that, like you said, I grew up in UN, in England, and then you going and marrying your wife from Germany and living in Germany and the difference in their style of speaking and.
You trying to make sense of all of it. And it's in, in us realizing that we, with a d, adhd, I think we, we learned to use people pleasing skills to survive and at some point we don't realize that. No, I just have to be myself. Like I don't have to do anything else. And we forget who ourselves our true, authentic self is, but it is this work.
This is why now you're a life coach to help us to be ourselves. And so what do you think was like one of the hardest thing in, in writing this book? Because like to me, I'm amazed like one day maybe I'll write a book, but to me right now that's something that's oh my god, that's mind blowing.
But I know you. Thousands upon thousands, about thousands of pages that you write, and this is how your mind helps you clarify things. What do you think was the funnest or hardest thing in writing this book?
Simon Arnold: The easiest thing was actually spending two days every day for a year and a half writing the book.
That was what, then people are in one. The 1% of writers that actually do this, I wasn't as good as Stephen King. Stephen King managed three hours a day. I think JK Rowling managed two, two hours a day, and I wanted to stick with that. And I did. I did that quite easily with my journalism background.
I'd written a diary every single day since 2006, every single day, so I could actually compare. Was different now than it was back then. I had half maybe a quarter written a book on culture as well. And I pretty much put everything together. But there's a really good point that I just wanna bring out actually.
Of course I live in Germany. I speak fluent German, which is fine, but I actually never felt part of society in England. I never felt part of society in Australia and also in Germany. So that means that I've never. I've belonged to any, anyone or anywhere. And this is where self-care comes from. If you've got no sense of belonging to other people or social systems, like I've got zero.
You build up the insight because that's where it all comes from, right? And I know that for my whole life. Hopefully with the A D H D chat conference and this area, this is my tri. But up until right now and this day I've I've always had to do it by myself and lead from myself, through myself as, give myself as much confidence as possible to go on, that's, if that answers the question.
Dr. Diana Mercado-Marmarosh: Yeah. And that's one of the hardest thing I think because our brain is conditioned to not think that way. Our brain is conditioned to think in the negative to make us think no, let me keep you safe. Cuz that's gonna be bad if you do that. And you're right, like community.
And belonging, like those are the things that are primitive and need needfulness. Like we all want to be loved and accepted. And if one of those two is threatened, like our identity or self-worth or self understanding of self, like just get shattered and exactly. That's why I created the A D H D group for physicians.
And again, it was not because here I am and I got all my shit together, but it's because I have figured out some steps and I wanted to share that. And in normalizing it. You then learn more steps and you learn from each other and you enhance each other and it, and we're not doing it again cuz we're broken, but we're doing it because we're just trying to be curious to see if there's a different way.
And all along you have to be that true. Both internal true leader and also that like referee no stop. You're being, you're gone way too far in. But at the same time, like we know that sometimes our brain like will tell us things and it can be traumatic and that's why it's important to realize that inner dialogue and that self-reflection, whether it's through meditation or it is through writing is so powerful when we actually sit down and do it because makes you focus.
like it makes you focus on what it is that you're trying to put on paper, right? Like not just sentences and sometimes yes they can free flow, but then you can go back and understand what you were trying to point at. And it's so much easier. And I think that most of us don't want to sit down and do that because we have this sense of it has to be right the first time, but.
You didn't learn to walk the first time like you needed to try different things. So that was genius that you gave yourself two hours every day because it's not in wanting to do two hours for two weeks and putting all this pressure on yourself to have this perfect product, but it was a, the muscle, the repetition, the trusting of yourself that something from there was gonna be life changing or worth sharing with the world.
Simon Arnold: Yeah. They, they say when you've written a book then the work starts. You have to basically every day you have to promote the book, of course. And just keep going. Do you wanna know the reason why I started the podcast, which by the way, next week is its first year anniversary.
Woohoo. So tell us. So I'd written the book and I was like, is this for real with this a d h D? Am I the only one experiencing this? And my first ever episode was called Blackouts, right? That I just basically came to the. Realization that there's no way I could have a blackout because I couldn't store the information in my brain anyway.
Cause it was like a si coming out. Yeah, I did a whole season, of course, 13 episodes, you're magic
Dr. Diana Mercado-Marmarosh: 13, huh? .
Simon Arnold: Yeah. It's amazing. And and then I spoke to Annie Bush a a brain coach and she actually said about, the free frontal cortex with the medication actually getting the signals and.
Retaining the information and basically said that blackouts, what I'd said on the very first episode was true . And and then the guest series started and I was like, Hey, we've got stuff in common as well. You feel the way I feel, whether it's male or female. And then of course we met, didn't we?
And, Narissa Bower and everyone I wanted then of course, To move from normal people with a D H D to medical professionals like yourself to actually say this is how we all feel as a generation and the people. Let's put it to the doctors and see if it holds water.
And it did. I'm running in typical A D H D style for the one year anniversary. I'm running three seasons at. So I'm running the Kids Edition ages six to 12. The Gen Z edition 13 to 19 for girls, young women, adolescents and season nine, which is adults. Can I explain what, what's coming , please do.
I'm now launching within the next week a it's called the gen. High functioning d h D program for the ages of 13 to 19, and it's a 12 week course. The mothers that have got in contact with me, especially for girls as well, from the ages of 13 to 19, we have a half an hour conversation twice a week.
It's what's gonna happen. We go through a theme. I'm very flexible with what they need to go through. It's always best that, a parent actually accompanies the teenager during the chat as well. Whatever age it is, really boy, boys or girls or young adults. And we just go there and we just do this together and just make progress in the best way possible.
Dr. Diana Mercado-Marmarosh: That's awesome. Yeah. Yeah. It's so good to be able to have a community of the same age group and it doesn't matter. Once we are adults, like we all. Mingle and stuff, but there is a difference when you're talking to kiddos versus when you're talking to adult. And so it's good that you are giving them each their space to be able to have that flexibility.
But yeah, that's her A D H D we. Yeah, there was a time also, like I just realized, like in January, I started my 10th cohort. I didn't realize it was my 10th cohort. Like I've just been doing this for about two years. But in one moment in time, just like you, I had three cohorts going at the same time, plus a full-time job, plus you name it, right?
And. . When we get excited about something and we are aligned with our purpose of what is meant to be, it doesn't feel at work. It feels so much fun. And then you're like, oh my God, I'm getting a little tired. Maybe I should slow down a little or reevaluate how to do things. But yeah, that's so cool. So tell me more about do you have another, like bookwork or is it just going to be your coaching for.
Simon Arnold: The second book's already written. . Yeah. I just need to basically edit it and then publish it. Perfect. There's lots of things going forward there. Lots of things. .
Dr. Diana Mercado-Marmarosh: That's amazing. Can you do one, you ready for the sec? The second one's written and now it's gonna give published soon. That's so
Simon Arnold: good.
Yeah. Yeah. And I talk about quantum theory. I will really go deep into metaphysics and actually. It is really neuroscience kind of geeky stuff, to be honest in certain areas. But also and people have said to me, how can you do this A D H D stuff? It's really heavy. And I said if you look at me, it's, I don't make it heavy at all.
We know that there's some real serious issues. If I can explain a serious issue actually The re the time when I was writing my book, there was a Canadian study. And this is what has gravitated me towards teenagers actually is the fact that the suicide rate for males was 5% and it was 9% for females.
And then they did, so that was April, 2020. I think. I'd have to have a look at the source. The middle of 2000 and 21 males had gone up to 9% and women had gone up from 9% to 23 and a half percent. I always crying my eyes out, Diana, when I was reading this stuff. I thought, this is a call to arms and I'm in a really good position to do this, so let's do this.
So even with that information, and you as a doctor, I'm sure you hear a lot of these real life events and causes and everything, but we have to know that, push it to the side, carry on with our work, keep it all upbeat, find new ways to move forwards and just make everyone's life so much better.
Dr. Diana Mercado-Marmarosh: Yeah. You are hitting on something that is so real. Again, Prior to the pandemic, we really didn't talk about mental health like, or we really didn't talk about A D H D because we just assume it's a kid being shy in the back of the room, or it's a kid being disruptive or whatever. Kid being lazy, right?
They're not doing their work as they need to, and we just dismissed it, but it was. Okay. Quote unquote, because they had a community they could still come back to, like they had a teacher, they had a coach, they had different people they could do, right? Then pandemic happens. Then all of a sudden it's you and mom doing home homeschool or doing virtual thing or doing something, and it's.
Not that human connection that would have allowed you to understand more stuff, right? And all. And maybe if they are on the computer, what are they doing? They're looking at social media at the picture, perfect thing, and da. And people don't post all their shit. They post all their beautiful things.
And you don't know that pe everybody's going through something different, but you. You don't understand that sometimes the reality is not the reality and you orchestrate all these things. And unfortunately, I've had this conversation too with a lot of ER physicians and I and I see it as a primary care doctor, but a lot of ER physicians say, I used to have one or two suicidal teenagers, like every three to three.
They're like, now I have five per shift or 12 hour shift. That's crazy. And again, and it goes back to not putting mental health front and center and this is why like you and I connected because I think we're both on the same mission of normalizing the need to use all the tools and not make one be better than the other.
While medication yes, can bring clarity. It's not gonna fill in all the other gaps. It's not going to help you set up those behavioral systems. It's not gonna help you to realize you need to go run or to meditate or to dance or to take pause, , or to do all the other things. And so it's so important to know that and then to go forth and change different ways and like you said, we are doing, knowing the why we're doing.
Is what's so important and a lot, and sometimes we, I don't know about you, but we all go into like the you should be doing this for free because da. And it's yeah. But all those hours of me studying and trying to give you the best tools and understanding and grasping like.
It's still work and it's not just work. It's amazing value that you're going to provide to hopefully alter the trajectory of that person's life. And it's not just for that, but when people pay, they pay attention. , they pay attention. And so I'm so glad that you looked at that data and I know it's coming because you have your kits and you would.
Thought not to be a sadistic of one of your kids, right? My, one of my nieces like had to be hospitalized, because of suicidal ideations. And you would think, okay, where did I go wrong? How come I miss this? I'm the aunt, I'm the one who, but again, everybody is in their own world.
And you don't think about that. You think about how can, here we are, how do we go forward? What do we do? What's the next step? How do I, how do we, what does she want? What do you know? And so she's doing so much better now. But it takes a community, it takes a village. It's not just like whatever.
And did I talk to her about coaching? Yes, of course I did. But not in a sense like you should like. Think yourself something else, but in the sense that, hey, we don't realize that our thoughts sometimes can be playing tricks on us. Like they're not the real thing, right? Yes. And so realizing that there's always a choice and not making a choice is still a choice.
Can help them feel empowered when they feel like they don't have any say so, because you know their parents are gonna say this, or their teachers are gonna say that and their friends are gonna say that. So it's so important to realize that we all can do something for someone. And sometimes it's just sharing the stories that can allow somebody else to see.
There, there might be a different way.
Simon Arnold: And I just wanted to pick up, actually, even though I knew there was something wrong at the age of eight, I always thought, keep yourself healthy. Keep yourself going. I was never addicted to anything. I didn't do any drugs. I never smi, I hadn't even picked up a cigarette before, and just to do that is, is pretty cool. When so many people just find it difficult. And, another thing, when I was medicated for the first time, I thought, oh wow, this is how people can actually think. This is cool. And then I was really disappointed that so many people just don't take the opportunity to.
Realize the best in their lives really. And when I do, I just wanted to put an extra thing in really that even though maybe unfortunately I haven't been through addictions and everything else, I've seen every manner of in as a physiotherapy assistant in medicine, in cancer unit, in the drugs and rehab.
Orthopedics and trauma and you name it, everything. And that's really where all the experience comes from. It's okay, I haven't had it myself, but I've experienced it from others and this is how we go forwards.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you. This has been an amazing conversation, . Of course. I'm sure we can go and dissect so many other things, but tell me if.
Where can people find you? Where can people get in touch with you? All right,
Simon Arnold: they can find me on LinkedIn. And that's for the course, the high functioning, gen Z course for the teenagers 13 to 19. Just find me on. On LinkedIn, write me a dm and or to my email address. I'm also on Facebook as well.
Simon Arnold or the 13 Hour Live Coach. Instagram is where you see some really cool pictures there and things. My book is best purchase by lulu.com, the 13 hour Life Coach. And the podcast. Yeah. Available on all, pretty much all podcasts provide us the 13 hour live coach.
And it just it's just good for consistent information about A D H D. And of course, I keep all the records there just in case maybe you, Diana, you're like let's have a look at executive functions. Which one can we go back to? So it's just you can pick and choose. A D H D area that you want to find, so please check me out on all those areas Really.
Dr. Diana Mercado-Marmarosh: Awesome. And do send me some of those links so I can put 'em on the show notes so that they can Yes. Will get straight there. Now if my people just started tuning in, because sometimes we have wondering attention, what would be one or two takeaways that you would want them to have from our conversation today?
Simon Arnold: I just wanna tell everyone that they're not broken. Okay. It's like, we are just fine. We just need to use different strategies that, you know that Eva I have, and this is the thing that maybe Diana knows a bit more about a certain area. And we are, we're fine. We are good as we are. We just need to celebrate ourselves and just live our lives really.
If you've got adhd, remember that you are not broken. You are perfect the way that you are. And if you do need any help, just find the best person suited to you really to go
Dr. Diana Mercado-Marmarosh: forwards. Okay. One last question. What do you hope to see yourself doing for fun in the next three years? More fun.
Simon Arnold: For fun. I intend to speak to so many people using sign language.
I love it. It's something I can use for my hands for and just yeah, just being able to communicate with so many more people in into world now that I've got this opportunity.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for being here. I do not know sign language, but maybe I could dance with you. That would be closing up
Yeah, of course. .
Simon Arnold: Yeah.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave work at work. And re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain. So that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.
Okay, so today's theme is one that I've been coaching a lot of my clients on, which are. What are the parenting hacks that could keep us sane? So A D H D, and how to chill or how to keep us sane. And so I'm so excited to talk to you guys about this. It's a discussion that is real. So here's some strategies that might be helpful and please feel free to send me a text or an email.
Leave a comment in the podcast letting me know if these are some of the hacks that you yourself are using or you want to use. If you tried them, did they work out or not? I can't wait to share the story. So first of all, , you need to establish a routine. Children with A D H D tend to thrive on routines and structure.
How we do this, it doesn't have to be necessarily step by step, but the more that you have a daily routine regarding meals or homework or playtime and bedtime, the more likely you can provide stability and predictability for your child. Number two, use some visual aids. These could be anything like calendars or chore charts to-do lists.
They can be very helpful, not just for the children, but also for you so you know what's coming up. And I have found some of these really nice big. Chore charts or to-do lists like at the Dollar Store or the Dollar Tree, and they can help your child stay organized and stay focused on the task. And it could be very rewarding to just check it off, know what is expected next.
Number three, provide positive reinforcement. This is a very powerful tool that can. Help your child realize that they have gifts and they have strengths. And no matter how small a task is that they completed, it can help to boost their self-esteem and to encourage good behavior. So if you notice that they picked up their laundry and they actually went.
Put it where it needs to be done, thank them for that. Or if they, if you notice that they took off their shoes and they left them in the same place where you had already had a discussion that they should be at, so that you know where to find them, like positive reinforcement can really make a difference.
Or saying, Hey, I really like how you handle that, or, I really liked what you did with that interaction, can make a big difference. Number four. Is mindfulness. It's a technique that can help you manage stress and stay calm in the face of a challenging situation. When we as parents are practicing mindfulness, it can be a way to role model for your kid that they.
Can to stay present in the moment and practice. Mindfulness can be done in different ways. It might be that you stepped out into nature and took a walk for a few minutes. It might be that you did a three minute Headspace meditation or that you did a three minute tapping solution meditation, or it could be you chose to slow down long enough to see what was going around you and being more present.
Another hack number five is to really prioritize physical activity. Regular physical activity can improve focus and attention for children, and of course with poor parents as well. And I say a hack could be that as soon as the kids get get home from school, take them to the playground take 'em just to do a walk around the house in the neighborhood if possible.
Or make sure that they are involved in sports, dance or any other active hobbies because when you're doing this, what you're ha what is happening is you're increasing the dopamine that they have, which then helps them to have enough. Energy to be able to do the homework or the task. Most of us want to go directly to the homework and then to the food or to different things, but when you are able to first prioritize physical activity, you have a way of it actually increasing the dopamine, which will increase your reserve.
Number six, limit distractions. I know it seems like almost common sense, but if you're able to minimize the distraction in your child's environment, such as turning off the TV or putting away electronic devices during homework or during Lunchtime or during dinnertime or during bedtime, like all that is going to cost them to be having attention that is dispersed throughout.
So this can help your child focus better and complete tasks way more efficiently. Number seven, encourage healthy sleep habits. Getting enough sleep is crucial for children with a D H D. So it can really help them refuel their energy and sometimes we might have to set alarms to remind us that it's time to go to sleep.
So these are just some of the few strategies that can help parent. Kids with a D H D, and of course you have to remember that each child is unique and that it's a D H. D is like a spectrum. And what might work with one of your kids might not necessarily work with the other. Be curious, stay curious, stay in awareness.
Realize what might be going well, and really take note like what worked well, what didn't be patient. Find the right strategies for your child, and with the support and resources you can help your child succeed. Thank you for spending your time with me. I really believe that time is your most valuable.
Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website ahdlivecoach.com, where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.
Hello. Hello. I am so excited today I have a very special guest, Dr. Ta Lupe au. A Lugo is a child and adolescent psychiatrist who helps to empower youth mental health by providing diagnostic assessment and treatment as well as educational to parents and caregivers about these disorders and how to ensure that they look after their own mental.
While caring for their children. She's the founder of St. John Kapp and the Emotions Ambassador Program, where she's actively involved in education and advocacy and our. Which is the area of youth mental health. She's the host of Walking on Eggshells with Dr. Talu podcast and has a YouTube channel under the name St.
John Cap. So today's topic, obviously, if you haven't gathered anything from what I just said, is very important because it always feels like we're walking on eggshells either with our kids or sometimes ourselves, whenever. A D H D is a diagnosis and so I'm so happy to have her here today to share her experience about why she is doing what she's doing.
Dr. Totulope Alugo: Thank you so much. Thank you for having me today.
Dr. Diana Mercado-Marmarosh: Awesome. You have a son, is it a son or a daughter that was diagnosed with a
Dr. Totulope Alugo: No, I don't. I just have I'm, cause I'm a psychiatrist, I deal with this every day in my clinic.
Dr. Diana Mercado-Marmarosh: Gotcha. So it feels like you have a thousand kids, huh? ?
Dr. Totulope Alugo: Yes. They're like my kids really
Dr. Diana Mercado-Marmarosh: Yes. Yes. Because you see them grow up. , you see them from day one and all the way till they're 18, so it feels like you, you have a thousand kids. . .
Dr. Totulope Alugo: I watch them go from elementary school to, they go to university. So I'm like a mom in that area. ?
Dr. Diana Mercado-Marmarosh: Yes. So tell me what got you into this special like niche, because I know you could focus on anything.
You could focus on why this tell me.
Dr. Totulope Alugo: I did a general residency in psychiatry, but then I did a rotation in child adolescent psychiatry and I just, Really loved it because I realized that I had an opportunity for early intervention because I believe that if you can intervene early, you can change a child's trajectory.
And you can also help a family really early by treating a child.
Dr. Diana Mercado-Marmarosh: Yes. Yes. You're so correct. I'm often. Shocked how it makes such a difference as we're growing up, right? Things that people might do can really. Enhance or sometimes not so much enhance how we ourselves interact with the world, and especially before the age of seven.
It can make a big difference, but that doesn't mean that you can't unlearn or you can't support them later on when more knowledge comes. comes along. Of
Dr. Totulope Alugo: course, of course. Whenever you get an intervention, it's always helpful. Yes.
Dr. Diana Mercado-Marmarosh: . What have you noticed that, when you do tell mom or dad, hey, your kid has a D H D, what have you noticed is usually the reaction.
Dr. Totulope Alugo: We get a variety of reactions. For some parents they already know because they already see the challenges at home school is telling them Your child is different. They're on the go all the time. Teachers are stressed out. So personally, for those kids who are hyperactive or impulsive, parents are almost always.
Already have a great idea. A few parents would say, oh, he's protect the younger ones. They're just boisterous. And so that way they bit up reluctant. But for the inattentive ones, I find they're being diagnosed much later and parents are saying things like, they're careless, they're lazy, they're just not paying attention to detail.
So it's really a mixed bag that I get.
Dr. Diana Mercado-Marmarosh: Yeah. And you're so right, like parents sometimes, , sometimes they know that their kid is, the way they tell me is my kid's high maintenance or they're have, they're a ball of energy and I know that, they're sometimes too much. When the kid feels like they're too much, that can also be
It could go both ways, right? But, When their kid, like you said, is just in the back of the class daydreaming, you label them as careless sometimes or not caring enough like you said. And it can be frustrating cuz they're like, how do I get them to get motivated? And sometimes, like you said, it's a neurological thing,
So it, it's so important to be able to have that awareness to even realize and then sometimes they're smart. And because they are attuned to whatever the subject is and they're passionate about then they have a mixture, right? Like you'll have somebody who does really well in one area.
And then another, not so much because they find it boring or they, there were too many steps in there that they couldn't follow along. And so you have a frustrated parent sometimes.
Dr. Totulope Alugo: Yes, I see so many of those kids who are doing really well at school, but at home there's so much tension because they're forgetting that chores, the living appliance is on.
They're just not meeting deadlines with, homework and stuff like that. Yeah. So it can be a real tension point between parents and the teenagers particularly.
Dr. Diana Mercado-Marmarosh: So once you have this awareness that you walk them through to make the diagnosis, what do you usually like? Tell the parent or tell the kid.
Dr. Totulope Alugo: I provide information on the disorder. It's a neurodevelopmental disorder, so I say, look, it's nothing that you've caused. It's not your fault. It's a disorder of the way your brain is wired. May have been inherited of your small, more than likely, and then provide practical steps to move forward.
One, I want 'em to educate themselves as much as possible on the diagnosis. So pro I provide them resources for them to understand the diagnosis, and then based on the impact on their functioning, then we then look at treatment options. But I always say there's some medication, there's some non-medication options that everybody needs because they're important for life.
So things like, Having lists, using alarms, reminders, those practical strategies, they're important. And then for the parents, depending on the age of the child, I really want to provide information on how they communicate with their child. So for example, for the younger kids, I would say to get your child's attention, you need to calm down to their level.
If that means holding. Getting down your knees, looking them in the eye, and then giving them the instruction, breaking the information into small, manageable steps such that it's not too longwinded. And then, providing information to school because you want the teacher to understand that this child has challenges and needs things to be done differently.
So really education is one of the key things that I like to provide after a diagnosis. .
Dr. Diana Mercado-Marmarosh: Yes. That's so key because that becomes an empowering tool, empowering method to be able to create systems for them and for the parent too, so that they can have strategies so that they don't feel anxious or mad or angry or overwhelmed and they have a way to take care of them, and take care of themselves.
Let's talk about emotions because I keep saying that emotions are a compass, right? Because emotions really can be helpful, but can they can get us into trouble also, when you're not aware that A D H D can have an emotional component to it, then it leads to some meltdowns or they could lead to some melt.
What have you noticed in this
Dr. Totulope Alugo: area? Oh, that's very common because you see a lot of e easy frustration. So for a child who is unable to focus, who is constantly in trouble they're anxious because number one, it's difficult to focus. The teacher is calling on them, they're losing chunk of information.
They're being labeled sometimes by parents or other kids, and so that is stressful. So you'd see a lot. Emotional outbursts, just, easily easy, frustration, anger. And don't forget, sometimes parents themselves also have a d h D. So even though they know that their child has h d, they know that this is not their fault.
But then before they can put the breaks on themselves, they've let rape, but they're yelling or screaming, so it can become a real negative situation. or if care isn't taken. So really providing information about, putting bricks on yourself. Self care, managing your emotions is important, but also helping people around to understand that this child is struggling and need support and not judgment is also important.
Dr. Diana Mercado-Marmarosh: Yes, those are all very important keys like, I have a pediatrician that works with me and she's been there for 20 something years. And so I'm so grateful that she's there because she's obviously a ball of knowledge, but she always tells me Dr. Mercado I'm sending you the parents because I'm sure.
I can see it, and I'm like thank you. Send them over. Because it's takes an astute person who's paying attention and who and who understands that this can be genetic. Yes. And while we might put all the interventions for the kiddo or try to, if you yourself are not putting your own max.
Your oxygen on or your, either you or your husband, or both, right? Then it might be a lot of, more of a challenge instead of an easier transition for both of you and the things that can help the kid could also help you, right? If you have an awareness that you need certain things before you walk out the door, like your keys, your purse, like X, Y, and Z that can. Deescalate how quickly the morning routine can turn into something stressful. , yes, . Yeah. And the same thing with like homework, right? If you know that exercise or play is gonna release some dopamine, like having room for that on the schedule on purpose, before maybe you do jump onto the homework.
Because if you went for a walk, even if it was 10 minutes with your kid outside in nature, All of a sudden you've increased some of their dopamine and then they're might able to come and sit down and jump into the homework a little bit more easier instead of you and them arguing that I can't do it right now, and it goes back and forth.
So yes, handling the emotions. That can come with the diagnosis. And then not only that, but how do you handle as you are implementing it, right? Because we keep looking at other people and sometimes we're like it's working in their household. How come it's not working in mine, ? And you forget that everybody A little bit different.
We all want to be doing certain things, but at the end of the day, how you do 'em is what is gonna make the difference in how then they have tools to do it later on.
Dr. Totulope Alugo: Exactly. I think we are really being intentional and realizing the individuality of your own family situation is important because we can't be comparing.
That's not always helpful. You can always get good information from other families, but not constantly compare. I think it's important to be intentional, to be practical, but also give yourself some grace. Because sometimes as parents we beat ourselves up so much for anything that doesn't go well. And remember your child doesn't.
Perfect parent. Your child just needs a good enough parent. And so I said to parents, you don't have to be perfect, just good enough. It's fine. .
Dr. Diana Mercado-Marmarosh: Yes. You're so right. Realizing that we're always trying our best and sometimes we didn't have information available to us. I'm Mexican American and like I didn't get diagnosed.
So I was, in my first year of med school because when I looked around in my family, we all kind. . That's the way we were, like, we were loud sometimes and we would get angry and then like we would be over it and then, we would be a little bit forgetful and sure, this at three o'clock for the party, but everybody showed up like at three 50 or four or whatever.
Everybody was on their own time and we weren't sure that was like a cultural thing or that was just an A D H D thing. Or if, we. Lost track of time somewhere, because we're always like busy people. And so it's understanding that, sometimes just the way our environment is.
It might also be like not hindering the diagnosis because I like the word that I'm trying to say is that there's evidence out there that, in minorities, Sometimes it gets diagnosed later on because we we don't realize that's nothing that they Nobody's diag. Nobody's taught us about it.
Yes.
Dr. Totulope Alugo: And I'm from Africa myself, and I would say the same thing, the understanding of A D H D, the stigma associated with any kind of diagnosis really delays things. And then there's a cultural aspect. We have this African time, any party, it's not fashionable to get there on time. . So is that because of a D H D or just because that's the cultural norm?
It's hard to understand. But I really see that a lot in the Africans who, whose kids have coming to see me. And parents just feel like they've being labeled, they've been unfairly targeted when it may not be the case. So that understanding in our communities definitely needs a lot of educating.
Dr. Diana Mercado-Marmarosh: Yeah. And I think you and I will get along just fine. We'll get along, we'll get them to the same at the same time. . But my husband my husband's white, so he jokes around all the time. He's whose party is this? What time is it on? Is it like on Regular time or like your time . And I'm like, be quiet.
And he's I just wanna go. He's cause because he hates being late. And not that I, I don't mind being late, but like you said it's a norm. Sometimes we go back and forth, right? Because there, there's this time blindness component to it that. Sometimes, like you said, could be culture, but sometimes we really have no idea of it.
And that can impact, right? If you are in a certain setting and you don't have flexibility of time in your work or if you're trying to get on a flight, right? That might not be okay at all. No.
Dr. Totulope Alugo: Yes. For a parent who probably has a D H D I think the way to figure out if this is a cultural habit or whether it's something more, is really knowing when you can be late. If it's okay to relate to a family gathering, but not to work, not to the airport, If you cannot make those, navigate those differences, then maybe it's time to get an assessment.
Maybe there's much more going on than just it's okay to believe because of my culture.
Dr. Diana Mercado-Marmarosh: Yes, exactly. Yeah. With a D H D sometimes, like if you ask us what time, how long it's gonna take to do a certain task, we don't have that awareness. I have to count on purpose the time before I gather the stuff to start the task.
like we go straight to the task. We tell you it's gonna take me 30 minutes or 10 minutes or whatever, right? But we don't tell you because we just don't associate it together they call it like the recipe, like you need the ingredients, then you need the middle part, like yes. And then you need the cleaning up, the stuff.
And for us, we just go straight to the middle assuming that we have everything and sometimes we don't have everything. And that's where some of that can get us into trouble. Yeah. Yeah. So sometimes my, my, one of my screening question, To my, to parents or is how many times did you have to reschedule this appointment before you actually got in to see me?
Because that could be a tall tale that, , they missed it three times or they didn't have it on their calendar or something like that. It's
Dr. Totulope Alugo: true, and I think just being aware of that for a parent is important. I have some colleagues, for example, who have only just realized that in their forties that they need to really schedule themselves, give themselves time, have everything written out, have a spouse that would remind them, have their kids, remind them, but that self management is important.
That definitely is important.
Dr. Diana Mercado-Marmarosh: Awesome. So tell me. What do you think is one of the key things to enhance the wellbeing of the kids? Like you, obviously you already told me, go set reminders and that, and talk to the teachers, but like for that kiddo who is like wanting to do the things, like what do you think?
you would really emphasize for them?
Dr. Totulope Alugo: Start with the basic thing. So for for every child, adequate sleep is important, healthy diet, healthy exercise is particularly important, like you said earlier on, to increase the dopamine, to burn energy. Strategies like using fidget stools, having a, like a Fiji or paper meat.
Then teaching them to, set reminders, set tasks for themselves, ask for help if they need to. Those are strategies I will be highlighting first and foremost before anything else is those basic pillars of health. And then the A D H T specific ones things to reduce hyperactivity tend to improve their attention.
And also for the older kids, if you know that you're gonna be, for example, an example is overspending. Some kids will say, oh, I went to the store to get one thing and I came out with 10 things. I'll say maybe leave your card at home and just bring enough cash for that one item. So those are some of this, the practical strategies that they could a child could.
To manage their symptoms and of course, talk to your healthcare professional. If all that isn't working there, all there may be an extra layer of help that may be necessary, medication and so on and so forth. The most important thing is talk to your healthcare professional.
Dr. Diana Mercado-Marmarosh: So where can people find you?
You are just a ball of energy and you have all those stuff that you have the right thing to support the parrot and the kid. Where can people find you?
Dr. Totulope Alugo: So have a blog at ww dot saint john cap.com and that's capital Double P. Then I also have a podcast working on eggshells with Dr.
Tolu on. Platform where you can find podcast. So Apples, Spotify, e t C I'm on YouTube at St. John Cap, also on Instagram and Facebook. So there's a lot of places where you can find me ,
Dr. Diana Mercado-Marmarosh: please go find her, follow her love everything she's doing. Okay. I always ask people this question, if people just started tuning in, because we have wondering attention, what is a one nugget you would want them to walk away with?
Dr. Totulope Alugo: Having A D H D can be a great blessing because I think, people are super creative, so you have strengths. So always think of your strength and not just the downside of having a diagnosis. Think of your child's strength. Your child has unique qualities. Focus on those unique qualities and not just on some of the challenges that you may be seeing that they.
Dr. Diana Mercado-Marmarosh: So Dr. A Lugo, tell me what you are hoping to do for fun in the next three years. In
Dr. Totulope Alugo: the next three years, I'm hoping to go on a vacation with friends. I'd like to go on vacation week, a girl trip, so I'm hoping for to do a girl trip in the next three years. We did one about seven years ago, so it's time for another one.
where do
Dr. Diana Mercado-Marmarosh: you wanna go?
Dr. Totulope Alugo: Probably Europe, the Mediterranean, maybe. Enjoy cruise .
Dr. Diana Mercado-Marmarosh: Awesome. Please invite me so I can come a lot . Yes. I love, I'm doing this Go trip . Thank you so much for your time and it's always great to chat with you.
Dr. Totulope Alugo: Thank you very much for having me. It's been great being here.
Have a great day.
Dr. Diana Mercado-Marmarosh: You too. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the. Share with your colleagues and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happy.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave work at work. And re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain. So that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in a personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the.
Hello. Hello. How are we doing today? I am so excited to have a dear friend with me, Dr. Mary Leung, and she is in New York, but. She is actually from Hong Kong and I am so excited to talk to her today. She's a, he heon physician who is actually helping other physicians start to live the life of their dreams.
So She herself is gonna tell us her journey, but she realized that charting was not the thing to do every day, all the time, . And so we are gonna have a conversation on why it is important to realize that it, you know, you can take breaks, you can reset, you can do things your way. And whether you have a D H D or.
You can still live the life of your dreams. And she's here to share her story and to share how she's now helping others do the same.
Dr. Mary Leung: Wow. Thank you for the amazing introduction. Time . Anytime.
Dr. Diana Mercado-Marmarosh: Anytime, .
Dr. Mary Leung: All right. So I guess a little bit about myself. Yes. I grew up in Hong Kong and both. Parents of physicians, I mean, they're retired now.
But when I was growing up they would they, they really loved their career and what, what they, what they were doing. And sometimes they would talk about, Patients like what they would do with each other during dinnertime. So for me it was a natural exposure to medicine and being a doctor and I thought, you know, grow, growing up I was always taught to always help people, you know, whatever we can do to help, help.
And so it was just natural for me to to say, Hey you know what? I wanted to be a doctor too, just to help. And my parents never forced me into medicine. And my other siblings, they're not in medicine at all. And so I think this medical path was just a natural thing for me. I think it suits my personality too,
So so then fast forward to. 12th grade that my parents decided to send me to the United States to study. And that was 12th grade and of course, senior year in high school, it was kind of a cultural shock. And I went from not speaking English outside of English class at school to speaking English all the time.
And I remember I had to translate, you know, in my head from Cantonese to English before I, I would speak, you know, sentences and And I was taking all these advanced courses, American history, that I didn't know much about and applying to colleges all at the same time. So it was and of course living away from home.
So all these things came together. And I think even though it was quite a different and stressful year, it really helped. Who I am and it really make me grow a lot as a person.
Dr. Diana Mercado-Marmarosh: So, Mary, tell me during that time, did you decide which boarding school you wanted to go to or like how did you arrive which one you were coming in the US.
Dr. Mary Leung: Oh yeah, so I am I actually applied, so it was kind of like a college entrance process and so how I chose was I actually only applied to two boarding schools. And they're both in the, you know, northeast region new England region. And only because a couple of my friends went to those schools already.
So I was like, well, you know, I wanted to be with them. So I just applied to two. And I ex thankfully, actually, Accepted by both of them, and I just chose the one that my good friends were in . So
Dr. Diana Mercado-Marmarosh: Yeah. And that brings up a good point, right? Like that we sometimes become brave or, because, I mean, that's bravery and courageous to like uproot yourselves, especially your senior year when you're like, this is supposed to be the cheer year.
I'm just gonna write it out and like finish and then move on. Right? But. Yeah, you took a, a flinch, but then you did it with the knowing that I'm gonna go with my friends. Right. So like, It's always so amazing how, what we're able to do when we feel like there's a support system there. Even though, you know, you don't know exactly how things are gonna turn out, but you know that there might be one or two humans on the other side that you can lean into and then it'll work out, right?
So I think this is so true about life. I really think, and. and, and I think that's how you, you bet on yourself to come and do that. And then you bet on it's gonna work out. And then like you said, it was stressful, but you were seeing the big picture on the other side. Did you know you wanted to do med school at that time?
Or you were too young at that time, you think?
Dr. Mary Leung: Yeah, I think I can't exactly pinpoint when I wanted to become a doctor, but. Pretty young age, and I think at that time I was already, you know, pretty set on becoming one. And. You know, studying in the, in the US was kind of like part of the rite of passage.
And I think, you know, as you mentioned, I think we as human beings, we, you know, our desire to belong is very strong. You know, I, I, I think we're not designed to be alone. And so, you know, if we have some commonalities with other people, You know, we tend to lean for them. .
Dr. Diana Mercado-Marmarosh: Yeah. Awesome. Okay, so tell me, so you do all the things and then you, how did you get where, where did you end up doing residency and or when did you realize, okay, my God, this way of medicine, this charting thing, this is not my thing.
Dr. Mary Leung: Yeah, so so medical school and then residency, you know, I actually. Chose to be in New York because of my husband. And we met when we were in medical school and I mean, I was in medical school and he was in dental school at, at that time. And so because his family is from here, you know the New York area.
So, so I chose, okay, you know what since I already moved 8,000 miles away, I might as well be. Someone's family. And so, so I did and for residency and fellowship, I just, you know, stayed in the same program. I think at that time I didn't really realize charting was really a big thing because we never have a lot of patient load.
Like of course, inpatient. doing consultations was very busy. But, you know it was, I never really had the outpatient experience with a full load of patients. So only when I started to become an attending So after fellowship I took my first job, and this is still my first job. And that I joined five other physicians in the, in a group.
So it was a private group practice. And that, you know, several years later, it actually became a part of the hospital practice. So anyway when I first started, I already have some patients to start with. And three months after I was in the group one of the doctors retired. So I had even more patience.
And so very quickly I had a pretty full load. But at that time we were still using paper chart. . So with the paper charts, I'm those who actually still remember it's actually a lot more simple. And People actually tend to document less. And of course there would be a challenge to read some someone's handwriting sometimes, but it was, the charting time was pretty short and, and a lot of times you would just kind of jot notes down when you're seeing the patients because you would bring the physical paper chart with you.
So so charting wasn't really a big problem. At that time only when, maybe like about 10, 11 years ago when we transitioned to the electronic system that was, you know, that started to become a problem. I mean, I've used, you know, of course, electronic records before you, you know, even when I was in training.
And in the hospital too, but with a full load of patients. I mean, at that time I was seeing, you know, 25 to 30 patients at that time. And so electronic charting was really a big problem. And I think a couple things. It's like I, you know, I had the notion that, oh, I wanted the, the chart, my notes to be You know, need to very organized, very detailed.
And so, so that was one thing. Second thing was I had to believe that I had to keep my patients appointments as punctual or as on time as possible. So what ended up happening was that, oh, another, actually one more thing was I felt like I had to really. To show that I was paying full attention to my patients, and because of that, I felt like it was kind of rude to chart in front of the patients.
So all these things add together that I was sacrificing my charting time till the end of the day, you know, for a lot of the charts, not all the charts, but you know, probably sometimes even half the. And what ended up happening was even though my official on paper clinic day would end at four o'clock, I, I wouldn't, you know, go home until past seven.
And a lot of times I didn't even have my charge done. But I wanted to go home because my kids were young at that time and I wanted. Catch them a little bit and send them to bed and and I would, you know, do more charting. Most of the, the nights. And so, you know, that kind of went on the cycle started again and again and I was just, Really feeling tired.
I didn't feel like I had a life. I I, I felt like I wanted to quit many, many times. But then I felt stuck because I was like, well, you know, what else could I do? I, you know, we, we weren't financially capable of. Me not working. And then I also didn't want to move because I felt like I had my, you know, married family.
Now I had my new friends and I, and I just, you know, I, I felt belong here. And I mean, I still do, but at that time I just felt like, you know, to, for me to pick up everything to move, it was just too much for me. So, so that, you know I think that went on for quite a few years. Really. Until the pandemic hit , that's when everything happened.
Right. Everything on re said. Yeah. . Yeah. So, so the pandemic hit and then of course, you know, I was seeing a lot of oncology patients and and they, they had to, you know, Get treatment, get the chemotherapy. So we were trying to kind of just really choose or select who absolutely had to get chemotherapy.
to, to get therapy. And the other people, if we thought that they could delay or even switch to some oral regimen or something like that, we would try to do that just to minimize the hospital or, you know, the, the patient load. So at that time I was. On average, seeing about a third of the patients as opposed to my full load.
And I was able to get home on time or even earlier than on time and I, I was amazed. I was like, wow. That's what it feels like. You're like,
Dr. Diana Mercado-Marmarosh: I can have a life ,
Dr. Mary Leung: yes. Well, I didn't really want the pandemic, but this actually opened my eyes to what feel like to be a human being again, to have life outside of work.
And, you know, I, at that time I picked up baking. I, you know, I was like doing all these things with my kids and, and it was, I, I felt even so I. You know, I mean, I did and I didn't realize how unhappy I was. And then in the pandemic, I actually felt like I lit up inside and I felt like, oh wow, you know, there, there was hope that I could actually enjoy medicine again and just have this little idea that what if I could feel the same way and.
Go home, you know, on time when the pandemic was over or when I had a full of patience again. So then at the same time is I was. Introduced to life coaching. I had no clue what that was. I thought coaching was just for sports, you know, for, you know for athletes. And so I was curious. So I, and, and then it was happened to be like physicians who were coaches.
And so then I joined a women physician coaching group program. And that really, Turned me upside down in a very, really, really good way. I just learned that, well, you know I'm actually in control a lot of the times and I also I get to decide how I feel based on how I view things. That really kind of, it makes sense, but then I never thought of it that way.
I mean, we were never taught that. We just, you know, we just think that, oh, you know, what our situation is is the cause of, you know, it's the cause of the problem. It's it's how we are. We can't really change things. But but what it's. Really important. It's actually how we view the situation. It's kind of like, you know, if it's snowing outside, like someone would think that, Hey, yay, you know, I can play in the snow with my dog.
Or another person would think that, oh no, you know, I have to shovel the snow. That that is really not a pleasant thing to do. You know? So, so I think how we view things is really affect how we feel. And so, so then I thought, well, . How about, you know, instead of having to chart all day on nights, you know, is it possible to, to actually cut down on my charting so I could go home on time and spend with my kids?
So at that time I was working with my coach and we were just really working on how. You know, how my day was structured and we figured out that a lot of the times was during first half of the day I was pretty good, you know, was able to keep up with the charting with the patients. But the second half of the day, what was happening was I was thinking that, oh, you know, I had half more days to to work.
Getting tired. I don't really want to do this much longer. And and so all these things just make me feel like. It was a burden and I was getting kind of frustrated. I was getting tired and I was shutting down mentally. So because of all that, that I was, you know, really slowing down physically and mentally.
And so I wasn't able to keep up with my charts and, and then of course, came the end of the day that I was even more tired, and And having a pile of charts to do, and I started to forget the details of the patients. I was like, okay who had a murmur again? Or, you know, like am I mixing little things up?
I mean, of course, major things I wouldn't mix up, but just tiny little things and, and, and so that got me even more frustrated, and, and so, so then, So then I was kind of redirected to say, okay, what do you ultimately want? So I really, my ultimate goal is really to spend more time with my family. So to do that is I had to go home on time.
And to be able to go home on time is I had to be you know, I have to finish my charts right. And so, so what kind of energy to use to finish a chart is actually I learned that in general there are, You know, positive energies and negative energies. So, you know, the negative type of energy or fuel are kind of like the stress, the frustration, the anger, you know, that those type of negative emotions as opposed to.
The positive emotions. Those are like the focused, determined gratitude content, you know, that those types. So and I also learned that the negative emotions, even though they can push you to do things, They don't last long, or, you know, you will feel even more burnt out after using them for a while.
So by choosing or deliberately to use the positive emotions, it's long lasting and it actually makes you feel happier, you know, afterwards. So my field was focused and. Determination that, you know, I, I have the, my end goal in mind. And and, and of course, you know, with the charting strategy is also important, but the mindset part is really what fuels everything, right?
And so so I focused on really seeing a patient doing the chart and and I decided that, you know what? I'm just going. be focused on that one patient at a time. So when when the patient is telling me things, it's okay to also, you know, Do my charts at the same time because it's all about that patient.
And it actually saves me time so I don't have to remember it afterwards or forget some things that the patient told me beforehand. So, so then just with more and more practice that I was slowly able to go home half an hour earlier, a little bit more, a little bit more, and now I'm actually going home, you know, as opposed to past seven and still.
Work to do. I'm going home five to five 30 with everything done. Awesome.
Dr. Diana Mercado-Marmarosh: Wow. So many nuggets you gave in there. And I wanna point out some of the things, you know it's interesting how, like you just said, people will interpret. A certain situation differently, right? Like the pandemic is a neutral thing.
Like, but what you think of it made all the difference, right? Like one person could have thought this is the best thing ever. Kind of like what you thought, right? Or another person could have thought, this is the worst thing ever. Right. A and then that happens, right? But so for you, because you were a specialist and because of how dangerous the situation, procedures, and different things were you, your workload went to one third, right?
Mm-hmm. for me, being primary care doctor, my workload went up. It didn't go down. Mm-hmm. because, Because there was, we just had to be the front line as primary care doctor, right? So for me, it unraveled the situation of like, oh shit, I can't keep doing what I'm doing because this is not working out. And for you, it unraveled, oh my God, is this what life is supposed to be like?
And so it, it was like different thoughts, but they eventually both got us to the same thing, which. Are we practicing the way we want to practice? Like are we, like, who has ownership of our time? Right? Like, and why is somebody else's time more important than mine? .
Dr. Mary Leung: And I think yes, that's a very important thing and, and I think a lot of us feel like we blame that, oh, I don't have time, I don't have time to do this or that.
But in actuality is you know, we all have 24 hours a day and we actually. Get to take ownership of the time that we have and we get to plan, you know, what we want to do. And notice that I say get to not should or have to. It's like, you know, I feel like when we say we get to is that we, we are in control.
We, we, you know, we have a choice what you'll
Dr. Diana Mercado-Marmarosh: do. Yes, exactly. And I think that statement that you just made is what makes all the difference when you decide. That you do have a choice and not making a decision is still a choice. And we don't realize that because I think in medicine we've been told always do first for the patient, always do da, da, da, da, da.
And. Yes, of course I wanna take care of my patients, but the day that I realized that I had to be the more important patient, that if I wasn't right then it didn't matter exactly how well I showed up for them because I wasn't Right. and, and not, and not right. As in like, you know, but you know what I mean?
If you're not rested, if you're not. A hundred percent happy that you're there. It over some, you don't even realize you're burned out at times because you've been doing, like you said, the same cycle over and over and over for a while. You thought this is the way it's, it's supposed to be, but then when you get a taste of what it could look like, then you're like, It doesn't have to be this way.
Like who taught us that we are supposed to do all this stuff outside of work? Like who, who, where, or how is this acceptable? Right,
Dr. Mary Leung: exactly. And it's just like, you know, as you mentioned that until we get better or get a taste of being better, we never realized how bad we were feeling. And, and a lot of us physicians, I think.
me included, that I didn't realize that I was burnt out, you know and you know, I was, you know, more angry. I was you know, just kind of more tend to really shorten temper. Although not show it all the time, you know? And, and I, you know, Just realized now that, hey, at that time I was really, really burnt out because I was not happy, I was dissatisfied, I was frustrated, stressed, all these things.
And and also it's like since I'm a hematologist, oncologist have to throw in this, it's like for example for patients with anemia, you know, they would be walking in, it's like, oh, I feel a little bit tired. And, and meanwhile they, they're very, very anemic to the point that. Actually want to think about doing a transfusion.
And but then since they're, you know, young, healthy, otherwise, I'm like, okay, you know, take some iron, you know and then we'll see you back in a couple weeks. Right? And so, so when they came back for follow-up, they're like, wow, I feel so much better. I didn't realize how bad I felt, and this happened over and over again, so I.
You know, and it's kind of like also with cataracts, right? You know, they didn't realize that they were seeing the different colors until they had the cataract surgery that, oh, it's like, oh wow, the wall, the wallpaper looks like that color. So I, I feel like yes, for me is, you know, with the pandemic, of course I did not want the pandemic to happen for People's Health, but for my experience, what's really an eye-opening experience and that.
I really think that everything happened for a reason and that I was also, you know, being introduced to coaching and I was able to change my clinic day really. 180 degrees and I, I now even have time to, you know I mean I, I had time to get my coaching certification and and also now helping other physicians to go through what I went through.
It's crazy how
Dr. Diana Mercado-Marmarosh: we, you went from. Not having enough time to all of a sudden having all the time to even like become a coach yourself and help other people. So tell us what that's been
Dr. Mary Leung: like. Yeah, and I think also that how I feel is so much different from, say, if you asked me three years ago I think the most common emotions that I had up three years ago was I.
Stressed, I was overwhelmed, frustrated. And now I feel, I feel, you know, I really feel grateful. I feel content. I feel actually, you know, joy and even though I'm actually doing more things than before, I don't feel like I'm doing more things because to me, At work doing my full-time attending job, I am helping patients for the most part, the way that I want to help them.
And and I also get to connect with them in a human way, you know, more, more than just talking about their illness or dead diagnosis. And outside of work is I also get to do what I love to do. I just, you know, Discovered that I love coaching and for myself and to help other people. So, so this to me, does not feel like work.
And I, I really, I learn a lot and I learn a lot from, from, you know people I coach too. So I feel like this two-way street is really enriched me emotionally and mentally. And I also, you know, learned. Take good care of myself because you know, as you mentioned in the Be, you know, I always thought.
Really taking care of others first before me. I was like, I didn't have to take care of myself. What is that? And I would just be, you know, thinking about my patients, my family, friends, and without really taking good care of myself. And of course with coaching, I realized that. Hey, you know, we, we have to take care of ourselves first.
We have to, you know, otherwise we won't be able to give what we don't have. And if it's kind of like on the airplane, you know, they always tell us to put on. Our own oxygen mass before helping others put, put theirs on. So it's the same way that is, if you don't have the fuel to, to go on, if you're running dry, you just can't give your full, your best to your patients or your family.
Dr. Diana Mercado-Marmarosh: Yes, that's, that's exactly what I always say. So tell me, was taking breaks one of the ways you took, you put your own oxygen on?
Dr. Mary Leung: Yes. So, So another thing that I learned is, you know, I, I, I used to think that I, I should just be going on, you know, especially at work. Just go straight and without any breaks because I would be saving time.
By not taking breaks. Like I would just be taking the absolute necessary bathroom breaks. That's before my bladder burst. And and sometimes I even think twice before going, so, so then I just realized that that wasn't really helpful because. As I was going on and on and on, I was just really getting tired and I was slowing down physically and mentally.
And and then I realized that, hey, you know what? , many things take breaks. Like, you know cars need a break to refuel. And you know, a lot of engines, they don't run all day, all night long. They need to be turned off. And so we, as you know, reliving breathing human beings, we gotta do the same. And I think a, a lot of actually, Companies, schools, they understand the concept, but maybe not so much in the medical field or in physicians.
You know, like schools, they have scheduled recess, lunchtime, right? A lot of big companies, they also have scheduled breaks, you know, lunchtime. But for some reason in the physician realm of things even though. Lunchtime is scheduled. A lot of times we choose not to take it because we thought that, oh, you know, we need to catch up this, catch up that, so that is really not healthy.
And I feel like, you know, with the break time of interrupting what you're doing constantly is you get to rest, you know, you get to rest your, your brain, you know, just to take a break because sometimes you don't realize that how overdrive your. You're, you know, really. Being in the state of so, so and especially physicians, like we think that we're super beings.
You know, we think that we're exempt from physical turmoils sometimes, you know, or we forget about that. We're human beings . So, so I think that's really important to, to take a break. And this is from me, the no break physician that had passed. Right? So taking a break you get to also, you know, recharge, you know just, just really Take taking even just a mental pause of what you're doing or just get up and walk.
You know, that, that really kind of like briefs, some fresh air and just simple things like that. It doesn't even have to be a long time. Like it could just be a couple minutes and then, and then you f you know, you feel refreshed and you know, then, then your brain can actually refocus. Better afterwards.
And, and also, you know, there is a chance for you to regroup. Kind of like even a, a quick chance for you to reflect on, oh, did I do this right? Or what if after the break, you know, maybe I wanna do things a little bit differently, you know, just have the time to, to pause and explore and and get ready to experiment something else if you need to.
And I think recharging our body is just so important that you know, we get drained and as we talked about earlier, that, you know, as we run dry, we really can't perform at the optimal. You know, situation that it's, it's just not very helpful for our patients or for people around us. So I think, you know, taking these scheduled breaks is very important.
And I also want to just quickly mention that. Even though it's important to take these scheduled breaks to, you know, reset, recharge, renew, re refuel, it is important to minimize the unscheduled breaks. So the unscheduled breaks that I refer to are like say if you get interrupted by. Your coworkers unexpectedly, or if your mind is wandering off and thinking that, oh, you know, what is on social media, a Facebook, or, oh, I heard this email notification.
Let me go check my email. So those are kind of the unscheduled pricks. And if. Kind of entertain the, your mind to go ahead and do that. You'll end up, you know, being distracted and you'll end up taking more time to finish the work.
Dr. Diana Mercado-Marmarosh: Yes, those are such important nuggets. Again, if you have a D h D or not, if you implement these strategies, they can really make a difference.
Like we all get into this like, routine, routine, routine, which routines can be very. Fault, but when we are not slowing down enough to reevaluate whether that routine is actually. Helping us and providing us, refueling us with energy or if it's actually taking away from us. And, and then if you don't give yourself that space, you might miss it.
And so you're so right about the breaks. Like most of us wanna keep going, going, going, because we think we're in the flow, but we don't realize we're. walking at like, you know, turtle speed. Mm-hmm. instead of like just, you know, rabbit speed or whatever speed you wanna be at. And, and, and realizing that some days we are gonna be at turtle speed and that's okay.
And some days we're at rabbit speed and, and it is what it is. But realizing that, You are choosing, or you're conscious, or you're aware that you are doing what is supported for you makes a big difference. So, Mary, where can people find you? Because I'm sure they're like, okay, I gotta, I gotta learn more about her.
We gotta work together, we gotta do some things. Tell me what, where can they find you?
Dr. Mary Leung: Yeah, so thank you. So I have the website is www.shiningwithgratitudemd.com and cuz you know, I, I have that name. It's because I really feel so grateful and I just want everyone to feel the same that. That we're just thankful for our situation, good or bad, because it's always teaching us something.
And and I always feel like we can choose to be grateful for whatever is, you know, coming to us and we can work hard to improve our lives. And so, so that's my website and I offer one-on-one coaching for physicians. And you can also find me on Facebook, Mary Lung, and LinkedIn at Mary Lung.
Dr. Diana Mercado-Marmarosh: Awesome. So I always ask this question of my, of my guests. So let's say that my my listeners just tuned in. Cause you know, we have wondering attention. What is one nugget you want them to take away?
Dr. Mary Leung: There's so many nuggets, right? . So I think the one thing is that you are in control. I think that, you know, even though there are situations, of course there are things that we cannot control, but just control what you can control because there are actually, if you explore it there are more things that you can do than you.
Than you think at first. And and for whatever things that you cannot control, don't argue with it. But just think of ways that what you can do to improve the situation if it's something that is, you know, according to your plan.
Dr. Diana Mercado-Marmarosh: Awesome. So be flexible, but also have a plan in mind so that you can try to get to your destination.
Yeah. So for in the next three years, what do you hope to do for fun?
Dr. Mary Leung: For fun, well, I always love to spend time with my family. I love traveling and so I would like to travel more and and of course, you know, to visit my family in Hong Kong. And just to go to different places before my kids grow up and go to college.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much for spending time with us and giving us your story. And as you heard it, guys and girls It is important to realize we all have a story and our story matters, and we can change your story if we don't like the way it's going, right? Like that's the thing we, we don't, sometimes we don't even realize that we didn't like the way it was going, right?
We have no awareness. But what if we could find ways? To work smarter instead of harder because all of us became physicians. Or by working hard. I mean, even if, you know, us, Mary had two parents with who were physicians and some of us have never had that opportunity and we didn't even know what we were walking into.
But Came through because we put in the work that, and, and now what about we put in the work so we can actually enjoy what we're doing, like and so that it could be easy or easier or it could feel like, it feels to marry and me that this is fun. Like we get to design it and, and have that privilege to support others to practice medicine also in their
Dr. Mary Leung: own.
Yes. And, and yes, it is possible to enjoy life and medicine again.
Dr. Diana Mercado-Marmarosh: Thank you so much. Thank
Dr. Mary Leung: you. Thank you for spending your time with me.
Dr. Diana Mercado-Marmarosh: I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave work at work. And re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain. So that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado. Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both
in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.
Hello. I am so excited to be chatting with you guys today about a really cool topic that most of us might not be aware about. And so it's, you're in for an amazing treat. Today we are gonna be talking about essential. Oils, and I want to introduce you. A real close friend of mine, Dr.
Ann Huntington. She's actually a physician. She's an internal medicine trained hospitalist medicine physician, and she's also a fellow of the American College of Physicians. And she. She's been very busy during this pandemic. She has lots of expertise in quality, patient safety, peer review, privileging and credentialing.
And she was actually the director, medical director of over 50 hospitalists. And she was able to successfully lead them through this pandemic and help all the patients and her colleagues. She really believed in lifestyle. And she thinks that this is the foundation to medical care and integrative medicine.
And she is actually the founder and c e o of give more Naturally it's l C and it All about essential oils, and she's launching an unbranded C m E course for physicians on the safety and research of essential oils as an integrative tool. So she's gonna tell us all about how she got into this area and if there's any tools or tips that might be helpful for focusing or for improving our mental health.
So I'm super excited about today's. So Dr. Huntington, as I've always, everybody probably already heard it in my intro, but you and I are having a conversation as two colleagues, but these are just our opinions, right? These are not meant to be Taken as we are their physician.
So they have to go talk to their own physicians and figure out whether this is for them. But anyways, Dr. Huntington, tell me how you got into this essential
Dr. Ann Huntington: oils. Thank you and thanks for having me. I'm excited to be here. Thanks for that introduction. I guess I'll go backwards to my outpatient practice for about seven years after I finished residency, I was an outpatient doc, primary care internal medicine doc.
And then I also did inpatient medicine as well, a hybrid role and As I got into that role, I realized there were so many things that I wish I could do that I just didn't have all the tools for. I could certainly help people control their chronic diseases, very complex situations, and, get tight control of their diabetes and their hypertension and really help them.
But I started delving into lifestyle medicine and as many people know and our listeners will know, lifestyle medicine is really the status and practice, study and practice of medicine through a healthy lifestyle. So through whole food, plant-based medicine whole food, plant-based diet, regular exercise, appropriate sleep and stress management, and reducing toxins and healthy relationships, and all of those things, and that really became a foundation.
For my practice, I really was focused on helping people, get healthier that way and really helping people get off of unnecessary medications that may be, a polypharmacy situation. As we would say, lots of side effects from those. Some of those were absolutely necessary to continue, but.
I focused on that quite a bit and then I would have all these patients come to me and say they would be taking all these supplements and I had no clue what they were talking about, or I didn't know their research on them or the safety. And you probably had that as well. We didn't really get trained on any of that.
I didn't get trained on nutrition or on. Supplements or vitamins or integrative medicine that wasn't part of my medical training, but I was always curious. I was open to hearing what my patients were trying to do to improve their wellness, improve their help. And I had one patient who told me she was using essential oils, and I remember sitting in the exam room, trying to, listen, and I just looked up at her, raised an eyebrow and I was like, I don't know anything about these.
I know they potentially can cause skin irritation, that's all I know. And I couldn't help her. And she didn't push the, she didn't push the conversation. We moved on to other things, but I really couldn't help her in that way. And I know that. Some of my patients who really had a they wanted a natural approach.
If I couldn't answer their questions, they would go elsewhere. They would seek out other, kind of practitioners or people on the internet or Dr. Google or whoever to try to find out the answers to their questions. And so in the background of all of that, I reached out to a friend one day when my kids just had cough and congestion.
This was several years ago before the pandemic and. I knew it was self-limited. I knew they were gonna be okay. It wasn't a big deal but I knew that, we could have a rough few days. And so I reached out to a friend who I knew had some essential oils, and for whatever reason, I, asked her, do you have anything that could help this?
And she sent me home with a diffuser, a little water reservoir that can vaporize some of these and some samples of certain certain essential oils. She taught me how to use it. and I went in, my kids were going to bed. I, tried it on myself first it was okay, and then I put it in their room and just I, stood outside as I turned it on and they were, settling down and it, within a few minutes I realized that their cough and congestion had subsided a bit.
They were, better. They went to sleep. They were much better the next morning. And because of the timeframe on, just seeing this and seeing the historical nature of, what would happen, I realized that they actually did something that they were biologically active.
That was my first kind of light bulb moment where I realized, that I needed to look into this more. And so I took a deep dive into this at that point and started looking at the research, started looking at the safety, started looking at the different use. And we can talk more about the different nuances to that, but it was a it's been a fascinating journey.
Somewhat of an overwhelming journey because there was not information out there that could it was really difficult to find the information that could satisfy a medical doctor to really learn about these. So it has taken me years to learn, to research, to experiment, experiment with these, to use them in my home and, with other folks to help them improve their wellbeing.
So it's been a journey, but it's been really exciting. I'm excited to share it with my physician colleagues, many of whom are already using these but don't know much about them, and they're interested to learn.
Dr. Diana Mercado-Marmarosh: Awesome. In your current practice what do you mainly use them for? Do you use them for the cough like you're saying now?
Or do you use them for more energy? Do you use them for or do you use them or what are you how is that working into your current
Dr. Ann Huntington: It's a great question. So I am now about four years ago I left my outpatient practice and did have been doing just hospital medicine. So it's a very different environment than I would use in my outpatient practice.
There are, there's plenty of research in the hospital with these, and I won't get into it here, but I do, share how docs can learn more about this. The health system that I have uses essential oils. They don't use super high quality , and so I don't think they know how to really use them.
So we're working on that. And some protocols, some of the health systems that use them know how to use them much better and have different protocols and we can talk about some of those ways. I remember going into one of my patient's rooms who was there for bowel issue and Was quite nauseated, having a lot of nausea, and we were giving a lot of medications to help her reduce her nausea.
And as I walked in the room that day, I smelled peppermint. And I was like, oh, it's pretty distinct. You walk in the room, you can smell it. And a nurse had put some peppermint essential oil on an absorbent pad, on a little card and taped it to right by her head to the hospital bed right near, near her.
and it was interesting, and that wasn't something that I prescribed. They have a kind of a protocol and it was interesting that her, nausea, she seemed to feel like it helped that day, that she potentially, required a few lessons. Issue was, symptoms were a little bit better controlled as she got through this issue that we were treating that we were treating separately.
And that was a really interesting scenario to see that, that in the hospital setting there are uses for these. And there's some, some other uses that health systems are using often a lot for calming. And there's some potential, in as we learn more about these as physicians learn more about these, there's some potential.
To be able to, really help people get through their difficult situations in the hospital. That's currently where we're using it. And then of course there's a lot of physicians using them in the hospital. Anesthesiologists are using them in the perioperative setting and also some surgeons.
And then there's certainly in the outpatient setting, these are being used quite a bit and recommended and educated.
Dr. Diana Mercado-Marmarosh: Awesome. And Have you yourself used them to help you with like focus or with any type of like energy or what have you used them
Dr. Ann Huntington: for? Yeah, that's a great question.
We use them for a lot of things. It depends on the situation. The more you learn, and especially as physicians, the more you know the mechanisms of action behind them, the more you know how to use them. So we'll talk about properties and then I'll talk about some specific oils that we. When you look at some of the properties of these essential oils, they're basically, and we're gonna take a dive back into organic chemistry.
So the docs who are listening, they, hopefully you don't have some bad memories from your organic chemistry days, . Cause we're gonna go back to a little bit of organic chemistry, but the way that these plants help protect themselves is through these essential oils, or there's, often tiny little oil sacks in the leaves, in the flowers, in the bark that can help protect the plant against disease, against pests and help pollinate and things like that.
So there's some beneficial properties for the plant. And this is derived from c. From a specific chemical constituents that occur in this, in these oils that have different properties. So when we're thinking of, calming benefits, , one of the, most calming chemical constituents is olol, and that is found in lavender and multiple other essential oils.
And when you see some of the very, calming essential oils you wanna look for lolol in the chemistry. And there's, of course others. So lavender is one that, that can be very calming and many of our listeners will, Probably had some stress in their lives and probably had some situations where they feel a little bit anxious or they feel a little bit worry.
And a lot of people will use lavender as the most commonly used essential oil. It's the most commonly studied over a thousand research studies and a lot of studies in the United States even and around the world on lavender itself. Roman camo is another one that, that people will use for calming.
And often, we use these two in kids as well, when kids are a little bit anxious and that can, really help do some calming. And I will say one of the most common ways to use these is through aromatherapy, and a lot of people will be familiar with that term. Where we can use it in a diffuser, like I mentioned, where you've got a little water reservoir, you put a few drops of essential oil in, and these essential oils are volatile, meaning they evaporate from liquid to gas at room temperature, and so they can go out in the air.
And the mechanism is like when you take bread out of the oven and you can smell it, you can smell the aroma. Or when you take cookies out of the oven, it's a little bit different. But these are. Little tiny micromolecules that evaporate in the air and can really exert their beneficial effect.
Some other ways that people use aromatherapy could be, like I mentioned with my patient on an absorbent pad or cloth. Sometimes they can be in a little dish and you can, take the lid off the little dish or cup and be able to get that aromatherapy or inhale that sometimes people will just smell them from an open bottle.
And if you, I've got one here. Just smell that aroma that can be very calming or soothing. Some people will put a drop in their hand, rub it together and inhale. So there's different ways to do aromatherapy and certainly massage. Folks who are massage therapists have used these a lot and will use sometimes massage aroma therapy where they'll, use, get that aroma benefit.
Also, the topical benefit, that's another way to use these. the topical way where these can absorb into the skin. You have to be very careful and know what you're doing when you use these topically. Because every, not everything that you put on your skin is good for the skin. And and sometimes skin can be very sensitive to this.
But that's another way to use these. So when you're thinking of and feel free to jump in if you have any other specific questions about that, but then when we're thinking about, alertness or sometimes. Sometimes people will use ones that can help with a little bit of uplift and citrus oils have been felt to really provide a lot of uplift and a lot of, some happier thoughts.
So we think of orange for example. Most people love the smell of orange. And when you extract the essential oils from the orange peel or rind the chemical constituent limine in many of the citrus oils can be very uplifting and beneficial. . And then one of my other favorites is is peppermint.
And peppermint has a very kind of cool, clear aroma that can really, feels like it open up your airways if when people use like really strong peppermint gum, for example, it's often in flavorings when they use, peppermint gum or sometimes peppermint tea or even a drop of pepper.
I, I will do a drop of peppermint in my mouth for breath freshening. And that really can open up your sinuses and make you feel more alert. So people will often pair citrus oils with peppermint, for example, to help. Maybe when they're studying to help them focus or when they're trying to do a difficult task, they may pa you know, pair those together to help them focus a little better.
And that can be a really fun way to use. I'll stop there and see if you have any other, , any other specific questions, but that's a, that's a few of the ones that I use. There's some others but just a way to think about it. Either the calming side or the, uplifting side or even the, focus side, mental alertness.
Dr. Diana Mercado-Marmarosh: Yeah. So I think that there is this is important to bring up because some people. To get in the zone or to get activated or to get yourself like ready to do a task that maybe sometimes we're not like, oh, I can't wait to do that task, right? , if you have a way to help yourself either.
For me it's candles I like to turn on candles and. Again, maybe it's the smell of it that just gets me there. I haven't tried essential oils yet, but I'm definitely open to trying something like that because the smell of the candle kind of helps me calm down or be more at ease and And so I could imagine, like you said, if you are with somebody who understands how much of it and what and when it could be very beneficial as a way for you to get yourself in that zone or get yourself To think about something different.
Because just like for some people it might be music that activates them. For some people it might be smells, right? For some people it might. And so I think this is a way for us to also consider, and like you said, you. Done some of this research and you understand that, we all try teas of different sorts, right?
And they are plant medicine, right? , all our medicines eventually are derived from something, right? And they are, it is just a different tool or it's a different method.
Dr. Ann Huntington: Absolutely. That was one of the reasons why I thought this was so important to share, is it is another tool. It doesn't mean that it replaces all of our other tools, but it really can enhance and augment our ability to, just really improve our lives with an additional tool.
And I agree. It often comes, our success in life often comes down to our routine. And I am reading the book Atomic Habits. I'm not sure , if you're reading that book. Yes. But it's a fantastic book that talks about, how life is really built upon our systems and our beliefs and then that leads to our habits.
And if we can have good habits that help us be successful, then we are often, very often to accomplish those tasks that we need to, even if they're difficult And One of the things that I've learned recently is if we're able to celebrate in a way, once we complete that ha that task, having just that pattern of Yep, I'm gonna do a difficult task.
I'm going to, get my setup where I need it to be, to improve the chances that I will get this done. And then I have a little way to celebrate and take a break. Once I've completed that, before I move on to my next task can be really Improve that, ability to do that and also improve our satisfaction in getting things done.
So that can be really fun. I know that, oftentimes when we are. Worried about focus. And this is, certainly when we're on screens a lot or when we are super tired, that can really reduce our ability to focus appropriately. And I think lifestyle is foundational, right? Having a healthy diet where you are really taking in the nutrients that you need to be fueled, hydrating getting good sleep at.
Really doing all of those things can help improve our chances of being able to focus, being alert, awake, not having that afternoon slump where we're super tired, right? We crash and then we, sometimes people fuel with coffee to get up, but, All those things are little habits that we can do that, a thousand habits can make for, really big changes in our lives.
And this is just one of those that can add to that routine. It's really fun. Yeah.
Dr. Diana Mercado-Marmarosh: And I'm sure like, Having some awareness of on these when you can't necessarily use some medications like for when you're pregnant or when you have other chronic conditions that maybe your autoimmune puts you more compromised.
Having the ability to again, reach to something more natural is just a way to also enhance, right? Or sometimes just being aware. Some people can't swallow pills or some people can't, so again, it's having different delivery methods that can really make a difference. So I think, yeah, it's so important.
Yes. And with Atomic Habits What they say is if you're able to habit stack, right? So if you add something like a pair with something that you don't like to do with something that you enjoy doing, and it's like you said, you're rewarding yourself for doing the thing that maybe you need to do or want to do.
And that can make a big difference. So for me, That means turning on the music and dancing to Shakira Aquin. I don't wanna do the dishes right . So it, it's or listening to a cool podcast or a good audible book while I'm doing the dishes. So it is just a way to figure out how can I still do the task or if I, and not make it be so hard with I like using and I've.
I like using the candle that usually has e equi, I can't even say the word eucalyptus. Is that how you say eucalyptus? Uhhuh. . Yeah. Eucalyptus. Does that, have you learned anything on that or does that have any type of, is there a eclipsis oils? I don't know why. I feel like that smell helps me to focus.
I don't know if there's anything with it or not, but I've, no, we all become a creature of habit. . , when you. Something and then is working. You don't change it, you just keep going to the same thing.
Dr. Ann Huntington: Yep. Exactly. Yeah, that's a great point. So everybody's so different. We're all so different.
Our body chemistry is super different. Just our preferences are different and sometimes. Different smells we really like, and then sometimes we really don't like 'em, and especially, as you mentioned through pregnancy, we can sometimes really, crave certain things and then the next week you're like, Nope, that's disgusting,
So it can change. But yeah, we should, so eucalyptus there is an essential oil that's eucalyptus and one of my family members grew up in California and loves Eucalyptus because it's there as well. And just that clean ar. And we actually use eucalyptus in the shower. When you're heating up the water just before you step in, you can drop a few drops of eucalyptus and have you get your little spa experience for a little while, and that can improve your day.
One thing to mention as we're talking about different preparations of these, that these products that contain essential oils is the quality. And it's interesting, the essential oil market is crazy. It's multi-billions of dollars and it's everywhere. Essential oils are every. But there's a distinction between the therapeutic, just the aroma and the therapeutic use.
The, you. I guess I should back up and say essential oils are in our food supply. They're used as flavorings in our food. They're used for, to enhance the flavor. Sometimes they can be used in our skincare products, in our candles, like you said, certain lotions, certain shampoos. And then, in massages that we would get, with an aromatherapy massage and then, on a therapeutic side.
And so sometimes we may be getting eucalyptus or lavender or tea tree in some of our product. But some of these products may actually not contain very much of the exact, of the actual essential oil because they're either diluted with other, other chemicals or other things that are in there.
And you may have very little of the chemistry to actually have a therapeutic benefit beyond the aroma. So that's one kind of distinction for, especially for the physicians who are listening, we're so used to having medi medications be pharmaceutical grade where if you say, all right, I'm gonna, prescribe a certain medication at a certain dose, you're pretty confident that you're gonna get that dose without much variation, right?
The supplement and nutraceutical industry totally different. Unregulate. You've got, lots of different suppliers and lots of different methods of processing and lots of things that, may not be what you what you think they are. So that's another thing to keep in mind when people are thinking about essential oils because they're everywhere.
But. It can be difficult to distinguish what are the highest quality and what are not diluted with a lesser expensive oil or with a vegetable oil without telling, telling the consumer. So that's something to keep in mind. When you're looking for high quality, make sure that there's a few, things that we can share with our listeners to find a higher quality essential oil if they're just buying the essential oil.
Look for the the name and the name of the essential oil and the parts of the plant that's used. Look for the Latin name that should be list. And it should be in a glass bottle rather than plastic. It should be in a kind of amber color to protect it from light and heat.
And it should be, it should smell like the plant. And some of us don't even know what the plants smell because some of them we may have never heard of or never walked through a field of lavender or, some of those are more common. Those are just some ways ideally it would say organic and it would be wildcrafted and it would, really be therapeutic grade.
Although there's many that will say their therapeutic grade and they may not be. So there's, it's pretty tricky to find a really high quality essential oil. I would look, certainly a, there's a lot of websites you. , sharing these, selling these. And very few of them actually, share a lot of the scientific knowledge and a lot of the, the.
Chemistry in the background behind them. So that's something to, just be aware of. But can be really, I don't wanna Go ahead. Put,
Dr. Diana Mercado-Marmarosh: put you on the spot or Oh, yeah. But do you have one that, or two or three that you sometimes like, or do you, that you refer people to buy from or is that something that you're still like working
Dr. Ann Huntington: out?
That's a great question. I'm gonna answer that in a little bit indirect way by saying yes there's certain companies that are better than others and and so I have, found one that I stick with very generally in a lot of physicians. Stick with them. I don't share it publicly.
Because I'm not promoting any certain company, but there are ways that, that I'm working on to be able to share with people because people are asking me all the time where do you get the yours and how do you find them? One thing to look for from a testing standpoint, and this is really important to make sure they do G C M S testing or gas chromatography, ma mass spectroscopy, and that they actually probably label their lot number or batch number so that you can look up where this came from.
Now GC m s is not the only way to test. Some companies do just GC m s, but there's far more testing that goes into having the highest quality essential oil. So I would say look for a company that really does. Very extensive testing. Not just G C M S, but different other types of testing, organoleptic testing and some of the others.
My website actually has some information on testing that's much more detailed. And so there's ways to do that and to at the companies and look at the sourcing, where they get these from. Do they get them in the lab? Do they make them in the lab? Do they get them from. Small family farms or for, from commercial farms or from a lab.
Those are all important questions, but yeah it's a really interesting process. If you're getting a $5 essential oil at the supermarket, you're probably not getting the highest quality. They're expensive to produce. Whether it be, distillation or other. They can be pretty ex, expensive and they can also take a lot of plant matter to produce concentrated essential oil.
So what would
Dr. Diana Mercado-Marmarosh: be a roundabout that you would think, okay, maybe we're on the right track, like a $50 one with saying something along, like you said, a glass and then amber looking container. And if they put something about G C M testing, then maybe we're in. Way, would it be something around the $50 mark just so that our, of course, everybody has to do their own investigation , and like we said, that we're not here to give you a physician advice and you still have to check with your own physician to make sure there's no contraindications with the current meds you're on yourself.
But just so that we have something in our minds of what we're going towards since maybe this is a thing we're all excited about and we're gonna go
Dr. Ann Huntington: exploring. Yep. It's a new thing. It's a whole new skillset set, actually. So it depends on the, it totally depends on the essential oil.
So citrus oils are relatively inexpensive somewhere in the 10 to $20 range, depending on the amount. It depends on how much. And then, lavender, peppermint, a little bit more expensive. In the 20 to, 20 to $30 range. And then something like Rose, which takes, tens of thousands of rose blossoms to actually, you.
Create enough essential oil for rose, essential oil can be a hundred, a couple hundred dollars. So it really depends on the essential oil. Some are just more costly to produce than others. I would say. This is, my website give more naturally. Dot com has information on testing and a lot of information on that, that people can can look for.
And they can certainly subscribe to my email list and we'll give a little bit, information over time about this and can certainly follow me. It has taken me a long time to learn about this and it can be overwhelming to people because there's so many options on the market and people wanna make the right choice and people wanna, try things out.
And I, and one other thing we should say is, as we've, as you've appropriately mentioned, yeah, we're not given medical advice. These actually aren't FDA approved. They're not regulat. And they're, I can't say that they cure or prevent, treat, any of the diseases, but I think they can help augment some of the ways that people are trying to feel good and trying to improve their quality of life.
So that's my biggest focus. But it's a fun it's a fun exploration. It's fun way to explore
Dr. Diana Mercado-Marmarosh: and learn. And so tell me about your fun exploration that has now led you to like your passion. Project that is now your big business, right? So tell us about that, because I think you're really gonna disrupt the field of medicine in a good way.
And I know you have a course, so tell us about
Dr. Ann Huntington: all of that. Yeah, thank you. Because it took me so long to learn about this and to sift through all the research and to learn the safety and to learn really how to use these effectively, I created a course for physicians, a virtual course. On what I wish I would've known when I started this process.
A way for docs to learn in a much more succinct way. They can learn the research, they can feel confident about the safety as much as the information as we have on some of the most common essential oils. And they can learn about the market and the industry and where things can go wrong. So that, that's what I've done.
It's taken me a long time to compile all this information together, but it's entitled an evidence-based Approach to Essential Oils. And it's a virtual course that has c m. It is it's four weeks. It has some live q and as well. This is just for physicians and pharmacists and dentists at this time.
And then, there will be other information for folks who are not physicians, et cetera, in the future. But it's a really great way for docs to just learn the basics and take a deeper dive into the research and the safety and learn how their patients are using these. And part of the reason I created this course was because our patients are using.
All the time. I will often have patients coming in to the hospital and say, oh, I use this. And I'm like what do you use it for? And then we have a conversation and they're already using these and sometimes they get good education, sometimes they don't get great education and they don't know about 'em really well.
And that's a concern in the industry where you have, sometimes salespeople that are teaching, they're trying to sell. There's a varied degree of education and it's gonna be different than having your physician educate you about these. Look at your whole wellbeing, look at the medications you're on, the medical conditions you have.
What your kidney function looks like and liver function looks like, and all of those things to make sure that they can give their best recommendations. So that's why I created it. It's gonna be really fun. It's launching next week and we'll be we've got some information out there, but I'm super excited for people to take a deep dive and learn with me.
It'd be. .
Dr. Diana Mercado-Marmarosh: This could become a vertical for them too, right? If they decided that they wanted to turn around and look into it in the future, as you continue to educate them they might decide that they, they might. Find a company that, that they really trust, with sa and who knows, right?
This could be something just like some people say, oh, here's some vitamins that you can try. This might be something ju It's not anything different than that. This is some essential oils that you might wanna try to enhance your mental health to enhance your energy level, to enhance , your overwhelm it to decrease your overwhelm and enhance your stress-free life.
Dr. Ann Huntington: ?
Yeah. Yeah. I think there's so much opportunity for us to learn additional tools to, help improve our quality of life and really they're, there's, they're so versatile because of, the way the chemistry is. They're just so versatile. They can be used in a lot of d.
Situations. We use them, like I mentioned, everywhere from helping, calm things down to, before sleep, to putting a little tea tree in my kids' really smelly tennis shoes, to help improve the aroma and everywhere in between. There's so many ways to, to use these.
And once, once you learn a lot about them, then you can. Feel more confident. It is, it's interesting. Some people use them far too much, I think, and they still, we still have to be careful because they're, people will say, oh, they're a hundred percent natural, they're a hundred percent safe.
That's not exactly true. There's always, a another side to everything. So people need to learn about these. But I think there's some really good benefits and so many physicians are, doing integrative medicine practices now. They're getting additional integrative training. There is some essential oil education in some of the integrative medicine training, but not as much as what I've, put together as a really good standalone course.
But they're, people are interested in their, telling their patients and giving them additional tools and paying it forward, which I think is really fun. Yeah.
Dr. Diana Mercado-Marmarosh: And I would be really interested in figuring out how I could help, like the parent of the kid who just is at their.
It's n right? Where they're like, oh my God, how do I, yeah. And or my Alzheimer patient who is just, does not have the awareness of why they are sound downing or why they're doing X, Y, and Z. Yeah. Like how cool would it be as a family member to have a tool. a help and to have the right tool, that is, yeah. Like you said, with the help of somebody who understands these and not just somebody who might take advantage of you cuz you're trying to do your best for them and you don't know what you're getting, right? Yeah. But, . Yeah. I think, like I said, I think this is a new tool that one should definitely look into because like you said, they're still using it, so you might as well understand what they're using so that yeah, you can facilitate the discussion because you, most of us think, oh, they're not paying attention to us or whatever, but they are like, if you they bring me all their supplements because I'm very open mind and. How much are you paying for that? That's my first question I asked. I'm like, did you realize these are just all vitamins? And I read it to them and I'm like, as long as you realize what's in here, and as then, and if you're okay with it, let's try it. Give it a three, four months of it.
And then if you really see a big like enhancement, why not? But if you don't notice a difference, then I don't want you spending in that, and so we have that discussion. Yeah, because sometimes they're not aware that what they are taking, they're double or triple taking it because they're also taking a supplementation of that specific vitamin B12 or that specific vitamin C and sink and all this other different ones, plus the multivitamin, plus the whatever they bought.
On the internet or something. Exactly. So I think it's so important for us to realize that when we are asking our patients, or even ourselves when we are, like, sometimes we don't mention all the other stuff that we're doing right. When we they ask us. Cause we're like, oh, that wasn't prescribed.
They don't need to know, but forget. Yes. It might like, it might have some enhancement or diminishing return. Unaware to you that you're oversaturated on something, right? Yeah, exactly. I really love what you're doing and like everything, sometimes we don't know why we are passionate and we hyper focus on something , but we gotta use that as.
As a tool to help others because you already did all the research. I'd rather come to you and just tell me what I really need to know Exactly. Because I don't wanna go and
Dr. Ann Huntington: figure it all out, yeah, I totally agree. We don't have time for that. . Exactly.
Dr. Diana Mercado-Marmarosh: Work smarter, not harder, .
Dr. Ann Huntington: Exactly. Exactly.
I think that's so true. And going back to what you said about the mom, with the kids I do know that sometimes, sometimes kids, especially if they are, neuro. They maybe not, they may be a little cautious to try something new. It may be a little overwhelming for them.
And we're always cautious about what we put on kids' skin and things like that. Sometimes the moms will put the oils in their hair. and hold the kid that's, really upset and that can really provide some calming benefits. That's a little mom hack that we use because it can really really help soothe them and can really, be another way to redirect the situation similar to, like you said, your patients with, that are elderly and that may be a little agitated that can, that can really be soothing as well.
There's some fun and potentially really beneficial ways to use these. But it's, yeah. I think it's, the possibilities are endless. And really the opportunity is really fantastic. I will say my course has a significant safety component because as a physician I wanna make sure you know that what I'm doing is safe.
And of course, there's so much information out there. There's no way I could compile all, 20,000 plus. But we will talk about interactions. We will talk about specific patient populations and conditions and what to be cautious of, because I want docs to be empowered with the informations that's out there.
It, it's gonna be out there. The patients often are like, oh, that, that sounds great. I'm gonna try it. They're just like, Great to jump at it. And the docs on the opposite end of the spectrum are like, Ooh, that's new. That sounds woo. It sounds like snake oil, . I'm really nervous about that.
Is that safe? And so you've got people on the opposite ends of the spectrum, and there's nobody in between creating a balance to say we just need to, we need to bridge that gap. And so this is an effort to bridge the gap of what's happening right now. Educate physicians who are open-minded and who are willing to learn and also educate patients like, You can't use 30 essential oils and not expect, these are still metabolized in the body.
They may interact with your medications. They may, cause issues. You need to, there needs to be some balance here too. And ultimately for those people who are listening who are like many of my really hardcore lifestyle Madison colleagues. Absolutely, I agree. Lifestyle is foundational, right?
This is not going to reverse the effects of your fast food intake or your high sugar intake. Oh, oh man, . So this is a way to augment a healthy lifestyle and really improve that quality of. So I gotta throw that in there. .
Dr. Diana Mercado-Marmarosh: Yes. You have to point that out too much or too little of something.
It always gets us into trouble. So tell us again, where can people find you? Yeah,
Dr. Ann Huntington: so my company is Give More Naturally. The idea is to give more tools, more hope, and more help. And it is www dot give more naturally dot. And you can subscribe to our email list, even if you're not a physician, you can subscribe.
And then the course again is for physicians, pharmacists, dentists, cuz actually dentists are using them in their practice. They may not know some of the dental treatments have some clove and other essential oils in them. And It will, the registration's open now again at C M E for those who are, can get reimbursed.
And then it will close next week and we'll get it started. And
Dr. Diana Mercado-Marmarosh: I talked her into giving us a code for listening. So would you mind sharing a code with us today, ? Yes.
Dr. Ann Huntington: Yeah. So for those folks who listen to Dr. Diana's podcast, we have a 10% off. So you would, when you go to check out type in podcasts as your coupon code, and I'll give you 10% off for this for listening to this session.
So I'm grateful for you to have and be on and being able to share this message.
Dr. Diana Mercado-Marmarosh: Okay. So before you go, I always ask everybody this. These two last questions. The first one is, let's say, the audience that you have right now, we tend to have wondering attention. So if you just started listening right now, what is the takeaway point you want them to take away
Dr. Ann Huntington: today?
Yeah, great question. Essential oils in general are safe. They are effective if you get the right quality and know how to use them and they can really be a positive force for good in your life and in your patient's. But it's a lot of work to learn. So for the docs out there, come and take the course, listen and learn, and we will continue to learn together.
Awesome.
Dr. Diana Mercado-Marmarosh: One last question. In the next three years, what do you see yourself doing for fun?
Dr. Ann Huntington: For fun? Ooh, that's a great question. I as similar to many of the docs and other people that are listening, I have lots of interests, so I have to narrow. I still, I think this is really fun to share, this message with people.
So there will be some consulting opportunities. I think educating medical students and residents will be really fun, and I've had some of those opportunities. And then I love to travel, so I speak Spanish, so maybe we'll go to Costa Rica sometime together. and and love to, I really love to, connect with people and I think that's an amazing aspect of my job as a physician.
And also, an interest on the.
Dr. Diana Mercado-Marmarosh: Hey, I would be like tax write off. I have to go test the original source of this essential oil, right? Like
Dr. Ann Huntington: all over the world. Go collect some, right? ? Yep. There. Yeah. Some of the companies, there's an opportunity go visit those places where they source the essential oil, so that could be an opportunity.
Hey, you and I, we gotta talk, . That's right. That's right. Let's plan.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for coming. It's been a pleasure. You having
Dr. Ann Huntington: you. Thank you so much for having me. Have a great day everybody. Thank you for spending
Dr. Diana Mercado-Marmarosh: your time with me. I really believe that time is your most valuable asset.
Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: [00:00:00] Come join me May 1st through the 6th, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.
Well, hello. Hello everybody. I am so excited today. I have a very special friend with me, Dr. Brittany Panico, and she is from Arizona and she's a physician. She's a rheumatologist. She's an. Autoimmune guru. Okay. A guru. Okay. So she's gonna talk to us about all the things but I wanna tell you about her because it's very special.
She is a board certified internal medicine doctor, and she's an also adult rheumatologist with experience both in inpatient and outpatient. And she is, Her platform is that we need to make sure we are doing this together. So she's an advocate for shared decision making and she really wants you to realize that we're a team here that you know, while I might not know everything, you might not know everything, but when we put our heads together, Everybody wins Your health wins.
And she is the chief of rheumatology at Summit Rheumatology and Gilbert, Arizona. So today we're gonna have a really cool talk about how sometimes steroids can make her A D H D misbehave a little bit . . Also, we're gonna talk about how sometimes we need to be aware that, again, when we are deciding that the course that we are getting from using certain medications are not, Exactly what we want.
We have to have this conversation about decision making so that we can pivot or figure out what the next best thing could be. So, without further ado, I wanna invite Dr. Brittany Panko today to share with us how she got excited about rheumatology.
Dr. Brittany Panico: Thank you so much Dr. Mercado. So Yeah, I'm really excited to be here and basically, like Dr.
Mercado said, I practice adult rheumatology and really, really want my patients to be a part of the team. So when we talk about medications, when we talk about diagnosis and what that means to you as a patient, , it's really important that we're all on the same page together. So excited to chat about different things that can contribute to either A D H D exacerbation or more trouble concentrating or trouble at work or at school or at home.
So yeah.
Dr. Diana Mercado-Marmarosh: So how did you land with ad with rheumatology? Like is that something you knew you wanted to do all the long, when you were in medical school or, or did just come about once you were like deciding towards the end?
Dr. Brittany Panico: So I became interested in a rheumatology actually, after a dermatology rotation.
I noticed that a lot of patients with psoriasis were coming in and really struggling with wanting to talk more about their condition, about more about how they felt, how their bodies felt. And in dermatology it was about treating their rash, their psoriasis, and we would see patients. You know, talk about medications, talk about prescriptions, and then the attending would often say, now you go see your rheumatologist.
And I didn't really know what rheumatology was at that point, but it really triggered me to think about. Okay, if, if this specialist is sending you now to this person, what is so special about that team that can fix the things going on? So I really started paying more attention to the way that rheumatologists kind of fit a lot of the pieces together.
And we're often kind of referred to as the problem solvers when things don't seem like they're going right or when we don't have an answer. Patients will often be sent to rheumatology to try to understand the puzzle of what's happening. So I really, really enjoy that problem solving approach. And then also it's just a really exciting time in the time of biologics, the time that so many new medications are coming out and really can change the way.
Patients feel and we can see it happening. So it's really, really exciting just to be a part of a field of medicine where we can really impact somebody's way of life for the better. And I just love being a part of that. Awesome.
Dr. Diana Mercado-Marmarosh: And. in your years of, of practicing have you seen a lot of us with a D H D come through to your clinic or some of us, or what have you noticed with like, the use of steroids?
Dr. Brittany Panico: So I definitely try to pay attention to that. If a patient talks about. Diagnosis of A D H D and how that might impact the way that they're feeling, because again, we're trying to put all of the pieces together with, with the person and what's going on, so, A lot of times in rheumatology, we focus on the way medications interact with each other, and I think that's really important when we consider the use of steroids or prednisone is the most common one that we use because a lot of people not in rheumatology are nervous about prednisone and patients come in oftentimes already having that kind of mindset of, oh, I can't really be on this, or, oh, I know it's gonna do something to my body.
And we use prednisone to calm down inflammation. That's our most powerful way to. Control of the inflammatory process, the fastest or quickest way. So I do find that, you know, we have to talk to patients and we have to, to talk together about the way that this medication might make you feel. So if you're already somebody who is trying to, you know, use systems to concentrate or have very specific ways of, of categorizing time, for example, steroid.
Are another way to rev up your system. So you might feel like you're caff the caffeinated version of yourself. So if you're sensitive to that, then steroids are probably gonna make you feel that even more powerful. And so, It's really important that we talk about potential mood changes or distractability or just ways that you might feel like you're kind of jittery inside when you're on something like Prednisone.
So it, it's something that I definitely sit down and talk with my patients about. and if they don't like how they feel, for example, if you're having trouble with insomnia or staying awake too long, or balancing your mood or feeling more anxious or more depressed or angry, or have changes in your temper, then it's really important that we talk about those things so that we can adjust the dose of your medication or modify how you're taking it.
Dr. Diana Mercado-Marmarosh: So did you say D caffeinated version or caffeinated?
Dr. Brittany Panico: Caffeinated version . Okay. Steroids give you more energy.
Dr. Diana Mercado-Marmarosh: Okay, gotcha. And so if they take the steroids and then they use their own medication, I mean, again, and some of the, some of us are on many me medications, so you, we can't simplify. And again, we're not trying to be your physicians per se, we're just having a discussion here.
And you have to check with your own physicians to get all the specifics for. Specific situation, but just so that I understand let's say you have somebody who takes a D H D medications and it's a stimulant, and then they take the steroid, it might enhance, like, and therefore they might have more anxiety.
Is that what we're saying?
Dr. Brittany Panico: Yes, yes. So sometimes I'll recommend to patients that they kind of stagger how they take their two medications or multiple medications so that you're kind of getting more of like an even flow throughout the day instead of those dramatic ups and downs of, of the feeling that you get.
And so, a lot of times, Prednisone as well can, if you take it too late in the day, kind of like a D H D medication, if you take it too late in the day, you can have trouble sleeping. So it is recommended that, that we talk about ways to, to help with that and sometimes just staggering the way you take your medications can be really helpful.
Dr. Diana Mercado-Marmarosh: Yeah, I mean we, like you said, sometimes we underestimate. The possible interactions or possible. Things that can happen. I remember not too long ago, maybe two or three months ago, I had a patient who came in and you know, she was having severe, severe headaches and I, and I wasn't sure if it was because she was withdrawing from the medication for A D H D because some people can have headaches whenever they're don't drink enough water.
Or, you know, if they went from a regular medication to an extended release medication and. I decided it would be cool to kind of reset her headaches or her with five days of steroids, . And sometimes that works wonderful for some people and for her, not so much. I think she was back within like two or three days and she's like, I don't know what happened, doc, but my husband says I'm a raging, blah, blah, blah, blah, and I cannot be on these two meds together.
And so I'm. And so again, we don't realize sometimes because it could be that, I mean, I've given that treatment a thousand times to somebody with headache and they've done wonderful and I've given the, you know, the A D H D and, and sometimes you don't. Think together until they come back and you're like, oh yes.
Okay. Yes. I, I see. And and so they swear they don't wanna be on one or the other, but I'm like, no. I think it was the combo of each, I think you would be okay if you just had to do steroids, if you have bronchitis or if you have an asthma attack or something like that. And like you said, being mindful of when can I take it and not taking them together exactly.
At the same time. Right. And then also, like, did you. Lunch, they just skip everything else. Right. And, and so it, it's so important to talk about this because both of those mets can be so common, right? And we don't, because they're so common. Sometimes we don't slow down enough to evaluate like what else is going on.
And so, yeah, that you. That's why I'm asking these questions and then we think back at our experience and you're like, oh yeah, I remember that scenario. .
Dr. Brittany Panico: Exactly. And sometimes too, when we think about the dosage, right? If you're on a chronic medication, let's say for adhd, you're getting the same dose pretty much all the time, and then you try something new or short term like steroids.
Sometimes our dose that we would think of, we just have to lower that for certain people and just think, okay, maybe try half a tab instead of the whole thing at once. But yeah, everybody reacts differently and, and again, a lot of times patients get really angry and upset that we should know better, but we don't necessarily know how medications are gonna affect individuals and.
What makes it so powerful to provide that feedback? Like you said, you know, if your follow up wasn't supposed to be for a week or so, but you're really, really struggling with how you feel, check in with us sooner so we know that you're struggling because if we don't hear from you, we don't know what's happening.
Dr. Diana Mercado-Marmarosh: Yeah, exactly. We cannot read minds, right, and and that's the thing too, like sometimes when things are going so well because they're going so well, you're like, oh, I don't think I need that anymore. You'd be surprised how many times like people just stop taking their antibiotics or they stop taking their anxiety or depression meds, or they stopped taking their blood pressure meds because they're like, but it's been so good and I'm.
Because you were on it. That's why it was so good. . And then they start like saying, but then it stopped being good. And I'm like, well, how long has it not been good? And then you like backing up and trying to find out the half-life. You're like, yeah, that's why, because now it's almost a hundred percent outta your system.
And, and so. This is why it's so important to have a conversation. Of course, we don't know all the possibilities that could happen. We're not like, if we knew that this is gonna cause a harm to you, why would we prescribe it? We would never do that. Like we took a oath first, you know, harm. But this is why we.
We need feedback because there's no way that we would know one way or the other. And if it is going so well, like you said, again, come tell us because then there's ways that we, of course, the less meds that you're on, we're happier because you know, less interactions. But we can help you like taper off so that we do it in a safe way so that.
Maybe you are in the, we get you to one fourth the dose of what you currently are on, but it still gives you that benefit that you need. And so that's why it's so important, like you said, to have that conversation.
Dr. Brittany Panico: Exactly. And you, you mentioned the tapering part too. So as a rheumatologist, a lot of. Our medications to wean off of them are designed to taper.
So just like I'm sure you talk with your patients all the time, don't abruptly stop something, you may have to slowly taper off of it. And that's true in rheumatology too. We don't want our patients to just cold Turkey stop something because. You mentioned the headaches or kind of those withdrawal symptoms that can happen with some of our medications too, so definitely that's part of the process as well.
Dr. Diana Mercado-Marmarosh: Is there any other medications other than steroids that you've noticed that can sometimes have interactions or Like for any mental health stuff that you've noticed or, or anything that just like as a primary care physician who's listening might be, you know, keeping that in the back of our
Dr. Brittany Panico: minds.
Definitely. And I think we kind of, you know, Talked with the about the prednisone as sort of a negative side effect, but a lot of the positive stuff that we're seeing, especially for patients with rheumatoid arthritis, with lupus and with psoriatic arthritis, is that the biologics or the injectable medications actually have a really positive effect on mood.
And things like anxiety and depression. And so the longer that a patient is in remission, meaning controlled disease from that condition, so controlled rheumatoid arthritis, controlled lupus, controlled psoriatic arthritis, then a lot of the mental health aspects are getting a lot better as well. So I've had several patients who come, About three months later and have been able to cut back on the dose of some of their medications, like antidepressants, anti-anxiety medications, just because they feel so much better in regards to their underlying autoimmune condition.
So I think that's a really powerful thing too, is that as we're following up with our patients, What aspects are getting better because you are on treatment for your other things and maybe we can start to taper some of those medications that have been pretty long term for people. So that's something that I really encourage my patients to talk to their primary care.
Team members about is, you know, I'm feeling a lot better, I'm having less pain, I'm having less anxiety, less depression, I'm sleeping better, I'm exercising, eating healthier. At what point am I able to maybe consider cutting back to see if, if I can manage and feel good with less medication?
Dr. Diana Mercado-Marmarosh: Yeah, you bring such a good point.
Like I am constantly. Cutting or taking away some of the blood pressure medication because their blood pressure was uncontrolled because they were in pain and now that their arthritis is controlled, like you said, now they don't need like three blood pressure medications because of course, even though I was giving them medications for the pain or whatever, like.
When you are living with chronic pain, like it's crazy, and then all of a sudden you start on methotrexate or you start the rheumatologist finally like can get in to see them and they can get them on the right thing and they come back. They're like, no, I feel great. I feel great. Like, no, I haven't used.
That Tramadol doc, I don't need it. Or, or, and then your, their pl blood pressure is like, I'm like, are you feeling okay? It's like nighty over, like, and I'm like, look, like testing them over and over. And they're like, I feel great. I'm like, are you dizzy? They're like, no. And I'm like, okay, well let's cut this off.
Right? Because like you said, all of a sudden you don't realize that we are like, pain can affect us in so many different ways. Right. You, you, you can feel hopeless or helpless and, and so you don't feel like. You know, you can function and so all of a sudden when you start to, yeah, you should be looking, how can I get off of some of the medications or decrease the dose.
So maybe you don't need 40 milligrams of Paxil, you just need 10 now. And, and like, we wouldn't know again because. We're so used to, this is what we've been doing forever. But then again, like you said, what is getting better and, and keep looking at it because sometimes medicine keeps focusing on like, what's wrong, what's wrong, what's wrong, instead of what is Right.
Dr. Brittany Panico: Right. Exactly. Yeah, and, and I'm glad you mentioned the pain aspect of it too. I see that a lot with my gout patients. Once we finally. Gout under control, then the need for pain medication specifically can go away. Meaning that you can completely come off of things like tramadol or narcotics if you've been using them and, and blood pressure, kidney function.
There are so many things that can start to go right once you treat the underlying issue that was making those. Become problematic in the first place. So exactly this, this whole philosophy doesn't apply just to depression or anxiety or A D H D. It applies to, to the whole body function as well.
Dr. Diana Mercado-Marmarosh: Yeah, because I mean, so much can change because if you were taking like.
The max dose of ibuprofen, the max dose of Tylenol. And like we were very careful watching your kidney, right? Because it was like right at the tip and all of a sudden I had to send you to that specialist and that specialist. Right? Like it, it, it's so important to realize that we, we are the whole system, not just one part of the, of the system.
Right? And so, yeah, I, I think it's, And of course when you, you realize that your insomnia was also steaming from your anxiety, and now you started to treat your anxiety, oh, maybe you don't need a sleepy medication because you're no longer anxious about that . Right? And, and so it goes round and round and round, but it's, it's so important that.
And I know sometimes it feels like we don't have enough time to talk about all the things, but if you, in general, before you go to the doctor's appointment, can like brainstorm what is going well, like that can help facilitate the discussion and then figure out where to go from it. From there, tell me more.
Like what your passion is in, in your practice? Like what, what, like what lights you up, .
Dr. Brittany Panico: So I'm really passionate about in a couple of things, but I think at the heart of what really lights me up is finding areas where we're sort of ignoring a population of patients. So, One of the things that I'm doing in my practice Summit Rheumatology, is we've created a gout center of excellence and we're really focusing on trying to network and reach out to the community about properly treating gout, and that can be.
Either through oral medication, there's an IV medication that we use, and really just identifying that gout is a problem that a lot of people suffer with and live with, and just periodically will seek care when they're having an event or a flare. Rather than addressing gout as a whole body systemic issue.
So there's a lot more research being done, a lot of work going into, you know, helping educate all sorts of, you know, medical specialties, primary care, podiatry, surgery, orthopedics, even cardiology about how gout fits within all of. Systems. So that's what I'm working on currently and I'm really excited about that.
I also really, really like treating psoriatic arthritis because again, it's kind of one of those sort of under-recognized fields where patients will most often, you know, see a dermatologist for psoriasis. But then not really realize that their back pain, for example, is related. They may just think, oh, I have back pain or neck pain, and I go to a chiropractor and it gets better after I'm adjusted.
But in reality, it might actually be related to the psoriasis and be a form of psoriatic arthritis, and that can be episodic for people too. So a lot of times these more episodic conditions are hard to identify. And I think just helping patients understand that there is access to rheumatologists, even when it seems like we're few and far between.
And so I'm just really trying to, to get the word out and help patients understand that. You know, a lot of the conditions, a lot of the things that you feel like are not related to anything else are actually tied to an arthritis syndrome. So those are the two things that I'm most passionate about. I also really like to treat osteoporosis.
That's another gap in care, especially in my area that. Patients who fall and break a hip are then not necessarily treated for thinning of their bones, right? We kind of just think, oh, the surgeon fixed it and I'm mobile and I'm doing okay. When in reality, we wanna treat the reason that it happened in the first place.
So that's another sort of avenue that I'm trained to target as well.
Dr. Diana Mercado-Marmarosh: Yeah. And realizing that, you know, it is part of the preventative, right? Like you need to have your DEXA scan so that you can see if you're preo osteopenic already, and maybe you need to be started on something and don't wait until you had the fracture, right?
Like, like do it beforehand. And especially if again, you might have other comorbidities that. Can predispose you, and not necessarily just age-wise, but like whatever medical conditions you might have and medications that you might be on that can, I don't wanna say ages a little more, but in a way they kind of do.
Right? So we just gotta be aware that it's not just the age per se, but that, you know, a 50 year old might. Very different than a 70 year old that looks like the 50 year old. And the 50 year old looks like the 70 year old. Right. Not looking but like in terms of bone wise and health-wise. Right. And so it's so important to keep all that in mind.
And yes, I so much about this thoratic arthritis, like you said, sometimes we don't, I think as primary. Physicians, you might get a glimpse of it more than if you just are somebody who's like in urgent care or in the hospital where you might not see them as often. Because like you said, sometimes they might come in for the back pain and oh, by the way, I'm so stressed.
And then like this rash came up, doc and I, it always comes up when I'm like, so stressed about taking this test. And you, you, you might not put it together until , you know, they've come up several times or somewhere you put psoriasis or somewhere somebody else put arthritis and you're like, ha. Like, is it happening at the same time or not?
Right. And and like you said, when you do finally get that diagnosis right, oh my God, it's like life changing for them. And I
Dr. Brittany Panico: think too, there's there we're kind of in this sort of split. Chasm right now where, where a lot of us have, you know, patients that are younger and maybe around our age. And then we also have patients who are aging and, and friends who have aging parents and really trying to fit that spectrum of, you know, disease processes of preventative for the younger folks.
And then we're reacting to things from. Our older patients and trying to put those together and make sense of it. So I really do try to, you know, not only as I'm taking care of a patient but may be younger, you know, also addressing as they have aging parents who may or may not live in the same town as they do.
You know, there's ways that we can help prevent things in that population as well. Yeah.
Dr. Diana Mercado-Marmarosh: And like something and now I'm gonna go off a little bit off course, but I thought it was something that I, I found it interesting and I don't know if you knew this or not, but I read like a study saying that sometimes when your, your, the mom has like arthritis, like that, that might increase the risk for like a D H D or bipolar by 50%.
But I don't really know if. Like like just coincidental, you know, because it could be that, you know, some people sometimes, as we. If the mom had gestational diabetes, then they might have diabetes later on. And sometimes people can have autoimmune conditions and then that can like predispose people for other stuff.
I, and I mean, at the end of the day, D H D is genetic, right? And so we don't know if there is direct associations or not. And I don't know if you have ever. How about any of this data yourself? Do you know? I haven't
Dr. Brittany Panico: read that particular study, but I do think that it's really fascinating because when we think about.
childhood events and how that can lead to health conditions as adults. It is very interesting if a parent is struggling with a chronic disease that maybe isn't treated optimally or isn't diagnosed and acknowledged how that affects the home, right? So, right. If I'm a mom and I'm in pain and struggling to get out of bed every day, my children are gonna be affected by that.
And as my children grow up and realize, What is quote unquote normal for their household that then will translate to the next generation and can develop into health conditions in, in that own person. So we're, we're in this phase where things that our grandparents or parents didn't really acknowledge or didn't have the tools to even be able to address when they were in their thirties or forties even.
How that's affecting, you know, us or our children. And, and so the more that we can get patients to see their doctor regularly get treated for the things that they're facing and just have these conversations about how to get help and how to address things that they're struggling with, that's only gonna help our children as.
Go through this process as teens and young adults be more comfortable with preventative medicine as well.
Dr. Diana Mercado-Marmarosh: Yeah, exactly. You, you bring such a good point because like you said, sometimes we just think, well, this is the way it's always been like, you know growing pains or you, whatever you name it. And people don't realize that yes, there could be juvenile arthritis.
Yes. There could be like depression in a kid, or there could be, you know, other things that are going on that are not just oh, they'll get over it, type of thing. Right. And, and so, Sometimes, I mean, our parents are always doing the best that they can with what the knowledge they had. But like you said information being at our fingertips, we should it's okay to get a second or third opinion sometimes just to make sure we're not missing anything.
Mm-hmm.
Dr. Brittany Panico: exactly. Awesome.
Dr. Diana Mercado-Marmarosh: Well, where can people find you? Do you only do in-person or do you do virtual too in Arizona? Or how, how can people cuz I know there's a lot of people with gout and sciatic arthritis and now that people know, okay, she understands my d h adhd, she can help me. Like, I'm sure they're gonna be coming to you.
How can they find you?
Dr. Brittany Panico: Well, I would welcome that. So I'm at Summit Rheumatology. And you can find me@summitrheumatology.com and we have a you can fill out a form if you're interested in becoming a patient. I do do in-person and virtual appointments to all of Arizona, so currently only licensed in Arizona, but I am looking to expand that.
So hopefully soon I'll have some updates there. But yes, in-person virtual summit, rheumatology. And then I'm also on Facebook and Instagram, az like Arizona AZ room, r h u m Doc, d o c AZ room Doc.
Dr. Diana Mercado-Marmarosh: Perfect. Thank you. With my podcast, I say you have people who are listening and sometimes we have wondering attention, and so we just tuned in and we just started p ta paying attention right this second.
What is the takeaway point that you would want them to walk
Dr. Brittany Panico: away with? So my best advice as a rheumatologist is to just ask for help and be a part of the decision making. So I love it when patients come in prepared for their visit and ready to talk about how they feel. and just being involved in their health healthcare decisions is the most empowering thing that we as physicians can impart to our patients.
Awesome.
Dr. Diana Mercado-Marmarosh: And I always ask this question too what are you hoping to do for the next three years
Dr. Brittany Panico: for fun? Well, that's a good one. So I'm hoping to travel more. I have three young boys and we're just really excited to get out there and, and see a little bit more of Arizona and to travel. So that's my goal for the next couple years.
Dr. Diana Mercado-Marmarosh: So are you hoping to like, go to the mountains, go to the beaches? Like I, I'm trying to see this big picture
Dr. Brittany Panico: here. , , so all over. We haven't been to the Grand Canyon yet, yet. I think that'll be a fun one for, for the kids. And then we love beach vacations. We have family in California, so exploring more of California.
And we came from the Midwest. We moved from Chicago, so taking them back to that area would be fun as well. But my son, my older son is almost ready for the national parks perk at school, so I think we'll take advantage of that as well.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for sharing all your knowledge today and being here.
And all the people in Arizona are so lucky to have her there. So, but everybody else who's not in Arizona, hang tight, follow her, listen to her content, and she's expanding soon, so you'll get to get in on that too. So thank you so much. And again, remember it is a conversation between the doctor and the. We don't know everything.
You don't know everything together. We can put it together but do pay attention to what's going on with you because you are with you 24 hours and we don't know unless you tell us what's going on. So thank you so much again for coming and it was a pleasure to have you today. Thank you. Thank you.
Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free masterclass and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth so that you can rest rediscover your strengths, reconnect with yourself and those physicians like you who are ready to leave work at work. And re-energize. This is the invitation for you to make 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain. So that you can start to dream the life that you always wanted this year in 2023. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Deanna Mecado Mar. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in a personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits, We're just as important as learning the new set of skills.
Hello.
Dr. Brittany Panico: Welcome everybody. I am Dr. Panco. Dr. Brittany Panco. I'm a rheumatologist in the Phoenix, Arizona area, and I'm here today with Dr. Marcado. She's a family medicine physician in Texas, and we are here to talk about time management techniques and how this can be important for people with all kinds of health conditions, particularly.
Autoimmune conditions. Dr. Mercado is a specialist with a d h, ADHD and is a life coach specifically for physicians, primarily, but adults with A D H D, and she has. A coaching program that helps people reclaim their time. She has developed systems that help people live life with time management techniques and time awareness, and I'm really excited to talk to her today about how this can overlap with virtually any chronic condition, particularly patients who struggle with things like fatigue and just being aware of how, we can create time and how we can get.
The things that we have to do with ease and less stress. So welcome Dr.
Dr. Diana Mercado-Marmarosh: Mercado. Thank you so much for having me, Dr. Panko. Yeah, like three years ago, I would've never thought, Hey, I'm giving this lecture, or I'm giving this talk, or we're having this conversation because I. Was somebody who always was drowning with a graveyard of unfinished projects and I just could not find enough time.
I couldn't even put myself on the calendar because I felt like there was so much to do that I was always negative in time. And . So anyways, the pandemic did a good number at getting us to focus on what is really critical here, because no longer did you have maybe the community that you were unaware that you had at your fingertips because, as a physician you're being cautious how many extra interactions you're having cuz you didn't wanna be in asymptomatic carrier of a disease that you could get somebody sick.
And . Yeah. So that got me to start to think, how can I do this in a creative way that doesn't feel like a drag ? And how can I do it in a way where it feels like I have some control? And I think with chronic diseases like autoimmune or even like chronic diseases like diabetes or high blood pressure, or even a D H D to where.
So much we feel sometimes it's out of our control and right. And it can make us feel like, what's the point? What's the point when I can plan to unru in the face, but it's not gonna happen. And so I think this is where then I started to realize that we are all in our own journey and that we shouldn't be looking at what our neighbors doing to measure ourselves like that.
We should look. where my zone is, like where I am at, and have that awareness that our executive function or our emotional regulation tools are gonna bury from day to day. And being aware enough to recognize. , how am I today? Am I at my 80%? Am I at my 120% or am I at my 20%? And nothing is good or bad if you're under 20 or you're in your 80.
It's just being aware enough to then create the systems to support you in that energy state. The thing is with our brain can't tell. , if we. If we feel like something's gonna be hard or easy, but it normally is conditioned to think that everything's hard, , . It's just conditioned to think that way because it's trying to keep us safe.
It doesn't want you to be in any pain. Like I haven't met anybody who wakes up and says, oh, today I can't wait to Inflict so much pain on myself that I'm just gonna be paralyzed and not do anything that I said I told myself I would do. And so I bring that up because sometimes we're not aware that some of the things that we're doing might be like a trauma response to a situation.
. And so we all hear five flight, but we sometimes don't hear a freeze or faw, which is like people pleasing. And so today, , when I wanna talk to you about how to create time with ease, it's gonna be I can tell you all the things, but really you have to look into yourself cuz you hold the answers and see, okay, yeah, I work best when this or this or this.
And you have to. Pick out what you like and then be willing to try something different that maybe you weren't aware of. So for example, people pleasing and saying, no are the fastest way. Setting boundaries are the fastest ways to create time, because if you are passionate about something, and then for example, you want to dance Zumba or you want to read a book, all of a sudden, like you had a block time to do that and somebody asked you to do something else and it wasn't really what you wanted to do, but you said yes.
Now you're not realizing that saying yes to that thing is saying no to yourself or say, and so that's what I mean when I say create time with ease, because if you are. Thinking not from a selfish way, but from a way of how do I refuel my cup so that I can be at that 80% if I need to be at that 80% instead of being at the 20% and not being aware that you have the 20%, that's the fastest wage for you to be able to have more energy.
And like I said, I know that there's sometimes things are outta control. Maybe the Zumba instructor canceled on you and you already had it on your calendar, right? So deciding on purpose, okay, what is my plan B for self-care? Maybe my plan B is just reading a book like, or maybe it is calling a friend or maybe it is.
to have tea by yourself and relaxing, like realizing that you still have that block time for you is how you continue to feel your cup. And when you do that, all of a sudden you're like in a place of abundance. And if you do decide you want to do something, you're not feeling like you're having to or an obligation to.
can be very energy draining and time draining because you're there and you're like thinking, why did I do this again? And like, all that reminiscent, right? All that energy Yeah. And emotional tasks that drain us. And so it, it's so important to realize that to create time, you can plan things but have a loose planning to it to where you're not so rigid and then you're then disappointed.
Life happened, but where at least if life happens, you still have some flexibility or some fluidity to it instead of like just being stuck. Does that resonate with you? It does. I
Dr. Brittany Panico: love it because oftentimes we'll book so many things in our day or tell ourselves we have to do all of these things, and then we're just rushing on and on to.
And I find that way with work, especially when we have a certain number of tasks to complete in the day, and if we get behind or something takes a little bit longer than we planned in our brain, that's just so much energy being consumed to think about rushing onto the next thing. So I like how you talk about building an a little bit of a buffer because that allows our brain recover.
from the event that we did or the thing that we had planned. Because for people who tend to be more introverted, that running or that motion even in your brain is so energy consuming and leaves people really feeling exhausted. So I really like how you explained
Dr. Diana Mercado-Marmarosh: that. Yeah. In another way to think about it.
Is we all wake up with a certain amount of decision making capacity. Executive function. Okay. So if hopefully you slept six or seven hours, we can say we wake up with a hundred percent battery of decision making capacity. And as we go through our day, the more decisions that we make, Like it depletes it a little, depletes it a little, depletes it a little.
So if you are not checking in with yourself before you know it, like we're overwhelmed, we're anxious, we're angry, because maybe we haven't like you just said, slow down enough to acknowledge did I finish this task? Did I switch to another task or and we're not and when? Switch from task to task, and people say, oh I'm multitasking.
It really is not helpful. There's studies out there that show that if you just stuck to one task from completion to end, like you could get through like what? It would take you in a whole year when you're multitasking. You could get through everything in nine months, you would have three months to yourself of doing nothing , and you just kept one task at a time and I know it's like human nature or sometimes it's just the environment that we're in, that.
Pushes us there. Ki if you are a physician and you're in a busy practice and somebody ask you this and somebody ask you that and la da, or then the phone dings or we are constantly being pulled in many directions, but when you again, are intentional and saying, okay. Give me a second.
When somebody comes and disrupts you and you finish your thought and then you pay attention to them, it, it might feel weird, but you needed that nugget for you to complete that thought in order to then fully give them your attention. Because otherwise it might take you 10 or 20 minutes just to try to get back to that task that you were doing.
And that's where we feel. We're losing time and we might not even be doing the task, but you're pissed off that they interrupted you. Again, that emotional like tax that drains your executive function, right? The
Dr. Brittany Panico: ruminating Yeah.
Dr. Diana Mercado-Marmarosh: It gets to . Yeah. And on purpose, like having set break points for yourself and saying, okay, after seeing 10 patients or after like at 11 o'clock, like I usually start to feel drained.
Like at 11 o'clock I'm gonna go to the restroom. I'm gonna take three minutes to do my tapping meditation, or three minutes to just take a deep breath , and then come back and get me a glass of water and then keep going. I know it sounds weird, but. Few minutes of you being purposeful, you are actually creating time because you are allowing your nervous system to decrease that cortisol level, that adrenaline rush that go into Okay, right here, right now, this is what I'm doing.
Right here, right now, . And so it allows you to increase your norepinephrine and oxytocin and it slows down the pace a little bit, enough for you to catch up with yourself and then keep going. And the more that you do this on purpose, the more that you start to see. . Yeah, I have a sense of time.
And somebody with a d h d, we, we have time blindness and so sometimes we have to use we have to use timers to get, to be our external source of time awareness. And so not making it mean anything, if you need a. Like if that means your husband comes and taps at you, or your nurse comes and asks you or your child, if you tell your child, Hey, after you finish watching that cartoon, come check on me and see how I'm doing and being aware to use others to help you to manage the time is the fastest way. The kids are like the most amazing at being like present in the experience, right? They have that curiosity and that sense of awe and everything. And we might pass and see the same thing and we might not think anything because we didn't even see it, right?
And it's just remembering that to create time with ease, you have to start with what you really want. Because if you don't even have an intention at the beginning of the day, believe me, somebody else will put all of their intentions in your calendar. Exactly. And it's not yours. And if you waited to earn it, You're never gonna earn it because we're so hard on ourselves.
So what I say is have a dopamine menu. Meaning what are the things that are gonna boost up your energy, your excitement, or just your peace, right? Because we're maybe something we're just trying to neutralize when we're like on overdrive. We're just trying to get to like neutral ground. And if you on purpose can pull out the things that you like, whether it's looking at your.
The vacation you're gonna go to, looking at pictures at the beach or looking at the mountain, you're gonna go on a hike or looking at a, the picture where you went with your best friend, like somewhere like that, like reminds you of the Hawaii, because otherwise if we wait until we completed all the.
We're gonna be doing some tasks just to be busy and not, they're not, those tasks might not even matter five years from now, 10 years from now. Versus if you said, okay, today my intention is to get to my kid's soccer game, so maybe you don't close the recharge, but you gave yourself five minutes before you jumped onto the next patient to do the assessment and plan.
And so it doesn't seem like you're saving yourself time, but you really are because most of. We can have a really easy time putting in the, what happened in the top, in the pro, in the physical exam, because we already did the hard thinking, which was the assessment and plan, right? . But if we waited, Then we're looking using long-term memory and instead of taking you five minutes, it might take you 20.
And so that's what I mean by creating time by being aware, then you realize what the intentions are. If the intentions are just close all your notes today, then you might go approaching that scenario in a different way. But all. Like when you have a chronic disease, you might be thinking that doesn't apply to me, but it does.
You might have certain medicines that you have to take throughout the day. . . So if you pair it with something you need to do anyways, like that's gonna help you because instead of, that's what they call habit Stacky. So let's say that. , you need to take a medicine for breakfast and then, or before breakfast, and then you need to take a medicine like that lunch.
And then maybe you need to take something at at dinner. What are you gonna do in the morning? I hope you're brushing your teeth. So maybe right before you brush your teeth, you take that pill and then you have it stacked, right? . So hoping you're eating lunch. So maybe at lunch, right before you have lunch, you take that medicine.
And so again, You could set a reminder or you could have it stack in at the beginning. It might feel weird and you might need reminders. Could be your spot, like I'm saying. As the goal is for you to automize things and just like we automize that medicine that you need, you have to automize that time for your mental health, like I'm talking about with meditation or with exercise and it, and don't think that we need to go like exercise, and do a marathon.
Like I'm talking like. Park a little further, right? , you go see your doctor or when you go to the grocery store , instead of spending the five minutes looking for the closest parking space, , like park a little further where they're not gonna hit your car. And you can actually get some exercise in there.
And again, that gives you a sense of you being in control of what sometimes feels not controllable, whether you're gonna have, Be really short of breath or be really, sometimes it feels like we don't have control, but you do what you can that day and that's okay. You don't have to always be pushing yourself.
We're not robots like , the cars need gas, the phones need to get recharged so we .
Dr. Brittany Panico: Yeah, definitely. And I like to, that you mentioned, touching base, checking in with yourself about drinking water and making sure that you're eating. Because a lot of us will be will try to do so many things today that we forget to drink in between, right?
If you feel like you don't have time to go to the bathroom, you're not gonna force yourself to drink. But like you mentioned, going to the bathroom can incorporate a few extra steps. It's healthy for you to drink your water, and you can do another kind of habit in that time. Like sometimes I'll tell patients, do a couple squats when you're washing your hands, or add some form of something in there that does benefit you and recharges your brain and just gives you that mental, clearance where you can just clear away the space for a minute or, close your eyes and take a few deep breaths.
Something like that. I like that you incorporate that habit stacking technique in, cause I talk about that a lot too.
Dr. Diana Mercado-Marmarosh: And when we're doing some of those habit stackings, it sometimes when you do something you like anyways with something you don't like, like that saves you so much time because it decreases the initiation that it, the task would've taken.
the dread. , exactly. Like for me, I hate doing the dishes. Like it's just, I'm not like, Ooh, sign me up. But I don't like how messy it looks afterwards. Or the drag when you've ignored it like a couple of days and so has your husband and everybody else. On purpose. Like I will put on a podcast or an audio book or turn on Shakira.
Something that like I can't wait to do and I'm like, okay, I'm gonna do that while I'm doing the dishes because then the second thing becomes you don't even feel it because you are not. So focused on that. I hate doing this thing. Which is not really true, but your brain keeps going there.
. And so instead you replace it with I can't wait to do the dishes. I'm about to listen to Shakira or whatever. Maybe we're never gonna a hundred percent do the thought swap, and that's gonna be okay, but at least it makes it a little bit. Doable or bonus if you can get somebody else to come do the dishes for you,
Exactly. Lemme get that out, .
Dr. Brittany Panico: Yes, for sure. Thank you. That was really amazing and I think we can all, learn something from you. So where can we find
Dr. Diana Mercado-Marmarosh: you? Sure. So you're welcome to come to my website. It's adhd live coach.com. I do have a 12 week program for physicians or any healthcare professionals who are looking to set up systems to support their son of genius so they can leave work at work and reclaim their freedom of time.
You don't have to have a D H D to work with me. You just have to feel like whatever systems you currently have are just not like the best and you're ready to find some better ones. And, sometimes we gotta thank those systems cuz they got us here, right? But Maybe they're not the best and we can prevent burnout or we can prevent feeling that stuckness, and do it in a different way. I used to think I just had to work harder to get stuff done. And now I'm thinking I just have to work smarter to get things done. Exactly. And most of us are very smart, and so we have to be willing. To just do it a little bit differently cuz you might just surprise yourself that rearranging a couple of things can make a big difference.
And so yeah, my goal is never to fix you because there's nothing to fix. It's just the system around you that needs a few tweaks. And I know some of us are like, I don't even have time for that, but, You are your best investment, and whether it's for your health, your mental health, your physical health, your spiritual health, you need to make sure you take that time because again, somebody else will put it on your calendar.
And it's not this, it's not you on the top of the priority.
Dr. Brittany Panico: Yes. And then you have a podcast too,
Dr. Diana Mercado-Marmarosh: right? Yes. So come to my podcast. It's called the Y A D H D A Physician's Perspective. If you have a story to tell me about your A D H D, or you have a family member that you support with their A D H D, or if you just have some tricks that you wanna share that has helped you with your chronic conditions, come and tell us, because we will take all the tricks
Dr. Brittany Panico: That's awesome. Thank you so much. I'm so glad we had this conversation.
Dr. Diana Mercado-Marmarosh: Thank you. It was a pleasure. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website ahdlifecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Come join me May 1st through the 6th, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Diana Mecado Marmarosh . I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs.
And some of my habits were just as important as learning the new set of skills. Oh my goodness. I am so excited today. I have an amazing treat. New Year, new goals, right? So I have a really good friend of mine here. It's really so important to have him here. He's one of been one of my guest coaches and.
Been treat and the, it went wild. My group went wild when we had him. He is actually an a lawyer and his name is Dr. Oh, sorry. I'm so used to saying doctor. But he is an honorary doctor in our group. Okay. So Marshall Litchy and I might have mis spelled or Miss said that, but he's here and he will tell us all about himself.
And he actually has a D H D and he coaches lawyers with a D H D. What an amazing service that is. And he has his podcast and he's just changing the world on his end. And so I'm so happy to have him here today. Marshall, would you tell us a little bit about us about.
Marshall Lichty: Yeah, you bet. I'm Marshall Litchy and yeah, I'm a lawyer, a Juris doctor, which the JD doesn't quite have the same ring that the MD does.
And yeah, I practiced law. I do no real lawyering these days, but I practiced law for about 15 years. And I was 43 when I was diagnosed with a D H D. For a lot of folks it will resonate with them that I had a kiddo who was having some STR struggles in school and we got curious about it and brought 'em to a specialist doctor, diagnosed him.
And as we were sitting in that meeting room, the doctor says, kinda looks at my wife and says, Now is there anybody else in the family that you know that has any of these characteristics? And all the heads snap over to me. And and then I got, I did some assessment and I did a full on assessment. I did the whole nine yards and kind of diagnosis.
And my life has been very different ever since then in almost all good ways. At the end of.
Dr. Diana Mercado-Marmarosh: Tell me, when you look back and they were asking you those questions, could you see all those characteristics in yourself as a kid, as a as a, high school and college? Could you see any of those things?
What stood out? To you.
Marshall Lichty: I think I, I was talking about this with a client of mine yesterday. If you're the mango juice and you're trying to read the label, you have a hard time doing it because you can't see the label, you're inside the bottle. And I think there were some elements of it that I saw plain as day, but some of them I just didn't. Really see them or I didn't know what I didn't know. And it was the, as diagnosticians, yes. Any, anybody who has a clinical practice knows that there's a gaping difference between somebody who really has thought about what they might have and they've been on the internet and they might be, Self-diagnosing a bunch of stuff, but they've been in the symptoms, they've been in the differential diagnosis, and they know what to play with so that it makes your job easier.
Sure, you gotta talk 'em down from having cancer, but at least they have talked about, I have this and I have this and I have this and I have this. And they can talk about it in a way that shows that there's been some self-reflection. And for me, that was the most interesting part was watching my son go through.
It led to this process of self-reflection, talking to my spouse about it and. Doing all of the research and looking for resources, and that's when I realized that there were no meaningful resources for lawyers with A D H D. And as I started thinking about what all of the implications of executive function challenges would be for a lawyer, I was.
Gobsmacked. I was like this is a huge challenge for lawyers because our jobs in many ways are just dripping with executive function. And I found very quickly that that there was a big need for what I was. Going through myself, great fortune of writing a book with some friends about how to run a small law firm and the book did well and we believed it.
It's a good book. I believe this stuff in there, but I owned a small law firm. I had a really hard time implementing some of the things, some of the things that we had written in the book and finally it started to make sense to me where those struggles were. It wasn't that I was lazy or crazy or stupid or any of those things.
The places where I struggled. Were reflected in some patterns that I was then able to see. Medication made a difference. Tools and tips and hacks and tricks made a big difference. And so starting to view my life as a search for healthy dopamine and healthy neurotransmitter processing has become a real joy for me.
Sometimes augmented by, not sometimes every day augmented by controlled substances, but also augmented by. Exercise and meditation and planning and sleep and a whole bunch of other things. And with those things, I feel like I've honestly never been in a better spot professionally. So it's, it has been a huge blessing for me.
Dr. Diana Mercado-Marmarosh: Yeah. And probably personally too, right? Because now, like you said, now you're choosing meditation. Now you're choosing, I don't know if you're exercising or not, but now you're at least more conscious that there. Like you said, a dopamine menu you can tap into whenever you need it versus before, maybe we didn't even have that awareness and we were going to go get that sugar or that.
Drink after work or whatever because we didn't realize that was gonna motivate us or keep us, push us through the deadline that we needed to commit to. And he and unaware of that, sometimes we could have been self judging, right? Or we could have been like, oh my God, I'm trying to lose weight, but I keep going to go get the cookie at 3:00 PM Like, who am I?
And like all this shame that can Keep us from growing or becoming or reaching all those damn goals that we keep making and like we don't really follow through because we didn't know, we didn't have the tools to be able to follow through or we keep trying to do things the way, like you said, it works for everybody else.
This is great. That's right. Checklist for A, B, and C. And if you don't have a D H D to do and it works beautiful but. We forget that with a D H D, what really drives us, our passion really trumps sometimes, although we do need that somebody to help us be organized and help us with some of the checklists that we ourselves on purpose, things are needed, right?
Because there's some things you can't ignore that are needed to, in order to be able to do. If you have a, you had a client and you knew that their. Case was, on Monday at 3:00 PM like you couldn't show up on Monday at 4:00 PM because then you missed that window. There was no window of oh, I had it on the wrong time and Maybe at 2:00 PM had somebody told you, okay, Marshall, are you in your car?
Are you driving towards whatever? And it sounds silly, right? But our brain wouldn't have given us the opportunity. We would've literally wanna be driving out of our thing at two 50 thinking we're gonna get there by three and have plenty of time and have the, the parking space and everything, right?
And aware that, oh God, we wanna keep doing things until the last minute because our. is just wired that
Marshall Lichty: way. , that's right. Yeah. The the classic time optimism. I love the phrase time optimism, cuz it puts a little spin on that predicament that we get ourselves into. One of the things that I've really been thinking a lot about lately in the context of A D H D for adults who are diagnosed later Is and I haven't seen medical research on it, certainly not peer reviewed.
And so this is anecdotal, it's observational. But I am fascinated by what I believe to be really significant parallels between people who are late diagnosed with A D H D, usually smart people with HighQ who are late diagnosed. Yeah. And the C PTs d literature. I'm fascinated by a complex PTs d as a. I don't know what it is, whether it's A L.
There is a lens through which you can look at either one of these and see a ton of parallels. And while I know that they are separate what I have begun to wonder about is whether there are elements of A D H D that increase perhaps dramatically the likelihood of a young person having an experience with parents during attachment.
That leads to C P T S D fascinating. Thing for me to play with and think about. And so I want to say it to this group because it's just something that I've been chewing on and I know that there are legitimate doctors in this group who are capable of thinking about this at a higher level. For me it's a curiosity.
It's something that I've been playing with, I've been trying read and research, but I think there are so many interesting elements of having D H D and beginning to work on that chain cycle that you mentioned. That is as much of the work as. Yeah. And in a lot of ways that people work through C P T S D, they are very similar to what we talk about, at least the emotional aspects of working through A D H D.
So anyway, I don't know what thoughts you have about it, if any, but that's something I've thought a lot about, as you mentioned,
Dr. Diana Mercado-Marmarosh: shame. Yeah. And so I think that's such an important. Topic that you point pointed it out to, I just interviewed a physician. She's wonderful, and she has 10,000 certificates.
Like she's family medicine, she's like psychiatrist in functional medicine, Reiki. And she actually, interestingly enough, her area of interest is. Addiction medicine and she talks about this correlation of trauma and and so I think you're onto something because me and her had a discussion and of course we had the discussion after I stopped recording.
I was like, God damn it, we should have recorded that. But that brings it up to the fact that I was talking to her, re realizing. That, most of our experiences up to the age of seven like really shape us into how we react with the rest of the world going forward. And so I was sh telling her that, I grew up in Mexico till I was 10, and then not until I came over here Sure.
All of a sudden, like I was meant to do certain things in a certain way, and them calling my parents was not enough. It meant that. My mom had to come and sit there physically for me to behave. And again, it was not because I wasn't doing my work because they would give me work and then they would give me more work and I would do all that work.
And you could see that my mom sitting there did not keep me from not asking questions or being disruptive, right? And so then they had to bring my dad in to do that. And so how she was talking about how that must have been traumatic for me to. Be myself, right? Because my dad would've probably spanked me because, my dad you're pulling him out of work.
This means money. This means like livelihood, right? And how like .
Marshall Lichty: . Now if y'all are listening right now, you're hearing a catch. Sons voice over there. Yes. We're talking about
Dr. Diana Mercado-Marmarosh: so the well meaning, right? Like well-meaning, well-intentioned. This is how teachers were taught they needed to do that.
And we were talking a conversation earlier, you and me about how I'm in a place in my life where really rethinking how can we. Help a society like, meaning like how can we make laws to where everybody is so inclusion. So instead of making it obvious that your kid has a D h D, how can we bring in tools and be like, Hey, in the front of the class, here's all these gadgets that can help you like to concentrate.
If you can use them like quietly under your desk and it's not distracting you, but they're using you to get you to still pay attention. But it's of like a side thing in the back and then. in the class can go and grab it. Now is you're not self-identifying you as a D H adhd. Only the people with A D H D can have this gadget to help them concentrate.
But anybody in the classroom can use this tool as if it's a tool and if it's no longer a tool, then you take it away because now it is distracting. That's right. Teaching. Teaching people tools. Right? And or how can I have those timers that are visual timers so that when you just say five minutes are up, people don't know what five minutes are.
But if they have a clock that says, oh, five minutes, and it, you can see the little red and then you're like, oh, okay, closer and then because of five minutes you implement it where then you turn around and you tell, Hey, okay, this is a time. Your friend next to you can tell you, did you catch the assignment?
Can we share each other? Can you group, instead of, again, making it seem like, oh, you're the only one that didn't catch it because you were so distracted in your dreams, like now you're working as a team, everybody works together. You're not making it mean a thing that you're asking questions, right? So why is that stemming from that now?
Now I can go back and see it was traumatic to have my dad sitting right next to me and. I'm praying for my life. Obviously that's not my life, but in my mind, I'm freeing for my life to be embarrassed. That's to be spanked out here in front of everybody. So used
Marshall Lichty: to disappoint, right? Realistically, that's what we're talking about at the end of the day.
And you ta, I I think you touched on some really interesting stuff there. The first one that I'll mention just on the side is that timer that you're talking about. The product is called a time timer. Yeah. And you can get it on Amazon. They have it in different colors. It's a whole, it's a whole thing.
And they're great. It works. For my kids. I had a client last week hold one up. He's I got a new time timer for Christmas for my in-laws and I've been using it and it actually helps with Poros or with other, tactics to stand tasks. So yes, time timer. But the other thing that I wanna mention, this is one of the reasons that you and I connected and immediately felt like kindred spirits was because your vision aligns with mine, which is to see that two things are true.
First, your parents were doing their best Exactly. And their. Probably led to some really tough experiences for you that you're probably still scarred. Working through. Yeah. The same is true for your teachers. They were doing their best. The opportunity that we have is to talk about D H D in a different way, to empower people, to educate folks, parents and teachers and coworkers and partners in our medical practices and things of that sort, which is why.
I think it brings us around to something that you and I talked about before we started recording, which was I think that A D H D accommodations or accommodations that in general are great for everyone. So yeah. For example, in your personal practice, you now have scribes available to all of the physicians in your group.
Yes. That began as a need that you. Yes, for executive function, for order for capturing notes, and you are out and about. Anybody who's listening to your podcast knows that you are out with being a D H D and talking about, and you've got a podcast and group coaching available. A great value, by the way, for anybody's like you are doing the thing.
So it would be bizarre to not be. Coming out at work about your adhd, but there are a lot of people who are not fortunate or not so bold or not confident that they're not gonna see ramifications at work. And for them if they have h adhd, but it's on the down low, you've made the world better.
But guess what, even better. And this goes back to your point about being a student in a classroom with a teacher who is aware of the benefit of fidgets and distractions. Now we get to have scribes in your. And all 10 physicians benefit dramatically, which means your patients benefit dramatically. And it's all because we made the world a little bit better for one person who had a D H D, and I think that is beautiful.
Now you, like I said, You volunteered to say, I have D H D. Yeah. But in a practice where people want to be accommodating, where we want to have our diversity and inclusion efforts front and center, we need to be thinking about what it looks like to do d e I for folks with Neurodiverse brains and feels like there's resistance to it.
The fact of the matter is, most interventions and accommodations for people with ADHD help every. I love that. I love that you did it. I love that your work is now, at least in part, built around coaching people to understand that in the medical profession because that has, that is just an absolute force multiplier Yeah.
To have physicians on the frontline, of course, working on their own d h adhd or the h ADHD that their kids have. They're sitting in clinic and they can talk to people about what this looks like. They can be advocating for accom. In their practices, not because they think anybody else has a D H D, but for their benefit.
I
Dr. Diana Mercado-Marmarosh: love that. Yeah. Yeah. And I think it it was, like I said, it was such an empowering thing that you were, you said yes to this complete stranger to be like, Hey, do you want a conversation with me about A D H D? Do you wanna come and coach my group? Like it was such a benefit for the physicians to be able to hear your side and to be able to hear, you know that if you don't feel like you want to say you have adhd, like you don't have to and that's okay, but you can still show up and tell them, I work best when blah, blah, blah, blah, blah.
When like I have my own nurse, when I am not moved from like this room to that room, like you just keep me in these two rooms when I am next to a window, when I have the ability to use. Phones and nobody's talking to me like it sounds. That's right. Silly. But we sometimes when we are employed with somebody else, we feel like, oh, I just have to follow all the rules.
This is the way it's always been. I don't want my job a jeopardy. I'm on the, I'm on the fine line because I keep getting those damn emails that I haven't closed my notes. And I can't ask for how dare can I ask for something for me to help me to do what they want me to do and so I thought it was so good that you.
Piece of advice from it, and I know you weren't doing it for everybody, and everybody's own case is their case. Just like when we say from, we're not giving medical advice, we're not giving legal advice here, but it's good to at least have a general understanding of how you can still empower yourself.
To ask for things. And look, it took three years of me asking for scribes. It's not like it happened overnight, right? And it's not like it's gonna happen, but it, at the end of the day, you had to realize how much does it takes us to replace us and to replace, a physician can take anywhere from a hundred to a million dollars a year just to replace you depending on what you do.
And so if you could say, I work best. When I have learners and I love to teach medical students, that's what I want. Or I work best when I don't have learners and I don't wanna teach medical students, I just want to do surgeries and this is my area, or I work. Like, how wonderful would it be that every time you show up and you do, what are your strengths and you feel so aligned?
Everybody benefits, like it's just a ripple effect instead of being like, yeah, no, that's not possible. And ours on virtual scribes, they don't, they're not even in the room. Like how amazing is that? Right?
Marshall Lichty: Listen, one of the things that I think is absolutely critical about this part of the discussion, first of all, let me back up cause I want a little bit of credibility in the room. When I was a lawyer in my first job, the first seven-ish years of my legal career were, was representing doctors in medical malpractice lawsuits. I then spent three years suing doctors in medical malpractice lawsuits.
So I have. A lot of experience with what it looks like for doctors to do well, for them to chart well, for them to follow on patients well, for them to do the things that not only provide great patient care, but keep them out of trouble. That has me thinking very often, weirdly, often. About the struggles that doctors have when they have a d h D and the point that I think is critical, listen the medical profession is not one where you go blasting from the rooftops that you've got, d h D, that you've got depression, that you've got anxiety, that you've got a substance abuse problem, that you made a mistake that you think you possibly might have potentially made a mistake.
It is no place for that. We're trying to change that and I think there's interesting movement around that, but we all know the stigma around not being perfect. In medicine, the idea that we would be suggesting that you're gonna march into your clinic or march into the hospital or march into your patients and say, Hey, guess who's got a D H D over here?
Nobody knows what it means. There are a ton of misconceptions about what that is. You will lose your practice, you will lose your patient. I don't think that's exactly true, but there is certainly that perception and there's certainly that here. And so the point that the doctor's making is how do. Try to have a different relationship with our lives and our practice in a way that doesn't threaten our livelihood.
And so that point about having a strengths based approach to navigating your practice is, I think the quintessential one. We wanna talk about takeaways. We wanna talk about tips and acts and trick, tricks and all that shit to navigate ADHD as a doctor in practice, I think this is it. You cannot lead a strengths-based.
Life if you don't reflect on your strengths. This is the time of year when I spend time with clients. Obscene amounts of time with clients trying to plan, planning our years, planning our quarters, planning our months, planning our weeks, planning our days, learning new habits, using new software, using new tools and templates and new workbooks and all kinds of, everybody's out there buying their brand new planners and all this shit.
There is a belief that we can change by just looking forward at what we want. If you are in a position where you are struggl, The single best thing that I can believe that I believe that you can do is start working on giving yourself permission to every day, if possible, reflecting on what it is like to be you.
That didn't go very well. That went great. I loved that. I hated that. That was a great piece of music I listened to on my commute while I was late. That was a great piece of art I saw, man, did I hate that patient? Boy, I never want to talk about doubt again. That is the worst thing in the on the planet.
These are things that benefit us because as we reflect and we give ourselves permission to not be doing something, to not be putting out a. Stop. Be feeling guilty that we didn't close our note. Be like, I don't have time to reflect. I have to go close the note. I don't have time to plan. I have to go see the next patient.
I don't have time to plan. I have to throw my scrubs in the laundry. The point is, we don't give ourselves permission to do things that we know will benefit us. And if you can start today carving out just a little bit of time to reflect on yesterday, on last week, on last month, on last quarter, on last year, that gives you a relat.
With what you like, what you don't like, what you're good at, what you're not good at, and that. Is what allows you to then go use a strengths-based approach when you're asking for accommodations. It is not my expectation that you're gonna march into one of your partner's offices and say, gee, I need scribes in the office because I work better with scribes.
If you can look back at the last year and say, every single time that I get in trouble here. When I get behind, when I get anxious, when I miss things, when my patients are upset, when we get fiery emails from, other providers, it is because of things that ascribe could fix. I don't want that anymore.
I want this practice to be better. I am at my best when I can have those things taken care of, so I can put my big, huge ass, powerful brain to work on solving real health problems. That message, Is gonna resonate every single time, but it's only through reflection and retrospective that you're able to talk about that in any meaningful way.
And so really as we enter 2023, if I can encourage you to give yourself one gift. One gift this year. It is find time, hopefully every day, even if it is just a little teeny, tiny bit of time. This is not a Woowoo gratitude journal. It's not Brene Brown. God bless her soul. I love her. It's not Glennon Doyle.
It's not. This is, think about how it went. Observe what you liked and didn't like. What would be better? What would be less good and hold. And then do it again tomorrow. And by the end of the year, you're gonna know a lot more about yourself. And I guarantee you that will lead
Dr. Diana Mercado-Marmarosh: to good change. Yeah. That's such an amazing, powerful thing.
Like you said, it's seems like we keep telling ourselves we don't have enough time, but if on purpose. Like growth is optional, like growth is intentional. Like you on purpose have to reflect so that you can see, yes, this work, this does not work. And it's seems so simple and it seems like why would I wanna pay anybody to tell me that?
Because again, it's so simple, but it's in the accountability and in the implementation and in seeing. What it's doing for everybody else around you who this is now the community that you're on purpose signing yourself up to be in. So like I'm sure that's why your clients are kicking ass now because they're coming and you're having that one-on-one or that group coaching with you to be able to do that and it's simple.
So simple that we're like, go do it tomorrow. We'll do it tomorrow. We'll do it tomorrow, and then tomorrow never comes. And then you wonder why you're still in the same damn horse race that has, nothing's changed. Although you have the best intention at the beginning of the year or the beginning of the month, or you name it every Monday you start to say you're gonna work out right.
But someday is not. A day in the calendar, like you really have to give yourself five minutes. And it sounds silly that I'm asking you to do five minutes, but oh my God, the five magical minutes make a difference. If you wake up with the intention of what am I doing today for five minutes, like on purpose, what is my fun, what is my priority?
Is my priority to go pick up my kids so I can see him at the soccer practice is my priority to close my notes, my priority to not miss my doctor's appointment. Like it, it sounds silly, but if your priority is. To do that. Then at the end of the day, if you just spend another five minutes, did I do my priority?
Why or why? love
Marshall Lichty: that. Yep. I think that is a beautiful loop that is virtuous in that if you can, and you do your five minutes, I'm sure that you've mentioned that on the podcast in Televis before. Sure. For me, when we talk about habit formation, when we talk about, putting things into our subconscious, I don't care if it's five, honestly, you get credit for starting if you even exactly.
Think about doing it today, right? . Yes. If you can do five minutes, that's great. And if you can do five minutes in the morning planning and setting intentions, and if you can do five minutes in the evening doing retrospectives and reflecting, great. That seems like a wonderful virtuous cycle. But if you can spend five seconds.
In the morning with one priority, and if you can spend five seconds in the evening with one reflection, that is a win. We are busy. There is not enough time, and the only way that we change that is by setting different priorities. And that is a message that I hear loud and clear from you. It doesn't mean that you need to put all of the other priorities that are crowding in on you to the side, right?
What it means is you can carve out, this is like the please. Whatever it is, the Juvenile Diabetes Research Foundation or whatever, say, for the price and a cup of coffee, you can. And that's what we're talking about for the, yeah. For the amount of time that it takes you to open Insta and scroll through the first four posts, you can also do a little bit of reflection or a little bit of intention setting.
And if you give yourself permission to do that, not to stop looking at Insta or TikTok, but instead to say, I'm gonna. Spend five seconds beforehand just doing a quick reflection. Now we're talking. So anyway, we got a little bit down a rabbit hole there, but I think it's No,
Dr. Diana Mercado-Marmarosh: But it's an a, a useful tool or that obviously you can do today.
Marshall Lichty: This, you don't have to plan your year. You don't have to talk about 2023. You don't have to talk about your five year life plan. You can do that fucking today. You can do it right now. In fact, I have an idea, doctor, with your permission, I'm not trying to hijack your podcast, but what if we, yeah, what if we shut the hell up for a minute, you and.
Yeah. You give a little direction to your people about what they might do and maybe we have them set their intention. Cause it's, for you and I, it's the morning. Yeah. People listen to it. But what if we have them take a little bit, five seconds, 10 seconds to reflect on yesterday and a little bit of time to set an intention for today, and then we just make 'em, do it.
Not make
Dr. Diana Mercado-Marmarosh: them whatever We encourage them to. We offer them the space too. That's
Marshall Lichty: right. The margin. Yes. Yeah, I don't know your.
Dr. Diana Mercado-Marmarosh: Listen, listening to us, they're already listening to us, so you know, why not now Give yourself the gift of those five seconds. So we'll both be quiet for five seconds to let you think of what your priority is for today.
All
Marshall Lichty: So that's what we're gonna do. We're gonna do one five second. Intentional priority setting. Pick one priority and say it to yourself out loud. If you're in the car, if you're in the subway, if you're listening to this in a group and there are a thousand people in the waiting room waiting for you, say it out loud what your intention is.
Then we're gonna interrupt you to tell you that it's five seconds, and then we're gonna tell you to do another five seconds, and this one will be to reflect on. Some period of time when there was earlier today or yesterday or last week, and find one thing that you can observe that you liked, that you hated, that you were good at, that you weren't good at all.
Okay, doctor, you're up.
All right. I got one. I'm gonna put my groceries away
Dr. Diana Mercado-Marmarosh: before my next call. My five seconds was, I'm gonna be on time for my appointment for my massage. That was my priority for today.
Marshall Lichty: Self-care and being unsound. Damn, that's next level. All right. Should we do five more seconds and do a little reflection?
All right. Here we go.
All right. What do you
Dr. Diana Mercado-Marmarosh: got, doctor? I am I'm smiling because yesterday, I finally had a, an amazing time with my kiddos painting. I didn't have my phone on me. I went and I left it to charge, and I, it was beautiful because I was not on call and I did not have my phone on me, I've been working on being present when I am present and not just texting while I'm doing an activity.
Marshall Lichty: I love that. Mine was I've been talking a lot about goals with people and I have a really tortured relationship with goals and so I did some kind of frame shifting for people and instead of goals, I was calling them very specific plans. . And so I have this hashtag V S P that I've just been like scratching out on stuff like V S P V S P.
If I wanna get anything done, I need a V S P. And so this morning I didn't sleep well at all last night. So this morning I got up and I did a V S P. For a project that I wanna accomplish this year, I wanna build a cedar strip canoe before the ice comes in next October. And I got a pretty good start on A V S P for my canoe building plan.
And that was great. And so the reflection really is vs p's feel good. And normally I wouldn't give myself time to think about that project and plan it out. But I did and that's what I thought. And the five confession was probably a little bit longer than five seconds. Neither one of us actually had a clock on, but yes, that's what
I
Dr. Diana Mercado-Marmarosh: did with my time.
Yeah. And that's the thing, right? Even though it seemed, we are not sure exactly what five seconds mean to either of us, because we don't have the time awareness and we don't have a clock. And this was a totally spontaneous thing, but you quickly saw how it was not a whole minute and how it was plenty of time for you to give yourself that gift of just thinking through.
The top of the mind without overthinking, without da, what came up? And it didn't take that long for you to realize what came up. And if we just give gift ourselves, that gift of awareness again goes back to awareness. What a difference it would be. I've been I was just telling Marshall before we start I'm so excited about my upcoming February schedule I've been toying with the idea of having more time to play and it took me a year to say, okay, I'm gonna have Thursdays off.
And so for a whole year I had Thursdays off and then it, and I kept thinking, no, I want more. I wanna play more. I wanna play more. And so finally on Thursday, this past Thursday, I was like, you know what? I got it. I'm gonna have Monday and Tuesday. I'm gonna find me a daycare where I can drop my kid off a little bit earlier and they have flexibility where my hub can pick up in the afternoon and then I don't have to feel like I have to rush outta clinic.
I'm gonna stretch my days Monday and Tuesdays off Wednesday, Thursday, Friday is clinic. And then instead of being here and there on call, I'm just gonna be on call Monday through Monday. But then that. The rest of the three weeks, I don't have to worry about having the phone attached to me so that I could actually be present with my family and not feel like I'm gonna miss something important.
And so it seemed like it was an instant thing. and then I talked to my manager on Friday and she's yeah, let's implement gifts. It took years. Years and me getting to the realization that, oh, I can have all the things. Oh, I can make containers so that I'm fully present wherever I'm at, wherever I'm at.
But again it took a community, it took self reading books, it took reflection. It took asking me, what do I want? Despite, and me working through oh, what are people gonna think? You're just working three days a week. I'm like, who gives a shit what I think I care what I think. I care what I want.
And if I'm happy, I it's so important. So anyways, I love it. I know that we, I just
Marshall Lichty: love it. That's, that is such an incredible thing to share with. We are not talking about doing something over. We're not talking about waving a magic wand and all of a sudden being a different person. This is toil and pain and joy and suffering and glory and grit and all of it, and it doesn't happen overnight.
But the message that I believe is real and true, and this is what I tell my lawyer clients all the time, a D H D Brain. In white collar professions will change the way that we work. We are creative. We see systems differently. We are entrepreneurs. We see change. We don't always know how to do it, but.
That's what other kinds of brains are for. Yeah. And that's okay. We will change the profession, but we need to give ourselves space and time to do that. And hopefully the gift that you can give yourself today is the opportunity to set some intentions and the opportunity to reflect a little bit and.
And be
Dr. Diana Mercado-Marmarosh: brave to to believe in what you need. Four out of the six physicians jumped on to this new way of doing it. They're all gonna do it exactly the same. Some of them might be off, Thursday, Friday. Some of them might be to do Thursday. Who, but they're gonna have three days a week.
But you just don't know. I'm not doing it for them. But like you said, everybody benefits when you decide to show up for you and for yourself. And we're changing the culture of medicine where you can have all the things where you can be who you want to be. Remember that you need to be around the community that's gonna support you to do that.
So of course, I know I could talk to you for tens of hours and it's gonna be amazing. Me too. It would be magnificent. And so I would definitely have to have you come back. That's what I was gonna say this, but tell us how, when people, yeah. Where can people find you? Because I know they have friends or lo who, have lawyers who would benefit your service.
Or they have a spouse who have, has ADHD and is a lawyer. Where can they.
Marshall Lichty: Like a true A D H D. I have a pretty good website that isn't, all the way done and perfect, but I would like it to be, it's at the J D H D. Dot com, the jd H D all one word.com. And I have a podcast called JD h d. It. I haven't released an episode in Forever and ever, and I have a bunch of shame about it, but there's some good stuff in there.
Interviews with Ned Hollowell, who's a world famous A D H D physician. Gary Johnson, my personal psychologist who is. Frigging genius when it comes to A D H D. So go listen to some podcast episodes if you're interested in it,
Dr. Diana Mercado-Marmarosh: and I could totally share today's podcast and you can put it on there and we can relive it.
And while we're double right.
Marshall Lichty: Why not? Doctor, as always, thank you. Please invite me back to the group and if anybody's listening to the podcast and you want to chat join the group and then I'll see you
Dr. Diana Mercado-Marmarosh: in the group. One last question. I know you have to jump off. What do you hope to see yourself in the next three years?
For fun, one thing. Oh, I'm gonna build this
Marshall Lichty: canoe and then I'm gonna paddle it around and I'm gonna build a house on a river and I'm gonna catch trout out of it and it's gonna be fucking amazing.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you for coming. It was a blast. Audios. Thanks, doctor. Thank you for spending your time with me.
I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free masterclass and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: [00:00:00] Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.
I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective.
I am Dr. Deanna Mecado Mar. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs.
And some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited to be sharing with you a very nice friend, colleague that I've been chatting with before we started, and I probably should have just hit record because that conversation was amazing already.
But I am so excited that she's here. She. All the things. And so hopefully I'm not gonna mess up her name. We practiced, but I'm gonna try. So, Ms. Reen Abk she is actually a family medicine physician. She's a psychiatrist, but she's an integrative addiction psychiatrist. Yoga instructor, Reiki energy healer, and the list goes on and on and on and on.
And guess what? She's an amazing person with adhd. Oh my god, I found the unicorn. Right? Sounds crazy. But as you guys know, we tend to be multi-passionate and multi curious, and we are lifelong learners. And so I am so excited to have her here today because she's gonna talk to us about the relationship that A D H D and trauma can have.
And I was just explaining to her that, you know, the more and more that I look into it that's why now I'm actually getting. I didn't tell her, but I'm working towards getting my certification also for trauma so that I can in further integrate into my course because I, I try to be very careful with my teaching because I don't want you to feel like, you know, everything I'm saying is exactly one size fits all.
There's not such thing, and I want you to try all the tools and walk away with the ones that make the most sense. But I am so excited to have her here. I would love for her to share a little bit about her story and then she can tell us a few things about trauma or anything she wants to tell us. I'm so excited.
Dr. Nesrin Abuata: So thank you Diana, for having me. I just as you said, I got training in, I'm a family medicine doc, a psychiatrist, and I feel like my life story, the overarching theme is all about integration and how do we connect the mind and the body. I am originally from Israel. I was born there, grew up there, and then I came out here from my medical training.
If you've ever been to Israel or heard on the news, we're always unfortunately making it on the news. There's a lot of trauma and. Trauma, big T trauma or small T trauma. So Big T trauma is things that are obvious that everybody sees it on the news and they're small Ty trauma, that it's the experience of what you undergo that puts your nervous system at a risk and not feeling safe.
That's a small ttra, so having grown up in that kind of place, I was just telling Diana as we started, when you're a fish swimming in the water, you don't know that you're in the water until you step out of it. And my growing up, I grew up in, in a lot of trauma without knowing it or understanding it. what you would think of as abnormal here because it's not everyday kind of life over there.
Growing up it was ki part of my life, and as I was going through med school and training and putting on a different lens, I began to see things differently. I began to tap into different sensations in my body and that's when I made the B Mind body connection and. . The trauma really lives in the body because we talk, we tend talk about mental health and psychiatry as in these are your thoughts, these are your experiences, but we don't bring the body into it.
And I learned that you can't separate the bind and the body. The trauma lives there. That's where what I call the crime scene happened. And you have to go back to the crime scene with tools, but you need to go back if you want to have that kind of openness. And healing in your mind. And so that's kind of how my path started.
So really, I feel like I was born for this role in a way given my path. And somewhere along my training, I felt like bringing in mindfulness and yoga. And yoga does. They, we always talk about linking the mind and the body. That's how I added, I call it the psychospiritual. So that you combine both the spirituality and the mental health and then you brain yoga and the body and so you don't separate.
So I tend to think of things like if you have a hair braid, you know, you braid and it's three strands. And so there is the mind, and then there's the body, and there is the spirit or spirituality and you braid it together and trauma. Changes the nervous system and impacts us in so many different ways that we don't want to just have one.
The more tools you have, the better you're equipped to address every part of you. Because before we started recording, I sang Diana about being in relationship with things and shamanism in different parts of shamanism. We're always talking about how can we be in relationship and as physicians when we are getting training, as medical students, we're always thought that the central.
Thing to any practice that you do is your relationship with your patient. You can have the best treatment plan, the best surgical intervention, the best techniques, but if you do not have that relationship with your patient, you are, you're basically on shaky ground. So bringing in, again, all these tools to help reinforce and healing the different aspects of our relationships with ourselves internally, but also external.
It's kind of where my path basically has been. So it's windy, but in a way it integrates. We talk about also being an integrative psychiatrist because integrative means that, again, we look at the whole picture, mind, body, medicine and soul. The food that we eat, the relationships that we have, the communities that we belong to, the histories that we come from, the land that we live on.
So it's multifaceted in that. And over time I've come to think of addiction as lack of connection. So when I hear people talking about addiction and I treat addiction, I'm always listening for where the disconnection happened. Because where the disconnection happened, the trauma happened, and that's where addiction rushed in.
Wow. That's
Dr. Diana Mercado-Marmarosh: such an incredible insight. And you know, I think because I'm thinking just like you are thinking, I people say that I'm more flex or less or whatever, when people are telling me that, you know, oh, that they're smoking or that they're drinking, or that they're doing cocaine or they're doing this or that, or whatever.
And, and when I ask them, well, how did. How does that help you? Like does it help you to concentrate? Does it help you to not feel numb? Like, like does it help you sleep? They're looking at me like I'm crazy because I'm asking them, how does it help you? Because obviously we're not doing something just to do it, and nobody says, oh, can I sign up for more pain?
Please. It, it must be helping them in some way. You know, just like, you know, when people with anemia come in and they're like, well, I'm, I'm wanting to eat the, the dirt. Like, what's wrong with me? And you're like, well, yeah, there's iron in there. Yeah, of course you're wanting to eat the dirt. And so it's so good that you pointed that out that addiction can be the lack of a connection to something.
And sometimes it could be like you're going for the cocaine because you don't have enough dopamine, or you're trying to also fill in a void. Maybe you were neglected and then you realize that food or this or that would fill in. Void. Right. And And it's so good that you have been able to use all your experiences, like they say, to really not just treat the body, not just treat the mind, not just treat the spirit right, but to put 'em all together, like as a human being, , and to really like see it from that angle.
Like, man, that's amazing. And, and like you said, sometimes you have to go through stuff yourself, unfortunately, like your pain becomes your progress or your, your speaking gigs, so to say, right? Mm-hmm. because you understand it and, and you can then turn around and, and say it, and, and it's like you can finish that other person's thought, thoughts, because again, you, you understand it.
Can you, can you, If you want to share, you don't have to. Can you tell me when you realized that you, yourself also had a d H D? Did that happen during childhood or was it like an adulthood?
Dr. Nesrin Abuata: No, it didn't happen during childhood. And again, it's when you also come from minority groups, which I do come from minority group.
There's not enough awareness about mental health and there's not seeking of mental health. And I didn't realize it up until the end of my psychiatry residency. So I was about done with residency, about to. And I was, when you're high functioning, which I was very high functioning, it didn't call for any assessment.
And so I, I functioned, I got everything done. It took a lot of effort, but I got it done. So, but if something would take somebody 50% of the effort, it would take me 150%. But I got so used to doing that all through my life that that was not new. And it wasn't until I began actually practicing that. People were sitting across from me with the patients and somehow when I was sitting with them listening to their stories, something clicked in my mind.
So somewhere between the end of my residency and at the beginning of my actual practice, I realized their blind spots were my blind spots. So a lot of times in A D H D, we were just talking about that before we got on the recording, you have time blindness you miss certain things and conversations.
You miss certain things with the order, the emotional overwhelm seems to be out of proportion to what is going on. All these things, but you're so steeped in that kinda like that we're talking about the fish in the water, you know, recognize that not everybody else is in that water. Yeah, so I would say the window to my understanding myself was through self-awareness.
And why did it? Why it happen at that time? I am not sure. Was it because I was ready? Was it because I was out of residency and all that pressure that comes on you? Maybe that's my guess. But I learned from that, that the window to anything is a self-awareness because then things change once you become self-aware.
And that's why I always ask my patients when I meet with them, if they know what's your motivation for change? What changed? What did you learn? And if they don't have the answer, that's okay, but I'm always putting my finger on the. Where is this leading? What are you learning as you go? Because I was have, one of my journeys on self-reflection and self-realization happened was that window somehow opened and once it did, I was able to change things.
Dr. Diana Mercado-Marmarosh: Yeah, self-awareness. It, it's the first thing that I, I always keep telling people if you're not, Then there's nothing you can do after that , because again, like you said, you're not even aware, you're swimming in in the, in the water. You're not even aware of that. So how can you then do something with it, right?
Mm-hmm. . And so, yes. From awareness, then you can move on to like processing it or realizing, yes, I, I'm gonna take an action or not, or realizing I'm going to regroup or what, what is the next things you have to do? Mm-hmm. , but. I'm so glad that you had that insight because I don't know if you would've had that insight if, if it would've made a difference again, because you would've kept doing it, and that's the thing.
And then if people, that's the theme, right? Like people don't realize how hard you're working because you make it seem so easy. So everybody else's who's looking in, but they don't realize that they're hanging on by sticks because you, maybe because you are in the, in, in the passion of it that you keep going it because it, it's aligned with you.
Dr. Nesrin Abuata: You know, the other thing too that I've. Reflected on, but I also work with children, adolescents. Our sense of identity starts from when we are, when we're very young and who we are, and it gets formed in school and with classmates and in families and communities. And along with that comes our executive functioning, understanding the world and a child in classroom who misses some of the instructions but doesn't wanna get in trouble and falls behind and then starts.
Developmentally, they will start blaming themselves when they're the age group of elementary school. It's very what we call ego systo. So if something bad happens outside, that means something is bad with me. Instead of thinking, okay, what else is going on? And so a level of a six or seven year old cannot explain to you, I was not able to understand the instructions because I got distracted.
And so you start picking up these, I think of them as rocks of your identity. You know, you put 'em in a backpack of who you are and you start picking it. So then by the time you're older and then somebody comes and tells you, do you have awareness of what's going on? You're so attached and fused with your backpack with the rocks.
What are you talking about? The backpack is so sewed into me. I can't take it off. And that's, that's a hard thing. It takes time. So, Diagnosis is the beginning with the awareness. But it takes time to unpack all these patterns in the brain because there are pathways, and these pathways will are well worn out with thinking over and over.
So these thoughts of, I am not good enough having the imposter syndrome, I am not gonna succeed. Nobody's gonna believe me, I can't do it. They come a lot of times from such a young age that you have to travel back to that age to undo. Along with skills and therapy and all sorts of stuff too. So awareness is the beginning, but there's a whole lot of path behind it too,
Dr. Diana Mercado-Marmarosh: you know?
Yeah. And that's why I constantly keep telling people that coaching is about one of many things, right? That you need to use all the tools, like you need to use therapy, you need to use cognitive therapy. You need to use systems like people helping you. You need. Use meds like you need to exercise, like it's one of many things and you shouldn't do it one thing only and and help it happen.
Right? And, and like you said, like when, when you love your parents so much and you want to do the best that you can at school, You're gonna work really hard unaware that you might just miss the mark because you didn't have all the tools. But, but you're doing it because of your impassion with that.
Like you said, you think it's your, it's you, there's no other thing but you. And, and so I remember like when we were finally in. In the US and my dad like had to come and sit down because when my mom would come and sit down in the teacher's classroom, like I wouldn't be quiet. I would still be like, I would do my work and I'd be running around screaming and like I was done.
Like, and they, and she would be like, well give her more work. And they would give me more work and I would do the work and then like, because I would keep doing the work, they'd be like, Well, forget it. We're just gonna skip her grade and we're just gonna skip her grade. And we're just, and so my dad would come and sit down and not until my dad was sitting there, like, I would be like, okay, I'll sit I don't wanna spanking in the middle of the classroom.
Like, you know, and, and, but because like you, we were talking about machismo and different things before, like, you know, my dad was like, Why am I missing work for this little girl to like, you know, I'm gonna give her a spanking here at the middle of the class. And I was like that. That was like, again, maybe traumatic, like right.
Traumatic that, oh my God, I'm gonna get a huge spanking. So that's what like, Shut me up to sit down and be quiet. But it was because I was fearing that he was gonna give me spanking and I was gonna be embarrassed, right? Mm-hmm. And, and so it's not like my A D H D got it got taken away from me. Like I, I was just having to react to the environment based on what was going
Dr. Nesrin Abuata: on.
Yeah. And in a, you know, in a perspective, when we look at the world, Through the lens of a six or seven year old, you're small, you're not big you're not in control. There's all these authority figures between teachers and parents. It doesn't mean the parents are gonna spank you, but there's that threat.
The nervous system perceives it as I'm not safe and what I need to do to stay safe in the context of, oh, I'm not doing what I'm supposed to be doing. It's already my fault. So that is a form of. And that becomes internalized. And then we carry that sense of shame with us and then shame. When it takes over the brain, we no longer have language to describe it.
It becomes stored in the body. And that's where when I keep talking about the mind and the body connection, then when I go back to the roots of the shame, we have to go back to the body to unpack it. Yes.
Dr. Diana Mercado-Marmarosh: You're so right. I hadn't told anybody about my diagnosis about A D H D because I was in such shame, and then when it was pointed out to me, A D H D was just a circumstance that you could decide what you wanted.
It was like saying that the sky was blue or it was saying like, I had high blood pressure, or I had cancer, or I had anything else and that I, what I made it mean was up to me. And I was like, well, no way. Like why would I wanna shame myself? Why would I wanna think like that did not. Take a while for me to process and to realize and, and of course now I feel like I'm speaking from a healed wound or healing wound, not a bleeding out he imaging wound.
Right. Because at that point I, like you said, I didn't have the language, I didn't have the connection, and I remember like multiple people asking me questions about feelings and I. What do you want from me? Like , there was no words because I was so used to putting all those things aside because maybe it was too scary to like sit in the shame or sit in the embarrassment, or it might paralyze me and not help me to do whatever needed to be done in order for me to go forward or do X, Y, and Z.
Dr. Nesrin Abuata: And you bring up a good point about how. . We learn how to be with our feelings from a very young age. When our parents can model it for us, when they can sit with us with the difficult feelings. When we're small feelings, feel like they're huge and we can't manage them, we can't digest them. Having parents that can parent and they can model it for you and digest it for you and make it small enough they can manage it, then you're able to connect with the feeling and be present with it and express it without getting overwhelmed, not being able to, or not getting help.
That is a form of trauma. The nervous system can't tell the difference between what's true and what's true. That's why the business the movie industry makes a lot of money because you sit in front of a TV screen and in your brain, when you watch somebody fall off the horse, you fell off the horse.
And so imagine when you're a child and, and even as adults, your nervous system sees that. It doesn't know what's true or not. And so if the nervous system picks up, this is dangerous. It has to react in. Really, the nervous system has limited pathways of how it can react. The first way it's gonna be fight or flight.
That's the first basic one. If there's a danger, can I fight it off or do I run? If not, then can I freeze? Can I play possum? Because the danger will pass away. Maybe they'll ignore me if I'm quiet. And then if that doesn't go away and the person is still undergoing the threat, then we end up with that last one that you said, that paralysis, that shutting down, that numbing, and the nervous system keeps moving between these three until we've processed it and healed it and integrated.
And imagine being six years old, you're not gonna be able to do all these. And that's where the parent or the therapist or adults helps you manage too, because part of an executive function, and you mentioned that too, is emotional regulat. And I think executive functional skills should be taught to all kids in school, but we don't do that.
And then you add a D H D, it's even harder to access emotional regulation skills. And also people with A D H D are more, they might, I always have a suspicion that people feel their emotions a lot stronger and deeper and more intensely than somebody else. And so the skills are really important to. So if somebody gets mad or angry, they'll say it goes from zero to five.
But with a D H D, the intensity is really high. So that's gonna take a lot more skills and a lot more intensity to calm it down too. And then you add to a trauma and then trauma intensifies because of the way the brain is also processing what happened too. Yeah.
Dr. Diana Mercado-Marmarosh: So I would you just describe exactly is like rejection, sensitivity, dysphoria.
Right. And so, The difference between that is that with a d h, adhd, like you said, it goes straight into the amygdala , and it goes straight there. And it doesn't like have that two second delay with the with the prefrontal cortex like most people do. And, and, and that's why you, it looks like, what the hell?
It just happened. Like what? And then five minutes later you're like, back to your peachy self and they're wondering what happened. Because they're so short-lived, like sometimes less than two hours. It's not like enough to say like, this is like anxiety, or this is like depression, or this is a mood disorder, which they can all coincide of course.
But in general, again, if you're not even aware of that, How can you begin to unpack it and how can you begin to, and it's so interesting, like when I ask my clients like, okay, can you describe like everything you love about yourself and can you describe everything you hate about yourself? Like every time they describe everything about everything they hate about themselves, it's all about their A D H D tendencies and, and they don't realize that it's.
Their character flaws, but it's their A D H D. And when you point it out to them, they're like, oh. And so it's such an, like, like you said, you, you internalize it like it's you and it's you all along and you don't realize, yeah, it starts and ends with you, but if you don't have an awareness, you cannot modify it.
But
Dr. Nesrin Abuata: then you add the layer of trauma where in trauma, the person to whom the trauma happened is unfortunately a. And in that kind of context, the victim gets blamed already. And it's very common for people that undergo trauma to have survivor guilt, to blame themselves in general, regardless of what age it happens as adults, as children.
And it happens because as children, it happens because the brain, like a, like I was saying, it's ego dystonic. Meaning that the belief goes with who they think they are because a child cannot believe. Let's just say their caregiver is abusing them, whether it be physical, emotional, or neglect, the child cannot come to accept such a horrible idea that the person that I have to rely on for my life.
Can kill me is hurting me. That kind of idea or belief results in the child feeling disconnected, and we are born and wired for connection. Connection equals our survival. It doesn't matter what kind of connection it is. Ideally we want a nurturing war mutual connection, but if it's a poor connection, any kind of connection, our nervous system will seek it out, that it will adapt our beliefs to actually make the connection work.
So that means that I cannot. in order to make the connection alive with the parent. As a child, I can't believe that the parent is bad because then who wants to have a connection with the parent? That's bad. But you can live with a thought about yourself. Something is bad with me. I am bad, but it's okay to be in connection with my parent.
And you can take that into adulthood again, when a trauma happens for an adults, no matter what it is, the survivors a lot of. They blame themselves that I cause it. What happened? It must be on me. Because alternative is to believe that really you were not in control of what happened, and to believe that you were not in control of what happened.
That's a very scary place to be at, and that is that kind of lack of connection. Connection to the self because connection to the self gives a sense of power and empowerment and voice, and in trauma, that source of agency and empowerment and voice is taken away. Unfortu. ,
Dr. Diana Mercado-Marmarosh: what are some things that you think.
Tools to help them to start or to even like identify if they, there's, they're being in the victim phase or if they can help themselves to process this trauma, like you said, the trauma store stored in the body.
Dr. Nesrin Abuata: I would say it depends on what phase the person in, because I was telling, talking to you about being in the fight or flight phase, in the freeze phase or in the collapse phase, in the fight or flight phase.
You can process things and you can notice. Because your heart rate is gonna be up. You might have tension in your bodies. You might have more thoughts of anger being animosity against other people, getting into fights, fight or flight. You can notice it. Or other people can now comes in the piece of awareness.
Can you learn to tap into what stage of trauma level you're in? And that starts with the body, noticing your body, noticing the tension, noticing a heart racing with anxiety attacks, noticing are you having back pain? Are you having headaches? Are you having shortness of breath? These sorts of things cue you into, okay, I might be in my fight or flight response.
My body is in that kind of trauma. The other one that I was talking about, the freeze part. That's where somebody feels, they tell you, I feel paralyzed. I feel like I can't take action or socially, it becomes what we call fawning. Fawning is when we're talking, Diana, I tell you what I think, I, I know what you want to hear, so I can't show you who I am because it's not safe and I had to find, I have to hide myself.
Finding is I fake it in front of you with the belief that hopefully, if you like me enough, we're gonna be. You know a lot of people because the fight or fight, we're not fighting every day. We're not arguing every day. It's not that common per se, but the fawning is there a lot. And then the last stage is the the numbness part.
And that's where somebody says, I can't connect to my fear. People cannot even tell me they're not in touch with their feelings. That's when they tell me, I just feel blah. And that's when I begin to wonder and to ask and to kind of bring in the awareness. Are you feeling numb? You can't feel, and then I ask, can you track your body?
Are you aware of your body in space and time? Are you in touch with your toes, with your feet, with the hold of your body? A lot of times in trauma, especially when it's chronic and for a long time, people are in their head having left their. So how to tap into the trauma so you can do something out. Like I said, you start with the body and you see what the sensations are and follow that.
Sometimes you might be able to start it on your own, but a lot of times you can need the help of somebody, like a therapist or a coach or a trusted loved one. It's hard to face it alone because it overwhelms the nervous system.
Dr. Diana Mercado-Marmarosh: Yeah. You bring in such amazing points, like, yeah, this is amazing. Oh my God.
Yeah. I'm like, my brain is going like amazing. Like I'm big of all kinds of things like I wanna have you at like I do. And I'm just like, okay, slow down. But it's amazing because again, when you start to see the connections, you cannot unsee the connections. And like you said, if you just work through each area of it.
It just opens you up to stop carrying all that heavy little rocks that you didn't even know you kept putting in there and put putting in there and, and you don't realize how easier it would be if you just unpacked those rocks that what got us here. And we're, we're trying to go. We don't need all that.
Like if you can learn or unlearn and so much of the unlearning, I feel like this is what I keep saying in my course. We get taught first, do everything for your patient. And, and I say, the day that I realized I was the most important patient in the room was the day that I realized that if I wasn't okay, but if I wasn't taking care of my mind, my body, my spirit, everyth.
Then I, I was just gonna come and then my patient was gonna get me at 20%. They were not gonna get me at like 50, 60, 80% because I wasn't the first patient in the room. And, and so that was such like a mind shift for me. And then that's when I started realizing, okay, so it does start an end with me, but I'm gonna need a lot of help
Dr. Nesrin Abuata: No, but you bring up a good point about how in healthcare, The message that's propagated as we get training as physicians, that the patient comes first and you are expected to run on empty, empty tank, even from our training. And imagine then growing up in an environment where the connection with the caregiver was poor whether that be actual physical outright abuse, but a lot of times the most common from abuse is neglect.
And so when you grow up in that kind of environment and that kind of connect, And caretaking where you are neglected and in that child's mind to take care of things and make the connection work, then the child has to become the caretaker. That child has to fill in all the gaps in order for the relationship to work.
In their mind, it doesn't make sense because adult will do whatever they wanna do, but in the child's mind, I can fix it, right? It's on me to do it. If things are not going right, I caused it. I am the beginning and the end of it. Just what you're saying in a dysfunctional. And so then you bring that to becoming professional caregivers.
We put ourselves last, we run on empty, and in a way, we perpetrate the same form of self neglect in these sorts of growing up young relationships. Professionally. I don't think our patients want us to self neglect. I don't think our patients want us to harm ourselves. I think that's the last thing they want.
They want a doctor who. Fully present with them, fully connected. My patients, I can tell when I walk into a room that they care about me because they ask me, how are you And I, I won't go details. I say, I'm okay, but I can tell they care about us as humans and we're not there. Talk about ourselves, but they do care about us.
And so what kind of message do we send them when we come into the room and we are running on. They already struggle with the relationships and patterns and trauma. Well, they have run on empty too. And so then you have two people with that sort of background, an internal attachment system with trauma and neglect, and in a way we're not helping each other out.
So how do you learn to heal inside so that they can, you can run on a full tank and energetically people can feel that, patients can feel how their doctors are doing. They might not say any. But we as people can tune in, we're intuitive. We're intuitive human
Dr. Diana Mercado-Marmarosh: being. Yes. So much to that. Again, like my brain is just like going like, oh my God, amazing.
I could share like 10,000 stories about what you just said and, and, you know, giving us ourselves permission, like you said, to have those conversations with candid conversations. Like you'd be surprised how many times I told the. I know you're not making the list cuz I didn't make my own list either. But I guarantee you that if you do X, Y, and Z and I'm gonna see you back the next week cuz I want you to tell me that you did X, Y, and Z.
What a difference it makes. And they just look at me and I'm like, I know because I was doing it too. But when you start putting yourself first again, the ripple effect that happens, and again, I'm not talking about like putting yourself and I tell them, You are in self neglect if you're not in self-care.
And I didn't even know what self-care was before. And and it sounds such cliche-ish because most people are like, oh, she probably means she's over there on the golf course and getting her nails done. And no, I mean, like eating sleepy baby, like the basic ADLs of, of life. Right. And, and when I say that out loud, they look at me and I'm like, yes.
That is self neglect. It is because you're not aware that you need your basic things and you don't, and again, it goes back to like maybe you're a mother and you just think you do all that first, or you've been, you are a physician and you've been told you're patient first, or you are the oldest one. And so you think you, you have the responsibility, like all these things that we again, get to reinterpret and then.
Ooh, I can see how that could have been traumatic or I, I am taking on somebody else's idea of what. Ideal for me, . And again, I didn't make the plan. They just told me this was the plan. And so you were well and told that this is what's going on. Right. And yeah. Wow. I mean, so many insights that you're giving and so many amazing pros.
So, Do you take do you do coaching? Do you do consulting? Do you, do you just see your patients in the psychiatry addictive treatment? Or what are, what are the things that you how can people find you? Because I'm sure they're gonna be like, oh my God, I can't wait to talk to her. She's
Dr. Nesrin Abuata: amazing.
Yeah. I do different things. I have my own private practice and so I see, I see patients there as patients. And then I also work at Addiction Center too. And then I also do provide coaching and. And I do teach, I have like classes online too. My website is my first, I'll type that in the, in the link here.
But my website is my first and last name, md.com. So N E S I N A B U A T A md.com. And so you can find me there, you can reach to me there. I have a YouTube channel. I have a podcast too. Yeah,
Dr. Diana Mercado-Marmarosh: tell us all of those so that they can
Dr. Nesrin Abuata: find. So my podcast is actually called My Grandmother's Blessings, and it's very, it's, it's kind of like 10, 15 minute short stories that are meant to inspire people to reflect.
So I bring a story, I bring an experience, and then ask the question so that you can internally reflect going back again to that self-awareness and awakening inside. And I love that podcast because I loved my grandma. I was very close to her and she helped. in a way. We were talking about the adult that sits with you through your feelings and processing and teaching you and digesting things for you.
And my grandma was that, and I hope that everybody listening to this can identify having that person or that source of love, because that can be from our pets that can ground us and help us emotionally regulate. So I was inspired by my grandma, so I called them my grandmother's and then blessings because kinda like you're saying how you go through stuff and the difficulty can become your medicine, it can become your wisdom.
So my hope with these stories that I share are, can you be inspired? Can you learn something? Can you reflect? And so you can, if you type it on Google, you can find it. So that, and then my YouTube channel is also under my name, Rin Abu, and also my website. And then I have a Facebook group Under Mind Alchemy, which is the name of my clinic.
And I called my, my clinic that because I really believe in mindful transformation. Amazing.
Dr. Diana Mercado-Marmarosh: So as you know, people listen to us have a D H D, and sometimes they tap out, although they shouldn't have tapped out because this is an amazing episode. But if they did, because we have wondering mine, what would you want them to take away if they just started listening?
Right.
Dr. Nesrin Abuata: Two words that come up. Three. Well, three words, self-acceptance, self-awareness, and embodiment. Know when you are breathing, can you feed your body. These are the three words, because if you can build that kind of building block, then you can process through things.
Dr. Diana Mercado-Marmarosh: Awesome. And the last question I always ask people, What do you hope to see yourself for fun in the next three years?
Dr. Nesrin Abuata: I would like to be able to do these what do you call them? They're like, they're trapeze. You can be doing the trapeze in the air. But you have to have a lot of core strength. And I've been working on my body and then we always talk about A D H D to me, you have to be in your body. It's the, this is the most healing thing.
So I've been challenging my body, so if I can build enough strength to be doing trapeze in the air, that's what I would like to be doing for fun. It's
Dr. Diana Mercado-Marmarosh: amazing. The reason I ask that question is because like when we go back to dopamine and fun is a fastest way to tap into dopamine, right? And so if you are doing something for fun, you're definitely refilling your cup and you're definitely gonna step up to whatever comes your way because you are in the fun mode.
I love that question. Awesome. Well, it was such a pleasure to have you and I can't wait to continue to interact with you and I'm sure I'm gonna. Beg and pray that you come and be one of our guest coaches in my program because I think we all can benefit again from that connection. And yeah, I'm already thinking of 10,000 things that I want to do.
So this is amazing, right? This is our A D H D. We can just feel the energy and the energy guides us there. So thank you again for for coming. It was such a delightful convers.
Dr. Nesrin Abuata: Oh, thank you for having me, and I hope that when people are listening, they're building these awareness and just, you know, never start with one question and then see what leads you.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Diana Mercado Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life.
In the past two years, I've come to realize, That I'm learning some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hello. Hello. I am so excited to be here today. I have a very special guest, Dr. Steven Le Leis and I'm Might have missed up, that please. Correct.
Dr. Stephen Lewellis: Yeah it's Luis. It's a hard one. All my patients get it wrong, so don't worry about it All ,
Dr. Diana Mercado-Marmarosh: Dr. Leis. And I think I messed it up again, but don't worry about it.
I'm gonna call him Dr. Steven . No worries him for today. He's in a and he's an amazing husband, of course, father, and he's trained in NYU and Stanford. He's a board certified. An investor and outside of his medical practice, he's passionate about spending time with his family and in strengthening the collective voice of physicians on social media, educating fellow physicians about personal finance and life.
Planning and investing in private real estate. As you can see, he's multi-passionate and I love this about him. And so today we're gonna have an interesting discussion about what is going on with him. He shared with me that he recently came to realization that he has a D H D diagnosis. And as you guys know, in my podcast, I've interviewed many female physicians and a few male physicians and we were just having this discussion about, I would love to talk to everybody because it's so important to have the perspective of different voices cuz their matter, our stories matter and a is a spectrum.
So I'm so excited to have him here today. Would you share with us what's been going on in your life lately?
Dr. Stephen Lewellis: Yeah. Can I call you Diana? Is that okay? Yes, of course. Great. Or Dr. Diana I am very grateful to be here. First of all, it's really nice to be on your show and I'm really impressed with what you've built so far.
And I'm happy to tell you a little bit about myself. But as with a, we can get a little time tracking. A little warped for us. If I'm going too far, just cut me off and go down a line of questioning. But again, my name is Dr. Steven Luis, and I live in a relatively small town in central Wisconsin, wasa, Wisconsin.
I'm a practice here as a board certified medical dermatologist. Hi, . And I am at home as well with my wonderful and very supportive and lovely wife and two small children. So we have that in common. I have a three-year-old boy and a seven month old girl. So lot of changes recently, and my job was relatively new.
I've been there for a year and a half. Finished residency in 2019 right into the pandemic with kids and jobs. So a lot of changes happened at once and a lot of challenges, and that led me down a road slowly and a little bit painfully, but finally a road to really addressing some underlying mental health issues that.
Suspected maybe in the past, but never had the never was intentional enough to address them or was brave enough or whatever it was until it really reached a tipping point in 2022. Essentially, that was the year that I took charge of my mental health, and I've already seen dramatic changes just from that probably about a six month journey since I first asked my primary care doctor to help me with what I was
Dr. Diana Mercado-Marmarosh: struggling.
He said hi to my daughter who just came and jumped in . And so if you guys are wondering who is he saying hi to ? Yeah, sorry. No. I, no, I'm just clarifying . But she's walking away. . But I wanted to ask you what do you mind sharing what you were struggling with? I, you said time blindness was one.
What else?
Dr. Stephen Lewellis: Sure. Yeah. Time blindness. I think we're We're the dreamers. We people often say so that was one thing I struggle with. Little things that I noticed about myself at work. I would be pretty overwhelmed with getting all the tasks done that I needed to, especially charting. I would always finish my charts on time cuz I I'm.
Pretty high achiever. So I wanted to get that done. I very much did not want to take charting home like I did in residency. So I made it a priority to finish most of what I could at work. But it was stressful. And if I was ready, getting ready to see a next patient and one of my staff members was presenting to me about the patient I would still be ha have half my brain on the chart that I was trying to finish.
And then I would. Asking them to repeat something they said five or 10 seconds ago. And I began trying to identify things that I may be doing that I was blind to. That may be really annoying other people in my life, whether it's people at work or people at home. And that was one of them my nurses and medical assistants and me.
Always laugh when I walk straight past the exam room that I'm supposed to go to because I, even though it's a short walk, I start thinking about something else and they just wait till I turn around and come back and we're all laughing. So little stuff like that, but also just feeling overwhelmed with the amount I needed to get done.
Another thing was I'm a dermatologist. They a lot of people in my field see a very high volume of patients and I have always felt very overwhelmed about the possibility of that or the prospect of that. Been difficult to grow into a higher volume practice. And I've wondered, is that just me or is there something that I could some coaching or counseling or medical therapy, whatever it is that it's not just me.
It's something that there's a reason for that. I feel like why is everyone else having such an easier time with this than me? So those are the, some of the things at work that I noticed. There were also things just with interpersonal relationships that just got to eventually got to a tipping point.
And I started questioning is there something about me that I need to address? So that I stopped getting in. These loops that we get in with certain people. And rather than trying to see what they're doing that's wrong, , and get introspective a little bit and get some help. So that, those are the general things that I noticed at work and at home.
But I think there was some tipping points in 2022 that made me get there as. I'm happy to be as open as possible on this show. I had a I have two brothers but one of them in June of 2022 unexpectedly passed away. And that was a pretty big shock and a trigger for evaluating some things in my life and just working through that trauma and that.
Led to some difficulties in other places and processing that and I, that's when I finally went to my primary care doctor, who I'm very grateful for. I have a wonderful family medicine physician at the place where I'm an employee an employee as well, and he just talked to me about what could be going on.
And we got down a road of trying to address a couple different things and happy to expand on that as.
Dr. Diana Mercado-Marmarosh: Perfect. Thank you so much for sharing and of course, I'm sorry about your brother passing away. Thank you. It is, sometimes in, in those trialing moments in our life where of course we don't realize that we've been carrying such a heavy load.
And for some people it might seem. You're doing it so easily, , but they don't know. They're just seeing the tip of it. They don't know everything that you're magically doing underneath. To just stay afloat, . And and I'm so glad that you're highlighting both aspects of A D H D.
And I joke around too. I'm like, either you cry or you laugh. I think I'd rather laugh because it gives me dopamine, . Yeah. So then at least we're onto the right track. But like you said, it's not until you look back that you're able to be like, oh, that's been there all along. And it's, and like you just mentioned A D H D, it's so important.
It to be identified in different settings. If it's just, okay, it's just happening at work, or it's just happening at the house, or it's just happening, blah, blah, blah, then you wonder if it's really a D H D or you're just bored, then you don't wanna be there. Sure. But when it is happening in multiple places, and like you said When you start being curious instead of judgy.
Yeah. And you then can start to, to shift because you then start to see patterns that maybe were not obvious because you weren't looking for them because this is the way you've been all along. But yes. That's one of the things with adhd that. A lot of people think it's that we don't focus, but we do.
We sometimes we even overfocus whenever we are on a certain task, like you were saying, if you're trying to do your chart, you're like, yes, you wanna hear them, but you're trying to do your chart . . That was one of the things I had to learn too, and I think you're already onto it, that when people come and are telling you something, I have to on purpose and I got coached and told to do this and so I'll give you the tip if you're not doing it yet.
I tell them, gimme. Give me a minute. Let me finish my thought. Yeah. And then you can have my attention and it's, at first it feels really uncomfortable to have somebody standing right next to you for what seems like an eternity. Yeah. But it's really 45 seconds or less usually. Yeah. But you don't realize that in doing that you actually.
Save yourself at least five minutes. Because what happens is that somebody who doesn't have a D H D can easily jump from one thing to the other. But for us it's task switching. And so in the task switching, it takes us a little. To go back to where we were at, especially we didn't give ourselves a nugget, and so it, it sounds weird, but if you really do, just ask them for 45 seconds so that you can document what you were thinking and then you listen and then you document whatever else they were gonna tell you.
Yeah. Then it's gonna be so much smoother for you and it's gonna be so much smoother for them. They're like you just said, they're not repeating themselves five times and it less frustrating for them for sure. Yeah. Yeah. And they would rather sit there or not sit there cuz sometimes they're standing.
Yeah. But it's gonna take them, those 45 seconds they can rearrange exactly what they're gonna tell you anyways. So that it's more effective for both of you. And I had to tell them later on, Hey, I'm not trying to be rude, it. I have h adhd and it took me a while to get to the dag to get comfortable to me to even say it out loud.
Yeah. But now I'm just like, there's an ADHD moment and I just laugh. Yeah. And like I tell them I'm doing this to help them with. and me with the communication. And so I use timers now, like you said, timeline is, yeah. So before I walk in the room, my nurses start the timer and then they'll come and they knock on my door, and then they ask Dr.
Marca, you need anything? And then I'll be like, yes, I need ua, or yes, I do, whatever. And so you could use that and be like, yes, I need a biopsy, or, yes, I need this, or whatever. And so now, I'm family medicine, so I do have a lot of patients with H adhd and I treat patients with adhd and I tell 'em, look, they're gonna come knock on their door.
They're gonna, this is my external cue. Yeah. So don't think that, it's just you e everybody's gonna get this external cue. And even though I've been using this trick and. The day that I forget to set it, oh my God. The, they're just are like, she's taking too long. What's going on? And then they go look at the timer, ah, she forgot it or something, and so now it becomes like a game with my patients. Oh, we have to meet the timer, hot dog. I'm like, yes, let's meet the timer. And I say this because you could make. Blind spots be something that you can enhance. So your pain points can become your progress.
And like you said, in this six months of you even getting this diagnosis , you've had some light bulb moments that now you're like, huh, okay. And yes, it can lead to a lot of misinterpretations with other people sometimes. Yeah. Yeah. I don't know if you know this or not, but like people with a D H D, the way we answer questions is how we're feeling sometimes in the moment.
And some other times is what we're thinking in the moment and how we're feeling and thinking. Sometimes they don't match up. . And so if I ask you the same question tomorrow, you might answer something different. And that's not a problem. I understand that. But other people who don't have a D H D, that's a big problem cuz they're gonna be like, but yesterday you said, and I'm like, yeah, that was yesterday,
And they're like, ah. And if you ask somebody without a d h, adhd, the same question, whether it's today or 10 years from now, they're gonna answer you the same exact way. And so that's just a little tip for you to know. Thank you. So that. You ever have a miscommunication with your wife if she doesn't have adhd or with a patient or somebody else, you could just be like, Hey, sometimes, We're all meant to change your mind.
So that's a, like not making it mean a thing, but at least be aware so that it doesn't lead us into trouble. Some somewhere . So that's a key for inter a key point for interpersonal relationships or communication strategy.
Dr. Stephen Lewellis: I like that. Just to your point there I. A lot of people on the outside who have not had experience with the diagnosis could see things as, using d h ADHD as an excuse.
Oh, that's my d h d, but or a reason to be. But I think the important distinction is that you are, we're talking about tips and things that we, no, we're not trying to change other people. We're trying to change our. To adapt to a world that is having certain expectations of us, and it is on us to make those changes and, but still have that, realize those things and take those actions rather than just saying, yeah I have adhd.
That's why I didn't, I asked you to repeat yourself, or that, that would be very frustrating. I think. It's certainly an important distinction to make in terms of people who are dealing intentionally with. Their uniqueness,
Dr. Diana Mercado-Marmarosh: I guess. Yes, exactly. I think to your point, that's what I'm saying.
Like I feel like a D H D starts and ends with us. Yeah. What I mean awareness, right? Yes. Because when you are. Aware that this is something that you're working towards. This is something that on purpose, you are trying to make sure, quote unquote, I'm not annoying them, but I am respecting them, but I'm also respecting myself how I think, how I learn, how I do things.
So it's a communication strategy, not to say, oh, please excuse me, I have adhd, but it's Hey, I, because I have H adhd, this is how a tool that I'm trying to implement so that we both communicate better. And so it, again, it goes back to the awareness. And you don't even have to say you have h d if you don't want to.
You can just say, I have noticed that I work best when, and then you just say da. When I have a quiet environment, when I have my own Nurse when I have my own, ma, when you help me start my note. When you put the first sentence in my h p I, like you, you can just say, I work best, Quinn.
And that's sad, right? Like I said, it took me a while to say I have d h, adhd and you don't have to. But now I'm like, I say I have h adhd, like the sky's blue because it is blue outside. And labeling things can sometimes. For, and again, it's not an excuse, but it's just okay. It's just like saying, Hey, I have blood pressure and I shouldn't be having salt or something.
Or I have diabetes and I should be careful with how much sugar I have. And so I think it's, again, creating just an awareness. People with ad with diabetes have their bracelets as says, I'm a diabetic. And again, I'm not saying you should go walk around and see I have ADHD everywhere.
But the point is that, again, if, and I now use this for myself, if I am doing something that seems like it's overwhelming me or it's too hard or whatever, hard means, right? I take a step back and I'm like, where's my d h d? And hands in this or what have I not done? ? Have I eaten? Have I taken a break?
Am I trying to do three things at once? Just like what you do with a kid, right? Like when they're crying have they eaten? Are they have a poopy diaper? What's going on? The basic things because. something is causing us to feel like overwhelmed. , there probably is an easier path.
It's just that we might be trying to do the dreamy thing of doing 10 things at once with our A D H D, yeah. With that being said in terms of the volume that you were talking about, When I was, going back when I was a medical student in a resident I think like dermatologists would see something like, I don't know, like 30 to 50 patients a day or something like that.
And I was always like, mind blown because, as a family medicine doc, 20 and we're like, we're like choking ourselves or 2020, some people see 25 or something. Yeah. I don't know. But I was never one of those. And if I was seen like about 20 something, I was like dying and I was always like two hours or three hours behind and I'd be like, wow.
Still here. Why don't they wanna see somebody else? And then they'll be like, no, we waited three months for you. Or six months for you. Exactly. Yes. Yes. And then I was like, you
Dr. Stephen Lewellis: probably listened to them. You take the time you're, they lo they, and they're willing to wait for that. But it still weighs on you that you're Exactly,
Dr. Diana Mercado-Marmarosh: yeah.
Yeah. So was that happening to you?
Dr. Stephen Lewellis: Oh yeah. The, that I've always intentionally kept my volume to a manageable degree, but I am trying to scale up right now and I'm trying to actively think of strategies for how I can do that rather than just do things the way I've always done and just try to do it more, more efficiently without actually putting in strategies to help that and systems to help that.
And I think this whole journey has. Making me a lot more open to that and excited to see more patients rather than dreading seeing more patients, which I would have been before. And that's, so I've been in a unique situation because I was, I worked at One place for about two years, right out of residency 2019 to 2021.
And then I changed jobs for a number of reasons and moved so I had to, I was building up a scaling up my practice and building up a panel of established patients. And it becomes a little bit more routine when you're not seeing so many new patients every single day. And then I started over two years and I started over, and now I'm about a.
And a half more than a year and a half into the new one and getting close to, seeing patients back again, which is great. But still seeing a lot of new patients every day. So that also makes it hard to scale up. Seeing someone back is a lot different than establishing a relation, brand new relationship with someone.
So I am being more intentional trying to think of systems and again, with the medication and with the just known knowing about these things about myself it makes it more exciting and more like a game and rather than something, rather than I'm running from a bunch of tigers or something.
Dr. Diana Mercado-Marmarosh: Yeah. So important, everything you just said systems are, are the key. And that's what I teach in my, I have a 12 week c m e group coaching. And I, and exactly what you just said, it's all about systems. It's about realizing your strengths. It's about where do I delegate?
Where can I change, where can I keep what is working? Yeah. And where can I. Take away steps, right? So that, maybe it's not you who has to keep running out and to go. Form every single time that you wanna explain this skin condition to your patient, right? Maybe it's having a binder there already that you just pull out one from and you give, and then that's it.
Or can the instructions be given by the nurse afterwards? Where can you shave off a few minutes here and there You can work at the top of your game. And like you said, how can you make it fun? That's the first thing that we do when they come to my course. I'm like, okay, what do you do for fun?
And they're looking at me like, are you crazy? I just told you I don't have, I don't have enough time. And I'm like, I know. What are we gonna do for fun? Let's schedule that in first. And they're looking at me like, What? And I'm like dopamine we don't have enough. So if we have a dopamine menu, then we can pull out stuff.
So instead of you going for the twinki, like you go for a chewing gum or you do a two minute app of a meditation or something else, right? And they're looking at me like I'm crazy. And I'm like, yeah, and where's your time off? And they're like, what? And I'm like, yes. Where's your time off? I need to know where your.
You're sleeping, eating, resting, what are you doing? That and yeah. So I think it's so important, like you said, to approach it from like new lens, right? , like now you can step into it and say, how can I do more, but not working myself harder but smarter now. Yeah. Yeah.
Dr. Stephen Lewellis: Yeah. And it's.
It's definitely a game changer and I think a lot of physicians narrowing it down, a lot of physicians who bridge or branch into physician entrepreneurship. Certainly. I think a lot of the root of that is wanting to have a bigger impact and reach more people and we get frustrated in. how non-scalable our day-to-day work is.
And you just have to be there and there's only one of you, and you just have to be there for every patient. And there's just, I can't see 90 patients a day. I just physically can't see that. Maybe I could see 50, but I would be probably miserable. And my patients wouldn't be as happy. So there's a sweet spot somewhere.
So there is room for growth, but it's capped, certainly. And so a lot of people who are ambitious like yourself and want to impact people in a different way and have have a small business as well, or a big business are drawn to things like group coaching, things like online courses, things that are scalable, but still you're putting your heart and your passion into them.
But it doesn't. Every aspect of it doesn't rely on you being in a room with one person. So that's a trend that I'm seeing at least, and which is amazing because there's so many great people, great doctors out there now helping other doctors. And we're at such a critical point where so many doctors are struggling more so than in the past.
And it's it's not position healed by self. It. Is it other docs helping helping them? Cuz we have such a unique perspective and unique challenges. What you're doing is awesome. Just the other, I think some people at this point are like, oh gosh, another coach like that. I, it's such a cliche, but we could have.
10 people coaching on physicians with a D, adhd, and there wouldn't be enough, not this one. And I just love what you're doing and I think more and more people are gonna be doing it, but it's not gonna get saturated because it's such a need out there.
Dr. Diana Mercado-Marmarosh: Yes. Thank you so much for sharing that.
Yes like you're saying coaching is such a new thing and yes, it seems like physicians are, I'm so glad that they're doing it. It's still, when you look at it, the ones that I know so far, maybe there's two. Hundred of us, at least the ones I know, but Huh. There's what millions of us who are positioned.
So again it just goes back to everybody is multi-passionate and like you are into real estate, like , a lot of us like run away from money, we're like, oh no. And so to you this is your stone of genius and who knows, maybe you would go into that or not.
Something that is so easy for you that you're like, why would people pay for this? People will pay for what they're not really your second one, , people would pay for for whatever their pain point is, right? Yes. So that's what it. What is important, but at the most important thing is like you just said, what gives you passion?
What would you do? What would you continue to do, like five years from now, 10 years from now? And how can you have a bigger impact? Because, you could easily set up a course on investing and like you said, that's scalable, right? Because you're now helping the masses and. would be so glad to be educated about something.
Or you can even set up a course about like, how to identify certain conditions. Even for physicians, like you could be like, Hey, this is for primary care doctors. Like this is the things you can do in the, in your office before you, you come and help me. Yes. And then how many more like. Patients in a, in you have taken care of, like indirectly, right?
. So like for me, like I feel like as I'm helping my A D H D physicians, I'm, he, I feel like I'm helping like thousands of patients because you are seeing all those other patients for me. So instead, I, like you said, there's only one of me and I can't see all of them, and yeah. So it's just so important to.
Leverage our MD degree because automatically we have credibility and automatically if we are aligned with what we're doing, like the money just flows. Yes, And that's something that obviously we need to get coached on because as physicians we're not used to like charging for all her advice that we give freely every day.
At the end of the day you serve and you earn, and then you're able to use that again to enhance the wellness of you, your family, and everybody around you. So it, it makes an impact long way. But we were also talking earlier I was asking you, in my in my coach I have 90% females in it, and I'm not really trying to exclude any males.
And so I was asking you do you think like coaching is something new that maybe that's why phy male physicians haven't flocked into it or we were just chatting you? You can be honest. You don't have to.
Dr. Stephen Lewellis: I think this is a really interesting point of discussion. Could be. Few episodes in and of itself, probably or a great panel discussion actually with a couple women coach, a couple female coaches, a couple male coaches discussing it.
And first of all, the numbers are obviously skewed anywhere on social media women towards men and I we're, I know we're talking binary right now. It's just for the ease of conversation. But it's certainly skewed. I think women. In general better at putting themselves out on social media.
I think a big one is that women are much more supportive of one another and eager to work in a group that's a very comfortable for women, at least what I've seen to be in a group of other women because of what they've. From, the patriarchy and it's a, may feel like a safer space.
And your group is not only for women, you're saying, how do I get more men? But there are a lot more groups for women only than there are for men only that I've come across in terms of coaching and things like that. Another thing is I think men are less likely to seek it out. We. Just typical I have a lot of patients, men who are there for a, 60 year old guy who's there for a skin check.
And the reason is my wife told me to go . I never have a woman who's in for a skin check who tells me, my husband told me to go. That never happens. So that's another thing. It's that vulnerability thing. It's the met weather, it's the machismo that you just don't want to admit it or just, Whatever it happens to be.
But I definitely don't think that, like you had mentioned, someone told you that, eh, no. Men may be better at delegating or something like that. Definitely not. I think women are in general, especially. Women who are professionals, who have families burdened with mu many more tasks. And we call it emotional labor, if you will than men typically.
Certainly that's how it is in my relationship. And so women will naturally get more overwhelmed and actually seek help because they are, they hold themselves as such a high standard, especially when they're trying to, when they're a. A mother and a wife. And a professional. So that's in a nutshell why I think those things are, and maybe it's part of the marketing, but I don't think that's the core root of it.
And I find myself, I don't know why, but I am drawn to female voices in this space. Most of the podcasts I listen to, and I guess that's because most of them are women. But I will listen. There's several podcasts that I listen to that are. Exclusively marketed to women whether it's coaching or investing.
And I just like their voices. I like the way that they work together. And I'm a little bit turned off by like the. The Instagram ad I'll get, that's all of a sudden in my face is this macho guy on his private jet telling me how he has this hundreds of thousands of dollars of passive income coming. And that's just I kind of scroll by and it's, but that's just me.
There are plenty of people who are drawn to that. But I'd love to talk about this more. I think it's fascinating and there are a couple male coaches that I know, physician coaches who are awesome. And I think we need a lot more. It will balance eventually, but it's a area to a disparity that.
Is ripe for
Dr. Diana Mercado-Marmarosh: something to trust. Hey, maybe that's an opportunity to step into, to be a male coach or a realtor. Here I am putting words in your mouth. But the point is that I think you having that perspective can also help you later on with whatever you decide to do because you have that insight.
And yes, I. Think that collaboration is key in, in, in entrepreneurship. Like I was just having this discussion yesterday with my husband because I was like, no, I am gonna do ethical marketing. And then he's, we were just going back and forth and he's be ready to be eating alive. And I'm like, I don't care.
I go this is how I do my business. I do it from a place of integrity. I want feedback. And then he's Some people don't work that way, like it's cutthroat. I'm like I don't have time for that type of stuff. I go, they're not working with me if that's what they're expecting, and so we were going back and forth on that and he's you are in your own little la land when it comes to business.
And I'm like, and so if it's working. Yeah. And, but we were just having that discussion about how sometimes marketing can tell you one thing and then you get into it and you're like, no, I don't feel like I. That, and so I was like, I'm gonna give feedback on that.
And he's you don't do that. You're cutting yourself out. And I'm like, I want feedback. If my shit's not what I'm saying, it's gonna be, I wanna, he's you're different . He's not everybody wants to know that. And I'm like, oh.
Dr. Stephen Lewellis: You're, yeah, you're attracting your people your customers are out there and yeah, I think, like your husband mentioned, being in la land like that, to me that's the same as saying you're being authentic to yourself and that's why people are drawn to you.
That's why your customers are drawn to you like Kevin Kelly this several books, amazing journalists and Techn. I think I think he ran Wired for a while. If he doesn't still has a very famous blog post called 1000 True Fans. And that's the sort of gist of it is that's all you need. That is it's very much less about having 6 million Instagram followers than those.
100 people who are your people and though who very much feel like you are authentically serving them. And that's why they say the riches are in the niches and all those sayings and stuff. You can, the, I could have a course on helping dermatologist with a D H D. Find their first rental real estate property and like that.
And that's just a joke, but it's also not Yeah.
Dr. Diana Mercado-Marmarosh: And I don't, I dunno where to invite you to find your people . Yeah. Because again, like you said, I am part of an A D H D physician only group that like, I'm so grateful to be there. There's a thousand of us. And you wouldn't think that there's like a thousand of us, right?
Because again, some of us don't talk, but. When you are there, like you should just see the memes that are there, , some like somebody posted last night. In that group, they said the question was asked by the interviewer, are you somebody who works hard? And then the person answered, of course, I work hard.
All the time, more than I need to and should, in all aspects of my life. , yeah. And again it's just a funny joke, but at the same time, it just goes back to sometimes we're doing it harder than it needs to be, and can we slow down? Can there be any better way? And can we laugh about it and be like, huh, okay, let me backtrack and let.
Do it in a different way or knowing, okay, no, this is what works. I'll just gonna do it this way or not, right? But yeah. Yeah. So thank you for having this insightful discussion and I think I am so glad to be catching you, like you said, on an earlier stages of your diagnosis, but I do wanna point out, like you said, it was, Probably having two kids around like a seven month old adds more responsibilities than what we were used to.
Plus you having your practice, plus working towards scaling it plus unfortunately your brother passing away, it, it was just like, The perfect, beautiful storm . It was, yeah.
Dr. Stephen Lewellis: So bridging into trying, finally really committing to doing things, entrepreneurial things as well. And I, the one thing I didn't mention, but it's it somewhat obvious from her age, my, my daughter was born on May 23rd.
My brother died the first week of June and we closed on the first investment property the first week of. So that was a lot and it was a combination of wonderful, joyful things and awful things. And I probably mo couple months after that ended up in my primary care doctor's office, sending him a pretty desperate message one night and then we had a good conversation the next.
Day or something cuz he's really responsive and he got me on a journey with some help of other people to a what feels like an entirely different person. And I have to work through that as well because other people in your life, when you're transforming yourself in a positive way that feels positive to you, you could feel you could appear foreign to other people and.
Intentionally working through that right now. Because it's a dangerous zone for sure. They're like, who are you now? What the I'm more myself. I'm a better version of myself, but I'm appearing very different and it's a shock and it can seem inauthentic.
Dr. Diana Mercado-Marmarosh: Yes. Oh my God. Like you said, this is a whole other conversation that we could probably dive into.
I know you're, you wanna close it off three or four episodes, but thank you for pointing it. Because like I said, yes, oh my God, we could definitely go into it into so many things and so many stories and so many conversations that I'm happy to be back on some other time I don't. Yes, of course. Yes.
I could definitely jump on on that. But again, it's the key of awareness of that. I think you're so ahead of the game and staying intuitive and in perspective and if like you just stay on the same thing thinking this is. Growth. Think about it like, to become a butterfly, like you have to be a caterpillar at some point, right?
And and growth hurts
Dr. Stephen Lewellis: growing.
Dr. Diana Mercado-Marmarosh: Pains all that. Growing pains. Yeah. And but the people that are gonna appreciate what you're going through. Yeah. Or those that obviously are always gonna be there. But sometimes the people that We're benefiting from our lack of boundaries sometimes.
Yeah. Interesting. They have the hardest time because they're so used to you being three people, and and now you're like, no, I'm trying to set healthy boundaries for me and for my family and sometimes it it can appear like you're cold or indifferent. Things like that. But it's so insightful again, that you are having these conversations and that you are working through that because it becomes important.
And so let's let me just ask you, where can people find you if they wanna chat with you?
Dr. Stephen Lewellis: Yeah, sure. I am becoming more active on LinkedIn. I'm really enjoying interacting there and offering some perspectives both in terms of general dermatology matters, as well as kind of personal finance and real estate.
And then on Instagram, I am not as active, but a great place to connect with me as well at Lou. Md just my last name, then MD and I also have a smaller account for my real estate investments that is Happy Monday Real estate on Instagram. And that name may be obvious why I chose it, but I'm just, that's part of the reason I bridged into entrepreneurship and other kind of establishing horizontal levels of income.
And other, adding pillars to my financial table because it's really, I want to look forward to Monday and I wasn't always looking forward to Monday. And I, and now it's much easier already because I've identified some things I was struggling with, but I want it to be even better in the future.
So those three places are the main areas to reach out to. Thank you.
Dr. Diana Mercado-Marmarosh: So as we've been talking about when we are in our zone, we sometimes space out . So if my audience just started paying attention right this second. Yeah. What is one takeaway or two takeaway points you would want them to take away from this episode?
Dr. Stephen Lewellis: I would say it's never, I have two. Number one is it's never too late to ask for help. I received help just in 2022, was my year of help mental health. And I received help with both chronic anxiety, which I knew I was struggling with, and adhd, which I did not know I was struggling with.
And both addressing both of those has changed my life already. And the second would be that there are tipping points and watch out for those tipping points. And if you go through something and all of a sudden things are falling apart you may be you may be at a tipping point where you need some help.
And investing in the expertise of others investigating real time and money and the expertise of others. The one of the best investments you could make.
Dr. Diana Mercado-Marmarosh: And one last question. What do you do? What do you see yourself doing for fun in the next three years? For
Dr. Stephen Lewellis: fun. I would, so I'm excited for my son.
He'll be next winter, he will be four years old and we're gonna have him on our local ski mountain here. We live in a small town, but we're very lucky to have a pretty darn good ski resort. So he'll be up on skis and I'm so excited to just see him doing that and my wife. Love skiing as well. We lived in Utah for a year and that was incredible.
So I'm excited to get back into that because we have gone away from that with the two very little kids. So that'll be fun. I'm just excited to have, yeah watch my son do gymnastics or dancing or skiing or whatever he happens to love. And spending more quality time with my wife and family as.
And able to get a control on the things that were stopping me from being, owing them, the very quality presence that I was not giving them until until I learned to get a handle on the things I was struggling
Dr. Diana Mercado-Marmarosh: with. Thank you so much for sharing, and as I shared with you, fun is the key.
Yeah. Keep having fun and keep striving to what's to towards what's meaningful for you so that you can practice medicine in your own terms. And so you can be, like you said, present for your family, because that's why we do what we do. We wanna be available in all the relationships in our life, whether it's with our patients, with our clients, with our family, right?
Relationships are always key. So thank you again for coming. So great to have this discussion, and I'm sure we're gonna have multiple other discussions because these are important conversations to have because not until you realize that, oh, this is a D H D thing, or this is a interpersonal thing, or this is a thing that people are just not discussing.
Can we start to have shifts and we, and awareness is the first step, and then you can go forth.
Dr. Stephen Lewellis: Yeah, the A awareness you just mentioned and I the one book that many of your listeners might know of, but it's a book called and it's really meaningful to me cuz it's the last book recommendation that my brother gave me before he passed away.
But it was one, it's one called What Got You Here Won't Get you There. And it's all about identifying in high achievers. You got to medical school, you got through residency, you got that. , but what got you there is not gonna get you to that next very different place. And it's all about identifying the things about yourself that may be really annoying to other people or grading or just holding you back in certain ways.
And it's it's much harder to do that introspective work and identifying that, yeah, there are some things about you that aren't so great and you can address. So I think that is a great one for people who. Looking for personal growth to check. Even though you didn't ask for a recommendation,
Dr. Diana Mercado-Marmarosh: No, thank you.
That's actually one of my models, so thank you for pointing that out. How crazy that we have solve these serendipities. I
Dr. Stephen Lewellis: I heard you mention it before. Yeah. And it
Dr. Diana Mercado-Marmarosh: triggered, it reminded me of it. Good. Thank you so much and again, it was a pleasure having you.
Dr. Stephen Lewellis: Likewise. Thank you very much for the opportunity and I wish you all the best with your practice medically coaching podcast, all of that.
I hope we can keep in.
Dr. Diana Mercado-Marmarosh: Bye bye-bye. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website at A D H d.live coach.com. Where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Diana Mercado Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize, That I'm learning. Some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hello. Hello. I am so glad to be here today. I have an amazing friend. From Dallas, Dr. Andrea Wadley, and she is actually the owner and head pediatrician at 1 27 Pediatrics. It's a really cool setup that she has going on. She is a home visit. Only direct primary care, pediatric and lactation practice, and she's able to provide convenient and really high quality evidence-based care.
In your house. Like how amazing is that? And she also helps with breastfeeding medicine consultations. So yeah, I'm so excited to have her here. And she does all kinds of education on breastfeeding, but this is probably her passion project and she's gonna share some nuggets about.
Some of the difficulties that can happen during breastfeeding time and how maybe taking some of those steps can be helpful to implement For any of us who have a D H D or any of us who feel like we might all of a sudden have something that feels like A D H D because of the new responsibilities during this amazing and exciting and challenging time of our lives.
Awesome. So thank you for coming. I'm so excited you're here
Dr. Andrea Wadley: today. Thank you for inviting me. This is exciting.
Dr. Diana Mercado-Marmarosh: Tell me how did you decide to do what you're currently doing? Because, I'm, did you envision this all along when you started off, like in residency into pediatrics, or what were
Dr. Andrea Wadley: you thinking?
Yeah, so I was. In pediatric training in San Antonio actually. And I had a pediatrician mentor, so my advisor was always telling me that I should start my own practice, and I told her she was crazy. So I never ever had that desire when I was in residence. C my husband and I actually met via the internet while I was in San Antonio and he was here in the Dallas Fort Worth metroplex.
So we met, we dated, we married and we were long distance for that whole time. We got married at the end of my intern year of residency, which was crazy. Why would anyone do that? And then we lived apart for the first two years of our marriage, so I moved back to the Dallas Fort Worth metro.
And it was. , it's really hard to find a job. As a pediatrician, as a doctor, you think the world will want me, and nobody wanted me, it felt like. And , I looked all around town and then I found this amazing job as a newborn hospitalist. I worked there for eight years. Loved every minute of it.
Loved helping moms and babies in the hospital during the first few days of the baby's life. But there was always something inside of me that was missing that I am pediatrician, so I wanted that. And as the corporate structure of medicine continued to press down on.
My heart and my soul . I had my own child during that time and just missed having time with her just because someone else was telling me what my schedule was gonna look like. So as a result of all of those things, I decided I wanted to start my own practice. So in the middle of that, having my own child as well and trying to breastfeed I was a physician.
I thought I knew everything, right? I'm a pediatrician. I take care of moms and babies, and I know everything about breastfeeding. Oh my gosh, I didn't. So it was soul crushing right to, to try and breastfeed my own child. All of those things mixed together and prompted me to want to start my own practice doing pediatrics as well as breastfeeding medicine.
So lactation consults. And then I looked at the horizon of medical care at that time, and it's only gotten. Maybe worse since that time. So about four and a half years ago, five years ago, I was like, I just don't wanna work for anyone anymore. I wanna do my own thing. And so in Dallas, Fort Worth, many of the practices, like anywhere else are owned by a big health system, which is not all bad, but just for me, that just wasn't what I wanted to do.
I wanted to provide a different thing for people. So I saw this model of direct primary care. It's like a membership, right? Think gym membership, Netflix, that kind of thing. But this, you're becoming a member of a practice. And it allows me to provide kind of care that. Is really outside of the insurance structure.
Insurance is, I do this, you pay me this, and then the insurance says whether or not that was okay or not, right? So this is more of a relationship between me and the patient. So each family pays me a set amount every month on the first and then it allows me to care for their kids in an kind of amazing way.
So a lot of what we do is over text message. I come to the house and see the. I schedule all their well visits in advance, I'm available to them when they're sick. So it's been a fun thing. A lot of growing pains, a lot of trying to figure it out. Cuz really when I started it was very unheard of.
And now thankfully, more and more pediatricians are getting out of the system and trying this out, and it's becoming a tiny bit more normalized. But also in addition to, a regular pediatric practice. So I see, kids. Big kids, little kids, babies, all the things. I've diagnosed a D H D more than I have ever in my whole life.
Being able to, see these kids for, and know them really well. But in addition to that, I wanted to do breastfeeding medicine cuz I think there's just such a void in. Care, from a physician's perspective. And there's a lot of things that I can do that a lactation consultant who, has a background in medicine but not necessarily medical.
Like a physician level type of education. So I can diagnose and treat and, all of that is best done. At someone's house. If you think about, I'm sure you, when you had babies, the last thing you wanted to do was leave your house. Yeah, I come to you for all
Dr. Diana Mercado-Marmarosh: those things.
Awesome. It's been fun. So I'm going to jump in here and say that there's so many things that you said that I a hundred percent relate to what you're saying. First of all, I also met my husband on the. So how cool is that? I met him back in the day. Gwen they had Yahoo Personals, , and it was meant to be like a joke type of thing because I, it was my first year of med school and I was just like, who can help me?
Buy lunch or dinner? Like I was a broke medical student, right? But it was more like a dare and. and here we are. But anyways, the point is that I could totally relate with that. The long distance thing. I've done some of that too. But yeah, that just shows you again how important it is to know yourself and to know.
What you want to do it and do it in your own terms, right? Because most people say, oh, no, long distance doesn't work, or da. But again, when you are mesh with what fuels you it becomes a no-brainer that you get to become a trail blazer in whatever you're doing. And it was so good. Like sometimes what we feel.
Like hurdles, like you said, oh, I didn't find somebody, somebody didn't, wasn't like, oh, I can't wait to hire you. Maybe it was like the universe letting you know to step into what you wanted to create and for you to practice medicine exactly in your own way. And again, to refuel you ended up tapping into an area that is so needed, like breastfeeding and I was, You couldn't hear me cuz I had my, myself on mute because my kids are running around like crazy here.
But when you, I was chuckling when you said I became a pediatrician and I had my own kid and I should have known everything about breastfeeding. I was laughing because, That was exactly my thought. I was like, oh my God, I'm a family medicine physician. Oh my God. I talk to people left and center about all the amazing things on why you should be breastfeeding.
In my mind, it was like peachy roasty, like they're just gonna get on my breast and it's gonna be up. Wonderful experience. And then I was so mad that I was like, what, I have to do this every two hours, like I have to, like what? And I remember also being frustrated and not having a lactation consultant to come and talk to me after breastfeeding.
They were like and I was only there 24 hours. And they're like, oh we'll set something up later. And that never happened. And so me going online and. On Pinterest or different places trying to figure out like, how can I improve my milk production or am I doing it right? Is it not and in my mind, again, it should have been just this peachy, rosy experience.
. But you don't realize, like you said, even though you've been medically told what the benefits risk are. Show you until you yourself go through it if you have the privilege of going through it. Or not , because some people decide this shit's too much work, , and so they really do. But what amazing it is that you're able to fill in the gap and teach people about how to do it.
Like you said, not. , like the medical version plus also your personal version. So tell me, when people reach out to you, what do you notice are like the most like challenging things or what do you notice? What do they usually ask you?
Dr. Andrea Wadley: Really. , it's mostly what we talked about. So they think it's gonna be easy so they don't prepare themselves.
So there's a lot with breastfeeding that happens and it's a lot of it is time sensitive. So our bodies do certain things because of the way our hormones work, right after delivery. And if we don't do the things that we need to do, really in the first week of the baby's life, breastfeeding for the long term becomes a lot hard.
Breastfeeding is very hormone driven in the first, seven to 14 days of life. And that's great. So every mom who's ever had a baby makes milk whether she wants to or not during that time period. But if you don't do the things that you. Putting the baby to breast really often, having an effective latch, all those things early on, then it becomes a lot harder.
So a lot of times moms come to me after they've done all of that, or not done all of that, or been given really bad advice. And they're. They're crying and they're in pain because they aren't able to breastfeed, successfully like they've wanted to. So cleaning up on the backside of that is a lot of what I do.
A lot of handholding, a lot of putting hands on mom's backs and saying, Hey, I cried every day and it's okay, we're gonna do this together. And changing their perspective on. You know what success really looks like, and maybe their goals are gonna be a little different now, but it's okay. And this is where we're starting and this is what we can do now.
So that's a lot of what I do. I deal, I see a lot of moms who are in pain and we talk through that and what to fix with that. I talk a lot of moms out of tongue tie is the reason for everything as far as problems go. And it is a big problem, but it's not the reason for everything.
Dr. Diana Mercado-Marmarosh: So maybe are you able to help with those tongue tie or do you refer them to. .
Dr. Andrea Wadley: So if the baby's young enough, I actually can do a pH autotomy, which is, clipping the tongue tie as a home visit, which is amazing. So I did a lot of them as a newborn hospital doctor, and I've adapted some of those techniques and I'm able to do them at the house.
So I do them on referral. So if I'm seeing a baby for the first time for breastfeeding problems, I tell them, I think maybe the tongue tie is an issue, but you. Giving them the options that they have. But yes, definitely a lot of the pediatricians in town will refer to me because they know that I'm not gonna do it for everybody unless I think it's necessary.
Dr. Diana Mercado-Marmarosh: Yes. Yeah, so it's so good that again you're able to bring all these tools and use them right there. And it's so good to have. Like I said, I think you're a trailblazer because a direct primary care is something that recently, like maybe the last two years I've heard more about, but you started this almost five years ago, and so you have really shaped it.
To be able to optimize how you take care of them. It's almost blending the old school doc, so to say. When, where they say yeah we're gonna. , you and I, were gonna do this way despite what insurances say or how long, or how much time they tell us we have to do to talk. And so you have that unique perspective.
And like you said, being in their home makes a big difference. For us to diagnose with adhd, we need to , look at not just one setting, not just how are they doing at work or how are they doing at school. You need to be able to be like, okay, how do they do at church? How do they do in their sports?
How do they do at home? How do they do at work or their environment? And so it, like you said, you have that perspective of insight. Tell me you have a D H D without telling me a D H D when you walk into their home. Yes. You're able to. Easily see maybe some piles of stuff that they haven't done or different things like that.
And I'm not saying that everybody has the same way, but you learn to pick up on things that are not so obvious. And us with a d h. You, we have this timeline is staying. So us getting to a doctor's appointment sometimes it's a challenge on itself. . So how amazing it is that you can come to my house and I just have to stay put where I was supposed to be and I'm always on time for your visit, so to say.
So that would be that. That's so good. Yeah. So I think it's so important with that. Now tell me. What have you noticed? Might be some tips that you could give. Many times when during the birth of your first kid or as you have more than one kid, , even if you don't have a D H D sometimes A D H D can get diagnosed then because again, the executive function and emotional regulation.
Is actually amplified. The needs are amplified and we don't realize that the systems we had for ourselves or for one kid maybe are not enough for for now. And then you throw in not sleeping or having the breastfeeding. Being a little bit more work than we anticipated and you can see why our brain can feel like it's in a fog all the time.
What are some of the tips that you have shared with your new moms? Do you have them through checklists? Do you have them? Ask for help from a neighbor or so they can sleep. What are some of the tips that you have noticed have been helpful at since you do this breastfeeding all the time, like to this is second nature for you.
Just walk in and do it. Most of us forget like. What we went through during those shows period of time because we were just trying to survive it.
Dr. Andrea Wadley: Yes, exactly. So I don't have adhd, but I do take care of parents most. I actually, I take care of kids, but definitely parents who have h adhd and I have a.
A chronic disease that kind of gives me that sense of adhd. Things that have worked for me and things that work for moms might be different. So as a new mom, I probably had some postpartum anxiety. You just feel crazy during that time. Just everything is just, Crazy. Your hormones are making your emotions amplified, your lack of sleep, your physical demands of being a new mom.
All of those things amplify anything that you probably already had. And like you said were coping with because you had strategies. So for new moms, for breastfeeding moms with a D H D, I would recommend some things that kind of I do to just manage my own life right now. But to write things down it's number one.
So that's my number one tip is to write things down. Which breasts did you feed from last? Write it down. Or put a little pin on your shirt, or, something that is a visual cue that will remind you. There are probably about 1.2 million. Apps or more for new moms now. So picking an app on your phone that can keep track of things like, your breastfeeding, your formula feeding your diaper changes, all of those things that your pediatrician's gonna ask you.
When you go to the appointment, you're like, I don't know, I just barely got up this morning. So if you have it all written down that will. It will help you to see your progress with breastfeeding as well. I'm feeding every two hours, I'm feeding every three hours, I'm feeding every hour.
Maybe there's something going on that's wrong and having that, written log will help your physician, your lactation consultant. Know how to help you better as well. Another tip for me would be, it's a big thing for me and it was a hard thing and it's a transition to a new mom, is protecting your sleep.
Babies are biologically designed to be awake at night because they're used to this. Dark environment all day and they don't know day and night and they like to party in your belly all night. , when you were pregnant, you remember that? Trying to sleep and the baby's having dance party.
Yeah. So that doesn't change much when they're born. Doing some helpful things with sleep for the baby as well as sleep for yourself will help your. Status a lot. I usually recommend in the first couple of weeks of life, the baby's out in the bright environment during the day.
Even though babies sleep most of the day in the first few weeks having them out in the bright sunlight in a room with light coming in, the noise of your other children or your animals or the phone or, all those things. So they're starting to get used to.
The wakefulness cycle and then at night making everything as boring as possible. Trying not to turn on too many lights, trying not to have this sweet, interactive conversation with them, but just doing the boring thing of feeding and putting them back down. In the early days will go a long way to reset their circadian rhythms.
And the other piece of it is babies need to eat at night, and breastfeeding, unfortunately, I unfortunately, the way it was designed is they have to eat at night. Their bellies are only so big, their breast milk is so efficient and they just need to eat pretty frequently. So you, in order to protect your sleep if this is something big for you in A D H D, which I know it is, and a lot of mental brain change sort of things.
Is to get help. So depending on your budget and your, support at home, maybe it's something your husband can get up and feed some pumped milk in the middle of the night so you can get a stretch of sleep. Maybe if your budget allows you hire someone like an overnight doula or like a newborn specialist I'm gonna be interviewing a newborn special doula overnight person in the next few weeks on.
Grand live and she does amazing things. She comes in and she cooks for the family and she helps the baby get into a sleep routine. And she helps you, whether you wanna breastfeed the baby and she does all the rest, or whether you want her to feed, some pumped milk or some formula even in the meal.
Fine. So it depends on your budget, but there's people that will help you. And then, maybe you don't have a supportive spouse or you can employ the help. A family member, maybe your sister can take a few weeks off and come help you, or maybe a cousin or, a teenager can come in as a mother's helper during the day.
Just there's all sorts of ways that you can protect your sleep and trying to get. Some consolidated sleep that will help your mental state. And then, the other thing the last tip which goes along with the protecting your sleep is asking for help. Having all those people in your life that can help you do all the other things, caring for your other child doing the laundry, cooking a meal, those kinds of things.
I think a lot of why women with ADHD or not, Don't succeed with breastfeeding is that no one helps them. Breastfeeding is a full-time job in the first few weeks. And so those are the big three things that I would say. There's
Dr. Diana Mercado-Marmarosh: more. So I'm gonna, I'm going to recap what you said.
And then you can chime in if anything I missed. But write it down. So writing it down helps you to not have to always try to remember what's going on, so it helps you just stay present in the moment and you touched on something that's so important, visual, something visual to have.
Like you said, put on a pin or something that says, okay, the last one I did was the right, so then when I'm gonna start breastfeeding, you don't, you put them on where the pin is not, and then after you're done, move the pin, so that if you're, you always start where the pin is, not because you already used that one last, again, it almost seems so simple, but when our brain can't remember, you're going off of which one hurts less? Oh, I think I fit with that one. Like you're like doing that type of scenario to try to figure out which one it was. And then, yeah, I remember them asking like, how many hours, how frequent.
You're like, I don't know. Why am I supposed to know they, and sometimes you're. Forever. It feels like they're just attached, like they never came off and you're already asking me to put them again. And so again, if somebody explains to you what you should expect or not, that can just make the awareness, makes all the difference.
And like you said It takes a village. It really does. Like you just said, it becomes almost a full-time job. I was so mad. I remember being so mad at, I was like, this is my maternity leave, it's a leave. And my husband's you're not on vacation. And I'm like, no. If I thought I was gonna have a little bit of break for me, like, when is my break?
And you almost, if you don't have, like you said, that help. I'm so grateful that my mom came and stayed with me. The first six weeks. That was such a relief because but I did not ask for enough help at night. Like you said. I have plenty of stored breast milk. Why couldn't I had s. Said, Hey mom, why don't you keep the baby right there?
And I'll sleep. Or why don't for that night I did not know to do that. Or I did not know to ask my husband to get up like my husband. I remember being mad sometimes cuz my husband's like, why I never sleep anyways. And I'm like, then. now it's so resentful because, but then I never asked.
So yeah, you don't know that you can ask for help. Again, now looking back, it's so obvious, but while you're going through it, it's not obvious. And then you have this sometimes physician complexity, oh, I can do all the things like you, blah, blah, blah, blah, blah. Or, Motherly instinct, or whatever you wanna call it, where you feel like you're responsible to do all the things.
But if we look back the way society is, like in, in some cultures, like you do have like multiple family members living in your household, so you have multiple hands to help you with childcare with. Nourishment of your kiddos emotional and intelligence, right? And so we don't realize that we were never meant to do all the things.
We weren't meant to be the, the cook, the cleaner, the nurse, the wife, the physician, the lawyer, the bill collector, the, we weren't meant to do 10,000 roles, but here we are and. Like you said, protecting your sleep. My God. That's how we recharge, right? Like when we, if we're able to sleep at least six or seven hours, like the next morning, we feel like we have a full battery instead of just at 20% and not aware why we're so groggy or so angry, or so mad, or so tired, or so bloated, or you name it, right?
And again, you don't realize that all that is normal. Because of the lack of sleep. And and sometimes, even if you've never had a kid, and if you're a physician who's gone through any type of residency, , or med school, by that means. During those rotations, you know what I'm talking about, like your brain sometimes becomes a fog or anytime you were studying for a board exam or something like that.
Like your environment is such where you're pulled in so many directions sometimes. That you don't realize that how important sleep is. And again, the importance of just writing it down, you have something to look at instead of trying to remember because our short-term memory is helpful right there and then you write it down long-term, forget it.
I have no idea. Like you said, I just woke up , what do you want from me? And yeah. amazing gift that you could give yourself by asking for help, I think that's the smartest thing. I, again, if I would could go back, that's what I would have done. I would have invested in a breastfeeding specialist who would've shared everything you just shared with me.
And I would've definitely have invested in having like you said, like somebody come help even for a few hours during the. So I can sleep or I can or even having somebody come do my laundry or anything like that. Because again, then it gives you time for you so that we don't feel guilty that we're we needing to do.
We, you are choosing to do all this for this baby, but at the same time you're like, where's my time ? And so it's that dynamic and I'm so glad that you're speaking about this because this helps to create boundaries, but it also helps to create a support system that is a healthy support system for yourself.
And the thing is, like you just said, throughout your life, you're gonna need boundaries and you're gonna need create systems. So why not start at the beginning to. To get it there, right? So it's so good. So where can people find you? Now I'm pretty sure everybody's gonna be like, I need that. I'm in Dallas
I need that. So
Dr. Andrea Wadley: I am on Facebook at 1 27 Pediatrics. I'm on Instagram at 1 27 Pediatrics, and it's spelled. . I am also working on releasing a breastfeeding course at the end of the month. So you can find that through my 1 27 pediatrics page, or you can go straight to breastfeeding.one 27 pediatrics.com.
My hope and dream and goal is, To, start with a basic breastfeeding class and then build from there and make a community where women can feel supported and, educated and learn about breastfeeding ahead of time, and then be supported during the process. And then I am on my 1 27 Pediatrics Instagram page on Fridays.
I call it Fridays, with Dr. Wadley. I'll be doing Instagram. This month, the next few months of, bringing in different people that help support breastfeeding moms. Looking ahead, I have a, OBN next week we're gonna talk about the hormones of breastfeeding, and then after that, a sleep consultant.
And like I said, an a overnight. Postpartum doula. So those are some people that are coming up just trying to support women in that. And then if you're interested in my practice, you need to live near Colleyville, Texas. So we're just outside of the airport here in Dallas, Fort Worth.
I also have a satellite office, another pediatrician who works based in Alito. So we're glad to take you into our practice if you're in the, those areas. As well as I do breastfeeding consults for women in Tarrant County, so the Fort Worth side of Dallas Fort Worth. Sometimes if you're a physician mom and you talk me into it, I'll go to Dallas and do a breastfeeding consult over there as well.
So I do those one time. Outside of my practice. But if you join the practice as a new mom, you get all of those benefits, within your membership as well.
Dr. Diana Mercado-Marmarosh: Okay, ladies, pull the strings. . . Yeah. What an amazing niche that you're doing. Again I wish I would've had this kind of support when I was going through it and what a great way to support your patients and the moms and.
It's such an amazing thing. But as the audience listening to this sometimes zones out and that's one of our gifts. But we do re refocus from time to time. So if we just started listening right this second, what are some like. What is the takeaway point that you would want them to have?
Dr. Andrea Wadley: Gosh, I think just knowing that breastfeeding is hard and it's hard for everyone. So everyone I talk to has a story about how hard it was and that it's okay, and then it's normal and still women succeed. And then the other thing is ask for help. Women, especially physician women, high function.
In society type women, we don't ask for help and we need it and it's okay. It's hard, but ask for help and you
Dr. Diana Mercado-Marmarosh: can do it. Okay. Quick question. What do you see yourself doing in the next three years? For fun? For
Dr. Andrea Wadley: fun. So as a part of the. Andre Amne Business School. We focus on having a life, right?
So I am planning vacations, so my 10 year old, my nine year old is turning 10 this year. So we're gonna do a 10 year old adventure somewhere probably in the mountains. Has to do with, getting in a boat and doing white water. It's one of her favorite things. Oh, fun. Eventually traveling abroad would be a thing for our family.
And
Dr. Diana Mercado-Marmarosh: then what plays abroad? Have you started
Dr. Andrea Wadley: brainstorming? Yes. So my husband lived in England briefly, so he's always wanted to take us there. So that would be our goal. Maybe not this year, but maybe next year.
Dr. Diana Mercado-Marmarosh: Cool. Yeah. It's so important for us to not forget to incorporate fun into our lives because, It drives us, it fuels us, it motivates us, and it keeps us on track. And we can't forget that, this life is not. Dress rehearsal, right? This is our life. We get one shot. So why not be intentional about it and why not enjoy it along the way? So thank you so much for coming today. It was such a pleasure to have you like again, some of the things that you shared today almost seems so simple, but it's those simple things that can make a world of difference and can really help us set up routines.
And systems to support us and to then the ripple effects that happens when you are supported. Everybody else went also. So thank you so much for doing what you're doing and the people in Dallas don't realize how lucky they are to have you. And hey, maybe later on we can talk you into doing texts wide breastfeeding course.
That's something for you to consider. . Or who knows, maybe you can do a course to teach the physicians as well so that we can turn around and provide care for our own people. All right. You take care. Have a good one. Thank
Dr. Andrea Wadley: you. You too.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable.
Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: I am so excited to talk to you guys today about something that is called Sluggish Cognitive Temple Disorder. They used to think that it, was a category of A D H D. They weren't sure, but now they're working on figuring out that it's totally separate from A D H D, although they can correlate.
And I wanna. Explain the differences between them and explain that because it's so important for you to be aware whether you have that in A D H D or if you just have that and not a D H D because the treatment that you use is different. And yeah. So I think it's so important. Okay, so sluggish cognitive temple disorder is something that is been talked about a lot or by Russell Barkley.
He is a clinical professor of psychiatry from Virginia Treatment Center of children in Virginia in Richmond Virginia. But anyways I learned about this sluggish cognitive temple disorder during one of his presentations while I was working to become a clinical certified life coach for A D H D.
He has a Barclay rating scale for the sluggish cognitive temple disorder. And on there he talks about some of the characteristics that really make it stand out different from A D H D. So when you think. The Barclay Rating Scale. He wants you to think, to wonder whether you have you're somebody who is daydreaming excessively if you're having trouble staying alert or awake during boring situations.
Whether you're somebody who is easily confused, whether you're somebody who is spacey or seems to be like in a fog. Mind seems to be elsewhere or who is staring off into stage, or whether you're somebody who feels lethargic or more tired than others, or whether you feel like you just. Have no energy.
You're slow moving or sluggish, or whether you are somebody who seems like you're having a hard time processing information as quickly or as accurate as others, or whether you feel like you are withdrawn like you get lost in thoughts, or you seem to be very slow to complete a task.
So the important distinction that he makes or that he wants you to differentiate this from A D H D is that it seems like A D H D is more of a productivity disorder and he wants you to think of sluggish cognitive temple more as. Accuracy disorder. I thought that was important to point out.
And what he was saying is that when you wanna think about this, whenever with a D H D, we know that it's not. One part. But with A D H D, it's more like the executive function. It's the emotional dysregulation, it's the processing and the implementation and the planning.
So there's so many other stuff, but people with a D H D, some of them, they tend to have Endless amounts of energy, and I guess that's what people usually say about me, but we also have to remember that it's a spectrum. But what makes this a little bit different from A D H D? It seems like there is a slowness to the behavior.
There is a slowness in the information processing, and there seems to be some mental confusion or slow activity instead of like impulsiveness that can be seen in a D H D. And I wanted to point that out because I know I had several clients and I've had several of my own patients where they just come and they tell me.
I am so tired I cannot seem to focus long enough what people are telling me. So I want you to be aware of this possibility because we might incorrectly label them as a D H D and give them the treatment for A D H D, and then that was not the right diagnosis and it might not help. And interestingly enough what Dr.
Barkley says is that we're not even sure if this naming of this disorder is correct because luggage cognitive temple disorder it might not be appropriate to be labeled that because it almost implies that you have a cognitive deficiency and it might not be, it's just that maybe the processing speed of it is a little bit slower.
And so he thinks like maybe it would be better to call it like a concentration deficit per se. But anyways there was a recent study in the Cincinnati Children's Hospital. They treated the kids with this disorder with Ritalin to help with their daydreaming sluggish symptoms, and it really didn't seem to make a difference.
And then there was another study that was published in an article by WTA at all in 2013. And there they noticed that the children that had a D H D or dyslexia. In addition, they also had this luggage, cognitive temple disorder when they were treated with stratera, or the other name for it is Atomoxetine that actually had a benefit to it.
So as you know that this is a non stimulant type of medication, and this type of medication will help with not only neuro it will help with serotonin and nor. Which is different from sometimes the stimulants help, right? And so it's important to realize this because we might have a patient, or you myself, may be somebody who is not quote unquote benefit from stimulants.
And if you are given a non stimulant like this, you might have a great benefit. So with A D H D, think more about it. Pro productivity problem sometimes versus with s e t or an accuracy problem. And so there is some data out there and this disorder just slowly started to get look into since the 1980s.
It's not like it's been around forever. There some of the data out there right now shows, it seems like kids are able to be more self-identifying. Like they can tell you that they feel that they're slow to processing or they feel tired or that something is. Wrong compared to when you're making the diagnosis of an A D H D, we usually tend to look at the external perspective.
Like we ask the parents, the teachers, like in different settings coworkers. But with s e t, it seems like you have more internal awareness that this. You are daydreaming too much. Your mental confusion or there's some, your hyperactivity is a heightened, you have more of that awareness versus with a D H D you need to rely more on external awareness.
And with that also being said, there's some correlation that says s c t there is some correlation that having some type of like family or child psychology or adversary can increase the likelihoods of you getting this. For example, if you have parents who are divorced or maybe they come from a low socioeconomic household or a low parent Education, those social stressors are more likely to lead to this S C T versus not necessarily the case that these same things would lead to a D H D.
So all those is all that information is of cool and interesting. And there is some data also that shows that 60% of kids with s C. Might have a D H D and interestingly enough, 40% of people with A D H D might have S c T. So the point is that it doesn't necessarily mean that you have both, but it could.
B that you have both and being aware of that might open up the possibility of maybe not only being on a stimulant, but being both on a stimulant and non stimulant to help you treat both things. So that would be interesting. And I actually, looking back now, I can think of a couple of my personal patients that I have them on, both stratera.
And also stimulants and now it makes sense why they're doing so much better, because both facets are being addressed. So anyways, I wanted to share that information with you. I was surprised to learn about these things. And, as adults It's more likely that the older we get, the more likely might have S C T and A D H D.
But interestingly enough, 55% of a D H D in attentive type might have the S C T. And again it makes sense, right? Because I just told you that this is more like a sluggish and. The hyperactive A D H D people are not going to necessarily have s e t because they're impulsive. And this is like the opposite, not necessarily impulsive.
Okay. One last thing that I thought was more interesting too. Sometimes with s e t it can affect it, it can give people problems with math. And so if you have a person who just recently. Diagnosed with a D h, ADHD, and they've always had problems with math. You might want to consider if they actually have sluggish cognitive disorder or both.
Okay. So it was so great to talk to you guys about this. So takeaway point here is that you might have. something else, not just necessarily A D H D or you might have D H D and sluggish cognitive temple disorder. So if you're somebody whose stimulants didn't necessarily work and you always feel of tired and you always feel like you're daydreaming excessively or you're confused easily, you might want to look into sluggish cognitive temple disorder.
And I hope you have a great one. And as always, I'm here to support you. Send me questions of whatever topics you wanna talk about.
Dr. Diana Mercado-Marmarosh:Hello. Hello. Welcome to Beyond A D H D A Physician's Perspective. I am Dr. Diana Mercado Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my A D H D. But I now see it as a gift that helps me show up as the person I was always meant to be, both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hello. Hello. I am so excited to be here with you today. Uh, we are definitely in January, 2023 now, and I wanted to start out this year, right? I wanted to remind you guys why we do what we're doing. Um, we forget that. Our growth is optional. , we always think that, you know, we have to wait until the new year.
We have to wait till Monday. We have to wait until whenever to start making a change. But the thing is, you really don't, someday is not a day on the calendar, right? You really have to decide what your intentions are for 2023 and go for it. And so this. Um, my intentions continue to be, to grow and continue to be, to only do the things that like light me up and the things that will, um, give me peace of mind and the things that will make a big impact in humanity.
And as you guys know, I'm on a mission to really. Medical field, uh, to really disrupt the way a D H D is viewed, uh, so that people can realize that mental health. Really important and realizing front and center that our emotions, um, can be used as a compass is, um, I think one of the key things that people are not aware.
And so with that, I want to talk to you about three questions that I always, um, Teach in my A D H D course, and I want you to implement them. Ask them of yourself today so that you can gain so many hours back. Okay? And I'm gonna ask you these questions and I want you to really, they're so simple that you're gonna be like, really?
That's all . But I guarantee you that if you start to apply, You're gonna save at least three hours of your day, at least. Okay. And it will start to add up and you will start to be, um, in alignment with what you want to do. And yes, I know that change sometimes is hard and I know that accountability is one of the ways to really, um, bring it in.
Yeah. And so with that in mind, You know, I want you to be aware that I'm here to help you in any way and. The prize of my course, as you know, is going up. Um, well, they should already gone up. Uh, you know, January 1st I was gonna start charging a 4,500, but I've decided that, you know, I have a D H D too, and I've decided that sometimes we all need a little extension and that un unfortunately, life is not dress rehearsal, but being kind and being human and being generous is the most important thing.
Because, you know, life should be abundant and it should always come back. So because of that, I am going to extend the deadline of my, of, of charging. So instead of, uh, going up to, uh, 4,500, um, which it will go up, , it will go up by, um, February 1st for sure. Um, I want you to use this as an opportunity to invest in yourself.
I wish somebody would've given me this, uh, opportunity when I was a medical student. When I was a a resident. When I was a, an attending, I, obviously, this is why I created the course because nobody told me about it or told me how my A D H D brain works, and every day I see posts that basically say, Help, I'm about to get fired because of my A D H D or people with A D H D are not even aware that there's resources there.
And other colleagues are asking questions on different Facebook groups, um, what they can do to help their colleague out because they have a great personality and they're amazing with their patients, but the administrative stuff is getting in the way. And so I want you to be aware. Our internal environment, um, sometimes mirrors or external environment.
And, and some of you are already getting my emails, and in one of the emails, you know, I wrote about how you can change yourself, but if you don't change the environment, it's kind of hard or you can. Quit and go to a new job, which is essentially changing the environment but not yourself. And it's not gonna change, right?
Like it's not just magically gonna change. You really have to do both. You have to learn about yourself, and you start to implement what you're learning into the. Trial and error systems so that then now they can support you and, and it's, the magic happens when you do both, when you change yourself and you change your environment.
So why am I talking about this? Because again, it goes back to our environment, whether it's physically like how your office is, um, how it flows or it's. You know, if you have a clutter everywhere, it makes you feel like you're not productive, right? And so with that being said, Whether it's these questions that I'm gonna ask you, you can apply to anything and what I'm gonna be bringing up with you today, this is, um, what I use in one of my master in masterclass or workshops that I do, that I've done and I've gotten really great feedback.
So I figured why not share it with the rest of the world. We all need to, uh, be in the, in the same. Start somewhere, right? Progress is always better than perfection. So with that being said, um, the three questions that I ask myself is always number one, is this still useful? It sounds silly, right? But we all get things at some point in our life that we thought it was the best decision.
Maybe that jacket or maybe that dress, or maybe you bought like some fancy silverware or who knows, right? Or uh, so you have to ask yourself, is this still useful? Like would I. Go into the store today and pay anything for it, because I would want to have it again. Yeah. So is it useful? Is it outdated? So you really have to ask yourself that.
Does it still have a purpose in my life? And here's the thing, we're talking about things, but these type of questions you can apply to anything. Like you could apply it to your job. Is my job still useful? Would I choose it again? Is my relationship still useful? Like, I know some relationships you can't really walk away from, right?
Like you can't really walk away from your mother-in-law or from, um, your sister or from, you know, different things like that. Not that I'm saying that any of those are my problem because I love those, but, you know, and coaching clients. I've been asked these questions, they're like, but you know, da da da da da is draining me and the holidays are rough and being critique.
Here's the thing, like when I'm talking about decluttering your life, I am talking about on purpose setting boundaries and knowing. Heartedly what's gonna support you? Right? So would you choose that relationship again with your, with that so-called friend, or you know that it, all they do is call and ask you for X, Y, and Z?
And it seems like it's always one-sided and it's energy draining and consuming, and you feel worse about yourself. Um, or would you on purpose decide? You know, if it's a relationship that you really can't get away with, uh, because again, like it's like a relative or something, you could on purpose decide, Hey, I'm gonna limit the interaction instead of going to spend with them a whole week, I'm just gonna spend with them one or two days.
Or you can't tell them, uh, when you do this, I am gonna do that. And so, you know, I'm very proud of one of my, uh, clients. She shared with us yesterday doing our group coaching. She was able to tell one of her relatives that, while you might do this a certain way, and I do this a certain way, I want you to respect that this is a topic that we do or don't do here and, and I need this from you.
And so she, uh, she was able to, uh, state her boundaries and she said it was a wonderful holiday. So the point is, And I asked her, um, why do you think you were able to set those boundaries and. Necessarily sometimes set those boundaries at work. And you know the answer was the universal answer, which is, well, I know that that person loves me unconditionally and I'm not sure that they love me at work unconditionally, right?
And so here's the thing, like what I said, what if those boundaries are being placed from a, a place of love and from compassion and so respect to yourself so it doesn't, when you're taking care of you. Everything just falls into place. So with that being said, I want you to make sure that you're aware of what the questions are.
So the first one was, is this still serving me a purpose? Right? Would I walk again and buy it? Right. And then the last one is, Can I, can I help somebody else with it? Like, is keeping it gonna give me peace or not? So it's so important that when we are talking about these relationships, we realize that, um, some of us, so the three simple questions like I was saying, are so simple.
The first question is, is it serving? The second question is, do I really want it? And the third question is, is this current or outdated? So again, these three questions seem so simple, but they can really help you to tone in what is important when you ask yourself is, is this serving me? It means, is it giving you more energy?
Is it freeing up your time? Is it being a benefit to you? Right? The other one is, do I really want it? Like, would I choose it again? And the last one, like I said, is the current or outdated because we all have stuff that we've been holding on for for years and years and years, and we might not need it. For example, , I don't know if you have kids or not, but you know, I have a four and a five year old and I've recently was able to, uh, give all my stuff like I still had one, one.
Like a, you know, a crib. I still had a change in station. I still had like the clothes, um, for up to four years of age. And even though I have decluttered multiple times, I was holding onto stuff just in case I had a third child. But what I decided was that, If I do happen to have a third child, that would be amazing and I can acquire this stuff again.
And meanwhile, why not give it to somebody who needs it or, and help them, right? So I say all this because many of us hold onto things and I joke around and I say, you know, I was so grateful when my kids were being body trained that they were not. that they had diapers, right? Because imagine if they were peeing everywhere or pooping everywhere.
But that didn't mean that I was gonna hold onto the diaper forever because I was able to use it. Like the point is, there's certain things that have a chapter in your life and then you need to let go of it. So if you really ask yourself, is this item that maybe you just did the laundry, uh, do I need to put it away or can I give it to somebody else?
It's gonna save you hours of time, because later on. When you are sorting the clothes, the clothes that you have left is only clothes that you have been currently little by little in a system-wise approach have been keeping that currently fit them. You don't have to then spend like a whole two days or something going through other drawers or being frustrated every morning that their clothes no longer fit, right?
So, I really want you to ask yourself, is it serving me? Do I really want it? Is it currently you're updated? If you apply these three questions to anything, like I'm saying, you're gonna get endless hours back and you could ask yourself like, is it really helpful for me to spend five hours doing the laundry a week?
Maybe it's not. Maybe that could be something that you outsource to somebody. What would you do with those five hours? Do I really want to continue doing the laundry? What would it cost me to continue to do the laundry? So I wanted to consider all this and make sure that you're aware that you have opportunity to really change.
And of course, of course. Um, You know that I'm here to support you in any way possible. Again, while this system seems so simple, it is in the group setting, non-judgment, um, supportive environment where, uh, we all can thrive. So, I'm so excited that we are here together. 2023. Keep in. Send me a link, let me know what you want me to talk about, ask me any questions.
And I would love to, uh, create this content around you. Do tune in to next week's episode cuz I am so, so excited about what I'll be talking about. Um, I don't know if you knew until recently, I didn't know that. Um, there's something called the s Luggage, cognitive tempo Disorder. A lot of people confuse that with a D H D, and so I'm so excited to be talking about, uh, how Dr.
Barkley, um, Really, uh, tis those two things out because, uh, the stimulants that you use sometimes are not so helpful. And so if you have somebody who has h ADHD or you yourself have d h D and you're not really finding the right medication, I wanna make sure you have the correct diagnosis and the correct treatment for it.
So, tune in, talk to you soon. Bye. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website at a D H D dash live. coach.com where you can find out about my upcoming coaching group classes, as well as free masterclass and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond D H adhd, A Physician's Perspective. I am Dr. Diana Mercado Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my A D H D, but I now see it as a gift that helps me show up as the person I was always meant to be, both in my work and in my personal.
In the past two years, I've come to realize that I'm learning some of my beliefs and some of my habits were just as important as learning the new set of skills. Well, hello. Hello. How are we doing? Then? A couple of weeks since I joined and did a podcast. I would say that I'm. Blame it on the weather, kind of like Southwest did, uh, this holiday week, right?
But life happens and I am just gonna roll with it. But today what I wanna talk to you guys about is how my. Adhd and not just mine really, but I think my family's h adhd, uh, help salvage the holidays and how we have, we've been having an amazing time because of our h adhd. Probably most people would feel, um, very, very, uh, overwhelmed with the change and the fact that, you know, The fact that, uh, anything that we went through this week, so for example, um, my week started off, uh, our vacation started off on December the 22nd, and we left Austin and we decided this year there's 12 of us.
And we, this is something we've decided beforehand that we, we, we decided that instead of giving each other gifts, like physical things that we would try to give each other experiences, uh, to decrease clutter, to improve bonding time to, uh, improve connectiveness. And so in doing so of. During Thanksgiving, , we were, uh, planning our vacation for Christmas.
So just six weeks away, right? Uh, we decided we wanted to have, well, we, we've been talking about it, that we wanted to have, uh, snowy, uh, White Christmas. And so , typical a d h, adhd, uh, and of course some wine involved. Uh, we were looking, uh, places to go find this quote unquote magical snow, right? So when we were planning for it, we were planning, we started off looking into New York because my husband's parents are in New York, and then we considered a Denver, and then we considered, um, salt Lake City.
And so due to the fact that, um, maybe it would be too much to ring 12 relatives to visit my in-laws, uh, we decided, uh, and it was kind of like short. Notice type of thing. Uh, and also due to cost as well, we were looking at the price of the flights and looking at the price and the availability to go from point A to point B because we wanted to rent, uh, 12 passenger van or, or a van that would have the.
Capacity. Uh, we ended up using the, we, we outlined what we thought was important. We knew that we wanted snow. Uh, we knew that we wanted, um, a way to transport to get to the places we weren't so, Skiing on, like, uh, necessarily skiing. Uh, but we wanted to at least be able to go tub, be, uh, or to goat sledding and to have the ability to make a snowman.
So those were like our big things. And of course we wanted to be together. We wanted to find a hotel or an Airbnb, um, that would accommodate all 12 of us. So with that in mind, we ended up, uh, using Southwest and, uh, we were looking at flights and stuff like that. And of course, we all know that we, once we decide on something, we can like hyper focus and we can make stuff happen, right?
So what I'm saying is that our ADHD brain, while it doesn't sometimes. To go off the course of what we had decided to do. It is very good at adopting to whatever is currently in front of us and being able to, um, Adjust and pivot, right. So when we started our vacation, uh, on December 22nd, uh, we went from Austin and we decided that, uh, we were going to Salt Lake because in Salt Lake City we could stay, um, , you know, uh, a few in little towns kind of like Midway or um, park City, and, uh, we could get the snow that we wanted and we could experience the city and just.
You know, we didn't come with a full agenda other than what I just suggested we wanted. And again, when you are, we're talking about traveling with 12 people. We're talking about traveling with four kids under seven. Um, there is a 3, 4, 5, and seven year old. And then of course we had two, um, older teenagers.
Um, And well, one is 18 now, so that helped. And the other one's 16. And then of course my brother, my sister, her husband, my husband, my mom, and so 12 of us. So the point is that
staying overnight in an unknown hotel can be fun, right? But it can also become. a nightmare . For some people, if you know, the bed doesn't feel good or it feels funny or smells funny or people are, you know, having problems with each other. The, the point is that, um, we ended up choosing Salt Lake City because we were able to find a hotel that.
Could accommodate all three of us with the price point that was not gonna break the bank. Uh, we stayed in Midway, which was very close to Park City, and we did come in, uh, we came and, and, and did things right. So with that in mind, we were there for, uh, for, we were meant to be, be there for five days and then we were meant to go to Vegas for another five days or four days I think.
So we booked flights because, uh, to, to make it easy in travel. And we rented a van when we got to Salt Lake City. With that in mind, You know, life happens and Southwest was, is going through, uh, staffing issues and weather and all that stuff. And when we get from Austin to, um, Uh, to Salt Lake, we realized that our two car seats didn't make it.
And we also realized that our two big luggages, which had all the clothes for me and for my husband, didn't make it. And luckily, the two little suitcases where my kids clothes were. Did make it so at least we had clothes for them. And of course, uh, you know, we stand in line. Oh no. Oh my God. Like there was a huge line, like 20 or 30 families did not get their lu.
Well, little bit. We know that that was like just the tip of the ice. So to say that we didn't know the iceberg, but we didn't know how bad, uh, the southwest thing was going to be, and that it might be about a month before we get our luggage, which I still don't have my luggage six days later. And so I think that the fact that.
My A D H D didn't make it mean anything about the fact that we didn't have her luggage. I, you know, I see, I, I looked around. Everybody else didn't have their luggage either. Um, I kept telling myself that, you know, the reason we were there were to make memories. The reason we were there was to, um, to spend time with each other.
And despite the fact that. The plane took off an hour and a half later than expected, and despite the fact that, um, we were sitting in the taxi runway for another hour because there was not a gate for us to get off into, um, I, I kept thinking that we. Got to our destination safely and that we were, and, and at that point, I didn't realize we were in the 30% that had got into their destination.
And I didn't realize that we were in the 90% that was not gonna get their luggage right. But my mind kept going to the fact that things can be replaced materialistically. , right? And that again, we were at the place we wanted to be at. With that in mind, the day prior to us even flying. , uh, we almost didn't have a car that we were going to use again because of the weather and the situation that was going on, but luckily, uh, they were able to, uh, help us find a car, uh, that was useful and that weren't well, and that was so good that we were able to have a car, uh, to move around and to travel and to, uh, do that.
And, you know, again, because we didn't have a huge, um, itinerary and we were flexible, I feel like that helped us to not only survivor our holidays, but to really be more present and to look around and to experience the beauty of it, of it all. Like, you know, the, the beautiful houses with snow. Uh, it also allowed us to.
More on each other and lean on each other's strengths and reasoning. Um, and I feel like our ADHD helped to save the holidays. Um, we were able to, Um, plan, you know, while we were there, we were trying to plan, we really wanted to go, uh, experience anything. Like we wanted to go tubing, we wanted to do the dogs list.
We wanted to go to the ice castles one, unfortunately. We didn't realize that all these places you need the reservations like three to four, two, maybe six weeks beforehand. And again, we didn't do that research. Usually we do that research ahead of time, but this time around again, we were kind of flexed and we didn't know what, um, if we, we didn't wanna book for things that, what if we didn't even make it there and we couldn't, um, you know, enjoy it and it would be all this money invested.
So again, a D H D was good in the sense that we didn't preplan. Because then once we were in the area, we walked around and we saw an ice skating ring. We looked up the times we came to the ice skating ring. I finally got to ice skate. I've been meaning to ice skate. My husband, uh, Promised me to do this on our, one of our first dates.
And you know, we've been together for 16, 17 years. I don't even know how long. It's been forever in a day. And we finally got to do it. And he remembered. And you know, even through that whole ice skating thing, that also was something that I had to work through. Like, I kept thinking about the fact that, you know, A few years ago, I fractured my ankle and that I had to be more careful and that what if I damaged myself again trying to do this.
Sport and I kept seeing people fall. But you know, um, my husband was, um, gently persistent and uh, he came and asked me if I would skate with him and, and I said, oh, well maybe hold my hand. Well, I, first, I tried, I got on the ice and I couldn't. Like I didn't feel safe or comfortable. So I got off the ice skating ring and then he came again and then he's like, I'll hold your hand.
But he really didn't wanna hold my hand cuz he said he didn't wanna gimme a false sense of security or stability. And I said, I think you need to, for the first time around that I would go around this ring because otherwise I'll be on the floor. I'm not trying to be on the floor. And so we skated one time around on the floor, uh, around, and I didn't.
And then I said, this is good enough, I'm gonna go sit down. Uh, and I played with my daughter and we were doing snow snowball fights, and then he came back later and took my daughter to go try. Uh, and he was taking turns with the kids. And, um, then eventually he came back and he's like, let's try it again.
And he's like, I won't hold your hand. And. . And so the thing is that after that I went ahead and did it like I was right next to him. It, it took me a while, , but I did it. I went around and somehow I was like doing some circles. I don't even know how I was doing them because, you know, I wasn't trying, I was just trying to stay upright.
People thought I was dancing. I wasn't trying to dance. They came and commented on like, that's awesome that you can dance on the eyes. And I was thinking, But I just try to stay upright, . So the point is that my ADHD and not overthinking it allowed me to do things and to step into the zone of excitement instead of the zone of fear.
Because we all have fears, right? But we shouldn't let those fears paralyzes. Again, stepping into our H ADHD of like, well, why not, or let me try. That could be very, very helpful. Alright. Another thing that I say about our trip is that. Even though we try to, um, again, book two being experience and it was going to be $30 a person and again, we're 12, right?
Um, I couldn't find it, like there was just nothing available. So my sister got on the internet and looked up like where to go, a sledding or tubing by herself for free. And when she did that, um, that opened up another world of possibilities and. Uh, that helped us to then just go to Walmart and pick up some flats, go through a thrift store and pick up some flats.
And we found a place where we could go and it was amazing. And we did it. We did the experience without paying an Army Electric. and we got to go and Maker Snowman and have Noman Fi uh, small snowball fight. And that was really fun. And then at the other days, we got to just go and try the local food. And then we try, we went to the historic district.
So the point is that, you know, Spain and in the moment allowed us to enjoy the moment and. Absorb the surroundings and just be present and enjoy the fact that we were with each other. And that made all the difference. The, the cousins could be the Grinch on the tv. We could make cocoa, we could talk about our year.
Like it was just amazing. And then of course, . Um, when it came time to figuring out what we were gonna do for the next leg of our flight with Southwest, um, our flight was likely gonna be canceled. And so, um, and, and so we decided to drive, you know, it was like a six hour drive from Salt Lake to, um, To a six hours drive from South Lake to Vegas.
But you know, our Southwest flight was more than two hours delayed. And I think we had to make a choice. And again, we decided, okay, if we go through Southwest, we might get there delayed, but we, our luggage might not get there. And if we go. . Um, if we drive, even though it's gonna take us a little time, it might actually be better.
And, you know, we listened to our bodies. If we were feeling tired, uh, we decided to pull over and take a nap and. Listen to or drink water and eat and, and so what was supposed to be a six hour drive ended up taking about eight hours. But again, we did it in a way that was safe for us and we used our A D H D and we kept telling ourselves, we don't have, um, you know, any type of restriction.
We just gotta get there. We gotta get there safe. That was the.
So throughout this time, we made it enough so that we could just take time for ourselves if we needed to. Like nothing had to be perfect. Uh, we just had to lean on each other and. Make a plan B, make a plan B, make a plan D, you know, and prevent potential meltdowns by making sure that our kids were fed, that they drank, that we were communicating with them what the party was.
And you know, and we're still in Vegas and we've decided we're gonna go try an escape room and we're gonna lean on each other's strengths and just keep exploring and being fun. So what I wanna say, In order for us to have, um, good holidays, you've gotta ask yourself what your priorities are. Like we knew we wanted to see snow.
We knew we wanted to spend time together. We knew we wanted to bond, so then we just worked towards that. So I really think staying flexible and looking at the bigger picture makes a big difference and allowing people to do what they like. You know, some of us didn't wanna go see, uh, a magic. so they don't have to, some of us didn't wanna go dancing, so they don't have to, some of us don't wanna go drinking so they don't have to.
Some of us wanna chill with uh uh, you know, seeing a movie and that's cool. So I think. And being okay with buying different foods. Like last night I had a gyro and my mom has some chicken, uh, you know, from a different restaurant. And my, my sister had another had in and out burger. So it's okay to do your own thing and it's okay to also compromise.
So I really think our A D H D one was,
uh, was also. Important. So anyways, uh, I'm back and I just wanted to wrap up this year by saying that it's okay to have self-compassion. It's okay to have grace. It's okay to be present. It's okay to use your A D h ADHD as your strength. I don't know how the rest of the, um, ordeal, the Adventure is gonna go, trying to get back.
But when we get there, it's gonna work out because in our mind, you know, doing what we want is what was the most important thing. All right, well, I can't wait to connect with you guys. Um, and I know some of you are gonna be doing the January course with me, AB. So excited about that. Um, that's gonna start on January the 23rd, if you wanna do the Monday class or January the 26th if you wanna do the Thursday class.
So do take, you know, right now, this is the lowest you're gonna get the CME credit. Uh, Sorry, this is the lowest you'll get, um, this year's rate for the January course. So it's gonna be, uh, so take advantage of that because it's gonna go up in price. Um, it's gonna go from 3000 to 4,500, so definitely save that 1,500.
If you can, uh, and we can obviously set up payment plans. Remember, you are your best investment. Definitely don't forget that. Take advantage of the fact that, you know, We are professionals, that we have resources that we get to decide how we practice medicine and how we live our lives in our own terms.
Anyways, it was a pleasure chatting with you guys. And, uh, please send me an email. Tell me how your holidays went. Tell me how your d h d are your strengths. Which ones are the characteristics that are your strengths? Obviously for our family, it was staying presence, staying flexible, being willing to pivot, being, being, uh, AB able to have a plan B and C, and remembering what the holidays are really.
Uh, so use your ADHD to. Envision the rest of your 2023 and not just to envision it, but to make it a reality. And if you want help in doing that, I can't wait to help you to do that. So please do that. Um, in January we're going to be doing the procrast How to Procrastination and Overwhelmed, uh, free Masterclass.
And I will be giving y'all the. Soon. But if you are also looking for a vacation slash growth opportunity, don't forget that my Costa Rica, uh, physician retreat or healthcare retreat is gonna be happening in May, May 1st through the sixth. So put that in your calendar. Uh, some of the physicians have used, uh, some of the remaining.
CME funds now, like, uh, to give a down payment and lock it in, and then they're gonna use the rest of the CME for 2023 to pay it. So yeah, let's touch base, let's work something out. I can't wait to support you and keep being amazing. Take care. Bye-bye. Thank you for spending your time with me. I really believe that time is your most valuable asset.
Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website adhdlifecoach.com. Where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mercado Mar. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my D H D, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my. And some of my habits were just as important as learning the new set of skills.
Well, hello. Hello. I hope y'all are doing well. It's crazy to believe that we are on episode 52. Yes. It's amazing. A whole year of recording the podcast. Um, why am I doing this? Well, because I believe that. , our stories really do matter. Um, a lot of times we don't realize that our self-talk, um, can really affect how we show up.
and how the rest of our day goes. So I've been listening to a book called, called the Soundtracks, and it's so interesting. Uh, he poses three questions, which he says that these three questions you can use to really stop your overthinking. He talks about the fact that, um, we all. Have, you know, some thoughts that are in our mind, and if we really took the time to slow down and ask ourselves these three questions, it could paralyze or overthinking.
So the three questions that he mentions are,
is this really true? The next question is, is this helpful to think about it this way? And then the last question is, is it kind? So let's go through like a story and figure out what I mean by that. So, you know, most of us always think, oh my God, I don't have enough time. And do, is that really true?
are you being really realistic with a number of things? Are are in your to-do list? Are you really choosing to do the things that are a high priority or are you not even aware that you're buffering with that because you are? On purpose, avoiding the other things that maybe would be having more bang for your buck if you did it.
So, you know, when we think we don't have enough time, like your brain does not go into like problem solving mode, , it just goes into like, kind of victim mode and it gets, you know, all stressed and overwhelmed and, and it does not take action. And try to, and try to find a solution, right? So you, you gotta remember that for it to be true, like 12 people from the court of law kind of say, would have to agree that yes, this is true.
Like, you know that you are five two, or that you know you're a female or that you're a male. Like that there would be like, no question about the vi fidelity or like, you know, the, the truthfulness of it, right? Okay, so you ask yourself that first question, so I don't have enough time you tell your, that's maybe not true.
Right. And then the next question is, is it helpful to think that I don't have enough time? Is it really helpful to think that? Probably not. Like, again, we just went through this whole exercise that if we're thinking we're not having enough time, we're not gonna take the necessary steps to. That we do whatever we need to.
We're not gonna ask people for help. We're not going to, um, you know, feel accomplished with whatever we did do. And then the last thing, uh, is. Is it health? Is it kind for me to think this way? You know, maybe you're thinking I don't have enough time and because I don't have enough time, that probably makes me like the worst mom in the world, or that makes me like the worst wife in the world, or that makes me the worst daughter in the world.
Like you can have all kinds of thoughts that not having enough time is maybe preventing you from showing up as like the best version of yourself. And because you're not showing up like that, you're thinking that you. You're horrible. You're not a good human. Or maybe you're thinking you're ashamed that, you know, you have the clothes from all over, um, you know, and you're like, oh my God, I'm not a good mom.
I don't have clothes put away. Like it's a mess. I'm a mess. Like, you're, is it really, I. Kind for you to think that way. Probably not. So it seems silly that those three questions would be, will create such insight. But you know, it, it's good to ask yourself those questions cuz you can really apply 'em anywhere.
Like is it, um, is it true that having h d means that you're broken? Is it true? Is it really true? Um, is it helpful to think that way? Is it kind to think that way? Probably all three don't really add up, right? But yet our brains sometimes have, have thoughts that we don't even like question that we, we don't even.
You know, wonder where that, where that came from? Like, why am I thinking this way? So like today, During our, one of our coaching sessions, we had our guest coach, um, and we were talking about decluttering, which of course, that's a part of my program that I totally love because, you know, each member gets three fr three sessions with my, with my, um, the coach.
And that's so amazing that they're able to then personalize it, whatever they wanna get rid of. But anyways, going off on a tangent, one of my clients said, I'm bad. Uh, you know, I'm bad. The house is a mess. Uh, I actually have to pay somebody to help me, uh, you know, come and organize my house, um, once a month.
And I, I'm bad, I'm bad with that. And so I quickly in the chat, I'm bad is, is not true. It's not helpful and it's not kind. I think. And then I put, um, badass is. True is helpful and is kind like I see her as her being badass, that she knows that this is an area that she has decided she want to, wants to invest in, to try to, um, help herself.
Acquire the tools that maybe she's not where she wants to be, but she, if she keeps thinking that she's bad and therefore she's broken, like that's not helpful at all, and that's not true. Like in my eyes, yes, she's badass, that she has gifted herself this opportunity for learning and growing and figuring that there could be a better way.
Again, you can quickly see how, uh, she then shared that, oh, she was ashamed of all the mess and blah, blah, blah. And I had to point out too that you know, you're not. You're not the mess, the stuff around you is the mess and you, you're separate from the mess. Just like we are separate from our thoughts and we're separate from our emotions.
Like we, we learn to deal with them and question them and try them on and see what fits and what doesn't fit. So we have to keep remembering, you know, that our A D H. is a gift, or it could be a curse. Your brain is going to lead you one way or the other based on what you decide. So again, your self-talk really does matter.
And at the end of the day, like your brain doesn't care. Of course it's programmed to kind of be thinking in the negative, uh, because it's trying to keep us safe. Uh, it's been like that for, you know, thousands of years. If you're too cool, calm and collected, I mean, we would've been eaten by the bear, right?
So, but using gratitude, um, as a way to hack it. Like if every day you wake up and you start your day with like three things that you're grateful for, and it doesn't have to be anything crazy, like it could be that, you know, Your kids are st are, you know, still breathing, that you have food on the table, that you still have a job.
Like you could think about anything that you're grateful for, and then you on purpose decide like, what is your intention for the day? Like, what are 2, 3, 2 or three things that you want to accomplish at the end of the day so that you could say that yes, this was amazing, or, um, at the end of the day, like deciding okay, what went well, you know?
So again, um, how you talk to yourself makes a big difference. If you are always telling yourself you're too slow, you could never change, like you don't have enough time, you don't have enough money, you don't have, you're too big, you're too small, you're whatever, like any. Anything that we are using against ourselves, it's gonna keep us from being who we are.
But anyways, I wanna invite you to come to my, uh, webinar that I'm gonna be having. Um, and you know, on there I'm gonna be talking about how to end procrastination. Um, because yeah, we all can end procrastination. We really can. and you are just a few thoughts away from it, and I want to support you in doing this.
I want you to understand that, uh, being able to, um, be all in on ourselves makes a big difference. So please join me on Saturday, December the 17th. From 11:00 AM to noon, uh, central, go to my webpage, a d h d live coach.com and that way you can sign up for my webinar. But, um, some of you already know my coaching program, uh, right now is $3,000 and.
If you get in, uh, in it now, you know you can reserve your spot for, uh, 2023 when it's actually gonna go up to 4,600. So don't wait. The time is now. The time is now to, uh, gift yourself the gift of time and to start to live and practice medicine in your own terms. Um, You know, uh, continues to happen and growth is really optional.
And so you gotta decide, you know, if you want a different result than what you've had in the previous years, you really gotta re uh, decide to do something different. So why not join my community for you can be a hundred percent fully supported. Come have fun, learn all the tools, all the hacks, and uh, yeah.
Enjoy, uh, you know what's to come. So like I always say, if you just started listening now, , the takeaway point is that there are three questions you should always be asking yourself. And those are I, um, those three questions are, is it true. Is it helpful and is it kind? So yeah, try that and send me a message.
Let me know, uh, what are some things you're working on or what are some things that you would like me to talk about? And, uh, we can, we can be in touch. Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Medo Marm. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize, That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited today. Uh, I can't believe it's. Episode 51. It, it's crazy how you do things and you forget you're doing things and all of a sudden you get almost close to like a year of doing things.
So with that in mind, uh, I've had a couple of crazy weeks, um, the three sessions or. Workshops in the last six weeks and now I'm super excited to tell you that I have my physician retreat that's gonna happen in Costa Rica. Uh, yes. So it's May 1st through the sixth, so I will put all the information later on, but.
It's gonna be really fun retreat because you get to go have fun and get CME and it's gonna be divine half a day workshop at the actual place, and then the rest of the day you get to play. So, and of course at the end of the day, we have to do the coaching so we can reflect, so we can implement everything that we're learning.
So today I have an amazing, uh, treat for you. It's one of my good friends and, uh, Abby. Shiller and I might messed that up. And so she's gonna introduce herself and tell us all the wonderful things that she's up
Abbie Shiller: to. Hi, I, first of all, I wanna go on that retreat I honeymooned in Costa Rican. It's amazing.
And then did, gimme a break. Give me a break. .
Dr. Diana Mercado-Marmarosh: You know, we went for our first year, uh, for, for, for honeymoon, right. And then, uh, we went at 11 years for like to celebrate like in September. I was like, before they tell me that Monkeypox is a, a thing and I can't leave the country. Right. So Costa Rica's
Abbie Shiller: awesome.
Yes, indeed. I, I, everybody who goes on that retreat is gonna be, have the best time. Yes. Um, okay, so I'm Abby Schiller. I am a goal coach. I help, uh, women transform their lives from one change to another. I help them reinvent. I help them grow businesses. I help them love parenting more. I am also the CEO and co-founder of the Mother company, which is.
Has a, it's a media company for young children and we have, um, the mission of helping parents raise good people. So I've co-authored 12 children's books and I have, um, a TV series that I created and, uh, just really grown a media company for children.
Dr. Diana Mercado-Marmarosh: Awesome. Yeah. And tell me, how did you get into that?
Abbie Shiller: You know, I was a mo so my career actually was in brand strategy and public relations.
I had been the head of PR for Keels, which is a skincare company, and after that I went to become the head of PR for ABC daytime television. So I was the one telling Barbara Walters for the View, like how to manage crises, um, which is a hilarious chapter in my life. Um, and an honor to work with such a. Um, and I kept thinking, I, so I had a real view of what was happening and at that time, baby Einstein had just launched and then sold to Disney for like 180 million.
And I was like, these are videos of toys for babies, and I could do this so much better. And there hadn't been any television to really help children with the issues that I needed. To help my children with, which were, you know, sharing and communication and expressing your feelings and becoming a good friend.
And really the only option at the time, and this really dates me, was Barney and I hated it. Yeah. And I thought for a generation of women who are reshaping stores like Target, so that they're like, design first. Why can't we have media for children? Is, you know, the, what is the Whole Foods version of Media for children?
And so we created a series called Ruby's Studio, which still airs on Amazon Prime. And, um, it's, it won an Emmy and it's just a beautiful series for children to help them learn about feelings and friendship and safety. We have, I think, the best program. Young children understand body safety, not like car, car safety or bike safety, but like personal safety, um, without any cringe factor.
And then we also have a show on siblings. So we did some beautiful content.
Dr. Diana Mercado-Marmarosh: Awesome. And so, you know, we, we, in this podcast, it's my perspective on what I think about, uh, ADHD or, or whatever, right. Um, is there anything ADHD related with you?
Abbie Shiller: Oh, a hundred percent. I am like poster child . Um, and for me, the h is for hyper focus.
So I definitely have kind of the manic moments of unfocus and what did, where did I? Just like three cups of coffee or tea, like all over the house that I can't remember where I put, or, uh, I'm saying something and then I, my thoughts draw. I have, I am like the poster child. I'm also dyslexic, so I have a lot of neurodiversity happening, um, which is for me, a superpower.
You know, we grew up, I grew up in a time like seventies and eighties where they didn't really diagnose us with that. And so I just thought I had a different brain that like got to figure out things differently. And so like for instance, I was always in the slowest math group because of my dyslexia, but I'm the only person who can do math intuitively because I just feel the numbers because I've had to learn how to do that.
So it's been. Absolute superpower for me to have a neurodiverse brain. And I actually have a little card on my desk that reminds me of that, which says, I am immensely capable of achieving great things because my brain works differently. The world needs my solutions. Yes,
Dr. Diana Mercado-Marmarosh: that's so good. You know? Um, I'm so glad that you tapped into your brain and you didn't make it mean anything, that we needed three cups of coffee or we needed to do anything in that sort, or that maybe you were approaching it from a different way that your colleague would have or your friend would have, or.
Or somebody else would have, because I think that's part of the problem that gets us stuck. We just keep comparing ourselves to other people and wonder like, how come I can't X, Y, and Z? But you embraced it and that made all the difference.
Abbie Shiller: Yeah, I actually think the opposite, right? Like all the other people are doing X, Y, and Z and it's not working.
So what br, what can I bring to the table that they could never think?
Dr. Diana Mercado-Marmarosh: Yeah. So you're able to enhance it and, and be, and give yourself the permission to think outside the box, because that's what's gonna get the job done, correct.
Abbie Shiller: That's exactly right in a way that no one else is capable of. And I have proven that to be true over and over and over.
It's so funny because when people get a diagnosis, I think their assumption is, oh God. But I actually was like, Hey, that makes a lot of sense . How awesome that there's a
Dr. Diana Mercado-Marmarosh: name for this. So how old were you when you were told, Hey, this is what's going?
Abbie Shiller: I literally, like last year, , I got tested last year. I'm 50
And I just kept thinking this is like, this is not normal. Like my husband is like, what's up with the nonsequitors? And you know, finish the sentence. And what, you started to do this task and then you did three other like. Okay, let's, let's figure out why, which is really helpful. And also the other thing that's really helpful for me is to recognize how I'm constantly low in dopamine.
Ha. And so I'm always trying to like get a dopamine fix. And so awareness, yes, awareness has been so great because I'm like, I don't need to snack, I just need like dopamine and I can do that other ways.
Dr. Diana Mercado-Marmarosh: Awesome. So let me ask you this, um, And you don't have to answer it because obviously it's your medical information, but, uh, you're welcome to or not.
Um, are you menopausal, uh, in, in age yet, or no?
Abbie Shiller: Oh, yeah. I mean, I, I'm, I love that you, like, you're, you're a doctor and so you approaching this in like a doctor leeway. Uh, I am, I, I will talk about menopause all day long because I think that it is so crazily un under talked about and underrepresented. Why don't we know like 51% of the population is going through this or will go through this?
It makes no sense that we are so in the dark about this. Um, I am. What's called premenopausal. So I am still very regular. I love that I'm talking about this. Still very regular, but uh, but with occasional hot flashes or night sweats
Dr. Diana Mercado-Marmarosh: or heart flash. The reason I'm asking you this is because some women.
Like yourself, sneak away until you hit premenopause or menopause. What do mean? Sneak away? Like you never get caught. You never get given the diagnosis because you keep like creating systems until you know, like you've probably were doing something that you were so intrigued and it was in your zone and that was giving you the domine.
But then you hit, like for some people you hit the, you know, High school or college, right? For some people you get to like law school or medical school or something like that. Or some people you become like the CEO of something and all this, that other people, you get to premenopause or menopause and that's when the diagnosis happens.
Or when your kid gets diagnosed and you're like, wait a minute, those are mine too. And so I'm pointing that out because again, A lot of us, unfortunately are like, oh, you just made it possible. That's why, blah, blah, blah. But what if they are, have missed your diagnosis of ADHD all along?
Abbie Shiller: So my kid was diagnosed with ADHD 10 years ago, , and I totally brushed it off because she didn't, I didn't know a lot about it, and I just felt like, like, that's not a diagnosis that's gonna help her.
She's gonna use that as a crutch. So I'm not, I didn't even tell her. I didn't even tell her. And then the more I learned about it, and the more I started seeing the things in myself over those 10 years, I was like, whoa, this is crazy. And now there I, I feel like there are flareups, I just call them flareups of like certain days where like the smallest task is just like, Lugging boulders behind you.
Dr. Diana Mercado-Marmarosh: Yeah. And again, like you just said, being aware that every day might be different and not making it mean anything and having that awareness of like, where am I low end dopamine, or am I really supposed to be doing this task like at 9:00 PM or should I have done it like at 9:00 AM Right. Uh, or is this a task I need to do or can I delegate this to somebody else?
Abbie Shiller: Right. Love delegation. Love it. Yes.
Dr. Diana Mercado-Marmarosh: Yes. Yes. So tell me what has been one of like your. Moments where like you couldn't help but LA laugh and now looking back you could be like, yeah, that's totally my adhd. You know, without saying you have adhd, but at that point, maybe you never
Abbie Shiller: knew. I had a video that went viral on Instagram and just a, a simple reel where I videotaped my cup of tea sitting cold on the counter, and I said, how do you know you have ADHD without, tell me you have adhd.
Telling you have adhd and tens of thousands of people liked this one video, and I realized I, this is something I'd done my whole life. Leave it in the microwaves, leave it on the counter, stick it in the car, whatever, . I was just like, that was like the aha for me of like, oh, this is a connecting habit.
Dr. Diana Mercado-Marmarosh: Yeah, my husband says that all the time. He's like, were you going to have that? I was like, yeah. They're like, cold or ? I'm like, yeah, cold . So
Abbie Shiller: much, so much. But you know, it's interesting. I used to think that it was because when I was a new mom, I was like, oh, I'm breastfeeding. So now I'm sitting here and I can't reach.
but no, like most brains don't. I mean, typical brains I guess don't work that way. I hate the term typical, like Right. I maybe if maybe typical versus special.
Dr. Diana Mercado-Marmarosh: Yeah. , uh, radiant . Yes. Yeah. Charming. I don't know. Whatever you would wanna call it.
Abbie Shiller: I mean, it really works for us on so many levels though. I mean, we really are magnets and dynamic.
there's, you know, yes, of course we can't remember to do a gazillion things or are late to things, but, but okay. Like, cuz we make up for it.
Dr. Diana Mercado-Marmarosh: Yeah, I know. I'm like, well when I show up, I'm here. What, what was the problem? .
Abbie Shiller: Okay, that's right. It's funny cause my mom actually was ADHD and I never knew that and I was always the last kid to be picked up at school cuz she was always late.
And she would forget things or like whenever we traveled, we'd get to the airport five minutes before the plane took off and like, I just thought that my, my childhood was chaos and I never realized until I had a diagnosis and now I see everything from my child. It makes so much sense. Yeah, it makes so much sense.
It was like, it brought me so much peace. I literally let go of so much anger that I had had towards her of like, why would you pick me up last?
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. I mean, that's the thing, right? When you don't know, like we can interpret things in a different way, and especially if you have adhd, like we hold onto some crutches and we think like, oh my God, they're rejecting us.
And, and then when you understand it from a different angle, you're like, Okay. Like she was trying her best, but that was her best. Yeah.
Abbie Shiller: Yeah. So, yeah. So many fender benders, , so distracted all the time.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. That's my, my tells me sometimes she's like, Mom and I'm, I'm happy. Like he's only gotten one tardy bill.
Like, you know that, that, that's, that's
Abbie Shiller: accomplishment. , I will say that I, I am not that mother even though I have the same diagnosis and I think that we can, we cannot lean, we don't have to lean on the diagnosis as an excuse. Like we can do better for ourselves. Yeah. And that's partly what I do as a coach.
I help women really like live the lives that they.
Dr. Diana Mercado-Marmarosh: Yeah, that's right. Like ADHD can start and end with you if you have the right tools. And I, in this podcast, I keep telling people that, you know, I'm not gonna push one thing or another that only, you know, what would be, uh, helpful for you. But you need to really be open to trying all the things.
It might be that exercise is all you need, or it might be that a low carb diet is all you need, or it might be that you just need a very passionate job and some boundaries on Quin to like stop, right? Or it could be that you need the meds and the therapy and the coaching, right? Because with the coaching, uh, again, you start to realize that you're not all those thoughts that your brain has on re.
Abbie Shiller: Mm. Yes, I'm a big believer And love yourself the hardest. Yes. Just love yourself. You know what I love to do? This is a little off topic, but
Dr. Diana Mercado-Marmarosh: nothing's off topic on here. , you're in the right room. Girl.
Abbie Shiller: I really love taking time alone, like just solitude time. So like for my 49th birthday, I, I rented a little tiny place in, in Maine on the ocean, and I just spent four days.
And it was like heaven to just like listen to my wants all day long and answer them, and it, it got me out of an environment of like routine and I just was able to be like, Hmm. Do I wanna pull over to that lobster shack right now? Yes I do. Okay, let's do that. Am I hungry? Yes, I am. Let's do that. Do I want a glass of wine?
No, I don't want a glass of wine like, All day long. I was just like totally tuning into my brain's requests and my body's responses, and it was like just an absolute gift to myself for my birthday at that time. And I, I highly recommend trying this. If you can't, I mean, it doesn't have to be a cottage in Maine.
It could be, you know, a friend's house or whatever. Like, just get out of your environment and listen to your wants all day long. Get away from the kids, get away from the job, whatever, for like 24 hours and just like, Respond to
Dr. Diana Mercado-Marmarosh: yourself. You know, you brought up such an important, uh, topic. Like I'm, I'm part of a physician, uh, female group.
I mean, I'm in many of those, but I'm in one of them and somebody posted. At first it, it looked like an angry post, but she was more like in like awe, and she was more like, we should have the audacity to do what my nanny's doing. So apparently her nanny asked for, uh, a weekend or, or, or two days. I don't know what it is, like every two months to get like, kind of like what you said, to get away and disconnect.
So, She can come back and be fully present and everybody was like, oh my God, da da da da. And then they were like, but wait, that means she's taking care of her. And, and then she's coming back and she's, and she's like, she's an amazing nanny to, to them like they, she's always like, Ready to go and present.
And it's like what an awareness of a 20 year old to have that insight. So young, right? Like most of us tend to like figure out midlife crisis or something like at 35 or 40 or 50, like we start thinking like, oh my God, how did I get here? Right? Because we, somewhere along the way, forgot to love ourselves or ask ourselves what do I want?
And at first everybody was like, oh my God, she's asking for time off. And then they were like, oh, we should learn from her and ask for time off. Why not? And, and like you said, like check in with yourself, not just your brain, whatever your brain is telling you, but like, does it really feel at ease in your body?
Um, when did you learn to do that and like to tune into your.
Abbie Shiller: I love that question because I think I'm still learning to do that. I am fully a recovering people pleaser and perfectionist. I . Hey, shout out to all of you. Um, I, I feel like this is an ongoing process, but where I, when I think I first learned how to do that was six months after the death of my father.
Right. When, um, the administration at the time was separating children from their. Uh, in immigration and my heart literally cracked I, and there was a definitive moment in which it cracked. I was standing at the kitchen counter making dinner, and I literally suddenly had like the most horrifying suicidal ideation, which is so far from how I've ever thought in my life.
I just felt absolute despair and loss, and I, I am an empath. I felt. The who I, it makes me cry even thinking about it still, the horror of the children being ripped from their parents after this journey and I just realized I'd hit a bottom point and that I was of no service to my family. I was of no service to myself.
And I decided I need to check out, I did what your friend's nanny did. , I needed to fill good. I needed to fill my love bank. And I believe that in those moments, the universe responds and I didn't tell anyone, but I got on the phone with American Airlines and I was like, how many miles do I have and how far away can I go?
And I had to just leave the. And I went my friend, because again, the universe responds. Um, and I am really big on manifesting. Within five days, I had a flight to the south of France and a stopover in Portugal by myself for 10 days, um, at a friend's house. That she had Airbnb and somebody had canceled. So I, she needed to fill the room.
And then I just used Miles and I literally did a 10 day trip to the south of France and Portugal for practically free to fill myself up again and to remove myself from the despair and get some, I journaled and I cared, and I listened to myself and I slept, and I, ugh. It was like, and after that moment I came back.
Whole, you know, like when there is, when we jump in the pool with our clients or when people are drowning or we start drowning in an attempt to help them like we are of no service to ourselves or of them. And so that is what I did and that is what your friend's nanny is doing, and we have to do that for ourselves.
There's just so much going on in the world that if we don't put our oxygen masks on first, then we can't serve anyone else.
Dr. Diana Mercado-Marmarosh: Yeah, it seems. The big shifts that have happened for you and have happened for me have come from. Moment of remembering that we mattered, remembering that we matter first, like not in a selfish way, but like you said, put your oxygen first.
And so for me, it was that moment in time when I realized I was the most important patient in the room. That if I wasn't okay, like it didn't matter how much I could wanted to fake it or to pretend to be professional or whatever they had told me. I was like, not well because I had not been refueling my cup and I was just giving away, like you said, people pleasing and again, and sometimes people pleasing and we don't realize that it's a mechanism that helps us to survive in what we're doing because then that means it's smooth trailing, right?
But then at some point you use it one too many times that you mask and then. Remember, like you said, to check in with your gut, to check in with your heart, your soul. Right?
Abbie Shiller: And you know, the barometer of that is when you start feeling the emotion of resentment. Like for me resentment is like the, any twinge of resentment is like you, you're already too thirsty, right?
you should have hydrated a long time ago. You should have felt fell. Sorry. Oh my gosh. You should have filled that was the. Isn't that funny? Thanks brain . You should have filled your love bank long ago. So resentment is like a great aha moment of, and for me in that kitchen moment, it was despair. I mean, my brain, there are a couple times in my life when my brain has become fully unrecognizable to myself and I just had to like step back and just say who, what's happening?
Another, can I share another one of those of. So in 2014, I had a spiral of a, I mean, I was running a company. I had two little kids. Everything on on paper seemed amazing. And then my mother-in-law died and a number of circumstances happened that triggered a number of other circumstances that were financial and mental wellness and a whole bunch of other things in my family that created a life within six weeks that I did not recognize.
I mean, here I was going along and then boom, a circumstance and then all of a sudden who, what's happening . Um, and I. It actually was a life changing moment for me because I realized that I needed to take my life back, and I knew that there was a, like, it is I, I know people can take their lives back. And so the first step for me was to research that how do you change your life?
I literally Googled that, how to change your life, how to transform, how to goal setting, habit forming, change behavior, human potential coaching, cognitive behavioral therapy. I studied. Everything for three months. I just literally like, you know, that like Diane Keaton movie like where she just like goes into like writing and she's just like the, the thing is flowing out of her.
That was me learning, just like sponging it up and I decided January 1st. That I was gonna create a, a, a program for myself, and I invited a friend to a hotel. I was like, I again, I checked out for 24 hours, separated myself from everything. And we went into a hotel on January 1st, 2015. And we just did these exercises for 24 hours and we ate and we walked and we brainstormed and we meditated and we did all of these things and we put a plan in place.
So we went from goal to plan, and then after that I started implementing. The steps of the plan. So I, I call it a gps I goal plan steps, and I started implementing the steps and within three months my life had fully transformed. And that's actually what my visioning course is now. It stemmed from that moment of darkness and uncertainty where I needed to turn my life around, and now I have a profession around it and I turn other women's lives around.
Dr. Diana Mercado-Marmarosh: Yeah, it seems like we're on the same journey. You know, what was. Painful or what was not what we wanted. We used it to now give other people a gift of opportunity to do the same thing for themselves and, and not because we're gonna tell them how to do it. Because everybody's in their own journey and what might work for me might not work for you, and we don't want you to feel like we're gas lighting or something.
Right. But we're providing a community. Right. Where they can come and give themselves permission to change the narrative of the story that they are currently in. Right. That they can decide that, yeah. All those pages and all those previous chapters, it's okay. Like we can go forward and create either end this book or start a new book or decide what you want to do, right?
Yes. And, and, and it's. When you are aligned with that, it's like a product or a service of of love, right? That because you gave yourself that opportunity, you now want to give everybody else the opportunity so that you already did the heavy lifted for them. You know, that hyper focusing and tried to figure out the things.
Um, yes. And I think that's what makes us so. Um, I, I like time vendors, right? Or , because people are like, when do you have time for, do all that? I'm like, well, when it's driven by passion and purpose, it, it doesn't feel like work. Sometimes
Abbie Shiller: I feel like time is such an interesting concept. I, I don't know about you, but I struggled for a very long time with time anxiety.
And again, my mother was always late. She has literally whatever it's called when you have no sense of time. That is how, one of the ways her ADHD time, blindness time, yes. But there's actually a medical term for it, I believe. Anyway. Yes, it's time blindness. And she has, she will literally say, remember last year when you think and you're like, mom, that was 20 years ago.
Um, it's be, it's ama like literally a part of her brain is like blocked, I think , but. I think, you know, for, for us, our demand, like the demands that working women and especially working moms have in terms of time is, in my opinion, a systemic problem. There's just no way that the expectations of, you know, getting everything done, it is possible.
And so that really creates kind of a math problem. But in addition, we in. Dump on top of that, the mental problem of like the drama around it and the, I'm so overwhelmed, I'm so tired, I'm so busy. All of that really adds to the feeling of it. And so when with coaching, we can take it apart a little bit and just think, you know, what would it look like if I got this course done with ease?
What would it look like if I did? Halfway. What's a, what's a B level effort here? And is that enough? What if, um, what are they actually paying for? They're paying for results. Does that mean that they need to get 15 modules or 10 modules or no modules? And just me showing up, right? So just remembering the perspective of, and I always like to ask my clients like, what's your goal here?
What's the bigger goal?
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. That's the same thing I asked my clients. Like I asked them, how would you know that you, you're, you've been successful in this program? Like, what is your success measure? Because whatever that's framing that end for Exactly, because whatever I think is success might be different when you think it's success.
Maybe to use success means you left your chart closed at work, or maybe for you success means you showed up at your kids recital because you finally. Time off and the things that are really important for you. Or maybe it could mean you, you got away and did a book or, or something else, right? Like and.
and giving yourself the opportunity to ask yourself those hard questions. Because in our mind, time is a hard question because we're always gonna say there's not enough. Right? And, and it's not just like, oh, let me just think the opposite and magically that's gonna be better because we know that's not the case, but it's in learning.
How to use planners or how to do it in a way where it doesn't be, have to be so hard, like you said, with ease , and, and when you align it with your values, it becomes a little bit more with ease.
Abbie Shiller: Yes. And I think that ADHD people have a challenge with this, especially because we have trouble deciphering priorities versus what's important versus urgent.
Um, I think that, Obviously have incredibly distractable brains in, in an unbelievably distractable world. Um, I think that there's a number of challenges for those of us with neurodiversity in terms of time use, and then I, I love helping people find the solutions around that and, and the tricks and what works.
And, I mean, there's also really great resources in the world for, for people with that. Again, you know, what's the larger purpose? I had a, I had a. A couple summers ago, like in the height of the pandemic, 2020, and I was working, working, working, working, working all day long. And my little guy, we had bought him like an inflatable pool.
I tell this story in my vision and course we had bought him an inflatable pool and he was just out there splashing in the pool by himself, and he called up to me in my office and he was like, mama, come play with me. I was like, I'm so busy. That pool's freezing. I'm not getting there with you. And then I had a realization of.
Like what is important here versus what is urgent? And I did have some, some urgent deadlines, but 30 minutes, 45 minutes in a pool with my kid would would mean the world. And so I got my bathing suit on. I got in that bug filled little kitty pool and we threw a little beach ball for 45 minutes and he talked to me about Marvel and we just fully connected.
And in those 45 minutes, like I literally felt. Fullness. My heart fill. His heart fill. We related to each other differently. After that, things became easier. After that, it was a little investment that I paid. In terms of not getting, you know, my work done for those 45 minutes, but it was an absolute privilege to have that connection and that make that memory with him.
And that's what I mean by just tapping into the priority. Like what's, what's the priority here? And for me, a goal is to be a present mom. And so that was my feeling of that. And we just have to step out sometimes to realize the larger.
Dr. Diana Mercado-Marmarosh: Yeah. And, and to realize again, why are we doing this? Like why are we working so hard?
Like you said, it's probably to spend time with your family, but are you spending time with your family and are you present with your family? Right? So like, again, it's creating that awareness and then, okay. Now what are the action steps so that I can create the life that I want on purpose, not by chance.
And I
Abbie Shiller: wonder how many people don't know how to be present. I wonder how many people don't know how to meaningfully connect. I mean, we have a loneliness epidemic in this world, even when we live with other people, even though we are surrounded and connect. Accordingly to the, to our phones, more than ever, we are so lonely, and that's because we just are out of pr.
Our, our connection muscle has atrophied, and so we have to make conversation. We have to put our phones down, we have to engage with people, we have to learn how to listen. Um, I, I just, I just see this, you know, parents and kids at the table with their phones and it just breaks my heart so much because these are the moments in which we teach our kids how to connect.
And they're not getting
Dr. Diana Mercado-Marmarosh: it. You know, at the, at the chat conference, they had one, uh, workshop that I thought was so interested, it just blew my mind. So she got us, she asked us to get in a circle, and she asked us to then stand up and walk around and meet with somebody. But you couldn't talk to them. You just had to like, look at them like, uh, in their eye, like eye to eye or whatever.
And if you felt comfortable, you would shake their. If you didn't feel comfortable, you just walked away. How crazy was that? Like it was so uncomfortable because like you're, you're trying to be like, polite and, you know, it's, and one person wouldn't wanna shake my head, so I just finally started laughing.
They're like, okay, fine. She's shake my hand. Right? But like, it's so like, the meaning of like body language and like reading people is like not a skill that we. Can learn, right? Because like you said, we're so like glu to her phones, right? And then she had us do another thing where, uh, then we, she, she had us be like, person A and person B, and person A could not talk.
They just had to listen and she didn't tell us for how long, , it was only two minutes. But remember, we don't know. And so it was just like, and she didn't want us to say Aha or Mm, like you just have to be like a mirror, so to say, like, but not say anything. And so it was so interesting. And then she had that person who hadn't talked, reflect back what that person had told him.
And so it was such a gift to be heard. Yeah, totally. And, and so it's just mind blowing how, like you said, we don't, we don't have, uh, uh, awareness of how we're doing things sometimes.
Abbie Shiller: Yeah, completely. I get it. What an incredible, what an incredible, um, exercise. I, I love those. Have you ever heard of the 36 questions?
So there's something called 36 questions. Two researchers developed it in New York, and the whole goal of it was to have an exchange of these 36 questions that at the end of which would foster intimacy between any two people, any two people. So they. Um, you know, they do it with couples who have been married for a million years who have lost kind of that connection.
They do it with friends, they do it with two strangers. They do it on dating apps. They have proven that the 36 questions will create an intimate connection between two people. And then at the end of it, like what you just said, you have to look into somebody's eyes and then that's it. Like, then intimacy is created.
Dr. Diana Mercado-Marmarosh: Yeah. That's so, that's so interesting to know that we eventually, if we talk long, We might find some common ground. Right. And, and develop that relationship. Um, yeah, so it was just interesting to walk around the room with people that I would have never maybe talked to, you know, but all of a sudden you just had to see them for themselves or their humanness and oh, and then at the end of the workshop, They said, we're gonna frame each other.
So what that meant was I had to look at you and by just looking at you, I have to say she's bold. She's like happy, she's vibrant. Like based on how they were presenting themselves and that that was also very cool.
Abbie Shiller: Wow. Did anybody say anything like, She's really insecure. She's really traumatized. .
Dr. Diana Mercado-Marmarosh: No, they basically said, oh, she, you know, they're calm, or they're, or they're reserved or, but they never said anything.
It was always pleasant.
Abbie Shiller: That's wild. I have such, um, intuition about people. I would have to be careful in those moments.
Dr. Diana Mercado-Marmarosh: So tell me, where can people find.
Abbie Shiller: Uh, you can find me on my website, which is Abby Shiller, A b b i e s c h i l l e r.com. Or you can find me on Instagram, Abby Shiller coaching, and, uh, I'm launching a visioning course to help transform people's lives in January.
It's gonna be a three month course with a year of support. I'm so excited about it. We're just a, a relatively small group of people who do this work in community and it's.
Dr. Diana Mercado-Marmarosh: Awesome. So like, you know, my podcast is, uh, geared towards people who have ADHD and sometimes they don't pay attention. So if they just started listening right this second, what would you say are the takeaway points that you would want them to listen to
Abbie Shiller: from the course?
Dr. Diana Mercado-Marmarosh: From my work? No, from what we were talking about, like the whole Oh, from
Abbie Shiller: today, . Yeah. I wasn't listening. Just kidding. .
Dr. Diana Mercado-Marmarosh: Well, good then everybody's on the same page. .
Abbie Shiller: Um, if I were to summarize this conversation, I think that I would say like, fill your love bank. We can't, we can't be of service to anyone when we are completely dele.
um, manage your time, figure out what's a priority to you and what's, uh, important, and try and find the balance between the two. And I always like to just let people know, you know, make sure you're being aware, be aware of what your thoughts are and what the results are that they're creating.
Dr. Diana Mercado-Marmarosh: Well, Abby, thank you so much for coming.
You guys cannot see the ruckus that is happening in the background, but I have my two kiddos jumping around and she has kept herself composed through this whole thing, , but I wanna
Abbie Shiller: make faces.
Dr. Diana Mercado-Marmarosh: Oh my goodness. It's just
Abbie Shiller: working. Mamas are amazing, right? We
Dr. Diana Mercado-Marmarosh: are superheroes.
Abbie Shiller: Thank you so much for having. Yes.
Dr. Diana Mercado-Marmarosh: Thank you for coming, . Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website live coach.com, where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happy.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Dean Meow Mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my. Adhd, but I now see it as a gift that helps me show up as the person I was always meant to be, both in my work and in my personal life.
In the past two years, I've come to realize, That I'm learning. Some of my beliefs and some of my habits were just as important as learning the new set of skills.
Well, hello, hello, hello. I'm so excited to be here with you today day. It's been a day. It's been a wonderful day today. I have met so many people here at the chat conference. and I just feel like my heart is full and. You know, one of the topics that kept coming up was about self-confidence. And, you know, somebody came up to me after, um, Dr.
Lola Day and Dr. NAA Bauer, and I gave our, our, uh, our speech today. Uh, during lunch we talked about how our programs. Bridging the gap where medicine is not able to, uh, we're talking about how skills. are gonna be taught and implemented, and that pills unfortunately do not teach you those skills. But of course they can definitely help so that you can get closer to what you want to accomplish and, and, you know,
People came up to us and told us that they felt like our talk was authentic and vulnerable, and that they felt the connection. And it's so important to realize that our stories. Really do impact how we perceive the world and how we see the world. And you know, somebody told me, oh my God, you made that look so easy.
And I own that compliment. You know, some, some of us don't want to own what our son of genius are, and I'm glad it looks easy, but sometimes we all know. Something looks easy because we practiced it a thousand times, right? . And so why do I say this? Well, because when we are doing something that we enjoy and we love that emotion can come through and sometimes you know that confidence comes through because.
You are aligned with what you feel like your purpose is. And I had so many wonderful conversations today, throughout the day, and you know, my intention for this conference was obviously to come share my ideas, but also to learn from other people and to learn from their stories and from their perspective.
And what I shared with them today was that, you know, three years ago, I would've never had said this out loud to other people that I had ADHD because of the mental stigma that I was associated with it. But now I say that, you know, adhd, it's kind of like the diabetes of, of psychiatry. Like you really have to.
Use all the tools in order for us to help us navigate this. Like you have to realize that yoga, that meditation, that, you know, sometimes paying attention to your God flora, , and, um, exercise, um, low carb diet. All that can be helpful in managing adhd. Of course, our sleep is so important, but I'm bringing this up because we don't realize that many times what we tell ourselves or how we talk to ourselves can really influence how we perceive ourselves.
We all have that innate need and want to be loved and accepted. Of course we do. And sometimes we misinterpret that our self worth, you know, is gonna always be measured with how productive we are. But the thing is, like if you go back to the essence of us as kids, um, we weren't like, We weren't in our heads when we were, you know, just born and people had to feed us and had to change our diaper.
Diverse. And, you know, as we were learning to walk, we weren't like judging ourselves for like stumbling and falling right? Like we were. So, you know, we kept going. And obviously when we had somebody there that was praising us and telling us to keep going, that was motivating. And so we had this conversation today.
talking about how praise can really motivate us to keep working and can improve our self confidence. And you know, before the age of 13, most of us with ADHD will have heard 20 to 40,000 messages compared to somebody without ADHD telling us We're not good enough. We're not fast enough, we're not tall up, we're not, we're too loud, we're too, you name it.
Right? And, and it's so important to realize that our confidence. Or lack of self-confidence sometimes can be shaped by those people around us, and a way for us to improve this confidence is to again, go back to what are so new geniuses For me, I really feel like it's speaking. It's really in speaking that I can portray a feeling and emotion and when somebody understands what they're good at and they're aligned with it.
That confidence just kind of radiates and lights you up. It, it helps you to keep going, right? It doesn't feel like work. It feels like play, and so criticism can really break us down or can really. Turn us off, and I'm not saying this, so that all of a sudden you can tell your husband or your wife or your, you know, your boss, stop judging me, right?
But so that you realize that when people give us feedback, listen to them, but you don't have to take everything that they're telling you. Ask yourself what part of that might be true or not. and do I value the person who's giving me this advice or not? You know, let them be wrong about you. If whatever advice they're giving you does not fit or correlate with you, it's okay.
You don't have to take their advice. We need to be able to praise ourselves for the wins that we. Because when we own those wins as little or as big as they are, then we don't wait to get to the final destination before we start actually feeling happy.
It means that you get to enjoy the whole journey along the. Because of somebody wise told me, once you are at the top of the mountain, you get to enjoy the happiness and the joy that you brought with you. If you didn't have it with you all along, you really can't enjoy it. And so I'm saying all this because self confidence is something.
That can really be practice, and you practice it by doing, like, by stepping in and being okay with a messy first draft and having choices and deciding whether whatever you're currently doing is worth your time or not. Are you enjoying it? Why or why not? And I really mean that. Like ask yourself, are you enjoying that relationship?
Why or why not? Are you enjoying that job? Why or why not? If we're not having these type of conversations, you're gonna one day wake up and think, what's the point? Because you weren't asking yourself all along if you were. In the right track. So when things come up, when you see something that is happening,
being willing to hold space, be willing to have conversations with those around you
and don't equate.
Failure
as being unsuccessful. You know, failure, I've learned it's the first attempt at learning. I. So go after your big dreams. Stop playing small. The world needs your zone of genius. This is literally how we function today. I've met so many wonderful people at the chat conference. People who are authors, people who are speakers, people who are of course physicians, people who are therapists, people who are doing all kinds.
in, uh, intuitive, um, biofeedback. I mean, we all need each other. I always say teamwork makes the dream work. So if you would like to join me in my course, come check it out. Come see what I'm about. Come join the non-judgemental community. Where you can learn all those tricks and hacks and techniques to leave work at work and practice medicine and live life on your own terms.
Please bring me any suggestions on what topics you would like me to talk about. Uh, send me an email. Go to my website life coach.com and tell me what you want me to talk about. I would be more than glad to talk about it and come join my course. There's gonna be a Black Friday special, so definitely be on the lookout for that and get yourself on my waiting list for January.
You wanna definitely purchase my course if you're thinking about doing it in January before then, because, um, the price will be going up after January 1st. You know, Christmas is around the corner. You need to invest in you today. I can't wait to support you in your journey. If you know anybody who. Would like to talk to me, spend in my way.
Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues. And don't forget to check out my website@coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are.
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Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Meha Marm. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize, That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
I am so excited today. I have an amazing friend here and I can't wait
to hear all her story
in the full totality, or whatever. She feels like Sherry. Uh, I have Dr. Danielle Milano Milano. She, she tried to help me earlier, but you know, It's she, we forget . And, uh, she's a full time, um, family medicine physician and of course she's an amazing wife and a mother, and she is a, she's a coach.
I'm gonna miss. Pronounced, but she cooks amazing food. Okay. Culinary Coach . There, it's, And so anyways, I wanna hear about her story and she's gonna walk us through how she found out she had. Okay. Thank you.
Dr. Danielle Malano: It is so exciting to be here and I'm just such a big fan of yours. I'm really honored to be able to share the space with you.
Thank you so much. So I, at the ripe old age of 43 years old, just found out I have ADHD and . Uh, it was a long time coming and I never really knew that this is what it was, but I always knew, I felt like. Something was wrong with me. You know, I was bright, I got straight A's in grade school. Um, I had a very structured, you know, childhood.
My parents were super strict. All I was allowed to do was, you know, homework and that was it, . And then when I got into college and was pre-med, it got more stressful and I found myself just, you know, falling asleep, studying or procrastinating or, you know, cramming the night before and, you know, was. The grace of God was able to get into medical school, and I went from California to Chicago, far away from home, and being away again.
That was just another big struggle for me. I thought everyone else was smarter than I was and I didn't feel like I belonged, and I was so afraid of asking for help because then everyone would figure out that I don't belong there. But again, because of that fear, Decided I would just try harder, study harder, work harder, you know, And you know, it got me to where I wanted to be.
I landed my first choice for my family medicine residency, and then I became a lowly intern all over again, just starting over in a new place in California, back at home. And again, I was struggling a lot. Um, so I again studied harder, worked harder. At a cost, right, Of just this feeling that I had in my chest and in my brain and like tingling all over my body, like constantly in order to succeed and perform and, you know, get, you know, what I needed to get done and take good care of my patients.
So, um, you know, I continued to perform like I, I thought at like a high level. Um, you know, when I got married and had kids, you know, we threw in another human being and then two other additional human beings into the mix where, um, you know, my tools that I had in place to keep me in line or just thrown out the window,
Dr. Diana Mercado-Marmarosh: I know the feeling . I know, right? It's not
Dr. Danielle Malano: just me anymore, you know? So I remember getting into an argument with my husband at some point. This was before we had kids. I don't know, it was something about something silly, maybe. You know, things weren't in place or things were a mess. And I totally married my opposite.
I'm type A, he's type B, super relaxed and chill. And I was just getting so upset. And then at one point he was like, Dee, you didn't marry. And then I was like, Oh, light bulb. You're right. I did not marry me. And if I did, I probably wouldn't work out because, um, I, you know, need to find someone that balances me.
And thank goodness that both of my boys have two loving parents who show their love in very different ways, and they can get the best of both. And so, you know, My boys started school and my young, my oldest one was doing great. He was getting straight ass. I was like, Wow, this is great. Let's, you know, have another one,
You know? And
Dr. Diana Mercado-Marmarosh: so kid number two came along.
Dr. Danielle Malano: Oh my goodness. A little bit different, right? They're two completely different human beings, . And we're not supposed to compare, but we still do. Yeah. Right. And I noticed, you know, TK and, uh, kinder, the teachers would mention things that he would, you know, have these outbursts or be more active.
He's, I definitely thought he was more of an extrovert than my oldest one. And, you know, they're different. They're kids, you know. So, but in the back of my head, I was like, Okay, should I be worried? When should I be worried about, you know, possibility of adhd? And I reached out to the teachers starting in first.
When she had sent an email, this was like probably post pandemic, so I knew there was gonna be a transition coming back into school in person. So when I put the feelers out about, Hey, should I get my kid evaluated? She's like, No, let's wait. Let's, you know, put these processes in place to help and focus.
And I said, Okay. Things went well for a while and then they didn't. So it would be this back and forth. And then finally after multiple back and forth, it was almost towards the end of, um, the year that I. You know, hey, should, you know, should I get him evaluated? Just say the word and I'm all in. I'm all for, you know, giving him all the opportunities to succeed.
No answer. And so I just went, took it upon myself. Got ahold of our pediatrician and she got the evaluation. And of course there's a waiting process. And we went through that process. We got the appointment and we filled out some paperwork. The teacher filled out some paperwork and then we finally had the meeting with the behavioral pediatrician.
And during that interview I was with Johnny and they have to take the history right of both of the parents, um, and the history of the child and in gathering my personal history. Mid-sentence. I was like, Uh, do you think I should get evaluated ? And he is like, Yes. Without hesitation. Yes, yes you should . And he said, Oftentimes we diagnose ADHD late, especially in women because they're more sometimes of the inattentive type, but.
When you were diagnosed late, um, maybe in adulthood. It's often because of a couple of reasons. Number one, if you're very bright, that could mask it, or number two, you had a lot of structure in place in childhood that again, masked the adhd. And he said, Honestly, I think you had the ADHD spanked out of you, because that was the form of discipline that I got.
You know, my dad. Mm-hmm. , another light bulb went off. And so I was like, Okay, let you know if I am going to give my son the best chances to be successful in school and his, in his relationships and in life. Like, why don't I do the same for me no matter how late? Right. Right. Um, I think at some point in our relationship, my husband said, you know, why don't you just, you know, go on medication on for like depression or anxiety or something.
And I'm like, in my head I'm like, You know, I honestly, I don't necessarily think I'm depressed. You know, maybe like, there's definitely an element of anxiety there, but, um, I wanna know, I wanna know if this is plain old, you know, anxiety and or is this anxiety stemming from something else? And if it is, I wanna make sure that I'm treating the right thing or I'm addressing the right thing.
So, sorry, my alarm's going off, so. I called my primary doctor and I got an intake visit with, um, one of the, um, uh, one of the, um, therapists from our psychiatry department. We did like a preliminary intake, and then she sent me paperwork, and again, because of the pandemic. We, it was hard to do in person evaluations, and so she sent me like a four page thing to fill out.
I had to have my husband fill it out, and then I had to find a friend who knew me from when I was in first grade to also fill it out, wait for them to turn all of that in, submit all of that paperwork, and then wait for someone to eventually review those and then get back to me. They got back to me and they told me that my test was negative, and
Dr. Diana Mercado-Marmarosh: what I kind of knew.
Coming on because again,
Dr. Danielle Malano: I function at, I feel like I function at a certain level, and I think a lot of women diagnosed late in ADHD have this issue too. They function at a certain level. No one else sees the stress that they feel inside. Yeah. So when she told me that my initial testing was negative, she offered me an option to do the objective testing with the psychologist.
And I said, Yes, of course. Absolutely. So I made that appointment. I went in, I saw the psychologist I had to conduct. Uh, she conducted. Computer test, which was 14 minutes. I forgot the name of it, but it was like the longest 14 minutes of my life. . You had to stare at a computer screen and press the space bar every time you saw a letter pop up on the screen except for the letter X.
And so I was trying to focus and concentrate. It would go at different speeds and then there would be a lull and then it would speed up again and I was just, it was hard . So at the end of the test, she reviewed it, she scored it, and she. Congratulations on getting this far with undiagnosed adhd, I almost burst into tears.
Like it was just so validating. So much of my life made so much more sense. I like wanted to tell everybody in the world . Yeah, this is, this is why I am me. Like people are like, Oh my gosh. You do all the cooking. You, you're a doctor, you're a mom. Like you're, you're so fit. You do all the exercise, you make yummy things and dinner and treats and all the things.
They're like, How do you do it? I'm like, I don't know. I love doing all the things, you know, And I do do, I do love doing all the things, but you know, sometimes that comes at a cost, you know, and no one sees
Dr. Diana Mercado-Marmarosh: that. I feel like,
Dr. Danielle Malano: and I think, you know, it's finally time for people to know. . No matter how well you think somebody is doing, you never know the struggle that they may be going through.
So yeah, and I
Dr. Diana Mercado-Marmarosh: think that's such an important point that that's why I'm tossing you right there, because just like you said, nobody knows at what cost, because you pointed out so many different nuggets there of the facts that. You're gonna work your ass off for something that you feel aligns with you, whether it's to become a doctor, whether it's
Dr. Danielle Malano: to be a good mom,
Dr. Diana Mercado-Marmarosh: whether it's whatever it is that fuels you, you're going to pour your soul into it.
And. We don't want to know other people that are, uh, that were kind of struggling. So we're kind of gonna mask, like, like I would stay up late to do some charting for me. Like, you know, 20, 30 hours. I didn't want anybody to know how hard it was working because, you know, I, I thought it was the, what I needed to do to
Dr. Danielle Malano: be able to have the privilege to,
Dr. Diana Mercado-Marmarosh: to do that.
Right. And like you said, the question you, you, you, or the, the common stuff, like, they're gonna find out I don't belong here. Like, they're gonna find out. And so you have that. Little fear of them finding out, you know, of course we belong in the room. You were always meant to be there, but your brain, because you're so multi-passionate, it looks like a hot mess to other people.
But it makes total sense to you. And, and like you said, like maybe those people didn't realize, you just magically got shit done. They didn't realize that it took. 10 times as much. Like maybe it took you two hours to do that project and your friend took her five minutes and you didn't think anything of it because you first turned into project, so it wasn't a big deal.
And so that's so good that you decided to get the next thing. Even though they told you, No, this is negative. You're like, Well, is there any other things to find out? Right? Like to get the next step. Because most of us stopped there, we're like, No, they already said it's, That's it. Right. But you knew inside that you were doing these
Dr. Danielle Malano: things and.
Dr. Diana Mercado-Marmarosh: And yeah, exactly. Like they said, Congratulations, you got this bar. Now let's get better systems in. Cause that's tir ass yeah's t I'm tired. Can I, can I still be like me? Can I
Dr. Danielle Malano: still be my amazing self that loves to do all of the things and like if feel less of that internal angst that just. Tortures me sometimes.
Um, and I think, you know, people don't get that. When I was sharing with some of my colleagues, like, you know, Yeah, I'm getting evaluated. We're gonna see what happens. And they're like, You don't need medication. Like, look at you, you're, you're like, you finish all your charts on time. You don't do any of your charts at home.
You teach other people how to do their charts. Like you, you know, you exercise during lunch, like you're not doing your charts. What's, you know, you, you don't, you don't need it is what, you know, you don't need your, because
Dr. Diana Mercado-Marmarosh: you're exercising, that's why you're getting your shit done. .
Dr. Danielle Malano: Yes. Right. That's like, it's my, one of my outlets to get out my, you know, nervous energy so that I can, you know, Regroup and get back on it and you know, do the thing, get my stuff done, and stay.
And you
Dr. Diana Mercado-Marmarosh: might have been motivating yourself by telling yourself, do it right. Otherwise they're gonna find out. So it was not a healthy way that you were doing it per se, and like you said, your anxiety was through the roof and you were trying
Dr. Danielle Malano: to mask it, right? Mm-hmm. . Absolutely. So, you know, don't get me wrong, I feel amazing after I work out , but you know, there's, you know, there's more than just one reason people exercise, right?
And so, you know, when you hear from others, especially your peers or your family or your colleagues or your friends that, Oh, you don't need help, that's just not a helpful, a helpful comment. So what I would say to people who hear from others, May share with them that they're struggling or they have X, Y, or Z diagnosis.
Um, it's not always necessarily helpful for you to say, Oh, but you look great. Oh, but you look fine. Oh, but you don't need help, because it dismisses their suffering.
Dr. Diana Mercado-Marmarosh: Yeah, and that's, I call it the invisible. Invisible disability, right? Because, Oh yeah. I'm not gonna say that it's ing because now, I mean, it can be, It can get us into trouble, of course, for sure, but it can also be a superpower.
But in order for it to become a superpower, you have to first own the diagnosis and then learn about it and be curious. But in order for all that to happen, you need to feel confident enough in your. To know that you're worth the investment, whether it means medication or coaching or therapy or, or all of your exercise or all of the above.
Right. And like you said, like we would never tell a diabetic. Um, You don't need insulin. I mean, your A1C is at 12, but you know, you don't need that. Like why can't you just get over it? Right. Why? Why did you ? So it's like the invisible disability because nobody can see how hard you're struggling. They don't see a broken leg there, they don't see a broken nose that is bleeding.
They don't, you know, and again, like you said, some of those words can be almost traumatic to us. Right. They're not validating how you're feeling and they're, they're almost making you feel like whatever you're feeling, you shouldn't be feeling that because you look great, you look amazing. Like, what? What else do you need?
Like,
Dr. Danielle Malano: exactly. Like, I don't deserve help , you know, And I try to instill that in my son too, because when he was initially diagnosed with, I thought, honestly, That he was gonna get like a soft diagnosis, maybe if that, And then when the physician said, Okay, so he's got severe combined adhd, and then with a little bit of anxiety, I'm like, What?
I was, you know, I wasn't expecting that and no, at such a young age when he thought that, you know, the ADHD was already, you know, causing some anxiety in him, I just, I really wanted to make sure. You know, address that. And so I dove deep like you had recommended. Thank you so much for recommending ADHD 2.0.
I read it on Audible on all of my commutes, finished in, and then, you know, I let Johnny know that this is your superpower. You know, he's so creative. He's such an artist. He has so much fun. He's super popular at school. Everyone loves him. He's so funny. And I remind him that, you know, he's got like what Dr.
Hallal describes as a Ferrari motor for a brain with bicycle brakes. And he really took to that and now all of a sudden he's reading this, these books, um, Dog Man, and it's kind of a comic style book. And I had no idea that it's also the same author that wrote Captain Underpants, who apparently has Ethan ADHD and dyslexia.
So they really love reading that and I'm just really grateful that they have those resources and can see. And now Johnny's just enjoying reading so much more. His grades are improving now that he's getting the treatment and, and services that he needs. Yeah, and,
Dr. Diana Mercado-Marmarosh: and like what an amazing thing that it was, that you were open to finding a better way for your son.
Right. And in doing. Like you said, you deserve the same thing cuz hopefully you're like my grandma. I keep saying this line over and over who lives to be 93. One of 'em was, the other one was 90. So like you still have like 50 years of your life going forward, which could be what if that could be like the next best face?
Like you thought that whatever you had done was amazing, but like you had no idea, right? Like right. And. So, yeah. So that's so cool that you were able to use that and model and support him and continue to advocate for him because like you said, you kept asking the teachers over and over like, Hey, are you sure?
Are you sure? Are you sure? And that's the thing with adhd, right? That it's not just like, School, It's at school and at the playground and at home and at the birthday party. And it's everywhere, right? Everywhere. And so you just make sure that you are supporting your kids the best that you can and providing them the resources the best that you can.
And when you look back like. I don't know how, if you can tell your family who has adhd, but Oh yeah. , because like, we didn't know, I thought that was just north because everybody, like was doing the same thing, right? Mm-hmm. and so, So now tell me about this like coaching thing that you're doing that's really cool.
Oh yeah.
Dr. Danielle Malano: So, you know, when I was deciding at some point in my life, you know, I think it was right around the pandemic in March-ish, 2020, I decided, okay, am I gonna go to therapy? Or, you know, am I gonna try this life coaching that I, that I had heard about? Online and, um, I ended up deciding to go with life coaching and that's where I got connected with so many other like-minded, like-minded women, including yourself, um, who were going through a lot of the same things I was going through and I had no idea.
I just felt so alone before I joined empowering women positions and seeing other women physicians. Share their stories and then thrive after whatever it is that they're going through and continue to change and progress and dream and improve and then struggle still. It was just so inspiring and I, and I think that really.
Fueled, you know, another passion in me, like I already enjoyed cooking, you know, and I already shared some of this stuff on the internet, on my Instagram account. It's, I have this, I think I said out loud on one of the groups, like, I wanna have a cooking show. And somebody told me like, You already have a cooking show.
It just happens to live on Instagram. And the way that was frame. Borrowing that thought and looking at that way, I'm like, You're right. I do have a cookie show and it lives on Instagram. And so because I thought that instead of, Oh, I just have this little thing on Instagram. I started posting more, I started getting more connections and then, um, I was reached out to by Dr.
Monte Mantravadi, who is the creator of Ahimsa, the world's first colorful stainless steel table war for kids, and I was their first physician ambassador. I made some reels for them. We are continuing in collaboration. I was a representative for them at the AAP conference in Anaheim last month. It was so much fun.
And so not only did I connect with her, uh, because I started posting more and, uh, I was reach out to also by Cutco the knives that I love and used almost, you know, every day. And I'm, you know, Kind of like an ambassador for them as well. And just making all of these connections is so much fun. And you know, the next step is, you know, to work on building a website.
And I was trying to decide, okay, you know, do should I get certified in lifestyle medicine or should I get certified in culinary medicine? And, you know, those things definitely, um, are so valuable that I was just getting lost in where I should go or what I should do. And it end, I ended up choosing, uh, culinary coaching.
Because, um, it was more accessible for me at the time, and I went through that process and that program, and I finished literally just this year. And now I can say I'm a culinary coach and, um, include that when I share all of the delicious things that I share online, whether it's on Instagram or on my future website or maybe in my future courses.
Dr. Diana Mercado-Marmarosh: That's so amazing, right? Like when you start to borrow other people. Thoughts. Like you were already a chef and you were already having your show and you didn't even realize that. Right. And but it's, so again, it goes back to our human connect connections and understanding that words matter and thoughts matter, and feelings matter.
And even though we don't want to believe that, I mean, they do. And realizing that when you're in alignment, like when you knew that this is what, what fuel you like, you were able to take in, continue those steps, that that then opened up the opportunity for bigger things for you to be able to inspire and help.
Not just other physicians, everybody else on Instagram, like how appreci is that? And so, so what is your favorite things of like cooking or teaching people? Like what is your favorite things
Dr. Danielle Malano: you like to do? Yeah, so one of the best things that I enjoy sharing, um, that I learned in my Culinary coach, um, courses, you know, Something that I already did, but I just didn't necessarily have a name for, um, is batch cooking.
And batch cooking is a way to, you know, make a big portion of something that you will either use either the next day or save and, you know, freeze for later on. Um, so that it will save you time the next time you know that dish comes around. And so I show examples of that. Instagram and then a lot of other things that I share is, you know, I definitely have a sweet tooth, I'm not gonna lie, but because I'm also really mindful about what I put into my body, I went about trying to find different ways to modify and have substitutes for different things that I would put in my treats or my, um, pastries or, you know, in desserts substituting maybe coconut sugar or apple sauce for oil and or just cutting the sugar in half.
Like you can just start. Cutting the sugar either by, you know, 25%, 60%, 50%, whatever it is. Honestly, you will not know the difference. It's still gonna be delicious. It's still gonna be sweet. And then the more you do that, the more your taste buds will change. And then recognize how delicious food already is without all of the other processed stuff, and you can just continue on in your journey of being as healthy.
You want to be in terms of your own particular goals? I don't like, my Instagram is not like a weight loss, um, um, feed or a, you know, or, or an obesity feed or anything like that. I'm just, it's more of a wellness, like this is what you can do. These are some options that you can take in order to be, Take that one.
To be a healthier
Dr. Diana Mercado-Marmarosh: you. Yeah. So you're just, uh, facilitating the process for us to be mindful and still have a cake and eat it too, right, ? Absolutely. Absolutely. So tell me, uh, what ADHD hacks have you been able to, like, lean into or what have, have you noticed that now that you implemented some of these, you're like, Oh, thank God.
Mm-hmm. ,
Dr. Danielle Malano: So for. And, and I remember this, you know, going back into residency, I, I'm a list person. If it's not front and center in front of my face, I'm not gonna see it. So I notice that if I make a list on paper, it works better than if it's a list on my phone, because if it's a list on my phone that, that I get a popup about, I'll just swipe it away.
I'll swipe it away, swipe it away. Um, for most things, I mean, there are some things that I do put, like a big exclamation point red mark on that, that do live on my phone. Day to day, if I make a list on a piece of paper in front of my face, when I wake up in the morning before I do any of the things, I am able to be a lot more productive.
So that's one of the things that I, you know, I do. And I, I noticed that, you know, once I got the diagnosis and talked about, you know, the different treatment options, you know, there's medications, there's therapy. I went for both, you know, because why not? You know? Um, and then when I first started and I told my husband, Um, he kinda made a wrinkly face.
Like, he's like, Oh, okay, is this really gonna work? Or what? And then he did say, he's like, You know what, you do seem a lot more chill during dinner because sometimes I'm like stressed out and you know, the kids maybe not, you know, be eating enough or well, and, um, or they're not putting away the dishes. And he, he said, Yeah, you look a lot more chill.
And then after that I, I went to go do some laundry and I noticed that while I was folding my laundry, I noticed that in my body, I had such less anxiety that I usually have in doing such a mundane task. Like I hate folding laundry . And so I noticed that that wasn't there as much. And then after that, I went to go, like, make some edits and post something on Instagram.
And while I'm doing my edits, I, I usually feel like palpitations in my heart. Like, Oh my gosh, this isn't right, this isn't good. Like, how am I gonna put this together? How long is it gonna take me to do? And I didn't have those racing thoughts as as much, right? It's, I just noticed that. I'm like, Oh, this is nice.
And so, because a lot of that was diminished, I'm able to post more. I'm able to do more. I'm able to get more stuff done because all of that background anxiety is, is a little. Faded. I mean, it's still there, , right? Um, you know, and I, you know, like I literally just got started on treatment about a month ago, but I do notice the changes and I'm just so, so grateful.
You know, when I was first deciding should I go for life coaching or should I go to therapy? I started with life coaching. You know, you start by starting. So I started there and then through that, Learn to borrow the thought that it doesn't have to be, and, or it could be and right. I did the life coaching and I can do therapy and I could do, you know, medications, all of the above.
You know, we definitely, you know, advocate for any kind of self, um, you know, um, self-help behavior, um, for your own mental wellness, for your physical wellness, emotional wellness, all of the. Yeah, I, you know,
Dr. Diana Mercado-Marmarosh: everything that you're saying, like I can relate to mine is the cookie. I'm not the best cook, but that's a limiting belief that I'm choosing to keep hold onto because I'm making my husband cook.
But, um, and seriousness, um, he calls me out all the time about that. Uh, but a seriousness. Because I had no awareness of how my adhd, like, I was kind of oblivious to it, like for, you know, 10 years because I got told like, you're gonna
Dr. Danielle Malano: outgrow it. Right? Or
Dr. Diana Mercado-Marmarosh: like, you should know better, right? And so it was not until like I joined e wp, like all a sudden I'm telling everybody about it.
And, and it was because, Life coaching. I didn't even know what life coaching was, but I joined cuz of the, uh, it was gonna gimme credits. I needed to keep my license so I knew I had to kill two birds with one stone and it sounded kinda cruel.
Dr. Danielle Malano: Empowered women physicians, like, I wanna be empowered, right?
Dr. Diana Mercado-Marmarosh: And so, So, yeah, I think that naturally we jump from one thing to another, but it's because we're seeking to try to understand ourselves.
Like that's what we're seeking and, and we know that there have to be a better way because just like you, I was listening to podcasts on my way home and back, like remember listening to podcasts, like this lab comes clean or something like that. Like I wanted to really. Out how to adult, you know, , like, I was like, why can't I kiss adult?
Like people are gonna be like, she's associate. Why can't she just do her laundry? Why can't, Huh. She do dishes. Right? Right. Or why does she have to keep doing her laundry like three times? Cause she forgot to dry it and now it's, and now she has to go Google like the vinegar thing or whatever. Right. And so, yeah, it, it's so funny that, that we don't realize that our brain and our self care, and I didn't even know what that word was.
We are our best investment. Like we can spend all this money on cars and purses and whatever, right? But if we like, and we can have it all and we can look at it and they look pretty, but we don't feel like just right because we don't feel right. And, and so again, it's in this therapy, it's in this coaching, it's in this medications and, and it's in this discussions like what we're having that.
We realize, okay, I'm not the only one. And you realize that some of the things that maybe are annoying to you or you keep swearing, you're not gonna do it ever again. Like it's not that you don't want to never do it again, but you realize that it's part of like your ness and it's part of your. What you thought is like a human like, I don't know, defect.
It's not a human defect, it's just part of your adhd. And again, I'm not saying that to excuse you, but it's for you to understand it. So then you're like, Okay, how can I then, and do I want to do it or can I delegate
Dr. Danielle Malano: this? Right. Absolutely. Yeah. And I found that I've also learned how to give myself a lot more grace.
I was, I was at Costco and literally like. Five minutes. Was about to walk off with someone else's cart, . And then I was like, Oh, I'm so sorry. And then five minutes later I went to grab an item, put it in my cart, and then the person's like, Excuse me, that's my cart . I'm like, Oh, that's probably, I know why that's happening.
Now I know why. .
Dr. Diana Mercado-Marmarosh: I could've swear this was just right there. Why you keep doing it, . Why you do it now I know
Dr. Danielle Malano: why. Now I know. I have
Dr. Diana Mercado-Marmarosh: an answer. Awesome. So, uh, what do you think you see yourself doing in the next, like, three to five years? For
Dr. Danielle Malano: fun? For fun, I already do a lot of things that are fun. You know, I, I, I travel the world.
Like my kids, you know, when they were born, everyone said that, you know, we would stop traveling or, or slow down because both my husband and I have the travel bug. I think. Travel bug is more pathologic than mine. However, we proved everyone wrong and as soon as they were born, my oldest one is almost 10.
We've been on a plane almost every month, you know, except for the pandemic. , You know, I think by the time he was seven or eight, he's been to 30 countries because we maximize every single day of vacation that we have per year. To the point where some people have asked if we work, and I'm like, Yeah, we work full time, you know?
But we use those vacations, They're like little mini retirements because we work so hard. And if we have like a little thing on a weekend here in one month and a little thing on a weekend here, in that. We can look forward to those things to help re-energize us, bring us back together, and that's kind of our together time, that's our family time.
You know, both of us work full time. My commute's an hour, so by the time I come home, I have, what, two or less than three hours left with my kids before they have to go to bed, , and they, um, I don't see them again until the morning when it's circus hour and we gotta shoot them off to school. So the time that we spend together and travel.
One of our, one of our big things that we do. Um, and then, you know, with my exercise, I, I make sure that I have time to do that. It's one of my. It's one of my must dos and I need to move every single day somehow. And whether it's at work, because I leave a pair of dumbbells there and a pair of jump ropes there or at home, um, you know, I, I will make it happen because it's that important to me.
And. Again, cooking is another creative outlet that I have, and so I just find joy in doing all those things. And then because I get to do all those things, I get to be a better physician to my par to my patients. I get to share with them what I cook or how I, you know, um, organize, you know, my day and how I get to get things done and, you know, just get to, um, have a better connection with them because I'm in a place where I get to be more.
Dr. Diana Mercado-Marmarosh: Yeah. And that's so important, right? Like not waiting until someday , but scheduling it on purpose. Not waiting to like, Oh, one day I'll make a memory. No, put it in there. Make it a memory, right? Like and that sense of play and adventure. It's refueling for some people and I would totally be on the plane with you, , my kid, you know, uh, when he was born.
Yeah. Same thing. I got told, uh, yeah, he had done eight trips by the age of one. Like, like, they're like, Why would you take a three month old to, I'm like, Well, why not? You know, absolutely. And yeah, they're like, Why would you take a six week old to go see the total eclipse? And I'm like, Well, why not? You know,
So it, it's just like you say, you play hard, you party hard. Right. Or you on purpose decide what is gonna be important to you, and which is family is so important. So it, it's, it's good to live the values that we say we, we value otherwise. Then we don't feel like we are aligned and that
Dr. Danielle Malano: leads to burnout really.
Yeah. And that's why, you know, I'm continuing, you know, working on this website and, um, maybe one day I'll have a course to help other people, you know, get healthy meals on their table without, you know, getting takeout all the time. And, you know, if. Um, cooking or cooking demonstrations can eventually be incorporated into my workplace.
That would be amazing too. You know, having these teaching kitchens is something that is exciting, um, for me. And if that's a possibility, I'm totally going that route Also. And you know, it's
Dr. Diana Mercado-Marmarosh: a possibility, right? Anything with adhd, like we don't stay in no boxes, right? Like, we just invent and like think outside the box.
And again, if it, we might not know the how, but you know it's gonna happen, right? It's just a matter of time. I can't wait to, for you to send me the picture, like, Hey, guess what? And I'd be like, Of course. Of course. It was just a matter of time, right? It's in the. Uh, we just dunno when the day will get here, but it's in the mail.
I know, I know it will be. Okay. Awesome. So, as you know, uh, people with ADHD sometimes tune out. So if they just started paying attention like right this second, what would be the takeaway point that you would want them to have?
Dr. Danielle Malano: So, if you are curious or wonder if you have adhd, it's not gonna hurt to get evaluated and.
If you do have it, great. That is your superpower, and if you don't, great. Now you know what it's not. So let's go find out what else it could be so that you could still continue to be the best you. Thank you. That
Dr. Diana Mercado-Marmarosh: is the best advice. You know, again, be all on you. You know yourself. Trust yourself, trust your intuition.
Be okay getting a second, third, fourth, fifth, whatever opinion you need because. Once you know, then you can establish what the next steps are, right? And meanwhile, keep doing fun things and make sure you put on the calendar outta sight, outta mind. So put it on the calendar and uh, Danielle, where can they find you on Instagram?
Cuz I'm pretty sure they want to.
Dr. Danielle Malano: Sure, yeah, you can buy me on Instagram at Eat Rome, Heal, Eat, because I love to eat and cook roam because I love to travel and heal because I'm also a physician. Say it again. Eat Rome. Heal. Awesome.
Dr. Diana Mercado-Marmarosh: So there you have it, and I'm pretty sure you could send her an instant message through there.
If you have a way to set up her show, hey, let us know. If you can facilitate anything or you want her to come speak, let us know. Right. So we're all here to, uh, uplift each other and together we are right. So I'm so glad you were here. It's such a pleasure to, uh, be able to feature physicians who are living and practicing medicine in their own terms and how fulfilling it can be.
Yes, sometimes our road can be rocky and it can show us lots of patients that we don't want to learn. But you know, it teaches resilience and it really teaches us to continue to live in
Dr. Danielle Malano: alignment with our values and you totally
Dr. Diana Mercado-Marmarosh: embody that. So thank you so much for coming. Thank you for having me. I'm
Dr. Danielle Malano: so excited for being here.
And thank you again for giving all of us a voice. Thank you so much.
Dr. Diana Mercado-Marmarosh: My. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mecado. Marra. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my. Adhd, but I now see it as a gift that helps me show up as the person I was always meant to be. Both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my beliefs and, and some of my habits were just as important as learning the new set of skills.
Hello. Hello. I am so excited to be here with you today. Um, a topic that we're gonna be sharing today is one that is very dear to my heart. Um, so October, right October if awareness, mark. And why is that so important? Well, if you have a family member who has ADHD or a coworker who has adhd, or you yourself have adhd, um, the diagnosis of ADHD can be life changing because.
It could go both ways, right? If you're like me, when I got the diagnosis of adhd, I thought it was the worst thing ever. . I thought that my life was over . I was like, Oh my God, everybody's gonna find out that I'm not perfect. Everybody's gonna find out that what I had going for me, which was being the oldest one in my family.
Meant I was the smartest one or the right one, or was gonna do everything correctly, and all of a sudden the diagnosis of ADHD meant that I was not perfect and that I was not the one that had all the answers as I thought I had. But to some other people, the diagnosis of ADHD can mean this is interesting.
Or Ha, I knew it wasn't all me. There was something else going on. Right. And whether you got your diagnosis when you were. Five or 25 or 55 or 75. Yeah. I know most of you are probably thinking, why would you even wanna know at 75? Right. The thing is, if you're like my grandma, who we have to be 90, well, one was 89 and the other one was like 93.
Um, you would wanna know, because even if you're 75, you still have like 15 years left of your life. That could be the next best 15 years. Right? Especially when we're getting to the. the stage of wondering whether this is all dementia , right? But when you look back, you're like, Uh, no. This is the way they've been all their lives.
Things start to make sense, especially when your daughter or your granddaughter or different people got diagnosed with it, right? It's a genetic thing. So I think it's important to realize that the diagnosis of ADHD can be life. And it provides you with the opportunity to see yourself having a blank slate to see yourself as, What do I do with this information now?
Like I can either go and hide and hope nobody finds out and develop the imposter syndrome like I did, right? Or you could decide. I wanna be curious. I wanna learn about it. I want to use it to my advantage and see it as a gift and see how I can tap into it so that I create a better life for myself and those around me.
Because the thing is that ADHD just does not just affect you. It affects everybody around you. And so by saying that, I wanna invite this conversation of trying to understand, of owning it because it's a package I recently heard, uh, Dr. Ramsey say that ADHD is considered the. Diabetes of psychiatry. It's a long, very long chronic, lifelong condition that you never outgrow, that you just learn to set up systems to manage.
it just like diabetes. You know, with diabetes you get educated, you get told these are what the meds you might try, you get told, um, you know, this is the way to check how things are working, and then you go and get blood work done and you get stuff done. Well with adhd, you get diagnosed and then you get informed.
The thing with the education, part of it is though, that sometimes, even though we think we know people without adhd, even even physicians, family medicine or psychiatrists, they don't teach us as much as. As we should know and, and I'm telling you from firsthand experience, I had ADHD and everything I'm sharing with you guys I didn't know.
I have now learned because I had hyper focused on it and gone and got curious after I got over my, Oh my God, this is a curse. And started thinking. ADHD can be a guest. I just have to learn to unwrap it. So today's discussion is about something that comes up every single day in my practice. I'm a family medicine physician and I treat adhd, and it's something that also comes up with my clients or potential clients through my coaching.
The question always comes up, What about medications? And so I want to tell you what Dr. Ramsey says, who is the ADHD guru? Okay. He says that ADHD medications are the safest and most effective evidence based. Treatment for adhd. Do you hear that medications are the safes and most effective evidence based treatment for adhd?
Why am I saying that? I'm saying that because there's so many myths around medication and. I want you to be aware of these because if you don't understand them, you might not be able to advocate for yourself. ADHD is a lifelong neurological condition. I wouldn't tell my diabetic patient. Okay, Good luck. I wouldn't say that.
I wouldn't say there's only. Right. I wouldn't say that. I wouldn't say well go exercise only. No. It's a chronic condition that requires one of many tools and all the tools, and it's a spectrum, and some people might need this, some people might need that. But if you are not aware or you don't have access or you can't advocate to get.
The safest, most effective evidence based treatment, which is medications, then you're already kind of crippled. Again, even though you have now the awareness that you have ADHD before, you didn't even have the awareness, right? So you didn't know what you didn't know. Now that you know, please educate yourself.
and everything I'm saying here, of course, it's my opinion, you have to go talk to your own family medicine physician or psychiatrist and have a, a discussion to make sure everything is safe for you. But in general, the evidence out there, the multiple studies that have done studies done, even with like preschool kids at the age of two and three, show that this is evidence based.
Okay. So I wanna talk about that because I think it's so important. So if kiddos, can take these meds and be safe, and these are meds that have been around, you know, probably what, like 60, 70 years? Some of them, right? And some of them at least 20, you know? Uh, so they've been around. Of course you have some other newer ones that haven't been around that long.
But the point is, is that all this has been studied, okay, Stimulants all or medications, just so there's different drug classes, which I won't go through. And again, not so that you can like, you know, have a whole discussion about this. But medications will work for like 80% of. 20% might not benefit from them due to maybe the side effects, or maybe there's a contraindication due to whatever other medications and chronic medical conditions that they have.
But in general, medications will help 80% of people. Why doesn't is this important? Okay, if you have a kiddo, right? Like if you, if you're a parent and that kid has. Being on medications is like having their own babysitter. What do I mean? Okay. We have a neurological condition that has decreased, uh, decreased effect, uh, if it like, Okay.
Has decreased executive function, right? An increased IUL sensitivity. So
how comfortable do you feel having your ADHD kid run around near this street? Probably not that comfortable, right? But if they're on their medications, they might have that two second delay to be like, Hmm, maybe it's not safe to jump out of the street. Right? So the point is that eventually they're gonna start to drive, right?
Eventually they're going to be at a friend's house. Eventually they're gonna be involved in. and if they are not aware or they cannot control, or they're doing their best, right? They're doing their best and they're still not necessarily fully embraced in their community because they're being impulsive, they're saying out loud, but maybe they shouldn't be saying, uh, they maybe they start being looked at as.
Being weird. Not that that's the wrong thing because hey, we gotta be interesting, right? But that, what I mean is that being on medications can decrease some of that
uncomfortness that can happen. It can also decre like decrease some injuries, like if they're in sports and they're not paying attention, they're doing their best, but they just can't focus. Right. They're more likely to get in trouble, right? And if they missed the ball or something, like, everybody's gonna be looking at them like, Oh my God, it was right there.
What were you doing? Why were you daydreaming? Right? So medication, like I said, if not, not, it's not something that you should. Not consider because you're thinking, Oh my God, they're gonna become addicted to this, or it's not effective. Or when they really need it later on, it's not gonna be as effective, or, you know, all those things.
Right. Adhd. Is less expensive than, you know, some of the therapies, some of the coaching, right. Uh, and it's readily available. Like you put it in their mouth right in the morning and you're good to go. Versus sometimes it's harder for us to get access. All those other resources that hopefully we do have access to, which is, again, therapy and coaching and, and all and all these other things, right?
With meds, just to use the meds. You are two times more likely to complete a task that you set yourself up to trying to do. It decreases the that task initiation. It helps us to transition from one task to the other.
And it, I, I always say it feels like going from having 25 tabs open to just five. I mean, it's still, I'm not saying I don't still squirrel, right. But now I have the ability to try to do things more. So before medi, uh, before medication. And, and I can tell on the days that I don't take them, for some reason, I decide not to take 'em.
I'm like dragging . Why? Because my brain just does not have that dopamine and that norepinephrine, that medications do that help me. Right. So there's different medications and you can talk to your physician about it, right? But you have some that are stimulant. What means that within 30 minutes of you taking the medication, you start to feel better.
And then there's some that are called the non stimulants, which mean that. Um, it'll take three to four weeks for you to start to notice. Right. And some of those are useful whenever, you know, you didn't tolerate the stimulants or whenever, you know, so, so they're all to consider. And then the third class is one that is actually for blood pressure.
It's interesting enough, in the 1990s they got. They, they got approved and so that, that would be like, uh, clonidine or uh, , right? And so those kind of help you to take the edge off a little bit like at night so that you can stop your overthinking brain and uh, be able to sleep and. So, yeah, again, I am not telling you what medication to get on.
I just, I'm facilitating that discussion that you might want to have with your provider so that you are aware of why you should be on medications or at least consider being on medications. Like don't just write them off. Right? And so there's a lot of data up there that says,
It's always mis misinformation that prevents you from getting on medications. Like some people say, Oh, they're so expensive. Like, I lost my insurance so I can't be on it. No, there's a lot that you can still on that you can use GoodRx or something else to try to get you the medications. And of course, right now we're going through a shortage, right?
With uh, Adderall. It's a national shortage, but there's other medications you can still try. So definitely talk to your physician. And I also want you to be aware of this, the fact that even if you started. Your kid on medications at the age of three or at the age of five when they're going to kinder, the medications can remain effective their whole lifetime now.
One, keep the stick there is that it doesn't mean that the same medication dose is gonna be used a whole lifetime. Like people go through changes, right? With puberty, menopause, and again, different conditions that you might have, they might need to get adjusted, right? Or different stressors that you have.
So I'm saying all this so that you realize that when you diagnose. It, it, it's a package. , right? You, you're gonna get the diagnosis. You're gonna have to own your diagnosis, right? You have to have buy-in, right? That means the education piece there, right? Then you try your medication, then you work on your accommodations, right?
getting your physical environment to facilitate you, helping you to understand how to create these systems and, and with medications. Now you have like a stepping stone to get all those systems right. That's where my coaching program comes in to. Uh, help. Okay. Now you can have like the ability to go from like 40 things to maybe five, and then we can like, make it a little bit better, right?
To, to teach you how to prioritize and strategize and how to not work against yourself, but use your strength as your strength. And so modification is where. Things get creative and fun because all of a sudden we start to see how to implement things. Ok. So I wanted to make sure that you knew that medications are, again, like I'm saying, the safest and most effective evidence-based treatment for adhd.
Did you hear that? I hope you did, but why is that important? Okay. I'm gonna give you some rapid bullet points and see if any of these make sense to you. Okay. So they're going to increase compliance of following the rules or. doing what is needed of you. Right? And now I don't want you to feel like, oh my gosh, it's gonna make you follow the rules because we know that people with ADHD do not follow the rules unless they make sense to us, right?
But what I mean is that maybe you'll drive a little slower, right? Maybe you will be in a hurry cuz you're trying to make up for the time that you didn't know you had lost. And there is studies out there that people without medications are like to die 10 to 20 years sooner compared to somebody who doesn't have adhd.
They're not gonna die from a heart attack. They're gonna die because they were racing, driving, or doing a Bunge jump or something that gives this adrenal. So medications are going to help with compliance of some of the rules that can keep us safe, right? Um, it's also gonna help us have a better working memory.
I'm not saying that, um, it's gonna make you smarter because you are a smart. With or without medications like that doesn't modify anything. Again, it just helps to facilitate how to prioritize and do your initiation of tasks and tasks machine, right, and actually it can also help your self-esteem. Okay, why do I say that?
When we have been told. Don't do that. Don't do that. You're too quiet. You're too, you're too loud. You're too whatever. Right? When we have been told more than 20,000 times in a lifetime, by the age of 13 or or 15, a person with ADHD has been told 20,000 times. Don't do that. Don't do that. Don't do. So, of course our self esteem is like nonexistent, right?
Because we know what we want to do, we just dunno how to do it. I mean, we're trying really hard and we almost make it, but we don't make it. And that really precious us. It could crush anybody, right? So, But then you have the other part, right, where we don't make it, and then we feel like shit for how many, how long, and we're making mean all kinds of things.
Even though the goal that we had to begin with was kind of unrealistic going up, it's going to decrease the punishment that we get for voters, right? Like, we're gonna piss off the principal or get ourselves in trouble for like,
Overreacting on some sort, right? Or not cleaning a room so we can go out
You know what I mean? It's gonna decrease punishment in some way or another. Right. And, and sometimes it could be decreasing, like the punishment of like not having to be the phone to be like,
Because you'll be a little bit more, have the ability to get organized and plan. And don't worry, I'll walk you through that in my coaching group on how to plan ADHD friendly. So, The point is that you're gonna have more awareness of your surrounding. You're gonna be able to play well in your sports or play, have, have a li more ability to read the room in your, uh, meetings and stuff like that.
And you're going to, like I said, decrease the risk of injuries. I, you know, I broke my, my foot in July of 20. 21, I'm, I'm trying to remember , and, you know, it was freak accident, whatever, right? It dropped the 50 pounds cement on my ankle, however, This is like just a day of my life, , you know, And yesterday, just yesterday, um, trying to go to the bathroom.
Um, I tripped to Cord and I like, I hit my left pinky, uh, toe. And of course I had to go get an x-ray. I mean, I was working and I, uh, I worked and then I went to go get an x-ray in between patients and luckily didn't, it wasn't broken. Of course, it's purple and whatnot, but this is just a day in her life, right?
And so medicines are important, . Now the other thing is that medicines can also. With those, uh, kids that have autism and adhd, and so it, it's important that you realize that medication can really help you in many, many ways. With that being said, I just wanted to put this plug in. Because this is a discussion that I have every single day with my patients, and I'm always surprised that they had no idea that it would affect their lives in, in all those ways.
That they had no idea that the reason that their coworkers are like, I mean, for praying for their life when they're sitting with them and they're driving, it's because of their adhd. Yeah, so I've had so many of my patients come back and say, Dr. Mud life has changed now that I have, now that you have helped me to optimize my ADHD treatment.
Like now I have my own business. Now I'm able to keep a job. Now I'm not told I'm a punk . Now I'm told that I'm actually listening. Not that I didn't want to listen before. Now I'm not that irritable mother or frustrated wife. Now I'm not being nagged by my husband anymore because he, you know, he's tired of telling me 10,000 times to do this now.
Now I've got enough promotion. Now I haven't gotten a speeding ticket or. Made my probation officer aware that this was something I needed. Did you guys know that 40 to 50% of people in jail have adhd and it's because. They didn't realize that medications were needed or because maybe they didn't even know they had that diagnosis and they didn't realize that they were, you know, they were just using the wrong thing, like they were using maybe smoking weed or they were using cocaine or heroin or getting themselves into trouble, right?
Alcohol, drinking and driving different things. Why am I saying all this again? Because this is a topic that is asked of me multiple times a day, every day of the week. To me, it's such a common knowledge thing that I'm like, You didn't know that. But when their face tells me that they get it and that they understand the importance of it, that they understand that the medication.
is one of the many tools that can help their future, that can help determine whether they will actually finish school, graduate. They can decide at that point what they want to do. They might wanna go and do like, you know, anything that it can impact whether they stay married or. That can impact the job that they have or not, that can impact whether they are able to pay their bills.
So medication, please consider it. Really consider it. Please realize that ADHD is one of the most rewarding. Conditions to treat in psychiatry because it has that 80% possibility of getting you to manage your ADHD and getting you to the life that you want. So again, I didn't learn this overnight myself.
They teach me this in medical school or residency. I. Had to focus because I got curious. And now anything I learn and read, I tell everybody because we all rise together through education. If you have any topic that you want me to talk about, please send me an email. Um, go to my webpage, life coach.com.
Let me know what you thought, or please leave me a review of this podcast so that other amazing human beings like yourself can also learn and get educated, and let's help each other getting power and really live the life of our dreams because life's too short. I would rather live an amazing life. Not them at all.
I dunno about you, but it's their term, right? Let's practice medicine in our own term. Let's become the CEO over lives. And, um, I wanna tell you these things. Uh, if you want to join my position group coaching, please come. Love to have you. Um, and, uh, let's be in touch. Okay? Thank you for spending your time with me.
I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues. And don't forget to check out my website@dlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happen.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Dean Mecado Mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. Made as a gift that helps me show up as the person I was always meant to be, Both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
So today, I. Talk to you guys about how beautiful our brains are and how sometimes we can go down the rabbit hole and, uh, learn very useful things. And one of those useful things that I learned was about forgiveness. So, of course, you know, picture this, I am trying to, um, , I'm trying to do some of my notes.
And of course to try to help me concentrate. I turn on my candles, I turn on, uh, YouTube, and I put it, you know, on a sound that doesn't on, on a music that. That has just sounds that doesn't have any words. And of course after a little while, then you have an ad that comes up. And one of the ads that came up was, um, about a mom talking about forgiveness and how forgiveness could like help you re rely your.
And of course there I am, right? Like paying attention. , I should be doing something else, but there I am paying attention. And so then that takes me down a rabbit hole to go figure out like if h d could benefit from forgiveness and all this other stuff, right? So this shares a story and he says that his meditation teacher told them.
If I throw a stone at you and it hits you, like who are you angry with? Are you angry with the stone or are you angry with a person? And of course, amongst this, well, I'm angry with a person because the stone had like no intention of hurting me. It's like just an object, right? So then the teacher asks them, if we use that same logic, should you be angry?
The person, or should you be angry with the pain that that person might be going through and it's just maybe reacting and doing this because they went through something themselves. And so that got me thinking, you know, um, we. Tend to be your worst critics. Right? Like I remember, um, for the longest time, and, and this is something of course I've been working in the last three years to rewire my brain and, and coming to the understanding that, you know, for 6,000 years our brains have been conditioned right to.
Survive . They've been conditioned to think and like the negative, to think like, What's it gonna kill me? What's gonna kill me? Right. And I've been coming to understand that if I keep focusing on the gap instead of the gain, and if I keep telling myself that I'm falling short on stuff, um, that's not gonna get me very far.
The thing is, like the way we talk to ourselves really matters. If I keep thinking, Oh, they're gonna find out like I don't belong here, they're gonna find out I'm not good enough. They're gonna find out. Like that emotion is heavy and it weighs on me. And sometimes I would tell myself all kinds of things that I would not allow my.
Ran even my enemy to tell me, but yet I was doing it as a protective mechanism thinking that if I caused that pain to myself, there would be nobody else who could cause worse pain to me. So I was like protecting myself. So in this exercise, you know, then I went down the rabbit hole of Latino. If people are affected or, you know, become traumatized because of their adhd.
And then I found another statistic that said that 80% of people with ADHD have trauma and that that trauma can really limit their own, like self development and, and of course can affect their self worth and all self-esteem and all that stuff, right? So, One thing that caught my attention was that the act of forgiveness is not necessarily for that other person, but it's for yourself.
Like that it would benefit yourself. And that in doing so, it would help like your brain have a state of more like, um, coherent. And so I thought that was interesting. So I gave it a shot, . I was like, Let me, let me try this method that they're talking about. And what they say is that, you know, when you forgiving people or even yourself because there's so much stuff that the younger version of us did not know any better and it got us into trouble, right?
So, You forgive others, um,
you are the one that benefits and you can really forgive anything, and that
forgiving them does not mean that you're dropping the charges or ignoring what happened to you. It's just that you learned to deal with it in a different way, or you learn to maybe see their point of view. That other person never even has to know that you forgave them. Like you don't have to. Like that person doesn't even have to be or anything.
You don't have to send letter, you don't have to anything. So what they talked about was,
There was an experiment that they did. I'm telling you, I went down the hole. . There was an experiment that they did at an institution where they put, um, 12 electrodes into pe uh, so that they could measure like the different way brainwaves to see how coherent people could become if they process their emotions and they give them all.
Free reign. They said, Okay, you're gonna meditate for five days and you're welcome to do whatever you want. Like you could picture a number, you could visualize something, you could listen to sounds. And then they started to say that this one lady. Was having like amazing, like synchronicities on the, it seemed like the EEG was lighting up and they were trying to see, um, if they could reproduce, uh, the state of meditations that monks could achieve after meditating for like, you know, 40 years or something.
Uh, and so that's why they were using this EEGs and this one lady was just like, Pull outta the park . And so they up to her, they're like, Ma, what are you doing? And she said, I'm just trying to forgive my husband to be such an asshole. They were like, Uh, aha. Okay. So some people were trying gratitude, some people were trying like, you know, different things.
But this lady, as was trying to do. Forgive. Right? So then they went ahead and did an experiment where they asked the next five days for everybody to forgive something like forgive something that irritated them, like forgive their coworker, forget themselves, forgive, whatever. Right? And they started to notice that that had the most like growth, the rewiring of the brain and.
And I, of course, have to go down the rabbit hole and be like, Hmm, let me try, like, let me try this experiment not to go get the wires on my very place electrodes, but let me try to see if I can think of something or somebody that I can forgive. And here's the thing, like we all hold onto things and. Those things really do weigh us down.
We, we think they don't, but they do. And, and going through something like this could really be something that finally sets you free so that you can do more things. And so through the studies they were saying that, um, people are saying were able to like, Have more physical endurance or were more resilient, or were more understanding and, and could tap into compassion better and had become, um, you know, just more in sync with themselves how they really wanted to be.
And so, They went through like, uh, a way of doing it in an organized way. They gave a method, and so I wanted to share that with you guys to see if this resonated with you. I tried the meditation one or two times, uh, before sharing it and talking to you guys about it. And I felt a shift. So I mean, it might be worthwhile trying.
So remember, when you are doing something like this, it doesn't mean that you're excusing them, right? Like if they stole money from you, it doesn't mean that you dropped the charges instead of go to jail. It just means that you make peaks with it and. Then you're able to just show up different for yourself.
So we often get that we have adhd and that part of the emotional dysregulation is real. You know, in the US they don't really talk about it, but in Europe they do talk about emotional dysregulation. So I'm just trying to introduce a possible other new tool that can help like tame that emotional dysregulation that can happen when we are holding onto those little grudges.
Okay. So they gave, they gave a set of, of, uh, sequence to follow. So what they say first is to picture that person or to picture yourself, like if it's yourself, let's say your younger version of yourself. Okay? Um, once you picture that person, You invite them or yourself to your safe place. Like maybe it's to the beach where you usually enjoy being.
Maybe it's to, to a mountain, maybe it's to a park. Wherever you call yourself a safe place, you invite them there, you see them walking towards you, and then you start to feel like what they made you. Like for 30 seconds, a minute at the most, like start feeling that emotion of pain or anger or disappointment or frustration.
Whatever it is, start feeling it, but do not feel it for longer than thir than 30 minutes. 30 seconds to one minute.
Once you do that, you are the one who's gonna talk. They're not gonna say anything. You're the one who's gonna talk. You're gonna tell them how they did you wrong, tell them when you did this, this happened, da, da, da. So you tell them like you read them like the charge, right? So you tell them how they wronged you after doing that part.
You are then gonna tell them what you learned from that event or that experience.
And then you're gonna try to understand why they might have done that. Instead of you judging them and telling them what's wrong with you, try to understand what might have happened to them. Like maybe somebody like abuse them or maybe somebody. Cause them some type of pain that then they thought that this was the norm to do to somebody else.
Right? So try to see it through their eyes.
I know this part's gonna be hard, but you, it's an exercise, right? It's a muscle. You gotta try to see it through their eyes to, to think what might have cause them to lead to where they're at. Right. And then after you see it through their eyes and you tell them that you understand, you're gonna tap into compassion and you're gonna tap into love.
So you're gonna picture yourself giving them a hug and, and forgive them. If you are not able to do that part, that very last part, then you do this whole exercise again every day. It might take you a week, It might take you a year to finally get over it or to not necessarily get over it, but to trans mutate that pain.
Weigh on you. And again, you don't have to do this by ever even telling them that you are working on this. It could be that the person is already passed and they're not even around for you to tell them. It could be that they're in another city or whatever. You're not writing them no letter. You're not calling them, you're not doing anything.
You're just a dual. All this in your mind, in your own space.
And remember, sometimes the most powerful thing is to forgive ourselves because we didn't know any better. We didn't know what we didn't know, and. We have blamed ourselves for so many things that sometimes we were not even aware that it was our adhd, like for our tardiness or for, um, for getting the keys or for, um, forgetting to show up for a kid's event because we have forgotten to put it in our calendar or for not paying the taxes or for, uh, you name it, right?
So, Forgiveness is a powerful tool that when you combine it with compassion and forgiveness into love, you are the one that benefits. And so I tried it and one of the meditations, or one of the examples that I tried was forgiven myself for lying. So I think I shared this story with you guys before. Must have been about eight years ago.
I don't remember how long ago it was, but was still living in Houston at that time. And everybody who knows me knows I'm not the best cook. , I mean, our, my first date with my husband, like the fire firefighters had to come over because I was trying to cook a steak and it got burnt. And at that time, you know, Uh, , it set up the, the alarms and everybody came and the whole building had to be evacuated and Oh my God.
Yeah. So anyways, they give my husband the, the Chinese thing and said she's a medical student. Right. Call a Chinese place. Point is that about eight years ago I was Trent to have a better cook. I was trying to make this. Roast Ciy chicken in the oven, and I was trying to be fancy, trying to follow all the instructions from a cookbook, and part of it required that I add some rosemary, um, spices.
Well, I had forgotten that, that the day before, I think. I don't know if I forgot or I wasn't paying attention or maybe I half listened or I didn't think it would matter that my husband had told me not to use certain spices cuz he had done something to them. I don't remember what it was. And I used the rosemary that he had told me I guess not to touch.
And I was cooking the, the thing and it was done. And I was so excited. I, you know, we were gonna have a fancy dinner and. And he asks me, he's like, Did you use Rosemary ons? Like, no. Even though I knew I had, but I could not bring myself to say that I had, because if I said yes, then that meant that.
That he was gonna reject my chicken and therefore he rejected my chicken. It meant we were not gonna have this nice, fancy dinner that I have been trying to put together this romantic night and da da da, right? So I was trying to protect the romantic night.
What developed after that was that he was so mad that I had lied to him that. Now I did not, we not have a fancy dinner. He stopped talking to me for like almost three days . And anybody who knows, uh, I'm an extrovert, and so you not talking to me is like death to me. Right? And then you throw in the rejection sensitivity dysphoria, and then you throw in the fact that you bring condition once just to think, which is love and acceptance.
I mean, I was like, what the hell? Right? And of course my brain of saying, You're overreacting, you're overreacting, you're overreacting, right? Like, that's what it kept saying because I wanted to keep me safe, like I wanted to be taken care of. Why am I saying all this? Eventually, of course, that led to me, um, uh, going to counseling because he said I was a liar, , and I.
Too many people, it might be like, Okay, it doesn't matter. I kept telling myself, it doesn't matter that white little lies shouldn't matter because they're white little lies. And I was it. It's always the means to the end. Like I was just trying to please him. I was trying to do a nice thing, but the thing is that we should be okay to say what it is without feeling like we have to keep masking or people pleasing.
So I, I learned from that experience that a white little lie could become dangerous. Like to him, his point was like, if you're lying about this little thing, what else are you lying about? You're gonna be lying about the big things. And of course, like we didn't even have any big problems. Like to me, those little Li white lies didn't mean anything.
But through the therapy, I got to realize that I was using White Little Lies as as a defense mechanism, right? Like I didn't want to be that five year old who was. Like not accepted or loved. Right. And I did, and I had learned the mechanism that if I am just well behaved and quiet enough sometimes, or change myself enough, like, you know, I would be okay.
So why am I saying all that? Because when I went through this exercise and. Used at meditation where I pictured myself, you know, my younger version, and I created that space. And then I felt that I was angry at him. Angry at myself. Why? Can't just understand, Don't know . But what I learned from the event is, You have to just be honest and, and, and that my integrity really did mean the world to me.
And that of course his love for me was important. But more importantly, my love for myself was the most important thing. And me being able to be my full self, bring my full ADHD self into the picture was more important. Um, And I learned to see myself from what I now know, my wiser self now understands because I have deep dived into understanding my brain and defense mechanisms and understanding that that time I had no awareness that I was acting in, in what is called like childhood, like emotional states, right?
Where I was just trying to, um, Man, I don't wanna say manipulate the outcome, but I didn't realize that how he felt did not have any, or should not have any insight on how I felt, meaning I controlled whether I was happy or not. And I didn't need to necessarily have this perfect dinner in order for me to feel like I was worthy of his love.
But in that moment, I didn't know that in that moment. I was trying to do my best to protect what I thought was the right thing to do. So my wise self, my older self now is able to tap into compassion and say, Of course, you were trying to just have a nice dinner. Of course, you were using a white line mechanism that had helped you to mask so much that at some point you didn't realize could.
Lead to one too many white lies that could maybe derail you from where you needed to be, right? So I forgave myself for not knowing what I didn't know. And here we are. I'm sharing this with you because it sounds silly, right? All this like, um, Feelings that we're not used to talking about feelings in the medical field, but what I've noticed is that feelings are at the center of everything and that we all are holding on to little events or grudges or traumas or something that has happened, and in it, it weighs us down.
It really does. So try it for yourself. See what you think. We all go down the rabbit hole. You can , you can let it be something or learn something from it like I did and apply it, right, Because it's in the application where things start to shift. So there you, they heard it . I can't wait to hear what your reflections are on this.
And yeah, if you are interested in telling me any other topic that I should listen to or do, please let. Um, thank you so much. We be touch. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website at.
coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my. And in my personal life in the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important, learning the new.
Hello, I so excited to be here with you today. So, um, I had a couple of interesting weeks. I went to Costa Rica, um, to celebrate my 11 year anniversary. Um, and actually we went for honeymoon, uh, to Costa Rica as well. So we decided it was probably time to go right now that we have. Little break from Covid and you know, I was like, we just need to go before, um, there's a new pandemic, like Monkeypox or something.
Right. And I booked the trip like maybe a month before we went. And you know, that's just so adhd, right? We're kind of impulsive sometimes, but sometimes those are the best decisions that we can make. Like life is too short. You gotta make sure that. You are living in alignment with what you think is important to you.
And so I wanted to talk about this week about how ADHD can be your superpower. How you don't let things kind of slow you down or get you in the way, even though life throws you some core balls. So, uh, I was hiking, um, All sudden I hear clunk. We were climbing the, uh, Ariana Volcano and I looked behind me and half of the hiking book booted had fallen off.
And my tour guide asked me the Laas, which means, are you gonna keep going? Are you. Play for it, or are you are like, are you out? Are you done basically for the trip? Right? And so that question
kind of like woke something in me. Um, it, it was such a quick question, right? It, it's funny how one question can change everything.
Can be taken in many different ways. It can be taken like, are you all in? Are you ready to play? Right? And so maybe some people would've said, Well, oh, I just have one boot. Like I can't keep going. Right? But the bottom of the soul still had something, The other part just fell off. And so, you know what I, I told them, See , which means like, yeah.
I'm gonna roll with it, see what happens. And so what happened was that I kept walking and 200 meters later, flunk here, the other part of the group fall off. And maybe some people would've thought, this is the worst thing ever. Right? But to me, like I couldn't help but laugh. Like I found myself in a situation that was so typical for me.
It just seems. First thing happened to me. For some people it might be paralyzing, but for me it would. I didn't make it mean a thing. Um, the thought were going through my mind where, you know, my ancestors probably climb the same volcano, their foot it. I'm sure I'll be okay. So our thoughts really make a difference on how we show up with the world.
Like maybe some person could have thought like, Oh my God, this is horrible. This is the end of the world. Um, but to me, I just kept thinking, this is another day, like not a big deal. And I just kept going. You know, I finished the rest of the hike. I think it was another 40. And I just kept telling myself, Hey, the universe just wants to a foot massage.
Interesting. On previous, like LA Rocks, right? And it just, it just tells you that sometimes life just happens. Right? And so at the end of the, of the excursion, I asked the tour guide. Hey, um, has this ever happened for you before? Like have people lost the whole bottom of their shoes before and he said, No, this is the first time this has happened in the last 15 years.
And you know, I was actually there with my friend Christina and her husband on this trip and. We were just laughing because my husband's like typical of Vienna, like some first time always happens, right? And so I remember when we went, um, it was prior to kids, we went to, um, a place in Australia and I think it was called Canes or something like that.
And it's supposed to be like the place to go and jump in. And scuba dive. My husband already had the scuba dive like certificate. I went through the course right there and then, um, and when it was my turn to actually apply what I had learned and go down, uh, I couldn't do it. Well, my brain was just telling me that it was gonna be one too many directions for me to follow.
I was panicking. I just could not see myself going underwater with like this oxygen. And it's so funny because like how many times do we do different things that you know, are not so scary for other people, but. Still do 'em right? But our brain is always trying to protect us in one way or another. And so yeah, I asked that same instructor how many people had like come all the way out here and they not go down.
And he said, Not many . And you know, when I was trying to, uh, learn how to ski, uh, down the mount in Denver, you know, I was doing a. Learning activity and I was one of maybe the only one who went down the slide, meaning I slid down the mountain like in the parking lot, like in the opposite end of where I shouldn't be going down the to be training.
So things just happened to me and you know, the. The instructors like, um, I think Deanna needs like one on one sessions. She does not need a group. She needs her own private instructor. And guess what? The next day I paid for my own private instructor and I, I got a little bit, I got the gist of it. You know, I learned to do some like, You know, but when I was going through the motions, the guy's like, Okay, you need to get off the, the, the cliff, like you need to get off.
And I was like, mm-hmm. I just stayed out there. And he got off and he's like, Oh my God, what is this lady doing? Right? And so it's just funny how sometimes her brain tried to, to protect us or we try to avoid the things that are getting, get us in trouble, or we still do it despite, So what am I talking about all this?
Because you know, today I am at a conference where it's, um, I'm part of a group that is a retreat where they teach you how to level up or how to, um, Practice medicine in your own terms and how to serve and how to earn and how to create legacy for yourself. Right. And we were given a cupcake that said happy 90th birthday, and we're looking around the room because you know, it's all physicians in there and nobody is close to nighty in that room.
Right. And it was an exercise. It was an exercise that said, um, what would people say at your 90th birthday? Like, what would they say about you? Right. And I'm pretty sure most of us had done this type of exercise, like if you were at your funeral, like what would people say about you? But you know, the 90 birth, 90 year old birthday celebration seemed like a more happier place because you're still kinda alive, right?
So, I describe my birthday as probably taking place on one of those cruises, you know, where you're six months out and. And it's perfect scenario because you have a Dr. Ward who's taking care of you, somebody's cleaning your room, right? You're getting off on all this different ports all around the world and you're being fed like amazing food.
And there's probably activities, I'm pretty sure they're probably make us go to sleep kind of early, but that's okay. Like. I would rather be on a six month floating a cruise all around the world than be somewhere like on a nursing home or something. Right? Why am I saying this? Because we don't know how many years we have left to live, right?
It could be one, it could be. 10, it could be 40. We have no idea. And so you need to decide what kind of life you wanna have in order to start working towards it. And in my, and she gave us like, Different categories for us to decide, like what would they say about us? Like what would family say about you?
What would like, um, you know, what would you have accomplished? And all those things. Right? And so to me, what came to mind was that, They, it is something that people tell me all the time, If we don't know you any better, we would think you're taking something because you have so much energy, you do all kinds of things.
You're the healer to everybody. You like to listen. Um, and then you, you like to disrupt shit, but it's not working. and you know, I really think that I came into this world. To share my story and to hear other people's stories and to find the amazingness in it and to collaborate together to make that happen.
So today I was listening to, um, to somebody say that it's okay to. sometimes not do the things that you think you want it because sometimes better things come your way and it's just so interesting how. what we think might be, you know, something hard, might be something not that hard because something better is coming your way.
Why am I sharing all this? Well, I guess I'm in an inspiration type of scenario. You know, I'm looking, we're in October. We really we're starting the last quarter, how you say it, right, the last 90 days of this year. And I'm wondering whether you have met all the goals that you wanted this year. Right. And last year when I came to this retreat, we had a similar, um, You know, projecting forward saying that writing out the date, like, you know, December 3rd or December whatever, 2022, like what would you have met?
What would you have accomplished? And I looked at my journal of what I wrote last year, what I wanted, and I wanted to have a long term nanny and a housekeeper. I still don't have those two things. Um, but I wanted to also have, um, date night with my hubby once a week and that is actually working. So, and I wanted to have more quality time and that is also working.
And, um, in terms of like my personal development that I wanted to do, it was starting a podcast or YouTube channel, which I am doing that. And in terms of fun, I wanted to have dances and I wanted to learn, um, How to do like a, like Suma or samba. Um, I already know Zumba, but I wanted to do samba, right? And so I, one my amazing position friends is, uh, actually teaching me to do that.
So, yes, um, I also wanted to schedule my massages and I am doing that and I wanted to paint more with my. And I am doing that too. And in terms of my business, I wanted to make an impact. Like I wanted to earn, um, at least a thousand dollars, right? Uh, sorry, a hundred thousand dollars. And yeah, I'm doing that too.
And so why am I sharing this? Why am I saying all of this? Well, you need to write stuff down that you want. If you don't write it down. You were not focused on it. The universe is not gonna match your vibration. You need to figure out whether what you're currently doing is important or not. And the systems that got you here, are they gonna take you there?
And you need to realize that in order for us to grow as a person, You need to have a network, You need to be in a community where people are growing themselves, and that takes sometimes investment in money, sometimes investment in time, that maybe takes a commitment to saying no to things that are maybe draining you and you need to have this talk with your yourself.
Like what would your wiser self tell you like. If you make a baby decision, like those baby decisions add up, like they can really be the difference between who you marry or who you don't, whether you are healthy in terms of exercising or not, whether you move to one place or another, whether you start your own business or whether you write a book or.
Go on a limb and go on vacation, you know, and plan in one month out. You get to decide what type of impact you want to have in the world. And so choosing you is important. You have the last 90 days. If you feel like maybe you need some help in getting you to where you're going and you don't know where to start, reach out.
I'm here, come to my group. You know, if you're a healthcare professional, I can totally get you there. Whether it's going home by three o'clock, whether it is, um, Coming to my retreat in Costa Rica, whatever it is, reach out if you have some, you know, um, opportunity where you want me to come and speak to your residents or come and speak to your, um, society or, or network event or whatever, like, let me know.
So this is where I'm at today. I am in the reflection mode. I am in the, what is my goal next year? What am I dreaming up? What am I gonna do the last 90 days? And how do I continue to prioritize and plan for myself, right? And for others. And, uh, realizing. Yeah, at the baby steps they add up and it's in that repetition that our habits become, um, you know, become our life.
So do decide that you're the most important person in the room that. Refilling your cup is important and that you are one unique you. There's nobody like you and that's amazing. And we want to, um, share any of your stories. If you know somebody who you think I should interview that could highlight. Um, any of our adhd, um, qualities, please let the, let them know.
Please bring 'em over. We all need to help each other thrive. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website at ADHD live. coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mecado Mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my. Adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life.
In the past two years, I've come to realize, That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
So today's topic is one that we don't usually talk about, which is dealing emotions as a compass. I wanna share with you three tools that will help you to. To develop a way of opting out of overwhelm and to really tame your inner critic. So emotions as a compass. Everything we do revolves around emotions.
They're really the center of our life and most of us don't even talk about it. And the thing is, Coming from the medical field, emotions are not something we bring up like we have been taught or told that we should always just show up in a very professional matter, leave whatever's going on with you at the door and do not let anything dissuade you.
I'm not saying that's good or bad, but that's what we. Been told that's what it means to be professional. What I wanna offer you though is that emotions are a very healthy way of us knowing that we are still alive. Emotions are at the center of everything. I don't want you to think as emotions are good or bad per se, but the thing is that we need to see that emotions are helpful and are needed 50% of the time.
We might feel good, 50% we might feel bad. Vibrations in our body are just a way that emotions show up. Why do I say this? Emotions teach us something. They tell us if something is going on, like if we're angry, if we're mad, if we're frustrated, your body's trying to tell you something. If we're happy, if we are feeling blissful, joyful, your body's also telling you something. So emotions. Are a way for us to self regulate our environment.
The thing is that when we have adhd, there is, we don't have that two second delay that a person without ADHD has between the amygdala. And the prefrontal cortex. And because we don't have that delay, we sometimes appear to get more worked up or lose our ability to regulate, or we get mad over something that shouldn't have really cost us to feel like we are overreacting.
Example, if you're trying to get out of the door in the morning, And you're trying to get your kids ready and one is missing a sock, one is not putting on the shoes, and you're trying to give them all these directions and the kid just starts to scream and melt down. , it's probably because, too much information was coming at them at once.
They can't follow all those things. So I wanna explain to you that emotions, are just a way for us to also make decisions. And so what happens is that, As you, you sometimes don't realize that people with ADHD can, we tend to be a couple of years behind our peers in terms of our cognitive development and our emotional development.
There's studies that show that. We are about 25 years of age when we really become who we're meant to be. And for some with adhd, it's fun until the age of 30. So when you're asking a kiddo, to do X, Y, and Z, or even us, when you're asking us to do all kinds of things, we become overstimulated.
So the first tool that I want you to talk about or acknowledge is that emotions can be a way for us to gauge our environment. It's in awareness. It's a engagement of what is going. And then be aware of this so that when you do have that moment where a lot of things are being thrown at you and you feel overwhelmed or you feel stimulated, over stimulated, just knowing.
That we don't have that two second delay can keep you or prevent you from going into this self blaming, self hating, self criticizing reminiscence, where you're like telling yourself that what's wrong with me? Why am I so slow? Why am I doing this again? I told myself I wasn't gonna react. Being aware.
Can help you name the decision, can help you tame that emotion that you're having. So don't think as emotion as like something good or bad. Just look at it as a source of information and ask yourself like, Huh. I wonder if I, When was the last time I ate, When was the last time I slept? When it was the last time that I did something?
We as human beings are so unique in the sense that we are able to think about our thinking, and so the tool that I want you to give yourself is this pause, create. A safe ward or make the decision ahead of time that if you have this flat of emotion, having the awareness that this is something that is normal for ADHD people, now you can create a way to give yourself that gift of the pause so that you don't make it mean anything and you don't go down a rabbit hole.
Criticizing yourself and blaming yourself for not quote unquote having it together. The second tool to self regulate or to decrease overwhelm and stop this inner critic is by changing your environment on purpose. Create self regulating actions that are going to refocus your attention away from whatever just triggered you.
For example, if my kid is tired and crying and frustrated, I can tell him what's wrong with you, right? I can do that, but acknowledging the behavior of the person. and then changing it, it's more helpful to say, I see that you are very upset right now. You validate their feelings, but then you can change the environment by maybe introducing humor or doing something different.
I can, of course, scream or I could change the environment like, Damn. Or there yet, you sooth yourself, right? How you could give yourself a hug for five to 10 seconds. That's very calming. You could. A nice song that is going to reset you or change you. For example, I bounce to the beat of my own drum is one of the ones that I think is so fun.
It just reminds me that we can do whatever we want to and that people don't, we don't have to follow other people. And so when my kids are having a meltdown, I. Pause, I look to see if there is something that I can do to change their environment. Maybe they need to go outside and walk. Maybe we need to start jumping around and there is some.
Places in Denver, Colorado that the teachers, instead of giving people a time out for having this meltdown that they're doing, they give them a time in they right there on like bicycles and. It's amazing because now they're getting healthy, they're increasing their dopamine level, they're feeling happier, and they're focusing.
So instead of quote unquote shaming them for acting a certain way, they're giving them a time in. They're allowing them to process the emotion, be in the moment, but. Changing the environment, having them walk, having them run, having them exercise, can do a big thing, have a safe work per se. So the third point, or the third tool that I wanna share is that community is key in order for us to be able to.
Enhance the way we show up with when emotions happen, instead of feeling overwhelmed and feeling like we're that, we're the worst person or inner critic is gonna go wild, we gotta realize that we are worthy. That there are people out there who really want to help you grow as a. And sometimes we just need to do repetition.
We really have to find an environment that supports us, and while some medications can help with this, something maybe like claine and want the sink and help take the edge off, really it is. That community of either cognitive behavioral therapy or dialectic behavioral therapy or coaching that will help you to implement and do the awareness of how you can rewire the way that you're thinking about things.
You start to create systems for yourself. And it is in discussing things that things get normalized and you start to see that it's a spectrum, that emotions, they're powerful because how we do things really is at the center of everything. Like why do we decide to get married to somebody?
It's probably because we think that, that we're gonna be happy with them. Why do we decide to go to school? Because we probably think we're gonna have a financial security, right? And so the thing is that using these resources in your community where they can support you, will help decrease overwhelm and will help decrease all these things.
So to wrap it up, when something hits you outta nowhere and you feel like, Oh my God, I just overreacted this, I, you are embarrassed or something, just take a deep breath, realize that we are not the behavior. Realize you're not your thoughts. Realize that. You have an option. You get to decide what your next step is.
You can take a breather. You can try tapping to help you calm down. You can try meditation. You can do jumping jacks. Change the environment. Call a friend. Join your community. Choosing is the key. You can opt out of overwhelm when you acknowledge that, okay, I have a two second delay. I don't have that space.
My brain is just trying to keep me safe, but there's nothing that it needs to keep me safe from right now. Realizing you have that power to override it, realizing that you are. Capable of creating the life that you want. So awareness, engage in self-regulation techniques and make sure you find the people that support you and where you can be you.
And don't worry about emotions. Emotions are just compass and they're all useful because you know to understands. Sometimes you have to go through pain and they're all appropriate at the right moment in time because again, they remind us we're alive.
If there's any way I could help bring any of these topics to support your audience, either by speaking, by coaching, Please reach out to me@adhdlivecoach.com. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@adhdlivecoach.com.
Where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Mel C: They would always put my clinical skills in the morning cuz that's when I perform better. So I work with the and I say, Look, this is my problem. This is when I focus best. I struggle to learn at the best of times, but I am very capable as you know. Can you please do this to maximize my learning? If you give me this clinical skills class, that is really important for my learning.
If you put me in the afternoon, I'm just gonna sit there and be a good, go and be quiet. But I'm not gonna take anything in.
Dr. Diana Mercado-Marmarosh: Hello? Hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mecado Mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as the person I was always meant to be, both in my work and in my personal life in the past.
Two years, I've come to realize that unlearning some of my beliefs and some of my habits, I'm excited to share all these skills.
Well, hello. Hello. I am so excited today to have a very cool guest on our podcast and uh, her name is Melissa Carlin and she is from first Australia. She's actually a third year medical student, so it's so cool for us to correlate our time zone differences. Likely she figured it out for me. That's not my sort of genius.
I would show up at the wrong time , but I am so happy that she's here and I'm gonna let her tell us a little bit about herself and, uh, how we met. Mel C: Hi Diana. Thanks so much for having me on here. This is really interesting. It's really cool. Um, yeah, so where did we meet? We met, I made a, a Facebook group, um, for doctors and medical students with adhd.
Um, and we met on there. Um, I noticed you'd post some, uh, A couple of posts that were quite interesting about some courses and things that you do. Um, and then you, you got in touch with me and that was really cool. So, um, yeah, so I made that group just, uh, I noticed there was a lot of, uh, medical students and doctors with adhd, but they don't tell anybody about it.
They, same with their depression and anxiety. They keep it a big secret. Especially, I don't know what it's like anywhere else in the world, but especially here in Australia, uh, there's still a lot of stigma.
Dr. Diana Mercado-Marmarosh: Yes. You know, that's so important that you created a safe. Place for people to come and join in a community that like-minded people could correlate and relate with each other because like you said, unfortunately there's still a lot of stigma and this is why I do this podcast and this is why now I'm like talking to anybody who would hear me about like changing the way that ADHD is perceived cause like we forget that.
What we're thinking really influences how we show up in, in the world, right? Like, if we're thinking this is the worst thing ever, or we're thinking, Oh, this is fascinating, I wonder like what, what it could help me in or whatever, right? Like it could just make a difference on how you then show up. Um, you know, in 2016, they.
Did a research or they did like a survey of medical students and they asked them, in the us they asked them like, how many had di uh, diagnosis of adhd and like, interestingly enough, like one third of the class had it. Yeah. So like, and, and so I'm pretty sure it's. Under, like reported and under. Absolutely.
And probably likely undertreated, you know, And so
Mel C: we've done this thing in Australia, so wa I think worldwide, uh, at Perth where I am for some reason, it's got the highest rate of a ADHD diagnosis and treatment, highest rate of Dexamphetamine prescription and. I literally saw a post on Facebook yesterday saying that it had risen by 20,000 prescriptions this year, uh, since five years ago.
But they always report it as a bad thing. Yeah. And they always report it, and then you'll see in the comments like, Oh, it's over prescribed all these addicts, blah, blah, blah, blah, blah. And I'm like, Nobody's reporting how much the cholesterol prescriptions have gone up this year. Why do you care about add, Why do you need to post that?
And, and, and, um, rev everybody up in the public who has no idea. But yeah, back, back to what I was saying before, um, Uh, when I started med school. So I've had it since childhood and uh, always got my accommodations and I sat my first exam in first year medical school in, uh, the special accommodations room where I have my isolated exams cuz I'm well aware of my accommodations.
So I sat there, there was one other student, I don't know if they had add. Um, but yeah, so I was there on my own and, and then, That was his first semester. And then at the very end of the year when we sat the last lot of exams, all of a sudden there was 10 extra people there. They all, um, all had d ADHD all their life.
And they finally, I think med school finally had very successful people. They managed to get through their degrees and everything. Med school seems to unmask it and it's, it's impossible for them to. The demand, you know what it's like, The demand is a lot higher. It's a lot different. Uh, you've gotta recall a lot of information.
You've gotta be very, very, uh, uh, strict in your study rating. You can't just cram anymore. Yeah. So, uh, yeah, it unmasks a lot. But the sad thing is, and, and I have this battle with the kids in, I call them kids because I'm like the oldest one in the med school, um, , I'm their three, they're all in their early twenties.
Uh, the same thing with the depression. So many of them suffer. And you know, it comes with the intelligence. I'm a big. Believer that the adhd, the depression, the anxiety, whether you have one or the other, it comes with high intelligence. You can't be that smart and have your brain not be broken. . Yeah. You know, like that stress of being smart all your life and overthinking everything, it puts that cortisol up and I just think that serotonin regulation stuffs up and um, yeah, massive stigma.
A lot of students and a lot of doctors, they're scared that if they disclose. Um, that it's gonna impact them. I mean, you don't have to go around telling people, but uh, they're worried if they put it on paper that somehow ara our governing body will, uh, not give them a job. But, uh, a lot of people who I know who do, do disclose it cause it is illegal if you don't.
Um, I remember my mate, he's got bad depression. When he went and got his internship, they called him in. For his paperwork and they like did their physical medical exam or whatever, just to check that your health can fit before you start work or give them their jabs and they just said, Oh, you've got depression, are you medicated?
Yep. Cool. No worries. Have a nice life. Like they really didn't care. They just wanna make sure that you're medicated, that you've got it under control and they don't care. But there's this massive stigma and so many people struggle with it. So I made this group. I made this group mainly actually for people trying to get into.
So I've made a separate group now because half the people in that group on Facebook were, um, pre-medical students trying to get in. And so it took me 10 years, get school, 10 years. I sat out entrance exam 12 times, had three interviews. And the reason for that was purely because aa, the people who, um, who organized entrance exam, their external body, they refused to give me my extra.
For 10 years. So my fr this girl and I, we kept seeing each other every year at the special, the, the special people who sat the special under accommodations. We only got like five minutes extra. We kept seeing each other year after year, after year, after year. And about after 10 years we're like, we should really know each other's name by now.
And I went up to her and I'm like, We've gotta do something. She was really hesitant about it. Um, and. She gave me her number anyway, and I chatted to her. Eventually we got a, a lawyer to write a letter to remind them you need to give these people their accommodations. And by that time we had just given up.
We had just given up. We, we didn't even study that year. And uh, we finally got 50% extra time. So if it's an hour, we get an extra 30 minutes. Um, split the exam over two days cause it's an hour exam. So my medication wasn't gonna last that. And, uh, we, after spending 10 years on the 50th percentile, we both jumped up to the top 15%.
So I made this group to help people as well, who are just kicking a dead horse because I knew I was smart, I knew, you know, I'm not stupid if, if I'm never gonna be a singer, Diana, I can't sing. I would love to be, but it's never gonna happen for me. I'm not ignorant. I'm not gonna like try and achieve something that I can't achieve, but I had good marks.
I was smart. I know I was cut out for it. If you let me sit the GA set for as long as I could do it, I will always get the answers right. So it wasn't, you know, I stopped telling people after the third year that I was trying to get into medicine. I used to just lie and say, Oh yeah, I'm sticking with teaching.
You know, Um, I've given up. I've given up. Cause it was just, it was just heartbreaking every year, after year, after year. So, uh,
Dr. Diana Mercado-Marmarosh: but that also speaks to the persistence of somebody with adhd. Like when you. Are aligned with what you feel is your calling, like nothing's gonna stop you, even though to the normal, I don't wanna say normal, because I'm all of a sudden we're calling us abnormal.
But to other people that don't have ADHD like they might have. Maybe they might have tried three times, four times and then they're like, Okay, this is not for me. That's right.
Mel C: They give up. They give up. Yeah. And it's very competitive. Even if you are a standard student, you don't have adhd. You these days, especially in Australia, it's so competitive.
You do have to sit it several times just to, cuz it expires every couple of years. So you have to renew it. Yeah. And it's just like a $500 exam. It's just a big extortion thing. Um, but you can't give up. But then unfortunately with the adhd, It's even harder. And a lot of people will fail it without the extra time, especially if they're not diagnosed.
Especially if they don't know how to write their letter to get their time and asa say the exam, people say, Sorry, we only give you five minutes. Too bad and so sad. Um, that's all we gonna give you. And people will say, Oh, okay. They don't realize, they can say, Actually no. Give me my time. I'm entitled to this.
And you're breaking the law if you don't. Right. Um, and they will give up and, and I appreciate you saying it shows my persistence and yes it does. But both my friend and I, we say to each other, we are the only two people in the world who understand each other. And we are the only two people in the world who will know what each other went through.
Because we both went through it together. We both went through it for 10 years. And it destroyed us. It really did destroy us. It really, it destroyed our families. It destroyed we. We both have genetic depression and anxiety anyway, but it definitely made it a lot worse. And, um, but,
Dr. Diana Mercado-Marmarosh: but look about how you now get to tell the story, though.
Like you didn't give up
Mel C: on your memory. I get to help people. I've helped so many people get in, but you know, every now and then, like now that we're in medicine, it's been three years, Even the other day we messaged each other and we said, Thank God we don't have to sit that exam again. And we'll lament.
Lament on how much suffering we did go through. It really was the worst time of my life. Yeah. I spent thousands on courses, tutoring courses with my adhd. I need silence at home to study, so I was always yelling and arguing with my family. No speaking. No, we can't go out. No, you can't have visitors over because you interrupt my study.
I need every second to do well in this exam and I need every second to get a good GPA for this last uni unit I'm doing. And it. Destroyed our lives. And when we both got in, we actually, for the first six months, we both really were confused. We were both . No, it was really sad. We couldn't enjoy it. We couldn't enjoy it for, I've coped a lot better.
She doesn't mind me saying this. She knows who she is and she doesn't write me saying this. I've coped a lot better, but it was really much harder for her. Um, I sort of, Not more resilient, but uh, more accepting and I get on with it and she had a harder time with it as well. She was screwed over a little bit longer than me.
And, um, it was really hard because we suffered for so long and we were treated so badly for so long, and we fought for so long to prove, yes, I deserve this. Yes, I am good enough and you won't let me in for 10 years. In an unfair situation wasn't like, Just give up. You're too dumb. We knew we could do it, and we both get high distinctions in med school now, you know, and for the it, it caused a lot of damage, psychologically posttraumatic stress properly.
We couldn't enjoy it because it was such a fight for so long. And then we finally got in, it was like, I finally, that battle was finally over. You know, it really, it really took a toll that we weren't expecting. I cried for 30 minutes, not because I was excited. I got in and I recorded it too. Was meant stop crying.
It was meant for 30, 30 minutes over how tired I was.
Dr. Diana Mercado-Marmarosh: Yeah. No, I mean that's so important that you're speaking about this cause the people that don't have a ADHD do not understand this part. Like they don't understand why you're so, they could probably label you a stubborn, why she's so stubborn. She should know better.
She could be go do X, Y, and Z. I'm pretty sure she could get. 10 times what she's gonna get as a doctor. Why is she going doing to do that? Mel C: Right. And also, people dunno. You as well. People dunno. You like, like I said, I know I'm not gonna be a singer. I'm never gonna try and be one. Do you know? So when you are telling family and friends, people who know you're smart, but when you tell them, Oh, I failed the exam.
Oh well, not failed. Oh, I didn't get an interview. Are you gonna, I'm gonna try again. I'm gonna try. You sound like a loser. You sound like their mind. They're like, Oh, you should really, Are you trying to get into medicine? GE should really give up. Like what? You know, obviously you're not good.
Dr. Diana Mercado-Marmarosh: Stop trying
Mel C: and was thinking.
In my Italian background, it's
couldn't't get in, didn't get in it. Justand, how much? Ha. Yeah.
Dr. Diana Mercado-Marmarosh: And I think that was so smart of you to stop telling people, like, sometimes we do have to keep our dreams to ourselves until we are already living it, because otherwise there's, we each have a little bit of a doubt in ourselves, even though we, we don't wanna say it, we have it like it's human brain to like, wanna keep you safe and not wanna make you feel like you're ridicule yourself or whatever.
Right? But, But when you have a little bit of doubt and then you have other people like amplify that
Mel C: doubt, like absolutely is not helpful and it makes you feel stupid. And then I had, best thing was that I had my friend with me and we were both doing it so we could both say it was happening to both of us.
The, the exam people were screwing over both of us, and we were both trying to get in and it was the system. But before I met, And I used to tell the same story over and over and it was just me. It just sound when it's just one person standing alone, it just sounds like you are the problem. So it's really great when you have someone going through the same thing so you can prove to other people, actually it's not just me.
I'm not a dumb loser who can't get in and I just don't know when to take a hin. Um, this is a proper problem. Yeah. So it was helpful, but I still stopped telling people cuz I just couldn't. I hated explaining myself. I hated explaining why I hadn't told any of my friends at that point in my life that I did have ADHD since I got into med school.
Now I tell everybody I don't care anymore because, you know, I just don't. Well, here's the
Dr. Diana Mercado-Marmarosh: difference. I think like you are now speaking from a healed wound, like you're now are able to tell your story because
Mel C: you, you.
Dr. Diana Mercado-Marmarosh: Are past the story in the sense that you're not reliving it every single day anymore, luckily, because you are now where you always were meant to be.
But like you said, it's the system that was preventing you from you, showing you so. So this is the paradox of the high achiever with adhd, that, like you said, you are smart, you know, but. The system does not allow you to show how smart you are because they don't give you the time for you to process what you need to.
Yeah. And then, and that's where. Had you understood that, okay, maybe I just needed a little bit extra time. Maybe I just needed a timing and maybe I just needed to speak out loud to somebody instead of just me reading this over and over so I can try to make sense of what it means. Right? Yeah. So that's where like if you don't understand that ADHD could be your superpower, because you're gonna be the one who's now thinking outside the box and able.
Um, share your journey. Then it, like you said, it looks like you're the only one with a problem. Cause everybody else isn't in that needed to be in and I'm not in, so it must be me.
Mel C: Right. And then, and then the other thing that annoys me is there's a few 80 HG people out there who did make it through the system and they sat it in the big room with everybody else understanding conditions and they managed to get in.
It's usually the engineers. Yeah. And you just like, God, it, you're making us look bad. Like Yeah. They manage, they just got that math brain and they managed to get in. But um, you know, but I have come from a different place. Like I'm very empowered now. Um, I remember in high school they used to, Oh, do we have to give you a separate room?
Oh, and they used to stick me in with everyone else. By the time everybody else left the room, my actual time was over. You know, and I never used to fight for it, but, you know, we we're, we are trying to fight at the moment to get an alternative entry pathway because over here we've got an alternative entry pathway for our indigenous Australians who have lower education, lower mortality.
There's a lot of disadvantage from, you know, their stolen generation and, and things like that. So we try and, Assist them to, you know, beat the barriers that they faced in their life. And people who live rurally get extra bonus points to their application. So what we're trying to do is have something similar like that for people with a learning disability.
Like three or four spots a year in the med cohort dedicated to those people who can bypass the exam. But you know, not just let anybody in. You still have to have a good GPA from your other degree. You still have to have good reference. You still have to do well in the interview. Um, I don't want a free pass for anybody If you've got a adhd, but you're stupid.
Too bad. Like I don't want you in bed, like you just, you're not getting a free pass. Like I'm, that standards still there, just cause you're disabled. I don't believe in token. Token bonuses. Free passes in life. But, um,
Dr. Diana Mercado-Marmarosh: what, what do you think, Sorry, to good job. What do you think ha was helpful? Like as you were studying through those tests or like even now in med school?
Like what has been the most helpful for
Mel C: you? Well, obviously my medication, without my medication, my life doesn't exist. From very young. Absolutely. There is no way in hell I would be here if I was not medicated. Absolutely not. Impossible. I don't e I'd probably be in jail, , uh, or, or hit by a bus crossing the road because I'm so away with the berries.
Um, absolutely. But I, because that's just a part of my life, I don't often think of that as a tool, but, but it is because I, I manage, it's a daily thing that I manage every. I decide when I'm gonna take it, when the best time to my life revolves around my medication, pretty much. And, uh, it's actually really hard because I've been on it so long.
I'm at a higher dose and um, when I'm on placement now, all my peers come home and study after placement. They go, they leave at 3, 4, 5 o'clock and then they come home and study. I can't do that because when I get home, I'm done with made bad's gone. I can't say,
Dr. Diana Mercado-Marmarosh: So why? Why can't they give you like a long acting and then like a short
Mel C: acting?
I've done all of that. I've done all of that, and then I'm tired. You know, even when I am medicated come through, my brain just doesn't work. You know, so I've done all of that. But what I do now, I work very closely with the uni and I'm really, really lucky. And I know this is not a thing in other universities, but my, my university Notre Dame, they are, it's a Catholic private uni.
They are very, um, very caring, very big on their pastoral care. Um, to the point that when people were in lockdown, they were bringing food, shopping to their house. And, uh, taking the people who they didn't want them to travel back home, they said, Please stay back in case you can't get back. I think they took them out bowling or something.
They were asking them what are their interests so they could keep them occupied during the Christmas holidays. Like what med school does that, you know, um, I've got their phone numbers in my phone twenty four seven. I can call the, the, the associate dean who can, you can't call deans. So my uni's very, very good and I work with them closely.
They will put me at placements very close to home. They will. So my travel time is cut, so then when I have an early day, I can rush home and still get a good time in studying. Um, sometimes like when I'm on a GP placement will arrange my schedule so that I have two full days instead of four half days, so that I can use that time of the two other days to study at home.
So, Working very closely with the uni has been a very big help and I'm very, very fortunate that they are so accommodating. They will put, if I have a, last year when we were at, when it was still theory preclinical, we would have a clinical skills and then we'd have some boring lectures in the afternoon.
Um, medicated or I don't listen to lectures very well. Uh, so they would always put me as a preference through my learning access plan. We have a special plan at uni for people like me. They would always put my clinical skills in the morning, cuz that's when I perform better. So I work with the EDI and I say, Look, this is my problem.
This is when I focus best. I struggle to learn it the best of times, but I am very capable as you know. Can you please do this to maximize my learning? If you give me this clinical skills class, that is really important for my learning. If you put me in the afternoon, I'm just gonna sit there and be a good, go and be quiet, but I'm not gonna take anything in.
So can we maximize my learning? Make sure you put me in the morning classes. And so for the last three years, that's what they've been. And it's very simple and easy for them to do. Usually it's all random anyway, the way they allocate the students. So the people who do it, the ladies who do it, they know me, They take my name, they put me in the first group, and it's, And it's just that simple, but that little simple strategy or accommodation.
Makes a massive difference to my learning massively because if it wasn't for that, I would struggle because there are times when we have a lab at night when the professors finish work and there is no choice because the labs have been at night for the last 10 years , and I enjoyed those labs, but I really struggled to get a lot out of them.
I'd take my tablets like right before that. But as an ex, you know, but then I wouldn't fall asleep that night. So, yeah. But you know, little things like that with my study was really hard initially. Um, as another strategy I had to abandon years of, a years of how I used to study. Medicine is very different, so always fronting up to lectures.
I realize very quick, quickly, if I watch lectures, I'm not learning. My learning style doesn't work. Last year I didn't watch a single lecture and I did better than I did the year before when I was watching lectures. So you really, with adhd, especially med school, you've really gotta reevaluate your learning style every single day, week to week.
Is this working for me? Do I need to abandon it? And again, like you said, being adhc a little bit stubborn sometimes, so it's hard to let go of something that you are comfortable with that has worked for you in the past. This doesn't work anymore. You know.
Yeah.
Dr. Diana Mercado-Marmarosh: Let, let me point out some of these nuggets that you just said in case the Audi, you said so many wonderful ones that you have figured out and have optimized your, your, your life in these last three years.
One, like you just said, the environment now are so much. If you're in an environment where they appreciate you, where they see you as, you as your gift, and they flourish that and. Really support you. Like you said, they, they brought you food and it's like you said, it's the little things of knowing when you function best.
Like you work best in the morning, some people work best in the afternoon, some people are night hours. Like they just, that's how they are. Right? And so you understand yourself and then you communicate that to them. Now you have a way higher like chance that it actually. Being in your favor because you spoke out loud what you needed.
Mel C: Right. And then yeah, but before you go on, also for anybody listening, um, don't forget, I have the advantage that legally I can request it. And, and I have that medical support behind me from my doctor saying, Please support this student because everybody says I'm a night hour. Why can't I be in that morning class?
Well, because you can cope. I can. You know, so you've gotta remember that I have that, that benefit that cause of my condition. I get that, that privilege.
Dr. Diana Mercado-Marmarosh: Yes. But here's the thing, like you, you're correct. Thank you for pointing that out. But even people that have the diagnosis and even that people who their doctor could easily write this letter, like they don't speak up, they don't advocate, they
Mel C: don't, Oh yes, absolutely.
You have to be empowered. And there's lots of people in my class, they just struggle because they don't wanna tell the med school. And I'm like, Can't you see what I'm getting? Look how supportive they are to me. They're not penalizing me. Yeah, but you are still scared.
Dr. Diana Mercado-Marmarosh: And struggling. Yeah. And, and that's the thing, like in, in Texas, like every state is different, but in Texas, like when we apply for a medical license, like you said earlier, they want to know, do you have, do you have a mental condition that could affect like the patients, right?
Yes. And so, so if you say, uh, yes and. But you don't put that you're medicated, then obviously you're in trouble. If you say yes or, or, or you say no because you're medicated and your mind is not a condition or it's not like a liability, then you're okay. Right? And so there's, there's no right way or wrong way of doing it.
But the point is that, It is those type of questions that can get, keep people from seeking help or like you just said, asking, uh, for the things that by law they are entitled to have, so that they could have a supportive environment if, if need be. Right? And now, don't get me wrong there, because of it, there's still some people that don't understand it and they don't want to like, Acknowledge that you have ADHD because you got diagnosed later on and you're, you didn't get diagnosed when you were a kid, and you're like, Well, you must not have it.
And it's like, what? Like we did a neuropsych test that was 10 hours. They said, I have it how I not have it. Right. And so it's just so important that. You realize that whether it's at a school, whether, whether it's in your marriage, whether it's a relationship, whether it's your job, if you're in an environment does not, that does not like accept you for all your strengths.
Exactly, and for all your like sometimes not so much strength, right? Like timeliness, then it can get you into trouble because you can keep trying to do the best that you can, but you're not playing in a level field because they're not helping you to thrive in that environment. So it doesn't matter how much you try, you're never really gonna succeed.
But if you're in an environment where they do see all your greatness, oh my God, do you like, do you
Mel C: flourish? Yeah, they're, they're really good like that. They, but they're like that, like you said, they do it with everyone. You don't have to have adc. So they're so good to the parents. In our cohort, we have so many parents who have just had babies.
In fact, our dean the other day said, Any girls here, if you have a baby, best to have it in med school because we'll support you and it'll be easier for you to have a baby now than when you get a job in internship. Cause then by the time you get to internship, your kid will be four. So have a baby now girls.
Because, we'll, we'll change all your placements around. We'll let you bring your baby to class. You can breastfeed when you want. Bring it to the exec. Like, and they'll put them in different classes so they can pick up their kids on time. They don't care if they're half an hour late cuz they know the parents work harder than everybody else.
Yeah. So unless, but, But there's some people who don't reach out to the med school cause they don't wanna be a hassle. And the other parents are having a good time and these ones are struggling. And nearly having car accidents rushing or neglecting their kids, not taking 'em to school when they can and struggling because they just won't speak out.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. And, and again, whether you have ADHD or not, nobody can read your mind. , absolutely nobody can. So, Absolutely. So you need to be able to voice out loud what it is you need. And yes, it might happen that you get it, or for all you know, you get something if it better that you wouldn't even expect to get, but, But if you don't even say it, then there's no way, like you already told yourself
Mel C: No.
And especially in med school and in this career. It is stressful. It is so high demanding. You're dealing with such deep, complex topics, sometimes really sad stuff, really confronting things, and the sheer amount of work. And in our med school, we're only aiming for passes. Passes competent. They really strongly encourage you.
We don't want you to get high distinctions. We don't want you to get. Just pass, please just pass his competence. And even with that mentality, you know, it's really easy in this field to to get very, very low and in a very dark place. And with that high intelligence group of people, you just at such a risk of depression and so many people break down and burn out.
And unless you're on top of it from the very beginning, it's. It's just gonna be so hard. It's just, it's, you need to look after yourself from the first day of med school
Dr. Diana Mercado-Marmarosh: and, and you need to speak up about it because when you do, it normalizes it. Right. And, and it doesn't make it be a thing like the more that you just realize you're human and Exactly.
You have basic needs. Exactly. Then from there, like it's just such a different environment. I, I'm so glad that you have such a, such a supportive environment in terms of if they wanna be parenting.
Mel C: I'm not, and it breaks my heart because. We are a standalone uni. It is very unique to Notre Dame and I think even I'm not, we've got two campuses, one here in the West coast and one in the east coast.
Um, and they, they work together as uni. Their ethos is the same and it was the same in my other degrees at this uni. But you know, there's other uni's med schools in per that are not the same. There's no phone number to call. You can't call some. You can email people and then that'll go to somebody else or somebody else, but there's, nobody can go to, um, you know, the, They don't care about your timetable.
They don't care about your extra time. They don't, you know, I've got people who have contacted me on Facebook. Who their uni refuses to give them their extra time for their exams, for their, their ADHD or their learning disability, or they are flag in them or making, making a scene about it, or they're not giving them time off to go get their double mastectomy for their cancer.
And, um, well just little simple things. I, I, I, I, I'm, we're so privileged at and looked after at Notre Dame that sometimes I, uh, I hear little things from other people and I'm like, Why wouldn't the you help you with that? What? And then I realize, Oh, actually, now that I think about it, I guess that is a big ask, but we're so used to it that it's normal for us.
It's, and, and I feel so bad because I see other people at other you struggle with, with very basic things, um, that our uni just supports us with. I mean, Above and beyond. I mean, support is support, but then to bring you your shopping because you've got nobody else because you're from the eastern states.
And studying here, I mean, that's pretty nice. .
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. And the thing is like, I mean, not too long ago, even here, like anything, if you don't fit a certain mold, you, you don't have the opportunity to even come into the school. Right. And then once you are in the school, like you have to try to, um, Stay put so that you don't like flunk out, but you don't realize, like you said, that not everybody's journey is the same, whether you are studying, you know, in Australia or you're studying in in Egypt, or whether you're studying in Brazil or, or in the us.
Like even in the US there's 50 states and they're in, even in Texas there's like eight, nine medical schools. And like you said, they each have their own unique culture. And way of doing things right, and so, I think at the end of the day, it doesn't matter where you study, like any physician that has gone through what you have to go through to like understands there's so many layers.
So you really have to be doing it for the right reason because like you said, the amount of work that goes into it, like I,
Mel C: it can, I tell people when people say I wanna do medicine and I know no. People used to tell me, other doctors used to tell me when I was trying to get in, they're like, run. Run far, far.
You know, I was earning $450 a day as a, as a substitute teacher, and I loved it. I loved it. And I still go during the holiday when we are on holidays, I go and pick up a few days. I used to finish at three o'clock. I had zero responsibilities. It was, I did a great job as a substitute. I just didn't do like coloring in games and stuff, like I worked hard with the.
It was easy. It was so easy. It was an easy job for me. I didn't have to think hard at all to to be a good teacher, and I was home by three, sometimes two 30, $450 a day, and. Why have I chosen this life, Diana? Why have I done this to myself? And I tell people there are easy at less you and I used to tell people I would do this job even if it only paid 30 grand a year for the rest of my life.
That's how much I want to do it now that I'm in med school. I'm a little bit, and I'm older and I know how much money means nowadays to, to survive well, but, um, I would, I still, I still love it. I still wanna do it, but I tell people, unless you are obsessed with it and it's your calling, do something else.
Yeah. Because it, I saw a sticker and it said, Medic, I'm a doctor or destroying my life to save your.
Dr. Diana Mercado-Marmarosh: Well, Well, this is why we want to do coaching because we have to change that model. We have to change the fact that we have been taught or brainwashed or whatever led to believe that. The patient is the most important person in the room.
Like it really has to begin with you are the most important person in the room because if your mind is right, then you show up so much better to take care of them because you've slept, because you're not angry, because you're not thinking of 10,000 other things that you being human need to think about.
And then you feel guilty that you didn't do X, Y, and Z, right? And so that's why it's so important to understand that. You do finish that. You can decide how you want to practice medicine. Maybe you wanna practice part-time, maybe you want to do that plus be like, uh, somebody who gives speeches or somebody who Exactly right.
You could do whatever. Right. Like
Mel C: that's the benefit. And that's what I like about it. Like, I could do anything after this. I don't have to practice, you know, I can do so much. I can just go back to the uni and teach. It's such a great job in, in that regard that it just opens. Opportunities everywhere. Look how many doctors go into politics.
Dr. Diana Mercado-Marmarosh: Exactly. Yeah. And so that's how then you, through your journey, even though, like you said, it was a very long one and painful one as you were going through it, like it's still opened so many doors for all those people behind you that you shown them that. Look what I did. If I was given the right opportunity, how many people could you give the right opportunity for me thereafter, Right?
And so, yeah, I mean, you don't realize probably how much of an impact you did for your school and for everybody around you and for the this Facebook group that you now have where you are fostering the possibility, right? Because we all need just a little bit of hope, a little bit of possibility of what
Mel C: if.
Yeah, I told one I remember last year after semester had finished. I went and picked up a couple of days relief at his high school and someone said something and uh, one of the kids said something and I said, Oh, don't worry, Miss Carlin has adhd. I said, Haven't I told you my story, boys and girls? And they all know that I'm in medical school.
And I told 'em the short version of my story and two girls came up to me and they were like, Oh wow, Miss Cull, I have dyslexia. And that was just so inspiring and I've been thinking that all my life, like I'm just gonna be stuck doing nothing because everything's really hard for me, but really inspired me.
And the other day, some kid cakes, um, somebody bumped into me. And they were like, Oh, I met you a couple of years ago and because of you, I did this, this, and this, and got the help that I, and I, and I fought for this and now I'm studying this. And I was like, Oh, that's awesome. Really. Like I really, um, you know, and even the other, again, the other day I went to get mask tested.
We have to get mass tested to get the right mask for when we were on placement. And the girl who was, uh, doing the masks, Testing the masks for everybody. She's got adhd, she's a nurse, she's trying to get into med school. Just from chatting. I spent an hour chatting with her and now she's just started med school, so, um, Or about to, about to.
Yeah. And, uh, she had no idea how to get her extra time, stuff like that. So, Yeah.
Dr. Diana Mercado-Marmarosh: So sharing your stories really does make a difference. Like it, they, they really do matter and they really do do that ripple effect, right? Other can feed themselves in you. So tell me, what do you hope to do in the next three years?
Like for
Mel C: fun In my personal life? Yeah. Ah, well, I dunno if you know, but I, uh, I'm an avid gardener. And I enter into competitions and stuff. And so I, this year I've neglected my garden. I've neglected all of that, so I really wanna get back into that next year. And I've also got a little YouTube channel where we go around filming all little, Cuz I'm Italian.
We go around filming all little Italian migrants in their garden. Um, and have quite a big following on that, so I'd love to do that. But the, the, the big thing that I wanna start doing, but again, it's a little bit tricky and even this, this, you know, I'm, I'm doing this with you, but this is even a bit risky for me because I think, Oh, somebody searches my name on YouTube, you know, But then I think, Oh, the chances of it are low could impact my job.
I always have to take that in consideration. But so next year or the year after, as soon as I qualify, what I really wanna do is I wanna make a series of videos, um, listing this sort of advice, giving these sorts of talks. Another one on depression anxiety, which I'm a big advocate for. So that's something I'm really looking forward to and dying to do.
I got little scripts written ready to go, but again, because of the stigma, I have to wait. I have to wait until I graduate. And get a job that's
Dr. Diana Mercado-Marmarosh: just around the corner Mel C: before I make, before I risk it. Do you know what I mean? Like that's how bad a society I have to wait to help people and plan it just in case impacts me.
But I am to that because I give these, I give this conversation and speech to so many people that. I'm getting tired of saying no over and over so I could refer to a video. So that's something that I really wanna do, an actual little project that, um, and start making these videos with little instructions.
Um, to help other people. So, but why don't you
Dr. Diana Mercado-Marmarosh: just start recording them cause they're fresh in your mind, but you don't have to release them or say like, you have ready when you're ready to go because you know, like you said, this is something that comes to you so easily, so might as well. Like
Mel C: That's a good point.
Yeah. Why am I waiting? Cause I'm gonna get older, so at least in the videos, I'll be three years younger.
Dr. Diana Mercado-Marmarosh: Hey, you never know. This could be like underground, like secret, like, you know, stuff that you could share with only your most pristi clients, right? .
Mel C: So, yeah, that's something I'm really looking forward to.
I'm really looking for. And also, once I graduate and I will be a doctor, then I have. That authority to make some of these comments. You know, I can go online and say, if you are depressed, you need to take your tablets every day. And these are some tablets that you could take. Like I could say that if I put my dad who's a pharmacist in the video, but I can't do it without someone of authority because what authority do I have as a medical student?
But then I think people go online and make videos to not take medications. But I guess I'm held under a different jurisdiction. Yeah,
Dr. Diana Mercado-Marmarosh: but you could say like medications work. You don't have to say which one you like. And you could say, and you could also say like, medications are one of the tools you can do X, Y, and Z.
Right. And at the end of the day, you're advocating for a better them. That's what you're advocating for. I,
Mel C: It's not, but again,
Dr. Diana Mercado-Marmarosh: yeah, all you're saying is. Look, what are you, what kind of life are you trying to get to? Like, whatever you've been doing, you need to up level those systems cuz they're not gonna get you there.
Like you're probably stuck in X, Y, and Z, which is normal. We all can get stuck. But the difference between somebody who stays there or he keeps moving is if they sometimes reach out for help. Mm-hmm. and, and that's it. Right? And, and then you can say, you know, And then later on you could be like, And I work here.
Come see me, .
Mel C: Yep. That's it. Yep.
Dr. Diana Mercado-Marmarosh: Start writing your book, girl, so you can sell your book. It's coming.
Okay, so where can people find you? What if they wanna send you an email or they wanna reach you to on your Facebook? Or where can they
Mel C: find. Uh, they can find me on that. Uh, our Facebook group, uh, which is doctors and medical students with adhd. Uh, we can always, uh, whack my email down somewhere if you want.
It's just melissa carlin hotmail.com. Uh, yeah. Or I suppose you could find me on Facebook. You could find me on Facebook. You can't miss it. Um, flick me a message. I'm very, I'm very, very happy to help anybody. I've got so many people who message me and often they just need a little instruction. Or who do I need to see at my uni?
Or my uni's giving me a hard time, or what do I need to say to get my time? Or, I'm worried about disclosing this. What should I do? Or, How do you,
Dr. Diana Mercado-Marmarosh: all those topics start doing you little videos like you said, so that you don't have to keep telling them over and over, you're like, Here's my link. Here's this link, here's this link.
And you know, you could, like you said, you have a YouTube channel, you can put 'em there and draft them, and then when you're, Yeah. Or you could give them the link to the private thing that only they can see if you're worried about
Mel C: X, Y, and Z. True. That's true. Yeah. Yeah.
Dr. Diana Mercado-Marmarosh: That's a good idea. So let's, So you know, we have a D and we have wondering attention.
So let's say somebody just zoomed back in right now and they're like, Oh, what is the takeaway point? What would the challenge from Mel C: is
ad is a gift. And a challenge that doesn't quite fit into this world, but can fit into this world. Um, and the biggest thing that I would tell anybody is do not give up. Do not waste your time, uh, arguing with the system and saying it should be like this. Society's not gonna change for you. You have to make it work for.
So forget about what it should be and work with what you've got. Make it work. Don't give up on your plans and your dreams. Know what your challenges are and what you need to to succeed in life. And then try and implement those things as much as you can. And when people try and make excuses to not give you what you need within reason, um, don't back down.
Because oftentimes these systems are just a bit lazy or they try to save money, um, and you just need to fight a little bit harder. Don't accept the first answer they give you if it, if it doesn't suit your needs, you need to succeed. Just as important as everybody. It's not a little bit more .
Dr. Diana Mercado-Marmarosh: Yes, there you have it.
You are just as important. Actually, no, you are the most important person. So you do need to advocate for yourself. And like I always say, ADHD is a gift, but you just have to know how to unwrap it because if you don't, it can get us into trouble. Like she said, we. Spend some money that we don't have or end up in jail using some types of stuff, but we shouldn't be on.
Cause your brain is asking you for dopamine, so important for you to advocate for yourself. And if the answer you get is not the one you wanted, what lesson did you learn so that you can go back and get what
Mel C: you need? And I think the other big important takeaway is you are not the only one you would not believe.
How many doctors have adhd? Walk into any ed department and you'll struggle to find someone without it.
Dr. Diana Mercado-Marmarosh: Yeah, and again, it's because we, we are following her path. I haven't met anybody who has ADHD that is doing something that is not in alignment with themselves. So that's why it's so important that you do you, like she said, and then let the rest happen as it's gonna
Mel C: happen.
Yep. That's it. That's it. Don't give up. Don't think you're unusual. Don't be ashamed. Don't be afraid of asking for. You're not the only one. It's just unfortunate that in this, uh, industry, people will keep it a little bit on the low down. Um, and hopefully you can contribute to just casually opening that window up and, and normalizing it.
Dr. Diana Mercado-Marmarosh: This is what this podcast is about, and this is why I'm like so passionate about, you know, going to speak up in private places but in public places, anywhere, so that people can see if they have a loved one or themselves that have something they can support you instead of, uh, hindering
Mel C: you. Yeah. And also I love to show people that this is the face of a d d.
Here are two doctors or our one nearly a doctor. This is the face of adhd. It's not the crazy kid on the couch, on the news jumping with a knife that you always see. We are just normal people who get a little bit distracted. Yeah.
Dr. Diana Mercado-Marmarosh: Who keeps things interesting? .
Mel C: Yeah. Like this is the face of D It is not a bad thing to have adhd.
It's not, you're not some weirdo, some troubled problem child. This is, this is normal. You are, you are just a normal, Well, I dunno if I'm normal, but
Dr. Diana Mercado-Marmarosh: extraordinary. .
Mel C: Yeah. It's uh, It's nothing to be ashamed of. It's a very common condition. And, uh, yeah, you are not, you're not, um, in some special category where you're on the outskirts of society or you're a weirdo or you're never gonna make it. I mean, I have five degrees, this is my fifth degree. So parents watching this, your child can do extraordinary things.
Just give them the support they.
Dr. Diana Mercado-Marmarosh: Exactly. Thank you so much for Well, thank you, Diana. Spend your time. As you know, time is our most valuable asset, and your story really does matter, and I really hope it inspires most of us who think, Oh, well, I'm gonna give after the first time. No, to keep trying. If this is.
In your path. Keep trying. Thank you. And ask for help because others, before you will tell you what worked and didn't work, but at the end of the day, you
Mel C: will figure it out. Yeah. Fight for, fight for what you want and once you accept that, you're gonna have to fight a little bit. Your life will be a a lot easier.
You just gotta stand on your ground and and go for it.
Dr. Diana Mercado-Marmarosh: Well thank you again so much for coming. Mel C: Thank you so much, dad. I really appreciate it. It's great fun.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast. Share with your colleagues and don't forget to check out my website@adhdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Tonya Caylor: Let them be wrong about you. That was a powerful statement that the first time I heard it was like, Oh wow, okay. Because it just, it gave me freedom to let go of the control because I think we get socialized in medicine to really. Perform and we want good grades. We want the a plus with extra credit when the gold Star.
And and that performance based approach really highlights we are caring what other people are thinking, and so it's not that we don't care. It's not like we wanna have a terrible reputation, but it's like giving up control and trusting that if you show up as your best self, your reputation is gonna be fine.
Hello.
Dr. Diana Mercado-Marmarosh: Hello. Welcome to Beyond adhd, a Physician's Perspective. I am Dr. Deanna Mecado Mage. I'm a family medicine physician practicing in rural. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life in the past.
Two years, I've come to realize that unlearning some of my beliefs and some of my habits, I'm excited to.
Hello. Hello. I am so excited today. I have a very special. And you won't believe it. She is in Alaska today. So it was fun getting our time zones to line up. And her name is Dr. Tanya Taylor, and she's a family medicine physician. And I have the pleasure and privilege of meeting her actually last year.
And it was a very cool. It was the Physician's Coaching Summit and we hit it off the very first night over our doors and some wine talking about how Covid has really led us all to come to an awakening that mental health is there and that we would probably all sub functioning, but now we've realized that.
We've put ourselves through unnecessary suffering, and she's actually on a mission to help educate residents and physicians and all the healthcare industry to be able to realize that, they have choices and they can make choices. And so I am so thrilled to have her here today, and she's gonna give us lots of good tips and share with us her journey.
So would you like to give us a little bit more information about you? If I missed. Yeah. Thank you
Dr. Tonya Caylor: so much for having me here, by the way. And I we really did. So I'm Tanya Taylor, family physician, academic physician coach up in Alaska, although I coach remotely throughout the lower 48. That's what, that's the term that we use out here.
And it was a great conversation because you and I, when we first met, realized that we had similar purposes and and you also had a very keen interest on. Academics, trainees who were struggling with ADHD and time blindness and those sort of things. And my passion has always been the residency level, academics and seeing that there were ways that you would be able to help that same population and with your expertise.
And it's an area that I love to coach in. And so it was a great conversation. I and we started like brainstorming. How could the people who follow and listen to me and the residents that I work with gain for those who have a d type tendencies or just time blindness or just want a little bit of a calm in the chaos.
And then me being able to talk to the followers that you have about. Ways to identify areas of unnecessary suffering and really begin to not only, survive, but flourish in their chosen careers. Yeah, that's how we got here. So thank you for having me. Yeah.
Dr. Diana Mercado-Marmarosh: So I'm so excited about this particular topic because I, I think that we don't realize that we are just future of habit, right?
And sometimes, We think we have the most efficient systems. . Yeah. But we realize that some of those systems actually might need to be upgraded because some of the underlying beliefs, or they're old software, they need to be updated. And we don't realize that, some of the, because we haven't questioned some of those things like that we ourselves, Adding to the suffering that we were sharing with everybody else.
And we don't realize that, we have choices. So today I think I wanna hear your experience. What have you seen in helping residents is there anything that stands out to you? That, maybe to them is not obvious, but to you, because now you have this expertise and you're able to see it from a detached lens and you're not in it with them per se.
You have the ability to hold space and help them see that maybe some of those things that they're doing are, are not really true, and their brain is telling them that. Yeah, I think that's,
Dr. Tonya Caylor: I kinda, you hit the nail on the head there with that description because not just residents but faculty and all attendings and whether they struggle with a d type tendencies or not.
We do have these habits and we have these ingrained thought patterns. That don't service well. So one of the largest areas of taking back like decreasing unnecessary suffering is actually our mindset. And I know there's probably, I think. Somebody has looked at the stressors in medicine and about 80% are systems issues.
And thankfully there are people now who are actively trying to improve the systems. But that 20% that we can control, a large percentage of that is a mindset and it can give you great relief just by that. So there's a few things there. One is identifying. I think just starting with the basics of when you find yourself frustrated, stepping back and looking at what are the actual facts, like not the story you have about the facts, but what are the actual facts?
Because we have these ingrained thought patterns that go and jump right onto different assumptions or put together stories that add to our previous stories that may or may. Tell the whole picture. And so just separating out facts and that I like to say it's a fact if you remove the adjectives, you remove any assumptions, you remove any loaded words, you remove any judgments.
Now, there's nothing wrong with those things, but for the sake of getting some clarity, when you take those things out and that is what you know, that by itself. Realize that you usually have a story and those stories about those, that circumstance, that set of facts is usually what leads you to the unpleasant emotions.
Now, this isn't about toxic positivity. You're not gonna look at a pediatric abuse case and somehow will yourself to, find the silver lining. This is just about. When you look at what you're thinking, how's it serving you? I think that is like an powerful thing and it takes some time.
And this is why you and I love coaching is because it sounds like an easy concept, but there's so many nuances that our brains really are attached to the stories we tell. And so that's where coaching really comes in handy to help you see what you're creating in your experience by. Not taking the time.
Once you have those automatic thoughts pop up to really looking at what you. That,
Dr. Diana Mercado-Marmarosh: That's so important. One of the modules that I coach in my group is self coaching and self care, and I purposely put both of them in the same class because, They both seem very foreign to us. .
Dr. Tonya Caylor: Yes.
Dr. Diana Mercado-Marmarosh: And like we have no problem, like self-sacrificing for our patients, for our family, for whatever. Even for the neighbor or for the people we haven't even met. Like we're Okay. Like busy, whatever we had going on. And it's so interesting that I walk them on how to do self coaching. And they're in awe when I tell them, Okay, only circle the.
They're like, There's no facts there. I'm like, I know. Isn't that thought ?
Dr. Tonya Caylor: It's so true. .
Dr. Diana Mercado-Marmarosh: And then we go through what they think are a fact, like I'm too slow or I'm always late. Or nobody loves me whatever your brain has told you like thousand times, right? , and you never question it.
And then I'm like, Okay, in comparison to whom? , , all 12 people in the court of law would have to say yes. Yeah. You were like 1, 2, 2 minutes late or whatever. And so it's interesting. Like what our brain offers because it's trying to protect us always. It's always trying to make sure that we don't look like a fool or whatever.
Like it's always trying to protect us. But sages us too, because it's no dramatic . Exactly.
Dr. Tonya Caylor: No, and I think it's really true, right? So when you think I had too many patients today, and that seems very real and you could probably argue that. Half an hour, but just getting like concrete, like what are the facts?
Okay. I had 14 patients in a half day, okay? There are a lot of physicians who would say, Wow, that is a lot. And there are a few physicians out there be like, Oh, that's all on a day's work, right? A fact is one that everybody would agree with. And so yes, 14 patients, we could argue that. But when you think there are too many patients on my schedule, what, When you check in with yourself, what emotion does that bring up?
And once you realize what that emotion is, what do you do out of that emotion that actually helps you see those 14 patients? Because most of what you. Is not serving you well when it's coming from that emotion. And and so when you say, Okay, I have 14 patients and a half day, what might somebody else think about that?
Or what is a different perspective? And even, it doesn't even have to be something positive. It can be like I'm gonna do the best I can. Just that is going to like decrease that amplified limbic system where you're amygdalas all ramped up and help you to settle in and get started in a way that serves you in those 14 patients best.
Yeah. So yeah, I think that's one. And I love that you you started in on my, one of my second points. And I, this is kind. Like maybe some unnecessary suffering, but I like to think of it as like how we protect and rebuild our energy and rebuilding our energy goes along with what you were talking about as self-care and When I give a, I have this talk that I give to physicians about time management efficiency, and I have a slide in that talks about prioritizing your downtime.
Number one, everybody's first reaction is what? Downtime. And then the second is what is that even doing here in a time management efficiency talk? And so it gives me the opportunity to, number one, tell them there is going to never be down. If you do not prioritize it, it needs to go on your schedule first.
It doesn't, it's not the thing that falls off at the end of the day if you don't get through the other check boxes. And so by learning, and that's very uncomfortable when you first start doing it, but learning to do that and you are you're refreshed and be by being refreshed, you're gonna be more effective, more efficient, and more present.
With what you're doing. And so in the end it is incredible efficiency and time management step. So I love that you brought that up. Yeah.
Dr. Diana Mercado-Marmarosh: Before we started hitting record, we were having a conversation and you asked me, How do you do everything? How are you? The secret. It's not a secret cause I tell everybody to do it.
But you just said you have to prioritize yourself. I had to decide that Thursdays I was gonna have a day off. Thursday was CEO day. I was gonna meet with the CEO all day. That's me. come to CEO all my life. Like I get to decide who I talked to. And it took me a while to realize that planning.
Really was important. And I don't mean planning where you have to put everything every 15 minutes. I don't mean that. I mean like the big things that you really don't want to miss. Like you don't wanna miss a doctor's appointment, you don't wanna miss your kid's recital. You don't wanna miss like what time you have to be at the airport, right?
Like the things that you really don't wanna miss, you wanna put and. I know usually when I say schedule your fun first, they look at me like I'm crazy. What you just said, right? What? Self care, what time For myself. But the thing is if you don't prioritize it, nobody's gonna be like, Oh my God, Dr.
You look so tired. Let's get you a day. Like, how many of us have Like probably needing to be in the emergency room ourselves. And we're still like over there trying to see patients. And it's so important that you realize you're human first and that as a human check with yourself.
What would any normal human be like? Would they like. Not call in because their kid is sick, or would they call in because their kid is sick? And we like guilt ourselves. We're like, No, but we're super human. And that's where I think people don't realize that. I'm not asking you to be super human, I'm just asking you to be human and that's okay.
Dr. Tonya Caylor: Yeah. I, as I'm listening to you just reflecting that I think this generation of medical trainees are a bit ahead of us where we were at that stage, right? Because most of them are now recognizing the fact that's not the life they wanna create, where they just go. And they want to intentionally build in.
This balance for lack of a better word, I like the word harmony, but they wanna have that built in and yet they're running up. The rub is that the medical culture is slow to change, and that's not just the attitudes of those of us who've gone before them, but it's also the systems that need to be in.
To allow that to happen. And again, that goes back to systems. And I am not a systems person. I'm a individual. I love working with individuals or small groups, but I do believe there's a lot of room and I really am hopeful that this generation of trainees will be able to take on that mantle of crafting the culture of medicine in a way.
They're still loving their job and giving to their patients, and they're doing in a way that doesn't mean they have to neglect everything outside of work. And so yeah, so I love that. Another thought I was, the other thing I like to really talk about in a manner of protect, protecting your energy so you can really enjoy and flourish.
Choosing service over people pleasing because I, there are a lot of altruism comes through in medical trainees and it's a beautiful thing, and then there's that piece of it that crosses over a line and it stops coming from a place of service that, that internal motivation. Like that's renewing, right?
It just, it's energizing when you're working from that place if it's what is driving you. But when you cross over to that, people pleasing, that is when you're doing it. And because you want them to be happy, you want to make sure they're not disappointed and you stop doing it from that service. That is draining.
It drains your energy. It leads to a lot of resentment, and so tapping back into. What your bandwidth is, what is coming from a place of authentic service? And what is you trying to co control other people's emotions and what other people think about you? Because you know what, that's what goes on in their mind is their business, right?
And you showing up as your best self, it doesn't mean that you have to be selfish and could care less about people and callous. But you're gonna be your best self when you're working out of that authentic service piece instead of that people pleasing piece.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important that you just said that because I think that was one of my aha moments that finally freed me up to really be me and embrace me because I'm not sure if you're aware or not, but people with adhd.
We, we don't take rejection well sometimes we have this thing that is called rejection sensitivity in phobia. And while of course nobody likes to be rejected, We'll just put it like that. But for us, it's almost like they're burning us. It's like we take it to the extreme and it lingers and it, because we all, I don't know, we all already self sabotage with some of the thoughts that we have, but this takes it to the 10,000 level.
And so we, I figured out from an early age, That if I was just not too loud, if I was just not too crazy, if I just got good grades like then I think I was people breathing because that's what told me that was gonna get me ahead. And I didn't realize that I was not just that and of course I did always want to be a leader and provide service, but I noticed that I was very, what's the word, Adaptable.
And so I could. But at some point you adapt so much that you're masking and you use sight of yourself. And like you said you cross a line that you didn't realize you're crossing. All of a sudden you're triple . All of a sudden I'm like, okay I know I asked for time not to pump. Like I can't be pumping in the patient's room.
Like, why do you have And so it cause us a line because you don't wanna say no, but at the same time, You still need to eat. You still need to be okay. And this is one of the things that we don't realize that like you just said If you go and give all your 140 at work and then come home, you drink, like you don't have that extra energy.
Why are we going to work to take care of her families, right? Like financially emotionally, all that, right? But then we come home and you're like at negative like 200, and then you're irritable and moody with them, right? And you don't realize. Them over there, you were people weasy. But then over here at home, you're not even people.
Weasy, you don't even care anymore cause you're so tired. And then it's it's so funny because I remember they would describe things to my husband and my husband be like talking to her about the same person. She's not that nice at home sometimes. And it's funny how you then have to realize, Okay, I'm gonna come and serve because this feels.
But I'm not here to self-sacrifice because if I self-sacrifice, then it is not gonna work out because you're only gonna get me at 20% instead of getting me at 90%, right? Because I said yes to something that really didn't want to, but I said yes because I felt like you asked me to and so we don't realize.
That sometimes we do have to say no, because I know that nobody wants us to be perceived as, Oh my God, the difficult one. But sometimes it's not worth the energy to try to convince anybody of any of anything. If you know you and you know your why, like it's okay. Let them be wrong about you.
You, you know why you're doing it. . And then like you said, you show up as yourself. And the moment that I learned that I wasn't responsible for my husband's happiness or my patient's happiness, but all I could do was control my own happiness. I was like, Oh, light bulb. I don't have to go and do things for others.
If it happens, great, I would love to provide joy for you, but it's not my responsibility, like it's
Dr. Tonya Caylor: so free. Yeah, it's definitely freeing to realize that I like what you said let them be wrong about you. That was a powerful statement that the first time I heard it was like, Oh, wow, okay.
Because it just, it gave me freedom to let go of the control because I think we get socialized in medicine to really. Perform and we want good grades. We want the a plus with extra credit when the gold Star. And and that performance based approach really highlights we are caring what other people are thinking. And so it's not that we don't care. It's not like we wanna have a terrible reputation, but it's like giving up control and trusting that if you show up as your best self, your reputation is gonna be fine. And if somebody disagrees, they can be wrong about you.
So empowering.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. And I remember that when I had that shift, it was such a lightning thing because it's always one or two patients that are Coughing and ruckus, right? And you're trying to please one or two patients that are like draining the energy out of you. And I'm like, all the other 80 or 90 people that I saw this week didn't say a thing.
They actually said, Thank you. So why am I worried about those two, three people ? And so our brain, and this is something I always tell people, like I purposely ask them, To begin the class and end the class with their takeaways but their wins for the week. And you'd be surprised how hard it is for them to practice that skill because they think it was just luck that made it happen.
Dr. Tonya Caylor: like you, it's too true. I didn't have that
Dr. Diana Mercado-Marmarosh: meditation and that's why I closed my notes. No that's not why you closed your notes. You close your notes cuz you're now following a system. Let's talk about your system .
Dr. Tonya Caylor: It's so true. Like dismissing the positives is such a common great, and it's really interesting cause I do the same as a lot of times I'll challenge the physicians I'm working with to what is going well, or, Hey, that was a win.
Did you celebrate it? Or, What do you love most about this? And they'll say and they'll think really hard and they'll gimme something. And then there's. They do this, but they blah, . Cause we have that built in negativity bias that is just common to humans, right? That really ramps up when we're under a lot of challenging situations and can become a habit back to that, bring it full circle back to that habit of how we think through things.
And so I love that you and I approach that similarly in trying to point their brains in a direction that's gonna serve them even better.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah, I think we all eventually reached those awareness because we didn't even realize we were causing self harm to each other because we I remember the first time I heard somebody say, If you are not practicing self care, you're in self neglect.
And I was like, Whoa, . That was wrong statement and chill there. But then I thought about it and I.
Dr. Tonya Caylor: Yeah, actually right,
Dr. Diana Mercado-Marmarosh: like if I'm not prioritizing myself, like I'm choosing to think that it's okay for me not to like, see myself as somebody who needs certain things and desire certain things.
And most of us, like when we've done surveys like. We just wanna know that we mattered and that, we're accepted. But I think that it begins with you. If you think you matter and you think you're accepted, then like everything else follows. Yeah. That's so good. Perfect. Yeah. So tell me, I'm pretty sure you're gonna have everybody wondering where could we find this big for my residents this amazing, Where can they find.
Dr. Tonya Caylor: Thank you so yes, Anybody, If you know anyone that is, works at a family medicine residency cuz I partner with residency programs and individuals within there to work with both faculty and residents. They can find me at Joy and family medicine.com. I'm also on Facebook at Joanne Family Medicine Coaching and on LinkedIn as Tanya Taylor.
And yeah, so refer any of those to me that might want to have an external coach create a safe space to be able to have these kind of conversations and unpack both individually in a group. I would love to talk with them and see how we could partner together. Yeah. So thank you again,
Dr. Diana Mercado-Marmarosh: Diana. Yeah.
Yeah. And we were talking offline before we started that it, it's so important to show up and ask questions because when we don't show up and ask questions it can lead us into a way where we end up in legal trouble sometimes. We're not doing chart, we're not doing something right.
And. It's so important to set up like environments such as what you have for residents to be able to come and talk freely without feeling like they're gonna be put in the spotlight and they're gonna be bluster and they're gonna be told that they're the bad resident or something. Right?
Because many times it could be that they're doing the best that they can, they just don't have the correct systems in place for them, right? And Please reach out to her and don't let it be a thing. Okay, . All right, great. I always ask everybody what they see themselves doing for fun in the next three to five years.
Where do you see, you're in Alaska now. I don't know. Are you gonna come to the States or are you just gonna go all over Europe or what are you gonna be up to?
Dr. Tonya Caylor: Yeah. I have a few ideas. I think one is, I'm just gonna say that I really enjoy the coaching job. So that will still be that's in my ideal three to five year future.
Also traveling with my husband. We love to travel and I have two little grands. They are three and five and within that timeframe, probably being closer to them so I can spend more time as they're growing up. Thanks for asking. I'm super
Dr. Diana Mercado-Marmarosh: excited about all of that. As some of the physicians that are hearing my podcast have ADHD and sometimes have wondering attention.
So if they zoom out and now they're back and they're ready to hear the takeaway message, what would it be for today? I think
Dr. Tonya Caylor: the takeaway today is that they likely have a lot more control of how their brain works than they've been led to believe, and by doing some mindset work, as unsexy as that sounds, it really can give you the power to enjoy the day to day, despite the circumstances.
Dr. Diana Mercado-Marmarosh: Yes. So there you have it. She gave you the key really. Think about your thoughts and then set up a community that helps you to unwind some of those thoughts and you know it doesn't matter. Use all the resources. Go talk to a therapist. Go talk to a psychiatrist. Go talk to a coach. Go join a dance class.
Go paint. Go do something for you that's gonna improve your self care, and that is going to help you get you to where you're going. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website at ADHD Live Coach dot.
Where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Diana Mercado-Marmarosh: Hello? Hello. Welcome to beyond ADHD, a physician's perspective. I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to meet both in my work and in my personal lives.
In the past two years, I've come to realize. That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills. Hello.
I am so excited to be with you guys today, but he's been.
Before, I'm actually gonna start a group coaching program in October. It's gonna be on Thursdays at noon central, and it's gonna be for all the healthcare professionals. So that means like the nurses, physical physician assistant. And that means nurse practi.
And pharmacists and dentist, anybody who can benefit from being able to practice medicine in a team setting. And doing such that will free up their time as well as their energy and be able to develop tools and techniques to help them with emotional dysregulation and effective executive function techniques.
I am so thrilled to announce this new group that I'm gonna be happy. So I wanted you to hear about it today. And before that I want invite you free masterclass. That I'm gonna be on September the first at. 30 central PM. So please go over to my website, ADHD, live coach.com to register for that. If you're not able to come live you can obtain it in the replay the next day.
So that way you can still the one hour CME credit by listening to it and the topic.
Masterclass is going to be how there's certain tasks that we all have to do and why not get the in basket to zero without it being a pain in a career. So I hope you're able to come. And if you know anybody in your team who might like an amazing nurse practitioner or physician assistant, Or from this pharmacist, send them my way.
I am so excited to be able to provide this service to them as well. Okay. So today's talk is going to be about the four A's, the four A's that will
Awareness get freedom of time. Okay. And so for me, the awareness acceptance action and alignment are the four A's that I want you to think about. So any time we have to do any tasks, if you can apply these four A's, you're gonna save yourself a lot of time, a lot of headache, a lot of frustration and you can apply really in anything.
To me, I
apply it to my everyday life. Like I take it with a grain of salt. I realize that awareness is the first step. If we didn't know that there was something that could be done better, then obviously we wouldn't be worried about it. And so when you don't know what you don't know, it keeps us.
From growing and learning. And so awareness that what if there is a better way for me is so critical acceptance so the acceptance that things might be boring, that things might be hard that things don't have to be the way they are, might be that thing that you need in order to keep moving forward.
Action. You have to do something. Anything to disrupt the current habits that you have, because if you keep doing the same thing that you've been doing every single day, because our bodies in our mind want to preserve energy and we are in autopilot and don't question little, disrupt the system, then we're gonna keep getting the same result.
If you want to get something different, if you're not liking what you've been obtaining and you want something different, if you're tired of pajama chart, if you're tired of not having enough time for your family, if you're tired of not having enough money in your bank account, you need to take action to change.
Your result so that you don't keep living in the same past present reality. And so how do you do that? you go back to the first three, you have to become aware that something has to change you then have to accept that. Yes, you do have a choice. Yes. You get to decide that you are worth.
Putting in the work to get to whatever version of yourself that you want, and then you take action towards it. And guess what? In order for that to happen, you have to be in alignment. Like your mind has to be in alignment with your heart. I know it sounds weird, but again, if you know why you're doing certain.
Okay. I wanna lose weight because I wanna be able to like, see my daughter graduate. And I feel like if I lose weight, I am gonna be able to prevent a heart attack or I'm gonna live longer. I'm gonna decrease my chances of cancer. Then that tells you like the why you're doing something. And so then when you're doing every action.
Towards that you asked yourself, is this action that I'm about to do? Is it an alignment with the goal that I'm trying to accomplish? Yes or no? If it is a yes, then go for it. If it's a no, then ask yourself okay, do I really need to do X, Y, and Z at this moment? And then with all of that, you have to be willing to.
Do it messy to do it. I perfect because whatever we've been doing has gotten us here, but the next version of us, that's gonna get us there. Needs to believe that you can do it. And I know right now you're probably thinking I don't know. I haven't been able to do it and that's okay. You can believe that, but guess what?
I'm here to help you. I'm gonna hold the belief for you. And I wanna hear from you. I want you to apply this awareness. Acceptance action. And then alignment. And I want you to email me tag me on social media, either on my TikTok on Instagram. And tell me how you applied this and how this worked for you, whether it's for inbox zero, that you came to my master class, whether it's that you're signing out for my.
12 week healthcare professional course, that's gonna give you CME and transform your life. Let know how things go. And I can't wait to hear the amazing things that you're gonna do because you chose you. You chose to have an awareness you chose to accept this task and you are taking action that is gonna align you with the goals that you want long term.
Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, share with your colleagues. And don't forget to check out my website at ADHD. Live coach.com, where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are gonna happen.
Cassandra Lopez: If you're not happy somewhere, or you wanna do something, don't stay there just because you don't know how you may make me and means meet your needs or different things like that. Just take the risk and. Very proud that I did. And look what has happened after that.
Dr. Diana Mercado-Marmarosh: So, hello. Hello. Welcome to beyond ADHD.
A physician's perspective. I am Dr. Deanna mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered. ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize.
That I'm learning some of my beliefs and some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited today. Um, as some of you might have already heard, I am in a transition state a little bit, and I am starting, uh, here shortly, uh, in October. A new group.
Um, well new in the sense that it's gonna be a healthcare professional group. So it's super exciting. So I'm opening the doors for, um, you know, if you're a nurse, if you are, um, nurse practitioner, a dentist, chiropractor, anybody who used pharmacist, um, Anybody who uses, um, CME credits to come and learn how to use tools to regulate your emotional dysregulation and executive function so that you can leave work at work as the healthcare team.
Um, it's. Then everybody wins. So today I have a very, very special guest with me, very, very a dear friend and, uh, coworker. And, um, so I can't wait to share her story and I will also let her share her story, but today's topic is about how it's so important to be intuitive. And it's so important to look around.
And see if you can find a gap in healthcare and how you can spin it to help you get financial freedom. So my guest today is Cassandra Lopez and. She is gonna share her story with you. But, um, she was working at a nursing home since 2014 and now has her own, you heard it, her own, uh, company that she founded and it's called, uh, beloved community care.
And, uh, she's gonna tell us about it. So please, Cassandra, tell us, um, How, how did you know you had D and like, tell us about what you're up to now.
Cassandra Lopez: Um, hello. Um, thanks for having me, Dr. Medo. Um, my name's Cassandra and I really didn't know I had ADHD at first. Um, didn't know really what it was growing up.
You know, it has the stigma to it and you see some kids taking ADHD medicine and it's because they're labor labeled. So I never, I didn't struggle through through school. I didn't really know anything about it until I was an adult. And I remember going to Dr. Mecado and not really know what was going on.
I was, I would forget things if I didn't write 'em down. And I remember I forgot to. And a very important bill that I couldn't set on auto pay cuz they didn't have it available. And I was like, what the heck? I forgot to, I forget to pay my bills. My what about bills got cut off? Like, I don't know what's going on.
So I kind of filled out a questionnaire and all the symptoms were there and then I got the diagnosis and it it's been helping. So. So
tell
Dr. Diana Mercado-Marmarosh: me, tell me, what was it like when you got the diagnosis? Like, were you relieved? Were you surprised? Were you shocked? Were you like, oh, thank God. Finally. There's something here that thought it was just me.
Like everybody has a different take to it. What was yours? Um,
Cassandra Lopez: I think I was kind of like shocked because like I said, in the beginning, You just have this stigma, stigma of ADHD and different things, but you as a friend and a doctor, I really trust you. So I was, I was off for it. I was ready to know the things that can help me and everything kind of makes sense.
Um, I could look at somebody and people would think I'm rude or not paying attention, but I could literally be staring at somebody they're talking to me. And I have no idea what they're saying or my mind is somewhere else. Or, and that's just things that I thought that were just me. But coming to find out.
You know, there was a name for it and you could get help for it. So,
Dr. Diana Mercado-Marmarosh: yeah. And what do you think has been the most helpful? I mean, everybody is different, right. But like, do you think taking meds has been helpful? Do you think reading or learning about different techniques online or exercising? Like what, what do you think has been helpful now that you have the
Cassandra Lopez: diagnosis?
Um, I think it's just a combination of everything. Um, my medication does help, but also. Just being more of aware of things and learning how to slow yourself down and write things down and plan more and, um, know that there's, you have to tell yourself there's only like a right now and not right now. So if it's not right now, you need to write it down, cuz you are gonna forget.
It's just so just learning different things that you can help, uh, use to help your everyday life. And it doesn't feel like you're just going in circles and circles, all the.
Dr. Diana Mercado-Marmarosh: So would you tell our listeners where you and I met?
Cassandra Lopez: So we met at a nursing home where we both worked. So, um, she was the medical director there.
I was one of the nurses there and that's how we met and developed our relationship in friendship. And I knew I liked her from the very beginning cuz she, I didn't know, she had ADHD at that point, but I just knew that she had. Clear boundaries. She, she kind of, I mean, she was very helpful. She was compassionate.
So that's where we worked and very knowledgeable. So I kind of went to her for everything. So I built my trust with her and that's when I got my diagnosis. So I just, it was a,
Dr. Diana Mercado-Marmarosh: but I mean, the point that I'm asking is that, you know, in healthcare, I think that when you're passionate about what you're doing, you're gonna do it.
And like you said, you said boundaries and all that. But your, your soul shines through, right? Like that, that's where you're drawn to be of service to others. I think people sometimes think that the healthcare, um, is, oh, there's the big bugs there. Right. But we all quickly see that the big bugs are really going to the pharmaceutical companies they're to somebody else.
And it's not necessarily the physician or the nurse, um, that is there. Right. But. As you were working in the healthcare. Especially, as you were working in the nursing home, what did you like about it? What were you drawn to it? What didn't you like about it? And what
Cassandra Lopez: did you do about it? So, um, I think what I liked about it was just being able to serve, um, the community and.
We're in a small knit community. So you kind of knew your residents and different people there. And also learning. I learned a lot, um, from making rounds with doctors and, um, nurse practitioners and different things like that. But I also knew I wasn't a hundred percent happy. Um, I knew that I was, it was kind of like a eight to five sometime, but you on call and I had an office job where I was sitting a lot and just very.
I'm not really good at small details. So I would like forget to check my emails and stuff sometimes. So it was just, I knew I wasn't, that's not where I always wanted to be, but in my position, I also see that there was a need that a lot of people do go to the nursing home prematurely solely because they don't have, um, they don't have someone at home to care for them, or it's too too much for a loved one to be a caretaker.
So I just kind of took that in and. Created idea. And that's when we decided to start beloved community care. And that's when we, we have a home care agency that goes and takes care of the loved one in their home, or could be in the facility if they just want extra eyes on their family
Dr. Diana Mercado-Marmarosh: member. So tell me, how is it that it's unique and you put your, your spin because it's not home home health, right.
And it's not, like you said, a nursing home. It's not a living facility. How did you come up with the idea, your idea, like, because that's important because people with ADHD don't realize that we are outside the box stinkers and that just because you don't see it, there doesn't mean it wouldn't be an amazing idea and you took off and ran
Cassandra Lopez: with it.
Right. So I, um, I just, in the nurse home, you see a lot of the care comes from the CNAs and. Those people, the nurses are there too. They pass medication, they do treatments, but, and there's a lot of paperwork. Everybody knows in charting that goes with that. But the CNA or the person on the floor, that's, who's given the direct care.
And to me that's most the most important care. So me knowing that I can run a business like that in higher CNAs on my own and in care. I just took it and ran with it. I knew I didn't wanna be a home health because a home health does offer that skill need and the nurses and the physical therapy and different things like that.
But they're in and out to do their skill need, which is needed, but there's no one there to actually take the time and care for your loved one and give them the, you know, the extra care that they do need. So I just found that. Ran with
Dr. Diana Mercado-Marmarosh: it. Were you ever like scared? Like, oh my God, like, I don't know what I'm doing.
Like, well, should I even do this? Is it maybe it's better that I just go to an H five job, like you said, there's more security there. Like what, what were your thoughts that you were having as you were trying to establish this? Um,
Cassandra Lopez: well, when I first thought of the idea, I. I do have a business partner, so I called him up and, um, we talked about it and he, he was just like, give me a little while, let me think about it or something.
I don't know exactly what he said, but. He's not diagnosed and I can't diagnose, but he has an ADHD brain. Let me just say that so, so he can think pretty, pretty good too. So, um, we were like, okay, we're gonna go and just run, run with it. But the more research we did, we found out we had to be licensed through this state of Texas and have a survey and just all these policies that we have to come up with.
So at that point I was like, I wasn't discouraged. Cause I know I. I usually try to real hard to get what I want. So it was just kind of like maybe a speed bump. And I think I probably called you a few times and you never discouraged me. You were just think, you know, always think big. And so we just did our research and got, did what we need to get our license and, um, licensed through the state of Texas and different things like that.
So I think at that point I was, it made me kind of made me think a little bit. Is this what I really wanna do? This is gonna be maybe. Too many steps, but it wasn't, we just kept taking one step at a time, one step at a time. And we probably got it done in about four months. And that's pretty amazing when we, what we hear from other people.
Dr. Diana Mercado-Marmarosh: Yeah. So I really like that you share that, that you knew that there was gonna be some steps and you kept looking it. And looking it up and looking it up and you never gave up. And like, I think most of us want stuff like, you know, order it today. I get it tomorrow, like from Amazon. Right, right, right. But we forget that when we are really answering a calling, like for you, this was your way to, um, fill in that gap.
That was not being taken care of at the nursing home, or could not be taken care of a swing bed program or could not be taken care of at the hospital and like, or home health, you found the unique way to do it, but you kept being curious instead of being afraid, you kept stepping into curiosity and of course, Anybody will be lying to you if they pretend like we're not all scared at one point or nervous or worried.
Right. But we realize that that's not gonna really get us to where we're trying to be. So it's so good to just step into like, okay, well, I did that part. Let me do the little next part, the next part, the next part. So, um, I'm listening to a book right now. Um, eat that frog and. Like most of us are not like, oh, I can't wait to go eat a frog.
Right. mm-hmm but the concept is that if we start our day with the things that are like the most important, that could really make a difference. So like for you, it was filling in that paperwork, like, uh, establishing an LC, uh, uh, look looking through those licenses, like everything that you needed, getting a loan, getting a location, getting all that and having like a bigger vision.
Then, like the loan you just took off and you're like, oh my God, I'm in debt. Right? Like most of us wanna shut down at that part. Right. But you knew that you had a bigger dream and you just kept focusing on who you were gonna help. I know you and I had multiple conversations about like, well, who's your ideal client, right?
Like, who are you trying to help? And the more that we know who we're trying to. The easier it is for us to show up. Right. Right. And, and, and it's so good that you, if you didn't know something, I think this is the ADHD us, you just ask who else does know or who might know, or what training can I go do? Or what else can I do?
Right. Because it's in that faith, when you are doing that. You don't realize that you look back and you're like, oh my God, I made a lot of progress in four months. I got this thing up and up and running. Okay. So how long have you been doing what you're currently doing? Tell us, tell us all the things.
Cassandra Lopez: So our year was, so it's been a year, so it's been, um, our year was in the end of August, I believe.
So it's been a year, a little over a year, so, and it's been. I wouldn't lie and say, there hasn't been small headaches, but they, there, there has been, but it's very, um, it has allowed some freedom that I didn't have before. Um, and we're just continuing to grow. So,
Dr. Diana Mercado-Marmarosh: so tell us freedom of time, freedom of money, freedom of what your, your own loss.
Cassandra Lopez: Tell me, yeah. Being your own boss is, um, definitely different. So I like. I don't think I don't ever plan on working nine to five again. So I keep that in my mind, uh, to keep going, cuz I know that's not where I wanna be again. So freedom of time, freedom of money. Um, and the most important is time though. So you can, I do have time to be with family and not always have to work all the time or have to explain to somebody why I have to leave early or take a quick break to be.
My family or something for my child. So that's, that's probably the best thing. Do you have people working with you? Yes, I do have people working with me. We have about 25 employees. So that's also another thing that I do. Like, um, it's just a blessing to be able to provide employment for. For people and help.
And we have sponsored a few sporting events and uniforms for our community. So giving back to the community is also a good thing.
Dr. Diana Mercado-Marmarosh: That's amazing. Right? Like, so the growth that you've had, that not only okay, now me and my partner are like, thinking about this idea, but this idea. So to say. And then you provide employment for 25 other people.
Like how amazing is that? Just because you decided to take a chance and decided that you were worth the opportunity to something better to provide a service. Right? Right. Yeah. Isn't that just like amazing. Yes. Ma'am. Okay. So, so what are some tools that have allowed you to like keep going? Um,
Cassandra Lopez: probably to always remind myself that you are worthy.
I know a lot of people think that they're not worth some of the things that they see come in their way, or they're not allowed to live a certain lifestyle or want certain things. So kind of remind, remind myself that and some different podcasts than, um, books to. and also planning. I think I would learn that from you, so to kind of plan and set boundaries that that kind of keeps me going.
So I have a planner and with my ADHD, I know that I have to have it on. Of actual planner, not on my phone, cuz if it's on my phone, I might pick it up and play a game or do something instead of looking at my calendar. So, um, just planning is a good thing. So I try to write everything down if it's not on my, uh, calendar for the day or if it's not an emergency, I don't add it because I just, you need to have time for yourself.
And so just that's one of the main things that I think is having a planner and sticking to the plan. Okay. And if you don't know something. Ask somebody and you don't have to know everything. There's somebody who is like my business partner, he's financial business, he know everything. So I don't have to worry about learning all of that.
You. Partner with somebody and reach out and have resources to help.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important to realize that you don't have to be all the things you just have to realize. What are the things that you can do only you can do? Or what are your zone of genius or what is what you're passionate about? And do more of that and then whatever still needs to get done.
Who can you delegate that can actually do it right?
Cassandra Lopez: right.
Dr. Diana Mercado-Marmarosh: Okay. So, um, I know, you know, um, uh, I've seen you grown as a person. I it's been a humbling experience and I seen you make decisions, uh, for the betterment of yourself and your emotional health and your mental health and your physical health. Um, What is one of the things that you think you're one of like proudest stuff in the last three years or the last four years that you see yourself now as a different person, because you've been able to accomplish
Cassandra Lopez: it?
Um, I would think just probably being able to let go of my full-time job. I think that's, uh, a lot of people think that they have to stay somewhere that they're either not happy with, or maybe getting mistreated or different things like that. Just. It's where you get your main income from or different things like that.
But really when you take the risk and just do what you need or what's on your heart, um, you might be scared, but it's definitely worth it. So that's probably the main thing I would say, if you're not happy somewhere or you wanna do something, don't stay there just because you don't know how you may make meet means, meet your needs or different things like that.
Just take the risk and. Very proud that I did. And look what has happened after that. So,
Dr. Diana Mercado-Marmarosh: yeah. So, um, it's crazy how the universe just sends you messages. Right? So this morning during my meditation, um, I was in a meditation group with other physicians this morning. Uh, the leader was talking about, um, the law of intention and desire, and she was talking about how.
Like, whatever your soul is, journeying, like what it wants, like you can accomplish it. That's why journeying it. Like you wouldn't be desiring it if you weren't worthy or you weren't already on a path to receive it. Right. And so it's so interesting that. Like you just said, if you desire something bigger, something, not just your eight to five, not just like, okay, this is okay, but it's not great.
Like we only get one shot at life. Right. So why not like do it with something that is meaningful for us and meaningful for those around us and, and decide that it's okay to take the risk. There's only there. So recently you learned there's, uh, the same pathway for fear and excite. They go on the same one.
The only difference is that when we are in fear mode, like we're holding our breath. I don't know if you noticed or not, but when we're like, we're kind of like, like bracing for it, right? Yeah. But excitement, like, it's not like you're not a little. Scared you still are, but you it's that like, you know, think of when you get on a rollercoaster, you or you have that adrenaline rush.
Right. But you're kind of breathing through it or like when you gave birth to your kid, right. Like you, it's not like you are like, oh, well, you know, I have fear. I'm not gonna like push him out. I'm just gonna keep like, like you have to breathe through that. Right. Right. And so it's just understanding. When our heart is asking us to go all in, like we need to listen, like, and we need to trust that.
Sometimes we do have to take those risks because if we don't take the risks, we might not lose the weight. We might not find a boyfriend. We might not find a partner for this new dream that we are going towards. Right. Right. And just because we've been doing things the same way over and over for a while.
Right. It doesn't mean it has to continue to be the same way. Like we get it, like, we all wanna put the least amount of effort in whatever we're doing, because we wanna conserve energy. But sometimes whatever we're doing is actually draining our energy instead of like refueling our energy. Right. And we honest, we have those encounters that are like, oh my God, like, why me?
Right. But at the same time, it's like, Hmm. I wonder if I didn't put a boundary there or I wonder what is going on with that person instead of like making it about you, like figuring out what is the thing there. Right. Right. So with ADHD, I, I really, I think I'm biased, you know, I really think it's like a superpower.
It allows us to like define gravity. It, it, it allows us to think bigger and not make it mean anything that it hasn't been done yet. Right. Right. I mean, everybody is looking at me like, are you crazy? You're trying to set up a retreat in Costa Rica. And I'm like, yeah. Why not? Like, it's just right.
Cassandra Lopez: Like, so it's just Rica
Dr. Diana Mercado-Marmarosh: yeah.
I mean, it's just Costa Rica, then you just book a venue. I mean, and I did. Right. so right. I mean, and sometimes we that's what we forget that just because we've been going on a certain path for so long, it doesn't mean we can't pivot. Like, it doesn't mean that things have to always be permanent. Right, right.
That's. Yeah. I mean, for, I've been talking to you about trying to do a retreat or starting a group coaching for the longest time. Right. And right. Um, for four months I thought I was gonna have my retreat. Over there in Puerto Rico. Like , I really thought that's where it was going. And then all of a sudden something was, you know how sometimes life cur throws you curve balls and you're like upset.
But what if it's like life telling you. That's not where it was meant to be, or that was not right. There's something bigger for you. Right. And so, yeah. And in three days I pivoted and I was like, no, it's, it's in Costa Rica. And I found the venue and I booked it and here we, you know, so it's like, you have to always remember why we're doing what we're doing.
I mean, it hasn't changed. I still wanna help physicians and I still wanna help healthcare people, professionals. To be able to live life in their own terms. And obviously you are in a living example that you're living life in your own terms, and that you're creating an impact, a ripple effect because now you turned around and are helping employing 25 other individuals.
It's like the ripple effect. And, and this is just like what, when you're in, I can only imagine like what we're gonna be celebrating. Three years, five years, 10 years, right? Like how amazing that's going to be.
Cassandra Lopez: Yeah, I can't wait.
Dr. Diana Mercado-Marmarosh: that's so good. Okay. So where do you see yourself like doing for fun in three to five years
Cassandra Lopez: traveling
Dr. Diana Mercado-Marmarosh: where, tell me
Cassandra Lopez: anywhere.
I'm ready to go anywhere. Just more travel. Yeah. That's what I,
Dr. Diana Mercado-Marmarosh: yeah, I really, I really think that traveling, like exposing ourselves to different cultures is the, is one of the fastest ways to grow because right. It takes us out of our bubble. It, it makes us wonder what it might have been like for people in that town, like 10 years ago, 40 years ago, 2000 years ago, like, right.
Like it's just. Makes you reevaluate, whether what we're doing right now is important or not, or is it gonna matter in five or 20 or 30 years from now? So it just gives you more perspective. Okay. Right. You know, you, you know, I love to travel. Tell me where, where do you wanna travel? Like Costa Rica, like Thailand, Japan, Brazil, like, what are you contemplating
Cassandra Lopez: everywhere.
I wanna hit em, all. I just, just, what am I go? Costa Rica is one for sure. I wanna go there. Um, I'm going to Jamaica pretty soon. So. That's one that I'm gonna knock out. So just everywhere.
Dr. Diana Mercado-Marmarosh: Yeah. And you know, it's, I, I, um, I know I'm pressing you to tell me where, but the only reason I'm doing that is because.
Clarity and intention, like if you write it down, like right, then your mind is focused on that, right. It's going to find ways or opportunities or the universe is gonna provide 'em for you. Like for all, you know, you can go help somebody set up. But you are setting up over there, right? Like how amazing would that be to go teach your model to somebody over there or to just go hang out and like, forget about work for like 10 days or five days or whatever, and not be attached to her phone.
Like we usually are. Right? Yeah. So, um, Other than helping right now with your, uh, your business. Are you helping other businesses start up themselves?
Cassandra Lopez: So that's something we're, we're starting. So we're looking into starting to create businesses like ourselves and then, you know, selling them or consulting and see if they needed help with anything.
So that is, um, our next plan that's in place. So we're. We have it written down. Well, I do. I'm pretty sure he, my business partner does too, but by the end of the year to have another business started and up for sale, so, and provide some consultation if needed. So that's on the, that's on their next to do
Dr. Diana Mercado-Marmarosh: list.
Yeah. And again, like, look at you dreaming bigger and bigger and bigger, right? Like, right. That's what this is about. Like, um, I've learned to be in rooms where, you know, we are not the unicorns, like. We all say, add more zeros to that, like, right. Have a bigger dream, like create bigger impact for all the people working with you.
Like why not? Why not me?
Cassandra Lopez: Right. And it's important to surround yourself with those kind of people. Cause not everyone's gonna see your vision. And they might think, you know, when I first started talking about beloved community care, especially in the nursing home, you know, people. Kind of roll their eyes or not, not really understand the vision.
So not, not everyone is gonna understand your vision. So even with us trying to create more of these businesses and maybe sell them and different stuff like that, um, it's important to discuss that with people that, that have the same mind frame as you, because you're gonna keep each other motivated versus someone who doesn't really understand it.
You know, so finding your service
Dr. Diana Mercado-Marmarosh: is important. Yeah. So that, that is so important. Like we are the average of the five people we hang around with. And sometimes, I mean, I don't wanna say our family holds us back because they don't, but sometimes, like you said, the people around you, um, they just don't understand or, or they haven't seen it done.
So like that's kind of weird or. Just an idea or whatever. Right. But we are so good of creating stuff from nothing of being it up and then making it a reality. Right. Right. And so that, that also tells us that because we can come up with thousands of ideas being aware that not all the ideas are meant to come to fruitation.
Right. But again, if you are aware of your intention or, and you have clarity exactly. What you want to, uh, study what you want to go and, uh, visit what you want to go. You know, what you want for your, for your company then it's, it's just gives you a framework on how to work backwards to try to obtain what you have.
And like you said, find shortcuts, like don't do it all yourself. Somebody in a different method might have been doing something similar. Ask them questions and see if you can shortcut some of the trials and tribulations that they went through. Right. And so that way together you enhance and you also provide a win-win situation for them any way you could provide your services to them.
Right. So, yeah. Right. So fill in the gap has allowed you to. Become your boss and, and get your own freedom of time and your own financial freedom. And that's like, that's not an easy task. So you should be very, very proud of yourself and what you're doing in our community. Thank
Cassandra Lopez: you.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So where can people find you if they maybe want to ask you about how to set up their own business, or if they want to contract you so that you can help their loved ones?
Like where can people find you?
Cassandra Lopez: So my website is beloved community care.com. So that is the website. You can, um, have my email address on, on there. You can email me. Um, my email address is Cassandra L beloved community care, so they can contact me that way.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So I always say my people have ADHD.
We have ADHD. Sometimes we know we tune out, but let's say like, right. The second is when they're like looked up and they're starting to pay attention. What is the takeaway nugget that you would want them to take away from our conversation
Cassandra Lopez: today to, uh, take the risk. And don't be afraid if you have a dream, write it down and just know don't you don't have to tackle it all at once.
You just little by little, just every day, write down what you're gonna work on for that day. Get it done. And don't try to overwork yourself, just get that part of it done. And tomorrow's a new day. You start on the next part. And then four months later you'll have a business you could have a business.
That's what happened with us.
Dr. Diana Mercado-Marmarosh: Awesome. So you heard it, break it down, ask questions, try again. Next day. Before, you know, it, breaking it down, adding of those steps they compound before, you know it, you're leaving your dream. And it's a reality because you wrote it down and you took steps and things happen.
We always forget that, you know, we have a. But we always have a choice, right. We could decide, oh, I'm just gonna skip work today. Or I'm just gonna skip exercise today, or I'm not, I'm gonna skip cleaning today. Right. But the next day, if we keep doing that, we end up a little bit further away from where we, where we wanted to be at.
So we have to be willing to try something new or something different. To obtain a different result. And so whatever quality of input you put in, you put quality input, listening to books, podcasts surrounding yourself, with people who are thinking, wanting to grow, then you're gonna grow. If you surround yourself with people who.
Are happy where they are, but not really happy because all they do is complain. , um, that's draining and that's gonna drain your energy. So you decide the choice is yours. If you're a healthcare professional that wants a different lifestyle that wants to learn how to create time. In your own way, how to, um, close your charts, how to just be more present at home.
how to quote unquote, become back to you and all of you and be inspired like Cassandra to live life in your own terms. Then definitely check out my website and sign up for my master class that is coming. Um, it's gonna be, uh, September 21st. It's a Wednesday at 7:30 PM central. So please join me or just listen to my podcast or listen to my YouTube.
We're using listen to, uh, TikTok anything, but keep listening, keep surrounding yourself with amazing people. I am so, so blessed to have Cassandra in my network. And so, yeah, I'm so excited. You're here today and thank you for. Thank you for having
Cassandra Lopez: me.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast. Share with your colleagues. And don't forget to check out my website at ADHD. Live coach.com, where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.
Dr. Sheila Perez Colon: Parents will say, like we are concerned because my son or daughter has attention deficit, hyperactive disorder is on medication and that's why she, or he is not growing. Um, so we, I see it a lot at first I approach it like every other patient. Like we get a good history what's going on within the history we ask about the medication and when I find.
In this case that they're taking medication for that condition. I go, you know, into how long, how much is the dose, et cetera. Uh, because yeah, I have seen. It's very frequent visit to the pediatric endocrinologist when there's like short statu or decrease pro velocity. And they want to know if it's due to the medications or no.
Dr. Diana Mercado-Marmarosh: Hello. Hello. Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna Mecado mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered. ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to
Dr. Sheila Perez Colon: be
Dr. Diana Mercado-Marmarosh: both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hello? Hello. I am so excited today. I have a very special guest. I have somebody who is gonna talk to us about how ADHD can affect or not affect your growth based on which medications you have and, uh, who better than a P. Endocrinologist who is double board certified. She's also a general peaks doctor and her name is Dr.
Uh, Shala fit. And yeah, we're super excited to have her here today. She, um, went to medical school in the university at they, and then she did her residency and her fellowship in New York. And so. She's been practicing about, uh, 13 years now and she just moved to Puerto Rico and is gonna start her direct primary practice there to help children and adolescents, adolescent.
Uh, but. She will tell you all about what she's into, but I know her specialty interests are puberty and growth and diabetes and, you know, thyroid and all that P C O S which sometimes a lot of us don't realize that polycystic ovarian syndrome can. Play a role with our insulin, uh, and our fertility. So anyways, she's happily married and she has a 10 year old daughter.
Who's already a fifth grader. And so we're gonna just hear her and see what she has to share with us today.
Dr. Sheila Perez Colon: Thank you. Thank you Diana, for that introduction. I'm so happy to be here. Awesome.
Dr. Diana Mercado-Marmarosh: So tell me, did you. Did you ever realize that, you know, growth, um, could be in a way linked to our sugars? Or, I mean, I know, you know, this is like, I'm asking you disguise blue because this is your specialty, but were you curious or what led you that down that route of interest when you were, you know, you could pick anything when you wanted to be, uh, a doctor, you that's the
Dr. Sheila Perez Colon: field that you chose.
For me. I, I knew that I wanted to work with children because I always enjoy, you know, their energy that's so like it give me so much vitality, but in medical school I did, um, fell in love with the endocrine system. So when we were ex. Planning and talking about the hormones and how the endocrine system work.
That's when I say, huh, that really triggers me, you know, that, that, that emotion and that passion for what I wanted to do to be able to kind of fix, you know, I, I think it always, endocrine is like a puzzle. We, we try pediatric endocrinologist, we try to put a puzzle together. So the patient present with the sign or symptoms, then we do the exam and then we're like, okay, what could it.
But very interestingly, and for me, it's very regarding that when I say, okay, there's efficiency of a hormone, I just keep the hormone. And most of the time we kind of achieve that balance. And sometimes if that hormone is in excess, I can also work to bring it down, to bring the balance. So that's really what, what make me go into bits and the cream and yeah, I see it every day.
I enjoy bits endocrine because of that. It, it, it get me thinking all the. It's not . Yeah.
Dr. Diana Mercado-Marmarosh: And then have you had any patients who have ADHD? Like do they come to you? I know they don't come to you because of the ADHD, but have you seen any correlations of the meds that they're taking, whether it would affect their growth or anything of that sort.
Dr. Sheila Perez Colon: So I have definitely seen it. I get a lot of consults for, for example, evaluation of poor growth or short stature. And some of them come directly from the pediatrician staying on the referral, or the parents will say like, we are concerned because my son or daughter has attention deficit, hyperactive.
Disorder's a medication. Why she or he is not growing. Um, so we, I see it a lot at first I approach it like every other patient. Like we get a good history what's going on within the history we ask about the medication. And when I find out in this case that they're taking medication for that condition, I go, you know, into how long, how much is the dose, et cetera.
Um, because yeah, I have seen. It's very frequent visit to the pediatric endocrinologist when there's like short statu or decrease of pro velocity. And they want to know if it's due to the medications or no. Yeah.
Dr. Diana Mercado-Marmarosh: And then have you been able to then give them a treatment so that they can continue with medications if they need to, or, um, I mean, I know every person is, you know, different and you can't really tell me names, right.
Uh, It is what it is, but what would somebody expect? Like sometimes is it just gross supplementation? Is it like, I know, like we say that ADHD is a deficiency in dopamine, like, and that's like a simple way of saying it because there's a lots of factors involved with it, but, you know, To me when I explain that to some of my patients like, and I tell them, yeah, I'm not surprised that you have diabetes and you're using sugar as a way to try to get you to focus.
Or I'm not surprised that you are smoking or you are drinking, or you are having so much caffeine because that can give you, um, you know, the dopamine that your body's again, crazy. And, and when we do make the ADHD diagnosis and I do start them on medications, all of a sudden they didn't even realize that they stopped smoking.
They didn't realize that they stopped eating all the, the food at 3:00 PM. You know, the cookie that when they were trying to do an executive function task, they couldn't. So they would go reach for the
Dr. Sheila Perez Colon: cookie to try to get them through.
Dr. Diana Mercado-Marmarosh: Right. Um, so have you, have you noticed like, uh, Any supplements that sometimes you suggest or any things that you, you suggest
Dr. Sheila Perez Colon: for them?
So for those patients who are on medication, um, again, I do the evaluation, like every other patients on C, like you mentioned, it's case by case, depending on, do I need to treat this patient or not simple way, just because you are, or the patient is on this medication. Um, do or, and they are not growing properly.
Is this a hundred percent due to the medication? Not completely. We need to rule out, like we say, medicine, making sure you don't have any other diagnosis, for example, that's my approach. So when they come, I do have it on mind that they're, they are taking this medication, but let me make sure you don't have like growth hormone deficiency, which could be contributing to your, um, short statu or just like slow down on your growth that you don't have TIAL disorder that you don't have any inflammation in your body, for example, an gastrointestinal conditions.
Right? Like having all those things. First, I make sure they don't have it. And once I, I don't find any diagnosis of that. I could say this could be maybe because of the medication Diana likely, you know, like through many years, over 20, 30 years ago, this has been studying and there's a lot of controversies within this medication.
That's stimulant or, uh, a D ADHD medications cost your stature or compromise the patient's adult height in the past. Many of them say, yes, they compromise the height. The patients end up having like less adult height and it varies. They say like one to three centimeter or two inches, however, more studies have shown like, oh, maybe it doesn't have relationship.
Maybe it's just like casual. Like it just happened to be incidental. Right. So as of today, if you still look on updated research, it there's a lot of controversy. So, and with AVO call results. So I, again, I don't blame you right away, but yes, I rule out other conditions and if they don't have dose, then I say, could this be due to the medication?
And, um, if I think it's due to the medication, then I always do it in a multidisciplinary team. I never tell the patient or the family. Right. Stop the medication. This is due to the medication. I always I'm like old school. Everyone say you're so old school. I always call the other physician who is giving the medication.
And I talk to them and say, what's going on? Why did we start. Do we need to have that medication or can we change it or no, this is what is working for the patient. And I'm okay with that because that's very important, but let me, then I, as an endocrinologist, who's following the patient, make sure they come like at least every six months to monitor their height.
Right. And make sure like the dose, if we C. if we can decrease the dose as possible, then we will decrease it. But there's, it's not a hundred percent. It hasn't been shown that yes, this medication for sure will affect the height. This is one of the, I would say one of the grace areas that we do have, and as an endocrinologist is something that I would like a clear answer.
There's different mechanism for that, you know, there's research that show that it inhibit like the growth release from the brain, right? The growth hormone is released from the brain. So it just stopped the release or the production. Of course, then they will be compromised height or they say, no, it's not the message directly through by the brain or blocking the, the brain message.
But it's through the liver. Like there's some conversion that happened with the growth hormone liver. So some research show, it could be that. And another proposed mechanism, it's like, it goes indirectly affecting like your bones. Um, but I do give advice like everyone else, you know, let's make sure that.
If we need the medication, we keep it. Let monitor you closely. Let me give you some straight, uh, recommendation for growth, making sure that patient is, is sleeping. And I know with this condition, you know, it's could be challenging at time, but ideally, um, 10 to 11 hours at night because we know the growth hormone is P and it release at night as well, uh, to make sure we're doing some exercise, exercise will help with the release of growth hormone.
So basic things, um, To help us, you know, like manage that kid. Not necessarily, we need to give growth hormone. Yeah. That's so
Dr. Diana Mercado-Marmarosh: good that you just explained all that because I think there's a lot of misunderstanding or like you said, just mix information out there. Right. Mm-hmm and that might be part of the reason that maybe like patients don't even start on the medication or if they do start on the medication.
Uh, you know, they are quick to blame it for something, right. Um, I, myself was not diagnosed until I was a first year medical student. So me being, you know, five, one I'm really probably five, five feet, or who knows maybe four 11. And I, I tried to give myself more inches. Right. But. I didn't take any meds until then.
So like, it could be that some of us are just short, like you said, coincidence. Right. And you just don't know, but like you said, modifying it and taking a multi team approach so that you could figure out if there is a different type of medication, because, um, you know, it, it could be metabolized through the liver.
Uh, differently or it, you know, it could be different things. Right. And so I think it's so important. What you just mentioned that people really hear, because we all underestimate the importance of sleep and the importance of exercise. And so it's so good that, like you're saying you are treating not just like the little chief complaint, but you're helping them be set up to, to really thrive, right.
To really thrive and, and enhance themselves. Um, Because as you're exercising, like you just mentioned, you're, you're causing the release of both hormone. Plus you're also causing the release of oxytocin and serotonin and Rine, which are the feel good hormones, which can help you tame yourself so that you don't always feel so overwhelmed or feel.
Oh, I have plenty of time and I'm gonna procrastinate. And then the adrenaline kick in, which is kind of like me taking steroids all the time. Um, and so it, it's interesting how the body will try to compensate, but if you just sit back and ignore what might be happening, uh, it's just a lot harder. You don't even realize how much harder you're making it on.
Dr. Sheila Perez Colon: Yes. I agree. And with, for example, we do know that medications, all medications have side effect, right? Um, one of the side effects of this medication is like decreasing appetite, right. Because of how it worked, the medication. So it's decreasing your appetite and yes, decreasing appetite could lead to some, maybe weight.
And why I bring that because for us to grow, we need to make sure our height and actually, essentially our weight is in normal weight. So patients who have malnutrition or have underweight that by itself could compromise the growth. So not necessarily right. It's like, oh, it's the medication by it.
Directly affecting no, it could be that in some cases they lead to decreasing weight or decreasing appetite. We're losing some weight. And of course the, the body's kind of protecting itself and there's some stopping of some mechanism that happened. Um, and then you, your height could be compromised. So it's like, I again, recommend parents who have patients in this conversation with this condition, ADHD who are in medication, who, or who are not because actually Diana interestingly as well, like we mentioned, it's like some patients have compromised height already, even without.
Before starting medication. So they already come for evaluation. We are thinking, or the doctor is thinking to start, but they already have like decreasing growth velocity or they have, may have mature stature. So not necessarily the medication, it could be again, the condition itself or, or everything that the ADHD involved, or again, could be something else.
It could be familiar genetic. So that's why we evaluate and make sure it's not something else before we kind of say, this is the diagnosis. It's secondary to. Yeah,
Dr. Diana Mercado-Marmarosh: that's so good that you also mentioned that because, um, and I know we're talking maybe about kids, but because I'm a family medicine physician, I see everybody see, I, I see the kids
Dr. Sheila Perez Colon: and I see the adults mm-hmm and with the adults,
Dr. Diana Mercado-Marmarosh: the way that works is that once you do start on some of them on sting lids, like I was saying, you do see the weight loss, like you're saying, and, and.
And now they feel so much better because. Think and function and do different things. Plus they're losing weight. And, and so it's good to realize that some side effects might be wanted because, you know, like I said, maybe you were carrying those extra, um, inches under abdominal area that was leading to cholesterol and was leading to metabolic syndrome or prediabetes or diabetes.
And now that you're. Some of that under control. And then sometimes we don't even realize I've had a conversation in, in another episode with a doctor, Rebecca, who was talking about the correlation of like venting because of ADHD and
Dr. Sheila Perez Colon: that impulsive fee
Dr. Diana Mercado-Marmarosh: that you forget. And then you remember, and then, you know, all the stuff that happens, the, the part is that you don't realize how we're all interconnected and, and it's all.
So
Dr. Sheila Perez Colon: I. Yes. Yes. Agree. A hundred percent. And we do, I mentioned like a part of the workup just for everyone who is listening when they present with decreasing velocity concern for height or short stature, right. Already we say, oh, he's short or she's short. We do the evaluation. Like I mention of the block work, right.
That I mentioned all the hormones. We also do like a CVC to make sure there's not an chronic anemia. We look for everything. In blood, but we also do an x-ray of the hand that we do it in all patients, including patients with ADHD, it's called a Bon. And what it give us an idea is to see, okay, let me see where we are.
Normally the chronological age, meaning the age of the patient. For example, E hypothetically, it will be an H year old boy. So he should be the chronological age is eight, but the bonus could be either delay, like kind of behind like a six year old or could be advance. If we are concerned about, uh, slowing growth, technically if it's not, um, early puberty or things like that, it tends to be delayed for some conditions.
And it may help us say predict how tall that patient will be. Or even if it's within normal and the bone is not affected. He's like the bone are our ag at all and match tech chronological age. I can calculate like within, when you're like 18 or 20 years, it's called predicted height. How tall you will.
What will be your final height and careful, we all endocrinologists. We say, this is not a fit. You know, it's not set in stone because it has some deviation, but it give us an idea to see if it will compromise or not. Because some of the study have shown. Listen, when patients are started on the medication, it, depending on the, how long the patient has been treated for, is it a short course of medication or if its for a long time, right.
And some of them say like, oh, if it is just like a short time, then you will see at deceleration at the beginning, but then it will normalize and the patient will catch up. others suggest like if it is for a long time though, patients may have like risk, but again, going back to the same, even for long time, if you look the studies, uh, updated studies, there's like controversies.
Yeah. About that. And
Dr. Diana Mercado-Marmarosh: so tell me, um, I know you're onto a new adventure, right. Um, now that you're in Puerto goal, mm-hmm , can you tell us a little bit about your practice
Dr. Sheila Perez Colon: and what people can find you? I'm very excited. Diana I'm opening. I'm bringing this new model, which is common in, in United States and it's like kind of a movement and it is like known as, um, It's direct specialty care.
And what I do is like, I kind of, I got tired of the traditional system because I have been working in different states in United States. Like I work in New York, in Los Angeles and in Miami, which I love all my patients and my clinic, but I'm very devoted to my patients. And I realized that with the traditional, uh, System, I wasn't giving the time and the care that I wanted to give to my patients.
So now I'm joining that movement and in Puerto Rico, I'm bringing for the first time, the, the direct specialty care, the specialty one. And on that one, I'm gonna be offering to my patient, which I open next week. It's my first day in clinic. I'm gonna be, yes, I'm excited. Um, I'm giving my patients more time.
I'm gonna be giving accessibility to my patient. I will be able to spend as much time as I want to with my patients so we can, you know, Families and patient and myself be on the same kind of team. Um, so I think that's very important and definitely for endocrine conditions, most of them are chronic. So chronic condition like diabetes, uh, need a lot of time.
So I'm gonna be offering this in Puerto Rico. Um, you can find me, I will be working in two different location. One is in San Juan, uh, in the north of the island. The other is in Dorado. Um, and I will be having clinic there in my Instagram. I have a professional Instagram page, which I am. Is slowly like trying to give some, you know, advice or maybe like just what I think about the endocrine conditions.
Right. My learning, my experience, and it is known as elite endocrine MD, and then an founder score. And my name Dr. Paris is kind of long, but that's how I wanted to, you know, I want everything to be there, so people know who I am and what I, I am offering. Um, yes. And you can find me there always, you can write me, um, in private message and I always.
Dr. Diana Mercado-Marmarosh: Awesome. So, um, now I'm gonna do some rapid fire questions. Um, okay. So, um, where do you see yourself in the next three to five years? For fun? For fun.
Dr. Sheila Perez Colon: Okay. I see, I see myself in three to five years here in Puerto Rico. I see myself like having, uh, time to enjoy with my family at the beach. I see myself like very happy with, with myself without how much I have grown professionally.
I I've see myself satisfied with the way I'm practicing medicine and the change that I did. And I see my patients driving.
Dr. Diana Mercado-Marmarosh: Awesome. Is there any place you would like to go travel or something that you're like, you can't wait to do that you think, you know, it's a little crazy, but you're dreaming it.
Dr. Sheila Perez Colon: I always wanted to go to Malif.
And couple of years ago, my husband did buy me the ticket and the hotel, but it depends of the seasonal, the season there. And like three days before we were leaving, they, they, they say that it was going to be severe thunderstorm for many days and they say it's better to cancel, so we needed to cancel. So yeah, I would like to go.
Okay. Awesome. So
Dr. Diana Mercado-Marmarosh: thank you so much for sharing everything, uh, today. And the last question is that, you know, my audience has ADHD. So if they just started tuning in like right this second, what is the takeaway point that you want them to walk away with?
Dr. Sheila Perez Colon: So for patients, um, right children and adolescent with attention deficit, hyperactive disorder, I will say like, if there's indication for the medication, if we need to start it and the doctor recommended it's okay to start it right.
Because there's some things that we need to address, but we need to follow closely either with the P pediatrician or the pediatric and endocrinologist, make sure that you go more than once a year, not just for the regular checkup, maybe go like every six month to make sure that we're tracking the, the growth velocity of your child.
To make sure everything is online. If there's any deviation or any concern, then a pediatric endocrinologist will evaluate. And then we will decide if anything needs to be done. Awesome.
Dr. Diana Mercado-Marmarosh: Well, thank you so much for your time and for sharing all your expertise, your patience and their families are so lucky to have you.
And if everybody go get her busy in
Dr. Sheila Perez Colon: Puerto Rico. Yes, I'm excited. Thank you Diana, for having me. Thank you for everyone who's listening or watching.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really. That time is your most valuable asset. Please subscribe to the podcast, share with your colleagues. And don't forget to check out my website at ADHD.
Live coach.com, where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happy.
Dr. Leslie Golden
I just got to a point where I felt like I kept just prescribing and adjusting meds and adjusting meds and higher meds. Not really getting to the core of, what was going on with people, that whole comprehensive health, that whole person. When I started diving a little deeper and trying to help people.
Maybe not increase her insulin. I kind of unlocked Pandora's box.
Hello. Hello. Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna mage. I'm a family medicine physician practicing in rural Texas. To be hindered by my ADHD, but I now see it as a gift that helps me show up as the person. I was always meant to be both in my work and in my personal life.
In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
Well, hello. Hello everybody. I am so excited today. I have my dear friend, Dr. Leslie golden. She's a physician and she also has a master's of public health degree, and she's not only a board certified in family medicine. She's also board certified in obesity medicine. So, so exciting to have her here today so she can share her, expertise.
And she's going to explain to us how, behavior can, can really manage, the patient's long term disease states. And so obesity obviously can be prevented sometimes, but sometimes it's genetic and sometimes it's. You know, just the easy thing to do when we're so tired at the end of the day to go through the drive through and stuff, but you have the real deal here today.
She, is gonna share all her expertise with us. And so we're so excited to have her, and she's gonna explain why, sometimes metabolic syndrome, can be something that, It's not so obvious just on labs. So please, please, please, tell us how you decided to go into family medicine and how you decided to do obesity medicine.
Sure. Well, thank you for having me so glad to be here. When I went through, med school, I was one of those people that I went into med school and I was pretty sure I wanted to be a radiologist. not entirely sure why. , and then went through and got in my first clinical rotation was family medicine up in Queens.
It was this single practitioner owned his own practice. Everyone knew him. He knew everybody. And I was like, this is a great experience. This is fun. But I'm gonna be a radiologist. Right. And so went through my clinical rotations and as I went through, I just couldn't let go of that experience.
That feeling that really knowing people, a child would come in and he'd say, His mom had this and the grandmother, I took care of her too and had this. And, um, and then I think the truth really came out when I got to my electives and did my radiology rotation. And I was like star for interaction.
When people would walk by in the hallway, I'd be like, come hi, come talk to me. Went into family medicine, for that relationship, that connection., as I practiced family medicine, loved it, but it's so broad, you know, everything and which is fun. But I just got to a point where I felt like I kept just prescribing and adjusting meds and adjusting meds and higher meds.
And. Not really getting to the core of, of what was going on with people, this, that whole comprehensive health, that whole person. Um, and when I started look diving a little deeper and trying to help people. Maybe not increase their insulin. I, it, I kind of unlocked Pandora's box of, um, just diving into like their nutrition, their physical activity, their stress, their sleep, their behaviors, their relationship with themselves and others.
And, um, found a home in obesity medicine, because it's such a complex disease that you have to look at all of it in order to help someone. Yes,
that's so good that you PO you found those con connections because the way that medicine right now is unfortunately, like if you're working with insurances, they kind of dictate some how much time we spend some time with their patients and they kind of say quickly, come in, come out.
Right. Mm-hmm . Sometimes it feels like bandaids instead of like getting to the root cost of why is it that they have obesity or why is it that they're depressed? Or why is it that they're doing X, Y, and Z. And so it's so good that you found a way to be able to start to make connections and, and using those relationships to help you to do that.
Um, have you noticed any links with people who have ADHD and obesity or have you noticed any pattern.
Definitely, you know, I think what's interesting to me about obesity and ADHD is in, in so many ways I can see similarities, right. Because very behavior based, but not completely behavior based. Right. Just a lot of, you know, the, the neuro the brain chemistry changes and, um, that in.
Conditions that there's stigma about. Right. I, I think there's still people, even the medical community that still don't believe ADHD is, is a legitimate thing, right? They, they, oh, it's because of inadequate parenting or, or, or you should grow out of it. And all these misunderstandings and obesity is so much the same.
Um, so many people think it's, it's a choice and, and it very, it very much isn't that way, ADHD in the behavior. That often people with ADHD struggle with can, can be a lot of the behaviors that we work with with patients that struggle with obesity, but at a whole nother level. Right? So, so much about obesity.
We work with patients on, um, structure planning, um, sleep, you know, impulse control, processing, their thoughts, and then you take. And take the ADHD brain and put those together and, and it it's, it just adds more complexity to it. And it's just another great example of just you can't treat obesity in a vacuum.
Right? Um, it it's, it's just so many layers there. And I think it was back in, I wanna say 2015, the American journal of psychiat. Did a meta-analysis and found that, um, patients, the, the prevalence of obesity was 70%, uh, increased by 70% in patients with ADHD, um, in adult patients. And I believe like 40% in, in children with ADHD.
And I think it has a lot to do with. You know that prefrontal area, uh, where we, where we see those struggles with the planning, the organization, the attention, um, emotional reaction and memory, and, and also the neurochemical changes, uh, with dopamine being low GABA being low, you you're gonna see.
Physiologic drive in someone with ADHD to naturally seek a dopamine increase from the external sources, which comes in food. And sure. We're not aware that that's what we're doing. But Austin, that's what we're doing. Yes, that's
exactly like, I didn't realize why, like around two or three, like I wanted to go get that cookie or wanted to go get that chocolate because I was trying to get through the end of the day.
And I was trying to give myself a little bit of dopamine boost. Right? Mm-hmm or why it is that sometimes even though you are quote unquote, trying to lose weight, you go and grab the stuff. Give you the quickest, like energy boost and you're not. And it almost feels like impulsively. You don't have a choice mm-hmm but like you said, when you approach it from the point of view, like, oh, let's set up a plan, let's try to plan for what's gonna happen.
If you do say slip or whatever, like how can you get yourself back on track so that it doesn't become. Except, you know, a one time slip doesn't become like a week or a month or a year slip. Right. Mm-hmm because then our brain can usually be like, ah, what's the point? Right. And so understanding that, you know, you have a way to change if you want to, to help yourself, um, in your weight and in the way you.
Take in information and process information. It it's so helpful to have a physician who can walk you through those, through those things. Um, yeah. So have you seen any specific eating disorders? I know sometimes binge eating can be part of like, uh, they don't realize that, but it, it, again, because of the impulse problem, sometimes it, or you forget, like you're so hyperfocused on what you're doing, you forget to eat.
And then all of a sudden. Binging or, or then you feel guilty about it, or what have you noticed, have you noticed any
patterns? I definitely would say that there's a strong link there between binge eating disorder specifically and, and that, um, that ADHD tendency with that impulse control that, that the emotional reaction control and external sensory seeking.
And, um, that, that just encouraging that, that rapid pace and, you know, You're consuming at the rate. Um, based off impulses before the executive part of the brain really has a chance to like, process and be like, oh, that's right. I had these more significant goals that I was working on. I was trying not to engage in this.
Yeah, that's so good. Um, and I know that we're not the, the patients like, you know, doctors per se, so we can't really give them a specific medication treatment plan or anything like that. But what I have seen is that sometimes some of my patients do really well with like a medication, like by. Plus, like you said, uh, maybe a, an exercise plan or a personal trainer or a nutritionist, like kind of like in a group approach.
Yeah, definitely. Cause in, in both obesity and ADHD, you know, there, there are several tools out there. To treat it right. So I often feel like the behavioral approach working on your thoughts, realizing that your, your thoughts don't control you, that you can increase your awareness and, and take control back over.
It's a big part of it, but the medications are a huge part of our toolbox as well too. And it, when we're talking about obesity and ADHD, we're talking. Diseases. Right? So the, the abnormal physiology is there. The BR the brain chemistry shifts are there, and we do have medications that, that can help. And, and in that study, they did show that when, when patients with ADHD were on medical treatment, They were less likely to have obesity, just really showing the benefit of that control and Vivs is very helpful in, in binge eating disorder.
It's FDA approved for that. There are some other medications that are, um, used off label that can be very effective too. Um, And on the obesity side of things, a lot of our FDA, FDA approved medications, you know, like Leggo, um, are very good at reducing that, that brain interest in food, those, those physiologic drivers within the hypothalamus that are encouraging, that, that seeking out of.
I really, before what Gabi came into the picture, you know, some of my, my patients who were, uh, prediabetic or had a metabolic syndrome, like I was starting them on SIS because it was, I just understood how it worked. And especially my ADHD patients who had obesity, like when I saw like, when I did RSIs plus like their ADHD me.
Oh my God. Like some of them lost, like. 2040 a hundred pounds. And it was just such a life changing thing for them that mm-hmm, all of a sudden they could have one more tool to allow them to self, uh, regulate something that they didn't think they could ever do. And so it's so good to be just really like, see the person as a whole, right?
Because there, like you said, there's so many components that can come together and can make a big differe. Um, so tell us a little bit about your practice. You know, you help patients with obesity. Are, are you also doing family medicine or are you mainly obesity? A little bit of both. Can you share a little bit with
us?
Sure. I, I still do a small amount of family medicine, mainly because of patients I've taken care of for, for a while. But I'd say it's been about three to four years now that I've been practicing obesity medicine and it is just kind. Taken over my practice, you know, and, and, and I enjoy it. I love it. It's been wonderful.
So, um, it it's been a welcome change because it's happy medicine, you know, it, it giving people hope and really having such a change in their lives, um, helping them make such a change in their lives. It, it really is fulfilling and in you're you're right. You give them that sense of self worth back. You, you see their confidence growing and then you see the way it impacts every other area of their life.
That. A switch has flipped, you know, in their head and they have this power over, over their relationship with food again or over their behaviors again, in the, in this, in the case of ADHD. So most of my practice now is primarily weight, health related, um, or even patients who have obesity, but don't necessarily wanna treat the obesity directly, but they want a physician that's going to.
Treat them in respect them, um, and not make every complaint that they have. About oh, it's your weight? Um, so kind of a, a little bit of, of all.
Yeah. That's so good. Um, so where can people find you if they wanna be like, oh my God, I can't wait to talk to Dr. Golden. She's speaking my, my choir , you know, where can they
find you?
Right. Right. So I, I practice, um, at Watertown family practice in Watertown, Wisconsin, and. It's uh, between Madison and Milwaukee. And, uh, I'm able to provide virtual care to patients across the whole state of Wisconsin. And I have, um, Instagram and, uh, Facebook pages, weight and gold wellness, as in worth your weight and gold.
That's
amazing weight, gold weight in gold. That's amazing. So, uh, where do you see yourself in the next, like three to five years? Oh,
in the next three to five years, you know, I. Huge advocate, um, for equal access to care for obesity. I, um, work with the obesity medicine association, um, on their national advocacy team.
And I, I would love in the next three to five years to. Have a little bit more of, of a national platform and, and be sharing and, and helping more people understand obesity as a disease and help reduce the stigma around the disease. And what
about
for fun? What do you see yourself doing in the next three to five
years?
Oh, lots of bicycling in, uh, vacations with family. So. You know, a few years ago, um, in a period of stress and challenged myself and wanted to take something else more. I had not ridden a bicycle since I was a child. Um, and decided I would take on rag. Bri. I don't know if you're familiar with that. um, but it's a bicycle right across the state of Iowa.
So I'm actually leaving tomorrow to, to head to rag Bri. Um, and I will be riding my bicycle with my husband and 25,000 other, uh, wonderful friends, um, across the state. That's
amazing. Yes. You know, we, we often forget that fun can be really what fuels us and what really can, uh, replace what sometimes food gives us
Right. Sure. So we gotta find what gives us the meaning to our things. So, um, it's been so wonderful. So the last part that I usually. Is that let's say that people just started listening to us, you know, because we have wondering attention, what would be the little nugget that you would want them to take?
I, I would just want people to, um, take home that everything can change.
You have the ability to still change your behavior, find ways, um, to take back control of your thoughts and. Change your health. And there are more and more people that are open to helping in, in areas of weight, obesity, mental health, more and more than probably ever, ever, that we've seen before. So reach out for help.
If you don't find the right person willing. Keep searching. That's beautiful.
Yes. Keep searching. You're definitely worth the investment. You're definitely worth, uh, realizing that, you know, a second or third opinion sometimes is needed because, um, different people have different personalities and sometimes, you know, we don't.
Explain ourselves as well. Uh, when we're saying something, but you need to keep advocating for yourself so that you can get the help that you need. And, and you're right. There's so many resources nowadays. So it's, it's worth definitely exploring, but thank you so much for coming to be in my guest today.
It's been one.
Thank you.
Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues, and don't forget to check out my website@adhd-livecoach.com, where you can find out about my upcoming coaching. Classes as well as free master classes and other exciting events that are happening.
Dr. Laxmi Naiki: realized that I am wired for addiction and that's a higher risk with ADD it wasn. Drugs per se, but my addictions tend to be typically work and food and perhaps impulse control shopping, things like that, that I didn't realize was part of the whole diagnosis. And I don't even, the word addiction is a little bit of a stigma for me, but it was in a sense that it was overwhelmingly doing it.
It wasn't just a habit. It wasn't just oh, I'm just shopping extra on a Friday night, it was like real. Hello? Hello.
Dr. Diana Mercado-Marmarosh: Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my. ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize. That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills. I'm excited to share all these.
Okay. So I am so excited today. We are gonna be talking all things holistic, so it's fun to talk about this topic. And I have a dear friend of mine here to talk about it and it's Dr. Lak NA and I might butcher that. So she'll help me out in a second. She is an ER physician and she's been actually practicing holistic medicine since 2015. And so I am so excited to have her come in and explain what her journey.
Been like, and she is from Atlanta, Georgia, or she's currently in Atlanta, Georgia. So yeah, this is gonna be such a good treat for everybody in Atlanta who can reach out to her and start to heal and start to integrate your health in a different way. Thank you. And please tell us your names.
So if I messed it up
Dr. Laxmi Naiki: so it's Lak and I practice in Georgia and our. My practice is spectrum integrative help. And, we take a really holistic approach to the healing, the journey for the person and specifically for a D there's so many different things that I had to learn about as I was healing, because, I self-diagnosed myself.
Back in, I think it was like 2010 when I started noticing just aspects of my personality. Whether it was impulse control issues, whether it was working memory, whether it was me being able to complete a task, but then unable to complete it. Or I add, I have a project on my plate and then I keep adding 20 more before the first one's done.
Classic. And just, I struggled with sleep. I was having definitely struggling, in relationships, boundaries, so many various different things that I just didn't understand what it was and I'm a physician. So [00:03:00] it was really, and eye opener and I started just looking up stuff.
And then, of course I researched came across the word D. And I started looking, reading more and more about it. And then I said, how do I start my healing journey? And I had other medical issues for which I went into the, holistic approach of healing. But only to find out that I think like 60, 70% of ER, physicians have a D D.
Our comorbid it's very high. Daniel Amman is the guru in add, and he talks about how ER, docs are perfect for the job, but at the same time, cuz you have this high stimulus, like encounters with people and then you go from test to test it really fast and before one task is completed, you move to the next.
So it's perfect for me. Like it's almost like it was drawn or calling. They should just call E. Add people apply, but but yeah, just through the whole process, really figured myself out and in a much different place now, a decade later.
Dr. Diana Mercado-Marmarosh: So what did you think when you first realized, oh, this might be [00:04:00] a D like, were you surprised?
Were you like relieved? Were you like ashamed? What did you.
Dr. Laxmi Naiki: It's probably a combination of everything. I was overwhelmed cuz I'm like, oh my gosh, what do I do now? Sure. The Western approach is here's your prescription pill, your, Adderall or Vivance or whatever you wanna write.
Sure. But the, I was looking for approaches to say, okay, this is what I have. We all have something probably. Yeah. And I'm not a big person for labels, but let's. The issues that come with it. And I was overwhelmed. I was just and that's also part of the diagnosis. I think the tendency to get overwhelmed very quickly.
And I was scared I was feeling alone, but, luckily I reached out to a couple of, clinicians that were trained and I said, Hey, what do I do? Unfortunately at that time, again, the approach was pretty much. The pill, this is how we treat a D here's a prescription and there's nothing wrong with prescriptions.
There's definitely a place for it. I think there's a lot of things that can be done as an adjunct or instead of, depending on the person, everything's different. Had a range of emotions. [00:05:00] And then I, I said, how do we, we're like clinicians, right? We look at the situation and we try to solve problems.
X is the problem. What's the solution.
Dr. Diana Mercado-Marmarosh: And so you said 2010, is that correct? Yes. So then five years later. So in, in this whole time you were in this whole time you were trying to do different ways of helping yourself,
Dr. Laxmi Naiki: right? Yes, I was trying to figure out. So for example, my relationship was struggling.
And so I was like, why is it struggling? How is my mind thinking versus my partner? And how, a lot of it was just, I needed in a relationship. For example, I needed to constantly do something new. Constantly have a new stimulus. And that was my brain wanting that dopamine perhaps.
And so I had to stop and say that's definitely not him. He's not wired that way. And so I needed to back it up and say, okay, how about we negotiate two new things a month? This was this negotiating process. As I was learning myself in those five years. And then clinically, I noticed that I needed to change many different aspects of my life.
I had a [00:06:00] tendency. I realized that I am wired for addiction and that's a higher risk with a D it wasn't. Drugs per se, but my addictions tend to be typically work and food and perhaps impulse control shopping, things like that, that I didn't realize was part of the whole diagnosis. And I don't.
Even the word addiction is a little bit of a stigma for me, but it was in a sense that it was overwhelmingly doing it. It wasn't just a habit. It wasn't just oh, I'm just shopping extra on a Friday night, it was like real, like my credit card bills were high, like scary high. And I was like something I just can't stop myself.
I can't control. And it was real. And so in those five years I was like, okay I need to now regulate all of it. And, thank gosh, I, I really worked hard at it. I'm at a very different place now and I'm able to regulate it and, I check myself all the time. I people have to plan when they work.
I'm the person that needs to plan fun. [00:07:00] Because I know where my tendencies are, yeah.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. So it's so beautiful that you say that because ADHD is the spectrum and like you said the labels. Yeah. They're there, but it doesn't matter really. You, if you don't understand how you are wired, like what you.
What like lights you up or what, can really derail you then it's hard for you to create those safety nets, to be able to guide you towards where you're trying to get at and where you're trying to avoid so that we don't get ourselves into trouble, right? Like you said the ADHD tax, either buying too much stuff or not even having what you need at hand, because you ran out because.
Forgot. And so what are some things that have helped you that you've noticed that now you incorporate and try to help your own patients?
Dr. Laxmi Naiki: Yeah. It's excellent actually, in terms of my life, for example, if it's work related, I have, [00:08:00] hard stops. I work in 90 minute blocks.
I only work three, four hours a day. I have a great virtual assistant, so I put hard stops and then I have a list of non-negotiables are, and I kid you not my non-negotiables. I have to exercise every day, even a walk like for 20 minutes in the sun, nothing, necessarily intense, but it's a non-negotiable the non-negotiable for me is sleep.
I have to get my sleep in because it helps me process things better. I'm not as impulsive. I'm more regulated. The body heals significantly during sleep during Delta sleep. Mono non-negotiable. It's exercise. I regulate, how long I work and my biggest one is actually, nutrition.
I'm very clear about what I put in my body stimulants, cuz I have a tendency for addiction. So I'm the person that just. Won't stop at the one cup of coffee. I'm the person that potentially can, excuse me, it's lightning and thundering here. So if it's noisy I'm the person that could potentially do the six to eight cups of [00:09:00] coffee and just not stop.
And so I knew my body and this is not everybody, but I knew my body and I have given up coffee and I do, more healing, herbs and teas that are more therapeutic for my body. Whether it's lemon brass or Rubo, or ginger turmeric tea, things that are highly healing for me, not necessarily addictive, but also feed the nutritional part of my body.
And so those are really my non-negotiables and I pretty much stick to it. And it helps me regulate the other aspects of my. Yeah, that's
Dr. Diana Mercado-Marmarosh: so good that you have that insight about the teeth. Some people, as might be using that, alcohol or smoking or different things.
And so I always say like the body's gonna get what it needs and we have to pay attention to see if there's a better way for it to get what it needs instead of causing us something long term. That can be more complicated. And now Do you in your diet, are you like [00:10:00] plant based or like low carb or what do you, or do you sometimes just tailor it like for your family or for your clients based on what they, what else is going on with them?
Dr. Laxmi Naiki: Yeah, it's, each person presents very differently because some people can have a D and diabetes. Some people can have add in autoimmune and there is a book, I forget the author, but there, he wrote a book called there's no such thing as a D. Which was very fascinating because I had to look it up because and that peaked my interest in the functional medicine approach to healing, which was let's go closer.
There's so many different ways to eat and people eat differently. So let's look at it primarily. I think a whole foods plant based diet is probably the best for most people. Almost everybody plant protein, generally isn't the most comprehensive protein. So you, some people do benefit more with animal protein or certain servings of protein limited, they do better with that, but in general, plants are the best way to go overall in general.
But more than that, [00:11:00] there's more emerging. If we were going a little more scientific in medical, there's more emerging data on the microbiome. And D so for people who have a lot of gut issues lot of bloating, gas, and D what we typically tend to do is we do a three month protocol to make sure that their gut is good.
What does that mean? We do a stool test that looks at their entire microbiome. to see what exactly is happening with all the bacteria. Do they have good bacteria in the gut? Because that's the source of all our nutrition. If whatever nutrition we eat uptake is due to the microbiome. So we look at exactly what's going on.
Majority, I would say are very depleted in fiber. Okay. We also rule out certain St infections that occur in the stool and it comes out the stool sample. If they're, parasites, if there's very high concentration of yeast can be in the microbiome. It's fine. But it's just the level to which it's there.
So we look at things like that. Those patients with the yeas, they usually have high sugar cravings, and we can [00:12:00] tell, and it comes out in that stool test. The other thing that's very very profound, which I'm seeing now compared to five years ago is 80% of the urines that we're collecting on.
People have herbicides
have, excuse me, have glyphosate in the urine. Wow. Which is yeah. 80% of urine samples. And I haven't really drawn the bell curve to see what percentile they're at, but they're pretty. And these are people that swear, they say, oh, I eat clean, I eat this, I eat that, but still we're seeing it.
So it's seeping in either through the soil, through the food, through all the exposure that we're having and sprayed on the food and all of that. So we're seeing much of more of that. Now. I don't know the impact of that, but I can't imagine it's not there on a D right?
Dr. Diana Mercado-Marmarosh: Yeah. That's so good to be able to have some.
Other type of tests and the usual. Oh, okay. Here's a questionnaire and okay. And even though. A questionnaire is okay, because then you have a [00:13:00] baseline, but it's you, the more that you compliment different things, the more that you approach the whole thing, because I keep telling people, medications are great.
Like it's the fastest way for the people that it, they work for. There's the fastest way. Within 30 minutes of you taking a pill, you can all sudden think a little bit better to do other things that maybe you would. Put out for weeks. But at the same time, like it's not gonna help you to do all those other tasks and to regulate your emotions and to be able to know how to prioritize like there's tools for everything.
And sometimes. The meditation or exercise or breathing techniques can help you to regulate some of that sympathetic overdrive that hits. And so if you then also have me food in your diet, that is not going to get you so worked up or, everything just compliments each other.
Yeah. And. [00:14:00] I was reading recently and you can tell me about your meditation journey, cuz I know you, you really use meditation as a way to cope. And I remember in our previous conversation, I was so intrigued by, how well it was helping you balance. And I think I shared with you like meditation.
I would love for it to work for me, but it's really tapping is what works for me. Emotional freedom technique works wonderful for me. So it doesn't matter what people use as long as they find something that, that works. That's where that, that goes with. But, with tapping I've had always been told like, oh if you have.
Trauma in your life, maybe you shouldn't do tapping by yourself. You need to do it with a tapping trauma coach. But I think, and a lot of people wonder whether ADHD is even a diagnosis or whether it's just right, like a trauma, or post-traumatic, or depression or whatever. But it's not. Trauma is not gonna induce ADHD.
It might just make your ADHD come about, [00:15:00] obviously sooner in age than it would have eventually come out. Because eventually our systems that we were trying to use to help us cope are no longer. Enough, like we hit like a saturation point. So to say, so what is your, what are your thoughts about this in terms of like meditation or like trauma?
And I know you, you have a lot of in your practice, you help with
Dr. Laxmi Naiki: this, right? Yeah. Yeah. So we see, it's really amazing points you're bringing up. It's actually pretty incredible. So thank you for bringing it to light, because what I am seeing is significant levels of trauma, obviously with everything going on in the country and the world the mental health crisis that we're at and it's presenting in various different ways now is a D due to trauma because of trauma, independent of trauma, because trauma is bringing up what already exists, it's interesting when they've done the brain scans, there's ation issues, there's connection issues that seem fairly similar in both states. And that being said, they both do exist. It doesn't, [00:16:00] to me, it's almost moot to see what caused what it's there both are there. I will say a lot of patients with a D have comorbid trauma.
Yes. High percentage due. And if that is the case, the highest, Impactful modality for me has been meditation and yoga. Now, Bessel VanDerKolk who I think runs the trauma. He's the head of one of the trauma associations. He also states yoga as being the one of the top modalities for healing. The yoga that I particularly practice is called inter engineering it's by Isha foundation and it's very therapeutic and it's really helped alter.
Energetically what's going on because I think the west, the con the limitation with the west, and it's beautiful, but it's still a limitation is that it's more scientifically approached. And it's the mind as the cause of a D trauma and the ease look at it. Like your energy is the cause of the a D it's a little bit different, cuz it goes a little bit.
In looking at why [00:17:00] this is happening. So trauma could be anything, right? Someone bullied you in fourth grade versus you've been persistently, emotionally abused by your parent, or you've been abused in a much more horrific way through sexual abuse or other things. And that imprint it, keeps scoring the body.
The body keeps score, right? According to that book written by VA Leonard, Paul, it keeps a memory. Of that in your body and you carry that and that can manifest as anxiety, depression, O C, D all these other things that come out or a D D. And so what do we do for that? A way to slowly resolve that is usually different modalities.
Do you do psychotherapy with therapist? Do we now need to put you on a pill, low dose of something. Do we try to address this holistically? And if so, yes, yoga is one approach. And if it's really traumatic and we're not able to get there with any of these techniques, sometimes there is very good data for plant medicine.
And there are patients that if I feel are. [00:18:00] Able to handle it, but are safe that we do recommend plant medicine for now. I don't do it as blanketly, as it's being practiced. Currently, I'm very conservative in my sort of choice and selection, because there's a lot of impact I can have when you put someone into a plant medicine protocol or ketamine therapy, because these therapies say stop the mind.
The mind is going all over the place with the a. Let's drop the mind. Let's go to the trauma. Let's figure out what happened in the childhood, the thoughts, the memories, the feelings all come up. When we drop the mind with all these plant medicines. And what happens is the person goes into this deep state, another world state, right?
Like it's with LSD and MBMA and those sorts of things. And they go into a different world and memories come up, which can be really intense, and they just can't handle it. So it has to be the right person that we recommend to. Somebody who has severe schizophrenia, who's unstable on multiple [00:19:00] medications.
It's not somebody I would recommend for this. And when they do go into these states and they come out, we make sure that they have really good integration in place, right after meaning there's a plant based integration specialist board that they can talk out all these memories that they just got flooded with in a day.
But it can be highly therapeutic from a trauma standpoint because what they tried to do with a therapist for 20 years, They were able to do within a week. And so there's many layers to it. It's very different. And only when you talk to your holistic provider or functional provider, you negotiate and talk it out as to what would work best with you.
Cuz each person is so different. Some people have seen remarkable results with doing intense yoga practices. And again, it's just certain types of yoga for me. The yoga has to have really good spinal alignment. It has to have, like you said, you brought up a beautiful point about breathwork as having an, a very kind of centering sense for the body, just to get centered because it's all over the place.
[00:20:00] Energetically ad. Breathwork spinal alignment and silence is a very big part of of doing a yoga practice, which typically not to say there's not beautiful yoga practices in other schools of thought, but generally in the west, they tend to talk through the entire yoga class. And when that happens, the body doesn't have a time to just get into that parasympathetic mode.
And so practices that are in a certain yoga practices that I recommend for people. It's just silence. You're just there with your thoughts by yourself and you get to integrate on your own what's happening. Yeah, we could talk about this forever. I'm passionate about it.
Dr. Diana Mercado-Marmarosh: And then like one of the ones that I like too, like yoga, like I, I like yoga Nira, that's really.
Call me, because there's also like evidence in that where it can rewire some of your brain and some of your subconscious like limiting beliefs and some of, and that it can [00:21:00] actually help modify your DNA. I was shocked by that , but I guess it makes sense, like different things that can be traumatic can also change your DNA sometimes.
And it's just interesting how much our body keeps to coping with our environment. And how we do have some sense of control if we are just taught about it. Because so much is how much we have to unlearn that self helplessness or just stepping into curiosity, to think about it in different ways.
Yeah. So a lot of people sometimes. The first thing they think, oh, okay. So holistic, that sounds great. But that sounds expensive. That's the first thing that they go to, but we have to keep remembering like how much is your health worth? Like it's an investment at the end of the day, right?
How much money did we spend? Trying to go to med school, how much money that we spend in our cars or in our purses or whatever we buy and. And if we don't have our brain working the way we want it to, or our [00:22:00] health aligned then what's the point, but I'm pretty sure this is the common question you get asked.
What do you usually tell people when they ask you these questions? Because I'm sure they're like, oh my God, what's due test is that expensive, but you know how they.
Dr. Laxmi Naiki: Yeah. We all, the way we work is yes, we don't take insurance currently. We're cash only practice. We give a tremendous amount of support, I think, above and beyond between appointments in terms of messages, emailing the cost, there's two ways to think of cost there's dollars, how much I'm spending and two untangible.
Quality of life, your relationships, your credit card bill, how much? And I'm not saying that coming to a holistic practitioner will solve all of those things, but you will definitely get the tools and direction that you need to go on your own. A lot of our patients come to us after nothing has worked.
And two they're highly. If I tell you some things about my patients, they are highly motivat. They are messaging me. Oh, I read this amazing book on I don't know, a macro biotic diet. What are your thoughts? Oh, I'm here. And I'm always [00:23:00] pushed to the edge because they are reading.
They are listening to podcasts. They're looking at, there's so much evidence out there. Not for everyone that I have to be on my toes. Constantly reading articles and stuff. So our patients are very motivated, very knowledgeable, and we're at, the cutting edge with some of the stuff.
Now it's also expensive because expensive, in a sense of, there's other add modalities that I often see come across my desk should we do a functional MRI for $5,000? I'm not sure if that's necessarily gonna impact, outcomes, but patients have gotten it. They don't necessarily know the evidence.
All of that, neurofeedback has great data for ADB, but you've gotta do 50 sessions you have to potentially, fork over, I think five, $6,000, if it's outta pocket we're nowhere close to that. And it's just important to make sure whatever practitioner you go to.
You really research their experience with a D you do your homework, get references and see what they're about, and then go to them. [00:24:00] And then it's definitely worth the cost because even if you're paying a little bit to, for the visits, you're getting a lot of tools. You're getting assessments, you're getting answers.
And if you have all of those, you probably don't need to come back. Most of our patients I'll be honest. See us about four to five times the first year. The second year they see us only twice because everything's been set up, they've figured everything out. We know what to do. And the second year is usually just a couple of blood tests and just following stuff through if they're very sick most of the labs are out of quest and lab Corp, which is through your insurance.
And then the specialty labs, like the stool tests and stuff. And food allergy tests, those are out of pocket. And they can range anywhere from, I think, a hundred, $150 to four 50 for the stool test. We've not really seen much resistance because we don't charge for the labs, they just pay the lab directly.
And they're just looking for answers. and if they feel better and they're getting outcomes, they're getting results, they're happy we see symptoms improve. But I do think that, I tell them realistically, before the first appointment, I said, it's gonna be a journey. [00:25:00] This is the investment.
Please don't start with us unless you can stay with us because there's no point in doing this for two visits and then just leaving it, doesn't help. And we're certainly not looking to, just take your money and not get results. That's not us. I will say that it is an investment, but in my eyes it's changed my life.
I've invested in it, invested in the functional medicine, holistic approach. And with ad dates, interesting something new will come up every. A new layer about my response to people who I am, how I am, and it's constant work for me, so I'm still learning. I'm still a student, but I'm definitely on the journey.
I am not currently on a medication because I feel that I can regulate myself without it. But there is a place and I use one, psychiatrist in Atlanta, Georgia, and she. Only trained in a, not train, not only trained, but she specifically focuses on add medications. That's all she does. I'm very specific about the [00:26:00] psychiatrist I sent folks to, even for that, because not every psychiatrist really knows the medications to that level of depth.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important that everything you just said really resonates with me because. When you're doing it for the right reasons. And not that there's a wrong reason, but what I mean is that when you yourself are the product of your product, meaning you have gone through something that has. Been transformational for yourself.
And then you're like, oh my God, it worked for me. And you can't wait to tell everybody else how, like it might work for them. It becomes like a no brainer for you to like, be talking about it. This is why I got into this because I didn't know what coaching was like two years ago. And so now I'm like, how come?
Not everybody has a coach, like how come nobody's drinking the Kool-Aid. And so it's just funny how I. It feels like it's, everything's been peachy. But it really hasn't, it just started to become peachy in the [00:27:00] last two years. But your brain kind of forgets because now when you're at this other new level, like you're saying you're constantly learning.
So you're, everything's new, everything's exciting. And you just keep leveling up and you just. Like you said your clients push you to learn more, not in a bad way, push you, but in a good way, push you because you want to show up and help them. And in the same time you are helping yourself. So it's a win, win now.
For your clients. And that's the same thing I tell my patients or my cl my patients. I have that I do treat with ADHD, but I also tell them, Hey, go seek a coach. Hey, go seek like a therapist. Hey, go seek like acupuncture, go seek like holistic, like functional medicine. There's some people in Houston that I refer to.
Even though it's a two hour drive for them, like they go. You are gonna send them to people you trust you're. And I tell them who not to go to also. Yeah. And so it. It's important to be [00:28:00] able to in your network have people you trust so that you can help each other and communicate with each other.
And do you mainly see people from Georgia or have you seen people come from all over just to chit
Dr. Laxmi Naiki: chat with you? Yeah. So I'm licensed in Georgia and Tennessee. However I do a one to two kind of educational consult for folks across the country. Not we don't prescribe medicines. We don't order labs, but people will often almost always contact me and send me all their information, their labs, their diagnoses, just to get an idea from me on what direction to go.
For their treatments and therapies. And I will give my advice on what they need to do. Like for example, we had, somebody call me from Boston that had gotten an entire functional medicine workup and were given, I would say like 15 supplements, which was just too much for the patient to take.
And they said, can you look at our blood work? Can you look at all our functional tests? Tell us what we need to. Give us a [00:29:00] better direction. And we did this was the patient with, the glyphosate at the 90th percentile. She had a leaky gut. She had obesity which was not addressed. It was addressed more from a detox perspective, but not, I think she would've probably benefited from a GLP one at that point, she, we give our own take on what direction.
And then the patient's daughter who contacted me. Went back, took the information. We wrote a report up and she said, this is what we're gonna do. And it's not that the physicians were not doing the right thing. It's just in the current insurance paradigm. They also don't have the time to look at the case in its entirety, and there's no residency for functional medicine.
There's no residency, so you can get your certifications, but if you don't know how to manage those labs and read the tests and know really clinically what to treat the people with, you're gonna get protocols of supplements. And then the patients are like, what is this? This makes no sense. And and
Dr. Diana Mercado-Marmarosh: I think I'm also biased.
Sorry to cut you off. It's like when [00:30:00] you yourself understand the diagnosis enough to where you can complete your clients. Words it there's so many layers that they don't have to describe to you because you know where they're going and why, what might be helpful. Again, I'm not saying that only people who have ADHD can help people who have ADHD.
But if you happen to find that unicorn who does, like, why not go to somebody who really understands you and so that it could. Make it be like one more thing that you don't have to explain. Because so much of medicine, like we are always trying to make sure we're following X, Y, and Z, but like you said, if you.
Have that hyper interest because it totally pertains to you. It just gives it to a different level. Perfect. So where could people like reach you so that they can send you their patients or they could [00:31:00] consult
Dr. Laxmi Naiki: you. Yeah, our website is spectrum iHealth, I, as in India, spectrum ihealth.com and you can find us at spectrum integrative health on Facebook, Instagram, LinkedIn all the fun social media sites.
And yeah, we're we're excited. We're growing and we're having fun and we're learning. I don't. Necessarily see ADB, but I see, multiple different conditions. Us, which ones? Yeah. Oh yeah. A lot of obviously, lot of women reach out to me. So a lot of it is menopause and weight loss and autoimmune.
And interestingly enough, we don't keep this in mind, but with trauma and a D The number one, silent killer really is heart disease. I'm seeing a lot of really tough cardiometabolic disease and we have a full-time lipidologist on staff. We have a full-time dietician, so all our patients have to go through her first.
She's a functional dietician nutritionist. So because again, fun foundation, if we don't get that diet, what are we doing? We're just writing you prescription pills for what. The [00:32:00] foundation is always diet. So she sees every single case coming through and we have this sort of team approach.
We have also a full-time Aveta consultant she's on the world health organization, board for Aveda. So she's just joined us, joined on our team. And my vision is really to bring this. Evidence based integrative approach to medicine, because I feel a lot of it has been lost due to lack of standardized training.
And we're not really sure. And, holistic has become this catchall term, and my vision for the, the practice is really to bring evidence based stuff together and to have this authentic way of approaching holistic medicines.
Dr. Diana Mercado-Marmarosh: Awesome. So where do you see yourself in the next three to five years?
For fun?
Dr. Laxmi Naiki: That's a good question. I need to pencil that in with my my work tendencies. Where do I see myself for fun? I don't know if I need a vision three to five years. I'm having fun now. Yeah, I try to have fun now. I don't really consider any [00:33:00] I don't know in my mind I don't really, piece it out as work or fun.
For me work is fun. That being said, because I have a tendency to overwork. I make sure I have these non-work fun. But yeah, I definitely. Try to re you know, relax through my meditation. I go out with friends on weekends, we're going on a trip this weekend for a week. Just doing all the stuff that's needed,
Dr. Diana Mercado-Marmarosh: do you think you would go like to a retreat, like in India or Bali or somewhere? What do you think would be fun that you might do in the next, it's in your bucket list, say in your next three to five
Dr. Laxmi Naiki: years? Oh my God. That's a lot of stuff. I wanna go like hiking in. Like a remote region of the world.
I wanna go to Bali. I wanna do this retreat that I do in Costa Rica. There's definitely stuff I wanna go to. Yeah, definitely stuff, places I wanna go that I haven't been to.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for coming. It's been such a pleasure. I always end this last question by saying that, Our listeners have ADHD and they probably [00:34:00] zoomed out somewhere
And so if they're about to like, just zoom in right now, and what is the one takeaway point that you would want them to walk away with from this episode?
Dr. Laxmi Naiki: Huh. I would say, look at, add as a gift, not as a diagnosis or a label. or an impairment. It's a gift. There's some incredible accomplishments I've made because I'm able to think quicker than people I'm able to do things much more than people I'm much more creative than a lot of people.
Those people have their gifts. I have mine, and definitely don't look at it in that way. Look at it as this incredible immense gift. And yes, there's potential that it may have some regulatory kind of issues, but you have tools. You have podcasts, you have books, you have coaches, you have therapists, you have tons of stuff now that you did not have 10 years ago or 15 years ago.
And there's a lot of help out there, but it's a gift. I consider it a gift.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much. It's been such a pleasure and [00:35:00] yeah who knows, we might be doing a retreat together soon. Who knows? I love to travel. So yeah, we gotta integrate everything so that everybody has a way to tame their
Dr. Laxmi Naiki: in touch.
It's been awesome talking to you. Thank you for having me. Thank you.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time
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share with your colleagues, and don't forget to check out my website at ADHD. Live coach.com, where you can find out about my upcoming.
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Dr. Emeka Obidi: Realize that ADHD is not bad. It it's just different. Especially speaking to the parent who is struggling with that decision for their child. To pause and really question and critically think about what's making them put up that resistance. Is there a significant opportunity cost to not get in their child help with the need right now, thinking about what possible advantage they might be in the future. Whereas a child is so right now make the right decision for the child.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello. I am so excited today to have a dear friend of mine, Dr. Emeka Obidi. He is a pediatrician almost 18 years experience.
And he's from Maryland or he's currently practicing in Maryland. Today we are gonna be talking about a conversation that sometimes it's a hard pill to swallow when you get the diagnosis, which is, getting diagnosed with ADHD. And he obviously has to give the talk to those parents when they get diagnosed.
And so we're just gonna talk about like how somebody who has. D might look like, because we don't realize that, you know, there might be something else going on, not just a kid being hyperactive and being a kid per se. And then what does it mean to try meds or not meds? Or what does it mean to get the diagnosis or not get the diagnosis?
Okay. So. Please, please welcome. And tell me, how are things going today?
Dr. Emeka Obidi: It is wonderful. Such a pleasure to be with you today, Dr. Mercado, thank you so much for having me on.
Dr. Diana Mercado-Marmarosh: Yes. So tell me, I'm pretty sure this is on a daily. That's what happens to me diagnosing different people on the, on the daily with ADHD or seeing how they're managing it.
What do you notice when people get that diagnosis? How, what happens?
Dr. Emeka Obidi: Yeah. I mean, the response is quite varied, right? You have parents who maybe already have ADHD themselves. So they've struggled through it and know that this can be a significant issue if not addressed. And so they recognize it in their maybe kids early and bring the kids in a happy to have that diagnosis made so they can start the process of getting the child, whatever help they need, right?
And you have parents who are not sure they know something is wrong or something may be coming up in school or at home, they think it might be, and they come and the kid is diagnosed and they have questions, but they're accepting of. The diagnosis and say, okay, well, you know, this is life as it is right now, let's see what we can do, what are our options?
And they can talk through that and ask very thoughtful questions and very like, you know, wanting to know really what's going on and how they can help their, their child. And I think parents who are also on the other end, who hear the diagnosis and immediately put up a resistance and. Honestly, those parents aren't necessarily bad parents. Right? They put up a resistance and not wanting to accept the diagnosis, maybe scared of the diagnosis, maybe not sure what that means. And, that can also be a more difficult conversation or situation to see because you know that, there might. Some significant barriers to this child, getting the help that they need in that scenario.
So, to answer your question, it really runs the Gama, you know, it's across the board, but, those other conversations where there are some resistance can be more challenging to handle because, oftentimes, you know, vast of, sometimes those parents love their kids as well and are thinking that they may be making the decision that's correct, or right for that child as well.
Dr. Diana Mercado-Marmarosh: Yeah, I know that my husband always tells me that even though he was told he had ADHD, his mom told him that he didn't need any meds, that he was just being a kid. And so he all along, he's never used meds. And it's just interesting how some people can do fine without meds but some people sometimes get themselves in trouble if they don't even understand that they have the diagnosis, right?
Because then you don't even know how to help yourself because all of a sudden, bad talking yourself, thinking that you are broken or thinking that you should be doing it a certain way. And blame yourself that you can't, but you're not even aware of where to even start, because you're not even aware that you have the diagnosis per se.
Dr. Emeka Obidi: Yes. That's so true. And I think that's where it's important for us to provide the best possible support for parents, you know, who are struggling with that decision to accept a diagnosis, or maybe even seek help for a diagnosis. Right. They may already notice something going on. Maybe you must suspect this might be ADHD, but afraid to get that diagnosis.
You know, I've had had a friend recently who had struggled through that with their daughter and some intimate conversations with him. It was difficult for them to come to that diagnosis and accept that diagnosis.
Dr. Diana Mercado-Marmarosh: So, if you are lucky enough to get the diagnosis at an early age during, you know, your pediatrician's able to help you find that out is sometimes if the patient gets started on meds, they might not take it the way they should, or sometimes they are undertreated. Right. And it could be a combo. It could be not being educated on how it actually can benefit them or thinking that they're gonna become addicted to them. Right? Or thinking that it's only something that you take while they're at school. And so all summer, they don't need it because they're not at school.
But then they come in and they're like, but they can't do anything at the house. And I'm like, no, really . So what have you seen?
Dr. Emeka Obidi: Yes, I've seen all of that, you know? I think that just to, to pick up on, on the last point you just made, some kids can't even enjoy play without. Proper treatment. Right? So they're on the ball field and they're just all over the place, you know, not paying attention to the coach, you know?
And they really enjoy the sport and want to be there, but are not able to perform to their potential because there's this other condition that is, you know, on treated that is affecting everything that's going on. Yeah. So I it's certainly. I think there's definitely a place to provide education. And, you know, I've been thinking about this more recently.
I think also, maybe when you encountered that parent who has that resistance paus into. Cause I think sometimes as. Clinicians. And I've certainly been there before. Also we almost put up a resistance also. It's like, no, you know, your kid really needs this cause you're advocating for the kid. Right. But I think it may be time for us to pause and meet the parent where they are, maybe help them see what might be going on because oftentimes there are other things that may be going on right.
There may be some cultural things at play. His friend of mine was from, you know, a different country outside of the US in a country where things like that are not, I consider that, oh, there's probably something seriously wrong here. Maybe all this is spiritual. Maybe there's, you know, this is just not. The child can have a headache.
The child can have whatever, something else, the ear infection, but when it comes to a mental diagnosis that has it own stigma attached to it, right? You may have issues relationally between caregivers, maybe parents is all on the same page, right? One thinks, or there's something wrong. We need to do one things.
Not has nothing wrong. Right? So all those things come into play. And I think maybe having a parent sitting them down and saying, Hey, listen, How about we, first of all, just recognize where you are, what your own personal feelings are with this diagnosis. Right? Just be more present, more mindful of your own possible bias and challenge it.
You know, challenge that assumption is ADHD truly different from another child who has diabetes or another child who has, you know, some kidney issue or whatever, right? Just constipation right? Whatever the issue is, just another medical condition. Is it really different and taking out time to think about your child.
And I know in most cases, parents feel they're thinking about the child. But maybe pausing and trying to think, am I really thinking about the child or is this somewhat about me also? What this maybe, you know, saying about me as a parent, right? How come I'm my kid? Isn't perfect. And I put that in quotation marks, right?
How come maybe accepting this diagnosis is saying there's something wrong with how I parented or something wrong with my gene pool or whatever. Right? So being sort of more recognizing that you may not necessarily be looking at child because you may wanna stop and say, okay, how is my child really doing?
Right? That is struggling and yes, maybe there are some marginal benefits to not having a diagnosis right now and having the child again in quotation, must labeled as ADHD. But is that gonna come at quite a high price also? Having a child who now has low self esteem, having a child who is having poor grades, having a child who maybe doesn't like schooling anymore.
Right? And so this path that they could have been on is truncated because of this horrible experience in the educational system. Right? So thinking that maybe there's more to look at here than just having a child who's labeled with ADHD in quotation marks and with the potential stigma that may come with that.
Right. Because they've also been studies that have shown that children who are not treated appropriately for ADHD have a higher likelihood of behaviors that get into trouble, whether it's behaviors with the law or not being able to hold on a job or having issues with their relationship and not being able to hold down a relationship and all these other things that could be unintended consequences for the child that you were trying to protect by not giving this diagnosis. Right? And so I think putting all that, just saying, you know what, I'm gonna trust myself to make the right decision for my child. I'm making that decision, not from a place of fear,
but from place of confidence and knowing and education, right. And just saying, this is what this child needs right now. And we're just gonna trust that things will turn out fine. You know, there's not a lack of examples of people who have thrived with ADHD, right. famous and otherwise. So that giving your child this diagnosis does not mean that you've just sentenced them to some terrible life..
Dr. Diana Mercado-Marmarosh: Yeah. So all those things that you just said are conversations that I have every day with my patients, both young adults or kids and parents or adults, because like you said, had they only known or had X, Y, Z like. Some regret that they have as adults. They're like, well, I wish I would've known. I wish of da, da my life could have been so much easier.
It could have been so much better. It could have been da, da, and, and I, what I always tell them is that, you know, who knows, like you think, but who knows, you might have had the diagnosis and you would've been like, no, I don't like that. Or da, da. Yeah. And you might have ignored it because some people do that.
I said, but. Now you're ready to understand. Now you're here, so let's go forward. Yeah. But there's still a grief that happens. Mm-hmm because you're like, what if or what could have been. Right. And so it's so important that you have this conversation and I'm so grateful that you're having this conversation, because like you said, we're always busy and sometimes mm-hmm , we don't slow down enough to like, explain the risks of not doing something about it, right? Yeah. And again, I think so. Not that you didn't want to, you just didn't know to like, you know, I grew up in Mexico till I was 10. If you look around my family, like that was the norm. Like we bicker at each other. We might say things we mean to, and then like in the weekend we're like kissing makeup and we're having a party. Right. And so you just didn't realize that those outbursts that you sometimes haven't say things impulsively. You didn't really mean because you still love each other. And so you just think that's just the norm. Like that's just my family and you don't realize that that's the emotional dysregulation that is happening.
And I think because like you said, in some cultures you just don't have those type of things in quotation marks. Right. You don't realize that. Yeah, you do. it's so obvious here, here, here, here and here. Yes. But you are not even aware that. Because of X here, here, here, and here. And then, and then you're like, oh, so that's why I crashed so many times.
Oh, that's why like I've eaten all this thing or I'm drinking so much, or I'm doing whatever...
Dr. Emeka Obidi: Self medicate.
Dr. Diana Mercado-Marmarosh: Exactly. Your body's gonna go grab what it needs, but it's so important. Like you said, that it could get you into trouble with the law and with your relationships. Right? Like I didn't get diagnosed until in my first year of med school and I think it was good and bad. I think it was good in the sense that I think had I had the diagnosis. I might have been all in my head that I'm no longer, like you said, " " perfect. Because I was the oldest one. Yeah. And in my mind, I was like, The role model, right?
Yeah. And so I think, because I didn't know any better, I did whatever I had to, to do it. And then once I had the diagnosis, I was all in my head like, oh my God, they're gonna find out that I'm broken. And da, da, let me work 10 times harder to mask how hard I'm working. Right. But again, who knows, maybe my life could have been easier or maybe not.
And so you just don't know. When or where, but. When you do the work and you understand, okay, nothing's broken. It's just, I always say it this way. It's being lefthanded in a right-handed world. So if you were given the tool, here's the lefthanded desk, here's the lefthanded pencil. All the sudden you might still be able to do what your peers and you need to do but in your own way.
So it's not wrong. It's just different.
Dr. Emeka Obidi: It's different. That is so true. And I think, you know, the, they, kids also need to hear that information as well. Cause I think oftentimes, like you said, sometimes they're the ones fighting against that as well. They don't want to take medication. Sometimes it's an issue with side effects and I always want to hear from the teen, you know, if they're having any side effects that the parents may not be aware of, because they may be feeling a certain way, that's making them you know, not want to take the medication, where it's a medication issue and that could easily be fixed by just doing something different, right. That doesn't have that side effect. But other times it's just, you know, how they think they're being perceived by their peers. And also what they feel is now they're not normal.
Now they have to take, you know, medication. Whereas they're friends don't have to take medication.
Dr. Diana Mercado-Marmarosh: Yeah. And what I say is that, you know, yes, we all been focusing right now on like maybe the negative things, like talking out loud or interrupting their friends when they're all talking, cuz they don't wanna forget what they're telling them and pretend that they're not listening. Right. But at the same time, these are the kids that tend to think outside the box, creative and figure out things. I always laugh at them and I tell 'em, you're like a tortured musician and they look at me and I'm like, yeah, you're probably really amazing at putting all these things together. And then you think it's crap and you wanna go dump it, but it's amazing.
And you don't see it because you're like the tortured musician. Like you can't see that you created this beautiful thing because you feel like you're not doing all the other things that society has told you you needed to do. Yeah. And therefore you discredit the gifts that you do have
Dr. Emeka Obidi: Yes that is true. Very true. And, this other friend I was talking about, the daughter is so creative, so creative, and they're always saying she just comes up with all this interesting, like when people are trying to figure out things, just sort of just here's the answer, right? Like, we've all been trying to hit our heads together, trying to figure out how to solve this problem in the home right now.
And you just blotted out the answer without even thinking twice. So I totally agree with you helping them recognize that that's a superpower in many ways. Can go a long way.
Dr. Diana Mercado-Marmarosh: Yeah. Because, because then you don't make it mean anything like now, to me, that's amazing. Of course, like you said, they're probably like, oh my God, there's a worst thing ever.
But then I'm like, this is the best thing ever. You can do whatever you like. Do you wanna be a doctor? Do you wanna be an ER nurse? Do you wanna be a policeman? What do you wanna do? Because whatever your passion is, as long as you're following your passion, you're gonna do it because people with ADHD, you cannot make them do anything.
Like, it has to be aligned with their values and their goals. I mean, they might do some stuff, but they're not gonna stay there. . That's why they jump from job to job, to job until they find what is really their purpose. And then like, it's the environment.
So again, if you know this about you, then all of a sudden you're not blaming yourself or anything. You'd be surprised. Like how many people are. Doc. I can't believe I'm now getting five times payment than I did before, because I realized that, you know, this was my passion, like you said, and now I'm doing this.
And, but again, sometimes we don't stop or slow down enough to really find out. what comes easy to you and like, why and then how can I help myself? And, it begins with the diagnosis, because like you said, it might be that they got the diagnosis and they never follow up because they're so ashamed of it and they don't, or they don't tell you why they stop taking it and you can't modify it.
It could have been, there's so many different meds. There's not just one meds. Yes, exactly. And again, what if meds are not the answer and that's okay. And, but we wouldn't know. If you don't come back
Dr. Emeka Obidi: Yes. We don't come back and sit that and have a discussion and a conversation. And I tell friends that all the time, too.
Yes. We have to look at all the possible ways to handle this. And like you said, it's not always meds, but where it is necessary, then it is necessary and that's what the child needs. And you open sometimes our run into is them not wanting to use an appropriate dose. I don't wanna increase it. I'm like, well, you're already taking the medication.
You know, there's no point taking an ineffective dose, right. Take the right dose. And they're afraid of, oh, but I don't want my child to be a zombie. And I'm like, well, that's why this is a partnership. You come and tell me if you're seeing a side effect you don't like so that we can or something that's happening.
Cause I'm not there 24 7. If you tell me this is what's going on, we can troubleshoot it and see if it's a medication issue, a timing issue, you know, and walk through it. Yeah.
Dr. Diana Mercado-Marmarosh: Yeah. So I give my patients like a handout, just like you give a blood pressure medication. I give them a handout and I tell 'em right there.
When you started the med, what time did you feel like it wear off. What side effects did you have? I treated like I'm treating high blood pressure and diabetes and whatever, because we're not gonna remember what, how you felt a week ago or two weeks ago. But if you have it in writing, then all of a sudden I can start to see if there's any patterns.
And then we can modify it if needed. And like the point that you just made is so important that not a lot of physicians are even aware of the fact that medications are processed through the liver, especially the most of the ADHD meds are. And so for some people, the extended release might not last as long as the regular, which is almost opposite of what you think would happen, right? And then you have some that are really fast metabolizer, so they might need to be on really high doses. Like you would think there's no way this little kiddo can like do this yet. They need it. And then you have this adult that you give them, you know, a medium dose and they're like, no doc, this is too much.
And like, they're like, I took half of it or I took one fourth of it, but it works for them. Like you just don't know. But if you have this in writing, then you have a little bit better way of managing. And what I was talking about, some of us think that we should just take the med while we're at work. And I'm like, well, I think you go to work so that you can provide for your family.
And I'm pretty sure your family wants you to be able to do things at home. Not just at work, right? Like I'm pretty sure they want you to also help clean your room or help you do chores. Right? Like it's a team effort. It's not just for work. It's something that we always have to like bring up, because for some reason, I don't know why people think that meds should only be used while you're doing work.
Right. In quotation marks. But like at home, if you're driving your kids around and you have ADHD, I mean, I hope you're doing something to get your ADHD controlled. Otherwise, you know, you're gonna be having an accident somewhere, right. Especially, cuz we're always late sometimes, you know, so, those are just things to consider that, you know, like you said, how much is it gonna cost you to not learn about it and not to provide or create systems with it?
Dr. Emeka Obidi: Yeah. And I think the more each person embraces whatever that diagnosis is in this case, we're talking about ADHD as they embrace that diagnosis becomes more and more normalized, right? So it's not like, oh, those people have ADHD and they are less than or different in a bad way. It's just, oh, they have ADHD, just like someone else has hypertension.
Right. And that we take away the stigma. But that doesn't happen. If we don't individually start to embrace what is and walk with what is and maximize, you know, what is in the life that that child or adult has.
Dr. Diana Mercado-Marmarosh: And what are your usual go to? Like, do you have any websites or books that you tell parents to listen to or do you just, what do you usually do once you tell 'em? Okay. Here's the diagnosis.
Dr. Emeka Obidi: Yeah, I have some, I have some, some resources here, practice, just, paper, resources that I give out. And those are very helpful for our parents. Yeah. And, can on top of my head, remember the, the source right now. But that's usually helpful.
Dr. Diana Mercado-Marmarosh: Sure. Yeah. So one of the things that I tell them is the ADHD 2.0 book.
That one is Dr. Hallowell's book, and he's a psychiatrist himself who has ADHD. And he's like one of the, I wanna say ADHD gurus because it's really good because it's written like how to help like a kid, but it's also like how to help an adult if you help. It 's super like validating because he talks about like the greatest and latest.
Functional MRI studies. I can show you like, you know, that you might have ADHD, although that's not what it's used to diagnose, but it's more to at least understand some of the stuff that is going on and to understand why females seem to be diagnosed a little bit later cuz of the, in a inattentive type of stuff.
But another website that I give my patients is, attitudemag.com because that website is all ADHD website. Like, it talks about how to help the parents with like a behavior or how to help the kids like declutter or like prioritize. And it also is for like teenagers or for adults. And it talks about finances, food and blah, blah, blah, blah, blah mm-hmm . And so they have free webinars and resources that are, they try to bring in like the therapists and the physicians and the, you know, uh, psychologists, coaches, all kinds of people.
Dr. Emeka Obidi: That's really good to know.
Dr. Diana Mercado-Marmarosh: Yeah. And then there is a conference called chat, C H a D D. That conference. And so that's really good because it's like two or three days of all ADHD. So it can really be very helpful for the parents or for the kids, if they're listening to it, to see that there's tools. So there's other people, like you said, normalize. You know, then it doesn't become such a problem because they're like, oh, okay, cool.
It's just different. But it doesn't necessarily mean anything. So where can people come and, work with you? Because, I mean, it sounds like you're a pretty amazing pediatrician. Who's able to explain, you know, ADHD and any other conditions that they might have. And I'm pretty sure they would, you know, win the lottery they came and worked with you.
Dr. Emeka Obidi: Oh, that's the kind of you? Well, my practice medical practice is in Hagerstown, Maryland, Western, Maryland. And, I do have a Facebook page and I do a Facebook live every, every Thursday at 1230 Eastern and talking about one topic or the other, I had a series I did on ADHD as well. And, name of the practice is Partners in Pediatrics And Family Health and, they can just Google pull that up on Facebook. P I P FH I think will pull it up also.
Dr. Diana Mercado-Marmarosh: Awesome. So. Where do you see yourself in the next three to five years for fun?
Dr. Emeka Obidi: Oh, boy is, well, I see myself doing some of what I'm doing right now. I really enjoy my practice. I also have another business that I run and it's an online education for new moms and, that information they can get at newbornprepacademy.com. And, I have an online course. I do that, newborn preparation course that just prepares new moms for their newborns. I enjoy that part of my practice as well.
Dr. Diana Mercado-Marmarosh: But for fun, what are you gonna, are you gonna travel the world? Are you going to..
Dr. Emeka Obidi: For fun? No, I missed that for fun. Look at me. Jump into, well for fun. I would love to do more traveling. My family and I actually just came back from Scottsdale, Arizona, and we had a wonderful time and went up to Sedona, to look at the mountains and it was beautiful and I certainly would love to do more of that. There's too many beautiful places in the world and, we're hoping we can do some more international travel next year.
Dr. Diana Mercado-Marmarosh: Awesome. What's in your bucket list.
Dr. Emeka Obidi: My bucket list? Oh, geez. These are hard questions.
Dr. Diana Mercado-Marmarosh: Where do you wanna travel? You said you wanna travel?
Dr. Emeka Obidi: I would really love to. You know, I don't know if I'll call it a bucket list, cuz hopefully I can get to do that very soon. I would really wanna go on a cruise in a Mediterranean and really visit some of the Mediterranean countries. I think that would be really cool.
Dr. Diana Mercado-Marmarosh: Yeah. That sounds amazing. yeah, I hadn't really seen Europe until a couple of, probably five, six years ago. I can't remember exactly, but yeah, I did a Mediterranean trip, cruise. Oh, really? That was wonderful. It was like a 10 or a 12 day. It was really good because it went, I think it, it took off in Spain and then it landed in Venice.
Like, so. Yeah. And so it was so good cuz I hadn't never seen Europe. So yeah. This was like a really cool way to like be in, in like pizza one day and be in, in Florence and be in like Greece and be like in Montenegro, all this places that you're in Rome. And then you're like in Venice and I'm like, oh my God, this is so cool. And it was enough ofcourse it was just a few hours at a time, but it was, but it was so cool
Dr. Emeka Obidi: Atleast still got a taste of each area, right?
Dr. Diana Mercado-Marmarosh: Yeah. You got taste and then you didn't have to like pack and unpack pack and unpack. Right. You just like, get off, see it maybe come back. Yeah. And so then you'd know later on, if you decide where you wanna go to.
Where you wanna go to where you wanna go spend some more time in the future, so, yeah. Yeah. So, cool. Awesome. Okay. So the last question, so, you know, our listeners have ADHD or know somebody who have ADHD and probably they just zoomed out like somewhere. So if they're just paying attention now, cause they just came back.
What is the takeaway point that you would want them to take away if they didn't listen to the podcast, but they just gonna walk away with this piece of information.
Dr. Emeka Obidi: I think it's to realize that just like you had said, ADHD is not bad. It it's just different. And especially speaking to the parent who is struggling with that decision for their child.
To pause and really question and critically think about what's making them put up that resistance. And is there a significant opportunity cost to not get in their child help with the need right now, thinking about what possible advantage they might be in the future. Whereas a child is suffering now and hoping that they can let down their guard.
Get that information. Think about it critically and make the right decision for the child.
Dr. Diana Mercado-Marmarosh: Well, thank you so much, Dr. Emeka. You just kicked it out of the park today, and I am so sure that people are gonna come and find you in Maryland, because it sounds like that's an amazing practice that you have over there.
Dr. Emeka Obidi: Oh, thank you very much, Dr. Mercado, it was real nice spending some time with you today.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane
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About Dr. Emeka Obidi
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Dr. Mydalis Diaz-Ramirez: Big message to our listeners, right? When you're lost, you know, in this despair, maybe burnout. So tired, sometimes you're so hurt that you become numb and you keep going. And then we talk about the golden handcuffs or, you know, gonna move. And you know what, at the end of the day, who's making the decision of staying. There is no one else other than you. So you're making the decision of staying there. You can make the decision of coming outside. You have to understand that you can find your path again. If you're in the right group.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Dr. Diana Mercado-Marmarosh: Well, hello. I am so excited today. I am speaking with a dear friend of mine. Who's become, such a instrumental part of my journey, and it's a pleasure to bring her on board today that this Dr. Mydalis Diaz-Ramirez she's actually, an anesthesiologist and an interventional pain management physician who after 20 years of training and doing what she loves is now transitioning into innovative medicine, really being a trailblazer and pioneer in the lifestyle medicine.
It's so good to have been part of her network and seeing her as she's been able to not only empower herself, but empower other physicians through master classes, six-month master classes to build their businesses, and practice medicine on their own terms. And she's also doing podcasting and all kinds of stuff.
So welcome Dr. Mydalis, tell us all the things, how are things going for you?
Dr. Mydalis Diaz-Ramirez: Oh, my goodness, Deanna. I'm just so excited. It gives me chills to hear you because, the way that we met was precisely through our mastermind and that's how it's going. Right. We have our new mastermind coming now in August and we're getting the new members and we're just like, It's been quite a transition, quite, the transformation for all of us, not for only the members of the mastermind, but for me too, as the facilitator and as a physician, it's been quite the changes, so we're very happy.
We're enthusiastic. We're very excited about what's coming up and, I can wait to tell you more about.
Dr. Diana Mercado-Marmarosh: Awesome. So how did you decide that you were gonna start this journey, like in, in pain management? Was it something that you always envisioned and then like what made you decide to transition to something more innovative? Like lifestyle medicine? So
Dr. Mydalis Diaz-Ramirez: Pain management, I got into it, actually pain drew me to pain. I went to medical school, I did my internship and then I chose anesthesiology. And then while I wasn't doing anesthesiology, then I developed some decorat veins on my right hand I'm right handed. So that eventually they dumped me at the pain center because I could not be in the, or, and then they're, I learn about pain management and it's like, I fell in love because then I could see the transformations are not only the patients, but their families.
And would I be able to do some, long-term follow-ups for those patients and do surgery, which I really liked. So one of the things that I had thought about doing was neurosurgery or even orthopedic surgery. And I, there you are. I'm doing those things. I'm placing spinal cord, simulators, pumps, and all these things.
And then 20 years later through the years, I've seen how patients have come to us. And there's so much more that we can in terms of finding nerve root costs for many of the things that people suffer. For example, we see a lot of patients who come when they're 40. And they were like on antidepressant and then something for sleep and then something for inflammation and really the root cause as in being examined, nobody wanted to do their, their hormones or just help 'em with those things. So I said, you know, what, why don't I focus more on prevention and then I can like, do see the whole picture for those patients and how that's, how this came. So we have found, lifestyle medicine, functional medicine, regenerative medicine, those ways of trying to get to those patients, give them like the best evaluation possible.
And then if they still need something at the end of the day, then we can work on those things as well.
Dr. Diana Mercado-Marmarosh: Yeah, that's so amazing. Tell me about this new adventure that you're doing. You found some of your partners through this mastermind, right?
Dr. Mydalis Diaz-Ramirez: It's funny, but because I tell my kids never trust anybody you meet online, right? Here we're I'm here with you. Like I consider you a friend. Have we ever met each other in person? Have we ever Hugg each other? Not yet, but we are on our way to do that soon. I'm hoping. And that's how it's been. So the, this has given us the opportunity to meet so many people. And one of them is my new partner, Miranda Phillips. She eventually asked me, Hey, is there someone that in Sarasota, I really want to go to Florida. And it's like, okay. You know, and then like, I'll call you right back. And instead of giving her some names of some people that she could be working here, part-time I gave her a whole business plan. I put together not a business plan, but a vision, a plan of a vision for our clinic.
And that's one of them. So I met her through the mastermind, my other business partner, Dr. Arun Rao, I also met her she's local here to Sarasota, Florida, but we truly, got to know each other through our mastermind. So now the three of us mastermind related, we are coming to real life, physical life, giving a service to our patients here locally.
And actually we want to make it a destination facility. So that's, that's one of the big, huge gifts this group has given our families. Really?
Dr. Diana Mercado-Marmarosh: Yes. I actually joined your mastermind. It was the very first one. Right. And it was before. Before the business, I would say where before my business, so I hadn't finished, I hadn't graduated yet from my life coach school training. At that time I finished in July and I remember it was all just an idea, right? Like I was something I was working toward. It was where the growth happened, where my baby was bur or so to say. And it was so amazing to be in an environment where it was intimate, because I, I believe we were like 10 in the group and it was so unique because you asked for the spouse to come along and here I was being so excited about my business and talking about my business with my husband. So I just assumed that he was gonna be like, yes, of course, I'm coming to support you in this, amazing mastermind. So I signed us up and then the day that we're supposed to meet, I tell my husband, I'm like, Hey, come on, let's get on the zoom meeting. And he's like, wait, what? You signed me up without asking me?
And he was like, yeah, I'm not going to another zoom meeting. I'm on zoom meetings, like seven hours a day. Cuz he works from. And he's like, I'm not gonna do one more zoom meeting. I can support your system or your business from afar, but I'm not going to another zoom meeting. And I was like, so embarrassed and I remember emailing or texting Mydalis.
I was like, would you still have me army of one because yeah, I made an assumption and she's like, yeah, come on in. It was just a really unique experience because. All the physicians in the room, male or female then brought their spouse and their spouses. Some of them were medicine, but some of them were not.
And that was where the beauty was, where y'all sudden had access to everybody else's way of thinking. And you could. Talk about whatever you were going or you're thinking you were working on and people could give you feedback. She called it the hot seat. They put you in the hot seat and then she brought experts to help you move you along.
And so at that time, I didn't realize how valuable. Yes. I realized that I knew accountability was needed, but now looking back, I don't know if I would've been such successful towards the beginning. Had I not had that type of environment where you're regularly meeting? Once a week and you're not just accountable to yourself, but to the whole group.
And so I bring this up because people with ADHD, we need structures, we need routines, but more importantly, we need people who are not gonna crush all their dreams when we think, because we have thousands of dreams and sometimes we have to make sure that the environment we're in facilitates that. But it also kind of, I don't wanna say restricts us, but I wanna say hones in on what is prioritizing is the word I'm looking for instead of restricting, I wanna use the word prioritizing because, not all thousand ideas are meant to come alive, but we gotta figure out which one you're really passionate about. And then what steps. So you don't get in the way. And this is where I was, it was such a blessing to be able to be part of Mydalis group. And so yeah, if you wanna share what it was like to have, somebody like me in your group, let us know.
Dr. Mydalis Diaz-Ramirez: Well, I have to tell you Diana, like you're one of our superstars. Because, we all know you've made all as part of your story with ADHD, you were really focused on what you wanted to achieve. You had a clear idea and you were very passionate. You were very driven, you are very driven. And, you've been an example and having somebody with ADHD, actually, my last cohort. We discovered like half of our, of our physicians had a ADHD.
Maybe there were some more who didn't, share that. But, as you say, the group parties has allowed us, is to hone down on what the dream is and then set priorities and then keep you accountable for that area. So we're gonna make sure that we're gonna identify first, you know, right. Different from home when you came the first time that we have onboarding process and we make sure that everybody writes down and, tells us in detail what they want to do.
And then we're gonna go and set the priorities. What is most important? What's gonna give you. Your best return on investment or at the quickest, you know, so that you can start right away. It doesn't have to be a business for many, of our, of our members, actually, it's the life, change that they're looking for and to look for opportunities and, what they want to learn.
Some people want just to learn about mindset and then getting into that mindset. Most of it is through entrepreneurship, what we want to achieve. But people with ADHD are able to focus on a small group. That's gonna have no judgment for them. It's gonna make them accountable. It can be with, or without your partner, in your case, you didn't have a partner.
And I remember like you asking me, can I come and say yes, yes, please come. Because what we want to do is change, the lives or our physicians so that they understand that they're control. And when you are somebody with ADHD at times, like you are really out of control because you have so many ideas going on and, so many dreams, as you say that we help you structure.
We help you give structure for that. And then once hopefully you have achieved this successful plan and you have. Taking into completion, then we can add another dream. So we don't have to cut you off the dreams. We just organize them with you and having somebody like you. That's the things like you have so much energy.
You can be such a great example and look what you've achieved. Like I always remember within three months you were already selling within three months of, I think two or three months, you were already selling your coaching business. And you were telling us everywhere what you were doing. And I just remembered this particular when you said, oh, I went ahead and I started selling and I didn't even press have the button for people to pay me.
I was like so funny, but it was so good because then that's, you know, like you knew you were gonna talk to somebody. and, you were gonna be able to get through those hurdles quicker than if you were doing this on your own. And even though your husband has the best intentions of giving you the support, he wasn't necessarily there for you, you know, step by step for the business.
So that's what, what we were there for you. So having somebody like you in our group is like a blessing and it's been wonderful. And we're so proud of you. Like you can imagine.
Dr. Diana Mercado-Marmarosh: Yeah. And, and it came full circle. When you asked me if I could come back and be a speaker for your program. And I thought that was amazing.
And even while I was already in your mastermind, I did also volunteer to be a speaker to our colleagues because we all don't realize like the gifts that we have that come. So naturally that we think that who wants to hear that, but actually. I don't wanna say I, you know, I was accredited to, but I was part of some conversations that happened that allowed one of our physicians to consider what he wanted in terms of, family style and traveling so many hours.
And we had conversations around, what does it mean to prioritize your time and your charting and your stuff. And we were all doing the happy dance at the end when he. You know, a different job that was aligned with this lifestyle that he was envisioning and the hours, and no longer having to drive so many hours and be away from his, family because of.
The charting and, he was optimizing, but he had just like, we all have some limiting beliefs that we think that where we are is the best we'll ever be at and not necessarily right. Like we get to dream every day and then come and implement it. in Mydalis group, how to execute it so that we could do it.
And it was having that vulnerability of saying, well, this is what I'm doing. And we weren't judging him for doing that because he thought that this is what he needed to do, but we could see past how much better it could be if he wanted it. Right? And so that's where it's so important. Like she says, sometimes it's just a mind shift that you need in order for you to practice medicine the way you want it.
And that opens up the ripple effect for how you show up for your family and how you show up, for your colleagues. Right? And by more importantly, how you show up for yourself, because we think we're functioning at the highest level, but it maybe when we get into a room, others can see your blindspot. And it's so much quicker that our growth can happen because they're showing it to us from a place of love.
Dr. Mydalis Diaz-Ramirez: And the transformation that you helped, achieve for that doctor. He gained four hours every day. From that transformation. So within six months he already had a different job. He was already studying about, a real estate, which was a way of doing passive income. And he was already publishing pictures with their family from the time, you know, he had so much more time off.
So he learned how to chart better. He changed to a job where he acquire it was more than four hours a day, because then at times when he was going at night. Actually almost every single night, he would then chart after having dinner. So now he wasn't charting at home. So he acquired that time plus a traveling time, which was a 12, four hours a day.
So that quite up at least like, I don't know, six hours a day, just from this transformation, plus the real estate knowledge and, the way that his, wife came to our mastermind. So she learned about those options as well. And, and it was really a family affair. So it was really transformational for everybody there.
Dr. Diana Mercado-Marmarosh: Yeah. And I think for everybody else too, to see it right, to see that this is possible, that I know somebody and I actually got to meet him and his wife in New York. When we went to go visit Dave's parents, my husband's parents. So it's like such a small world. Like you said, sometimes people that we meet online that were like, well, who are you meeting?
But you meet in person and, like, you know them because you've been talking to them for six months, like week by week, you, you understand their ins and outs, their love, their fears. It's such a powerful area that it's almost like you were in residency again, but without the drama, right? Because in residency, you're just all trying to survive, but like now you have a purpose, like invested in yourself and in the wellbeing of your family and on purpose are deciding that you have a goal in mind. And that you're just gonna get from point a to point B. And I don't know how you would do it, but you would magically just spring, like the person to talk to for that stuff.
I remember it was through. Brought like Dr. Unah for me, when, for me, she was a superstar at that point. Like somebody, I was just like in awe with, right. I was so starstruck. And like now I, I have been able to work with her in her program, but you created those opportunities and you brought other people for me, super bowl expert with ads to talk about branding and, it was just like, wow, like to get the collabor of people.
In this to talk to us and they see it as like, oh, I'm talking to physicians and we're seeing it like, oh, we're talking to superstars. It, it's just amazing to be able to make those network connections. And then to think why not me?
Dr. Mydalis Diaz-Ramirez: I have to tell you, like, that's what I found the most. One of the most significant things, besides all the friendships and transformations is that this is one of the best times, if not the best time in history for physicians to really come together and help each other.
And I, I, you say like magic, I really called a lot of people to be able to, to get. And, you know, you would get like some responses and some notes. But I never stopped asking because for us to transform, we really need those examples. And what better than having somebody who's been successful at that come and tell you person to person, you know, what, what you can do first?
Like, yes, you're capable of doing it. Like, I think it's universal that they say, you know, I'm, I'm not special. I'm just like a doctor. Like you are. Who took these steps and here are the steps that you have to take and, boom. And then you ask them, Hey, I'm having problem with this. Oh, don't worry. This is the way that you do it.
So that's how we advance. And to me, having access to these tons. So as you say, superstars has been, has been a blessing and there's no better time. And I think that we all have to take advantage of that so that we all raise, you know, we all grow together. We all lived each other and it's been quite a gift.
And, I want to thank our coaches because our coaches, without our coaches, there's no mastermind and you're one of them you've been you've. One of them helping us from the very beginning and, yeah, the coaches. It's amazing in our page, we have some of them, we don't have all of them. But it's those journeys, you know, like you, you can think of at times just looking back, I don't know, five years ago, would I have thought in my mind that I would be talking to somebody like that? Maybe not, you know? But here they are and they're like us and they're talking to us and then they inspire all of us. It's quite the gift.
Dr. Diana Mercado-Marmarosh: Yeah. And, I wanna point out that, like you said, I made a lot of phone calls. I got some, yes, I got some nos. I got no responses. I think that's the part that trips us up with ADHD. We think, oh, that's too hard. I don't want to ask people, what are they gonna think? Da, da, da, da. And I think because you took. Some part of that, like, it was so easy. I just had to show up. And of course I had to do some steps afterwards, but you took away as many of the things that would get in the wake, which is just starting or just the conversation. Right? Just starting that conversation. And I think that's why. It's so important to not take it personally, but you can see why people with ADHD do take it personally, if they don't understand that in human nature, usually, the two things we really want is love and connection, right? Those are the two things we want.
And when we feel one or the other is being threatened, then yes. Some of us feel rejected, but people with ADHD, a hundred percent of people with ADHD experience, what is called rejection, sensitivity, Dysphobia, which means that we will take it way outta context that, oh my God, they don't wanna talk to me.
That's it, I'm a failure. And we go to all these other places, but instead. Not making it mean anything is so easy, but it's so hard at the same time. But when you're in an environment where the people that are coming to talk to you are coming because they want to, because they decided that, yes, I want to help this person get to where I am.
And like you said, I'm not any different. I just took extra steps. And, it's the same thing. It's a muscle, right? Not all everybody. Well, nobody really knew all the form of meds. Right? We don't know all the names of these meds, but we learned them. Right? We all learned them because we knew it was part of the thing.
And I remember you crushing when we started talking about like real estate, like my mind would just wanna shut off because I was like, I don't know, money. I don't need to understand. And it was, my husband was always like, yes, you do. You need to understand money. You need to have an express spreadsheet.
You have to see how much you're spending so you can see how much you're making. And I was like, why do I have to know that? Like I know there's plenty. And so the problem then becomes that if you don't understand where you are, You don't know where you're going. Right. And a lot of us sometimes get stuck in that.
We feel like what, wherever we're at, we're comfortable at, and we don't need to go anywhere else. But if there's a something inside of you that tells you, yes, I'm a physician, but I want to practice more. I want to do more. I wanna have more impact. Then you really need to listen to that little voice, because it's gonna nag at you and you just have to take some steps.
So in your master class and in your podcast, you really highlight the importance of network. And like they say, you're the average of the five people you hang around with. And so it's so important to not necessarily go out there because what am I gonna get back? Because you're planting seeds everywhere, because one day you don't know who's gonna help open a door for you, or likewise, you don't know whose door you're gonna help open that can help and impact the rest of humanity. Right?
Dr. Mydalis Diaz-Ramirez: Yeah. One of the things that I've decided to lead my life, with is one is love. You know, like we all, as you say love, and the other one is contribution, and I've seen that by giving. I'm not giving to get, but it just happens that you just get more. I really was not expecting to have these partners from the mastermind coming and it, it just happened like that.
And, I cannot tell you how life changing it. It's been like every day we have changes that are happening right and left. In terms of the podcast that you were mentioning, it's called designer physician life. And we want to give specific tips in each podcast. Episode that you can start right away. So I remember the conversation you having in our mastermind.
And I'm saying this because you allow me usually what happens in the mastermind stays in the mastermind like, like Vegas, but Deanna just mentioned it. It's like she didn't, she had that conversation with her husband and she brought it to us. It's like, it was so funny because there you go. Like, she doesn't know how to put that button to, to get the people to pay.
And then she's spending some money in coaching and all these things, and it's super important that, you know, and it cannot let that. You cannot give that authority to anybody else. Right? You have to have the authority because you know, what's gonna happen to you. It's like the comparison I make is when you have a patient and you give them instructions for labs or physical therapy or something, and then they come a month, whenever you tell 'em come between four to eight weeks later to report on those changes.
They come and it's like, oh, nobody called me. It's like, really? And then you get so upset. It's like, how come nobody called you? Couldn't you call that place? You know? Like maybe they didn't call you because they got busy, you know? And that's what happens with everybody else. One, when you receive this, notes for example, and people are telling you no it's because maybe they're busy with something else.
It's not that you're not a good person or representative that has nothing to do with you is that they're busy doing something else. And that's why you have to take matters, you know, into your hands for your destiny. And, you have to understand all these things yourself. We don't learn any of these in medical school. Right? So in our podcast, we will have specific tips so that you can learn about your finances, what to do about how to really get with people who are aligned with what you do. And we teach people to still love your friends. Still love your family. Still love your coworkers, but if they're not supportive, if they are in a different mindset, Spend the social time with them and spend your creativity time, spend your inspiring time, spend your entrepreneurial time with that group that's really gonna help you succeed. That's one of the big things that we talk about.
So first yeah, you have to take matters into your hands. Don't worry that you've had some rejections and this is not a matter of being difficult or hard. One of the things that we learned from, Kenji, for example, when he came to talk to us about mindset, it's not talking about heart is if it's a worthy challenge.
So is this a worthy challenge? Is it worth it that somebody with ADHD or not ADHD is going to be able to reach to someone? Who's gonna coach them. Yes. It's worth it. So let's work on it. Is it difficult? Is it hard? We set those aside and then we see the challenge if it's worthy or not. Is it worth it for you to take care of your of your own life?
For example, Diana, April, 2021, just a plan, just an idea. A year later, you've made some extra, how much, how many times have you made from the money that you invested in your coaching? It's at least twice right, by now. Is that correct?
Dr. Diana Mercado-Marmarosh: Yeah.
Dr. Mydalis Diaz-Ramirez: Now that you know your numbers.
Dr. Diana Mercado-Marmarosh: Yeah. I know now that I know my numbers, I will tell you. So when I started, when it was just an idea, by the time I graduated, I had made $2,000. When by the time I graduated July of 21, and then by June of 22, I had made $148,000 from that.
Dr. Mydalis Diaz-Ramirez: It's just over a year later. Right. And then now you've been offered the possibility. Right. We dunno how that's gonna materialize the possibility of between three to six months in your life making twice one and half or twice your salary that you make in a whole year. Is that correct?
Dr. Diana Mercado-Marmarosh: Yes, correct. Yes.
Dr. Mydalis Diaz-Ramirez: So what would have happened for Diana Mercado-Marmarosh, if she was still waiting to start thinking that it was gonna be difficult, thinking that she could not do it thinking for that period of time that she was not worth that she was gonna get rejections. Hmm. And she was wait for it to be perfect. To have to know how that bottom to charge for people was. Huh? You would have missing all these things. Right. And look where you are. So that's, that's a big message. To our listeners, right? Doesn't matter that you have ADHD, you have to get into the right group, right connections.
We're fortunate that we've been able to have people like Diana and a bunch of others in our group who have ADHD and then help them achieve their dreams. And these are things that you have to take into your own hands. You have to take your own future. And as a physician, when you're lost, you know, in despair, maybe burnout, so tired, sometimes you're so hurt that you become numb and you keep going. And then we talk about the golden handcuffs or, you know, gonna move. And you know what, at the end of the day, who's making the decision of staying there is no one else other than. So you're making the decision of staying there. You can make the decision of coming outside my own story just recently. Not, not that long ago, I had decided like I had businesses and I had the clinics and then I sold those clinic successful.
And I decided to start to stay, to remain as an employee in those clinics, because I wanted to spend some more time with my kids at this stage of life and all these things. Right? So I gave those rights away by staying as an employee. And I realized that really that's not the life for me, you know? And I cannot blame them for being who they are.
It's I only blame myself for staying there for as long as I, because it just doesn't make me happy to not have that control. So when they came to me, And I had already resigned. I gave them three months that I was gonna resign from this job and then six weeks into this process. So I still had like six other weeks left.
They come one day at the end of the day and they tell me, today's your last day, you know, what do you do? Like we have decided to accelerate your departure. So then I decided immediately that's the first time and the last time that anybody will tell me, what I'm gonna do the next day at work, right?
That's all I can do. I cannot be crying. I cannot blame them because at the end of the day, I was the one who chose that job. Right? So as a physician with, or without ADHD, you have to understand your options. You have to understand that you're in control and that you have to understand that you can get you, you can find your path away your path again, if you're in the right group.
Dr. Diana Mercado-Marmarosh: Yeah. And, I think you were able to go through that for a lot of us, that type of stuff would've been crushing, right? Like being told you no longer have a job, but because you were in this growth mindset. And the people around you were there to say, it's funny who you surround with because now for most of us, and if we lose a job, like we don't make it be the end of the world because we realize that it's okay.
I am the secret sauce. So it doesn't matter where I'm at. I will make it even better. And before we used to think, you should bow down that you have a job. Right. But now we have come to realize that nobody owns us, unless you let them own you because you're not living in alignment with your values. It didn't crush you. It made you stronger.
Because of the community that you had, and it allowed you to dream and think outside the box to do it your own way and to trust in you. And, and I was actually gonna ask you about this because I know you're one of few physicians, female physicians who has been able to secure what your new practice that you're going into secure alone, and even asked to be in the board of financial planning for this bank now. Right? Like how crazy is that?
Dr. Mydalis Diaz-Ramirez: Totally crazy. Never in my whole life would I have thought that they would offer that to me? Like what's going on. So, yeah. And it's because of this mastermind because of the company that I'm with. That we've been able, and then the things happen to you, like, as they say, like, life is happening for you. Right? And, in this case, we went to this program and we, at the end of the day, we have received more money than what we went for asking, asking for to that program is a local bank and they have requested us to be part of their marketing materials. They think that we are a good group and they even offered us to have some shares at the bank.
Like what like, are you kidding me? But yeah. So that's there, it's available and, it can be available to you two. I don't know if you're gonna be, you know, shareholder at the bank specifically. I don't know yet if I'm gonna be a shareholder myself, but the opportunities there, and these opportunities only come when you surround yourself with people who are in the same mindset going that way.
And, you have to work on your mindset. It's not something that came to us overnight after so many years of leaving a life, you know, of fixed mindset is something that you really have to train. You have to work, you have to read, it's, you know, something about reading is that people ask me many times what's the one book and I can tell, you know, the book that triggered it for me was Rich Dad, Poor Dad.
That was the book that triggered it. But it's certainly not the book that has told us everything that we know about entrepreneurship. Right? So when you become a physician, you know that you're gonna have to study so many books, right. That so many years of studying for you to be able to become a physician.
You don't have to study as much to become an interpreter. You certainly have to study and not only one book, but you have to read, you have to train yourself and you have to grow that mindset and you have to surround yourself with people so that then these opportunities will come. Yeah. So totally surprising.
Dr. Diana Mercado-Marmarosh: Yeah. And the good thing about this is that, I read the. I listened to the audible version of rich dad, poor dad while I was in your masterclass. I think that was one of the ones that started to break my idea of, I don't understand money and get me to show up. Even when, you know, I was so grateful that David, who was in our group would explain things and Miranda would explain things.
I wouldn't really understand everything that was going on, but, I kept trying to understand it because I wanted to have an open mind and I kept telling myself, you know, you didn't understand all the medicine you were learning when you were learning it, but you had to have an open mind. And it's the same thing.
Like we have to have an open mind that something can change and. and in their masterminds, it was all kinds of things. Like some people wanted to start a winery, some people wanted to start, you know, a retreat. Some people just wanted to have a very productive practice. Some people wanted to a better style of life, real estate.
So that's the beauty of being able to be surrounded by people who want to just invest in themselves and in their future. And so, yeah, so I was saying 150,000 that I probably have made, but I wanna say like two thirds have been invested back into my own coaching, into other programs, into hiring coaches to come and teach in my program, into go me going to conferences so I can continue to level up and understand trauma based consent and all kinds of stuff, that not only benefit my mastermind, but now benefit my patients because I use these techniques with my everyday patients.
And it's now so wonderful to see the mixture of it and who you become and what you can now decide like, okay, maybe in three years from now, you know, in the summers, I'm gonna take my kids to go, you know, for a whole month to a different country, to understand and live, and immersed without me on being attached to my phone, like actually learning things for learning. Right? And so you start to think outside of the box of how you could envision and I'm like, well, why not teachers have summer soft? Why can't doctors have summer soft if they decided to. Right?
And so, again, It might be a crazy dream or it could be the why not start of a conversation, right? It is so wonderful to be able to look into books, look into each other and, to understand that you are worthy of that challenge, like you are worthy to put forth the challenge.
Dr. Mydalis Diaz-Ramirez: And one of the things that you just mentioned just subtly, but, important is that you've been able to invest back in yourself. So when you start this journey at the beginning, that you're so scared, not understanding with your fix mindset, you're asking what is the cost for that? Right? That's the question?
What, what is it gonna cost me? And now we know it's like, what's the investment. It may gonna be like, so that's a big change that happens. Oh, what is that too expensive? And I say, you know, what is more expensive? So Dian, what's more expensive to you? Like not doing, you know, doing nothing a year and a half ago versus like investing yourself? What was more expensive, not doing anything. Right?
Dr. Diana Mercado-Marmarosh: So like two, three years ago, I mean, I was paying it with time and money and suffering. Well, how? I was having two to 300 charts open, right? I was, using 20 to 30 hours, unpaid outside of work, trying to mask how much I did not have control of the situation and how taxing it was.
Luckily I had a husband who was very, non-judgmental on the, whatever it took for work. He just thought, well, that just comes with the territory, but he didn't realize that I didn't realize that it didn't have to come with a territory. Had I invested in my mental health. Had I invested in my ADHD coaching in my life coaching, but I didn't know those tools were available for me.
So therefore, I thought this is the norm. And so I'm here to say that it doesn't have to be the norm. There's always a way that you can do it. And if you surround yourself with physicians and they don't even have to be physicians, coz my first ADHD coaches, they were not physicians. It's up to you. And currently my own private one-on-one business coach is not a physician.
Actually, she didn't even go to college and I am learning so much and I am kicking it out of the park because you don't have to have a degree to have common sense sometimes. And sometimes we just need a little bit of approval to like push past their dreams. And so, yeah, so right now I am going to continue to have a one-on-one coach who knows for how long , but as long as I can, because that's what keeps me available.
It's like you have to be in a mindset that is clean to be able to help those around you, and I am still in my, in Dr. Una's group coaching. So it's a accountability everywhere. I am putting myself in a place where people are my network and of course, making amazing connections. Like with Mydalis, I am constantly in contact with Mydalis because we are each other's way to continue to grow. And it's amazing to be in that environment .
Dr. Mydalis Diaz-Ramirez: And one of the things is that first it's no secret anymore. Right? That how they do it, how did that person do it is not secret anymore. So we can be part of that secret, which is now allowed. Yeah. The other thing is that once, you know, how it is to live in these lives is like preaching.
Like you have to tell everybody it's not only about like they knowledge its power is really its responsibility. Like we feel responsible for, for those around us and to bring them up like this in terms of the mindset, it has been such a powerful, Changing our lives, that for our next employees, especially like at this new clinic that we're building, they're all gonna get mindset, training, specific mindset training.
We're paying somebody to teach them mindset things that we can, we can do too. They just have the programs organized, for them as employees from that point of view, like certainly bring the things from the mastermind, but we decided to do it this way. And it's, it's all the teachings that you have to share.
And what happens is that when people are in that growth mindset and you're part of that journey with them, they show up happier. They want to contribute more because they have meaning. They know that they're part of something bigger and we all can be part of that whole mesh of something bigger coming together and growing together and brewing together.
And that's inevitably that's what happens is a result that comes from all this work that gets to be done. And yes, you have to work at it. In our mastermind, like people will ask, oh, how that I don't have time for that. I'm just so busy. I have my kids. Well, I have kids, I have a husband, I have the mastermind, I have a podcast and I have my business and we have to go to Congress and stuff.
So we learn how to. Set priorities, how to manage your time based on our principles and our vision, our missions. So we identify all those things. And then we invest in ourselves because as I said, nobody's gonna do that for us. And this is how it gets done.
Dr. Diana Mercado-Marmarosh: So Mydalis, I'm gonna wrap this up in the next few minutes, but I know we could talk for hours because we always do, but tell me, where do you see yourself in the next three to five years for fun?
Dr. Mydalis Diaz-Ramirez: Oh, my goodness for fun. I love to travel. So I truly, in terms of traveling in my bucket list there's a couple of things that I really want to do. One is I really want to go to Antarctica. And when Thomas listens to this, my husband, he's gonna laugh because he says not gonna go to Antarctica, but what am I gonna do there?
I just want to go there. I don't know. Like I want to see those spend with myself firsthand. So I really, within the next five years, I really want to do that. I really want to have been able to share some different experiences. I want to share with my, with my family still, like, I have been able, I've been blessed to give them some, some things, but I just want to give them more in group experiences that I have planned and then fun things in terms of like work.
I really want to be this, Mastermind so successful that we really get, you know, 60 to a hundred, physicians a year where we can help them, specifically help them one on one, in these small groups, I don't want to be do big groups. And then I think for big groups, I would be speaking to, to larger groups.
I have already done some of that. And then from, from a fun way at work at the clinic that everything's running really smoothly and that we have become a destination facility with all the things that I want to have for this clinic, for our dream, sharing that with the physicians that we have.
Dr. Diana Mercado-Marmarosh: Awesome. So you know that people with ADHD have wondering attention sometimes, so let's say they zoomed us out and they just, started listening again. What is the takeaway point that you would want them to take away from this whole episode?
Dr. Mydalis Diaz-Ramirez: Take matters into your own hands. Don't think that something is difficult and unreachable surround yourself with the right people. Get coaching, start reading and start today. Don't wait.
Dr. Diana Mercado-Marmarosh: Awesome. And where can they find you? Cause they need to find you.
Dr. Mydalis Diaz-Ramirez: Two things that you can do. One is our website, maxallure.com is M A X A L L U R E.com.
There you can find our next webinars and when we're starting with our next cohort, where you can join and other is the podcast Design Your Physician Life, which you can find in any major platform.
Dr. Diana Mercado-Marmarosh: Well, it's been a delight to have you today. Thank you so much for sharing this space and sharing your wisdom. And like she said, don't wait, start, start TODAY!
Dr. Mydalis Diaz-Ramirez: Thanks for having me, Diana.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane
Link to my website to register for October 2022 Cohort (waitlist):
Transformation Physician Group Coaching
Instagram: @beyondadhdlifecoach
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About Dr. Diaz-Ramirez
Pain Medicine Specialist in Sarasota, FL and has over 26 years of experience in the medical field.
Her mission is to guide physicians on how to achieve the life of their dreams through entrepreneurship.
Website: maxallure.com
Email: pauline@maxallure.com
Instagram: @maxallure
Dr. Teresa Anderson: Mental health can be approached from so many different directions from the physical side to have people who were mindfulness, meditation, and movement instructors. There is hope. If you have tried and failed multiple antidepressants or multiple therapies for depression, anxiety, or PTSD, you're not at the end of the road.
You're not at the end of the rope. Ketamine is a great offering. PR TMS is a great offering and just. Investing in yourself, even though it can be a little scary.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Well, hello. I am so excited today to have my good friend, Dr. Teresa Anderson. She's an adult outpatient psychiatrist, and she specializes in depression, anxiety, and PTSD. And she's been in practice for more than 13 years in Cincinnati, Ohio, and six years ago, she started to. ketamine infusions to her treatments.
And I'm so excited for her to come and talk to us about this. It's like state of the art treatment. And we are trying to make sure that, you know, everybody is aware of other possibilities other than just, you know the standard so that we can see if, you know, they get more personalized treatment in her clinic is our really state of the art.
And we're so excited to have her here today. So why don't you tell us a little bit about yourself and what you're up to, and I am so excited to have this talk with you today.
Dr. Teresa Anderson: Well, thank you so much for having me. I'm excited too. So, like you said, I've been in practice for about 13 years in Cincinnati, Ohio.
I'm an adult outpatient psychiatrist. And, there are three different parts to our clinic. I do the standard psychotherapy and medication management for folks with depression, anxiety, and PTSD. For folks who aren't responding as well to treatment, who've tried and failed multiple options, either got nasty side effects or didn't get a great outcome on the medications that, that we've tried them on.
We can offer ketamine infusions, and we can also offer PR TMS. I thought I'd talk a little bit about ketamine infusions first. So ketamine has been on the news of late. It's sort of like the latest, greatest craze in mental health. It's been touted as a rapid acting antidepressant, which we don't really have those and it's been around for eons.
So it went generic in the 1970s. Traditionally, it was used as a dissociative anesthetic. So that means that it's not only going to take you out of your pain, but you're gonna be on Mars and forget that you were ever in pain, but it's fairly unusual. In terms of a medication, because most anesthetics slow your heart rate and your respiratory drive way, way, way, way down.
And so ketamine does the opposite. As a matter of fact, this was actually used as a buddy drug in Vietnam and some of the soldiers carried it on their person. If their mate got blasted or in severe pain and the medic wasn't around, they could give them the ketamine without needing an anesthesiologist nearby monitor their cardiovascular rate or a sympathetic tone.
So recently it has been shown to act very quickly as an antidepressant. Especially in folks who are in the case of like acutely suicidal and it can have its effects in as little as one treatment, or it might take several, our standard course of treatment was set forth by the national institutes and mental health.
In that we use 0.5 milligrams per kilo of body. And infuse over a time of like 45 to 60 minutes. We give six infusions over the course of two to three weeks. For whatever reason past the three week market seems to lose its efficacy. But it's really well tolerated. It can be done in an outpatient setting without the presence of an anesthesiologist.
We just monitor their cardiovascular rate. We, you know, monitor their vitals, um, make sure that they're comfortable. And the biggest side effects about 30% of the time that people have is mild headache or mild nausea, which we can treat in house. People are free to leave of their own volition. After the fact they do.
People to drive them home. cause they're not with it enough to drive. But outside of that, it's tolerated really well and works really beautifully about 70 to 80% of the time, depending on what other medications that you're taking, or if you have any like major other medical risk factors or whatnot.
Dr. Diana Mercado-Marmarosh: So have you noticed that this has helped like the emotional dysregulation part of like the ADHD that sometimes some of the stimulants necessarily don't hit?
I know that in the US, the emotional dysregulation is not like a must needed criteria to diagnose ADHD, but like in Europe it is. And so I think it's just a matter of time that maybe in the US we start to recognize. This part of it and wonder if that would be complimentary per se.
Dr. Teresa Anderson: Yeah, I agree wholeheartedly it's it gives the patient two things outside of like lessening of anxiety and depressive symptoms, but it gives the patient significantly two things.
And one is the ability to take a step back from reacting, which I know is a problem. A lot of folks with ADHD have the impulse control thing. And gives you just an extra second or two to add that filter in, like, is this how I really wanna respond before you, you know, before it automatically just hits your brain and out your mouth.
Right? And so it gives you that little bit of space, that little bit of objectivity to decide how you wish to respond instead of reacting automatically. The other big takeaway that a lot of patients and I said, have said to me is a huge blessing for them is that it really cuts down on the negative internal, constant judgmental running commentary that a lot of people have with depression, anxiety, ADHD, all that.
And it's. Again, providing some space for your brain to breathe a little bit and to decide how you want to behave, decide how you want to react instead of respond instead of react. So,
Dr. Diana Mercado-Marmarosh: and that's great that, you know, within, like you said, if it works for you within a couple of treatments, like six treatments, you know, Three week span of that could now be an area that you could target because some of that impulsivity can get us into a lot of trouble at work or with our spouses or with our kids.
Right. Sometimes we just. We don't mean to say what we said, and then we're in trouble because we said it and then we are like, oops, I didn't really mean it that way. It was just, you know, it happened, I think like obviously meditation and running and getting away from people can help, but like, wow, this is like a cool way to be able to target that.,
Dr. Teresa Anderson: Absolutely. And, you know, PR TMS, the other offering that we have the personalized, repetitive transcranial magnetic stimulation, we've actually brought people down off their stimulants, or at least able to reduce the dose significantly because we are stimulating the underactive areas of the brain that help with that filter.
Dr. Diana Mercado-Marmarosh: So, do people have to be like your patient just at the clinic to be able to get this? Or can somebody else like refer them to you? Like another psychiatrist or another family medicine doc or internal medicine doc.
Right. So any, any other clinician can refer us patients I'm actually full on the psychotherapy and med management side ever since COVID surprise, surprise.
Dr. Teresa Anderson: But that's amazing. Yeah. Any other physician, any other psychiatrist who doesn't offer this and, and wants their patient to seek out this type of therapy, as long as we, you know, get a referral and a release of information. So we're not practicing medicine and avoid. Yes. It's absolutely acceptable.
Dr. Diana Mercado-Marmarosh: And do you just take people from your state or would you be willing to let other people come from other states or is it insurance dependent or is it just if they can pay out of pocket or how does, does that usually work?
Dr. Teresa Anderson: So our clinic is all self pay and we have people visiting their families from different states all the time. Again, as long as we can get ahold of their treating doctor, you know, we know they're not like using an alias or something. And as long as we have a list of their current medications and we have a good communication, open communication with their current treating provider, I am totally fine with it.
Dr. Diana Mercado-Marmarosh: That's amazing. So you've been doing this for the past six years, is that correct?
Dr. Teresa Anderson: We've been doing the ketamine for the past six and a half years. We've been doing the PR TMS for the past almost four years.
Dr. Diana Mercado-Marmarosh: Wow. What do you think, what got you into this side of side of it? I mean, it's such cutting edge stuff. Like I'm so intrigued.
Dr. Teresa Anderson: A number of things. One is sort of a silly answer, right place, right time. I was finishing up my maternity leave and I had. Drop down my patient load to 20 hours a week. And a group outside of Boston approached me about the possibility of ketamine infusions. And I had studied it for a long time and I thought it was the coolest thing since slice bread, but I assumed that you had to be affiliated with a major hospital to do it or needed, you know, large services or actually, no, you just need an infusion nurse and a place to keep drugs locked up and safe.
So. At the time I was coming back from maternity leave, the doctor who I was renting space from was getting ready to sell the building. So I was gonna need a new place to live anyway. And so in terms of my business. And so I just decided to go ahead and get a space big enough to be able to provide the ketamine infusions.
So it just kind of worked out timing wise, three years later, PR TMS sort of fell in my lap. I had a young lady who was very brittle bipolar patient and, and she's given me permission to share like generic parts of her story. And she was a stay at home mom to two kiddos on the autism spectrum. And I mean, her life was hell on a daily basis. And she came to visit me once a month and she was on five different medications. Her moods weren't stabilized, she wasn't sleeping well. And she had a lot of stress, but she was mostly focused on her kiddos and mostly wanting to get help for them. And she'd come to me and say, so I'm gonna try a natural path this month.
I'm gonna try chiropractor next month. And we're gonna try this. We're gonna try an elimination diet, this, and, you know, Whatever works and you're not hurting your kids. You're trying to get them treatment. You're trying to help their lives be better. I very much respect that. But so one month she comes to me and said, have you heard of PR TMS?
I said, well, I've heard of TMS, transcranial magnetic stimulation. She said, no. PR TMS is this guy out of San Diego who, is a radiation oncologist. He found a way to target the treatment using an E EEG. And so he's looking specifically at your brain, which areas are most underactive or overactive and can actually target the TMS.
It has like a 90% advocacy. So he has a clinic set up in Indiana. I'm gonna move my family there for six weeks and see how it goes. I'm like, good luck, God bless. I mean, I didn't know what else to say but six weeks later she comes back and she got the whole family treated. She is on less than half of the medications that she was on prior to leaving.
And her mood is better. She's sleeping through the night. Her husband, who was a footballer in high school and college no longer was multiple concussions, no longer had headaches sleeping through the night, her kiddo, uh, on the spectrum who was super, super, super uncoordinated was now riding a bike. And her kiddo who was barely verbal, now wouldn't stop talking. And I said, who the hell is this guy? I've gotta meet him. And so I sent in my information and told them my interest and that I'd been in business already for, you know, like 10 years or so. And they flew their whole team out to meet me and gave me a presentation. And he actually, Dr.
Murphy actually showed me. A video of a family member who was on the spectrum and who was basically nonverbal, you know, beating his head against the wall, biting mom and six months of twice daily treatment. And he lost him, his IEP.
Dr. Diana Mercado-Marmarosh: Wow.
Dr. Teresa Anderson: So I said, I don't care what I have to do to get involved with this. I'm doing it because this to me felt like for the first time the brain was no longer a black box.
Dr. Diana Mercado-Marmarosh: Yes.
Dr. Teresa Anderson: We could see. What areas were underserved, what areas were overactive? We could temper both. It wasn't a one size fits all treatment and standard TMS is great for who it's great for, but it only works about 30% of the time.
All the treatment is given at one place. There's the lateral prefrontal cortex, where we think the seat of the emotions lay, right. It's given it one frequency at one amplitude, one dosage, one size fits all. That's great and all, but what if your brain doesn't work in the average range of 10 Hertz? Then you might actually screw up the things that you're doing well.
Dr. Diana Mercado-Marmarosh: Right. Kind of like when you think about chemo, right? Like the way that now they've been able to do target radiation and stuff before, right? Like they would just be like, here's all this chemo, they were. Things you wanted, right? You didn't wanna lose your hair. You didn't wanna be vomiting. You didn't wanna, you know, you just wanted the area that was not was the cancer to be killed, but not everything else.
And so this is amazing that with such precision, you could personalize now what you need to target. Wow. What a blessing, this type of treatment is.
Dr. Teresa Anderson: It is huge. And I can't tell you, it's so exciting to see patients, not only like verbally reporting that they're feeling better, but like also the EEG changes. We give an EEG every, week essentially.
And we do neurocognitive exams based off of what they need, either PTSD, depression, anxiety, ADHD, sleep, or concussion symptom inventory, and all of those things improve as well as you can see the EEG starting to. Like tighten up and be cleaner. It's just, it's just phenomenal. I've never seen anything like it.
I tell people that I'm so nerdy about it. Cause it's like star Trek medicine. I still can't believe it. Yes.
Dr. Diana Mercado-Marmarosh: That is like star Trek. I mean, it's just unheard of, you know, we hear all and we try all kinds of things, right? Like people have tried, acupuncture, people have tried all kinds of things, and then you finally have something that, you know, starting to be so, so well received.
Do you get to go to like different conferences and teach others to also do something similar?
Dr. Teresa Anderson: So we haven't yet Dr. Murphy's in the process of writing a textbook about his findings and about, and sort of using the clinical data from our different clinics around the United States. So far, I think there's about 10 of us up and running. So he's, he's in the process of running a textbook, but, the hope is that eventually that we could train other physicians to do what we do. .
Dr. Diana Mercado-Marmarosh: Yeah. I mean, you are definitely a trailblazer there and wow. In 10 clinics, you know, when we think about how big the US is, 10 clinic is like, you know, nothing, I wonder if are y'all gonna be expanding to other parts of the world or do you know if there's something alike that is being done elsewhere?
Dr. Teresa Anderson: So there are lots of different TMS types. And there are lots of different like experimentations with different types of train length, or amplitude or frequency or location. A lot of people are experimenting with this and having different kinds of results. The nice thing about PR TMS is that it's not painful.
At all, very few side effects and the treatment can be targeted to the individual specific needs. For instance, a person with ADHD, we would target more of the frontal lobes, the executive functioning, the attention concentration decision making and impulse control. Right. A person who had more depression than anything else who'd be targeting where our standard TMS brothers would be, you know, using their paddle, a person who was recovering from a stroke and had motor difficulties, we would be actually, you know, treating it on the motor strip.
And so, the way that we can personalize it, it unlike anything that we've ever seen. I know Dr. Murphy had been in talks with some folks, outside the us, and I don't know where those have gone so far, but, he's in the process of opening up like 10 to 15, more, mostly around the coastal regions. He had no plans whatsoever to expand to Cincinnati.
We just sort of stumbled upon him. because of my patients. So I feel incredibly blessed in that regard, but yeah, it's, it's a work in progress, but we're partnering with him to try to help onboard docs and answer any questions that, you know, if they need anything.
Dr. Diana Mercado-Marmarosh: That's so amazing. So where do you see your current business? Like in the next three to five years? Like what are, what is up and the works for you?
Dr. Teresa Anderson: Oh, that's a fantastic question. So it's been on my mind greatly. I would love to set up more of a holistic mental health clinic because I think mental health can be approached from so many different directions from the physical side to have people who were mindfulness meditation and.
Movement instructors like yoga Tai Chichi. I would love to have nutritionists on board as a person who suffers from celiac disease. I know it made a tremendous improvement in my own mental health. When I gave up gluten not to mention, I don't have cystic acne anymore and you know, not chained to the toilet 24/7. So noticing changes in diet, especially for kiddos with ADHD and, you know, removing the process. I would love to have float tanks. Because you can actually being submerged for an hour, three, one hour sessions can reduce your cortisol without any medication intervention whatsoever. And so for my PTSD folks, that's huge.
There are lots of folks who still have the stigma of, oh my God, your strength. I don't wanna look at you. I don't wanna talk to you. You're reading my mind kind of scenario. And so for those people, maybe we could introduce them more gently, so to speak. Two ways of movement, two ways of nutrition to the float tanks, to vitamin infusions, that sort of thing, to get people interested in their own mental health and wellbeing on the back end and say, oh, I wonder what else they offer.
There are people who are in dire need, who are in emergent circumstances who need more the PR TMS, ketamine psychotherapy, med management. And then they think, okay, well, you know, I could do kind of a step down. I don't need this anymore, but I could still do other things. And so to have more holistic sort of care for people, that would be my ultimate goal when we're working towards.
Dr. Diana Mercado-Marmarosh: That sounds amazing trailblazer all the way. So what about like in the next three to five years for fun? Like, do you see yourself traveling anywhere or doing any other extra stuff?
I would love to travel. And my seven year old has ADHD as well. And so he, more than anything, I'm always like future oriented, right? Like I'm always thinking about like, 10 20 steps ahead.
Dr. Teresa Anderson: And he always says, mommy, what do you want to do today? And I say, well, I have to drop you off at camp. Then I have to go to work. And then we probably need to pick up something for dinner and then we probably need to do this and that he goes, no, that's what you have to do. What do you want to do? So he is my, in the present guy.
Right. I would love to experience like Canada or Mexico or Europe with him through his eyes because he keeps me grounded in the present moment. He's very good. Like that.
Dr. Diana Mercado-Marmarosh: That's amazing. You know, I, I've been sharing with a couple of people in different episodes that I would love to, you know, and in the next three to five years, as my kids get a little bit older, maybe during the summers, like pick a country and like go for a month to that country and verse in the food, the language, the history of it, like how amazing would it be to be.
Not just reading books. Right. But at least you experience it. Right. Like the combination of both things. So, yeah, I think that's really cool to be able to pick Mexico or Canada or Europe or any place. Right. And, just live in the moment, like you said, because so often we forget to live in the moment.
We're like, like you said, we're like we have all these checks. List. And then we forget, like, why are we even doing the checklist? Right.
Dr. Teresa Anderson: These babies and grand babies. I totally get it. Yes, absolutely.
Dr. Diana Mercado-Marmarosh: All right, well please tell us, where can our people find you? Like, where can they reach out to you? Give us your website, give us your, social handles. That way we can get ahold of you.
Dr. Teresa Anderson: Oh, absolutely. So it's super easy. On the web it's www.andersonclinic.net. So that was easy. If you wanna give us a call it's (513) 321-1753. If you would like to give us an email because you have questions. It's admin A D M I N @ anderson clinic.net. And if you want to take a peak at my very, very, very, very, very fledgling TikTok channel it's Andersoncliniccincy, C I N C Y. And we're working on, we already have content written for 12 podcasts. So we're hoping to get that up and launched in August or September, and that's gonna be on apple and all that kinda good stuff.
And that'll be called psych waves.
Dr. Diana Mercado-Marmarosh: That's so great. So the last question that I say, you know, my viewers have ADHD, so sometimes we zone out so let's say they just started paying attention, like right this second, what is a nugget you want them to take away from?
Dr. Teresa Anderson: There is hope. If you have tried and failed multiple antidepressants or multiple therapies for depression, anxiety, or PTSD, you're not at the end of the road. You're not at the end of the rope. Ketamine is a great offering. PR TMS is a great offering and just investing in yourself, even though it can be a little scary. Absolutely.
Dr. Diana Mercado-Marmarosh: Well, there, you have it. We had an amazing interview with Dr. Teresa Anderson and she's cutting edge on all things, mental health, as we know, COVID really has brought up to front how underdiagnosed and undertreated it can be.
But. When you do invest in yourself, everything else you can think more clearly, and you can make decisions from a place of calm instead of overwhelm, that makes a world of difference. So reach out to Dr. Anderson, cuz she can really help you. And if you're somebody who is interested in maybe providing this for your patient, Definitely reach out to her because you know, you gonna join her as a trail trailblazer.
Dr. Teresa Anderson: Yeah. And if, if there are folks out there who are interested in providing this type of treatment within their clinic, I would reach out to Dr. Murphy's website because he can onboard you or at least lead you in the right direction. And that's www.prtms.com.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for your time.
Dr. Teresa Anderson: You're very welcome. Thanks for having me.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane
Link to my website to register for October 2022 Cohort (waitlist):
Transformation Physician Group Coaching
Instagram: @beyondadhdlifecoach
Tiktok: beyondadhdlifecoach
----more---- About Dr. Anderson: Hello, my name is Dr. Teresa Anderson. I'm an adult outpatient psychiatrist specializing in depression, anxiety, and PTSD. I have been in practice for the past 13 years in Cincinnati, Ohio. Six years ago, we added ketamine infusions to our available treatments and became the first psychiatrist-run ketamine clinic in the state of Ohio. This treatment offers hope to people who have tried and failed multiple medications and therapies, with an efficacy rate of 70-80%. Three years ago, we added PrTMS (or personalized repetitive transcranial magnetic stimulation) and became one of 8 clinics in the nation providing EEG-guided personalized TMS treatment. Standard TMS treatment only works as well as medications, about 30% of the time. Using an EEG to pinpoint lower-functioning areas of the brain, we nearly triple the efficacy to closer to 90%! And because the treatment is so specialized to the individual, it is safer to use on a wider variety of conditions. In addition to mood disorders, we have improved the outcome for post-stroke victims, ADHD, concussions, post-COVID, and perimenopausal brain fog!
If you'd like to learn more, check out our website at www.andersonclinic.net Call (513) 321-1753 or Email us at: admin@andersonclinic.net Follow us on our fledgling TikTok: @AndersonClinicCincy Instagram: @ theandersonclinic And be on the lookout for our Psychwaves podcast starting in August of 2022!
Dr. Diana Mercado-Marmarosh: Most people with ADHD. Totally understand. When I say time blindness the thing with this time blindness is that it can be perceived in different things. It can be perceived as not keeping track of time in awareness of being able to create a time sequence.
Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Well, hello. Hello. I'm so excited. Today's topic is about time blindness, you know, most people with ADHD. Totally understand. When I say time blindness, it's inability to sense the passing of time. and it just makes it hard, for the person who is experiencing this, because it affects all levels of their life.
And so when you think of time, blindness. Think about it kind of like a sensory issue. Like it's not intentional. Like nobody wants to just on purpose, look bad or mislead people one way or another, and there's different reasons. And I'll give you examples of how we can get in trouble with time blindness.
Usually things that people with ADHD really enjoy doing, we can tend to hyper focus on things and we underestimate how long it's gonna take us. You know, things we enjoy, maybe we're seeing a patient and the encounter runs way over past it. It might be that we were really, you know, enjoying the encounter we were having.
Or it could be that maybe, you know, we were gonna go and hang out with friends and we thought it was gonna take so long and it took a lot longer. So things that we enjoy, we tend to underestimate how long it's gonna take. And then things that we don't necessarily enjoy, like washing the dishes. I don't like washing dishes or maybe cleaning things around the house.
We way overestimate how long it's gonna take and we don't even wanna start. And so what happens with time blindness? Is that sometimes it can make us look like there is a character defect or a character flaw, and we end up beating our self up for something like that. Right? When we think about ADHD, I want you to think about the fact that, you know, it's not that we can't focus all the time.
It's sometimes we can't inhibit certain things. Like we can't inhibit certain perceptions or like this sensory stimula that I was just talking to you. And sometimes we can't inhibit certain actions and we are driven to do things over and over almost like, you know, because it's important to us.
And so the thing with this timeline is, is that it can be perceived in different things. It can be perceived as not keeping track of time in awareness of being able to create a time sequence, like, you know, how long each task is gonna take. So then we can spit out an appropriate estimate, or it could be that we don't know how something happened, and we feel like we don't have any control over time reproduction.
Making sure that we can redo that over again. So this is important because once you have realized that there's a term, you know, now you are at least aware of the problem. And from there, you can seek to accept it and realize that, okay, well, this is me now. I don't have to make it mean anything. Now I can seek, take action, right?
Form, uh, solutions for it. So to change the system, you first have to change yourself and to change selves. We first have to gain some awareness of where we're at, right? And so with that being said, there's certain things that you can do to help you be aware of what you need to do. So if you think of, of using techniques like a timer, a timer is gonna create that shortcut or that buffer to be able to consciously track how long something is taking you.
And so it can help decrease that drive to start something, because most of us don't wanna jump onto something that seems like it's impossible to accomplish, but if we at least tell ourselves, okay, I'm not gonna get sucked into like cleaning the house for like eight hours. I'm only gonna commit to like 20 minutes.
Then you have a start and end time, and it's more likely that you're gonna give yourself that time to do it. And so with that being said, You can increase that dopamine energy and decrease those timeliness by keeping track. I use timers all the time, so that I have an awareness of how long it's taking me to walk into the room.
And then I have my nurses knock at a certain time. And that way they ask me if I need anything. And sometimes I do, you know, I might need a shot or a tetanus shot, or I might need wound culture or some sort of something, right? And so they can help me by doing that. And it's enhancing the care that I'm giving my patient and it's keeping me in line.
With ADHD. One of the things with the time blindness is that we just don't know that we have to give ourselves some buffer time. Like most of us just wanna tell you how long it's gonna take, tell us to do up certain things, but we don't give ourselves the buffer time. Like we don't on purpose count in that, you know, there might be a flat tire somewhere on your drive or that, you know, you might be, you're almost outta gas and you have to stop.
If we don't give ourselves some buffer time, then we might not be aware, right? And, I think the other thing with timeblindness is that sometimes we're not intentional with the things that we're doing. Like sometimes we don't say, okay, I just need to do this one thing. And then off I go, we try to put in another and another and another.
So. That's why we always seem to be chronically late to places. So even the things that are important to you, like sometimes we might show up late and it's not like we're doing it on purpose, but you can see how, if we're not creating a safety net for ourselves, either a reminder, like the day before to give you a heads up that you need to show up at a certain place an hour before or 40 minutes before it could get us into trouble.
So you seen timers. And alarms and, maybe creating your journal can be ways for you to add some buffer time into whatever task that you're trying to complete. And so, you know, this is an important topic. I would just wanted to bring up this time blindness so that you could know that it's one of many things that we talk about in my course.
If you're interested in learning tools, please, please. Definitely. Look into, getting an ADHD coach, if not with me, with anybody else or even just bringing the topics like attitude.Mag is an amazing website where you can learn a lot of tools because you know, if you have ADHD or you have a kid that has ADHD, You can have now some insight about this time blindness, and then you can create a better system to help them instead of just labeling them that they're having a character issue.
And so this way you can support yourself or support your loved one. Anyways. I wanted to just talk about time blindness. So the actionable steps is get yourself a timer. If you don't have one, use it to decrease the initiation task, that it is the initiation force to jump onto a project and then use it to stop, you know, use it to stop so that you can move on.
And you know, most of us when we have so many choices, We spend way too much time looking at stuff, right? Like I love planning vacations, but before you know it, if I'm not careful, like I can literally spend two hours just looking at all these hotels. And then I had so many choices that I didn't even make a decision.
So now I've learned to use the timer to help me to just give myself 20, 30 minutes to search the area and to make a decision. Anyways, I hope this tips continue to save your time so that you can invest the time in the things that you love. Have a blessed one, take care.
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register for October 2022 Cohort (waitlist):
Transformation Physician Group Coaching
Instagram: https://www.instagram.com/beyondadhdlifecoach/
Tiktok: beyondadhdlifecoach
Dr. Katrice Brooks: Give yourself, grace, this is a journey and we're on the journey. We're all trying to be better and you're even wanting to be better. You're on that journey. So give yourself grace and radically accept yourself, build community and other people. That's, you know, mirroring body, doubling, delegating, optimize your habits.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Dr. Diana Mercado-Marmarosh: Well, hello? Hello. I am so excited today to have one of my friends Dr. Katrice Brooks. She is a double board certified Family and Lifestyle Medicine Physician, and she has more than 10 years of experience. So you need to talk to her because she does the whole holistic approach. Okay. She makes sure that she helps her patients get the care that they need.
She's the one who stays there and listens what she listens. She spends times with them, she answers all the questions. She's so passionate about health equity, improving their quality of life by reducing medicines and of course helping the patient make decisions. And so it's so important that you listen to today's topic, because she's gonna talk about how ADHD has been one of her superpowers to help transform her patients' lives.
One of her newest adventures has been having her own clinic. And so we're here to talk about how an ADHD entrepreneur can have all the things and how that can create a big impact in not only her personal life, but in the lives of her community. And everybody who works with her has this amazing transformation as well.
So Dr. Brooks, please let us know where you are and tell us a little bit about your clinic or what it's like to have ADHD and, start this amazing using adventure.
Dr. Katrice Brooks: All right. Hi, Dr. Mercado. I'm so excited to be on here. Just talking with your audience, super, super excited. You are amazing, and you're doing amazing things.
So I'm really so honored as well. My life basically changed when I began to accept my brain and to start working with it rather than working against it. When I stopped trying to, be like everybody else. And I started trying to help and support myself and that journey of supporting myself and radical acceptance, has helped me to radically accept my patients and to help them rather than to try to put everybody a square peg into a round hole, trying to fit everybody into these boxes. It helped me to see kind of the individualistic needs of people and meet them where they are and help them get where they're going. So I really kind of transform my approach to my patients. So I really do think of it as a superpower. And I have lived with this my entire life and not. Realizing kind of what it is. And I do wanna say that I'm self-diagnosed ADHD or self-diagnosed neuro divergent, and I might be, you know, just on the spectrum or a product of complex trauma, but my brain, you know, just doesn't work like, most other people, or my brain works like my brain.
I can't even say like other people, but my brain works like my brain. And I found that what everyone else did and the rewards that they were getting in their brain, I didn't get the same thing. So I had to create paths for myself. And it's been a journey because as you know, I'm sure as your patients know is taken me. I've taken lots of hits because of it too.
Like it is now my superpower, but this journey to entrepreneurship was because it was almost my Achilles heel, you know, I know you, you actually have a course where you've given talks on recognizing ADHD in your coworkers. And I wish some, one of my coworkers would've recognized it in me. You know, I like most other physicians who struggle with ADHD my entire career with those 10 years of experience working for big medicine.
Almost the whole time since hitting the ground, I struggled to close my charts. I would have periods where I did it. Great. And then I would, it would fall apart and I would do it great. And I would fall apart. And you know, the, the talk in the office would be like, Dr. Brooks is such a great doctor because, you know, ADHD does allow me, that's my superpower.
I'm able to talk to people and really hone in and listen and be present and they love it. But you know, when it comes to finishing tasks that I don't wanna do at the end of the day, I struggle. You know, But I've, I've learned to harness that. I'll talk about some of the points that have kind of got me there, but you know, it has been a journey and a journey of self discovery.
Dr. Diana Mercado-Marmarosh: Yeah. It's so important to highlight what you just said, radical acceptance. And I think everybody who has ADHD or who, like you said, maybe trauma induced ADHD, will know that we tend to be our inner critics. When we learned to be like, okay, nothing's wrong. I'm not broken. I just think differently. And therefore, I must do things differently.
The moment that you started, like accepting you, then all of a sudden, like you just said it was radical because you started accepting your patient. I mean, they teach us not to be judgemental, but we're human. Like humans have judgemental minds. Yeah. Even if you want or not, we do right. Practicing on purpose. Radical self acceptance is like so rewarding for you and for your patients. Right? If you don't practice self acceptance, if you don't say, okay, this is what's going on, how can I help myself then? Like you said, it's almost like Achilles because you don't know what you don't know. So how can you do things differently if you weren't aware that you were quote unquote not doing it your way
Dr. Katrice Brooks: And so I found that was step one is to give yourself grace, cuz then otherwise with ADHD, I would be mad at myself constantly. I forgot my keys. I can't get out the house. Like all of the things I'll be like, Ugh, what's wrong with you? And it's like, that's okay. It's just, it's my brain. And I just to accept it doesn't mean that I don't want to change it.
To deal with it. It just means that here we are, this is, this is what I have. Right. I struggle to leave the house in the morning. I know that. Right. So now I can change things about it rather than just beating myself up about why can't you do this? What's wrong with you? Which is, that was the approach that I took for most of my life.
I would bear white knuckle. Until the time where I couldn't and it would, it would fall apart. You know, we only have so much willpower, the built systems and other things so that I don't have to white knuckle it. That is just, that helps me. Yeah.
Dr. Diana Mercado-Marmarosh: Good. Now tell me about this adventure of your practice, like, tell me what that's about. Because again, we, even though we have ADHD, like we all benefit from structures and systems, like you said. And then when you go from, okay, corporate is down my neck telling me I have to do X, Y, and Z to now you're like your own boss. And like you said, you now have to set up the systems for you to tell yourself I gotta close this otherwise I'm not gonna get paid. And people working for me are not gonna get paid. So tell me, what have you noticed or what have you done now in your
entrepreneurship?
Dr. Katrice Brooks: Great question. And so part of me leaving corporate medicine was that I felt like a cognitive machine. I did not like to kind of the stick and carrot kind of do this. Okay, I'll do this. And so when I left to create my practice, I was very aware of my shortcomings and corporate medicine and how I was struggling. And I really wanted to design something different for myself because I was designing it. So I also wanna be transparent. I actually also do locum still as you know, part of making money.
And I'm, I'm actually thriving in locums. That's a whole nother story. But when setting up my own practice, my own entrepreneurship, my own, clinic one, I set up a direct primary care clinic so that I do not make money based on me submitting the bills, but it's a membership model. So I make money. You know, constantly, and that's not something that I, I won't say, have to worry about, cuz that comes with a whole new set of billing issues. You have to make sure the credit card is on file and that it hasn't expired, but I made it so that it's not, I submit this chart. I can get my money because I won't say that model didn't work because now I am thriving and locums, I figured it out.
But I thought that that was the problem. So when I set up my clinic, I was looking for a model that wasn't so dependent on that. So when I did that, also, I gotta strive. That has absolutely changed my life. I really, really struggled to close my charts. But again, now in locums, I close my own charts, you know, 25 30 charts a day, because talking to you, you've taught me a lot of techniques and I've, I've figured out that, but on my own. I really hated the in depth work that I like to do in primary care spending all this time with patients and talking to them for an hour. I really hated also charting while I was doing that. I really felt that it interrupted the patient relationship. And so I got inspired from hello and it's been wonderful.
I wish that I had gotten this before. When I was employed. I might have been able to stay employed. Although I did ask. This journey to entrepreneurship. I realized that I was struggling and drowning and I felt that I had to, my company couldn't save me cuz I, they, they would ask, what do you need? And I'm like, I don't know.
So they said, oh, we'll close your, your we'll close your schedule. Closing my schedule didn't work for me. That means that I don't get paid. That means I'm not seeing patients and making RVs, which is how I would get paid. And yeah, I get to sit here and close the chart. I can make the money you already made, but it doesn't help me in the future.
And it doesn't set up systems, so they didn't know how to help me. They didn't have anything scheduled. So I realized I was drowning and I realized that I just needed something different like that, that scenario wasn't working. So the scribe certainly helped me. And. it allowed me to spend time with my patients that I really needed also something else that, not struggle, but these systems.
So now that I work for myself, I, control everything, right. Nobody's saying you gotta do this. You gotta see these patients and you gotta make sure that you make this money and you have to be here from this time to this time. But I had to say that. Right. And for me, it's easier for me to follow my own rules and to follow someone else's rules.
I don't know why, you know, so I set up rules for myself. I have these rules that when I have patients on the schedule, I have to come in 30 minutes early. Otherwise I'm barely making it in on time. Right. We're we're arriving together and it's like, oh, I'm sorry. You know me? So I had. Create these rules, but the rules are just suggestions for my life, because I know when I follow my little rules, it runs right.
These things that the..
Dr. Diana Mercado-Marmarosh: They're your systems, right? Yes. You created your systems. So, I mean, we call them rules or whatever, but the really your systems you're creating. A wiggle room or like a safety net, right? That's exactly it like, you know, yes, I'm gonna arrive at the same time with my patient, but what if. I arrived, 30 minutes earlier. I can set myself up. I can breathe and I can show up how I want to show up because I decided I want to show up this way. Not because X, Y, and Z person is telling me. Right. But you've noticed to throw an error. What. Makes you feel like you're showing up your best version and then not only that, but you are empowering your patients to be listened to and you're creating it so that, okay.
I'm doing the wonderful things that I love, which is that interaction with my patient, not having to write this damn chart, like my scribe is gonna help me. But at the, the same time, like you said, I get to go and practice in locum. Because now it feels fun. Not because you have to. And so. It's so different because now you're practicing medicine in your way.
And like you said, even though your provider where you were at before wanted to help you, they couldn't help you because you were not even aware of what you needed. And this is something that I always try to tell to my clients, because when I'm talking to you guys, you guys have to understand that you're talking to Diana, like three or four years ahead of you.
I was there and I was there for like 10 years. And you're talking to Katrice right here, like you, because maybe you've been considering doing DPC or you've been considering doing locums because locums is cool because. It's like Playland, you go, you do what you need to and you piece out. Right.
Dr. Katrice Brooks: Love it. Love it. It's great. Really?
Dr. Diana Mercado-Marmarosh: And who knows, like if they're close enough, there can be like, oh, I love you. Let me follow you. Right. Like, which I'm sure you've had.
Dr. Katrice Brooks: I do. Absolutely. I do it, in Wisconsin. And so I kind of bring my cards with me sometimes because I do all this stuff and I'm like, oh, check me out on social media.
And they can see the passion. They see that I'm a doctor who's so invigorated and happy to do the work now rather than being run down, like. Life is a joy for me now, I, I enjoy my locums and working that and doing urgent care. I love my clinic, but I'm, I'm happy with medicine again. This is really figuring this out has really just helped me to love medicine again, entrepreneurship.
But again, my ADHD for me makes that a superpower. So I'm really thrilled.
Dr. Diana Mercado-Marmarosh: Yeah. So this is so important for our listeners to listen that, you know, we don't have to stay in the damn hamster wheel. if there's something that is not working, just ask yourself, what could I do different? Could it be different? How can I create it different?
Don't just learn the hopelessness. We can unlearn that stuff. And unfortunately, sometimes it's trial and error, but when you do create your systems, Yeah. Oh my God. Do they work right?
Dr. Katrice Brooks: oh my God. And it's trial and error, but it, it kind of has to be like, your system may not work for me. You know, some of it will because there are like some principles that, you know, we, we all share, but, I literally have.
All my habits, right? So my morning task and my afternoon and stuff, and I tweak it like I look and say, oh, that didn't work for me. Or when I do that, I really slip into that. Or, you know, I spend too much time doing that. Or if I scroll my phone in the morning, then it's hard for me to get outta bed and do the rest of the stuff I need to do.
So my systems have been years creating it, but they absolutely do work for me. They allow me to thrive and to soar and to not worry about the little things. Cause I've my previous self has already thought about that and figured out the best route. And so I can rely on the work that I did and build from there.
And that it's been amazing. And every day, little tweaks, like, Ooh, I need to include that. And I need to put this on my checklist of, you know, when I travel. Cause I have to have these checklists because otherwise I'll forget things. And I have, you know, I call it my autism bag. I really don't mean to offend anyone, but I have my book bag.
You saw it when you saw me that I carry everything in and when I don't have that bags, I don't have a meltdown, but it's like, oh, I forgot this. And I'm, it's in my bag. Like just those things I know that I need. And so if I bring them with me, I have them. And those that is my system. My book bag is a system for me.
It has my mask and it has, you know, wallets and just all sorts of things that I may need a bag of pens, just all this stuff.
Dr. Diana Mercado-Marmarosh: Yeah. So you, you have figured out that if you have your backpack with you, you have the essentials that you need. And you don't have to think twice they're there, your future self already knew what you needed. And so it prepped you. And then you don't have to worry, like you don't have to go hunt for the prunes, like all over the hotel, looking for things , or whatever. Right? Or you don't have to be like, oh man, I can't walk into this store because I don't have X, Y, Z, or you have your charger in there, which, you know, we all gonna lose 10,000 chargers.
Right? So like I saw a post the other day, somebody said, oh my God, my husband like will not share his charger. Cause I've lost three already. And so sometimes it's just, like you said, having little checklists and because the more that we do things. That's how they become habits, right? Because it's so easy to build a bad habit or to build a good habit.
And, and the people that work with me know that I don't like using the word good and bad because I like effective and inefficient. Even the bad ones or the inefficient ones. They still give us a result because we're doing them. What if on purpose, we decided we wanted to have fun time and like block fun, time off. Right? And then the systems we use were efficient to actually protect that time off instead of seeking into it. Right?
[00:17:47] Dr. Katrice Brooks: Absolutely. I am obsessed with habits. So that was kind of my. Before I realized that I had neuro a neuro divergent brain. It was like, you know what, if I do things in a certain way, I get better outcomes. So like, I read all the habit books. I'm working on a habit app. I am obsessed with habits because our habits, you know, over the long term, that is the result of our life. And so that is also optimize my habits. I'm constantly tweaking them. I'm constantly is this efficient and effective. I also use that as well.
When I was younger when I was in first grade, my, my teacher told me I was lazy. And that, you know, this is like just inner. I got like a D in handwriting, probably this ADHD. Right. But the thing is, I was just efficient. I preferred efficiency. Right. So I like things that are efficient and I'm always seeking efficiency in my life.
And I'm always re reevaluating those habits, all of them, because I want to maximize efficiency. And, you know, there are days where I don't, you know, days where I'm off and it's like, okay, You know, I've protected this time. I've blocked off this time to be off, to not do things, but in order for me to run and optimize and have the life that I like living, that brings me joy habit, it served me.
Dr. Diana Mercado-Marmarosh: Yeah, that's so good. So tell me, how do you engage in your selfcare? That's probably been one of the most to me self-care has been what has been so radical and life changing for me. Is there certain things that you do that you feel like empower you or help you or recharge you?
Dr. Katrice Brooks: Yeah, I actually feel that self care saved me and this really roundabout way. And cuz I got ADHD. I like to talk, but at the beginning of the pandemic in 2020. Was it yeah, 2020. I actually got like, almost obsessed with taking care of my hair. The salons were closed and I'm just like, oh, I have to do this. So I joined this like group and the group actually fell apart and that gave me more time.
And then I'm like, well, what do I wanna do with my life? But self-care is paramount for me. So literally every day I take the bath, I call it my water therapy. I get home from work. I run my bath every single day. Like when I, when I do locums, if my hotel does not have a tub, I need a different room because this is a part of my self care.
And sometimes I can't do it. Right. So we do have to be flexible if I'm traveling too much or there is none, then I won't. But as soon as I get home every day, you know, my bath. Part of my bath is my whole routine. Like I have a skin routine that I do in the morning and in the evening and my hair routine, and this really helps to, center me and sustain me.
And I found actually the same with patients. I found patients that had, I have patients that are literally on F M L A, that could not leave the house. They were just having a really hard time because of anxiety, but we could talk about their skincare and how to get their skin together. And they really put in the work for their skin, but they had a hard time literally leaving the house and exercising, but I again met them where they were. So it's like, okay, well this maybe gives you dopamine doing the skincare. You feel good about this? Let's keep filling you up with this and using that to maybe do the other things that we wanna do.
So self care for me is absolutely paramount. Sleep is paramount. I do not like if I don't get enough sleep, I am grouchy. And so I make sure that I protect my sleep. I, in terms of my systems, I absolutely have to be in bed by 11. I've known that since I was probably 18, that like I always known that I have to get sleep.
And if I don't, I do not work. So sleep is super important. Literally the self care of, you know, finding time to relax, finding time to even connect with other people. You know, sometimes I find that I like to be a hermit. Part of selfcare is, you know, making sure that I talk to my sister and my family and, you know, connecting and recharging because that helps fill up my cup as well.
So those things are just as important as my work.
Dr. Diana Mercado-Marmarosh: Yes. That's so good again, if you know how you're taking care of you, then it's so much easier to be empower others to do the same, right? Yeah, because we, you probably see this in your patients. Like they come in and they have a no awareness. And it's okay.
It's not their job to figure out that's why they're coming to us. But thing is sometimes we don't even have awareness that we're burned out or we're tired. Right. Because we've been told all along, like, keep going, keep going, keep going. And we don't realize that taking that pause, like you just said to go and to take your bath on purpose, to feel your skin on purpose, to breathe and know.
These few minutes are mine. Yeah. Like I don't have to do anything, be anything to anybody, whatever these are mine. Right. Helping them to do the same. Oh my God. It's like, when I tell patients like, okay, today's meeting, we're gonna see quick meds. We're taking off. And they look at me like what usually you're putting on and I'm.
Well, anytime we have more than five, they play around. So then I'm getting meds to cover to cover the side effects of the meds, right? So like what can we take off? Or what can we go down on? Or what can we do? Right? And so incorporating exercise and like you see routines tapping different things that can increase the dopamine level goes such a long way.
Dr. Katrice Brooks: Absolutely. I also wanna mention the exercise and eating. I'm a lifestyle medicine doctor, so I, have to, and I didn't, but you know, exercise is fundamental as well. I found that, I do daily in the morning, Ash chaga. And if I don't, then my life can still run. Right. Like I can push through, but it doesn't cause me to thrive as when I'm doing, you know, yoga every morning, which has, you know, meditation and movement. And, you know, when I'm eating my fruits and vegetables and trying to get my daily five, you know, I have more vitality and more energy, right. By really feeding my body good fuel. I'm able to work better, you know, work better, sleep better, be a better person.
And so, you know, it's, sometimes those things fall apart and self-care is probably one of the first things that fall apart. That's how I kind of know when something is going on. It's like, Ooh, I haven't washed my. You know, I haven't done my full routine in a few days. It's like, something's going on with me? Let me do some introspection to see what's up. Right? Like it's these habits that I normally have that are doing so well are slipping up. Let me dig deeper.
Dr. Diana Mercado-Marmarosh: That's so important that you have that insight to not be judgemental, but to be curious, because you'd be surpised. My clients are like, but I was doing so well. And then I just stopped and that's it. I'm broken. I'm like, no, you're human. something else took priority. Absolutely. Let's look back. What was working, what was not working? Why did this fall by the website? And don't make, can be mean a thing. It it's normal like, like routines, like, you know, we all been taught.
21 days or whatever, but we looked it up the other day when we were in a group coaching session. And I remember I heard it from the one thing podcast, 66 days or something and we Googled it while, you know, we were in the thing and it said anywhere. From 21 days to 221 days. Every person's different. And so then that's why they average it and they say 66 days, but give yourself grace, you've been doing certain things for how long, and now all of a sudden you, it came into this awareness and then now we're trying to change everything. Right? So it's so, so nice. So tell me, how do people work with you if they want to be part of your holistic approach, practice that you have?
Dr. Katrice Brooks: Awesome. So pick people can work with me in a variety of ways you can join my clinic. the website is quench.clinic. So that is literally my clinic's website. If you want to become a member, you can join. I am available in Wisconsin, Illinois, and North Carolina. That's where I'm licensed. But if you are unable to work with me clinically in my clinic, I do have a Facebook live show that I have, weekly and I'm on Facebook.
Take all the socials I'm on them. Um, I'm on them literally as Katrice Brooks, MD, or Dr. Katrice Brooks. Very, very easy to find. If you Google me, you will find me I'm out there. Happy to help. If you wanna ask me any direct questions they can email me at hello@KatriceBrooksmd.com. But not medical questions, but you know, happy to help. So yeah, I'm out and living in the world.
Dr. Diana Mercado-Marmarosh: Awesome. So where do you see yourself in three years? For fun? What are you gonna be doing?
Dr. Katrice Brooks: That's a good question. I think I'm working towards a more nomadic life. So hopefully in three years, say three years on this day, I will be say maybe two months in another country enjoying it, but also doing some telemedicine and just living my dreams.
That I'm doing that now. So life is a joy and more of it. I also hope that you didn't mention, but I hope that quench is, possibly multiple locations. So I'm serving even more people on a bigger scale.
Dr. Diana Mercado-Marmarosh: That's amazing. So good. So what do you think is your one super powerful ADHD?
Dr. Katrice Brooks: Oh, good question. It is hyperfocus. My ability to hyperfocus. I think that has helped me become a physician. It's helped me to anything that I wanna learn. I can just make myself like, oh, I'm interested in that. And then my brain's like, know all about it, right? Like it's then will give me not unlimited dopamine, but it will, you know, an abundance of dopamine.
So my hyper focus. I love it's something that I I'm happy to have. Dr. D mentioned another colleague of ours, like follow the dopamine. Sometimes you can, sometimes you can't, right? Sometimes a dopamine will have you, plan, you know, money, money, or not money crush, candy crush all the time. But sometimes, you know, it helps you get through med school.
So I try to, to supplement my dopamine quest for things that are good and along the path of what I've picked, but I, I love that I can hyperfocus.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So this is the last question. And people usually laugh when I say this, I say, because people with ADHD have wondering attention and you know, we all zoom out and then we're like, wait, what, what was, let's say they just started listening like right now, right this second, what would be the takeaway point you would want them to have?
Dr. Katrice Brooks: So I have the three things actually that we talked about. I, I list them out and I'll just sum summarize them, right? So one is give yourself grace, this is a journey and we're on the journey. We're all trying to be better. And you're even wanting to be better. You're on that journey.
So give yourself grace and radically accept yourself. Two build community and other people that's, you know, mirroring body, body, doubling, delegating, you know, getting scribe and three is to optimize your habits. So give yourself. Use people and optimize your habits. That's it. You know, just rinse to repeat.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for your time. This has been such an incredible opportunity to chat with you and you gave us so much value, so much content. You're real, you're honest, and this is why I love you. That's my friend. Thank you, all your patience. Love you too. So thank you, you so much again.
Dr. Katrice Brooks: Thank you, Dr. Mercado. This is amazing. You're amazing. Am so honored. Thank you. Thank you.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
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Link to my website to register for October 2022 Cohort (waitlist):
Transformation Physician Group Coaching
Instagram: https://www.instagram.com/beyondadhdlifecoach/
Email: overachievewithadhd@gmail.com
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About Dr. Katrice Brooks Double board certified Family and Lifestyle Medicine. Dr. Katrice has more than 10 years of experience in primary care.
She is passionate about health equality, improving lives by reducing medication, and patient autonomy. Dr. Brooks transforms her patients lives with holistic approach to care by really listening and helping patients achieve their goals.
Website: quench.clinic/
Facebook: facebook.com/katrice.brooks.7
Instagram: @katricebeemd
Email: hello@katricebrooksmd.com
Dr. Vanessa Calderon: Once you realize that there are two things happening every day of your life. There's the truth. What's the actual truth. And then there's everything else and everything else are your thoughts. And when you don't have awareness into everything else, the thoughts it's like the matrix. When you have the blue pill or the red pill, the point of it is that you're either living a life in your head.
Where like you're just living in your thoughts or you're living in reality. Self-compassion is not a soft skill. Self-compassion is one of the hardest, most impactful skills to cultivate. It's the one skill that's gonna open you up to allow love to come in, but also for you to love others more. If you want to do something that's hard, I challenge you to start practicing self-compassion.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
I am so excited today to have a very special friend, Dr. Vanessa Calderon, she's a board certified ER doctor with over 20 years of experience in leadership and of course serving her community.
And she is a life and executive coach for many, many leaders. And she's gonna tell us about this today. So I'm so excited. Would you tell us a little bit about yourself, Dr. Calderon.
Dr. Vanessa Calderon: Of course. Thank you for having me, Diana. Hi everyone. It's so nice to be here with all of you in this community. So yeah, as Diana mentioned, I'm an ER doc by training, prior to my life.
As a physician, I was a healthcare activist and social justice activist. So I did a lot of organizing work, grassroots organizing work, which led me into leadership because once I started my career as a physician, I realized I wanted to affect change on a systems level, not just. On the one-on-one patient level.
However, patient care is still a passion of mine. I love the one-on-one patients that I get to take care of in the hospital, but I started doing leadership work very early on in my career, and it became, you know, chief resident in residency ever since residency, I was doing leadership work. And immediately after that, when I started as my first year attending, I was doing an admin fellowship in leadership. And it became a department chair about a year after residency and had been doing department chair, medical director work. And in fact, about a few years ago, I turned down a chief medical officer role because I decided that my passion really was in teaching and inspiring and empowering other leaders to stand up and lead, which is why I transitioned into executive coaching.
Dr. Diana Mercado-Marmarosh: Awesome. And so throughout your life, and as you've been doing with all this. What have you noticed has been like one of the key things to get you to this like leadership roles? Is it confidence? Is it like being fearless? Like what have you noticed and what can support that confidence?
Dr. Vanessa Calderon: Yeah. You know, it's really interesting. I think there's two things. Yes, absolutely confidence, but there's another big one, which is having a sense of belonging. I think, Early on. I was the type of person that I never needed permission to be in a room. I never needed permission to raise my hand. I would show up to the meetings and I would sit at the board table.
I wouldn't sit in the chairs in the back and I don't know what it was inside of me that I never felt like I didn't belong, but I realized that it's not. A super common feeling. And when I started coaching other women, I realized something that a lot of women needed was that confidence that they actually belonged.
And, you know, as you, and I know because we're both coaches, that sense of belonging is a mindset. You need to build that before you step into the room and once you have it and you're in that room. It allows you to show up with that executive presence. You can sit at the room, you can sit tall with your back straight up.
You can speak confidently when you do raise your hand to speak. And it's not like you're not gonna feel insecure. You definitely will, but you always show up like you belong in the space. And that I think led me to continue to raise my hand to. Speak up for myself to highlight the work that I had been doing when I had created a project or a program.
So that was really beneficial. And I will say that as I've been doing this work and have sort of matured in my experience, what I've learned is that. That got me really, really far, but what continues to take me further, but now from a space of, cuz one thing didn't mention is, you know, I'm an Enneagram three.
So if you know your Enneagrams three is the high achiever, it's the person that never feels satisfied with what, where they are. And their biggest downfall is that they achieve from a place from like a wounded place like that. It's never enough. Like I'm never enough. I have to keep achieving. And for me it's a common story.
I grew up, you know, as a brown Latina, I grew up with so many inferiority insecurities. Like I wasn't smart enough. I wasn't good enough. I'm, you know, a daughter of immigrants. And we had a lot of scarcity stories around money in my house. And so I had a lot of these scarcity stories. And so achieving for me, I think was easy because I love to achieve I'm disciplined.
I'm committed. But also I was coming from a wounded place earlier in my career where I needed to keep doing it and faster and faster, which is no, you know, no surprise that I became a department chair so quickly, but I also burned out in my career really early on, which happens to a lot of Enneagram threes or hyper achievers.
And so when I came back from that. I realized I wanna continue to contribute to the world and I'm still really ambitious, but I wanna take care of myself and I don't wanna put myself in spaces where I'm gonna burn out or makes it easier for me to burn out. And I realized that the link between continuing to achieve from a place of sufficiency, as opposed to a place of scarcity, which is where I was coming before is really self-compassion.
And being able to love myself along the way and know that it doesn't matter if I don't achieve that next goal, I'm gonna be okay. Whereas before I was so afraid to feel disappointed.
Dr. Diana Mercado-Marmarosh: Everything you just said, like a hundred percent resonates with me. And I think that self compassion that you just described has been the hardest and most rewarding thing that has happened for me.
Like I, everything you just said, like I, a hundred percent resonate with the fact that, you know, being a minority and coming from like immigrant parents, like that's totally me. The only thing you didn't say is that you have ADHD, which you don't, but I think. The fact that I had that on top of it always made me feel like we had the opposite experience.
You felt like you belonged regardless. I felt the opposite. I felt like I didn't belong, but once I was in there, like, I couldn't be quiet. Like I had to say what was wrong. And so I made myself belong. even though in my mind, I had this internal drama that, who am I to speak up? Because of my ADHD, I spoke up and I just couldn't help myself.
And like I had to call bullshit everywhere. I saw that there was something wrong, either for my colleagues or for myself or whatever. And so I was very compassionate for everybody else, but I didn't have self-compassion. And that was the hardest thing, because that was my inner critic wanting to be good enough to be in the room.
In masking that they didn't know how much or how hard I was working to try to be there. And every time I go through the exercise of self-compassion with like my clients, or even with myself, none of us, none of us. And I don't know if it's like a physician thing, because I even done it with male clients and they still don't understand what I'm talking about.
It's like something foreign. Like you said, when you step into self-compasion and you actually start to embody it, we're so good at giving advice. Like, we can give you advice for everybody else, but we can't apply it for ourselves. And when you ask them, well, what if I just told you all that, that you just said, what would you tell me?
And like, their face just like sinks because they're like, oh my God, why can't I do that? Like, it makes so much sense. Right? And when you tap into self compassion, like you just said, your confidence sky rockets, because all of a sudden you accept yourself as you are. And like you said, you're not proving anything to anybody else.
Like you're just measuring yourself against yourself instead of yourself against whatever society has told you, you have to keep up with. Right. And like you said, sometimes we don't realize that because we just wanna keep improving. And it's not from a place that I wanna improve because I just wanna improve.
But it's because from it's it was from a place before, because if I get there, then I'm worthy enough or I belong in this room or blah, blah, blah, blah, blah. But now that you have this, self-compassion, you know, you always belong in the room and it's such a different feeling when it's from a place of acceptance because, you can't help, but to be confident because you're at peace with where you're at that day. Right?
Dr. Vanessa Calderon: Wow. Yes. That last thing that you just said, which is you are at peace with where you are, but also you are at peace with who you are a hundred percent. Yes. And let me tell you, you know, in the beginning of my journey, even though I felt like I belonged, I still was super insecure and I still have a ton of insecurities, but the big difference, now from before, because you know, I've been on this journey towards loving myself, rediscovering myself and creating that self-compassion for myself for, I don't know, at least, Seven years or so, but I've been in leadership and out there doing the work for, two decades. And so I just have to say that even though I'm on this journey, it didn't even become real or feel real to me probably until like, The last year or so.
And it was about the same time that I went hardcore and launched my business because when you become an entrepreneur and you're out there putting yourself out there all of the time, every deep insecurity, you have shows up to the very surface and it's out there for the whole world to see. and you have two choices.
You can hide behind overworking and continue to do that and continue to hustle and, you know, try to make everything perfect. So nobody judges you and work harder, harder, harder, or you can just let, go and love yourself and say, Hey, this might not be perfect, but it isn't for me, it's for the people that I'm serving, you know?
So it doesn't matter. And. I think once I decided that I was gonna be all in on the journey of being an entrepreneur and it's not like I was leaving a hard life, I had an incredible life as a physician leader and I loved my job and I still love being a clinician. I love being an ER doc. Before, when I was a department chair, I was sitting on med exec.
I had a fantastic job, a great lifestyle, a ton of time for my family and my kids. So it's not like I was running away from anything. I was fully choosing to do something else because I was ready to be in service in a different way. And when I decided to do that in it, and. It's not like it was easy, you know, it's not like you go into this and like flowers and rainbows and unicorns.
You're a success every night, it takes work. It's like a whole new skill set that I'm building we're building. Cause I know you're on the journey too. And a lot of my old insecurities were coming up. A lot of my old stories were coming up and that's when I learned, wow, I really need to love myself. Like I need to double down and I.
And I actually have a little quote right here in front of me on my computer that says I'm all in on you. Hey Vanessa, I'm all in on you. Like, I love you so much. I'm all in on you. And on the right of me, I have a little baby picture of me that is adorable. You guys can't see it, but Diana can see it. If I show her a little picture there and I have this little picture of me framed because.
You know, my inner critic is just as loud as everybody else's. And I think that the more you do the work of self-awareness and the more you do the work to grow, you start picking up on your inner critic so much louder. Well, you didn't even realize that was your inner critic, cuz you didn't have the awareness to separate those two things.
And now that I'm at a space where I can separate those two things, I realize, wow, my inner critic was really loud. And so now when it shows up. I just don't make space for it. You know, it still shows up. It's not like it doesn't, it still shows up, but I just catch myself and I say, Hey, I'm not gonna say that to myself today.
I'm all in on me. You know, I love myself. And so I, I just highlight that because it's a total journey, you know, and for me, it's gonna be a journey for the rest of my life. And one of the things that I think is so amazing about the journey of self-compassion is that the more you learn to accept yourself and love yourself, ultimately, what he does is it opens yourself up to receive the love of everybody around you, people around you that wanna be supportive, that wanna be helpful, that wanna lift you up.
You're able to be open to that, whereas before you were just so closed, And the other thing that's really beautiful is you are able to love at such a deeper level. And for me, what that means is I'm able to be in service at a deeper level. And my whole mission in life is to be in service to others. My mission in life is to empower others, to be their best selves.
You know, I've always lived a mission driven life, and even now my mission is to be in service. And the more that I love myself, the easier it is for me to be in service to others.
Dr. Diana Mercado-Marmarosh: Yes, everything you just said resonates again so much when we decide to step out of our comfort zone, like you said, not because you didn't enjoy what you were doing, but just because your soul is calling you to serve in a different way and how else it is to empower those professional people around you, who might be hurting because again, they haven't discovered what self-compassion means because nobody's told them. And because we all walk around thinking that we are a hundred percent our thoughts and some of our thoughts, we have never, ever questioned because they're facts in our brain. Like I'm too slow or I'm too disorganized or I'm not good with money, whatever thoughts come in your, into your brain, in your brain.
They're always like a fact. And you can sit there and tell me like three examples, how to support those thoughts, because they're a fact, right. But. The funny thing is that whatever we focus our brain onto, you're gonna discover evidence for it. And sometimes, you know, those thoughts. Could just be miscued right.
Like they're not really a fact, but your brain has a allowed your told you that they are. And sometimes we somehow think that to be strong means to do everything yourself and not to ask for help. Right. And so we don't realize that self-compasion just, like you said, You wanna be of service, but just like you're giving you wanna be receiving because if you don't, then the universe is not gonna help you because you think you got it all together.
Right. And what if you got even more help when you were in the right energy and you were taking care of yourself and you rested and I keep saying it, and I sound like a broken record. We are in self neglect if we're not really taking care of ourselves. I mean, it's not just self care. Like it's self neglect.
If you're not sleeping, if you're not eating, if you're not asking for help, like all those, tie back to self compassion, because you don't realize how much it is to take care of yourself and the thoughts that you're having could change. And, and that your circumstance, sometimes the circumstance, you know, is something that would just happens.
And, and it's how you interpret it. Like some people see it as good or bad. But it's always your thought about the good or bad and the beautiful thing about coaching and the beautiful thing about having these discussions with people who want to work smarter instead of harder, is that once you tell them that yes, your past happened.
But how do you wanna remember your past? You get to reinterpret it, however, it makes sense to you and they look at you, like you're weird. And you're like, okay, well then go walk around and carry that monkey for as long as you want or leave it there and see what it taught you. Right? Like, again, it it's how you look at it.
When you're able to see that your thoughts are not you and you can separate them. And like you said, you are willing to be all in on you. And sometimes we're a little silly and that's okay, because life is not meant to be a hundred percent serious. and, you know, it's so important to have these discussions because I don't think we slow down enough to feel and see if you just ask yourself whatever you're thinking, is it serving you or not?
Can we put it down and can I think something else that might be empowering? Like I, I heard a chord the other day saying like human human beings are so silly. They set up their own limitations. like, isn't that funny? Like, it's true. Right? Like we limit ourselves and sometimes it sounds silly, but like being a doctor is kind of safe in the sense that you have guidelines and you have.
Best evidence and da, da, da, da. And so you kind of like hide behind that. You're like, well, this I'm doing it right. You know, X, Y, and Z. And then you go to like the business part of it. And there's like, no rules. All of a sudden you have to do it. Like, however, whenever. And you're like what I have to decide, but how we always wanna know how right.
And they're like, Who cares about the, how you make it up as you go. You're like, no, that's not safe. And like you said, it brings up all our insecurities but at the same time, it lets you be aware that what if you did trust yourself? Like what if you did get it right? And so it goes back to finding that self compassion and being.
Willing to fall flat in your face, because maybe that's the more evidence that you needed or the more data that you needed to keep moving forward. Right?
Dr. Vanessa Calderon: Absolutely. There's so many good nuggets in what you just said. One of the things you said that I think for me is just so interesting. It's like this idea once you realize that there are two things happening every day of your life, there's the truth. What's the actual truth and then there's everything else and everything else are your thoughts. And when you don't have awareness into everything else, the thoughts it's like, you know, the matrix when you have the blue pillow, the red pill.
The point of it is that you're either living a life in your head, in your dreams, almost as cloudlike living words, like you're just living in your thoughts or you're living reality and an exercise that I've been using a lot, especially over the last few weeks, is this exercise of what is my truth. And I use it when something just like quickly triggered me or like something brought up something in my head, I'll ask myself, what is my truth in this moment?
And I just ground myself in that space because the only truth is that I can feel my feet on the ground. I can feel the air going in and out of my nostrils. I feel a little pressure in my chest, you know, or I feel my stomach kind of nodding inside. That's the truth. Everything else is just a thought, you know?
And so I ground myself in that because it's really important because what happens when you get triggered? For example, someone says something, they kind of trigger you it's they say something and then you make it mean a bunch of stuff in your head. It's your old subconscious thinking patterns, your habits. Right? So one of the things that's so important, I think, especially bringing this back to self-compassion and that exercise about what is my truth in this moment is that. Especially, you know, I have this morning journaling exercise where every morning I get up, I just ask myself one prompt, which is one of my thinking.
I let it all out. And then I get to see the old stuff that comes up because we all know the benefits of positive thinking. But of course our brain doesn't go to that as a habit. Because we have the negativity bias, right? Our brain goes to the negative more. And when you get to see all your thoughts on paper, I then choose what I actually wanna believe.
I see, like my only truth in this moment is that I have a pen in my hand and I'm sitting down right here. What do I wanna believe today? And then I get to choose the thoughts that will serve me. And that right there is how you create the reality. Of your dreams, you create the reality of your dreams by choosing the thoughts that serve you.
And for me, you know, I create the reality of like, I'm gonna be all in on me me. I'm gonna love me. No drama necessary. When I have a task, for example, this is a big one for procrastinators. Why do we procrastinate? We procrastinate mainly because we're afraid we're avoiding something. And what we're avoiding is not the task.
What we're avoiding is what that's gonna bring up for us, like what that's gonna make us feel like. And so for a big one, for me, for example, I often avoid things that I feel like I'm not gonna be good at, or I avoid things that I feel like I don't know how to do yet because I'm avoiding the feeling of overwhelm.
I don't wanna feel overwhelmed and I don't wanna feel sometimes I don't wanna feel like a beginner, you know, like, oh, I don't know how to do it. I'm gonna have to spend all this in my mind. I make up these stories. I'm gonna have to spend all this time researching to get it just right. And of course I'm a recovering perfectionist.
And so things need to be done, not just done, but done right. And so I'm avoiding this feeling of overwhelm. And so one of the thought errors that I catch is. Oh, no, but I won't do it. Right. And so the way I support myself in that is I see that as a thought error and I get to create grace for myself and say, okay, like, what is it that you need right now, Vanessa, you need a hug.
You need love and you need to be reminded. There's no drama necessary. Like, yeah, that's gonna be a new task. Yes. It's gonna be something different and yes, you might feel overwhelmed and we'll meet that overwhelmed with compassion. You know, when you feel overwhelmed, we'll love ourselves through.
Dr. Diana Mercado-Marmarosh: So the procrastination, I joke around a lot because people with ADHD were like, we have too much time.
That's like way over there. So we'll like outta sight out of mind. Right. And if we don't have enough time, we're like, oh my God. And the funny thing is that we don't only procrastinate on the things that are really important to us. We also procrastinate on the things that are boring to us, but for two different reasons, the things that are very important to us.
If we don't get them, we might feel like a failure or we are afraid of the success either way. We're, we're gonna put it off because if it actually goes the way we want, all of a sudden we might be more busy and we have this like scarcity mindset around time. Right. Because we feel like there's never enough time.
And so sometimes we procrastinate, I think because of either we don't have a clear mind of what's gonna happen, which steps need to be taken, or we are trying to do everything at once instead of breaking it down, or if we actually do it, we are afraid that, oh my God, I'm gonna become so successful that this is not gonna work out.
I'm not gonna have time. Sometimes procrastination also means that maybe that was not like aligned or wasn't meant for you at that time. Right? It's, it's funny with the word procrastination, because some people don't know how to slow down sometimes and their body literally makes them. And so it's like, they're procrastinating, but it's also, like you said, it could be that you are on purpose or your brain is on purpose, trying to tell you to slow down, or maybe you are afraid that it's not perfect enough and therefore you don't hit submit.
But, I've learned to tell myself that, you know, a messy first draft is better than, than a perfect undone draft at all. Right? And so sometimes we just need to do things because then at least the intention is there. And then you can always ask somebody else for help to make it prettier to make it more acceptable, to get us to point B or C or whatever, but at least the jist is somewhere. If it's meaningful for you.
Dr. Vanessa Calderon: Yeah, absolutely. I agree that we all procrastinate for different reasons. And I think the most important thing is to be onto yourself. If you are someone that does it in an all honesty, everybody does it. So when I say, if you are someone I'm saying all of you, cause you all do it.
The difference is why do we do it? What's your reason behind it? And I know for me, it's because I'm avoiding a feeling and for many people, that's what it is, but there's also something called strategic procrastination where you strategically say, I have this idea. I'm gonna put it right here and I'm not gonna act upon it yet, but I know that the idea is there.
I see it every day. Like I do this sometimes and I'll put a little note card and I'll leave the note card about my bedside, for example. And every day my brain's going to work, thinking about it and figuring out like how I'm gonna make it really amazing. I'm not ready to execute on it yet. I wanted to keep mingling and what'll happen is as you're going throughout your day, you're gaining evidence, you're seeing things of how that's that idea's gonna work out. And then eventually when you're ready to execute, now you have all this awesome stuff inside of your brain, you know, that's ready to go. So I think, there's, there's different reasons why, I guess the important thing is to understand why you do it, but also is it's serving you.
So if your procrastination is not serving you and now you're in this, you know something to be called, like a negative, where you're procrastinating and it's not serving you now. It's time to reexamine. Now it's time to come to Diana and get coaching and figure out why am I procrastinating? So we sort of got off topic a little bit when we were talking about self-compassion and we spoke about procrastination, but I don't know if you wanna stay on this topic, but we could also jump back to self-compassion and talk a little bit more about like actionable ways that people can actually, you know, cultivate self-compassion.
Dr. Diana Mercado-Marmarosh: Yes, that'd be great. And I was gonna ask you if you knew, if there was a link between self-compassion and happiness or joy or anything of that sort.
Dr. Vanessa Calderon: Yes. That's a great question. Taking that second question first. Yes, there is a link. I mean, you can imagine right now, you know, my life as an example. In my professional career, when I was highly achieving, you know, I have a degree from Harvard, I was chief resident.
I have all these accolades behind my name and I was doing all of that and I was still feeling like I wasn't enough. Right. Like, I still had a super strong inner critic. I had a ton of insecurities. I had to keep achieving. And for me, when I was deeply insecure, some of the ways I would show up as arrogant, as opposed to humble.
And, you know, I like to think of actual confidence, confidence for me means showing up, trusting yourself. That's what it means for me and humility for me means having curiosity. Like being super curious and so humble confidence means trusting in yourself and being super curious, you know, knowing that you don't know everything, knowing that there's more to learn, but still being confident in who you are in that moment.
And the difference between that and arrogance is for me anyways, that arrogance is more of this like sort of fear based response. You're afraid of something. You're you think you're insecure, there's something else that's sort of guiding you. And so you think you need to put up this front. You know, where you show up, like, you know, everything and that's way different than humble confidence.
And everyone here that's listening knows somebody who shows up confident without arrogance and arrogance, you know, when they're really just afraid. And I know for me, one of my fear based responses, especially before, when I had really stepped into this work of self-compasion is, there were times where I was afraid, you know, and I would show up arrogant.
Like I wanted to seem smarter. I was super insecure. Remember the first time I got a department chair role, you know, I'm a five foot, a hundred pound Latina. And the people I was leading were people that had been practicing medicine for a very long time, much older, really tall white men. And I remember I had to sit at a department meeting and lead these people or counsel some of them that.
Doing things that I had to counsel them cause they were getting bad patient outcomes and a ton of insecurities would bubble up. I thought that to meet those insecurities, I had to show up as arrogant. And the truth is you don't like had I trusted myself, had I loved myself. Had I had the level of self-compassion I have now I would've been confident showing up with the humility that I needed, knowing that I'm confident in who I am and what I know I have this position for a reason, you know?
And so. Back to your question about how self-compassion and joy are linked really is when you love yourself, you can let go of all those fear-based stories, you know, all those insecurities and yes, of course, insecurities will always show up. As long as you have a human brain, you're gonna have an inner critic.
And the inner critic brings you insecurities all the time. What if you fail? What if you're not good enough? What if you know, and even the most successful think right now. I want everyone listening to think about who they imagine to be the most confident, successful person in the world. And I want you to know right now, as you're thinking about that person.
That, that person also has a super loud inner critic, just like yours. When they look in the mirror, they don't think they're good enough. They don't think they're smart enough. Sometimes. You know, I remember the story of, Barack Obama when he was sitting in the oval office at his desk and he looked up at the wall and he said, what the heck am I doing here?
Abraham Lincoln said at this desk, like, what am I doing? You know, and so I just want everyone to remember that, that we all have that and the more you can lean into self-compassion, the more you realize that you can love yourself in those moments and let go of the fear and really just lean into joy and just be proud of yourself, you know, from a place of humility.
Dr. Diana Mercado-Marmarosh: You know, the story that you just explained about Barack Obama sitting there and wondering what the hell am I doing here? Reminds me of Erica. She is a lawyer in our life coach school. She's actually the VP, yes. And she said, you know, We are our ancestors' wildest dream and it's crazy how we become who we become.
And then we don't like take ownership of it sometimes because again, our inner critic is there and it's so loud, right. And sometimes, like you said, our inner critic is just trying to protect us. Like nobody wants to be like, Ooh, how can I look like a fool today? Right. Like how can I make an ass on myself?
Nobody wants to do that. So it's meant to keep you safe. But at the same time, like this. Inner critic, because it's trying to keep you safe instead of like silencing it sometimes like just being like, okay, tell me what it is, Diana, what is it? And then you can like counteract it, whatever it tells you.
Just listen to it. Like you would listen to a friend, even though you're mad at that friend, you would listen to them anyways, like with the sore eye. Right. But you're still listening. And then maybe just saying, okay, I understand. I understand. I understand. But what if it could be this other way? Right. And what if this other way means I get to love you?
And I only get to love me and I get to accept me right. For me. And like the good, the bad and the ugly. And like, I think that's then how you show up, like you said, as in a humble humility where you know that yes, I belong here because I belong here. I'm choosing to belong here. Right? I accept all of me. I think again, it goes back, like you said, joy and confidence to that self-compassion.
And, and now tell me what are some ways that you practice self-compassion or how can other people practice self-compasion for themselves?
Dr. Vanessa Calderon: Yeah, so I practice self-compassion all of the time. So I'll share a few things that I think are tangible, that people can do. One is I really, 100% recommend if you're not already doing this to create some sort of morning journaling practice or journaling routine, just to really get clear on the thoughts that come out of your brain in the morning.
So my routine for example, is as soon as I get outta bed, I'll go to the restroom if I have to. And the very first thing I do, I usually get up before everyone else in my house is I sit quietly for 15 minutes and I journal, and it's incredibly important to do it in the very, very beginning, because that's when your brain is gonna share, show you everything, all your thoughts on default.
And what I wanna highlight for everyone listening is, the majority of our actions are taken by default 95% of what we do are taken by subconscious thoughts are patterned thoughts, who we become along the way, only 5% of what we do comes from conscious thinking. And so the work, especially all this like really important thought work and mindset work, what it's doing is it's rewiring your brain so that your new patterned thoughts, your new subconscious thoughts.
Are things that you actually wanna be thinking and doing, as opposed to who we were as kids, you know, the fears that we had when we were children, for me, for example, all of that inferiority that I was feeling, because I was a brown, you know, daughter of an immigrant, you know, not never feeling like I was good enough or smart enough.
So the very first thing I do is I get up and I journal. And when I'm journaling, I see all my subconscious thoughts and I choose what I wanna think on purpose that really serves me. And that I think is one of the most important practices of self compassion is choose your thoughts that will serve you.
Thoughts that really show you grace and love. And then the other thing is there's this really amazing researcher who I absolutely love on self compassion. Her name is Dr. Kristen Neff, and the way she describes this is this, she reminds us that human beings are mammals like all other mammals. And there's three things that human beings really love.
And you can imagine this by thinking about a baby. So how do you, how do you comfort a child? You swaddle them. So, one thing you do is you keep them warm human beings love to be kept warm. So when you're showing yourself self-compassion, if you're in a space where like you're feeling disappointed or sad or you're feeling rejection or whatever it is that you're feeling to love yourself in that moment, maybe all you need is a warm blanket or something cozy around your shoulders.
What else do, what else do babies need? What else do mammals need? We, we like touch human touch. So the hug or the kiss on the cheek that babies love. So I love to show myself self-compassion by doing two ways, in terms of touch, I give myself an actual hug. I'll put my arms around my shoulders and I will do that all the time when I'm being coached, when I'm sitting by myself.
And the other thing I do is I put one hand on my heart. Sometimes I put both hands over my heart and just really sit there for a moment and just love myself or one hand on my heart. One hand on my belly and just feel myself, breathe to ground myself. But another thing people love to do is you hold your hand, just put your two hands together and just hold your hands for a little bit and just love yourself in that moment.
Okay. So the first is warmth. The second is a human touch. And then the third thing is a soothing voice. You imagine when you swaddle a baby and you're holding them up to you, what do you say to them? You give them that soothing voice and that's what gets them to calm down. And so do that to yourself. How can you provide that soothing voice for yourself?
And so I literally talk to myself and I have no problem doing it now. And I'll say, Hey, what is it that you need, Vanessa? What is it that you need? Okay. Yep. I love you. Like, I hear you. I hear that. You need love. Okay. I love you today. Or I'll write myself a note sometimes when, like I receive like a really, like a really nice evaluation of some sort or someone just like reviewed my podcast or someone just gave me really positive affirmation.
And I'll read that and old me would read that and be like, oh, it's so nice that they said that delete go on with my life. And one of the things that we need to do to really remodel our brains, and this is neuroplasticity in action is the way you remodel your brain to tilt it towards positive is you take in that good with just as much time, that you would the bad stuff. Cause what do we do with the bad stuff? We sit, we ruminate without we like, think about how there could be wrong. You get super defensive sometimes. Or you start trying to talk about like how you can do it better next time. But when the good stuff comes in, you let it roll off your shoulders.
And that's, that's normal human behavior because the human brain is like, you know, it's like Velcro for the negative, the negative just sticks, but it's like Teflon for the positive. The positive will just roll right off. So one thing that's really important to do is to help the positivity stick. And so when I get a positive affirmation, I'll read it out loud.
And if it really makes me feel good, like I did this for a performance review, six or eight months ago, I got a performance review and it was awesome. And initially I wanted to push it away. How could that be true? No, maybe they say that to everybody. And I was like, whoa, what are we doing here? Let's sit and take it in.
And then I wrote myself a letter. Dear Vanessa. I am so proud of you. Listen to what they said. Like you really affected their lives. Look at these evaluations. You're always scoring this high. I'm so proud of you. And that for me was my own sort of soothing words. And so I encourage all of you to think about how you can use one of those three super easy things to show yourself love when you really need it.
And I used to only use self compassion when I was down, like when I was feeling sad or disappointed, or when I was. And now I realize I've shifted my brain to a point where I use it all of the time. I separate my thoughts, another really important practice, like I mentioned earlier, and this is a lot of inner critic work, but when your inner critic starts showing up, The first thing I do is I ask myself, what is the truth in this moment?
Cause that thought is not the truth. And when you do that, what you're essentially doing is you're bringing awareness to that moment, which turns off your amygdala. So your amygdala is your fear center and that's where your inner critic is coming from. All your fear is coming from those faces, but when you turn it off and you bring awareness to that moment, then you can shift your brain.
Okay, this is the truth. What do I wanna believe?
Dr. Diana Mercado-Marmarosh: Yeah, that's so good to help you ground yourself and to practice those things. I think, like you said, when I started a morning routine, that was the start of changing how I was thinking and being intentional and being mindful of what are the two or three things that I wanna accomplish today.
What are the two or three things I wanna feel today? What are the two or three things that I want to help myself? Right. And so. It's so important when you do it that way, because you, again are being intentional. Like you said, there's a golden hour, you know, in the morning and, actually the hour right before you go to sleep as well, where you shouldn't be on your phone, because then you go to sleep, you know, in a reactive state and you wake up in a reactive state, you touch the phone again.
When you on purpose are deciding how to calm yourself down, to relax, to sleep and what you're gonna do throughout the day. You're going to be a lot more aware of what it is that you're wanting to do instead of just being reactive all day. You get to be on purpose, deciding your life, how you want to do.
And so I'm so glad that you are doing this work to help others really step into their own self-compassion because that really is gonna boost their confidence, boost their joy, and obviously smash the inner critic and it smash that imposter syndrome. Right. So tell me where can people find you if they wanna work with you?
Because I mean, it, it sounds like, you know, this is very powerful work that you're providing.
Dr. Vanessa Calderon: Yeah. Thanks so much for asking. So, there's two ways people can find me. The easiest is just to find me on Instagram at @Vanessamd, or at VanessacalderonMD.com you know, I created this actually free guide that's awesome. That talks about all of this type of work. And so people can find that really easily at vanessacalderonmd.com/guide, and it's a five step guide that really teaches you why we do certain things like for a lot of us, it's people pleasing. Like why do we people please, and how do create boundaries and how to see no without guilt and that,
just that practice alone, frees you up to create so much more time to do the things that you love. And so for a lot of the people that I work with and that I help learning those skills and it's five super simple steps that you can start using right now. And then once you get good at it, you use it over and over again, you stop saying yes to things that just don't make sense, you know, or you go back and say, I do really wanna speak at that conference, but I don't wanna do it for free you, and then you go back with the confidence to ask for money, to get paid, you know, and all of a sudden they say yes, and now you're speaking at the conference and you're getting paid and it's a win-win. And so you, anyone can download that guide. I created it for free. And it's, vanessacalderonmd.com/guide. It's the ultimate five step guide to stop people pleasing.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much. One more question. Where do you see yourself in three years from now? What are you doing for fun?
Dr. Vanessa Calderon: For fun. That's a good question. I was about, you know, when you said, where do you see yourself in three years from now? My eneagram three brain was about to tell you all my successes, you know, like where I see myself in my business. But for fun, we are gonna move. I currently live in California, but we're leaving the state. And so we're moving out of state. And in three years I see myself traveling with my husband and my two little beautiful cuties and exploring the world internationally.
You know, we've held off a lot because of COVID and our kids were young for a long time. And then my mom got sick and we. Are itching to travel. We both used to travel a lot before. And so, it's time to expose our kids to put backpacks on their back and rent a car and you have to try to eat the food wherever we are, you know, no matter what. And, that's what we'll be doing for fun.
Dr. Diana Mercado-Marmarosh: You know, I've talked to my husband about this and he used to think I'm crazy, but he, you know, the more you talk about it, the more it becomes like it's almost there, right? You can taste it. Like I'm telling him that in my ideal world. And I think we're in the same wavelength where, you know, maybe the summers, we just pick a country and we, there were there the whole summer and you get to learn and study and live the culture and do everything the whole summer, every summer, you know, at a different place. Why not? I mean, that's how I think we grow west people when we just get immersed in it. Right. Like you just take what you like and let go of what you don't and keep. Leveling up. Right.
So that's so fun. Awesome. That sounds so good. I'm pretty sure we'll be traveling somewhere sometime together. I love travel too. So one more last question. And this is the one that I say, okay, my listeners have ADHD and sometimes, attention goes somewhere. So let's say they just started paying attention right now, they didn't listen to everything else we said before. What would be the one sentence or two sentence you would want them to take away when they think of today's episode?
Dr. Vanessa Calderon: I want them to take away this, that self-compassion is not a soft skill. Self-compassion is one of the hardest, most impactful skills to cultivate.
It's the one skill that's gonna open you up to allow love to come in, but also for you to love others more. So. To be in service more. And for a lot of us, you know, especially if you're physicians, we are wired to heal and we are wired to be in service to others. And we have a tremendous capacity to be in service to others, but we cannot do that well or to the fullest when we have not first filled our own cup.
And so the one thing I will say is if you want to do something, that's hard, I challenge you to start practicing self compassion.
Dr. Diana Mercado-Marmarosh: Yes, like you said, that was one of the big things that really started to heal me and allow me to start speaking from a place of a healed wound instead of an open wound. And, it was such a powerful thing.
So thank you so much again, for sharing with us, all the important things that you're doing in the world. And I can't wait to see all those fun pictures and, continue to see your business blossom.
Dr. Vanessa Calderon: Thank you. It was so wonderful to be here with you
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register for October 2022 Cohort (waitlist):
Transformation Physician Group Coaching
Instagram: https://www.instagram.com/beyondadhdlifecoach/
Email: overachievewithadhd@gmail.com
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About Dr. Vanessa Calderon:
ER Doc and a certified professional coach and resiliency expert. She helps BIWOC physicians stop feeling overwhelmed, anxious and disorganized. And, live their life with intention and purpose, and create wholehearted success they can be proud of.
Website: vanessacalderonmd.com
PDF Guide: 5 Step Ultimate Guide To Stop People Pleasing
Instagram: instagram.com/vanessacalderonmd/
Facebook: facebook.com/vanessacalderonmd
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
I wanna talk to you guys about coaching and therapist, because I feel like one is not better than the other. In fact, I feel that if you use all the tools, you might actually land on something that might work for you.
So this week's topic is a very important one to me. I wanna describe the difference between a coach and a therapist. And I also want to give you insights on how to choose a good coach, especially for ADHD. I think it's so important to be able to have this mindset or frame of mind that way, you know, how to help yourself. First of all, I wanna say that it's very common still for people to not be even aware that.
There's ADHD, life coaches out there. And, you know, I wish I would have known this when I was going through med school and residency. I did not know that there would be other tools when I got diagnosed. I just kind of got told. Okay, well, here's a medicine and, good luck. And part of the diagnosis, I was very ashamed about the diagnosis.
I, I think the stigma of having something like this, I was making it mean that I was broken. And I think because I didn't know any better, I didn't know, to go ask for my medication to be adjusted because it wasn't working as well. It should. And I didn't realize that, you know, I was given Lin five milligrams and it worked great for a few hours, but then when it didn't, I made it mean all kinds of things about myself.
And even though I was a first year medical student, and again, in the medical field per se, I was not aware of how medications worked and that, you know, regular medication. Not extended release medications only lasted in your body about four to six hours. And that extended release medications would last in your body about eight to 12 hours.
So it is known that 6.1 million people in the 2016 were diagnosed with ADHD. And it is known that about four to 5% are adults that have ADHD, right. And even in 2016, there was a study that showed that 30% of medical students identified themselves with ADHD. And so I'm hoping most of those medical students made it through.
And they're now attendings. So that just tells you that maybe people are not talking about this. So if you're not somebody who has ADHD or know a colleague that has ADHD, it just might be that they're trying really hard to not show you how hard they're working. One in four Americans, you know, still feel like ADHD is a stigma.
It's a mental stigma. And so I wanna talk to you guys about coaching and therapist, because I feel like one is not better than the other. In fact, I feel that if you use all the tools, you might actually land on something that might work for you. And yes, while I am a physician. And of course I do believe in ADHD medication.
I'm not here to say that medication is the only way I've been a blessed enough to use medication that has helped me. But I understand that not everybody's able to use medication. In fact about 20% of people cannot tolerate medication. It's important to know that when you at least have the diagnosis, then at least you can start to open up your brain and become curious and understand how it works so that you can start to figure out tools to help you.
So with that being. A coach. So when you look at a coach, you're looking at somebody who's gonna help you with certain things like a coach will look where you're currently at, like your present state of being and will help you to get to where your future state of being is. So it will help close the gap of what you haven't accomplished yet.
So it works more on behavior per se. Techniques to get you the behavior or the outcome that you want. So with the coach, they might be able to help you gain more clarity. They will decrease your own self judgment. They'll help you with like self-esteem issues or figure out communication. To help improve relationships.
They will help you with planning and creating schedules and figuring out how to break up tasks that seem too daunting. And of course, with time management and especially with ADHD, we will also work with emotional dysregulation. Basically with a coach, you're kind using a shortcut to help you to get where you want to be so that you can get rid of that irritability, those blocks and habits that maybe are not as efficient for you with the therapist.
It's more like you're looking at pathology. So it's more like you're looking at what's going on. What happened in your past? Like you, you're looking at your present and you're looking back, like what happened in your past to get you to where you are today? And so it's more dealing with like mental illnesses or more like, with anxiety, depression, post traumatic stress disorder, stuff like that.
So with a therapist, you have somebody who's licensed. They have a medical code of ethics. So to say with a coach, you don't have to have a specific license of some sort for you to call yourself a coach. So that's where sometimes it gets tricky because, you know, you wonder whether that person can help you or not.
And like, how do you know if they can help you? With this being said, sometimes you just have to talk to different people, different coaches and see if their experiences. Or their abilities align with what you're looking for. You know, sometimes that is more important than them having just a formal diploma or training or whatever, like whatever kind of experience they have that might be useful.
So there's not a regulating body per se, for coaches. Of course there is where I trained is the life coach goal. And then the certified, the international certification school for like the other coaches. But with the ADHD is specifically, there is certain organization that is called ADHD coaches organization.
It's just a list of people who, you know, are professional coaches. But again, nobody can specifically tell you that this person is better than the other based on their diplomas. It's gonna be more of an experience. Who do you relate to? What can they help you with? Right. What is important is that when you are looking for a coach, you have certain questions in mind.
So you might wanna ask the coach like, Hey, what kind of work, you know, have you done with your clients? What kind of results should I expect to do? And you might want to see. If you're looking for a coach, like short term or long term, or are you looking for a coach to help you with a specific task or like a specific problem?
Like maybe you want a coach who's gonna help you close your chart. Like that's the type of coach I am. Or maybe you want a coach who is going to help you clear your clutter? Like that's my course geared towards that. Like I have, Rosemary who is the declutter ADHD coach who will have three sessions with them and then they'll personalize it.
So like you have to ask the coach, like, what are you gonna offer me? Or can you help me with X, Y, Z problem? Like you gotta tell the coach, Hey, I'm working on not being late or I'm working on procrastination or I'm working on completing this thesis. Can you help me walk me through this? And so you might also want to know if that coach has a specific niche or like, do they feel like they can help just kids? Can they help adults? Can they help physicians? Can they help nurses? Can they help professionals, teachers? Like who do they usually work with? Those are questions to ask the coach. The other thing you could ask them is like, do you do private sessions?
Like, is it one on one or is it like a group session? And then like, you can also ask them like, how are we going to meet? Like, are we gonna meet in person, are we gonna do a phone call? Are we gonna get on like Facebook messenger or like zoom? And then you can ask them like how long the sessions are, what is the time investment?
And then of course you want to ask them, like, what kind of experiences have your previous clients gotten? If you already coached people in this area? Like what, what do I expect to get for like example in my group coaching program? My model or my thing is I help physicians. They don't have to have ADHD, but they, you know, if they feel like they have a time blindness or chronic procrastination problem, I help them create systems so that they can enhance their zone of genius.
And so that they can reclaim, you know, 10 plus hours per week of their time. And so my goal is for them to leave work at work so that they're able to use their free time to do whatever they want, whether they wanna start, you know, a side business, whether they wanna be able to pick up their kids every day at school, whether they want to start that book that they've been wanting to do, whether they want to practice medicine in their own terms.
Right. So you. To ask them specifically, what can those clients expect to get? So that, that way, you know, if that coach or that group is your ideal, Another difference between therapy and coaching is the investment with therapists, you can use sometimes like your insurance, like some of your insurance might pay for that again, because it's considered like medical condition that they're treating and it's licensed professionals. With a coach, it is not considered like a medical condition that they're gonna be treating. It's just more of a partnership. For the coach is gonna help you to accomplish X, Y, Z result. Right? With that being said, there's still some similars and differences. So the cost is pretty much about the same as a therapist. Usually some people can do some pro bono sessions and then it varies anywhere from three to $1,500 per month.
It really depends, on what it is. So when you have private, that's more time that it's one on one versus when you have a group. So it just depends. They tend to have you sign an agreement or they give it to you in an outline of what it is that you are agreeing to. Like, are you signing up for a three, six, one year program?
Are you doing group or, private in general, coaches are gonna require the payment upfront for a couple of reasons. One is because they're doing this for you. I know it sounds silly, right. But no, the investment that you make, the decision, when you say I'm all in on myself, when you put money to back it up, it really sends like an internal message to yourself that you are totally worth this investment.
And, and it allows you to commit yourself to the possibility of changing whatever your current situation is, to what you want it to become. So it's in that investment that you now have the probability, the chances just go up dramatically. So it's for you, it's for you to be able to be all in on yourself so that you can have that outcome that you want.
Most of the time, it is a full payment up front, and sometimes they make exceptions. They do monthly payments or something like that. But again, the reason is because usually most people will lose interest by like the first month, like in the. Fifth to sixth session, they'll be onto something else. Or maybe they haven't made the progress as fast as they wanted to.
And they'll think that it's not working and they'll wanna give up, but if they have already paid up front, then it helps them to continue going through the program. Right. And here's the thing, like most of us want that magic pill. Right? just gimme the pill so that you could go away. But it's not gonna happen.
Like with ADHD, you need to be able to allow yourself to use different methods. You know, coaching is a partnership. The coach cannot, cannot. I agree. Cannot, cannot, cannot care more about your outcome than your. Own outcome. What does that mean is that you need to be all in the coach is not gonna run the race for you.
You need to put in the work, but the coach is gonna provide you with tools and techniques to create shortcuts, intellectual, emotional shortcuts, right. So that you're not having to work as hard. You're gonna work smart. And so a lot of us don't want to get off this damn hamster wheel. Right. Because we're so used to going.
And when we say, okay, get off the wheel and you're like, no, I'm like, get off the bike. You're like, no, I can't. This is working. You're like, but if you get off, I have a Ferrari over there that kind of has, you know, GPS and we can get you there faster. Sometimes we need that external accountability to be able to allow others, to see the shortcuts for us, that we haven't been able to see this investment is for you to be all in on you.
And so the faster that you decide that you are worth this, the faster you get to your. And so here's the thing. Coaching is just like going to the doctor in the sense that if you missed appointments or you cancel, you know, within less than 24 hours, like, they'll count that as a session. Because remember that coach on the other side, they had to make arrangement.
They probably got a babysitter or they did whatever it needed to happen so that they could be readily available for. right. So you gotta make sure that you treat this when you're ready. Like we're never gonna feel a hundred percent ready, but you gotta give it the importance that it is because as you invest in yourself, you are your best investment.
The outcome of it is gonna just be like a thousand fold and come on, we all know like how much money have we invested in trying to get our medical degree? I mean, most of us unfortunately walked out with like two to three to $500,000. Right. And we're still paying student loans. Some of us, I guess, were lucky that might have had people who helped us pay for it, but not all of us are in that same boat.
Any investment that we've done, we've done it because we think it's gonna get better. You know, you could ask if your physician, if to write a prescription that says that you need ADHD coaching for your condition, and you could use it after you talk to your tax accountant or whatever, you could use it to write off.
To write it off on your taxes. Right? So that could be something that could be like, you could use it as a business expense, if you're self-employed or if it's helping you manage your work. Right. If you're a physician like working with me, you could use that because you're gonna get continuing medical education.
In my program, you get 20 CME's for my three month program. You could use that as, you know, a financial investment for your career. Right. But it's a lot more than that. I mean, how much would you pay to be able to have your systems that support you and you don't feel like , you don't know what is coming or going, so you can feel like you're not having your brain being pulled in so many directions.
With that being said, like each coach is gonna set up their own thing. Like you get to decide, most people will coach for anywhere from three months to a year and they can decide that they want to do private weekly, classes, usually after three to six months, people will ask to be when they've gathered tools and techniques they'll they might paste them out to like every two weeks or once a month, or they might decide that they want to do group coaching all along.
It doesn't matter. You get to decide what works for you. There is pros and cons on private versus group coaching. With me, I feel group coaching is amazing because it normalizes the situation. Like you'd be surprised how many different specialties are represented in my program. Like I have people that are OB GYN. I have internal medicine. I have psych, I have PS. I have family medicine. I have nocturnist, I have surgeons. I will say that it's probably 90%. Female and 10% male right now in my program. I don't have any bias against men. It's just that, as I was told by one of my clients, who's a male. He told me, you know, it's probably cuz males are having their wife or significant other do a lot of the task males don't tend to feel like they have to do all the things like some females do sometimes.
So I don't know if. Why, but Hey, if you're a male listening to this and you're a physician and want help, please come in. I don't have anything against you guys. Anyways. The point is that you gotta figure out what works for you in a group setting. You get to just hear what other people are saying, and you don't feel like you're always the one on the spot.
Although I tend to, you know, give you that possibility to speak up if you want to or let you pass. And so coaching. I know it can feel kind of, you know, weird, especially if you never come across it. But like I said, it's not the magical remedy. It's just one of many tools that you could use, like to tame your ADHD.
Like you could use exercise, you could. Use journaling, you could use therapy, you could use medicine, right? It could be many of those things, but it is important to realize that coaching is evidence based and, you know, physician leaders can guide other physicians who might have ADHD to seek professional help and support them and reinforce that there's coping strategies that can help with their wellbeing.
And so it, it is important to know. You know, our wellbeing matters and being in the room where everybody is trying to level up and trying to get their work done at work so that they can have more impact at home. Right? Most of us work really hard at work so that we can provide for our family and like, People at work, get to see us at our best.
And then we get home and we're like drained and we're like irritable and bitchy and you know, all the nine yards . And so what if on purpose, you decided that things that were draining you, you don't have to continue to do, and we set up some boundaries so that you can become the person you want to. And if you're already doing all that kudos to you, I'm so glad you're ahead of the game.
And I'm so glad that you are doing this for yourself. So anyways, I just wanted to do a short little talk with you guys today to just talk about how coaching versus therapy is different and how you can use both tools to help you to realize why you've done what you've done and where you're going.
Coaching can be very, very powerful today. During one of our coaching sessions, I had somebody who shared that they felt like they were wasting time because they were on leave and that they didn't like change. And that change was hard. However, I reflected back to that person that I had seen them grow as a person in so many levels.
And do all kinds of things like reclaiming their garage back, stepping into their stone of genius, being willing to say what's on their mind without feeling like they had to be people pleasing. And it's been so powerful to see how courageous that person has been. And when I reflected back. That whatever they were sharing with me were just some of their thoughts and nothing rooted on facts.
They reflected on the fact that they have made a lot of progress. Our human nature just always wants to focus on negative things. and those negative things can unfortunately keep us from continuing to grow. I've been reading this book called the gap in the gain, and it talks about if we keep measuring ourselves against our quote unquote shortcomings, we're never gonna feel like we reach X, Y, and C thing.
And we're always gonna feel like a failure. It was talking about, we should use our goals as a measure to look forward to, but not as like, if we accomplish it, all of a sudden we're worthy and if we didn't accomplish it, we're not worthy. But we should look at as, as where was I when I started this goal?
Like, what was I doing? Like if you're constantly just measuring yourself against yourself, then it's not a competition. It's human nature for us to be looking around and see what. Everybody's doing and wondering if we're doing it right too, or if we're fast enough, slow enough, you know, whatever. But what if you just compared yourself to yourself, like how you were, you know, one month ago, how you were one year ago, what was important to you five years ago?
Like, that's so important because when you start to look at. Then all of a sudden you start living in the gain instead of the gap. So the gap is where you feel like you're not incompetent because you didn't reach X, Y, and Z. And you always feel like shortcomings versus the gain is where you feel like, oh my God, I'm making growth.
I'm in progress. Like compared to a month ago, I've done all this. I've learned all this. And so it, it allows you to be more joyful and spontaneous and more kind to yourself. And so if you applied the same things to your relationships, like if you look at your kids and you're like, wow, look at the girls they've had in the last three months, instead of looking at like, oh my God, this is your shortcomings.
You can easily see why some of our self-esteem issues stem from there. It's like, you know, if you had ADHD and you didn't know you had ADHD, you can see how much you wanted to accomplish certain tasks, but you just could not accomplish them because you didn't know how it's like you being, you know, you're being blind.
And you don't have glasses and we're asking you to just look harder, but how can you look harder? Or it's like asking you to write, you know, with, with a right hand when you're lefthanded, right? Like you can't instead. What if I came and I gave you the left handed desk and the lefthanded pen. And what if I gave you the glasses?
Like all of a sudden, you're not judging yourself for your shortcomings, but what if we celebrate you for how you got here without even knowing that you had ADHD, you kept going because you wanted X, Y, and Z. And we all know there's nothing a person with ADHD cannot be made to do anything just because it has to be aligned with us with our values so that it could be me.
Because we call ourselves chronic procrastinators, but we know we can spend time whenever we want to. Anyways, that's what I got for this week. I just started my group coaching session, my new cohort, this June 20th. So a few days ago. So if you guys are interested in being on the wait list for the future ones in October, Reach out.
I do have monthly free webinars and you're welcome to come and check out all the stuff so that we all can start living and practicing medicine in our own terms
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register as waitlist for Oct 2022 Cohort:
Transformation Physician Group Coaching
Email: overachievewithadhd@gmail.com
Dr. Diana Mercado-Marmarosh: Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello physicians. I want to invite you to go to my website, ADHD-lifecoach.com
This is the perfect time for you to realize that, June 20th is right around the corner.
That's when my 12 Week Physician Coaching class is going to start, it consists of 20 CME credits. Make sure you get on my waiting list and you can do that also by sending me an email on my website, you can contact me. You can get all the details. All right. Take care.
Well, hello. I am so excited to be with you guys today. Yesterday, I had an amazing class with my group coaching clients. And we talked about, I brought in a special coach, Dr. Jill Winner, and she's actually a physician who talks about tapping or what is called the emotional freedom technique. And the reason I asked her to come and be a guest in my program was because I felt like my clients needed to hear from an expert who uses this on the daily and really show them yet another tool that could help people with ADHD manage our own emotional dysregulation or overthinking or anxiety or our focus that happens.
And so the way all this started was, during the pandemic, I felt like maybe I was just a few thoughts away from like, " always losing my shit in clinic". I know it sounds funny, but at that time I didn't realize that. It was my ADHD that was causing me to sometimes just become flustered, you know, like I didn't realize that there was boundaries that I needed to create and I didn't realize that I wasn't slowing down enough to see, okay, what do I need to do?
I think I would just become overwhelmed because you know, they would knock on my door. And asked me to sign for orders or do different things that were not necessarily an emergency. And I was getting distracted or as soon as I would walk out, I would feel like I was just flustered because they would ask me to do this.
Or the ER was calling or the hospital was calling or the nursing home was calling. And I felt like I was being pulled in so many different directions and I didn't realize. I could say, hold on, what is really important? What do I need to address first? Why don't I need to address? So I didn't realize that, you know, it was just my, sometimes my ADHD acting up when I would " blow up on my nurses" or whoever was coming to ask me different things.
It's just that my brain could not be pulled in so many different directions anyway. When I discovered life coaching, I realized that, okay, maybe there's more to just my thoughts or whatever. In my inner critic. And slowly I started listening to different podcasts. And I remember coming across one of them that talked about tapping, which stands for emotional freedom technique.
And I looked that up. It was talking about a different form of meditation. And while I tried meditation, I was always in my head wondering if I could concentrate long enough or not. I was always wondering if I was doing it right. I remember the first time I went to a meditation class. Like there was like, it was an in person thing and it was before this whole COVID thing.
And I remember like we, we were being guided through the meditation and like, all I could see was black. like, I couldn't see anything. And the person next to me was talking about this beautiful rainbow, like scenario that she had gone through and some beautiful things and, just remember turning over to my friend and being like, what the hell?
Like, is she on something like, how come nobody shared ? So I always thought that meditation sounded cool and I had read stuff, but I just could not relate anyways. When I heard about tapping. At that point, the tapping solution was an app that was being advertised. So they had a promotion or something going on for healthcare workers where you could download it for a certain amount of time for free.
And then after that, like you could decide if you wanted it. And so, you know, yesterday when I shared with my group, I have used it myself to keep me " insane", from going insane. 2,838 times. And my app here says that I've used it 497 hours and nine minutes. And so. Somebody pointed out to me, that's like 21 days.
And I was like, oh my God, I didn't realize how much I was leaning into this. So the emotional freedom technique or tapping is an intervention that draws on acupressure and psychotherapy principles to like try to decrease stress and emotional issues. And it's really quite simple and benign. Like there's nine areas in your body that you tap, you usually just use your fingers and tap across these key points. And these are the areas that if you were going to go get acupuncture, that's the same areas where they would insert the needles. And so the cool thing about it is that it's evidence based and there's been lots of studies that show that it does decrease cortisol levels.
So I thought, well, why not? Like, why not use this Meridian points? Like I said, there's nine areas and you usually just use the tapping to the top of the head, to the face, to like under the eyebrow and the nose. Clavical area. And then like the side, like on the axilla area, and it's meant to help decrease or clear or process emotions or trauma, it can help with PTSD, anxiety, stress, phobia, chronic pain, anger, resentment, chronic headaches, or sleep problems, or any other conditions.
So it's meant to kinda relax or sympathetic nervous system. And deactivate or at least bring down or flight or fight mode. And so it's supposed to just bring us down. So with the cool thing that I like about tapping is that it's not meant to cause you to just ignore or think of the opposite feeling it's meant to help you sit with it and feel okay with it.
And so I think it's really a really cool technique that if you never tried it, you should, because. It can help you be able to process things. So what I've noticed is that when you're tapping, there might be areas where they, it feels more tender than others. And usually that's where maybe there's a block, an energy block that you might be experiencing.
I even use it like for my kids, like at night so that they can go to sleep cuz, oh my God, I feel like they have more energy. And so usually, you know, take like five minutes. We'll do the child one and they'll go the fall ride to sleep. So this is a really good thing to use. So I wanted to just share about this tool
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register for June 2022 Cohort:
Transformation Physician Group Coaching
Email: overachievewithadhd@gmail.com
Dr. Latifat Akintade: I like to remind people about the concept of seeds. Imagine it will look at an orange seed and we're like, it's small, it's too small. The chances too small. It's impossible. It's a small seed. How can you expect to have a juicy orange from something as tiny and dry as this. So maybe it is possible. So I like to remind people that whatever is in your hands, like, look at your hand, do you have seeds in your hands?
It may be the knowledge you already have. Maybe the resources you have access to. It may be the podcast you're on right now. Maybe the podcasts that I have or what I'm talking about money, like where is the seat? And what are you doing with the seed? Are you planting the seed? Are you sitting down thinking it's impossible?
The chances low. Thank God. The farmers don't think that at the beginning of the season, because if they do, we would all be screwed by now because how dare we think that it's possible to have like a big plant of corn that grows many corn from one seed of corn. So what seat do you have in your hand?
Dr. Diana Mercado-Marmarosh: Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello physicians. I want to invite you to go to my website, ADHD-lifecoach.com
This is the perfect time for you to realize that, June 20th is right around the corner.
That's when my 12 Week Physician Coaching class is going to start, it consists of 20 CME credits. Make sure you get on my waiting list and you can do that also by sending me an email on my website, you can contact me. You can get all the details. All right. Take care.
Awesome. This morning, I'm so excited. That's the word? Awesome. That's how I feel when I talked to Dr. Latifat. Awesome. Awesome. Awesome. So I have an amazing treat for you guys. Dr. Latifat Akintade is a practicing gastroenterologist and she's the founder of money coaching school for bad-ass women physicians. She's also the host of the Money Fit MD podcast, and she combines her interest in personal finance.
Her training as a certified life coach and her passion for physician wellness. So her mission is to equipped every physician with the tools that they need to be financially liberated and find their purpose to live out their calling. So listen here, she's helping you guys live and practice medicine and your own terms.
So it's such an amazing, awesome experience that we're going to have today as we chat with her. So please pay attention, Dr. Latifat, would you mind telling us how you got here? This sounds so amazing.
Dr. Latifat Akintade: Thank you. Thank you so much for having me. It's a pleasure to get to hang out with you finally right now. Thanks for having me here for those that I haven't met, I'm Dr. Latifat, I'm a GI doc like Diana mentioned, and I live in California. I'm the mother of three little ladies that are absolutely absolutely love, they drive me nuts. And it's great. And I have the distinct honor and pleasure of being the owner, the creator, the coach and the director, really all of my Money Fit MD Money School For Bad-Ass Women Physicians.
It's a community that's growing for women physicians. That want to be bad-ass at money. And the reason why that is important is, you know, it's interesting. People tell me that. I help women become bad-ass at money. And I have this thought and this belief that every woman, physician, every physician, actually, every human has what it takes to have money.
So people already have the inner, I think about them like an onion. They already have the core of bad-ass theory. And what I literally do is just help them remove the layers, like the onion skin, and then they shine and we add some knowledge. From financial education to that. And poof people do crazy stuff in the world, including have money live well, decrease burn out, change their own generation or direction and generational trees and really create the life that they want to have.
Dr. Diana Mercado-Marmarosh: Yeah, that's great. Now, were you somebody who was always good with his money situation or like the necessity get us here?
Dr. Latifat Akintade: Necessity is the mother of invention. It got me here. No, I knew nothing. Absolutely nothing about money. The only thing I knew about money was that to spend it. And it wasn't a way I wasn't even spending frivolously, but my centrals were probably at that point in my life more than a lot of people's essentials.
So I have financial responsibilities in my family. And even as a med student, as a resident, I needed to, I was the one with the more money out of my siblings. And we lived together, even though my source of income was literally student loans. But I didn't know anything about money though. I had debt.
I didn't know how much I owed. I didn't know who I owed. I know that I got, letters from auntie Sally. But I didn't know. She was the only person that I owed or not. I just knew that she was the auntie that was all up in my stuff, but I didn't really know how to address the money stuff. I was busy as a resident and then as a fellow, but the interesting thing was no one had also taught me.
So here it was, no one had taught me. I had, life was busy. I chose to ignore it. And so those two things together created me with the fear of what was going to happen to my life if I didn't get my money and stuff together. So, and that happened during fellowship. At that point, I had two kids and I remember sitting down one day looking at my daughter and thinking, if I did not get my money issue together, we were going to create a life that was me overworking, burn out, not having a choice in how I practice medicine, not having a choice to be the kind of mom that I want to be. And that scared me to pieces. And that was the only reason why I decided to get my money crap together. And that was literally six months ago, six years, not months, six years ago.
Dr. Diana Mercado-Marmarosh: Yeah. So what I hear you say is you made the decision to understand money, even though nobody had ever taught it. So this is something that we can learn to do for ourselves.
Dr. Latifat Akintade: Absolutely. I mean, no one, I taught me, I didn't know how to do it. And even when I started the language was really foreign to me.
Right. I was learning the same lingo, like 5 billion times. I mean, at some point I was like, wait a minute, what's going on? I'm a physician. I do crazy stuff. I learned all this amazing stuff yet. I can't even figure out what a 401k is. Right. Yeah. So you can realize that it's not about the actual knowledge and learning, because if it is every physician would be like a multi-billion a year, because we're incredibly smart.
But there are reasons why that information doesn't seep into us there's a reason why we don't retain it. And part of it is the way that it's been taught can seem really complicated, right? Can seem really. Just trained and really it's a lot of, money's also shameful judgment full, and those actual things makes it hard for it to attract us and makes it hard for us to sit down and learn it and assimilate it.
And so for me, even when, even though I was at one stage, I didn't know. But after I decided to, once I jumped into it, it wasn't happening for me because of those baggage. So I pretty much had to figure out how to make money into a language that I could understand. And then I finally started getting, I was like, oh, I don't have to do it that way.
I don't have to hate myself. I don't have to cheat people. I don't have to like, you know, be like negative talk myself. Like you mean I can act. Learn to do this in a way that is kind and the, where that is simple in a way that is loving in a way that's not judgemental. And that's how I had to learn it for myself when it came to money.
Dr. Diana Mercado-Marmarosh: Yeah. You know, I think both of us have had this conversation, you know, when we've been in, in different places, I've been the, have the privilege to hang out with you in, in some conferences where, you know, we don't realize that we are carrying around. The beliefs of other people about money or about, you know, education or about whatever.
And that, like you said, we have some limiting beliefs that we never questioned because that's just what has been taught to us. And like, sometimes we are not even aware that " " money feels this way or that way or whatever. And that actually prevents us from really stepping into, you know, living the life that we want, because money is a neutral thing.
Like it's not good or bad, but most of us, because of whatever we're carrying around our, I don't want to say baggage because some things could be actually very helpful. Like when we, maybe we're thinking, okay, if I invest in education, then I'm going to have a better outcome. And I'm living proof of that.
Like my parents, my dad was a welder, right. My parents were immigrants. And so they knew that if they invested in my education, then I could, here I am, I'm a doctor. Right. They knew that some investment, like some loans are good. And then some things like maybe we go spend money on some things that maybe are not as best assets to us, but we don't know at that time.
That's the beauty of it, like understanding that when money comes, like, how can I take care of it? How can I use it towards me to help me and benefit me instead of like all of a sudden being like, well, I'm used to being stretching every quarter or in looking for coupons, because then we have all these other patterns that we don't realize that.
And so you, you know, that I have ADHD and, and the people who are listening here have ADHD. And because part of it is like, we want that dopamine high of like finding something cheap. We buy all this shit that we don't really need because we found it cheap. Right. And then we forgot. We have like 10 things of that because we bought it on sale.
And then, it's like this thing where you're like, really now you're spending $20 to host 25 cent items in there. And so it's this thing where you have to realize that sometimes getting things for cheap. You pay for it in the long run because all of a sudden you're hoarding stuff and all kinds of stuff, but at the same time, you, you didn't go and compare, oh, which medical school is the cheapest.
So I can go into that one. Like you were like, wherever they accept me, I'm going right. And so it's so interesting if we don't question our beliefs. And if we don't realize that money, if it's not aligned with our values can get us into trouble.
Dr. Latifat Akintade: Absolutely. And I love that. I mean, I love the, so much, you said that I want to dig into and some people may go, oh, you know what?
The limiting beliefs I'm make it even more simple. Cause I love simple. I'm like, we can do complicated, but we don't have to. Why not? Right. And it's just like literally thinking about it, like the sentences in our brain. Right. And we'll have multiple sentences in our brain every day. Some more than others, some can be 6,000, some can be like tens of thousands.
Right. And just sort of like the sentences that are landing in our brain. And all of our sentences is a lot of times with tend to choose sentences that feel familiar. To us. Right. We feel like, okay, the ones that are familiar to us, it's like, oh, you know, you looking in this, it's like, you go to a buffet.
I'm Nigerian. I love Nigerian food. I like other foods as well. But if you put me at a buffet, the first thing I'm going to grab me and be like the Nigerian popup, because I'm like, okay, I know what this tastes like. Right. So what happens is we're getting all the sentences in our brain and we choose them, the ones that feel familiar. And the ones that feel familiar, that feel comfortable are the ones that we've lived in, right. Things that we've heard from our families, from the society, right. Things like, you know, women should be stay at home parents or, you know, guys should be the ones in charge of money or money's the root of evil.
We choose those thoughts that are familiar. And sometimes we don't question them. You know, I'm not going to say good or bad, I'm going to say, does it help you achieve what you want or not? So the thing is, if you're choosing sentences that feel familiar and it's creating the status quo, but you don't want the status quo, you want to create something else.
Then that means that you may have to choose something that may feel uncomfortable, not familiar, but you know, in your excellence that it's going to get you the result that you want. So if you've been thinking that money is hard, that could be a sentence. That's literally a sentence in your brain. That's come from generations.
And because. You know, again, we choose what feels familiar. You have evidence you're like money feels hard. And then you look around for evidence and like, oh yeah, there was that one time that I couldn't do 5099.29 plus 10,000 at 29.559. And they're like, see, money is hard. But that was the time that I heard my grandma say money was hard because she went out to the store and forgot her purse at home.
See, money's hard. Like we start to make ridiculous, crazy evidences just to support that comfortable sentence that would pick in. So in order to change, just like, you know, if you're going to the gym in order to like, get a different results, you have to work out and he may be a little uncomfortable.
And that is choosing new sentences that may feel uncomfortable, may feel different, but you know that if you continue on that line, it's gonna feel more familiar and you're going to get the muscle that you want. So that's where that I think about, when it comes to choosing those sentences in your brain, that's going to work well on may, help you produce the result that you want.
The other thing I wanted to address is with ADHD and also other people, like there's always something happening in this world that. Me reasons to distract you from creating what you want to create. Like there's life, that's always happening. There's never a perfect time when things are so together, right.
That you don't now it's like altogether. And what I like is I want my women to be able to have their kids. Right. So maybe your brain is one that is like newer divergent, and you have like 10,000 stimuli coming at the same time. You doing all this other amazing stuff. But the question now is because we know your brain is beautiful and there's nothing wrong with you and your brain is amazing.
In fact, I pay one of my coaches that I pay multiple five figures every year. I pay her for her brand and she's a neurodivergent brain. I love her. Right. So your brain is value. Your brain is an asset. However, what we'll want to do is how can we make it so that you are building your wealth, your net worth is growing even while your brain is braining and doing what it does.
Right. And that's how you. Create systems for yourself. You create automated system where it's like, okay, what decision am I making about where I want to invest? And every month it's scheduled to go automate into that. So while your brand is here, braining and doing what, your, whatever kind of brand you have, your net worth is still growing because you've already automated.
And so if you're like, I still want to go buy 20 things, which there, you know, of course that's what Dan is doing here to help you optimize your life and helps you grow the life you want with whatever kind of amazing, beautiful brain you have. And while you're doing that, you're networking can still be growing.
So it doesn't have to be. Either or, and what we don't want is for, you know, you've been a single mom, you've been a married person. You've been the primary breadwinner you with a newer divergent brain. You with your neuro-typical brain, we don't want whatever, but to be the reason why you don't have money, I want you to have money and also get to leave the full experience of the kind of amazing brain that you have.
Dr. Diana Mercado-Marmarosh: Yeah, so many amazing gems that you just pointed out. So like you said, sometimes the thought money is hard. People also associate that with, I have to work really hard to get the money, right? Like they, they put those two things almost side by side. And so, like you said, Some of us with neurodiversity brains, if it's too simple, sometimes we're like, that's boring, but if it's complicated, we're like, okay, sign me up.
But then somehow the money comes up and you're like, oh no, that's too hard and money. I don't understand. And then they walk away. Right. But like you just said, why can't you just look at those simple sentences that keep coming up and then focus, whether that sentence helps you or hinders you? Like, is it getting you closer or farther away from what you want?
And like we said, money is not good or bad. The more money you have, if you normally are doing your thing and have a high energy, and like you're investing, you're going to find more ways to make it work, to help yourself, your family, your community, right. Yeah. The more you have, the more you can invest in do stuff.
Right. And like she just said about automation, you know, it could go both ways. If you have your credit cards saved in your Amazon and you quickly go and purchase everything because it's so easy, then maybe that's not something you want to automate, but yeah. You know that if you have yourself, your credit card saved to pay your water bill to pay whatever it is, then you're not going to get the fee.
So that's where you want to automate. Right? But like she just mentioned, if you have it in your calendar, that this is how I'm going to build my wealth every single month so that when life happens, You don't look back and you're like, oh my God, 10 years just went by. I forgot to even fill out my w four or whatever form I had to do.
And I didn't even realize I never paid money into it. You'd be surprised how many people. Oh, I forgot to fill that form for the FSA or I didn't know. I had to use that money or dah, dah, dah, dah. And so again, it's so good to get to talk to physicians or to talk to anybody else who understands money. If it's not coaching financial advisors, bookkeepers.
This is the fastest way for you to get somewhere. When you yourself don't have a tool, like sure. You can figure it out by why do you, why can't you take a shortcut? There are some shortcuts, like Latifat had to learn it years of learning it, but now she can give it to us in like a cool package. that you can do it yourself.
Dr. Latifat Akintade: Absolutely. And I think that part of it too is whatever that is. We all have our baggage for lack of a better term, right. We've learnt a lot of amazing stuff from our families. And we've also learned some things that may have served our families, but not serving us. And they did their best and taught us. What helped them survive, right? So maybe for you, you know, for you, maybe your family immigrated from somewhere and they have to hustle and work crazy and work day and night. And for them, that action was what led them to have the money, to be able to take care of you. They did the best that you can, but in my opinion, now they've ended the Baton to.
And we get to take that to a different level. If we keep doing it the same exact way, we keep creating the same exact cycle and we're going to create the same pathway for future generations, but we get to take what they've ended the Baton. Now we're going to take that with our M D R D O R M D BS degree, the access we have to internet the access
we have to coach it that maybe they did not have them. They may think coaching is a waste of money because they didn't have money to even take a break from anything, talk less. Right. And that's been the thing, honestly, when I find out, found out about all this like mindset mentality, I actually cried because I was like, wait a minute.
You mean, this is the key. And no one has been telling us this and we've been told to work harder and grind hard. And that really was not the key to this. And I literally cried. And that is why, like my goal and my mission in this season of my life is to give this like, to the ends of the earth, because I'm like with those tools, it doesn't have to be a hustle.
Like it was right. It doesn't mean that life is going to be perfect. We are humans. Life is never going to be perfect. But what gets to happen is as life is happening, we still get to elevate our generation. With to get to elevate and do it better and differently than the other, you know, the feed the past generation had, my parents wanted me, like, they encouraged me to be a physician as well.
And in fact, with, you know, business or all that stuff, That was unfortunately late right now. What I said that was a waste of time because for him, he thought that being a physician is the ticket to success. That having been a physician means you have secure finances. Being a physician means automatic.
Well, those were the sentences in his own brain. And so for me now it's not to now take the center. That it was in his brain and automatically wrapped myself in it. If that's not, what's going to help me. Right. It's me understanding that. Okay. What was the goal that he wanted? The goal was for his kids to have a good financial future.
And now I get to create the, how that may not be how he thought, because now I have resources that he did not have. And that is what I wish we would all do is learn about the mission. But the, how has. And that is about investing in ourselves. It's about automating, it's about learning the ABCs of the financial world.
It doesn't have to be complicated. I don't do complicated stuff. I can, but I just choose not to. And it doesn't have to be shame or judgment full.
Dr. Diana Mercado-Marmarosh: Yes. Or so many gems there. Yes. Like if you look back, everybody's always doing their best. Right. I don't think they wake up and they're like, how can I make this harder on myself?
How can I make this harder on my family? Right. Like, I think everybody's functioning from a place of, I'm just trying to do better, than my parents did and their parents did, and their parents did. And I always tell people, you know, the more, you know, more decisions you made, but then more comes up, right?
And so data comes in, you pivot data comes in, you pivot, right? And so this is the key, keeping it simple. Trying different thoughts, trying different systems and seeing which one is getting you closer. And like you said, sometimes it is a little bit uncomfortable or a lot uncomfortable, right. Because we're not used to.
However, this is a beautiful thing. If you know where you're going, if you can envision yourself being, and it doesn't necessarily, and wealth, yes, we're talking about money, but we're also talking about the wealth of your soul. We're talking about the wealth of the time of freedom, right? Like all kinds of wealth that you can get to, if you decide to.
And if you look around and see who has done that, are they walking the talk, you know, and can I talk to them? Can I get their advice and then knowing, okay, how can I personalize it for me? Right. Because everybody's way might not be your way, but if you're at least in the room, when you're seeing several people getting it, then it's a lot easier.
Dr. Latifat Akintade: Absolutely. And I love that cause it's so we're also different and that's the beauty of it. I'm so pro diversity because I mean, I'm a black woman talking about money. I want every human to have money because I truly believe that we're not meant to fit together. We're all meant to be different and that's a beautiful thing.
Right. And so I'll give you an example, like in my money school, there was literally someone in there who had been. You know her challenge with money, she has been struggling with money, how to do it. It just fell hard. And I said, listen for you specifically, what gives you joy? What fuels your soul? What gives you joy?
And for her, it was like light and play. So her path to money, her path to money is play. So she started playing and her goal, her work was to find a way to play everyday. Do you know that when we chose to take that approach with her within a week, she had accomplished things that had taken her months.
She'd been stalling for months. We're all different. And the part of the problem is we think we have to do with the same way. We don't have to. It's a matter of figuring out the path that works with you and that's why it's so like, we cannot ignore the mindset part of it because the mindset, the way I think about. For those that are in healthcare, it is like our genotype, right? It's like the genotype and then the phenotype gets to be different. But when we get the genotype, right, then you have, you can change the condition and choose different actions and still be successful. It is so, so important for us to make sure we're not trying to do it exactly like someone else.
Yes, they can be an example, but that example doesn't have to be just in the actions they're taking in the mentality that they have that is helped them succeed. And that is what we can learn from.
Dr. Diana Mercado-Marmarosh: Yeah. So that, that brings me up the mindset of like fixed versus growth mindset. Right. And I hadn't really even learned about those concepts until this last two years.
And to me, like, I dunno when I make goals, I might not know how I'm going to get them done, but if they're so important, I know I'm going to try A through Z until it gets done. And, sometimes you don't realize that maybe that is a growth mindset, right? Because you have decided it doesn't matter that you will learn and you'll figure it out.
But somebody with a fixed mindset, they don't put themselves out there because they might be a little bit afraid that they might fear they might disappoint somebody or something. With a fixed mindset. It's really hard because you don't realize you're the one telling yourself, no, you have no awareness that you already, that nothing's going to ever change because you're not seeking the possibility of a change.
And so the best example I give, and I always talk to my patients about this now that I've realized, I said, you know, I tell them, you know, It's what you're thinking. And they look at me like I'm crazy and I said, no. If you had $10,000 in your bank account and you needed to buy a truck, you might think, oh, that truck is for 40,000.
I can't, I can't buy that. But that's your fixed mindset? Another person can think, well, I have 10,000, but I don't think I can spend all 10,000. Well, maybe I, I keep five there just in case. Okay. I just need 35. What can I do to find $35,000? Like that's a growth mindset. It's still the $10,000 in the bank and that hasn't changed.
Right. But if you're now thinking of possibilities to get that 35. You start thinking, oh, I might sell some tamales. I might have a raffle. I might buy some stuff to cut lawns. Or like you start to think, you're not just gonna be like, no, well, that's a good idea. I mean, but I can't afford that truck. I mean, nobody in my family can afford that truck and that's it.
Like they never leave that. Right. So this growth mindset and fixed mindset makes a big difference.
Dr. Latifat Akintade: Absolutely. Absolutely. And it's very, so I love that analogy. I love that explanation. One that I like to share with people is it's it kind of fits into growth and scarcity mindset, right? Because growth mindset is also based on scarcity mindset.
It's ignoring the fact that there may be other options. It's like, you know, having a key that's like hugging like one toy and say, no, I'm never going to let go of this toy. You're like, it's fine. The toy is dirty and it's to be washed, like I'm never going to. So that is like fixed mindset and also scarcity mindset.
And I had a, one of my amazing friends. Her daughter was having some issues and I got to speak with her daughter and I said, it's literally like facing the wall, staring at the wall and saying, there is no door in this. There's no door. There's no door. There's no door. It's like you are literally staring at one space only.
Is it possible that there could be a door behind you? No, there is no door, right? That is a choice that we can choose. Or we can say, is it possible that they may be aware out of this room? Is there possible there's a window. And the only way you're going to do that is by one, acknowledging that maybe it's possible.
That maybe it is possible and be willing to take the chance I'd exploring that small chance of possibility. And then moving, doing something different, it takes a move in your body. It takes a changing your actions, it changing your mindset, which is uncomfortable because you move in your muscle. Right.
And then looking around, oh, actually that may be a door. Or maybe at first look, you don't see a door. Cause it's like wall filled with curtains and now you manage. That father and go move the carton out of the way and that same way it is going to help you grow your life. And it's going to help you grow your wealth because maybe you've made mistakes in the past.
And you're like, all investment is bad. All right. It's like, maybe is it possible that there's a human in this world? That's a good example of what money should look like. Is it possible? That's a way of investing that is ethical. Is it possible that you can learn money and help other people learn? Is it possible that, I mean, yes.
I know that your parents tried, they invested in stuff, but is it possible that you are the one in your family that's going to cause a change in the financial direction? Is it possible like, no, it's not possible. No, it's not possible. No, it's not possible. Maybe it is possible. Maybe there's a 1% chance.
Right. And the thing is this, I like to remind people about the concept of seeds. Imagine, imagine it will look at an orange seed and we're like, it's small, it's too small. The chances too small. It's impossible. It's a small seed. How can you expect to have a juicy orange from something as tiny and dry as this. Right? So maybe it is possible. So I like to remind people that whatever is in your hands, like, look at your hand to have seeds in your hands and you'll see maybe the clinical income you're earning. It may be the knowledge you already have. Maybe the resources you have access to. It may be the podcast you're on right now.
Maybe the podcasts that I have a what I'm talking about money, like where is the seed? And what are you doing with the seed? Are you planting the seed? Are you sitting down and thinking it's impossible? The chances low. Thank God. The farmers don't think that at the beginning of the season, because if they do, we would all be screwed by now because how dare we think that it's possible to have like a big plant of corn that grows many corn from one seed of corn.
So, what seat do you have in your hands? Are you going to plant it? Right? Are you gonna plant that seed? Are you going to water it? Are you going to take the actions? Are you going to invest your money? I ain't going to look at where your money is going. Are you going to do it on any emergency fund? Are you going to ask for more money at your job?
Are you going to stop billing appropriately? Are you going to rest? Are you going to take time off? Are you going to pay to have someone take care of your kids from one extra hour or two extra hours so that you can breathe. Those are all invested into your wellness, or are you going to stay stuck and say it is not possible.
This is the only way is it possible or there's another way. Yes, maybe it feels like 1% chance, but thank God for 1% chance then God for that one. Spot of corn that is now growing into this big tree that is going to be able to feed our family. Like, what if it's possible?
Dr. Diana Mercado-Marmarosh: Yeah. Like so many gems there, again, you know, that 1% chance brings up for me, I'm thinking of, atomic habits and how he, how James talks about that.
What have we just tried to improve ourselves 1% every day? Like what would it look like at the end of three months at the end of six months? 30 years, right? If every single day you're just trying to improve yourself 1% and not because we have to, because we need to be better, but we were always home. But what if it would just help us to become who we want to, who we're dreaming too? Right? What if 1% is all it takes and the 1% makes a big difference. We might think it doesn't. And I always share this analogy from that book too, he talks about like 1% could go both ways. So 1%. If you don't correct it. Like if you thinking today, doesn't matter, I'll start tomorrow. Today. I'll eat that extra cookie today I will skip exercise. Today, I won't close my notes that 1% compounds. And before you know it all, you have all of a sudden, you have systems that are not supporting you because of your routine that you're allowing 1% to build up. Right. But the opposite holds true. 1%. If you start saving your money, if you start closely, and if you start taking that self care time, like it compounds too.
And he explains like that an airplane can take off. And if the pilot does not correct that 1% diversion with the flight that it's moving, that the airplane that could make the difference between landing at New York or like Washington DC. And 1% does not seem like a lot but makes a big difference.
And so this 1%, like she said, could be like the little hinge that opens the big window, right. To get you to where you're going and the possibility of what if. Instead of, no, I can't. What if I could, what if there was a better way to make more money to exercise more, to get more rest, to go on that vacation, to have your charts close, to decide on purpose that you are in the right environment by that work or in your family or whatever.
Right. That 1% really does make a deal.
Dr. Latifat Akintade: Completely agree 1% and the power of compounding, right? Because a lot of times, part of why we don't start is because it looks overwhelming and it looks like a huge fountain, but if you don't start walking up the mountain, you don't that climb. And it's always going to feel like that.
But everything compounds, you know, you may look up money and go, I've heard that I need, you know, 25 times what I spend per year to be financial independent, you know, that doesn't have to be just what you put in. Everything compounds, but if you don't start investing, it doesn't grow. Right. So that's a key and I need women physicians to be in the game.
I need minority women. I need women of color because we get to be an example of what's possible for those that are looking around and also saying there's no one in my family, that's done this. You get to be an example of what's possible. So when you just start right start where you are and nothing is too small to invest, you have a hundred, let's start. Do you have a thousand? Let's start. And before you know it, you get more excited cause it start seeing it builds. And suddenly you start investing more, your money grows, your knowledge grows, your life grows, and it's just the most beautiful thing. So one of the biggest fallacy that I hear is I don't have enough to start.
I can start. Right. Just start, just start because you don't, you will never succeed if you never start. And if you keep waiting for the perfect time, you just wasting time and we'll know the time in the market, when it comes to investment is the most important thing. So yes, absolutely. Love it. Love it.
Dr. Diana Mercado-Marmarosh: Is there any like books or any resources? Of course, you're going to give us all where they can find you a little later, but is there anything that you think that they should start and granted, I know that there is a difference between reading and then again, having the network and the support to help you implement what you're reading. If we're planting that seed, like you said, where could they even start at least?
Dr. Latifat Akintade: Absolutely. Absolutely. I mean, I have a podcast where I talk about all things, money and mindset. You literally can go in there right now and go listen to it. It's a Money Fit MD podcast. I talk about building wealth from the inside, out where you start from otherwise in terms of books, depending on where the major challenge you have is because I have people that read and don't execute or take actions.
So there may be even a knowledge gap. The white coat investor has a good book that I think is good for the basics of that. Check it out. Absolutely recommend a rich dad poor dad also has a good book that talks a lot about the mindset stuff. I'm writing a book right now that is probably going to be released at the end of the year or early in 2023.
I know I'm excited about it and it's literally. Putting together, the things that I wish people had taught us when it comes to the foundations of money so that we can actually execute and create the work that we want. Because what I find is that many times the information we just taught is not helping us.
Right. We're taught, like cut all the expenses in the world. Listen, you're going to cut until you bleed. Right? The bottom line is that's not how people build wealth. Yes. You take your money and redirect. But it also has to like go in from being a consumer, to being an owner. It goes from like going from being a saver to being an investor, like closing your hands, but going from that to like opening your hands up, like there's certain principles of money that will not be.
The other thing I think is really important is our relationship with money is super duper important. And unfortunately, there aren't a lot of books that talk about that out there. So I think that all of that is going to be important when it comes to money. But if you asking, where can I start right now?
I would say, absolutely go check out my podcast that is free. I have a lot of free resources on my, you know, my website that you can take advantage of. And of course I have the money school as well for women physicians that are like, okay, I just don't want, I don't have all the time in the world. I'm busy, but I want to learn the essential information.
And I want to have the sort of like the mindset piece that I need. And I want the community of women that are going to normalize this experience so that we can grow wealth together. And that is what I've created in the money school that I've created for women physicians.
Dr. Diana Mercado-Marmarosh: And what I hear is it's simple so that, you know, don't make the excuse.
Oh, I have ADHD. I don't have any time to go do this. She is packaging it in a way that it's a chewable implementation and she'll hold you to it that you implement it, so that, at the end of the day, we've talked about this so much. Like there's no project out there, or course out there, or coach out there who is going to cost you or make you do the hard work.
You know, everything is hard work, but why not do it in a place where you're going to be supported? Why not do it? Knowing that you're in a relationship that is going to, that has your best interest in mind and that you're going to do it both ways. Right. So, yes, please check out all her stuff. We need to all get our wealth aligned because nobody's gonna be like, oh my God, do you want more money? Let me give it to you. So you have to decide if that's something you want, whether for you, for your family, for your generations to come. And if that's something that you do want go talk to Dr. Latifat so she can give you the short cuts.
Dr. Latifat Akintade: Absolutely. Absolutely. You know, you still work, but for me, when it comes to money, my MOS simplified, I love things simple. I want it to be joyous. I want it to be effective and I want money, that's going to augment my life, not money that's going to grind me or burn me out, but money that's really going to be a reflection of what I want it to be.
And I truly believe that. And I don't care if you check out my program or not. The bottom line is if you're listening to this, I truly believe that you care about yourself and care about your life and you want the world to be a better place. And the way that I think about money is that money. Tool for that.
So whatever way you need to do in order to create that, I think you definitely should. And stop procrastinating. Just take one step because a lot of times we, like, we want to wit on two we're confident, but what we don't remember is that confidence comes through taking action, right? Because imagine every time you want to do the first time you deliver a baby, like, I want to be confident before I do my first week as a resident, we're never going to have any OB Docs.
So, what do we do? We learn the knowledge we take action. And the more of that confidence comes through taking action. You don't get confident. And then you take the action. Confidence comes, yes, you learn the truth because the OB docs, they had to learn the stuff, right. They had to learn, but you will tell, they would tell you that their confidence grows.
The more action they've taken. And that is why I want every single one of the guests who commit today to take an action. Any. I want to hear about it. Share with me, find me on social media. Let me know you took an action and I will high five you, because I'm truly, truly believe that women physicians are going to solve a lot of problems in this world and women in general.
And that's what it means when you have money in your hands. It's a great thing for the world. And I cannot wait to high-five you.
Dr. Diana Mercado-Marmarosh: Awesome. So tell us, where can we find you on the social media?
Dr. Latifat Akintade: So you can find me on Instagram and also on Facebook Money Fit MD, or you can go on my website, moneyfitmd.com. And also you can go on my podcast, which is The Money Fit MD podcast.
And I will be in your ears talking to you about how we can help you have money from the inside out.
Dr. Diana Mercado-Marmarosh: Awesome. Well, this has been an amazing, interview, and I'm just going to say this last part, which people laugh when I say this part, you know, because we have ADHD, sometimes we zone out. So let's say we just started paying attention right this moment. What do you want to tell them? So they can take this tool away.
Dr. Latifat Akintade: I want you to go find my podcasts, The Money Fit MD podcast. That's one. And I want you to take one action today that you've been avoiding taking, but you know, it's the exact direction you need to go with your money and don't forget to find me on social media Money Fit MD.
So I can high-five you, celebrate you, because the more we celebrate you, the more wins you're going to have. And I'm all about that.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much. You have. Imperfect action is better than perfect inaction. So get to it, have a blessed day.
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register for June 2022 Cohort:
Transformation Physician Group Coaching
Email: overachievewithadhd@gmail.com
Dr Latifat is a practicing Gastroenterologist and founder of The Money Coaching school for badass women physicians. She is also the host of The MoneyFitMD podcast. She combines her interest in personal finance, her training as a certified life coach and her passion for physician wellness. Her mission is to equip every physician with the tools they need to be financially liberated to find their purpose and live out their calling.
Website: https://www.moneyfitmd.com/
YouTube: MoneyFitMD
Podcast: MoneyFitMD
Instagram: @moneyfitmd
Dr. Rebecca Berens: Whether you're a physician or a patient taking those eating symptoms that you're feeling seriously, not feeling stigmatized, talking about. Because it's so life-changing to not have an eating disorder anymore. And when you're going through it, you feel like it's never going to end. But if you are feeling any of those symptoms, discomfort around food restriction, bingeing purging, any of that, please just talk to someone about it. And get the right kind of help because it is life changing.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello physicians. I want to invite you to go to my website, ADHD-lifecoach.com and register for the masterclass that is going to be happening on May 28th at 11 central time. It's going to be a really good masterclass that is going to teach you how to leave work at work. We are going to be talking how to chart with ease. When you come to this master class, you are going to be able to walk away with practical tips that will help you to develop an empowering mindset for efficient charty.
And you will also learn how to implement boundaries that will improve your patient care and free up your time. Of course, you're gonna recognize which distractions might be getting in the way of you closing those charts. So sign up, go to my website, ADHD dash life, coach.com. And also this is the perfect time for you to realize that, you know, June 20th is right around the corner.
That's when my, uh, 12 week physician. Coaching class is going to start it constantly. 20 CME credits. Make sure you get on my waiting list and you can do that also by sending me an email on my website, you can contact me. You can get all the details. All right. Take care.
I'm excited today. I am speaking with Dr. Rebecca Behrens, she's a family medicine and she's also a breastfeeding lactation consultant. So exciting. She grew up in Houston and she has stayed in the area. Lucky her right? And the nice traffic I'm being the seizures because obviously I stayed at myself, you know, during med school and residency in Houston.
So I am so happy to be speaking with Dr. Berens today. Her family medicine residency was actually at Georgetown University and she's worked for several years in F Q H C in south Philadelphia. And. Came back to Houston and has shortly opened her private practice. And she treats individuals and families of all ages, but it specializes in women's health and breastfeeding medicine.
And the really cool thing about Dr. Berens is that she does. It's a holistic approach to her patient's care. And she takes patients and otomy very, very serious. she works together with, with her patients to help them meet their health goals. She herself suffered from an eating disorder while she was in college and in medical school and her recovery has greatly shaped her practice.
Since she works with many of them who are recovering from, or have recovered from this eating disorders. And so she's the example of what is possible. So this is her mission and she's pursuing a lot of other endeavors. Okay. I think I butchered that last part. Tell me, what are you currently a member of?
Dr. Rebecca Berens: It's I'm sorry. It's the International Association of Eating Disorder Professionals. And that CEDS is, Certified Eating Disorder Specialist.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much.
Dr. Rebecca Berens: Sorry, I should've printed that out for you. I apologize.
Dr. Diana Mercado-Marmarosh: So today, like I said, we have a very special guest and you guys really have to lean in because this is something that unfortunately is not talked about enough.
And when we think ADHD, all we're thinking about is somebody who is not focusing. Right. But we're not thinking about why they're not focusing or what they're using to try to get themselves, to focus right? This is why this is important because the body's going to get what it needs. And sometimes, unfortunately it's going to be through wine or it's going to be through food, or sometimes we're starting out to like unconsciously get, start running or start meditating. Right. And so that we're hoping the latter is what's happening, but sometimes we'd not even aware that we're using wine or some substance abuse for other things. So, today we're going to have a very special talk. So Dr. Rebecca, you tell us a little bit about why this is your mission in which I kind of already alluded to it. And anything that you've noticed in terms of maybe ADHD coming into part with this.
Dr. Rebecca Berens: Yeah, absolutely. So, so as you said in my bio, I did, I suffered from an eating disorder in college and medical school. I had anorexia and as I was going through my recovery it's as many eating disorders do, it shifted from restrictive, purely restrictive anorexia to, purging and bingeing. And this is the very question of how eating disorders happen when you're going through recovery, if you're not getting adequate support. So, you know, going through that experience, I really did not have a lot of support from professionals during my recovery, until much later. and so, it's just something that I've always had in the back of my mind whenever I'm treating a patient, I like to ask about it because I know it's common and I know it's not often brought up and I want to make sure that any patient that I'm seeing is going to get better support than what I got when I was going through it.
I never actually intended to treat eating disorders because I was concerned about being triggered or, you know, having difficulty with that. But I'm at a place now where I feel very comfortable with it and I feel very passionate. About treating these patients. And so I think what I've noticed in my current practice, I have many patients who have ADHD who are seeking care for me because in my private practice setting, I have a membership model.
I have a lot more time to spend with them. So I'm really able to better care of the patients who have ADHD, who are often turf to psych by primary care doctors, because we just don't have time. And so in talking to several of those patients with ADHD, I noticed some symptoms of binge eating disorder, or of other, you know, other types of eating disorders.
And I wondered, I wonder if this is related to ADHD in any way, because I, it was literally three people in a row that I saw that all had very similar stories. And so I started to do a little bit of digging and I found out there is actually a link between ADHD and some eating disorders. So, something that I've just sort of realizing I'm trying to better treat my patients.
Dr. Diana Mercado-Marmarosh: Do you think it's because they're using the food as a way to increase the dopamine, to get them to do certain things? Or what do you think is that correlations?
Dr. Rebecca Berens: So I'm in the research that I've done in the patients that I've seen, who have these, I think it's a couple of things.
You know, eating disorders are rarely about food. They're usually emotion. They're usually about trying to take control over something that you can control because other things in your life seem out of your control, which I know for many people with ADHD, There is, a feeling of being out of control because you don't have the ability to do the things that you need to do.
Your brain is blocking you from doing the things you need to do, and you know, there's a lot of, as you all know, everyone who's listening and you certainly, it's a big problem. And so that's usually. The predisposing factor to an eating disorder, it's usually ends up being triggered by someone being told to lose weight or trying to get healthier, and then trying to take more control of their eating.
And then it becomes an emotional control as well as this weight obsession. And so that's usually how it starts. And then there are some factors that predispose someone to, because a lot of people diet in the U S it's very common. It's something that we talk about all the time in our culture problematic, but it's a thing.
And plenty of people who diet don't have eating disorders, but there are certain people who are going to have personality traits or neurochemistry. That's going to predispose them to then develop a full-blown eating disorder when they start engaging in a dieting behavior. And one of those traits is Alexithymia.
Which is, a trait that basically it's a personality trait and it basically means difficulty understanding or explaining the emotion that one is feeling. And so if you're not able to, to understand, explain, you know, talk about what you're feeling, you're going to try to control. Unexplained feeling in some other way.
And that may present itself in an eating disorder. And it's a sustaining factor in eating disorders. And that trait is actually associated with impulsivity. So I suspect that has part of the connection is coming from that trait. The other thing that I think is, is a predisposing factor for someone with ADHD is if you do have any level of impulsivity, you may have a binge episode kind of impulsively.
Because you're feeling bad or something's going on in your life, or you did meet anything all day because you were distracted and then you're super, super hungry. And then you binge and, you know, any of those things could happen. And then you may feel like, oh, I feel so full. And then you may try to impulsively do something to correct that.
So it's such as a purging behavior. And so the eating disorders that are most correlated with ADHD are bulemia and binge eating disorder. Not surprisingly because. It is a more impulsive behavior than a restriction, which requires overtime constant focus on restriction. This is more of an impulsive in the moment behavior that then becomes a habit that then becomes sustained by all the other factors that contribute to the eating disorder.
Dr. Diana Mercado-Marmarosh: Wow. That's so insightful. I had never put that together, but like, now that you've mentioned it, you know, I do see sometimes in myself and sometimes in my clients that it was not until I discovered coaching that I started to get in tune with like my feelings and that awareness, because I had no idea, like I had no idea why I would all of a sudden be okay.
And then like two minutes later, I was listening to my shit, like, you know, and I don't mean that in a way, but it's like, I would be so overstimulated or so much stuff was asking for my attention that I would just be like, yeah, Leave me alone. Right? Like, and all of a sudden there everybody's looking at me like what happened?
And I'm like, well, why did you pull me out of the room? Like, why do I need to sign that right this second? Why is the phone ringing and why is the patient asking me 5 question you and again, I can say, then you forgot you haven't eaten. Right? And so like, you mix it in with all these things and those that are in your, this irrational person to everybody else, but it makes sense, like you just described.
You were not even aware of the motions that got you to that place or the steps that got you to there. Like now of course I can look back and be like, well, of course you didn't set that boundary there. You didn't set that boundary there. You didn't tell them not to double book. You didn't tell him not to like open the door and list.
There's fire, you know, like there was so many things that I didn't have any awareness. And even now when I'm coaching somebody or even when I'm being coached, they're like, well, where is it in your body? And I'm like, well, why are we talking about my body? And they're like, well, what emotion are you feeling now?
Are you angry? Are you sad? Are you? And I'm like, why does it matter? They're like, well, just lean into it. You know? And so it's funny because yeah, I had no awareness and sometimes my whole day. Revolved around, like, what do I feel like eating today? Like the whole day, like it was consumed with feely, like what I wanted to be sometimes.
And so it's so interesting. So, I don't know that I ever suffered from Bulimia, I think I enjoyed every single pound that I ate. But you know, I think it was providing that emotional support or comfort in the moment. And I can see that how the times that I was so stressful because I was running in high school.
I didn't gain that much weight. But then when I got to college, you know, all of a sudden I went up in weight and then I started running and then I lost weight. And then I got to med school. I went up in weight and then I started running. Then I lost weight. And so it was this period. Have you seen the food, like you said, maybe as a way to not feel my emotions because I didn't even know that I did regulate them or anything or have awareness of it.
Dr. Rebecca Berens: Yeah. And I mean, it's a super common, it's a super common phenomenon and, you know, there's, there's diagnostic criteria of when it is this emotionally eating disorder, but you know, it, if you are someone who is predisposed, neurologically, And based on your socioeconomic situation, your family dynamics, you know, all of these things are gonna play into, to the development of an eating disorder.
But if you have some of these predisposing factors that ADHD will predispose you to, it does increase your risk of progressing into an eating disorder. And so, it's something that, you know, since I've noticed this link between in some of my patients, I am, super mindful. Now every time I do see a patient with ADHD or really anyone because it's so common to ask about eating habits, ask about, you know, doing some screening for meeting sources. There are verified, validated screening tools for eating disorders that I think should be more widely used, and what you discussed specifically about that transition from high school to college college, to med school, you know, these periods of time, especially high school to college where you're finishing up puberty and your life is changing and your stress level is changing and your control over your life is changing. Your independence level is changing. That is the classic time when an eating disorder starts, because it's so much for you to cope with. And if you don't have the tools at hand, and if you're, you know, genetically biochemically and neurologically predisposed, it's very easy for an eating disorder to develop very quickly and progress very quickly.
Dr. Diana Mercado-Marmarosh: So would you give us any tips? I know there's some of us who are physicians who are hearing, how can we ask this question? And I know you said their screening questionnaires, and maybe you can tell us later on which ones and we can put it on the link.
How could I be sensitive enough to ask so that it doesn't like, you know, trigger them or not the trigger then, so that I'm, I am being mindful, you know? How could we ask
something like that?
Dr. Rebecca Berens: Yeah. So the two validated screening tools are the scoff S C O F F, and the SDE. those are the two validated screening and I personally think we should use those, like at an annual wellness exam for real. I mean, it's obviously eating disorders are more common in women. Overall binge eating disorder is actually roughly equivalent between women and men. But anyone, any woman really from mid to late adolescents until forever.
Really? I think it's a good screening tool to have. It's a very quick, it's just a few questions. And it can be an opening point for a conversation. And so I think adding that screening tool would be very valuable and especially in a patient who's predisposed, like if they have ADHD or if they live in a larger body, if they have a family member with an eating disorder or another mood disorder, these are all people who are going to be at higher risk.
I think just adding that screening tool into a preventative exam or an ADHD followup, or, you know, any of those kinds of things or mood disorder follow up. Just asking the questions because there's a lot of stigma about it and people are not necessarily going to bring it up. But I think even more importantly than that is the language that you're using around weight with a patient, because there's a lot of stigma that comes from doctors to patients that is very triggering.
And obviously, you know, as doctors, we're on health promotion and we want to make sure we're helping our patients reach their best level of health, but making the end point. Is rarely helpful because it's not always, it's not always directly correlated with the person's metabolic health and someone who genetically lives in a larger body.
It may not be realistic for them to get to a, you know, quote unquote normal BMI that may not even be healthy for them. Focusing on the behaviors that are healthy, you know, eating fiber, getting enough exercise, getting enough sleep, getting enough nutrients, focusing on these health behaviors rather than on the number on the scale, I think is a really helpful way.
And it also just helps these patients feel less stigmatized. A lot of the patients that I see are patients who maybe haven't seen a doctor in years, because they're so traumatized from when they did see a doctor, patients who live in larger bodies and have an eating disorder who went to a doctor.
And all that doctor told them was like, you just need to eat less and move more and lose some weight. And you, I've had patients with all kinds of conditions that are 100% not related to their weight. Like I have a patient who has ulcerative colitis. I refer them to a GI doctor. That was the first thing the GI doctor said.
I was like, this patient has an elevated fecal calprotectin and all the signs of IBD and the GI doctor talked about the weight before talking about getting a colonoscopy, which is the reason I referred them. And so, you know, I think part of this is driven by these insurance metrics, these hospital metrics, focusing on BMI and counseling.
But if we, as physicians want to try to address this problem, we need to be focusing on our relationship with the patient, focusing on the patient and their health and not on some arbitrary number.
Dr. Diana Mercado-Marmarosh: Yeah. And I think again, in the last two years, I think my mind has expanded so much now that I've been coached on it and seeing how we're, how sometimes we make other people's words mean something more than they are and how traumatizing it can be that you hold on to them for a lifetime.
And it was something. Somebody said like in two minutes and in sometimes if it is your, your doctor, I mean, for me, obviously my doctor, when I was, you know, then I graduate from medical school, said, Hey, you know, you're, you're about to be actually residency with residency. They're like you, you're about to be a full attending.
You need to get. Psychiatrist, like stop coming to the student health clinic. Right. And so I thought, okay, it's Houston, right? Like I could find any doc and they should understand ADHD professionals. So I go, and then the physician tells me you're a physician. You should know better. You outgrow ADHD. And like that two minute interaction caused me to ignore myself and my ADHD for 10 years.
Right. And so, again, it was. Something that somebody says in passing that could really like get cemented into you. Again, now I understand now I have tools that I can say, well, that doctor said words. Like that's a fact, he said that, but what did I make it mean? Now, if I would go back, I would say, well, you just met me.
You just had a two minute interaction. If you're not comfortable with treating adults with ADHD, please refer me to a professional. This is their specialty. Like now I could have said that, or maybe I wouldn't have even said that I would have just walked out and being like, okay, well that one, off the list next, right?
Because there are so many docs. Right. But at that moment, because I was in my head about the shame. And like you said, I wouldn't have asked and I didn't ask for help again. And so. We forget that it is important, the language that we're using, like you said, what it would mean. And me, I have this conversation with them all the time.
When, when I do see that they're overweight, you know, I say, Hey, you know, let's do some labs, like, have you been trying to lose weight or, or are you happy or what's going on? And we joke around. I said, if you're happy with your weight, then why are we having this conversation? But if you're not happy with your weight and want to do something about it, let's go for it.
And I say, you know, we're going for five to 10%, because then that can really decrease how much, you know, one, if you lose 10 pounds that can decrease one ton of pressure on your knees. And like, I want you to walk up the stairs if you want to. Right. Like, and so when we get to the why, like you said, the behaviors is what is gonna all of a sudden be,
I'm a person who exercises, even if it's five minutes a day, you are the person who exercises, not the person who doesn't marathon, but you're the person who exercises. Right. And so this is why then they have buy-in to do whatever they do. Right. Because they know the why behind it. And I'm not there to be like, well, you know, you have to lose a hundred pounds.
Otherwise it's not worth me talking to you. Right. Like that that's unrealistic. However, I will tell you, oh my God. Rybelsus has been amazing, even though they're not meant to be for weight loss, like. Because I understand the mechanisms. I sometimes, you know, use it for other things if that's what the patient wants and if they're willing to, and, and there is a correlation, even though you say that, you know, eating disorders don't happen because of food sometimes, and it's an emotional component, there is a correlation.
People sometimes do use the food for the dopamine and they end up with diabetes, ADHD and people with diabetes. And then all of a sudden I start treating them for the ADHD and guess what? Their diabetes reverses, because they were only using the food for that fuel that they needed. Right. And they didn't realize that they were being impulsive to try to help themselves to complete say tasks. Right. And so there is a lot of correlation that that can happen with that.
Dr. Rebecca Berens: Yeah. And I mean, you know, the, the FDA approved medication for binge eating disorder is Vyvanse. And I think there's a lot of underlying neurochemistry things that are am, and so I think, you know, it's, it's not necessarily appropriate for every eating disorder certainly. There are a lot of patients with binge eating disorder who I think it is, you know, if their ADHD is better managed, they are able to cope better in so many other areas. And, and they're able to do that. And, you know, I think, I mean the most important thing with all of our patients in any situation is always to look at them as an individual and not make any assumptions.
Dr. Diana Mercado-Marmarosh: Exactly.
Dr. Rebecca Berens: Don't make assumptions that because someone has a BMI of a certain number that they were lazy or they don't exercise, or they don't eat well. You know, there are people who are genetically in very different sizes of bodies. And we don't ever give people a hard time about their height. We also should not give them a hard time about their weight and.
You know, we don't expect people to lose or gain height by doing anything.
Dr. Diana Mercado-Marmarosh: So I wish it could be taller.
Dr. Rebecca Berens: You know, it's we, we ha we have to, yeah. There's heels. Exactly. We have to look at people as individuals and not make assumptions about them. And I know this happens to patients with ADHD because I have so many patients with ADHD.
Who've told me I was treated like I was a drug addict. You know, because they went to seeking care for their ADHD. Right. That's inappropriate. And you know, we, we want to make sure that we're being mindful and, judicious with use of substances, but we can not make assumptions about people. We have to treat them as an individual and that's, that's the underlying most important thing.
Dr. Diana Mercado-Marmarosh: And, you know, you bring up a really good point that, sometimes we don't, again, the body's going to get what I need. Right. And sometimes we don't realize that they've been using smoking or marijuana or sometimes cocaine or other things, because again, they don't have it. And so it actually having undiagnosed or untreated ADHD, right.
Substance abuse is a risk factor for that. Right. And so that's so important to know because you can't just say. That person has cocaine or has marijuana in their system. And therefore I cannot treat them for their ADHD because if you and I had that conversation and I'm telling you, you're probably using that because of X, Y, and Z.
And. Decide that you're going to take the chance on them. And you're going to be checking the urine, like, you know, whatever contract you decide it with them. You'd be surprised how many people like come off of that things because now they are being treated so well. And now then are able to keep a job.
They're able to get married. They're able, like so much stuff can happen if you are open-minded and just treat them where they're at and not make all these assumptions. And, and, you know, they usually say one strike and you're out, you know? And so we have a conversation. I mean, sometimes I give two strikes and then I'm like, dude, like, we're all human, but you and I have this thing and I ain't trying to lose my license and because I want to help all the other people.
So like we, we have this like talk to talk. Right. And I think, like you said, not judging. Understanding where they're at. And, and one thing that I want to say here, which I think maybe you already know, or maybe you don't, but you know, in Europe, emotional dysregulation is one of the things that they use to, to diagnose ADHD, here in the U S it's not used for that.
Because they're like, well, how can we say you're too emotional or whatever. Right. But like, I just described how, you know, dysregulation has happened if I just blew up and everybody's looking at you, like what just happened? And then five minutes later, you're back to your PG self because you just needed to like, like reset.
So it was safe. Right. And so again, understanding that emotions really can get us to go one place or another. And then the difference on how the rest of the day goes or doesn't go, right, can really be so mindful. And in the more than maybe you can teach ourselves or teach our patients how to, like you said, be able to name that emotion mainly that would be a tool for them to like self-regulate so that they can do whatever tasks they have on file throughout the day.
Dr. Rebecca Berens: Yeah. And I mean, that's certainly something that, that is a big part of eating disorder treatment, you know, in going through therapy or even in, um, with dieticians, like talking about that emotional connection and what it is that you're feeling when you're making a decision, because it plays such a huge role.
And, and like you said, the body's going to get what it is. That is so true in an eating disorder like that perpetuates eating disorders because when you are restricted calorically, your brain will focus on food all the time, because it wants you to eat? Unfortunately that's a negative feedback loop because then it, the person's, you know, mind over matter is like, well, I'm going to restrict food further and it just creates this spiral, but it's, I mean, it's so true.
The body's going to get what it needs and we have to be able to draw out what is the underlying issue here and how can we feed that issue and fix that issue, or at least learn to manage it.
Dr. Diana Mercado-Marmarosh: And like, I always explain this to my patients too, with diabetes. I'm like, look, I know you want to go eat sugar. And I know you're like wanting to like punish yourself for that because you know that your sugar is high, but. Your body doesn't know that your blood sugar is high. Like your organs are not getting it. Your A1C is above nine. It's not going through. So of course it's asking you get some food out here. Right? And so when you explain it to them at that level, Then they understand, and they're not punishing themselves or not restricting themselves or doing X, Y, and Z. Right. And so now it's not their behavior. It's not their brain telling them to do whatever it's again, understanding that there. So these other mechanisms.
The body's trying to save you, not trying to sabotage you, but it almost feels like it is sabotaging you. And like you said, things that we do is unfortunately become habits. Right? And sometimes they become, you don't realize, so the body's going to use. Good or bad habits and theirs, because they're still going to support you somehow.
And so it's in being mindful and being able to get to a provider like yourself, who's holistic and can see you. And like you said, you have more time. It's not just like, okay, your time's up. Great. See you next time. Right. Where you have a little bit more time to then be able to spend with them and tease out where it is that they might be sabotaging unaware. Right. Because it's not like we purposely wake up and we're like, how can I make my life harder today? Like nobody does that. Right. So, yeah. So this has been such an amazing conversation. Like tell me where can people who are in Houston have the privilege to come work with you. Tell us all the things.
Dr. Rebecca Berens: My practice is located near the Heights in Houston. My practice is called Vida family medicine, and my website is Vidafamilydpc.com. I'm on Instagram and tick talk @Rebecca Behrens MD. And I actually treat patients from all over Texas. I have quite a few patients who don't live in the Houston area and they come see me a couple times a year, and we do a lot of things virtually.
So even outside of Houston, I can still take care of you here in Texas.
Dr. Diana Mercado-Marmarosh: That's amazing. That's so good. Now, what are your like big goals in the next two or three years? Or if you want to share a dream with us? There's no, there's no police here. You can, you can dream with us. Tell us.
Dr. Rebecca Berens: So, you know, I, when I first opened my practice, I had a mindset of I'm going to get to X number of patients and take care of them and do primary care and it's going to be great. And I'm really starting to feel pulled towards these patients who really struggled with the healthcare system. Particularly people who have recovered from, or are recovering from an eating disorder.
like I said, I never set out to treat eating disorders. It was not something that I thought was in my life path, but. Patients appeared in front of me who had it. Whether they were attracted to see me for some way. Like they knew that I would understand, or I was able to draw it out of them because I have, I don't know.
But, I'm feeling a pull towards that. So I'm not really sure what my practice directions are going to go, but I'm, my goal has always been to try to provide access to health care to people who are underserved in the space. And these patients certainly are because it is very hard to find a doctor who understands all that complexity, or if not understands has the time who address it.
Dr. Diana Mercado-Marmarosh: Yeah. That's, that's such a amazing, niche that doing. And I think I relate to so much that you're saying like, again, and right now in my practice, it is family medicine. I treat a lot of people with ADHD, with diabetes, with anxiety and depression. I obviously I have ADHD. I don't have all the other stuff. But because agan. I, feel like I can relate to everything and I can see the correlations. It's like, they're drawn to me. Right. And I think that now I'm able to, and probably you too, you're able to relate to them so well, because that wound has healed. It's no longer open. And so you're able to speak from a healed wound and you're able to see.
Past, and you're able to, like, before they even tell you, like, I can complete that sentence for you because you have had that, or you have been coached through that or gone through therapy for that, or, or you've done X, Y, and Z. And so I think it it's just that people can come to the people they feel comfortable with.
And like you said, you just know which question to ask, because that's the question you wish somebody would have asked you right? Yeah. So it's such, such an amazing thing. So what are you going to do for fun in the next year or three years? You tell us all the things come on.
Dr. Rebecca Berens: So my fun is, I like to sew, i sew clothes for myself. I don't sew for other people, people always ask if I'm going to make like clothes for my kids and I'm just like, it takes way too long. And then to grow out of them, I don't know about that, but I like to sew, and I really am hoping that I'll be able to make some more time for that and go, my practice has only been open for about two years.
So it's been a busy two years and it's been a COVID two years. So there hasn't been a lot of time, but I'm hoping to make some more time for that. And, Yeah. Just, you know, enjoying time with my husband and my kids and that's my fun.
Dr. Diana Mercado-Marmarosh: Awesome. So you heard it guys, you need to make sure you follow her, tell us again, the website or your handle so that way they can reach out to you.
Dr. Rebecca Berens: Yeah, my Instagram and Tik TOK are both @RebeccaBehrensMD and my website is Vida VIDAfamilyDPC.com
Dr. Diana Mercado-Marmarosh: awesome. So this is the last part, and I always joke around, you know, we have ADHD over here that people who are listening and sometimes we tune out. So if you just started listening, like right this second, like what is one little nugget that you would be like, yes, this sums it up , or this is what I want you to walk away with.
Dr. Rebecca Berens: I think what I want people to walk away with is: whether you're a physician or a patient taking those eating symptoms that you're feeling seriously, not feeling stigmatized, talking about them because it's so life-changing to not have an eating disorder anymore. And when you're going through it, you feel like it's never going to end.
But if you are feeling any of those symptoms about like discomfort around food restriction, bingeing purging, Please just talk to someone about it and get the right kind of help because it is life changing.
Dr. Diana Mercado-Marmarosh: Thank you. You heard it get the right type of help. It's life-changing and she taking patients, all of Texas. So please reach out and definitely remember the holistic approach. And remember that, you know, you need to be your own advocate. Nobody can read your mind. And unfortunately, even when we do advocate for ourselves, the other person on the receiving end might not know how to help us. So it's okay to go get a second or third or fourth opinion because in doing that, you keep advocating for yourself and then the right person is going to hear you and it's going to see you.
And it, it is going to be life changing. So don't give up, don't wait, 10 years. Like I did, you know, be an advocate. Then you can turn around and tell your story and help those around you.
Well, thank you so much, Dr. Rebecca Berens. This was such a delightful conversation and I am so happy that we had it.
Dr. Rebecca Berens: Yeah, thank you so much for having me. I appreciate it.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Link to my website to register:
Transformation Physician Group Coaching
About Dr. Rebecca Berens
Dr. Berens is a family physician and IBCLC. She grew up in the Houston area and attended Baylor College of Medicine. Her family medicine residency was at Georgetown University/Providence Hospital. After working for several years at an FQHC in South Philadelphia, she returned to Houston and shortly after opened her private practice. She treats individuals and families of all ages but specializes in women's health and breastfeeding medicine. She takes a holistic approach to her patients' care and takes patient autonomy very seriously- she works together with her patients to help them meet their health goals. She suffered from an eating disorder while in college and medical school, and her recovery has greatly informed her practice. She takes a Health at Every Size (TM) approach with her patients and works with many patients who are recovering from or have recovered from eating disorders. She is currently a member of IAEDP and is pursuing CEDS certification.
Website: vidafamilydpc.com
Email: info@vidafamilydpc.com
Instagram: vidafamilymedicine
Facebook: vidafamilymedicine
Dr. Funke Afolabi-Brown: Sleep is your superpower. And just make that like an appointment. I usually say, make your appointment, make it like an appointment with your sleep. And because sleep has so many health benefits. Think of it as your appointment with your doctor, you wouldn't just like call your doctor and be like, Hey, sorry. I'm running late.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello physicians. I want to invite you to go to my website, ADHD-lifecoach.com and register for the masterclass that is going to be happening on May 28th at 11 central time. It's going to be a really good masterclass that is going to teach you how to leave work at work.
We are going to be talking how to chart with ease. And when you come to this masterclass, you're going to be able to walk away with practical tips that will help you to develop an empowering mindset for efficient charting. And you will also learn how to implement boundaries that will improve your patient care and free up your time.
And of course, you're going to recognize. Which distractions might be getting in the way of you closing those charts. So sign up, go to my website, ADHD-lifecoach.com. And also this is the perfect time for you to realize that June 20th is right around the corner. That's when my 12 week physician group coaching class is going to start.
It comes with 20 CME credits. Make sure you get on my waiting list and you can do that also by sending me an email on my website, you can contact me and you can get all the details. All right. Take care.
Link to my website to register:
Transformation Physician Group Coaching
I am so excited for today's episode. I have a dear friend of mine here, one of the leading experts or the expert in sleep. So it's going to be such an amazing treat for you guys today. So Dr. Funke Afolabi-brown is an assistant professor of pediatrics, as well as a board certified pediatric pulmonologist and sleep medicine physician. Wow. All the hats, right? Yeah, I totally it's a big treat. So she helps children sleep better and breathe better.
And by extension, she helps improve the sleep of their parents. Ooh. Where were you when this was happening to me? Okay. In addition to teaching and seeing patients, Dr. Brown is a speaker. She's an educator and a writer of the founder of Restful Sleep MD. She is passionate about helping busy professional women and their children prioritize sleep to achieve their optimal health and live to their fullest potential.
Okay. And so when I say she's a speaker, I mean, Jesus speakers, she speaks in. All over. So, we're talking like national and international and she goes to wellness retreats and she helps some of our coaching groups. And she's actually one of my really expert guest coaches. So it's such a treat to have her here.
And so when you need to talk about somebody to somebody about sleep, this is your go-to person. So Dr. Funke, thank you for coming. Tell us all the things.
Dr. Funke Afolabi-Brown: Oh, thank you. Thank you. I'm like, who is she talking about? Okay. Okay. It's me. It's me. It's me. I'm owning it. Yes. Thank you so much for having me. I've been really, really looking forward to our conversation. I'm just so excited to talk about all things sleep to your audience.
Dr. Diana Mercado-Marmarosh: Yes, and you know, we've had this private conversation, but you know, a lot of us don't realize how ADHD can be impacted by sleep. Like, and then you understanding the sleep and pulmonologists aspect of it. You can give us this unique perspective, right. Do you mind telling us a little bit about how, what connections you make.
Dr. Funke Afolabi-Brown: Yeah, absolutely. So, you know, it's so funny when you look at, you know, first of all, when we talk about the benefits of sleep, one of the things I usually talk about is the fact that sleep is not just a luxury sleep is not something that you do at the end of your day.
Okay. Most places are closed. I'm just going to shut down or it's dark outside. Sleep is not just a cure for sleepiness. Sleep is a fundamental biological requirement. Like every organism has to have that period of sort of quiet sense and sleep. Because of the functions that it has on our brain on rest and recovery on our hearts, on our hormone system, on our metabolic system, on our mood and our health, our decision-making just go from top to bottom, I'm telling you sleep impacted. And so when we flip that over and don't sleep, then we start to get into a lot of issues, both with our physical health, our emotional health, our immune function, and as well as our mood now, one of the key features or one of the key functions of sleep and benefits of sleep is to help with executive function, to help with creativity, to help with decision-making to help with, Making those emotional connections.
Okay. If we don't sleep well, then we're not as creative. We have issues with executive function. We have issues with impulsivity. And so it turns out, especially they've done a lot of studies in kids and adults and the symptoms you see when you don't sleep. Well, it almost mimics ADHD like symptoms.
So when we talk about. You know, just that like difficulty with full costs , you know, impulsivity, like I said, just like even anxiety. All those things can occur with sleep deprivation. And I seen a lot of people. I mean, ADHD is very, very common in children, in adults as well on a similar, a lot of people who may have been diagnosed.
It sounds too. I've had ADHD for years and really on meds and there's been difficulty with controlling their symptoms. And then they've been referred to, you know, to see a sleep specialist. And we found out, oh my goodness, they sleep deprivation. They sleep issues that are underlying this and addressing that, I mean, will not take away the ADHD, but it literally is the missing piece.
So it's so imeshed. Right. It's almost like a bi-directional relationship, like, literally almost pretty much co-exists, you know, up to 70% of people with ADHD, depending on where you, what literature you're looking at, also have some kind of sleep issue or the other.
Dr. Diana Mercado-Marmarosh: Yeah. Wow. So insightful. Would you say, like, I was going to say the more we sleep, the more we rest, but you also can't always be asleep for 10, 12 hours, then you can't really function. Right. And that might be assigned to something else, maybe depression or something else, but would you say like five hours are okay, or would you say like, and again, I know everybody is different, but there's a certain amount that is needed for us to like really get some rest.
Dr. Funke Afolabi-Brown: Absolutely. So there's some genetic conditions where you, they call them like short sleepers.
It is like ridiculously rare. So when people tell me that they survive on five hours of sleep and they need only five hours of sleep, I suspect you probably either have that genetic condition, which again, is ridiculously rare or. You're just not being truthful to yourself because we, we have norms okay.
Of the range of sleep that's required for everyone. And it varies by age. So of course children need more sleep. So, you know, we're talking about newborns who sleep up to like 17 hours a day to teenagers that speak about eight to 10 hours. I mean adults. The range is also pretty wide. It's about seven to nine hours.
Again, it varies from person to person. Some people need less, some people need that nine hours to be able to function. Well, it's not like a magic pill. Like, oh, I must get nine hours of sleep or I'm doomed. One of the exercises I recommend that, you know, my clients do is just give yourself time, maybe like a weekend, a couple of weeks, or you're on vacation where you don't have an alarm clock set.
You don't have some kind of urgent meeting and study yourself, go to bed. Regular time and see when you wake up without the alarm. So that really will let you know if, how much sleep you really need really. And so most people, once they do that exercise, even if they've been sleeping about five, six hours, they realize, oh, actually I need seven and a half, or I need eight hours.
So that will really be the judge. And then you can't walk back when you get back home from vacation or whatever, and slowly start to try to extend your sleep towards that goal.
Dr. Diana Mercado-Marmarosh: That's great. Now we've all have heard about this and we, maybe we all do it to some extent, but I think the people with ADHD definitely do it.
You know, this asleep procrastination or like revenge to not go to sleep. Right. And then we're like, I should know better. I don't function well the next morning, but we still do it the moment. Could you speak on that a little bit for us?
Dr. Funke Afolabi-Brown: Absolutely. Revenge procrastination. It is a thing. And you know, we're seeing it more and more with just, you know, our 24 hour lives, our lives, our world, our society that never shuts down.
And so I see it more with that, like personal you've been going, going, going all day. And maybe now at the point where you feel like I deserve. Some time to myself, I deserve just some time to wind down, but then what do we choose? We made them choose things like maybe watching some TV and just like, okay, I'm just going to relax here for like an hour.
And so that hour becomes two hours and we slowly start to push back on our sleep time. And then the problem is now we're going to bed later than we should. And then we are waking up. At the same time. So our sleep is short. And so then it becomes this whole vicious cycle that, you know, it's at the end of the day, we were hurting ourselves.
But you know, it's a mental thing to thing of, okay. I've had, everybody has had a piece of me today. I want some time to myself, but then it's our sleep that ends up suffering. Because we're trying to buy that extra time, extra TV time or extra time to binge watch your show or whatever like that. And then we slowly just to push back on our sleep time.
Dr. Diana Mercado-Marmarosh: And so one of the things that I tell my clients and my patients, you know, is, we know that we all want rewards. Right. So instead of waiting to the last few hours of the day, on purpose scheduling, like, I'm going to be 20 minutes on Facebook from like noon to one or whatever, right?
Like if you have blocked it out, what you're going to be doing, then it doesn't become like a need that you need at the end of the day. So then that's the way that kinda helps out. Right. What other techniques do you think other than us trying to set up an alarm, I always tell people, like, maybe put your phone to charge in the other room.
So it's not like right there with you. And of course we've already. Some people know not to have a TV in their bedroom. I do have a TV in my bedroom, but I try not to turn it on after a certain amount of time, because I know I will get sucked into it.
Dr. Funke Afolabi-Brown: Yes. Great question. So I followed this acronym that I created is called CREATE, healthy sleep habits. I think that's a great place to start or maybe a little bit before that is the fact that everybody can sleep weel, so understanding that mindset shift of, I understand how important sleep is. Even if I have not made the best decisions to promote goods before myself, I can start and I can start tonight because sleep is free.
Right. And so then you then say, okay, where do I start? And then you go online or you try to Google sleep hygiene, and then 20 Steps come in and you're like, okay, forget this I don't think it's for me. And so I've kind of distilled it to like six most important things that you can pay attention to that you can follow because it's evidence-based.
And so the first thing is C-onsistency. And that's the thing with the prevent procrastination. If we go back and bend your sleep time starts to be flippant. We'll start a flip on flop and your body doesn't know when it's going to sleep, but we watching another Netflix show tonight. Or are we going to just be on Facebook? Like set a time? I love the idea of the alarm and me. I usually to set boundaries. Right? So. You need to be able to set boundaries, to be able to be consistent. So whether you say by 10:00 PM, nobody can gain access to me. Right? You don't have to train people, do people that like bombard your phone at very late hours.
Once you put like either a do not disturb on your phone or something like that, they know they can't reach you. Of course you can leave. Of course, people that need you in the case in the times of emergency, make sure they can have access to you. But other than that, you're going to sort of train people to say, you know what?
My sleep is really important to me when I sleep well, when I wake up, I can help you solve your problems. I can be a better person. And so really starting from that consistency and it's consistency to your bedtime consistency to wake time. So depending on when you wake up in the, in the morning, right? If you wake up, I give someone that wakes up at 6:00 AM.
And you're supposed to get seven hours of sleep that , come back. How many that would, that would be, that means you should be in bed by, you know, or eight hours of sleep. For instance, I mean, you should be in bed by 10:00 PM and just make that like an appointment. I usually say, make your appointment, make it like an appointment with your.
And because sleep has so many health benefits. Think of it as your appointment with your doctor, you wouldn't just like call your doctor and be like, Hey, sorry, I'm running late. Like you wouldn't get an appointment. Right. That's it. Right. And so that's one, the consistency and consistency. When you go to sleep consistently, when you wake up, because you're training your circadian rhythm, that internal clock and your QA for sleep.
And then,
Dr. Diana Mercado-Marmarosh: I was going to ask you, you know, I think, that is something we can definitely work on. And like you said, treating it as an appointment that can be like a game changer now. I believe you have some kids, right? How easy or how hard was it implementing some of these techniques with your own kids when like, obviously you and I have like an idea of what we want them to be doing.
And then what they actually do sometimes are like two different stories, right? And like, what are some tricks that have helped you with your kids or any insight that could help us? Because obviously if they're asleep, then we can go to sleep. Right.
Dr. Funke Afolabi-Brown: That is awesome. And let that be the motivation to really make it like a house thing. So not just you, you have to get everybody else on board. Like if you're, if you have a teenager who decides I want to have a party at 10:00 PM, you're not going to sleep no matter how much you set the intention. So we literally have it like before bedtime, because bedtime can be chaotic, especially if you have young kids and they're bouncing off the walls, they sort of have this energy rate and the attention seeking during that time, because they're overtired. So that consistency needs to include your family and say, listen, everyone, we're going to start bedtime routine. So even if you set a bedtime at 10:00 PM, that's all, when you're going to go upstairs. Right. Your kid, depending on their age and depending on the number of hours of sleep they need, they, you literally have to go to. Get them ready have a routine for them. The second part of that, my acronym R-outine is not just for our children. Really. We talk about, oh, they have a bath. We sit and get som we read a book. We as parents need that routine as well, just to show be a role model. And so have that routine for them where they are anticipating what's coming up next. And we're doing it over time and really staying ideas to be consistent. This is what we do. We're going to keep it simple. You know, we read two books, we sing one song. We have this no more.
I need to pee. I want to get a glass of water. I need another hug. We set limits, you know.
Right. Think of you, you know, as parents, of course, you know, we want to, especially as busy professionals, you know, we want to cater to our children, want them to feel loved. You've given them the whole day for you to show them that love.
So at night, all that stuff is delayed tactics. So I think really when you drill down to like, okay, we need to set limits, this is what we do in this family. They will follow through. There'll be some pushback, but if you stick with it, That's it, that consistency piece they will get on board. So that's definitely something that.
Dr. Diana Mercado-Marmarosh: Yeah, that's such great advice, you know? So tell me, how did you decide that this is the field of medicine you wanted to go into? Is this something that you have always been like, so passionate about? Like as far as you can remember?
Dr. Funke Afolabi-Brown: Absolutely. I'll answer that. I just, so just. Rumanian part of my acronym before I forget no problems. So there's the a is, (CREATE) A is A-ssigned the bed for sleep and sleeping bed. Don't use the bed for your desk, your office desk, your dinner room, your movie theater. And then E, is having, an E-nvironment, that's cool, that's dark and noise free.
Sorry. There's E M then there's a, and then T is T-ackle-Technology, which we've talked about. Put charge your phone outside. That's perfect. And then the last E is E-liminate caffeine, alcohol. All those things can affect the quality of your sleep and I'll share those resources at the end of today. At the end of our talk.
Now, when it comes to why sleep medicine, I struggled, I struggled, I had insomnia at some point during training. It was a combination of sleep deprivation and insomnia, I would say because what was happening was I was trying to burn the candle on both ends. I am not a night person. I'm someone that literally, if I could go to bed at eight 30, that would be my sweet spot.
But then I was trying to follow the crowd. Right. So when everybody else was going to study, I would go to study and then they would wake up at evil, odd hours and I would wake up then as well. So I was burning the candle on both ends and it made me really anxious, stressed out. I was working 10 times as hard for the same results.
And so, you know, once I realized that my superpower was sleep and I figured out how to make sure I got enough sleep and I just saw how it changed my life. I'm like, oh my gosh! Oh, my goodness. People need to hear this. And so, and that's been my mission. And then of course, when the kids came and then, oh my gosh, they took my sleep away pretty much right.
Working through that process as well. It really motivated me then to say, I do need, so I'm going to go. I'm going to get additional training to really learn the science of this. And the evidence behind this and everything I had done, even before I did my sleep fellowship was, you know, was what I ended up learning more.
And so then that really pushed me and motivated me to, to help women like myself who are doing all the things. And we have so many competing priorities, you know, not necessarily prioritizing sleep, which really is like a critical element to our ability to do the things that are important. Right. So, that's really been just a story really of how I ended up here.
Dr. Diana Mercado-Marmarosh: Yeah. I mean, if we think about it, one third of her life, we spend it asleep, right. Or we should be spending asleep. But sometimes like you said, we don't prioritize it and it could be a couple of things. Maybe we don't have the ideal bedsheets or we don't have the right lighting in the bedroom or, we have too many distractions and you were able to see that one of the denominators that. Helped you show up how you wanted to was the more you like rested and slept, the more you were able to show up instead of like you said, trying to do everything. And, and some of us sometimes don't have that awareness that we need to slow down. And reevaluate the situation and then like speed up. Right? Some of us just want to keep going and going and going. I know where that there's no gas and eventually you're going to be pushing the damn car.
Dr. Funke Afolabi-Brown: You're running on fumes. You're running on fumes that is so true. And it's harder. It's so hard.
Dr. Diana Mercado-Marmarosh: Yeah, I had you just stopped and say, okay, I have one fourth of a tank. Let me fill up right now
Dr. Funke Afolabi-Brown: Exactly! Before we start to go uphill. So I'm not pushing the car.
Dr. Diana Mercado-Marmarosh: Before it doesn't become a community problem. When everybody has to push you uphil.
Dr. Funke Afolabi-Brown: Exactly.
Dr. Diana Mercado-Marmarosh: So tell me, what are you up to these days? I know you were just. I'm doing a TV show, right? Like I'm so excited about all this. Tell, tell me, tell me about all the things.
Dr. Funke Afolabi-Brown: Oh gosh. All the things. Yes. But while I say that it does sound like a lot, but one of the things I want to say is because I prioritize sleep, I kind of can drill down on the things that are going to give me the best. Sort of literal bang for my buck in that sense, teach me how to build systems in place. So I don't get burnt out on so that my sleep does not suffer. Right. So I just want it to profess that. Well, I was recently, you know, part of what with baby center to create a course for babies' sleep, which is been such a need and such a desire in my heart.
And so BabyCenter, if for those that don't know, is this incredible organization that literally take you through the Fest moment? You realize you're pregnant till your child is older. So they go through so many steps on developmental milestones and things. And one thing they just introduced is a course, which literally takes you step by step into what you should expect for your baby sleep, right from the moment you bring them home from the hospital to like, or even before then, from how to arrange your baby's room and set it up so that we can sleep well when you bring them home to like taking care of naps and sleep training and things like that. So that was an incredible experience. And, you know, I'm going to put the link.
The link is also going to be on my website, restful sleep md.com. So you could sign up and gift it out to new moms in your life or moms who are struggling with sleep and things like that. The other piece I also have is the other end of the spectrum, is Kids Sleep Course for Teens. So I have a teenage sleep course as well, which is really driven and created for our teenagers who also feel like they are invincible.
They don't need sleep. What we know they are so exhausted. So that that's for them. And I didn't leave the mamas out as well. In fact, I have. The special touch for moms. And so I do have one-on-one coaching for moms. So like you guys get the icing on the cake where I literally walk you through how we can get you sleeping well, how we could get you setting boundaries so you can prioritize your sleep. So you're not running on fumes. And the best place to find me is, my website, as well as on Instagram @restfulsleepMD.
Dr. Diana Mercado-Marmarosh: Yes. You've shared so much of your tips today, but guys don't get full. Well, she's only shared, although she, you can see she, she's serving here from a place of abundance, you can see how her knowledge can be in, in burst into all the stuff that she's doing. So you, you already know that your network, it really becomes your net worth. So you gotta make sure. You know, if you know somebody who, who can benefit from their kid, learning how to sleep, or you have that teenager, or you yourself know that something's has to change because we cannot continue to, you know, run without gas.
Right. You need to make sure you reach out to her. And the same thing, like maybe. You know, you've been telling your teenager this, right. And they're not paying attention yet. Guess what? Let's get a physician to tell them that this is why it's needed. Right. Because sometimes we already know, even though we're saying the same thing to them, they just don't accept that.
What we're telling them until somebody. Yeah. Tells them and, and who better than an expert in that field, right? So don't hesitate, like run, like run to her webpage, run to her Instagram. You need to see everything that she's saying. And if you have any retreats or any, lectures that you need her to come and talk about, definitely reach out because you might just change somebody's life, you know, because sleeping might mean, not an accident the next morning, because they have enough awareness and enough reflexes. Right. So I always tell my people. You know, uncontrolled diabetes, it can be like drunk driving and lack of sleep can be like drunk driving because of reflexes are so not on point. And we don't realize the importance of it.
And so yes, please, please reach out.
Dr. Funke Afolabi-Brown: Awesome. Thank you so much. I love that. I love that analogy you just gave the same way we wouldn't want to share a road with a drunk driver. We don't want to share the road with a sleepy driver and we don't want to be that sleepy driver. And so, yes, please prioritize your sleep as much as you can.
Dr. Diana Mercado-Marmarosh: Awesome! Well, thank you so much for being here with me. This was a treat. Reach out to her and, definitely send us an email telling us how sleeping impacted your life. Okay. All right. So last question. I always do this. So, you know, we have ADHD. And sometimes we space out.
So let's say my listeners just started paying attention, like right this second, what is the one take home point you would want them to take away with?
Dr. Funke Afolabi-Brown: Oh my God. I love that SLEEP IS YOUR SUPER POWER!
Dr. Diana Mercado-Marmarosh: Awesome! Sleep is your super power implement it today. Tonight do that today. Thank you, Dr. Funke.
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
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About Dr. Brown
Dr. Brown is board-certified in pediatric pulmonary medicine and pediatric sleep disorders. As a double board-certified pediatric respiratory sleep medicine physician, Dr. Brown helps her patients breathe better and sleep better. By extension, she helps improve the sleep of their parents.
Dr. Brown is a speaker, an educator, a writer, and the founder of Restful Sleep MD where she helps busy professional women and their children prioritize sleep to not only achieve their optimal health but also thrive and live to their fullest potential. She does this through courses and programs focused on educating and empowering busy professional women to make sleep a priority as a critical pillar of their health.
Website:https://www.restfulsleepmd.com/
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Dr. Tamara Beckford: Self care is aligning yourself. Self care is more than I carve out to, to go and get a manicure and pedicure and a massage each or every two weeks or every month. Self care really starts from within. So what you're doing on the outside is good, but what you do on the inside is even better.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello I'm so excited today. I get to interview one of my dear friends, Dr. Tamara Beckford. She is a speaker. She is a wellness expert, a coach, and a board certified ER, doc. She is the CEO of URCaring Docs and UR Caring Society, where she helps busy professional women put their health and their wellness first without feeling any guilt.
Did you hear that? No guilt take care of yourself. She's a very sought after speaker and she's been on like thousands of podcasts and she's delivered so many presentations, both nationally and internationally. So today it's a really amazing treat to have her here. She teaches organizations how to implement self care programs for employees so that they can be more productive and of course manage their stress.
So in her spare time, she interviews doctors from a cost of world and they get into the ins and outs about self-care wellness and the fantastic things to do outside of medicine. Today, she's going to talk to us about self-care and she's going to get real with us. So I'm super excited to have her on. Welcome Dr. Beckford. .
Dr. Tamara Beckford: Thank you. Thank you for having me.
Dr. Diana Mercado-Marmarosh: Awesome. So this is an ADHD podcast, but self care, I think is a word that most of us, when we associate self care, we don't really understand what that means. Could you define self care for us and why you think maybe it'd be relevant to ADHD?
Dr. Tamara Beckford: Absolutely self care is aligning yourself. I break it down into three main portions, which is aligning your mind, your body and your spirits. Self care is more than I carve out to go and get a manicure and pedicure and a massage each or every two weeks or every month, self care really starts from within.
So what you're doing on the outside is good, but what you do on the inside is even better. So, self care, really, when I talk about the mind, we're talking about a lot of mindfulness. We're talking a lot of alignment on. Where you'd want to see yourself and are you really doing the things that you need to do to get you there when it comes to your health?
When it comes to how you're feeling? When we talk about the body, we're talking about really alignment of movement of, when we talk about the spirit, we're really talking about interactions, things that's really going to release some of those positive hormones that are within the body. That gets us feeling good. And being well overall. So it's an alignment of the mind, the body and the spirits. So self care, as I said, it starts from within, it's great to do a lot of things with on the outside, but really started from the inside is the best place.
Dr. Diana Mercado-Marmarosh: Yeah, I think we can get ourselves in trouble, meaning we can arrive at self neglect if we are not practicing self care. And I know when I say the word self neglect, a lot of people are like, oh my God, you overreacting. Am I really like,
Dr. Tamara Beckford: No, absolutely not.
Dr. Diana Mercado-Marmarosh: Because we all been there and we're not even aware that were there.
Dr. Tamara Beckford: Yeah, no self neglect is the I'm too busy to. So I said that we live in a world of feeling of a lot of self-importance like, you know, and this might sound, some people might get offended.
Like, what do you mean I am. You absolutely are important, well self-importance becomes when you are too important to do things for yourself because you're doing things for others, right? So my boss needs me. This person needs me, or the person needs me. So what about you? You need you, so that's where self neglect comes into place.
You're just so busy. We love throwing that word around. Oh, you know, it's really great that I'm doing all these things. And you feel important, but your body will let you know, as, as the added Manchester, if you don't take care of your body, your body will not take care of you.
Dr. Diana Mercado-Marmarosh: Yes. You know, this morning, I was listening to a book called The One Thing. And in there the author was talking about how their doctor plain asked him. So if health and your mind are not the most important things, what is? Like your body's not going to take care of itself. Again, if your mind is not aligned, like you said, the internal thing is not producing the external thing. If your mind is not telling you that your time is just as important as that person who just told you need to, then you're not going to physically put on the calendar a space for you to take care of you.
Right. You're not going to book that appointment to see your doctor. Book that massage, book that time with your girlfriend, book that date. Right. And I know it sounds like, oh, that's not self care, but it is because it's like, if you want to stay married, you need to plant and continue to water that seed. Right? If you want to have a relationship with a friend that you value, again, you have to continue to provide value to that friendship.
Right? It almost seems like, well, you just said, I had to like do it for me, but you are doing it for you because you're choosing them. You have decided. So that's very different from all my friend needs me, but...
Dr. Tamara Beckford: You need them. And that's so important. Interestingly, you know, During this particular recording, we're still in the pandemic, however, we're not as deep in it as we were say two years ago. Now, when we talk about the pandemic, you know, we have people who have a lot of different personalities entering into the pandemic. There was this shutdown, right? The whole place shut down. Unless you were an essential worker, you have to stay home, stay put, and figure it out.
Now, those who are introverts, you know, you're like, yes, this is great. I don't like hanging out with people anyway. At least that's the thought process, right? So this is like really awesome for me. So I'm able to do this by myself. I finally get to just lock myself away and it's mandated. So there we go. But interestingly, you know, as some introverts, well, how long did it take before you realized that like, Alrighty, I'm going back crazy here.
And I need to like, interact with people. One month, one month. Right? So as much as we sit and think we don't need others, irrespective of your personality type, you do. And that's part of self-care. Right? So you're thinking like, oh, I'm being by myself. I'm great. This is really well, it that's a part of it, but socialization, which is why I called it. It's it's really aligning with the spirit. Socialist socialization is a part of healthcare your self care, which is also part of healthcare overall, well, it's a part of your self care because human beings are social beings. We're not loaned some walls all the time. You know, there are periods of time when you want it and need to be by yourself, but there are also periods of time when you need others, you need to socialize.
You need to feel a sense of belonging and that's very important. When you're talking about watering, that seed watering that, aspect of your relationship, that's just as important as you take in time for yourself.
Dr. Diana Mercado-Marmarosh: Yeah. And let me ask you this, have you personally, or maybe a family member that you know, and I know you and I have had conversations before where you shared with me that one of your brothers has ADHD, have you noticed if there is any type of correlation with self care and like how well pulled on quote, you can focus. Or you can concentrate or you are not as irritable whenever your self care is quote unquote in alignment or the self care battery's full. So to say.
Dr. Tamara Beckford: Absolutely. So my brother does have ADHD and he was recently diagnosed and this is.
Probably literally one year ago now. And to give those who are listening to perspective, my brother and I are roughly 18 years apart. And, you know, seeing him grow up. So it's like you're 80, almost 18 years older than someone you're literally just watching them as like a child. And then, you know, moving on throughout.
That throughout his life. So now he's an adult and he's going to be starting medical school in a few months. But through out the years, there are certain, especially seeing him as a young adult. You know, we have noticed my family and I like, there were just like ways where like his name is David. David just thinks differently than the rest of us. Like, what is it like, why would you make that decision? The others, but then now it makes sense. Now when it comes to his self-care, he has been very adamant. And exercise enthusiastic to me, you know, and he does it regimentally and I feel that that helps part of his self care.
I've also noticed, like, you know, when you're talking about growing up with someone, now, some people might get diagnosed with. ADHD or ADD at a younger age, right? There might be like five or six. But when you see someone get diagnosed in an adult, there's such a difference because it's like, ah, finally I knew something was like, I couldn't put my finger on it.
Like. Well, and this is not from our perspective, his perspective, like, oh, I knew it. So there were certain things that I've noticed along the way that he, you know, David incorporates into his life, like one we've talked about, you know, his self care of his exercise and just like his stress reduction.
And he gets very, stressed. As an adult now, you know, he knows how to channel it through exercise and just letting that go as a kid. I remember doing, I think he was in the fifth or between, junior high, fifth grade. He started having a little tick. You know, and it's just the stress and it manifested in a tick like I am, and I'm going to just say, well, you know, you get them evaluated.
And I'm like, you know, he doesn't have a tic disorder. So you recognize that this is really the stress and not being able to let it out because when you're five or six years old, some fiber in fifth or sixth grade, you can't really express yourself as well as you can. And you know, that something's different and, you know, You are trying to your body's way of manifesting it.
It was just the stress release was just his tick, that tick emotion. It didn't happen very often, but when it does happen, that's an external manifestation, like, okay. You're obviously under a lot of stress. Some of the other things that he started in, but he incorporated, to get through life when we talk about, and that's one thing you talk about pretty frequently is that time blindness.
So. And learning to prioritize, but which one of these is important right now? So I've seen some of the challenges, especially during the first, years of undergrad, just trying to determine like, well, you have all of these assignments. Which one is important now, you know, so there were times when I would sit with him and I'm listening to, you know, when I have this and this and this and this, and he might, you know, go and work on assignment, number three.
And I'm like, well, where is assignment number three due? Oh, you know, that's due in like six weeks. Well, what about assignment number one, that's due in two days? Like why would you work on assignment number six? You know? So it's, those are some of the aspects that we just had to like, just tease through and just go over and over to just understand it.
Like, yes, your mind might want to take the path of least resistance at this point, because assignment number three, it sounds like, oh, it's easy. I can knock this out. But in the relative timeline, what's important assignment. Number one is what you need to really hit the nail on the head. You know, you need to overcome that, the mindset, way of trying to block you by saying like, ah, this is too hard.
How do you want to sit down and exert excess energy towards this? You know, these are things that's important to you. And one of the things that he also does right now in the time-blocking is he had some alarm on his phone, every 15 minutes. It's telling us the time it is now nine 15. It is now nine 30.
It is time for you to get off the phone. So he's using all of these techniques to just really. Get through and, through life and believe it or not out of all four of us who? Our family, my mom, my dad, my, he and I, he's the most organized out of the, all four of us at this point.
Dr. Diana Mercado-Marmarosh: Yeah. So it sounds like once he got the diagnosis, he became curious enough to understand how his brain works. And that was a form of self care for him because he started to use tools that maybe he would have never have even considered. Cause he didn't even know that was something going on. Right. But now he didn't make it mean anything. He's like, okay. I have ADHD. My brain just thinks a little bit different and therefore I'm going to use some of the tools to help me set up a system that will help me. So like, like he had the best intentions he wanted to do all six assignments. Like that was never a question. Right. Did he find some of them more boring than others? Probably. So of course, knowing that he wanted to jump onto the one that was probably quote unquote the easiest and didn't have a time crunch because it was due six weeks from now, versus that one that is due in two days from now, and you feel burned and you feel that little pressure and you feel a little bit uncomfortable and it makes sense. Why not until in his mind, it's just six assignments, but not until you have the quality of the question will give you the quality of the result. Right?
So if the question now, like you were wise enough to direct him was, well, which one is due? Time-wise not how boring or how easy, but time-wise, what is the most pressing thing? And so if you have that same concept that you apply for yourself, like in terms of today, what is the one thing that will help my self care, therefore decrease my stress level. Therefore get me out of this overwhelm hamster wheel.
Dr. Tamara Beckford: Absolutely. No, it is, this is very, very important. And this is one of those techniques in self care. When you're saying, what are some of the one, one or two few things that I can do, for self that can get me through my day? And so I think it's so important now, a lot of people, we definitely recognize that your day really is as important and the way your day goes really is manifested by the way it starts.
Right. So how are. Starting your day. Are you starting your day by going through things that are bringing anxiety starting your day, by going through things that are bringing guilt? Are you starting your day by things that are making you angry, or are you starting your day by, going through a process, that can keep you centered so that whatever is coming at you, you can respond to it versus react to it. And that's why I think this is one of the most important aspects of a self care routine. And for me, that self care routine begins upon awakening. So when I wake up. I am not reading that email from work. Trust me. It can wait another five to 10 minutes. I am not listening to like an argument and reliving an argument through my mind. I am not jumping on social media to see who's arguing with who, or, you know, whatever things that's going to bombard me with insecurities and, bringing that up. No, I'm starting my day by investing in my mind and investing positively so that when I enter into my day, as I said, I can respond to whatever comes my way.
So it's self care. When I say that your mind, body, and spirit, there's an alignment that occurs investing in positive reinforcement in your mind. Actually the first thing of your day. I don't say in the morning. And I'm specific by saying, by not saying morning because I work nights. So my morning is 4:00 PM.
That's the time that I wake up and that's when I invest in my mind. So when from 4:00 PM, when I wake up, I'm investing, first thing I'm doing for me, part of it is spirituality is reading my Bible. And I'm really centering myself. Right? So frame you, if you're not into reading your Bible, reading anything spiritually, maybe it's reading, some gratitude things that you've written in the past, that's making you recognize and say, like, I'm very grateful that these have happened to me. Maybe it's you writing down and expressing your gratitude for what's going on right now, maybe it's listening to. Positive affirmations that you've, that you've spoken into a recording for yourself, or maybe it's looking at it on the wall, whatever it is, you're infusing yourself and you prepare your mind for that day. And it helps a lot.
Dr. Diana Mercado-Marmarosh: Yeah. You know, that's one of the tools that I teach my clients and my coaching group, that how you begin your day or what you focus on is what's gonna get magnified, right. So if you're thinking of the 10 things I didn't do yet. You're going to be all anxious. Right. But if you're focusing on what are the three things I'm grateful for? What are the three things that today, if I did, I will feel like I have accomplished what I needed to do. When I have accomplished that, then nothing else really matters until those things are accomplished. Right. And that it is a form of self care. And it's also a form of living in being uncomfortable. That it might be a little chaotic. While you're focusing on those three things, because you're not allowing yourself to be distracted with the dishes. You're not allowing yourself to be distracted with the laundry because we, even though we don't like doing that, we can easily want to go do that because we haven't done the really thing the matter, because there is a lot more work to do, learning, to be uncomfortable sometimes with a little bit of chaos or deciding who can clean up that chaos because that's not your one thing. Yeah.
Dr. Tamara Beckford: Who can you delegate that so that you can focus on self so that you can focus on the task ahead? And that's why when I even talk about self care, so self care. It's a process that will allow you to achieve any goal that you want in life. It really starts with self. So when people hear self-care, they're not thinking that self care is a process that helps me to achieve goals. They're like, well, self-care is a positive. That helps me relax. No, it's 10%. It's only 10%, you know, because once you've aligned all of those three aspects of your life, can you imagine, even, like we said, during this pandemic, a lot of people, even the intro that if the introverts was sick and tired of being by themselves, you can imagine those who were extroverted, those who needed to be seen to be heard.
One of the ways that they found were on in online communities and that's where you and I met, right. When you're aligning yourself with like-minded people that's self-care because you no longer feel like an outsider, you no longer feel like you're disturbing the other person, because all these people think just like you now, when you're around people who think like you, what do you think that you're feeling at that time?
Are you feeling anxious or stressed? You're feeling belong. You're feeling a sense of belonging. You know, you're feeling yourself some bonding that's oxytocin release right there. You're thinking, you know, you're bonding with others and you're all having an alignment, you know, and you want more. Right? I said, we want more and more and more because you're feeling it, you're feeling a sense of belonging. And so that's a process of the self care. How can I align myself with like-minded people? That's feeding into your spirit of self-care.
Dr. Diana Mercado-Marmarosh: Let me, let me ask you this question, which I already know kind of what you're, where you're going, because I know you, but this is a question I think that needs to be asked, you know, I think you and I, have never been afraid to like, do the hard work and you as an ER doc, like you're used to juggling 10,000 things and then learning on the spot too. Like what is the most priority, but do you think taking rest is a form of self care or do you think yes. Or do you think that's like, you're not being productive and that's not like worth of.
Dr. Tamara Beckford: Oh, that's a such a great question because we live in the hustle, hustle, hustle society. And one of the unfortunate mindset of being in a hustle society is that rest is for the week. No! Without rest, you will become weak. Now rest is a part of your self-care and it's an utmost part. And that's the part of taking care of your body, right?
There are so many positive benefits from resting. Now, rest, of course, it's challenging for you. If you work shifts that are really. Especially as an ER, doc, some your knots up, it's a very unpredictable schedule. Most emergency physicians schedule. So rest is something that you battle, but rest is so important that without it, you start having negative health. Risks that start to manifest within yourself.
You start having memory loss, you know, rest is such a restorative part of yourself. Making time for it is just one of the utmost things that you have to do. Now, if you weren't that important, then it wouldn't be part of our cycle. Right? So even if you are constantly on the go and they've done studies, they've done studies that well, most of the studies that done is in doctors or residents, because we are really one of the professions at the very sleep deprived, but it's shown that if you have a resident or a person that's been up for 24, 48, going, going on 48 hours, your cognitive skills have declined tremendously. Right? So those important decisions that you're trying to make, you're not going to make them that well..
It's just as if you're making the decision while drunk in that's what this, you know, that's what the statistics shows. And that's what the studies have been shown that it's, as if you're making a decision drunk, when you are completely sleep deprived. So rest it's restorative, it reinvigorates you and it brings back a sense of not just understanding, but all the decisions that you truly want to make in life and the important decisions needs to be done with rest.
Dr. Diana Mercado-Marmarosh: That's a great point. Now, as an ER doc, I'm pretty sure you see all kinds of things come through. Right. And I'm pretty sure that some of those, crazy accidents sometimes happen to people with ADHD because they forgot to put on a helmet or they decided to speed paths because they were late. Have you noticed any correlations? You know.
Dr. Tamara Beckford: So I haven't directly looked to see, and, you know, that's something that's important because a lot of my patients who are coming in, who have, um, ADHD, there's still a subset that probably will not let me know that they have ADHD. And yes, and there's also another subset where they do have ADHD. They are taking their medications and they are, managing it as well as possible. Um, so with those who are managing the ADHD, you know, th whatever accident occurs, it occurs. Because it's an accident, not an intention it's not done on purpose. So, and that's so important for us to really express to those of you who are with ADHD or without sometimes things happen. It's not your fault. And you know, a lot of times I know we get into this aspect where we try to blame ourselves, man, had I not done this? Had I not done that? Maybe this is related to my ADHD. You know what, there's a subset that if you were using your skillset, you know, especially for, your clients, I know you teach a lot of skills on a lot of skillset for them to incorporate. If you've been incorporated in your skillset and things happen. It just happened.
Dr. Diana Mercado-Marmarosh: And like you just said, like, you can have all the techniques, but when things are going to happen, they're going to happen. And it might be that they don't happen to the extent I do not apply this.
Dr. Tamara Beckford: I do not apply their skills.
Dr. Diana Mercado-Marmarosh: Absolutely. So that's. So important to have some certain checklist, like, do I have XYC is my kid in the car? Not behind my car. Like, things can happen at an instant, whether you have ADHD or not, but having some checklists, even though they seem boring and repetitive can really saving two minutes. Like trying to save two minutes can cost us five hours or cost us a lifetime right.
Of something. So sometimes we just have to slow down enough because we're so excited about life, but we got to slow down enough.
Dr. Tamara Beckford: I've seen that. And, you know, interestingly, um, with us even talking off camera, when we talk about like the ADHD mindset and lifestyle, You know, I said that within the different specialties in medicine, the one that's more aligned with an ADHD lifestyle and mindset is emergency medicine.
Emergency medicine is a, one the most challenging specialties to stick with one line of thinking for say even five minutes, because you're constantly being interrupted. You're constantly being interrupted. You're interrupted at least within an hour. I wouldn't, numerous times within an hour, you're interrupted by signing an EKG.
You're interrupted by, Hey, this lab is back. You're interrupted by what are you going to do with that patient? It's like, Hey, this family member wants to talk to you. And this is all while you're picking up new patients. You know, discharge a prior patient, call it in a physician about the patient, you know, going to the patient, informing them what's going on, getting new information, processing the new information and you know, the disruption continues.
So when trying to have, as you mentioned, checklist, to ensure that you check all the boxes so you can give each patient the best care possible. You can see how using that and the time block. Next thing you know, this patient's been there for hours. You know, did you do, did you at least go see that patient because you were interrupted so many times a trauma came in, a heart attack, came in.
This patient is lovely little old lady. Okay. Cause she sprained her ankle. She still needs to be seen, you know? So it's important to that. You said you use these techniques and these checkboxes and this awareness that time flies. This time, blindness that occurs within our lives in order to give the best possible care.
So it applies to not just those with ADHD, it applies to those, those of us in specialties that really have a lot of interruptions in our brains.
Dr. Diana Mercado-Marmarosh: Yeah. And it's interesting because. When I started my coaching group in my mind, I thought it was going to be properly just like I thought it would be like, ER, doctors with family medicine, doctors, like in my mind, that's what was going to have.
And interestingly enough, I have. All ethnicities of people working with me, but more importantly, all specialties, like I've had a pathologist, I've had psychiatry, pediatrics, like OB GYN, ER, docs, nocturnes, like, family medicine, like you name it. Like they've all even had a, I have a couple pain management doctors. I have a couple, PMNR and like, it's so interesting that. Our brains each have a uniqueness to it because even surgeons. Right. And they're like, people ask me if I have ADHD. Cause how can I sit there or stand there for that many hours in that specific like body part when I can't even have a conversation with somebody for five minutes, right?
Again, it's what you focus on or hyper focus on that, your zone of genius that just lets you be. And so it's so interesting how self care implemented, regardless of what specialty you're on or in can really make a big difference. Because if you think about it, like we all have to go all those rotations, right?
When we were medical students. And then depending on what residency you did. So me as family medicine, I had to still go to them all again. Right. And so internal medicine, I guess, has a little bit of that. Pediatrics. Probably not to that extent because they're not having to go catch babies, but, but still you could see how some of the primary docs are able to go through all that and then they can cope or not if they don't have their self care. Right.
Dr. Tamara Beckford: Absolutely. And you know, one of the highlights that really had me. Focusing on the self care was really this pandemic because when I looked at a lot of my colleagues in emergency medicine, I mean, you know, they were going through so much and I'm not, and I'm saying they not as if I weren't going through it, but being able to handle like, you know, the anxiety level.
Skyrocketed, you know, am I bringing this onto my family? Am I going to survive this? What is this? Because the beginning of the pandemic, we just heard there's this virus that, you know, it attacks respiratory track and people are dying from it. And, we don't know how to protect it, but you need to use PPEs.
But. You know, by the way, you need to start reusing these things
Dr. Diana Mercado-Marmarosh: By the way, we don't have PPE.
Dr. Tamara Beckford: And we don't have enough. So, we need you to start using this mask that normally you would have thrown away each time you enter the room, but now I need you to use it for this couple of days. So, you know, there's so much as going through one's mind.
However, incorporating some of the small to, self care techniques that I've mentioned throughout this interview. So far, I was actually able to get through all of this without feeling exhausted or burnt out because. Even though I'm still working full time. I mean, we're still building businesses, I'm still interviewing doctors.
I'm still doing my own podcast and, and it's just like, well, how are you able to do all of this? And you still have a family because I'm incorporating self-care. So the most important thing I've invested in is in my mind, And I've invested in my body and my spirit. So this self care routine that I have invested within myself has gotten me through and I've recognize it, wow!
Now if an ER, doctor in the middle of a pandemic, which is one of the worst things that can happen to somebody in the ER, because while everyone can run away, we have to run towards it and I'm able to get through this. So then obviously whatever I'm doing is working and that's why I'm here preaching on my soap box about the importance of self-care within not just the community in medicine, but outside of medicine.
Dr. Diana Mercado-Marmarosh: Yeah. I think you just brought up such an important point. What distinguished you from other people? And I think it was the same thing for me, was being willing to feel I was worth the investment into looking on how could I find tools to support my brain, my heart, my soul. For me, it was tools to help me understand about executive function.
It was tools to help me with time productivity or time blindness, but really at the end of the day, it went back to the self care because not until I felt my time was just as important as my patients' time or my family time. Did it make sense for me to invest in myself? Because I mean, none of us who are physicians ever knew, we were going to be like, you know, almost half a million in debt with loans.
Right? And then when we talk about coaching or therapist or psychiatry or whatever, We're like, oh, that's too expensive. It's like, how do you measure too expensive means like, does that mean keeping a job? Does that mean not having an ulcer because you're not, you know exactly. Right.
Yeah. Which one is it? And so I think what. Finally had to learn was that I could either stay in the victim mentality. I could keep arguing for my limitations. Right? And then I get to keep them.
Dr. Tamara Beckford: Oh yes. Because you're going to win because it's in your mind that your limitations are yours and it is way more important. So what others are telling you. That's nice, but you just do not understand this and apply does not apply to me. You don't understand.
Dr. Diana Mercado-Marmarosh: Yeah. So I could keep arguing for my limitations or I could decide. To do it a different way so I could get different results. Right. And so I have to learn the hard way, you know, that if you kept barring on your future, not protecting your energy, you were borrowing on your futures ability to function. And it's ventrally it was going to come to a point where you were going to slowly die out or quote unquote burnout or something was going to happen. Right. Something was going to give. Yeah. And so I think all of us could relate whether you have ADHD or not. If you're a physician working through the pandemic, If you did not prioritize yourself care, you eventually got to burn out and you didn't even know.
I didn't even know I was just irritable. And I thought that was the norm because how else would you feel? And I just thought I was angry and I, how else would you feel like I didn't realize that I was feeling that because of what I, what I was telling myself, I was in victim mode.
Dr. Tamara Beckford: You're you're telling yourself, well, I'm just tired and you know, so why shouldn't I be tired if you really think about it? A, B, C, D, right?
Dr. Diana Mercado-Marmarosh: It does add up.
Dr. Tamara Beckford: So what are you going to do about it? What do you mean, what am I going to do about it? You know, I'm tired because I'm just tired. You know, so yeah, there isn't a particular thing to do about it. I'm just tired. And so now that you've recognized what's going on, like, how are you going to improve upon it? Like, you know.
Dr. Diana Mercado-Marmarosh: So what's your next step. Okay. So yeah, so that's where like the shit hits the fan when you're like, okay. The system that , got you here, got you here. Do you like being here? Oh, you don't. Okay. What are we doing? Let's go
Dr. Tamara Beckford: What's next? Yeah. And that's the thing too. Your systems got you to where you need to be.
And as life is very dynamic, you know, it's not a static process. So the systems that you needed five years ago to get you to where you are now, if you continue using those systems, it's doing its job. You're still going to be right here. So if you want to get to the next five years, there's a chance that you might have to change those systems because the system from five years ago is to get you to the present the system to get you to five years in the future might not be the same systems. It's going to work and keep you in the present.
Dr. Diana Mercado-Marmarosh: And I think in order to even realize what five years down the line looks like, you have to start getting yourself in the room with individuals who are asking those same questions, right?
Dr. Tamara Beckford: Absolutely. Socialization aligning your spirits with those who are thinking like you, those who want to do things that are similar to you, or even more importantly those who have done things that you would like to do?
Dr. Diana Mercado-Marmarosh: Yes, exactly. Because that's what I feel at the end of the day. My take home point for people who are listening is that self care can be you asking yourself the question, where do I want to be in five years? Like. Our wise mentor, yours and mine Dr. Una, always tells us that there's no dream police, right? There's no gold pulleys, right? There's no imagination police. So you get to decide how you practice medicine, but here's the thing, self care has to be at the front and center. Your systems have to be aligned. And like you said, you don't have to know how, because obviously we, might've not even be aware we're missing that piece. Right? But you need to be able to talk to the people that are leaving. Proof in our, the example of what is possible and invest in yourself. And so with that being said, Dr. Tamara, please tell us where to find you because we need this. Self-care.
Dr. Tamara Beckford: Absolutely. Thank you so much. So, if you would like to have me as a speaker on any of your podcasts conferences, I am available also for retreats. You can find me at drbeckford@urcaringdocs.com that's D R B as in boy, E C K. F O R D at your caring docs, you are C a R I N G D O C s.com. You can also find me on LinkedIn with the same name, Dr. Tamara Beckford and on all the other social media platforms. It's your caring dots? That's U R C A R I N G D O C s.com.
So that's on your Facebook, on your Instagram, on your Twitter and also on the tik-tok.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. And I always say this last thing and people laugh, but you know, we have ADHD, so we tend to tune out. So let's say that my readers or my listeners just finally started paying attention right this second, what is the one final nugget that if you tell them this, they're going to feel like they got the whole episode.
Dr. Tamara Beckford: Absolutely. So the final nuggets is that self-care is really aligned in your mind, body and spirit to help you achieve all the goals that you would like in your life. It's not only about the manicure, pedicure or a massage. That's your self care.
Dr. Diana Mercado-Marmarosh: Woo. That was awesome. Okay. She brought it home. So there you have it.
If you want to get, you know, Oprah's doctor, she is, she is the doctor that can speak like Oprah. You need to get in contact with Dr. Tamara Beckford and she will set your retreat, a straight work environment that needs self care or your own self into alignment so that you can get where you want to go five years from now.
Dr. Tamara Beckford: Absolutely.
Dr. Diana Mercado-Marmarosh: All right. Thank you again for coming.
Dr. Tamara Beckford: Thank you for having me
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
Dr. Tamara Beckford is a speaker, wellness expert, coach, and board-certified emergency physician. She is the CEO of UR Caring Docs and the UR Caring Society, where she helps busy professional women put their health and wellness first without guilt. A sought-after speaker, Dr. Beckford has appeared on dozens of podcasts and delivered presentations on wellness and self-care. Today, she teaches organizations how to implement self-care programs for employees, so they are more productive and have tools to manage stress. In her spare time, Dr. Beckford hosts the Dr. Tamara Beckford Show, where she interviews doctors from across the world about self-care, wellness, and all the fantastic things they do inside and outside of medicine.
Today, she teaches organizations how to implement self-care programs for employees, so they are more productive and have tools to manage stress.
Website: https://www.urcaringdocs.com/homepage
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Dr. Grace Esan: I want to be able to give a voice to woman, a lady, a gentleman, a child who's not being diagnosed and does not know how to get to the next level so that their doctors are able to help them.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
So I am really excited today. I am talking to one of my friends, Dr. Grace Esan, she's a pediatrician in Evansville, Indiana. And she's Nigerian American who grew up in Legos, Nigeria. She received her medical degree from the college of medicine, University of Legos. She completed her pediatric resident trainee at the Brooks Le'Veon Hospital Center in Bronx New York City.
And she's a certified pediatrician. She specializes in the treatment of infants, children and adolescents at all stages of the growth development with the emphasis on ADHD, anxiety, depression, and oppositional defiant disorder. She's been in medical practice for over 20 years. Dr. Esan is happily married and she's the mother of two beautiful children and her pet chihuahua.
So please, please, please, everybody listen up to Dr. Esan. She's here to share everything. How are you doing today?
Dr. Grace Esan: I am very well. Thanks for having me.
Dr. Diana Mercado-Marmarosh: I am so excited. I am doing well myself. I just got back from a Disney vacation with my family. So I am still in the process of recovering and getting back to work.
You know how we were a little slow after those vacations. We were smart this time around because, we did Disney break Disney break instead of like all the way straight, like we've done in the past. So that was good. We need a break sometimes. All right. So I understand that, you were diagnosed with ADHD yourself.
Would you mind sharing with me the circumstances surrounding your diagnosis? Were you surprised at all?
Dr. Grace Esan: Actually, yes. I was quite surprised. It was, it was a self-diagnosis really, because I was evaluated a friend of an adult friend of mine who was having trouble. She's having lots of trouble at work.
Punctuality to work, timeliness to get projects done. And then now it was now extending into the home where she was forgetting to take the kids where she needed stick the kids too. So I got to an adult self reporting screen and I took it home to her and I had her feelings out and whilst I was feeling it out, I was just looking through the questions that was the first time I'd actually looked at the questions for an adult.
I'd done the Connor's, I've done the Vanderbilt for kids, but I've never actually looked at it on an adult scale. So I'm looking at this adult screen and I'm like, yes. Oh my gosh. That was so I had this aha moment. I'm like, oh my gosh. So after thinking about it for a few weeks and actually acknowledging the fact that yeah, most of those things are true and they're struggle for me.
Then I, went down and they said with my family physicians. For how to actually do a formal evaluation and come up with options for me.
Dr. Diana Mercado-Marmarosh: Were you surprised, like you said you were surprised, but were you like when you looked at it, were you surprised in the sense that may maybe many people in your family behaved or acted or did certain things in a certain way. And so you just didn't think anything of it or what were you thinking? Like, were you one who was tardy or what, what was the things that like, kind of gave you that, oh, maybe there's something.
Dr. Grace Esan: Okay. So definitely tardiness is an issue because I, definitely suffer from time blindness.
I started to do stuff and I totally, I have no concept of how long it takes to do anything things that I think should take five minutes, actually take an hour and things I should take an hour, actually, five minutes. So, punctuality was kind of a problem. The ability to actually be having a conversation with you while I'm actually listening to a conversation over there or doing two other things at the same time that just came naturally to me, , it wasn't anything that I thought.
So I really didn't think that I just thought it was me. I didn't think it was a medical diagnosis and stuff from there. And I did not think it was a problem now, after, the diagnosis, then I realized that there were some things that I definitely could do better because like I said, time, blindness is still, it's a huge problem for me, really.
Especially when we're seeing patients. I don't know whether you you've experienced that before, when you're seeing patients and you're really into what it is you're trying to do for this patient, then time disappears. Because you're intent on what you're doing. So I've had to have a walk around to where my staff will send me a flash.
Through the computer. It's still me. Hey, you've got to get a move on. And that kind of helps snap me out of it. I put clocks in the room, so lock them in areas where I can actually see the clock so I can pay attention to, you know, like, but sometimes that doesn't doesn't work so that my backup work around was to then have my staff send me a text during the visits, telling you that you have 2 in the waiting room, or you have one waiting it's time to wrap up that kind of thing. And so that's how I've had to navigate that.
Dr. Diana Mercado-Marmarosh: Yes. Everything that you just said, I could have said, I also have the time blindness and I got diagnosed during my first year of med school.
And. It was funny. Cause like my husband, I guess he just kind of knew and he's not medical, he's an engineer, computer engineer. So anytime I gave him a time and he's like, okay, let me add an hour or let me add an hour and a half. And I'll be like, no, what are you talking about? I'll see you in an hour and a half.
And so it was funny because like my family, we had to give them like for graduation and for wedding invitations, like for my side of the family, with like an hour, earlier than the event so that everybody could show up. And then his side of the family, like it was normal time. Right. And so it's just funny how we don't realize that we do hyperfocus usually on the things that we really enjoy. Like, you probably love talking to your patients, but whether it's five minutes or 45 minutes, like to us, time is fluid. And so we don't realize it's been that long. And then I don't know about you, but then all of a sudden, like you said, you're on to the next patient and you don't want to slow down enough to write the note because you just did an amazing interview with that patient. And you're like, feel bad that you're rushing to the next one. Right. And so it's like you're here, there, and, not any everywhere. And yeah, so I ended up also like having some workarounds, meaning like I would tell my nurses to come like knock on the door and like try to help me out.
But then when I finally started like getting an ADHD coach for myself, like they told me. Just set a timer. And I know it sounded silly, but I didn't have that external cue. So setting the timer made a big difference because then they would either knock on the door or come and ask me, is there anything you need, which was helpful because then I could be like, oh, this person needs a vaccine or this person needs a UA or whatever.
And so it, and it was my cue to wrap it up. But yeah, otherwise like sometimes when I forget to put the timer on vibrate or on instead of just silent then. They have to come in. Cause they're like, oh my God, like, we didn't realize you forgot to put the buzzers. So they were waiting. They're all conditioned to hear the timer and then come knock, you know?
And so, yeah, it's, it's interesting. I've been using the timer almost for two years and even randomly when I would forget it, it's not like you would think two years you're conditioned. You're not like you just don't have that.
Dr. Grace Esan: I think. Yeah. The time blindness is, it really is a thing. And the hyper-focus, it really is a thing.
Cause I don't know about you, but I love, I think if I was not a physician, I might have been a policeman or policewoman because I love, I love the puzzles. Oh, we've got this and this and this is over here. Let's see if we can put it all together. Okay. So when, if I'm in that zone doing just that, then that kind of just disappears.
Dr. Diana Mercado-Marmarosh: Yeah. And usually like what you were saying, the things that you think is going to take an hour and it really takes five minutes of the things that are boring because our brain has like decided that's too much or too painful or too boring. So you should like try to avoid it like a playground.
Yeah. So do you think like your diagnosis impacts like you and your family or those around you? Like, have they ever told you oh my God, like you're interrupting me or have they ever tried to do the time thing? Like my husband does to me, like, try to make the time, like gives you extra plenty of time so that you could make places or stuff like that.
Dr. Grace Esan: I really, really, really, really do my best. To, not to schedule things around times that I need to go someplace because I'm very conscious of the fact that it's different if it's just me, but it's frustrating to my kids because they want to be, they want to get to school at the right time. And I think the worst feeling as a mom is to know that your child has tardies because of you.
It's totally different if the child was tardy because they were doing something else though, when it's because of you. I mean, you just have that. It's just bad. It's bad. Exactly. So I, I try not to schedule anything of interest, anything that is really interesting, at that time. And then the other thing I do, especially in the mornings, because the mornings are usually.
When, we have to like, you know, be on time. So I, I do everything as a routine in the morning. You get up, you brush your teeth, you take a shower, put your clothes on, and then you head out. I do not look at my phone, looking at my phone. It's a huge distraction. So let's not look at the phone. It's just head on out.
Dr. Diana Mercado-Marmarosh: Yeah, that is so important. What you're pointing out, you know, we all want to be a creature of habits. Habits, right? That's human nature, but we also have to be aware that there are certain things that can derail us. And like you just found the hack there, like to get you out the door, you have to do XYZ. And you know, that the pinpoint could be, we get on Facebook or tick-tock or Instagram or email or whatever.
Like sometimes I try to look at the labs before I go in and I'm like, I'm just going to call them on my way, because I'm going to get distracted by, you know, by a callback or something else. And before, you know, it you're like, oh my God, the kids are late. Like you said. Yeah.
Dr. Grace Esan: So I, I try not to do anything else. Just focus, get the kids to school. And then, everything else, I can do.
Dr. Diana Mercado-Marmarosh: And then everything flows. So, I mean, we've been talking about some of the things that, you know, can be sometimes a little bit more challenging with ADHD, but of course we all have amazing traits also with ADHD that make us who we are and have helped us to become who we become.
What do you think are some of those traits that you feel that might've been helpful and responsible for you succeeding and becoming the physician that you are.
Dr. Grace Esan: Okay. So the upside of having ADHD is, that we're very creative. We're creative, we're impulsive. Impulsivity is not always bad. Impulsivity can be actually. quite really, really cool because that impulsive, reach out to touch somebody when, you know, just instinctively touching a person and calling that person down or making that person feel better. That's impulsive. Oh my gosh, absolutely amazing today. You know, that just comes out of nowhere, makes that of a person's day. Having a problem. Something just crops up and everybody's like, oh my God. Oh my God, am I going to, I'll do this? Like, what's the big deal. Okay. So that happened. All right. You just, you do this, you do that. And the other person does this and it's really not a big deal. You know, the ability to kind of just like. I think because we're always late.
Maybe that maybe that's why
So your dress ripped. Okay. It's not a big deal. You know what? Come with me. We'll find some tellers to facilitate. We'll turn the dress inside, out, tape it back, tape it out, and then you can go finish up what you're doing. And then we can get rid of the dress, you know, the creativity and the spontaneity. I think is a huge gift. My kids never know what might be coming. I might turn around and look at them and say, you know what? Let's go get ice cream. Oh yeah. Or. Let's go away for the weekend, you know, without necessarily planning for it. And those, those kinds of things I actually think are priceless.
And so I think the creativity, the impulsivity, the ability to think outside the box, I think the plus is actually I whole lot more than the negatives. If, if I was to be asked about.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important because anytime we talk about ADHD and of course, this is why I'm doing this podcast to show that it can be a beautiful gift.
If you just pay attention and realize. How to unwrap it, right? Because with everything comes responsibility. And like you said, because we can think on our feet and because time is fluid for us, I feel like you said we are don't make it mean anything. If we have to try, A B, C, D until we kind of get to the solution.
And I think, like you said, we're not really judgemental with other people because sometimes we have to try different things and really not trying anything it's the fastest way to get stuck. Right. But if we're at least trying something, we know we're walking towards the solution. I think that's a, such an important trait because that allows you to be present with your patient right there.
And then you're not, you know, a thousand miles away you're right there. And then, and you're fluid with the situation and you're able to prioritize. If something else needs to take priority, you are able to jump onto that.
Dr. Grace Esan: To make a quick pivot.
Dr. Diana Mercado-Marmarosh: Yeah. So what do you feel like you spend most of your time doing and you wish maybe you would do a little bit less though.
Dr. Grace Esan: Are you talking about professionally or...
Dr. Diana Mercado-Marmarosh: However you want to answer
Dr. Grace Esan: Professionally? I spend a lot of time, you know, working, doing documentation. I really hate that. That's my nemesis. That's right. Actually skill is documentation. I'm not a big fan of documentation. And it seems like going from when I was in medical school to where we are now, it seems like I spend more time documenting stuff because we're collecting data.
And as far as I'm concerned, I really don't, you know, I'd rather just see the patients are. Yeah, I know the data is helpful, but I wish I didn't have to be the person to have to collect all that data. So documentation. Now at home, what would I, what would I say that I wish. For whatever reason is that I would say to actually just sit still,
for whatever reason, I'm constantly moving. Well, I know why I'm constantly moving constantly moving. I'm constantly on the move. I gotta do this. I gotta do this. I got to do this, but yeah. Seems actually just sit still.
Dr. Diana Mercado-Marmarosh: Yes. I totally relate to what I would want to do less of. And it's like, Less documentation as possible. And, I've tried to get the whole system and my clinic because I'm the medical director. So I'm like, if they can do it for me, they can do it for everybody else. So that it looks the same. So we, we get like the nurses to start the note so that they can, we know why they're coming. Of course they tell you one thing and then they tell them another.
So sometimes it works, sometimes it doesn't right, but at least the note has started. And then I've gotten away from writing paragraphs to like more like, bullet and try to get the HPI
Dr. Grace Esan: 'cause I do bullets too. I'm like, I do not do paragraphs. I want to be able to just look at it and know what it was. I did the last I don't the paragraphs. I do bullets. Here for this, and this and that...
Dr. Diana Mercado-Marmarosh: Yes. And then I tried to get that HPI to like mimic my assessment and plan. So that next time I see them, like, I can take the assessment and plan and plop it into the HPI if we're following something or whatever. And I try not to like put a lot of stuff. I just tried to put like diabetes dash on control dash, no changes done because A1C was a 10th patient noncompliant with meds, period. Like I'm not going to like, you know, and sometimes, you know, I give myself the five minutes between walking into the next patient to at least do my assessment and plan. And I try to give myself like so many nuggets to where I'll put like right foot cellulitis, X size. Dada allergic to antibiotic penicillin, given backdrop, like, so that later on, when I go do my note, I know it was the right versus the left foot.
Like I know more stuff to fill in the things that it's easier and doesn't take as much executive functioning thinking, right. Because I don't know how your EMR is, but mine, I would have to go into one area to see what meds I order another area to see labs or another area to see like problem list. So it would just take too much to try to construct what I had, what had happened that day. Right. And the 15 to 20 patients a day, like out of sight, out of mind. Right. So it was hard sometimes.
Dr. Grace Esan: Right, right. That is, that is very true. I'm going to ask you a question though. I'm going to ask why, why did you actually get evaluated for ADHD inmed school?
Dr. Diana Mercado-Marmarosh: So it was actually my roommate at that time, as she told me, she said, Diana, I think there's something wrong with you.
And I was like, why? She's like, I see you studying like 80 to a hundred hours. And I think I'm maybe studying like half that, if that she's like, I don't know if you're over studying to where you're so exhausted and you're not retaining the amount of information she's like, or maybe you're anxious or depressed.
My dad had just gotten diagnosed with cancer at that point. And so she's like, I don't know if that is keeping you from like, kind of being all in or whatever is going on. She's like, I think you need to go see somebody again in my mind. I didn't think it was a problem. That's what I've used to always do.
Like, I was always the last one to finish a test. I was always the last, I was always the one who even when they're pulling away the test, I'm like, hold on, let me just do C all the way down. Like in the last five or 10 that I didn't finish. Right. And so I didn't think that was a problem. I knew that whatever, my test scores were not super high to get into med school. And I was even put like on a probational program, like to get into med school, like they selected at the like 20 or 30 of us. And they said, you have to do the six week course before you start med school to make sure blah, blah, blah, blah, blah.
And so in my mind, I was used to working hard. I would outwork anybody if you gave me the opportunity to go into med school. Right. And so I didn't think it was a problem, but to her, she said, I think there's something going on because the amount of information, the amount of time you're doing it, I don't see you retaining it.
So that's how that happened. I ended up getting tested and sure enough, I had this time blindness, because again, I didn't even know it was a hundred hours. Like we get so focused into things that I thought it was like, you know, five hours or something. Right. So I didn't realize that was a problem. And I think now I understand that I didn't really have that much of a problem in high school because I was running like 10 miles a day, like with my cross country team and I was dancing and I was active. So I was getting all that dopamine. I was getting it from there. And then I get. College in my first year, like I almost like I was put on probation and I was like, oh my God, I'm like, I'm a straight A student. Like, how am I on probation? This doesn't make any sense. But now looking back, it makes sense because I didn't run anymore. Right. I was just sitting there, studying and I couldn't prioritize, it was a different style of testing the way that they were doing it from where I came from. And so I remember getting a C in chemistry and going to talk to the professor and they're like, and I was like, well, how did I get a C I've never got an, a C in my life.
And he's like, oh, this is average. I was like, I'm not an average student. And so it was just that realization that. I didn't realize I had gotten away with my grades because I would talk to people about it and I never had to prioritize like the whole book. Like to me, everything in the book was a priority.
So I couldn't tell what was more important than others. So then, but later on I realized, oh, I I'm more visual. So if I went to look at the pictures, then I could understand it. And then it was a lot easier than if I just ran into trying to read the book. And so when you were saying earlier about reading a book, I was like, oh my God, I haven't read a book in a while, but I've been listening to the audio.
So that's the work around the audible.
Dr. Grace Esan: Yeah I do audibles, all the time.
Dr. Diana Mercado-Marmarosh: So somebody else is reading it here for you. And then if you really want to, then you have the opportunity to go buy the Kindle or to, you know, because I already know that if I buy them, they're just going to be sitting on the shelf. I'm not going to open.
Dr. Grace Esan: The thing also is, with the articles, then I can still be puttering around.
And I guess I just have. , I don't know what it is unfortunately, or I am doing, but I just kind of constantly have to be touching something or doing something. So at least I am listening. I have the airport in my, in my ears and, and then I'm moving around. Like I said, I don't know what it is I'm moving around doing, but..
Dr. Diana Mercado-Marmarosh: No, but I mean, that makes sense because that also increases your dopamine.
I didn't realize that, that's how I got through med school. Like I will listen to the audio recordings and I was walking in. Two or three miles. And that's how the information would like sink in. Or if you were doing a task, like I hate doing the dishes, you know, doing the dishes or laundry or something that I'm not like, not so thrilled to do think when you pair it to something that you are enjoying, then it's like easier for you to retain, but because you are being active, it kind of gets, you know, more, more connections in your brain to step.
Dr. Grace Esan: That makes a lot of sense. Yeah. I'm more auditory. I retain things that I.
And some visual, but like med school was mostly what I heard. I could not write notes to save my life because I couldn't, I couldn't focus on, on processing what was being said and writing at the same time. It was not, that was not a thing I could not do that. So my work around for that was to know the people with the really good handwrites and on good notes and to spend all my pocket money..
Dr. Diana Mercado-Marmarosh: Hey, like that's the thing, right? Like one quickly learns how to help yourself if you know that that was not the thing. Like I knew, like I had to get a tutor. So that way, when we were talking, I could hear what they thought was important. Everything's important. And how do you want me to tell you? So you could only, I'm pretty sure.
I don't know if you have this problem, but you know, our notes at the beginning are always like a book. You're like, what? like they told me all this thing, how am I supposed to know? That's not important.
Dr. Grace Esan: Exactly.
Dr. Diana Mercado-Marmarosh: But you know, now you can laugh about it, but then it was like, life or death in your mind
Dr. Grace Esan: because you didn't know where.. It's overwhelming.
Dr. Diana Mercado-Marmarosh: Yeah. It's really funny. Like, you know, now, like I said, now you look back and you're like, oh, the irony of it, you know, I remember my first clinical rotation was actually family medicine and I did not pass that shelf exam. I was like, oh my God. And that's what I went into.... and I'm board certified now. Right. But it's just funny that you were supposed to have so much knowledge to do family medicine. Like you supposed to have known a little bit of surgery, a little bit of OB GYN, a little bit of like pediatrics, you have to know a little bit of everything. And that was my very first one.
So. Well, of course I didn't pass it. Like, how's that going to pass it? If I'm like brand new off the books and all of a sudden, like I have to do this test. Right. But then later on, of course, as you went through the rest of the rotations, you come back and you retake it and it was, it was fine, but it's just tells you how sometimes your experiences don't match up with the book.
So it is what it is. You just don't have to make it mean anything. And unfortunately, as we go through school, we're so used to validating ourselves through some like test scores.
Dr. Grace Esan: That's that's the only, I mean, there's no other instrument by which to measure, just how well we're doing re that's all we've got. And so based on that, because I don't know about other ADHD'ers, but I did not believe that most ADHD 'ers actually test as well as the intellect is.
Dr. Diana Mercado-Marmarosh: Right. Exactly.
Dr. Grace Esan: So because they have all this other things, and then you also have the fact that, you know, some people also have dyslexia in addition to the ADHD and have dysgraphia and you know, all the things too.
Dr. Diana Mercado-Marmarosh: Yes, exactly. So what do you think are your next goals for the next year?
Dr. Grace Esan: Next year . So this year is kind of, the beginning of a different chapter in my life because I am going to be an empty-nester this year. Both my kids are off to college. And so now I have all this time on my hands.
Now, the fact that I have all this time on my hand, um, I want to be, I want to make sure that I don't just use it for just, you know, just filling it with nonsense things that don't make sense. I want to actually make an impact or do something that is meaningful. And for me, what is meaningful is there's this ADHD journey that, I found myself being passionate about.
Being passionate about having children be diagnosed at an early, earlier age than middle school. Because like I tell the parents, I think the biggest thing for me is not really the academic performance, it's the hidden insults, emotional and social insults that's afflicted upon these kids because they can't remember stuff.
So they think that, they are constantly moving. So they think that they're troublesome. People are constantly redirecting them. So they think they're not liked or love because they're rough and they have no idea what boundaries are. Other kids will avoid them, so they don't get hurt. So they just think that nobody likes them.
And I think that it's not, I think that's horrible to have to grow up thinking that you're a problem you're lazy or you're a troublemaker. Nobody likes you. And it's only because you have this disorder that can be treated that makes you constantly move, makes you inattentive to visual cues, makes it inattentive to things going on around you makes you such that.
You're not performing well in class. So, that's my big thing. My weak thing is that. And then the other thing that's I have also found out in my practice is that there are women, there are lots of moms that actually get diagnosed in my office when I'm diagnosing their kids. So that's the other thing.
So my big thing for this next year is to actually, I've already whichever. I set up a business or sell. I say, it's not a practice because I'm not practicing medicine there. But what I want to do is I want to be able to give a voice to a woman, a lady, a gentleman, A child who's not being diagnosed and does not know how to get to the next level.
Does not know how to articulate what it is they're going through so that their doctors are able to help them. Because I read online where in all these places and chat rooms, Where you have all this ladies who have all the symptoms and the doctors are like adults don't have ADHD. ADHD is only something for a child.
So to where, if you come to me, I can help. I can help; A - evaluate you. And B - We give you, somewhat of a portfolio that you can take back to your physician, telling your physician, that based on all these symptoms. Yes. You meet the criteria for having ADHD or ADD, and then have that discussion with you before you go to your doctor about what your options are.
And therefore, when you go to your doctor, you can have an informed conversation with your doctor about what it is that is going on with you and how you want to navigate your ADHD diagnosis. So that's what I'm working on currently. I have a website, thrivewithdrgrace.Com. And then my emails thrivewithdrgrace@gmail.com, and then I have an Instagram handle, which is @thrivewithdrgrace.com, so if you want to go check it out, you can check it out. But that's what I'm working on. That's what I've been working on for the last few months. That's really, really my passion, because like I said it's crazy going through life and not even realizing that your life could actually be a whole lot better than what it is.
If only you knew what your diagnosis was and if only you're able to, to navigate your diagnosis. So that's what I got.
Dr. Diana Mercado-Marmarosh: Yes. That's such an important reminder that sometimes we forget about the females, like you said, this is an ADHD diagnosis that is hereditary, right. And a lot of females don't get diagnosed until their kid gets diagnosed or until they go to med school or law school or some college or they get promoted or they hit menopause. Right? And so. Probably because unfortunately, sometimes the females are the quiet ones in the room, so they're not causing too much ruckus. They're just kind of daydreaming. And there's not a lot of studies that have been made on females again, because " " there's too many hormones going on and they don't want to deal with that situation. Right? But I think it's finally changing. And what you're doing is so needed, 'cause like you said, you don't know what you don't know. And if you're not aware that you've been working like two times or three times or 10 times harder than somebody else, you're not aware that you're driving, you know, without your glasses, then it's kind of hard for you to do it any other way.
But being aware of what to say or how to advocate for yourself and what to expect. You know, that's the first step, right? Because unfortunately, if you do get the diagnosis medications, while they're going to help, they're not going to help everybody. And then there's also that emotional component to it. And all these other systems where coaching can be so helpful or a therapist or both, right?
Or in the addition of other stuff like, you know, exercise and meditation and journaling and all kinds of stuff. Right?
Dr. Grace Esan: All kinds of things. Yes. And I think also the other thing is if, you know, if you understand the reason why you're a certain way, then it explains a lot of things that then makes you know that you're not going crazy.
It doesn't become an excuse for you that not trying to figure out work around for yourself might help you understand the fact that you know what, I'm actually not a lazy person. I'm actually not, you know, I might be a procrastinator, but there's a reason why I'm the way I am.
And that's not an excuse. Cause I know what I need to do is figure out ways around the reason why I'm always late. Maybe I need to come up with a routine or the reason why I get that, like I just discussed our time blindness we've kind of figured out how to get it. We'll get the nurse to come knock on the door or I'll get the text message on my computer telling me it's it's time to move on, but you have to come up with workarounds, but if you don't even know that that's a thing you're just going to continue. You're going to beat yourself up. Like, I will tell you that I used to sit and wonder why it's, why it was that, my contemporary's to get all their work done much faster than I could. And I was walking as fast as I could. But what I didn't realize was that I was very inattentive. So even though I thought I was walking really fast, the truth is I'm working on this, but my, my mind is, is doing this. It's thinking about. All the things that thinking about what would happen if abstract things, lots of abstract stuff going on in my head while I am supposed to be doing this one task.
And so, you know, it just helps, it helps you in that. Oh, that's a reason for that. Okay. I get it. And so I don't feel so bad about it. I don't feel like I'm incompetent. I don't feel like I'm inept. I just know that I'm inattentive and therefore I need to figure out how to get my attention to focus.
Like you said, exercise helps, yoga helps,, meditation helps. Medication helps, like you said, not everybody needs medication, but there are some people who do. And so. Yes.
Dr. Diana Mercado-Marmarosh: That's so important, everything that you just shared, like the more that we understand ourselves and approach it from a curiosity point of view and understanding and being self-compassionate because all our life. We probably felt frustrated or irritated that we couldn't perform to the level that we wanted to. Right? And it's like a catch 22 because you're like, well, I want to lose weight. But then all of a sudden you're eating all these sugar when you're trying to complete a task. And you're like, I don't understand myself, I just have this goal, but then you don't realize that you're using that sugar as dopamine to get you to complete the tasks you have to do.
Right. But what are you doing? Meanwhile, you're like beating yourself up and telling yourself, like I'm broken, I'm dumb. I can't even do this. I can't stay on task. You know? But your body's going to ask for what it needs, you know, and for some people, unfortunately, it's, you know, alcohol smoking drugs and it can get us into all kinds of trouble. Right? If we're not aware, right. If we're not aware again. And so yes, it's really having this conversations to figure out, is there something else that might be going on other than me just thinking X, Y, and Z, because unfortunately, we're so busy that we don't slow down enough to ask. Is there a better way or is there a different way sometimes, right?
Dr. Grace Esan: That is very, very true. We don't, I mean, we just, we just go and it's not just us. It's everybody. We just would just go on and go and go. It's really difficult if you, if you're just going, going through all the motions and. Yeah, like this has done the wheels pedaling really, really, really, really hard, but not getting anywhere fast because.
Dr. Diana Mercado-Marmarosh: So my two kiddos are jumping on. They're trying to be part of this podcast as well. Anything else you would like to share with us before we let you go?
Dr. Grace Esan: No, I think, just to re-emphasize the fact that or that, I'm all about helping people thrive with their ADHD diagnosis from the very beginning, which is I'll help evaluate you and tell you, all right, here's, here's what I think I actually will set up a one hour consultation where I will consult with you and tell you, you know, Tell me all your, all the symptoms. And I'll tell you whether I think it's ADD and then I'll put together something for you to take to your doctor and also discuss with you what your options are.
Because like we just, we just went through all the options. Now there is medication there's therapy. There are alternatives is yoga. There's meditation, hen. There's wanting for those people who can ride, you know, that will all, all things that are guaranteed to increase the amount of dopamine release that your brain needs in other to be able to be focused. So.
Dr. Diana Mercado-Marmarosh: Well, thank you so much for coming, Dr. Grace Esan, it's been a pleasure to have you here. So like you heard her follow her on Instagram. Her handle is @thrivewithDrgrace or go to her website, thrivewithDrgrace.com and definitely reach out to her as you heard, both of us are here, sharing our story so that hopefully if you or somebody you know, is struggling and, you know, feels like maybe they're not fully realized they need to figure it out.
And don't be afraid to get a second or third opinion because unfortunately like Dr. Grace was saying earlier, you know, sometimes, people are easy to dismiss you because unfortunately, they don't realize how hard you're working, because maybe you're thriving in some other areas of your life, because like she just said, your emotional intelligence is not a marker of your ADHD.
Like you can be an amazing professional and it doesn't mean that. You know, you don't have ADHD, so definitely reach out. And, that way, either of us could help you, but, thank you again for your time,
Dr. Grace Esan: Thank you very very much for having me on thank you so much.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane.
About Dr. Grace Esan:
Dr. Esan is a Pediatrician in Evansville, Indiana.
She is Nigerian American who grew up in Lagos, Nigeria where she received her medical degree from the College of Medicine, University of Lagos.
She completed her Pediatrics residency training at the Bronx Lebanon Hospital Center in the Bronx, New York City.
She is board certified in Pediatrics. She specializes in the treatment of infants, children and adolescents at all stages of their growth and development, with an emphasis on ADHD, Anxiety/depression and Oppositional defiant disorder.
She has been in medical practice for over 20 years. Dr Esan is happily married and is the mother of 2 beautiful children and her pet Chihuahua.
Website: thrivewithdrgrace.com/
Email: Thrivewithdrgrace@gmail.com
Instagram: @Thrivewithdrgrace
Dr. Mitra Ayazifar: I should. And what I do, are two different things..
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello? Hello. I am so excited today to have one of my good physician friends here with me today. We're just going to be having a conversation that is probably a conversation that you might be thinking yourself. Whenever you get a little bit scattered mind or you feel like you get squirreled, you might be wondering if you have ADHD yourself.
You know, sometimes we're pulled in so many different directions. So me and Dr. Mitra Ayazifar are going to be talking today about what kind of questions you should ask. How can somebody gets screened for ADHD, and then is there anything wrong with us? Like, are we being perfectionist or are we being procrastinators or like, what's going on?
So we're just going to have a conversation and see where this takes us. But I want to introduce her. She's a very, very special guest and I'm so honored to have her here with me today. Dr. Mitra Ayazifar ,she is an MD of course, and she's an ophthalmologist in a solo, private practice in California. She is the owner and the CEO of Capital Eye Medical Group with two locations in grass valley and also one in Roseville.
And she partners. Patients to develop their best potential vision so they can live fully and enjoy their hobbies for many years to come. And we are so excited that she's also an ovarian cancer survivor. So, so much to talk about today. And I am so excited. She's here and she's willing to be all in to ask the certain questions, go for it.
Dr. Mitra Ayazifar: Thank you so much, Dr. Mercado for having me on here. I'm so excited to kind of express, I guess, some of the questions that go through my mind on a daily basis. And I'm sure I have so many colleagues and probably so many patients that, you know, wonder. Is it just that I'm disorganized? Is it that I need more organization systems?
Is it just that I have too many things on my to-do list? Or is it just that I don't want to do the things that I procrastinate on, so it always makes me wonder, Hey, is there a particular, you know, is there like a scale? Having ADHD, are there different variations or is it just that, you know what? I procrastinate and that's plain and simple, I guess I need answers to those questions.
Dr. Diana Mercado-Marmarosh: Awesome. Yeah, those are very good questions and you're right. People that sometimes have no awareness, whether this is just like, you know, too many things, it makes you wonder. But let me ask you one question before we jump into that. Do you feel like you have so much potential, but like you never fully reached that potential?
Have you ever felt that way or do you feel like no, I'm pretty content where am at.
Dr. Mitra Ayazifar: You know, obviously I felt that way before I joined, you know, Dr. Una's EntreMD business school, because I always felt like I wanna, you know, I want to provide more for my patients. I want to do more, more than just check their eyes more than just, you know, uh, check on their visual complaints. There's so much more that goes into it. And I think part of it just came from being on the other side and being a patient myself and wondering, wow, you know, there's so much out there that not necessarily every single physician, like, no, but we need to be our own advocate. And I try to be an advocate for my patients too.
Having joined the school. I think now I have so many things that I want to. You know, I love my practice. Thankfully. I love doing what I do. And I feel like, gosh, you know, like these experiences that I have, I want to somehow share it with, with patients or people. What else can I be doing? So that's, that's how I feel. I feel like now I have a path where I have the network and the support to kind of do the things I want to do.
Dr. Diana Mercado-Marmarosh: Yeah. And the reason I asked you that question is because a lot of my patients, because I'm a family medicine doctor, and when I do diagnose it, when they come in, you know, we do the screening questionnaire for anxiety and for depression.
And then I also give them the screening questionnaire for ADHD, which we're going to go through right now with you, just so we can see where we're at. But one of the things that they always tell me is that. They feel like they have a graveyard of unfinished projects that they have like 10,000 ideas and they feel like they can't do them all at once because they're so excited.
They want to do them all at once. And so they feel like they're never a hundred percent like realized or they had so much more potential. And like you said, maybe it, is that something that is so good that you pointed out that sometimes you might have ADHD and you're just not aware that you do because you unconsciously have set up your own systems or have placed yourself in an environment that allows you to thrive.
So for example, you might've married. Somebody who is very OCD and you didn't know. Right. And so they're kind of compensating for you, or maybe you be in a work environment where they don't mind that you're a little bit late. They don't care as long as you get your work done. And they're not like, why aren't you here at 8 51, you were supposed to start at nine.
You should have been 10 minutes early to be on time. And you know, you roll in at nine 30 and they would already fired you because you rolled it in at nine 30 and. Oh nine because you know, 9, 9, 59 it's still 9, you know? And so I don't know if you have felt any of this. Did you ever feel like you weren't a hundred percent realize where you want it to be.
Dr. Mitra Ayazifar: I think, you know, now that you're mentioning that this is probably why I respond, well, maybe I do better when I have a coach. So I feel like definitely, you know, having started the EBS has helped a lot. Also with like the health coaching. I feel like, okay, I know what I'm supposed to eat. I know what the philosophy is behind, you know, intermittent fasting and all of that.
But somehow that accountability seems to put me in a situation where I'm much more successful with it, you know, with the mindful marathon, shout out to Michelle, Quirk, you know, joining her program. I feel like, okay, if I told myself I'm going to train for a 5k. I'm not sure that I would, you know, stay on task, but then having these weekly, almost like homework helps me keep up with it and actually be excited about doing that.
So I wonder if everybody's like that or is that. Portion of ADHD that, you know, makes me do better with that. Just accountability in general. The only thing I have to say, you know, I'm my own boss at the moment. So she's really mean. And the only thing, the only thing I see is like on my, my desk, especially at one of my locations, goodness, you know that these papers are piling up and it's like, I've already taken care of the patient.
I've done the patient care, I've done the surgeries and it's all the other stuff that I need to do that that's not medical necessarily that I just don't like to do. Yes, I do.
It's painful. I barely get on my, I'd rather get on my, you know, on my phone and, you know, listen to a podcast or something else rather than do that. Oh my god. Yes. Yeah, yeah, yeah.
Dr. Diana Mercado-Marmarosh: And the thing is that even though it's boring and painful, you are probably going to delay it till the last minute. When somebody tells you I need this, otherwise X, Y, and Z concept. Because, and that's the thing with ADHD, and I know I haven't asked you the questionnaire, but the thing with ADHD is that it's almost a missed namer on the diagnosis because you hyper-focus on things that are of interest to you. Oh my God. Do we hyper focus? Like sometimes we think we're going to spend 20 minutes doing XYC two hours later. Are you done? And you're like, oh, what? Like you were so in the zone. So to say, and it could be very complex thing.
So like you just concentrated in a surgery and then, like you said, this other thing that seems like should take you literally five minutes to complete a form, they take you an hour because it's painful, like you just said. And so it's the executive function tasks that are boring, or when we decide to do it, like at the end of the day, when you already made 10,000 decisions throughout the day, and you're like, Ooh, I can't wait to do this task that is boring and painful, but I already did what I needed to already took care of the patient.
They have their meds. I'm done. Right. And, I always joke around and I say, how come nobody was videotaping this? Like, this was an amazing encounter. Like why don't like can't just somebody submit my video from them, like, and pay me like we did amazing. They just compliment me. Why do I still have to sit down and write it?
It's the thing where you leave your heart in the room and you realize how long you were in the room and then the time blindness of it. And then you go because you're a little bit late and then more late and more late, it adds up. And then you don't have time to do this boring thing that is the chart. Or the callback or some paper that has for FMLA or whatever.
Right. And then some of these things, unfortunately, are not paid for like the FMLA paperwork or something else that you're having to do. So it's like an additional task that you don't want to do. And so I don't know if any of that resonated with you, but let me ask you the questionnaire and see what you think.
Okay. All right. So to make it simple, we'll just say, we'll do like a 1, 2, 3, 1 being does not apply to me, three being like, yes, for sure. This is totally me. Okay. And then a two is like, yeah, I could see that, but it's, it's definitely not a no. Okay. So 1, 2, 3, but if we were doing the questionnaire, it's like five of them.
So I get, I don't know if you could remember five, but it's usually harder to remember. Never rarely, sometimes, often, very often. So that's why I'm just giving you either as a, never to sometimes, or the very often. Okay. That's what I'm going to have. Answer it think about it, like never sometimes or very often.
Okay. So the first question is how often do you have trouble wrapping up final details of a project? Once the challenging parts have been done? Let's say you already got like 80% of it done, but then you still have to wrap it up the final details. Like how troubling is that for you.
Dr. Mitra Ayazifar: Sometimes.
Dr. Diana Mercado-Marmarosh: Okay. How often do you have difficulty getting things in order when you have to do a task that requires organization?
Dr. Mitra Ayazifar: I guess. So right now I'm only focusing on my patients. Right. So without the systems that I have set in place where I double and triple check, you know, like the lens number and all of that, I would say it would be, I guess, sometimes still number two.
Dr. Diana Mercado-Marmarosh: How often do you have problems remembering appointments or obligations?
Dr. Mitra Ayazifar: Often, unless I have put it in my calendar and the alarm goes off.
Dr. Diana Mercado-Marmarosh: When you have a task that requires a lot of thought. How often do you avoid or delay even getting started?
Dr. Mitra Ayazifar: Often.
Dr. Diana Mercado-Marmarosh: How often do you feel like you're fidgeting or squirming with your hands or your feet? When you have to sit for a long.
Dr. Mitra Ayazifar: I would say a one.
Dr. Diana Mercado-Marmarosh: And how often do you feel you're overly active or you're compelled to do things like you were driven by a motor kind of like impulsive, like you just have to get to that right now.
Dr. Mitra Ayazifar: I would say not compostable. Never.
Dr. Diana Mercado-Marmarosh: Okay. So those were the first six. So if you had scored five of those had been up sometimes, or very often you would have scored a positive.
Right now you scored 1, 2, 3, 4. So you're a little bit shy of saying that you have ADHD right now. Let's do the bottom part and see what it shows. How often do you make careless mistakes? When you have to work on a boring or difficult project.
Dr. Mitra Ayazifar: Never. Because I just avoid them.
Dr. Diana Mercado-Marmarosh: I would say often that okay. Was they never because avoiding. Okay. Number eight.
Dr. Mitra Ayazifar: I don't even get to that point.
Dr. Diana Mercado-Marmarosh: How often do you have difficulty keeping your attention when you're doing boring or repetitive work?
Dr. Mitra Ayazifar: I would say a three because it's so boring, you know, it takes me longer.
Dr. Diana Mercado-Marmarosh: Yeah. How often do you have difficulty concentrating on what people are telling you, even when they're speaking directly at you?
Dr. Mitra Ayazifar: I would say never that's you know, that's the best part of, I feel like that's the best part of my job when I'm in the room and I'm listening, coming up, listening to patient's stories that I take so long in the room, my ma has to come and knock on the door. So I am paying. attention to what they're telling me.
Dr. Diana Mercado-Marmarosh: How often do you have misplaced or have difficulty finding things at home or at work?
Dr. Mitra Ayazifar: At home? I would say, often. It's usually my phone, my keys. Where's my computer.
Dr. Diana Mercado-Marmarosh: How often are you distracted by some activity or some noise that is around you?
Dr. Mitra Ayazifar: I would say sometimes. So that would be a two.
Dr. Diana Mercado-Marmarosh: How often do you leave your seat in meetings or another situation when you're expected to remain seated?
Dr. Mitra Ayazifar: Oh, never at work. I behave.
Dr. Diana Mercado-Marmarosh: How often do you feel restlessor fidgety?
Dr. Mitra Ayazifar: I guess sometimes it depends on the activity. I would say two.
Dr. Diana Mercado-Marmarosh: How often do you have difficulty unwinding and relaxing when you finally have time for yourself?
Dr. Mitra Ayazifar: I would say sometimes, two.
Dr. Diana Mercado-Marmarosh: How often do you find yourself talking too much when you're in a social situation?
Dr. Mitra Ayazifar: Never. I actually am pretty quiet.
Dr. Diana Mercado-Marmarosh: When you're in a conversation. How often do you find yourself finishing the sentences of other people when you're talking to them before they can even finish it themselves?
Dr. Mitra Ayazifar: I would say I actively am aware of that. So I would say never to sometimes I wish there was a one and a half somewhere.
Dr. Diana Mercado-Marmarosh: Okay. How often do you have difficulty waiting your turn in situations when there is turn-taking that is required?
Dr. Mitra Ayazifar: I would say, I would say never. I follow those rules. I mean, I am able to follow those rules.
Dr. Diana Mercado-Marmarosh: How often do you interrupt others? When they are very busy?
Dr. Mitra Ayazifar: Never.
Dr. Diana Mercado-Marmarosh: Okay. So on the bottom, an eight or more would have been considered positive. And on the bottom you scored 1, 2, 3, 4, 5, 5 out of eight. So on the top you scored four out of six and on the bottom you scored a five out of 12, so there's obviously some of the things that are there that could say, you know, that you have some possible ADHD characteristics, right. But this is a screening test. Like if you really wanted to know a little bit more in detail, they do have what is called neuropsych testing. And that's a little bit more eight or nine hour tests where it's almost like a neuro psych test. Right? So they'll give you some things for you to answer some pictures, some things to draw back they'll ask you questions, like math, all kinds of stuff, because they're trying to see how you're functioning.
The thing with ADHD is that especially in females, they don't tend to be diagnosed until later in age. Like usually after the birth of a child or after they go to like college or med school or law school or some type of professional school or. Promote it like to now be like the CEO of this, or like some level leadership thing, or sometimes even when they get to menopause because of the changes in the hormones and the low estrogen, like that can cause stuff to be more obvious.
And then females tend to be more inattentive type than hyperactive. So there might be missed. So it's like that female who was in the back of the room was quiet. Who's not screaming, who's just daydreaming. So they're like the perfect student for the teacher. Right. Because they're like, great. She's just in class.
And she said a little angel. She's not saying anything. I know aware that her mind is in 10,000 other places and not really right here. Right. And that's why I was asking some of those questions as you saw. How often do people tell you, Hey, but you were looking at me, how come you didn't catch none of that.
It seemed like you were like, did you space out? Like what happened, basically? What happened? You know? So that's the thing with that, right? Sometimes it gets, it gets a little fuzzy because they automatically assume, okay, well, she is. She's gotten this far, she graduated from college and sometimes they ask you, did you graduate from college?
And you say, yes. Are you married? And you say, yes. Do you have a job? And you say, yes. They're like, okay, you don't have ADHD. That's the old way. Like, but they don't know how hard it is for you to be carrying all the hats in the air. You might be doing it out of obligation or because you love what you're doing and you don't realize that you're doing it harder than somebody else is doing it.
And I think even in the profession, I feel like there's all these norms that get thrown at us. You know, you're supposed to work like you don't have a family and you're supposed to have a family. Like you don't have a job. I was asked recently by one of the male physicians that joined my group. He asked me, he's like, why is it that I'm one of like many females in this group?
He's like, how come I'm the only male? And he's a psychiatrist. And so I say, I'm not sure. Do you have any insight, am I saying the, the content wrong, you think I might not attracting male? Like you think I'm being exclusive. And he said, you know, I think it's because males tend to delegate tasks a lot easier than females do.
And so he said maybe his wife needs like the males, wife needs to come to your course. Cause I'm pretty sure they're burned out. He said, I'm pretty sure the males have no idea. That they even have ADHD because they're used to be in tardy and somebody else picks up their stuff. He's like, I'm not trying to generalize.
He's like, but as a male and a psychiatrist, he's like, I can tell you that males, you know, usually don't come to see me until they have hit rock bottom because somebody else has. Picked up their slack. Like maybe they got a divorce or maybe they failed board exams or whatever. He's like, otherwise they're not going to come and seek help.
And so it's just interesting how there's so much regarding ADHD that we still don't know. And then you throw in the genders in there and then like what sometimes we feel as females, like, we feel like this mother nurturing thing, we want to take care of everything. And we want to be perfect in all the areas.
Yeah. And so why do you think you procrastinate? Like, do you think it's just like you asked me that question, which we still haven't even acknowledged or discuss whether it is for procrastination or whether it's really just a form of, you know, of you just doing all the things. And sometimes we do need rests, but what makes you think that you procrastinate?
Dr. Mitra Ayazifar: You know, I actually was puzzled about this because we were, I mean, in a group and you might be too where we were going to read book about Brian, Tracy, with something about frogs. I forget it right now.
Dr. Diana Mercado-Marmarosh: Eat that frog!
Dr. Mitra Ayazifar: Eat that frog. Okay. So I downloaded it on my audible. I knew I'm like, okay, I'm in this group or I'm going to be listening to this on my commute because you know, when I go to my one location, I have 45 minutes each way. This is the perfect time to listen to this. Can I tell you it's been several months and I haven't finished it. I mean, I'm procrastinating on listening to a book on procrastination. I don't know what to say about that. I'm like, okay, I need to gain some insight. About what Brian, Tracy is saying about this.
And I haven't finished a book. I don't think it's because there are so many other things. I mean, there are so many other things that I want to do
Dr. Diana Mercado-Marmarosh: So tell me what what's going on. Like, are you putting it in, are you putting play, forgetting about it? Like what, what do you think is going on?
Dr. Mitra Ayazifar: I think I know it's there, obviously, because, you know, I even came over with the Tik Tok laughing about it, but I don't, there are other things obviously that I like to listen to also, but I know it's there. It's like it's it's right here. Saying, you know, Mitra, you haven't listened to me. This is no, you wanted to find out, you know, how to get around procrastination.
That's why I'm thinking. Well, maybe it's not just pure procrastination. Maybe it's ADHD. I need to figure it out. It's in my phone.
Dr. Diana Mercado-Marmarosh: Did you find it boring?
Dr. Mitra Ayazifar: Maybe, maybe I almost felt like, oh, I really need to sit down and take notes with this. And so if I was walking the dogs or if I was driving, that was probably not the best time for me to, I guess, take advantage of it.
But then when I do sit down, there's so many other things I, I need to do. Like that's not at the top of my list and yet I should figure it out. You know, I should. And what I do are two different.
Dr. Diana Mercado-Marmarosh: I give you a quick tip there any time we say I should do X, Y, and Z. We're never going to do it. No, it's it's like a innate wire thing somewhere, somebody told us we were supposed to do it a certain way. That's why you're saying I should be doing XYZ, but inner gut is telling you no. Fucking way. I'm not doing that. Like, it's just telling you, like, it's creating some type of visceral response, no matter what you're not going to, because it doesn't feel aligned with you.
It's not a value of you, at least not right. The second. It just doesn't feel right. And so just catch yourself any time you use that word, just get curious and become interested in why did I think that? So there's the thing like that. Yes, you're correct. There are certain books that you need to maybe hear two or three times, or you may have, you need to hear it and come back and you can get the gist, but you really need to sit down and like you said, journal on it or outline what it means or whatever.
And you're not going to catch everything at once, but at least you can go through. If you find it interesting with an open mind and curiosity, but I think some of us, we are like an all or nothing. It's either I'm all paying attention or I'm not paying attention at all. And so we want to get perfect. Like you said, all the notes, and like you said, when you sit down that all of a sudden that's not as important than something else.
In general people with ADHD. And even though we maybe with this screening tests, it's questionable whether you have it or not, but there's a lot of stuff that maybe that I'm saying that's still relate to you and can still be applicable for most of us it's now or not now. And if it's not now, if you don't put it in the calendar of when you're going to pick up that nugget again, it's just not going to happen.
It's just, won't, there's never going to be a perfect time when you're like. Oh, this is the perfect time to learn how to overcome my procrastination. Like never are you going to be like this is it! Right. And so if you, this is an intention of yours to like, at least get curious about it. It doesn't mean you have to apply anything, but if you get curious about it, then you're tapping into a different thing versus if you're walking in with, I should know how to figure this out, then you come in in with like an expectation that it's almost kind of negative. Like I should have already figured it out. Why am I so slow at this? Or why, why am I so dumb? Whatever, insert the line that your brain is probably offering.
That is probably not the best way to approach it. Anytime we throw the word around procrastination, our brain. It doesn't matter who it is. Our brain has equated efficiency or effectiveness to equal, worth or productivity. Right. When we talk about procrastination, we're like, that's a negative feeling or that's a negative thought or that's something I should not be doing.
Somebody, one of my clients pointed out to me the other day. She's like I had the most validating experience with my therapist the other day. She says, it's really beautiful when you're opening up to understanding yourself from a non judgemental way. Although I wasn't, she said I was being judgmental.
Like you just said earlier, when you said my boss is, so mean, we have this inner critic, right. For some reason, things that. They beat you up. Nobody else can tell you anything worse than what you already told yourself. So supposedly that's going to motivate you to like do it, right? Like put the fear in Jesus, in you.
So to say so that you can get it right. But we already know nobody functions their best when they're feeling like that. Right. But if you feel like loyal to your boss, like you're going to do all this other stuff. Right. Because it's aligned with you because it feels right because you're being accountable, like you said, and that's something with ADHD too.
We will do anything and everything for anybody else, not for ourselves, we forget. And so that's why self-care is so important, but you've have figured out the hack, that's showing up with somebody being accountable to somebody that's going to get you to then be like, okay, I can be tethered somewhere.
Like I had to come back to earth. Cause they're asking me questions right. With this being said, like, when you, you decide, okay, I'm going to. so what, what her therapist told her that getting back to that point was with a procrastination. She asked her, you know, she was telling her, I can't believe I did this again.
I have not done my grand rounds. I know I had to prepare this lecture. I knew like three weeks ago I had to prepare this lecture and like it's next week. I have to prepare my next, your legs weak. And haven't started. I like I knew for so much time and she's like, I always do this. I should show shoot.
So she was doing the shoot shoot, shoot. And then that there were solar. Whoa, whoa, whoa, whoa, stop. Stop. Right there. Stop right there. She said, do you work well under pressure? She said, yes. Have you finished your stuff under pressure before she said yes. So then why do you have to do it any other way? If this is a way you do it, then do it again.
Yeah. And she said, everybody says, I should have everything she's like, should, should, should. So she said, I felt validated that I didn't have to do it differently than I was doing, because I she's like really only takes me three hours because I already know what I want to say, but not until I have a deadline, do I have to jump in and do it?
And she's like, and I feel good about the outcome of that.. So she said I did it, I did the three hours, like, like I, she gave me permission to keep doing it and to not feel guilty about it. And she was like, and I felt proud that I was able to be somebody who could complete it. And she said, I felt good for the first time to use my own system.
Even though it looks like procrastination for somebody else, but this is the way I function. And it has never failed me before. Why do I have to beat myself up for listening to the way I function? That was so insightful. Now I'm not saying that to going Kershaw, everybody to leave everything to the last minute, but I'm just saying that sometimes depending on what task it is, especially a task that you have never done before.
You might have to break it up into chunks. Like maybe the first time, you know, you think of the idea, maybe the next time you researched the idea. Maybe the next time you do a dirty draft, maybe the next time you go and insert it, whatever, like you might have to break it down. But some of the stuff that we procrastinate on could be that either they're boring or in our brain, we have decided they're too big of a task to do right this second.
So we rather buffer with some other low hanging fruit.
Dr. Mitra Ayazifar: So I'm curious, like with someone, when do you say to someone that has ADHD and I'm sure you approach this many times where like they have to study for a board exam where it's not, you can't cram that. Like how do, how do you even coach them into doing
something like that?
Yeah. So with that, this is what we have to always explain to people is. Our brains, the ADHD brain is still curious. Like we are always going to be lifetime learners. It doesn't matter, which is good. And it's bad. I mean, it's always good, but it's bad in the sense when, like you just said, you're having to do this board exam, you're just supposed to give back the facts.
Like if they say. What are the three pre-renal, blah, blah, blah, blah, or pause Reno, blah, blah, blah, blah. Like you should be able to spit it out. Or like, if you see an MCV of a hundred, you should automatically be thinking, okay, well, it's going to be macrocytic anemia. I has to always be bottoming, B12 deficiency, or fully like, those should be things that you could put right by.
Dr. Diana Mercado-Marmarosh: People with ADHD, they're going to go read everything about macrocytic anemia, everything about folic acid. Like they're going to get lost in the weeds. They can't see the big picture when they read. They want to read every single letter. Because they're afraid they're going to miss something because they can't figure out that they need to prioritize and they don't get through the whole thing, but they need to learn to do it their own way to study.
They have to learn. Do I have to synthesize this by drawing? Do I have to synthesize this by making a flashcard? Do I have to synthesize this information by. Talking it out with my tutor because my tutor would tell me what is the actual prioritization of that data? Because in our mind, everything is a priority.
You can't figure out which one is the priority, and therefore you can see why some of them go through like questions and they do 10 questions. Three hours. You're like, sweetheart, you're not going to have three hours to do 10 questions, but they really want to learn every single little detail. And so this is where I say, I'm sorry, but the board exam is a memorization exam and you're never going to have 30 seconds.
To examine your patient. So right now, when you see this, you think this, when you see this, you think this, this is gonna be a different type of tests. This is not the type of test that you are going, the way you learn, which is okay, because you learn by further understanding. But you're going to have up-to-date in your exam room when you're seeing your patient, it'll be okay.
You're going to have time to bring them back and do whatever you need to. But for this board exams, they need to really know themselves. And this is where they have no insight what has worked before and what won't work before. This is where they really have to get curious. And it's so important that they use.
Work with like a learning specialist. There are some out there, or even with like an ADHD coach or just any, uh, learning coach, because then you start to figure out how your techniques work only for you. And you don't have to, it's normal for us to compare, like it's human nature for us to compare, but what you make it mean after that is what makes the difference, because if you were comparing and you're like, but they're so fast who cares?
You, how do you learn? How do you do it? Because they're not taking your test, you're taking the test. It's your name on the test? And so it's bringing it back and sometimes again, people want the all or nothing. They want the highest grade. I'm like, who cares? You just want a pass, a pass means MD. And so that's where, where we have to get back to that.
But that's a good question. Yeah. The standardized testings do not reflect how smart and how driven and how motivated somebody with ADHD is because it's just not a fair test because we're not used to spinning things back. We're used to understanding so many different levels and sometimes too detailed for what the test is asking.
Okay. So I think I
have a couple of plants, obviously. I think the book where I say, oh, I should listen to this. I think I've been trying to do it perfectly the first time. Right. So as you said, it's okay to go through it once, listen to it once, whether I'm walking or doing whatever, and then come back to it, listen again.
And then if I need to take. Take notes. And as far as I should, I think I need to get better with planning it. Okay. When am I planning on doing this? You know, and calendar. And just get to it, put a task list, prioritized and, and basically
get it done. Yeah. And even if you decide I'm going to listen to this for 10 minutes, if my ride is 45 minutes, I'm going to listen to it for 10 minutes.
I'm just, or I'm just going to listen it for one chapter. When he sees, he says, he's done with a chop there. Perfect. Then I'm going to listen to something else. Like it doesn't have to be all or nothing. Right. What have you just listened to it for five minutes is better than nothing. And it's just, you just get curious.
And that's the thing too. When I tell people when you're reading something, don't just jump into it. Like, look at the titles, look at the pictures, ask yourself a question from what you're looking at. Like, huh? What are the two types of blah, blah, blah. Like when you're looking at it, if you ask you questions from what you're doing, all the sudden you're reading with intention.
To grab information of the questions you create it from the, the bold words and the big titles, right? Not just diving in for, you don't even know for what. Right. And so now you're reading with intention. And so a lot of people have district Tuk, which I haven't done yet, but some have, whereas. If they like the book the first time around, or if they listened to it.
But they're like, like one of the books that I've been listening to, which is the way of integrity, each chapter has like a journal prompt, which like, again, you're on driving, so I can't be doing it. Right. But then I ordered the book. And then I'm like, oh my God, that's a big book. Thank God. I first listened to the audio because I wouldn't have opened the book otherwise.
Right. But then now, because I can go exactly to the book where I wanted to do, and then you can read the book with intention as, as well. You know what I mean? And so it's just doing it a different way and doing it and not being worried about it. Yeah, that, that definitely
makes sense. So yeah, I think just this perfectionism thing is not helpful at all.
It's like, why does it have to be perfect the first time? And there, there are definitely some of the books where audio books that will take me a lot longer. Like you said, it's like, I will listen to a chapter and it's, it's boring. It's good information, but it may be boring and I can't do it all in one sitting and I don't have to, so I'll come back to it at a different time.
And books like those, like you want to listen. So that's why if you break it up into chapters, like if you decide I'm just going to listen to one chapter, I'm going to just listen for 10 minutes and you're listening with the intention of what can I implement today? Like what little thing can I implement today?
Like eat the frog. He, he talks about doing the biggest task. First because that's like what you're trying to avoid, but, you know, while that's a good idea, not necessarily the right idea for everybody, because that might send them through a rabbit hole and three hours are gone, which might be okay. Right.
But what if for you, it worked better that you decided that you were going to do. Two of the tasks of when to take five minutes and that's going to get you pumped up and then you jump into the tasks. That's the hardest, because you're already going the brain can't tell. So once you start something you want to continue, right.
And so, again, there's not a right way. It's just, how can I implement? And the thing with all these books you take, what fits you, try it. And you let go of. It's just meant to, it stimulate your own brain to come up with your own ideas or try some of lawyers. Right. But these types of books where they're like self care books, they're not just meant to be like passive they're meant for you to try to.
Implement. And we already know, none of us are like, Ooh, I can't wait to change all my life today. You know, most of us are comfortable and even most of us are comfortable in being uncomfortable sometimes because we at least know where we are. And I always joke around. I see the tick there. Let me remove it.
You're like, Nope, Nope. Don't move it. I feel the pain. I know the pain and I'm like, no, I can pull it out. You'll be okay. No, no, leave it alone. You're like, okay, you're going to walk around with a tick on your butt. Yes. Leave it alone. Okay. You know, and so it's just funny how our human brain gets used to different things.
Absolutely. Absolutely. Is there a book about like, that's your favorite. You know, maybe not eat that frog something other than that, as far as like organizational skills or something
that you would suggest, well, I don't know about organizational skills per se right now. I'm still working on them myself, honestly.
But one book that I would suggest that I think you would really love. It's the four hour. Like, that's my goal, like to one day have only work four hours a week. Like how amazing would that be? And again, the way he talks about it, it's fun. He's telling you stories and he's telling you all kinds of stuff.
So it keeps you interactive and it makes you like, almost be like, Huh? That sounds amazing. At one point he goes through the whole thing. He says, you know, there was one time I had three VA's who were working for me all over the world. And it was funny cause I was in a fight with my wife. And instead of fighting with my wife, I send my VA a message to send her an email telling her blah, blah, blah, blah, blah.
And then of course I had to send the other VA a message to buy her flowers because I knew I had lost that fight, but still, you know, So it's so funny how he was like, you know, it's amazing to shoot somebody a quick email and be like, Hey, take care of this. And then you go to sleep and somebody in India or the Philippines or Australia takes care of it for you.
And because they're working, that's their norm or time zone. And so I think that's a book that you should definitely look into. I did listen to eat the frog. I liked some of the stuff, but other stuff, I was like, eh, For our workbook. I think that you would a four hour Workday that you would like that. Okay.
I'm going to
look into it for sure. And one more thing before we wrap this up, I mean, with procrastination and I think this is the thing for everybody. Sometimes it's not procrastination sometimes it's just that we're tired and we're trying to do things at a certain time. That that is just not ideal.
Like we're sometimes like some of us are trying to pajama chart, right? Like, you're trying to do something that requires executive function. Like when you have no time, like no energy, like, it just doesn't make sense. So sometimes some of these tasks, it's not that we're trying to procrastinate. It's just we're we feel like we're ignoring it, but we're at the same time, we're kind of listening to our body that this is not ideal.
Like, yeah. Jump on there. And it's going to be three hours for you to do, like what a, probably taking you 20. The next day after you had slept. Right. And again, I think we go back to this thing that society keeps shoving your procrastinator procrastinator. Well, what if I am like that? What if it means I'm an ideal restaurant?
You know, I like to rest, right. And so you just gotta figure out how are you using it and don't be using it to like, keep telling yourself there you're only worth the. Doing producing money for somebody else, you know, or for yourself?
No, that's, those are very valid points. It's almost like, oh, well, if I have the diagnosis of
ADHD leading that, that, that makes
it okay.
That I'm, you know, procrastinating. I don't know what I was looking for, but I know these are definitely questions that probably other people have also. And. I, you know, obviously for my patient care and everything, there are certain things that I have like 10,000 checkpoints, just because I want to make sure and double check and triple check everything about them.
But this is more like the things I need to take care of.
And here's the thing that it just, because today, maybe the way you answered the questionnaire, it doesn't seem like you have ADHD. It doesn't mean that that was correct, because what happens is people with ADHD, they might tomorrow my ask you, and you might have a totally different answer.
This is funny, but it's not funny because people with ADHD. One day, my answer, based on what they're thinking and another day based on what they're feeling, sometimes they don't match. And so the people that don't have ADHD, you ask them the question. It doesn't matter what day you ask them, or what year you ask them.
They'll give you the exact same answer. People with ADHD. I'm telling you one day to the other, they changed. And then you can see why everybody around you is so confused. They're like, but yesterday. I said, and I was like, yeah, that was yesterday. What about it? You know,
You know, and so, so you could see how you're not meaning to be difficult, but they say, they call you difficult, but you're not trying to. And you're just like, yeah, that was what I was feeling yesterday. But today I'm thinking this and you're like, they're not the same. No, because yesterday I was mad and today I'm super excited.
And today, and today I'm thinking that this is doable, but yesterday was an impossible. And they're just like, oh my God. And so, so I'm just telling you this, because what I have seen is that, that at work, because again, our level of responsibility that we might be functioning, because you answered a lot of question based on how you were doing work.
But if you answer the question based on work and home, it might show something else because. You might've already spent or your executive energy at work and you come home and you're like hot mess. Like you almost feel disconnected. And so that we, something else to like look into, because like you said, you might have all these checks lists and you have developed your systems unaware that you have developed systems, but it could be because you were so careful.
Not on purpose, of course, because this is something not that we do. It's just that again, we jumped from one thing to another, to another, uh, and we have a time blindness and everything comes at us and we get overwhelmed and sometimes irritated because we can't prioritize because everything seems so important right.
At that moment. And so what happens is then you have those checklists. So therefore you don't think there's a problem there for ADHD, but if you were to take away those systems, damn hot mess here. See what I'm saying, they could have been somewhere along the way you might've gotten burned and you're like, oh no, we're going to way over turn it all the other way.
And so now you're way compensated by checking 3, 4, 5 times where somebody else never checks more than once. Like they just totally trust themselves. Not that I'm saying that you don't trust yourself. I'm just saying in general people overcompensate, sometimes for that.
Dr. Mitra Ayazifar: Yeah, no, I totally understand.
Dr. Diana Mercado-Marmarosh: Yeah.
So now I just give you more things for you to go home and think about, and just be curious and just observe don't judge, just observe and don't judge, right. Just be like, huh? Like when, when do I function? And what am I not wanting to do? And just get curious with it and be like, where is it a hot mess?
Because you know, in my, in my course, it sounds funny, but I actually have a declutter coach. And like, you would be surprised like that my, my physicians are like, yeah, keep that part. Don't don't let go of that part. Like, you wouldn't think that. You know, people like paper clutter, or like systems with like, I don't know why we have 10,000 lids that don't match, you know, and, and socks that don't match.
And you're just like, where did they go? I know it was like the stocks become lids. I dunno. The
Dr. Mitra Ayazifar: clutter coach did that. That would be very interesting. Yeah.
Dr. Diana Mercado-Marmarosh: Hey, I'll refer you. She's amazing. So tell me, where can people come and find you? Cause it sounds like you're doing amazing things over there taking care of people's eyes.
And, and I always think that they should go see a physician, especially our diabetic patients. Right.
Dr. Mitra Ayazifar: Right. Um, so I am, um, my website, you can find me at www cap. I med.com, C a P E Y E M
Dr. Diana Mercado-Marmarosh: E d.com.
Dr. Mitra Ayazifar: Um, I will share my link tree, which has my tick-tock has my Instagram and my Facebook, but basically my practice is in Northern California.
And it's called capital I'm medical group. I am my boss. That's why I said she's mean. And
Dr. Diana Mercado-Marmarosh: so I get to say that she's working on she's working on getting better and I'll give you another trick real quick with that. And I picked up this trick at an emotional intelligence course. I didn't even know they had those courses, but they do basically.
Any time you catch yourself being mean to yourself or a thought that just pops up, that you don't even realize that it's not the truth, but it's, it's kind of hurtful picture your, your S your niece who's three years old, or your daughter who's three years old saying that thought to you. Or that somebody's told that thought to them, like, let's say if the thought is like, you're too, you're too loud or you're too, you're too fat or you're too slow.
Whatever thought all of us have a thought that keeps popping up in whatever we're doing. Picture a three-year-old being told that somebody, you, you carry that your daughter like that, they just told you that you're just. Or you're just low or whatever. Right. And she's coming to you asking you for advice.
Like what would you tell her? You're probably going to give her some advice that you're going to, the mama bear is going to come out, right. You're not going to hit her being talked to, and it doesn't have to be even your daughter. It could be anybody that you were being seen wrong. Right. And so it's so weird how we.
We'll have so much more compassion for somebody else, but ourselves. And so when you do that, all of a sudden, even your three-year-old take, take your own three three-year-old picture of yourself and, and, and defend that person really. Because at the end of the day, again, You can get more bees with honey than you can with vinegar.
That's true. That's for sure.
Dr. Mitra Ayazifar: Thank you so much. I appreciate your time. Thank you so much for interviewing me.
Dr. Diana Mercado-Marmarosh: Thank you for asking all these questions, because I really think there's a lots of people out there wondering this thing. So these are perfect questions because like I said, unfortunately, and this is why we're having this conversation.
Unfortunately. Females are not given that opportunity to be screened for ADHD if they are smarter, older, educated. Right. Because they just assumed that no, that's just a shallow thing, blah, blah, blah, blah, blah. Right. And so they will spend so many years with a diagnosis of anxiety or depression. And never get to the right thing until somebody else picks it up.
Right. And so if you find yourself, like you said, Lucy, and all the keys spending, having to spend extra money on late fees or, you know, being impulsive sometimes and buying all the things or, you know, just. Watch out for that. Cause it might be something else.
Dr. Mitra Ayazifar: Thank you very much. Now I'm going to be definitely checking in with myself more often.
Dr. Diana Mercado-Marmarosh: All right. Well, thank you so much. Have a blessed day. Thanks. You too.
As omeone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group. Beyond ADHD, a physician's perspective so that you never missed an opportunity to create time at will do share this podcast with your friends.
I can learn to live life and stay in their own lane.
About Dr. Mitra Ayazifar
Dr. Ayazifar is an Ophthalmologist practicing in CA and has been practicing for over 25 years. Her goal is to make a positive difference in the health of her patients in need. She believes that vision care goes far beyond a simple eye examination.
Website: capeyemed.com/
Instagram: Instagram.com/mitramd3/
Facebook: facebook.com/DrMitracapeyemed
Tiktok: tiktok.com/@drmitramd?
Dr. Jia Ng: Writing is very cognitively demanding. We always think that writing is only words on paper, but actually writing comes from processing. When you just go in to a session, thinking that is going to come up with it within five minutes is impossible. Academic writing is nobody's first language. Everybody has trouble when they first start, there is a structure behind it and there is a skill.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Okay. I am so excited today. I am going to talk to a dear friend of mine. This is Dr. Jia Ng, and she's a board certified nephrologist and a clinical researcher at the sector school of medicine at Foshe Scott Northwell. And she's also the founder of PublishedMD. Where she coaches clinicians on how to publish research papers and achieve their academic goals without the overwhelm., oh my God, this is such a needed thing.
You know, one of my biggest limiting beliefs is that I'm not a good writer, that I'm a slow writer that I can never publish anything. I remember it was always so painful to do, you know, any type of like project that required writing. I would rather be like, can I turn in a video? You know, but obviously you need to be able to communicate in written form and also, you know, through video or whatever form. Right?
I am so excited to have you here so that you can share it tricks and anything, but I'm very curious. How did you decide to coach other clinicians to do this? The writing part? I know a lot of us have problems with writing notes, much less something more like this, like a research paper and stuff.
Dr. Jia Ng: Thank you so much for having me. Yes. I went into this because I was struggling myself. And first I am, English is not my first language. And then I came in thinking I wanted to do research and I struggled for a whole year. Could not write, could not get first draft all my projects. I like abstract conference abstracts, but never a full paper.
And so I know the struggles and after getting, courses and coaches, because that's my path. I found certain ways. And so then habits that really helped me. And so now I see clinicians in the same pain and I know I can help you. So I decided, and I was giving workshops and saw the results like, oh, just by doing simple steps, you can improve and you can like get it.
So that's why I kind of started doing this.
Dr. Diana Mercado-Marmarosh: That's so great to hear that we all like simple, believe me, your brain wants to tell us it's no, no, it's complicated. I can't even start. So when you break it down and make it simple that at least sparkles or interest, and obviously we got through med school, right.
So we could do, we do a thing or two there, and it's interesting. English is also my second line. Primarily Spanish speaking first, up to the age of 10. And then I, I learned English. When did, what is your primary language? And then when did you learn English?
Dr. Jia Ng: So, I'm Malaysian. I went to actually a Mandarin school and we learned Malay and English as part of. Even though I speak English as Malaysian English, which is somewhat broken with a mixture of dialect can in there. So when I write my, my essay it's is usually, I've missed either grammatical errors or spelling errors. So that's, that's my issue with writing initially.
Dr. Diana Mercado-Marmarosh: Yeah for us, we call it TexMex, you know, Texas English and Spanish mixed together TexMex.
And some, we make up some words that have nothing to do with like either English or Spanish, but whatever it's fun. Right. So tell me. Have you ever worked with anybody who has ADHD or have you, what do you think would be some tips or techniques that might help somebody who has, you know, in their mind, maybe a limiting belief.
You don't have to have ADHD to think you're not a good writer, but some of us with ADHD have that belief. What kind of advice would you give them?
Dr. Jia Ng: Yes, there's this myth like you birth is you feel like you have to be a naturally good writer. That that is a big myth because it is a skill. And I would even say that academic writing or academic writing is not, is nobody's first language.
So everybody has trouble when they first start, there is a structure behind it and there is a skill. So usually first you need to know. The, the invisible structure in a paper, like what goes in, what, where, and even though like the discussion section looks like paragraphs of something, but actually if you look closely and if you know the insight part, there is a structure like paragraph one, You need to write something, paragraph two, you need to write so then wait. So, there is a structure, first know the structure, what needs to go in where, and, and once you go there, it is more like, how do you break it down? Which section needs to have only methods, which only have certain results and you don't mix them. And it's very prescriptive. It's almost prescriptive that that's why it's easier once you know, the, the prescription or the algorithm. I find it easy.
Dr. Diana Mercado-Marmarosh: You know, you bring such a good point up. Most of us, any tasks that we're trying to do, if we don't understand the rules of the game, right. Or the task, it's going to feel impossible. Right? If you are giving the 411 Hey, This goes here, this goes here, this goes here then at now it doesn't seem like such a big task or such a big thing. And so how long have you been writing or publishing papers yourself?
Dr. Jia Ng: I would say four years. No, no. I've finished my fellowship two years ago. So that means that was the time it was my biggest struggle. Couldn't get any paper out. And so truly writing it's two years more intense writing. And, you know, when you set about that structure, like HPI, you know, when we first write our notes, assessment and plan it is always just a mess, but now you've been a physician or attending for a long time. Oh, everything's easy. This goes here. This goes there. So paper is the same. You just need to know the underlying structure.
Dr. Diana Mercado-Marmarosh: Yeah, that's so good. I mean, I always tell my patients, like, if you don't even understand why I'm having you check your sugars or what is actually a carb, like, how are you going to win at this game?
It doesn't make sense for me to just tell you here, some meds. Goodbye. Right. I said, because you know, your diet is obviously going to negate. If you go and drink, you know, a whole 12 cans, right. That cost you $5 of Coke. Those $5 Cokes are going to negate your $2,000 insulin or Tresiba, right.
And so it's the same thing with our brain. If we allow one. To say, like you're not a good writer, like that might negate the whole experience. That of what, if you could have shared your findings with the world and it made a change, right? Yeah.
Dr. Jia Ng: Yeah, exactly. That's, that's why I'm doing this. Like, if I can help one clinician do it, that one paper means they can help a hundred patients. And that means I would indirectly I'm helping another a hundred patients. So, so that, that's why I want to do this.
Dr. Diana Mercado-Marmarosh: Yeah. So you're trying to help spread the word and make more of an impact for others, right? Yeah. That's, amazing. So, what do you think are one of the biggest challenges when people are trying to do the, this research papers or any writing in general?
I mean, you just said, if you don't know the structure, but what do you think are other things that can get in people's way when they're trying to do something like this?
Dr. Jia Ng: So first is the writer's block, try and put too much in, in too many hours. So writing is very cognitively demanding. So we always think that writing is only when words on paper, but actually writing comes from a processing, synthesis.
So you first need to read the words. Then needs to synthesize and transform it into an idea, then idea, go to the paper and then paper, you need to write over, over again to get a clear, beautiful message. Right? So this whole process is like five or six steps. And when you just go in to a session, thinking that is going to come up with it within five minutes is impossible.
Even for the most, the experienced person don't do that. So sometimes I think it's better to flip kind of think through, oh, at this, this time I'm actually only doing synthesizing. I'm writing is part of my writing activity, but I'm only thinking about idea. Let me form my idea. Maybe I'm just scribbling.
And so you take the pressure off of trying to write a beautiful paragraph within that session. So, so that's one like taking off the pressure. Second thing. It's better to do a short, intense focus within like 20 to 50 minutes instead of four hours. Because as I say, it takes so much energy that once you're done, and if you don't build a habit that you can't do more than 15 minutes, if it's a, if you haven't written a paper forever or any, you can't expect to do it.
So I usually coach, say, you start with. 10 minutes, get the flow. Even if nothing's coming out, you just write, oh, I can't figure out something. Or let me scribble a few things out. Just the whole thought to hand to paper, that itself is a skill, a cognitive skill that needs to be a habit that needs to be built.
Dr. Diana Mercado-Marmarosh: You know, you just describe one of the key things that I coach my clients every single time. It's that initiation state of taking off the pressure. When we have a backlog, it's almost daunting to look at that in-basket or to look at that amount of charts that you have to close. We are used to sitting there for eight hours and like, almost like quicksand.
Right? You feel like you're not productive. And so the first thing I tell him is, yeah, you're gonna do 20 minutes. Short, intense focus, no phone, no Instagram, no Tiktok, you know, NO! You're gonna work and then five minute break, 25 minute break. And I said, max, two hours. That's it. Even though I know you want to sit there for eight.
No, you're not doing that because you're going to get the same amount in the short amount of time versus the eight. I've done this before. I've done it multiple, multiple times and people have. Themselves now all my clients. And they're like, oh my God, you're a genius. I'm like, I'm not trial and error. You just do trial and error because what happens is that, like you just said, there's certain amount of executive function that is required and certain amounts of energy level that is required.
Like you have to know any of you tell yourself that you're going to. Yeah, eight hours or four hours to writing. That's intimidated for the brain sometimes. Right?
Dr. Jia Ng: Right.
Dr. Diana Mercado-Marmarosh: Exactly. You freeze up, but if you tell yourself, like you just said, well, whatever comes out in 10 minutes and then walk away, then there's like, like you said, there's no pressure, but more importantly, what you tapped into is that 1% initiation, because people with ADHD.
We can think about it like the mountain, but we don't realize that it only takes one step to start climbing the mountain. Like you don't need the whole mile up, you just need one step. Right. And just when you start, then it's easier to take the second step and the third step and the fourth step. And then you look back and you're like, oh my God, I come this far.
But then work people who want to complete tasks, we do. And so then that 1% where those 10 minutes. Are so good because they breaks through that. Well, I'll wait for the perfect time. When, when the hell is it going to be the perfect time, it's never going to be the perfect time. Right? And so sometimes you have to have a messy first draft.
And that's what I say do have messy first draft, because you're so much ahead because you started it.
Dr. Jia Ng: Right! You know, you're charting and in academic writing is exactly the theme. So would a messy first draft and sometimes, and you talk about. What often happen is, oh, you start the first sentence in, oh, I need to find out a statistics.
Then you start open the Google, Google scholar and you start looking for statistics and then, you know, like the tent article, anything. So, so instead I say you put a placeholder and you just type and you put, oh, need to find steps. Parenthesis or you find a better word, then you move on. It's like, oh, mortality. I think I need a better word, just put, need a better word and move on until you're done. And you're like, oh, maybe let me think about a better word. Find us the SAR is, you know, so, so then you, you at least have something on a paper and you can chip away, you know, you first need to have the stone. before you can start, what do you call it? Carving it.
Dr. Diana Mercado-Marmarosh: Yeah, that's perfect. You're so right. You need to, you need to just start. And like you said, you don't have to have the details. All your brain wants you to. I have to have that detail before I move on. And like you said, you can squirrel yourself. You're all of a sudden you're your tent. And then you forgot because something else was more interesting when you were reading, you forgot what's the statistic you were looking for there, right?
Like all of a sudden you have all these. Statistics and you're like, wait, was I going to, I don't think that was the point of that paragraph, but it sounded good. So now you post it in there and that was not even what you meant, yeah, so that's so good because then, like you said, Another day, you can come back.
Like maybe the first day you just did one part and then another day you come, maybe the D that's when you go and research and do all that squirreling or whatever you want to say it, you research and you find the articles that are more credible or not, or which one supports it or not. And then maybe another day you then read, was that really what I wanted to say or not?
Right. And so you can break it up.
Dr. Jia Ng: Right. Right. In fact, I, even for editing, I have a system. So I think writing comes with systems that help us everything. So when I edit, I don't edit words first I go look by. Hmm. Does the, does it overall, does the paragraph look like it flows even though that's grammatical error?
So I just go with big, big chunks. Firs I edit first round. Let me just make sure the ideas. Uh, sequence. All right. Ordered once. That's good. Then let me look at each paragraph. Is that too much extra fluff, then only I go to each sentence. Then only I go to, each individual words then wordsmithing, then, then the next round.
Okay. Let me put all of the references. Then here, I spend one whole hour looking at articles first, looking at stats and looking for this. So if you have a process, then you are not context switching and not switching from one task to another. That makes it faster. And you, because you're breaking it down, it's like, okay, I'm just going to spend 20 minutes looking at 10 articles, and that's it.
Dr. Diana Mercado-Marmarosh: Wow. That's that's genius. You know, you're pointing out stuff about task switching. That's something that I like hone in in my course, because we don't realize like, people always say, well, just batch stuff, just batch stuff. Well, when you batch stuff, we don't realize we're tasked with jeans. Sometimes if we're not careful, like it takes a different amount of executive function.
Or I call it energy level or thinking process. However you want to define it to synthesize, like you just said, and then another is just to scan, right? Like it's different areas. So sometimes when you go from like, just writing your first draft to wanting to have your final draft, like you're missing the steps in between.
And that's where you're, you might be task switching, because like you said, now you're thinking, oh, I just thought about that idea, but then I'm looking for this other journal and I'm looking for that. And so you're going back and forth. You're not, like you said, there's not a sequence that you're doing, so you are helping them set up their systems so that they do one task at a time so that they're not scaterred everywhere. And so it makes it more manageable in a stepwise approach.
Dr. Jia Ng: Right? Exactly. Exactly. Yeah.
Dr. Diana Mercado-Marmarosh: That's great. How can people like contact you and like find out ways to work with you? Because I'm pretty sure you're going to have a lot of people be like, okay, yes, I need a system. Cause I'm all over the place. And it's going to take me like six months to do something, to even choose a topic.
Dr. Jia Ng: Yes, yes. Right. Choosing a topic. It's also a big thing because we always think it has to be a sexy topic, but, but actually we, the, the topics are already in it's because, um, you see patients all the time. That's where your questions are, you know, where the problem is.
And, and research is not about just creating data, but solving a clinical problem or solving a research problem. So we have it in us. It's just that sometimes we need to know how to dig the questions, then you can answer the question. So, so that's a whole another topic, but bottom line is, it is in us. And if you know how to draw that out, you can find it.
Dr. Diana Mercado-Marmarosh: Yeah. So tell me how, like, how do you see yourself in three years? What are your goals?
Dr. Jia Ng: In three years, what really hoping is to expand how to create the system that I can replicate for many people, not just in a small group, but to more, more and more people, because it is so simple. Sometimes it's so simple that, oh, I can't believe it's so simple.
They just follow the steps. Then you can do it. And so I want to spread it to as many people as possible, hopefully institutions, because that's where the gaps are because academic clinicians, they, they need to publish papers, but never got training. And so that's a gap. How do you expect people to publish papers when you have never thought that taught them how to do it?
Like me go to medical school to see patients, but we ex we are expected to publish papers, but never got trained. So I want to fill that gap. That's where I'm going for.
Dr. Diana Mercado-Marmarosh: And in terms of your personal life, what are the next big goals of audacious goals or fun goals that you have for the next three years?
Dr. Jia Ng: Next three years, I really want to con continue coaching in a group setting.
But now I want to be going to universities and doing workshops. That's, that's where I'm really heading, because, that will be where they can get the most out of it. Like during that time period where the training, or when it up for promotion does a good time where, okay. They are motivated. It's been, I can help them and then, you know, kind of match made in heaven that way.
Dr. Diana Mercado-Marmarosh: And do you have any things that you want to do, like for fun? Like, are you, do you like to go travel? Are you, do you have any goals or something you're looking forward to now that the pandemic seems to be slowing down enough?
Dr. Jia Ng: Yes. One day we're hoping to go through Iceland to see the Northern lights.
So I think that's my next goal. We were going to go this year, but we were not sure that the COVID situation is the war. So, so we decided whole off.
Dr. Diana Mercado-Marmarosh: Well, I'm so intrigued. Yeah. It's, it's always amazing to learn from other cultures and other environments around us. Like the Northern lights. I that's in my bucket list too, one day to go and see that over there.
So tell me, I mean, you know, that sometimes we space out, right? And so if my podcast person am I on the other side, Finally started listening and paying attention. What is one piece of advice that you would give them if they just started to pay attention? And what would you do?
Dr. Jia Ng: I would say the, to repeat back, my point is make it so small chunks of writing, right?
Writing does not come naturally. So don't, don't even think it's supposed to come naturally. You actually need to build a habit, start small in small chunks and limit yourself. If you can do 20 minutes. Great. I like to put the timer. If you can, once you get a habit go to 50 minutes, but more than 50 minutes. Take a break.
And then you do a second session as like what Dr. Diana said really no more than two hours, unless you are a seasoned writer. So that's the first one. And the second thing is I can't emphasize enough. This one I did not mention earlier is you have to write during the daytime when your brain is clear, not in the middle of the night, not after your kid's asleep, not after you have finishing, finishing all your patients.
That's not the right time to do writing because. It is so cognitively demanding. So you have to however it is, you may skip a committee meeting here and there, but you're writing. You need to do it at your clearest time.
Dr. Diana Mercado-Marmarosh: Yes, that's so nice to hear that you two have tapped into the whole thing about writing.
When your head is clear when your energy level is up for today. I don't
know why physicians think that it's the writing or notes, you know, it's such an easy thing
to do and it's pajama charting right? Like. And so if you don't take that too to that level, then it just becomes harder.
Dr. Jia Ng: Yeah. Like what you said, but the word respect, you know, writing needs to get some respect from you that the true attention that it deserves. So it does need that.
Dr. Diana Mercado-Marmarosh: Yeah. So, awesome. Well, it was amazing chatting with you where can they find you, like tell us all your social media stuff.
Dr. Jia Ng: So you can find me on my website. I think it has everything. Www.publishedandb.com and I do have a YouTube channel. You can search, it's also published MD there.
I give tips and strategies on, more, more than. How do you write academically, you know, the style and how do you break it down? How do you read a paper fast? How do you like all the tips that we take for granted, but, oh, I wish I knew that then I could have, not squeeze it two hours or two months of my time.
Dr. Diana Mercado-Marmarosh: Yeah. So good. Well, there you have it. Go follow her. Don't make writing harder than it is. Bust those limiting beliefs and find an amazing coach right here. You can't get it any easier. The simple systems to support you all the way as you publish your research papers. Dr. Jia has your back. So go talk to her, break it up and get yourself published because the rest of the people need you.
Dr. Jia Ng: Thank you so much!
Dr. Diana Mercado-Marmarosh: Someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group. Beyond ADHD, a physician's perspective so that you never missed an opportunity to create time at will do share this podcast with your friends.
I can learn to live life and stay in their own lane.
About Dr. Jia Hwei Ng
Dr. Jia Ng is a Nephrologist and Researcher, founder of PublishedMD and her mission is to help busy clinicians publish papers and achieve their academic goals.
Website: https://www.publishedmd.com
Email: info@publishedmd.com
YouTube: https://www.youtube.com/c/PublishedMD/videos
Twitter: https://twitter.com/jiahweing
Dr. Weili Gray: You know, your life is worth it. We only get to live once. So get to know yourself. What, is the life that you want to live? And what's stopping you because whatever is stopping you, there are ways to overcome that. Live the life that you want and live it now because tomorrow may not be there.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Oh, my goodness. I am so excited today to have a dear friend with me. It is a very, very special treat that you guys have today is Dr. Weilli Gray. She's a board certified sleep integrative and lifestyle medicine physician say that fast three times who practices in Vermont. She is also a Registered Life Planner and the founder of Dare To Dream Physician, where she offers life planning and host a weekly podcasts. So excited to have you here. I want to ask you all the things, but first, first of all, we'll start with, how did you decide to become a life planner in addition to all your other hats, all those board certifications.
Dr. Weili Gray: Yeah, well, first, thanks so much for spontaneously inviting me on your podcast. You know, we, we had like a, what two hour notice and that normally I would like run away from that, but I went with it. So I'm super excited to be on here. And, regarding the question of, you know, why am I doing a million things?
Like, you know, I already have all these board certifications. I practice. As a sleep physician at the hospital in rural Vermont. And, about a year ago was actually when I accidentally I call it like I accidentally got life planning. And in this workshop where I got life planning, I was, I had so much clarity in a short period of time on what is it that what's the life that I really want to live? What, are my dreams? And not just like, you know, like we all, I mean, both of us are physicians and, you know, at some point we had dream of becoming a physician, but, you know, once we became one, it was like, well, is this it? Is there more, you know what, that's not the end of her life right there.
And so just having that long view on my life and saying the things that, maybe I'm scared of right now or the things that are causing me distress. And, to, to really put that in perspective and say, well, this is what I want in my life. This is what I want to accomplish. This is the legacy that I want to live, you know, where do I really want to be?
And so when you look at that long-term perspective, it puts all these other things into context and the things at that point about a year ago, I was in a lot of. pain and suffering. Like, I, I felt like things were a lot of things were happening to me that, I felt like helpless and, just, I felt like I couldn't, I didn't have a grip on my life anymore and I had just turned 40 at the time.
So it was like, wow, is this what a midlife crisis? It was like, and, and so that's how life planning, transformed my life. And that's why I decided to, you know, pay it forward and become a life planner and help others, who might be suffering some, something similar, also have their transformation.
Dr. Diana Mercado-Marmarosh: Yeah. You know, that's so interesting. What you just shared, how sometimes it is through stress that we, I mean, I don't want to say we hit rock bottom, but we get to a point where we have that question. Why am I doing this? Right. Like, what is the point of all it is? When did I decide that being a physician meant X, Y, and Z.
And I think COVID really did a number on getting several of us to ask ourselves those questions and to wonder whether being a physician was just one part of it. And how could you then leverage it to do something else? That'd be enough physician didn't define you and that your interest. And ways, like you said, designing your life on purpose instead of just deciding that it happens to you.
Right? That's how I always felt. Turning off fires, not like me on control. Like that's how I felt prior to coaching. And definitely it's so interesting how we all sometimes get to that point in our lives. And sometimes, unfortunately some of us don't have that moment because we're so busy running around. But I am so glad that you had that clarity and that you found that resource, and now you are able to use it for others so that they too can have their transformation and such a breath of fresh air.
You know, most of us, when we think of planning or like, how do I run away faster? You have to have, did you think that thought at some point or no?
Dr. Weili Gray: Yeah. So, we can absolutely talk more about this later, but my brain definitely is not into planning. I like, I mean, part of me likes planning, but then the other part of me loves spontaneity and, just, you know, doing things on the fly and what, and so the, the word life planning is
it is maybe it doesn't capture all of it because in the heart of what I do as a life planner is also to help each one of us, including myself, enjoy the present moment and to live life more intentionally and more mindfully. And, you know, those are a lot of buzz words that I like I'm usually turned off by like, you know, these buzz words, like, what does that mean?
Like, what is the living, you know, in the present and, you know, living mindfully mean. But it's really just soaking everything in. So a lot of us, like, for example, you know, I'm a mom of three kids and I was, you know, if I talk to like a friend, you know, when I was in college that like, I remember telling a friend in college, You know what, like what's the legacy we want to leave behind?
And I remember telling her I'm like, I, I want kids. And like, this is like a weird thing to say, you know, for like an early 20 something year old. And I didn't want kids then, but I was like, I really, you know, I, I feel like that's part of leaving a legacy in the world that was important and important thing for me.
And, and then, you know, here I am, you know 10, 15 years later, And I have three kids. And then yet most of the day I feel like I felt like I was really struggling. Like I was struggling as a mom. I was struggling as a physician. I was just struggling as a human being, struggling as a wife, just struggling with everything.
And I just had to slow down and just look in front of you and say, You know what I had voice this 15, 20 years ago and said, this is part of what I want in life and why am I not embracing this dream that I'm living? Because so many people may not be able to have this. And, you know, I shouldn't take that for granted and just taking every moment in like, you know, when, if my daughter comes up to me and I'm trying to, you know, get some work done on the computer and she says, Hey, you know, mommy, I like look at this, you know, cause that's how kids connect.
Right? They want to show you everything. They want to tell you everything. And instead of being annoyed, be grateful, be enjoyable. It just take. The senses and like what she's showing me and the way she's talking to me. And so that's part of life planning is to really be in that moment and just enjoy what we actually have to, because oftentimes some of the reflective exercises that we do in life planning, You know, what you have, you know, 24 hours left to live and, you know, knowing that, and that the feelings that come up from that, what just reflect for a moment, you know, who did you not get to be?
What did you not get to do? And what, what did I miss? And it's so interesting because a lot of us may have these dream. Like if you ask me right now, we'll be like, wow, it'd be great if I was financially independent. So I didn't have to worry about making an income. If you know, I had a house by the beach, like of course I can name all these things I would love to have.
But if you reflect now knowing that you only have a day left to live. A lot of the things that are so valuable to us are the things that we already have. And, and so to live life in alignment with our values and the things that we do have, and not take those things for granted and not, you know, that's, that's living in the moment, that's sort of, you know, living in the present.
So, so that's, was part of my transformation was. I was just, you know, like I was working really hard. I was cranking out our reuse, you , trying to, get a bigger bonus check and all of those things, like, you know, chasing the carrot. And even though that wasn't really part of why I went into medicine, it was like easy to do.
Cause these were like metrics on paper, but yet what I was giving up was that ability to. Enjoy the dream life that I was already living. So this is part of, , part of the, what I love about, you know, going through life planning and that it's not just planning, it's actually just enjoying life. Yeah.
Dr. Diana Mercado-Marmarosh: That's, that's so good that you made that a point because maybe some of us have not heard of that term. And so we would have totally have misinterpreted. And now how you say it, it's basically. Making sure that you design your ideal day or a deal a week or the rest of your life, like you said, based on your values and your.
I had to ask myself that same exact question, because COVID forced me to, if I had 24 hours, I had a week. If I had a year, if I had five years, what would I do? What wouldn't I do? And then why am I still doing. Who said I had to do it. And from there, like you said, we quickly realized that there's different levels of wealth.
It's not just financial wealth. There is spiritual wealth, energetic wealth, right? Like how fatigued are you that you can't even enjoy that awesome thing you just bought, right? Because you can't even like get on the bike because you're tired. Right. So there's all kinds. And then you can not ignore the time, the gift of time to enjoy those around us, because we don't know.
I mean, we could die in a car accident or they could die in a car accident or somebody could, you know, you could be at the wrong place at the wrong time. Stuff happens. Right. And so I know those seems like we went deep quick, but those are things that if we don't slow down enough, we might miss it because we get so busy, so busy.
And I don't know where we got this notion of like pack more, pack, more pack more. And the more you do, the more productive you are and the more productive you are, the more self-worth you are like, who came up with that? Like, What if it means do less and less is more because all of a sudden, you know what it is that you need, you break it down to the must haves and the nice to have.
And I guess I could have. And you're right. Like most of us would definitely not go to work that day. I don't think. Right. We wouldn't. I think I would go to the beach somewhere with my family and have a nice dinner steak or whatever, eat ice cream, right. Call the people that I love and not call the people that irritate me.
Right. And so it's again, on purpose deciding. What makes sense for you and for your family and not necessarily what the world is telling you should be. So how did you decide you wanted to be a doctor?
Dr. Weili Gray: Yeah, that's a great question because I actually was really anti pre-med. When I was in high school, I was like doing group projects with some of my classmates were like really gung ho pre-med.
I don't even know how in ninth grade, you know, you want to be pre-med, but I guess they were, you know, really, you know, they were really gung ho about it. Just the way, the way that they talked about, you know, like making the grades and, you know, like, just like the whole application process to college, it was just like, none of that was on my radar.
So it was like, oh, wow, this is not really sitting well with me. And you know, if this is what pre-med is, okay, that's definitely not what I want to do with my life. So it was pretty anti. Going to medical school. Cause I'm just like, yeah, I'm really not that type of person, you know, who's gonna, you know, plow everything in my way to get, you know, to my goals.
And then I always liked the sciences. So I was an astrophysics major in college. And, junior year I went to a liberal arts college. So it was like, yeah, that was my major. But I also took classes in art and art history and, you know, the humanities. And so it was a lot of, a lot of fun. And. I went abroad junior year, and to England.
And, part of that is England is a great gateway to travel to the rest of Europe. And I also traveled around in Asia and a lot of that travel, like I was doing by myself, like, you know, I had a backpack and that's about it. This is before cell phones. I didn't have that. And it was just such an amazing experience because everywhere I went, I got to meet different people, like people from different cultures, people from different walks of life.
And, you know, even like people who spoke different languages. And it was just so much fun to connect with people. And I'm just like, wow, this is just, this is so wonderful. Like, this is like what, what it means to me to be human is to connect with others in this, you know, really genuine way. And so when I came back from my study abroad experience, You know, reality hit.
Cause I'm like, okay, I'm a senior now. You know, um, I'm graduating with an astrophysics major. I don't see myself doing the whole PhD thing cause you know, I can't focus on one topic for the rest of my life. And so I'm like, what do I, what should I do? And then I thought about it. I'm like, wow. It kind of makes sense to maybe look into
medicine, but that's like, not like I was rarely really gung ho about not doing that. So I had to reconsider doing that and I started shadowing, doctors in the community. I shadow in the emergency room. I took a year off after college and like volunteer with AmeriCorps and worked in, worked with kids in the school system.
And it was, it w it just felt right in the end. So I, I applied for a post-bac program. And then I did, to do my pre-med classes that I didn't do in my astrophysics major. And then I, and then I went to med school. So it's been, I have to say there wasn't, there's not been a moment like in my heart where I feel like.
This like working with patients, like I never felt like this was the wrong choice for me, but as most physicians have experienced, you know, in our country with the, you know, 40% or more burnout rate, there's a lot of things that sort of, that's not necessarily related to, you know, connecting with patients, helping with patients, that are really weighing, that can wave physicians down and certainly.
Been I've experienced a lot of that and including, you know, having a baby during my intern year, that was kind of, a lot of juggling, you know, work-life balance has been really challenging.
Dr. Diana Mercado-Marmarosh: Wow. That's great that you, you took that opportunity and you got to explore all those cultures and then. You had the insight that you were somebody who was not, was going to be bored if you just did one thing. Right. And so. You pick the field that was going to be ever changing right. Medicine, and you have no idea what's happening because it's ever changing. Right. And so you decided to do that in your own terms and you didn't do one, right?
You, you went into sleep and integrative and although that works right. And so that's so good. Tell me, did you ever feel like. You know, you would go down rabbit holes because you were so intrigued by different things.
Dr. Weili Gray: I always go down rabbit hole.
It's the part of the joy of living right. Is being a lifelong learner. And it's that, it's that curiosity that I remember having, you know, when I was a kid that I never outgrew, that, you know, I think that makes life interesting.
Dr. Diana Mercado-Marmarosh: Yeah. And was there ever a point in your life that you thought, Hmm, I have 10,000 interests and I'm going down rabbit holes and I'm trying to do all the things.
I wonder if I'm struggling here. I wonder if my, if I might have ADHD or was that not even in your radar?
Dr. Weili Gray: Oh my goodness. Deanna. This is where I have, like, I have to thank you so much for 'cause. I, I actually, I, I'm never. We're associated with ADHD at all. Until I signed up for your group because, although, you know, your, your podcasts, has the word ADHD and it, but you know, all your messaging as you're sort of talking about what you help physicians with is, you know, time management and, you know, getting charts done.
And although I was like, well, I don't know anything about ADHD except for, you know, like some of my patients may have it. I, I signed up because I'm like, I definitely, you know, when you, when you use the term time blindness, I was like, oh, there's a word for that.
And so, yeah, I definitely needed the help with. You know, getting my charts done because, you know, although I love the part of connecting with patients, the charts were really boring and, you know, sort of not, not the part that really killed me. And so I. I showed up to it's group coaching. So I showed up to my actually I didn't, I couldn't even make the first session, but I listened to the replay of the first session.
And as I'm sitting there listening to the replay, I'm hearing all these physicians and, talk about their struggles, you know? Yeah. They talked about charting, but then they all were very open about that they have ADHD or they just got diagnosed with ADHD. And, and not only do they talk about their struggles as a physician, but also as a mom and, you know, just like in, in general, in life.
And I'm thinking. Wow. Well, first of all, my first reaction, like maybe five minutes in, I was like, this is interesting. Like everyone's are, is ADHD but me. But you know, this will be good for me, like, cause I really need help with turning. And then as I'm listening, like maybe 30, 40 minutes, Lynn I'm like, why are they all describing me?
Other people? Like there's a group of people that struggle with this too. And so it was like, it was this light bulb moment. I'm like I'm 41 years old. You know, I, I graduated from high school. I graduated from college. I did my postdoc, I did medical school. I took all those, you know, step exams and board exams and residency and had three kids.
Wow, this, this explains so much of why I, you know, have this like lifelong struggle of feeling overwhelmed. And it's so funny because then I look back and you know, I don't have an official diagnosis of ADHD. I'm on the wait list to see somebody for this. But it's, it's just, you know, Two or three months that's passed by.
I've read, I've listened to a lot of podcasts, including yours and, I, you know, read, at least one book, if not more than one book, I'm trying to look ADHD 2.0 was the first book that I read and just, you know, read articles and just did a lot of research on this, on my own. And it's and I have to say, you know, thank you Diana, that, you are so positive about this diagnose that one, that you speak out about this, because even in the short period of time that I've, you know, associated with having an ADHD brain, I've just, you know, I've been sort of in one-on-one conversations, with other physicians, I've sort of just share them like, oh, this thing just happened.
You know, I had. Light bulb moment. And so many of them then shared with me that they have ADHD and I'm like, oh, I didn't know that. And so thank you for being transparent and being not only transparent, but just being so vocal about this because it is. It's out there and it's one of those things that if you didn't put yourself out there and didn't, you know, become vulnerable and share your struggles that, that so many people, you know, wouldn't even know including myself.
So that's one. And then the other thing that I thought was really an interesting observation was like, I was kind of proud of. Yeah. Like, I think I have an ADHD brain and this like explains all my struggles, but at the same time, you know, like I'm really excited to be identified with this. And I think that's also from you because you talk about it in such a positive way that it didn't even occur to me.
That some of the physicians, you know, who, don't openly share that they have ADHD. Actually, you know, they admitted to me that it's, it's like they have, you know, not necessarily some of them will say, you know, they have some shame around it. Others are just like, I just, you know, almost tried to dis- associate myself with it, even though I have the diagnosis. And so it's been really, really an interesting, interesting journey, but I will say that looking back, I remember as a high school. So although I don't have, you know, an official diagnosis, I'm definitely more of the inattentive type. Like I was the kid who sat in the classroom and like, I wasn't disruptive.
I didn't move a lot. I, but I would daydream or like, I wouldn't necessarily process in the same way as maybe the way the teacher was teaching it or other kids would be able to process things. And so I did struggle with low self-esteem in high school, like ninth grade. I remember there was a class physics class.
Like I felt like I was just like, I don't understand. You could describe, you know, motion with math. I like that didn't click in my brain. And because I was stuck on that, like, I couldn't move past, like learning, like memorizing the equations. And so I just remember doing really poorly on the test and in that class. And I was like, maybe I just don't need to go to college.
Dr. Diana Mercado-Marmarosh: All or nothing, our brains so good at that. Right.
Dr. Weili Gray: So, and I, I had a lot of this, you know, sort of a lot of this low self-esteem self-esteem that I just internalized cause I'm like, I don't get it. Like, I, I feel like I'm a fairly intelligent person, but there's some things that I just really struggle with.
And I even remember going to my guidance counselor in high school who was such a nice lady. And I was like, I, you know, I see some other kids getting accommodations, so, you know, take their tests. Cause it takes me a long time. Like I'm always like the last one to finish. Like I'm like I could have used a little bit more time, but I'm like, okay, I'm just going to try to finish.
And I'm like, you know, can I get something like that? And it's so interesting because I just remember, she was like, oh no, you don't need that. Like, do you really? You're you're probably okay. Like she sort of, you know, shut it down, even though she was like one of the nicest people I knew in high school and, and that was it.
And I never really like, you know, going through college and going through medical school, I, it was a struggle for sure, but it was just like, it never crossed my mind again, because. If she had answered differently, if she was like, oh, okay. Maybe like, maybe you should be tested. I think it would have just been, so, you know, the trajectory of my life would have been some difference.
Dr. Diana Mercado-Marmarosh: Yeah. So, you know, so many amazing points that you just shared and. Go through those. So first of all, I was that physician, the ones that you're describing, where they trying to mask, and they don't want to tell anybody anything. I mean, I neglected my diagnosis for 10 years after, you know, they told me that I should know better that I outgrow it.
Because I felt ashamed that how come, I didn't know better, like in how come somebody told me I didn't, this specialist just told me that I'm faking it. Basically. That's what they're just finished telling me. Right. And, and the thing was that I did, I ignored. But I didn't know that I was working harder than everybody else, because I mean, I thought I'm going to do whatever it takes to do this for my patients. Right. And I didn't know it was at the expense of my health and at the expense of my mind and all that, because I just thought I do what I want needs to get done because I love my patients. Right. And so it took me discovering life coaching and ADHD coaching to start to see it as the gifts. And, and to realize that, you know, things evolve and that emotions cause we can get very emotional, real quick, right?
Emotional dysregulation and executive function. They can come can we're overstimulated. And when you get curious, then all of a sudden you're not judging yourself all the time. And I think it was the fact like you just pointed out because they dismissed you. You never like second guess. Should I take a step and get a second opinion or whatever, and you're right.
What if I had had enough common sense to be like, you're one of like 500 doctors here in Houston. Let me go get a second opinion. Why do I need to like talk to you? You just met me for two minutes and you walked out right. But again, because of the feeling I was having and just like you, I don't want to say that it was a low self-esteem, but it could have been because we tend to have that little inner critic that says like, you're amazing.
No, you're not. Yes you are. No, you're not. It's like the little angel, and a devil, right? When you're doing it wrong is quiet. Like we Excel, we kick it out of the park. Right. But we keep like questioned ourselves along the way, every step of the way, because it doesn't come easy, but because it doesn't come easy, we don't expect it to, so we're okay.
Trying to narrow, try and error, trial and error because we don't know any other way. Right. Because that's how we have gotten to the end result. And not getting to the end result. If it's something we want is never an option. Not because we fear failure, but because that's aligned with you. And so you're going to exert all these energy that you don't even know where it comes from sometimes. Right? But then you pay for it a couple of days later, like exhausted, right. Chronic fatigue. So it's like you're in constant survival mode. Unaware, if you slow down enough, like you said, and have some aha moments, you can be like totally thrive mode. But when we get to that thrive mode, it's because we're not long, no longer judging us.
And yeah. So I kept looking around and I could not see, like you said, physicians talking about it. And so I didn't want to talk about it naturally. Right. Because I think I had told five people if that, you know, prior to two years ago, and then. I don't know. I think I posted something on ADHD for smartass women.
So that was my like shining star that got me to start thinking of it differently. And she said, Hey, let me, let me interview you. And that was February, 2021 that she interviewed me. And since then, like a lot of people, a lot of physicians throughout the world started reaching out to me and they're like, oh my God, I'm so glad you said that.
And it's, again, something that it's a little bit sad that we keep it hush, hush, because people still have that misinterpretation that you know, that you're maybe being argumentative because you're calling out BS on some systems that no longer make sense because the people that made it like are long gone.
Right. And so it there's so many things or maybe you look like you don't care because you're showing up late. But again, you're not, it's not that you're trying to show up late. You have that time blindness or you're too loud. You're like, I'm not trying to be loud. I'm just speaking my boys, what's your problem.
You're like, you're too boring, you know? And so it's just the flavors of it, right. Like you said it's sometimes because you don't know, because I didn't know I had ADHD. I think that's what got me to med school because I didn't know, I wasn't in my head. And so sometimes what you don't know is you don't know, but then when you do know then.
It all goes to what you're thinking about it. Right. Because for me, I was thinking shame, but for you, you were thinking, oh, I am proud here. Yeah. This is my super power. Right. And so it goes back to what are you thinking about it? And then how can you support yourself? Because while pills can help. They don't teach you the skills.
They don't teach you about time blindness. They don't teach you how to work with your strengths. They don't teach you how to do whatever you need to do in a way that is not inefficient for you. And that's the thing. My group coaching is not meant to be only for physicians with ADHD. You don't have to have the diagnosis, but you need to feel like time just gets away from you or like clutter, somehow magically shows up, like, you know, like for some reason the socks become like lids for your kitchen that you don't know what happened, you know?
Like, and so I think when you are able to come to a community where. You can be you and you're no longer being looked at like, oh my God, that's the doctor that needs like 5,000 reminders to like, get their charts done or to like get out of the room or to whatever. Right. Then everybody else is not the norm.
Yeah, such good points. I, and I, I would say that, you know, I love the work that you're doing in this space. And, and also, you know, even before joining your group, I, you know, even though I had no idea about this ADHD world, some of the things that helped me, which also I see you are actively, you know, working toward helping other physicians with is.
Helping them see their worth. And, and I'm not talking about that, just like in a negotiation point of view. I see, you know, the whole like time blindness and, and, you know, chronic lateness and, um, sort of, you know, like being scatterbrained and those things, I could see how that easily leads to a low self-esteem or, you know, this.
Julian like, you know, I'm just not good enough. Why is it that everyone else can do this? And I can't. And I mean, to be honest, like there's a reason why, you know, ADHD is groups and the neuro atypical category, because most people don't have brains like this. And so when the rest of the world has a norm, like social norms and especially for women, you know, like women are supposed to be the nurturers, you know, they're supposed to like keep everything together.
So when you have these norms, And the person that you are, can't meet these norms. It's natural to feel like, oh, I'm not worthy. Like I'm, you know, I'm just for whatever reason, like I'm broken and, and what coaching and, you know, life planning and this self development work can be so powerful is allowing us to see that.
Okay. We're not like the norm. But we are worthy. We have inter like intrinsic worth. And, um, and, and the word that you like to use, that, which I love is, you know, you have a zone of genius and you need to embrace that. And so, like, for example, um, also I highly recommend the book that Deanna, um, uh, talks about a lot, which is ADHD 2.0.
And in that book, um, there is like a tart, like I actually, you know, cause I'm not really good at reading books, I like to listen to books. And so, so in the, in the book, even if you get the audible version, it comes with this PDF chart and it just reframes the traits that are often associated with. Either ADHD or, you know what Dr.
Hallowell calls, um, the bass trait. And, and so it's, you know, so like for example, impulsivity, you know, that that's a negative framing and that's sort of how, like, in the, you know, in the diagnostic criteria and sort of in society, you know, they, they use that word impulse impulsive, you know, that person is impulsive, but what's the other side of impulsivity, right.
That person is a spontaneous. Is a venturous is fearless, you know? So you have, you know, you, you have one part that's impulsive, but then it's the other part, you know, it's, it's the same trait just flipped. It flipped in a positive light,
fierce
Dr. Weili Gray: that actually is. You know, changes the world and, or drives innovation.
And so it's exactly, and that's, you know, this strength based approach that you, so advocate is that, which is, I think, why I never, you know, as I'm embracing this new identity of having an ADHD brain, like, it just didn't even occur from me to me for that more than a few minutes to be ashamed of it because you, you know, if you frame it in this positive light, It's it brings value.
And so that radical, self-acceptance the, you know, the compassion, all of that you talk about, you just have to look at it and it may be, you know, it may not happen overnight because, you know, especially if you keep having these negative messages that you tell yourself that the others around your society tells you, you know, you're not going to be able to flip this overnight, but if you, if we start.
Reframe, you know, these traits that are associated with ADHD in that positive light. I think that will take away the shame because it's true. Like most of the cool stuff that happens in history, like I'm willing to bet happened, you know, of someone who's neuro atypical, you know, whether it's ADHD or something.
Yeah.
Dr. Diana Mercado-Marmarosh: Right. Yeah. Yeah. Such good point. So tell me you joined because of the charty did that improve or did that stay the same? We're all friends here. You can tell us the truth.
Dr. Weili Gray: Yeah. So I definitely has improved. So I, and I was, I told you before that I actually had one-on-one coaching that wasn't like specifically designed for ADHD or just kind of life coaching that I did with another coach.
I told her about. What I really need to work on is like my time management skills. So I had, you know, even though it was a different program, like I had already dumped, done some work in this and it, it worked like, I was like, so amazed. I'm like, wow. Like I went into that before coaching. I went into that and I remember saying to my coach, I'm like, Okay.
I'm glad that you can see that this might be fixable, but I'm like, and I would love it to be fixable, but I don't have any confidence in that. You know, I'm just chronically, you know, a procrastinator and, you know, I just struggled with. Just time. Like, I didn't know the term time awareness at that point, but I'm just like, I don't have this.
And so, but through coaching, just through little, little reframes, it, um, really helped me. And then what happened was, you know, I didn't, I did well for. A while. And then, you know, something happened in my life. I don't even remember exactly what it is. Things just started piling on and falling apart. And I'm like, I definitely need a refresher deal.
So I signed up for your program and yeah. You know, even within. Within like a few weeks, things started really coming back to me. I'm like, of course, like, yes, like, do you know, do this? This is, I applied some of the techniques that you use. And then also just kind of learning what works for us, like experimenting.
Um, it, it, it helped me. It's just even the, just the awareness, like, okay. I know I'm not usually aware of time and by the way, I love that quality of time blindness, like, so I don't say that was shame because it's the whole time I do believe time is a social construct and it's not being aware of time.
That helps us be more creative and helps us to do something amazing because if time yeah. Uh, always ticking in my head. I wouldn't necessarily be able to do that amazing thing, but when it comes to charting, it's actually really good to have time awareness. So that's where, you know, timers come in, you know, you give us a timer, um, when we sign up for a coaching with you and, and, and that little things like that are really helpful.
[00:39:18] Dr. Diana Mercado-Marmarosh: Yeah. Thank you. Thank you so much for sharing that. So what do you think has been like one of the things that you would give advice for people to do? I mean, you you've been giving us a lot of advice, but you know, As you reflecting your last year, like, what would you like to tell people, like in the last year you have a lot of growth I've been seeing, you have a lot of girls.
You're one of my classmates in one of more business coaching program. So I seeing you, like, sky's the limit with you? What would you tell people if you reflect back in your last year, what would you tell them? What advice would you give them? Yeah, I
Dr. Weili Gray: would tell them, just going back to the, finding your own words.
And when I say like first, knowing yourself, knowing your why, you know, that goes back to the life planning, like what resonates with you. What's gonna spark your soul on fire. So knowing those. Really important to you and then designing your life to go with what's actually important to you. But then also having trust that you have this intrinsic worth, that no one around you can take away from you.
And so, and that intrinsic worth is often tied to your why. It's like, why am I here? You know, I am here because. Insert, you know, your life mission. I want to make a difference. I want to help people. I want to heal people. And if you know that your why, and that's what strikes a chord with you, then, then go pursue that.
And nothing's going to get in your way. You know, these little things, like if you're struggling with like, you know, finishing charting and, and, you know, like washing dishes, right? Like my husband was like, that's not one of my favorite things to do. Those things are not that important find what's important to you and then design your life around that.
Because, you know, as physicians, most of us have the privilege to have some sort of help, right. Like, I mean, I don't have a house cleaner. I try to look for one, but we don't have, you know, we don't have someone like that in our area. But it's just like, I use the dishwasher more, you know, I told my kids to use the dishwasher more.
I'm like, even though I'm female and I'm a mom, like, it doesn't mean I have to wash all my dishes. It's it's because it's stuff that's not important to me. Like, yeah. I want my kids to like, eat off clean dishes, but like, I don't have to be the one to do it. Right. Like I rather be saving the world. And so it's, it's, it's knowing your.
Like knowing your worth, knowing your intrinsic value. And then don't let anyone take that away from you because you may hear messages from society. Right? Society's going to tell you, oh, you know, but it's the mom's responsibility to make sure, you know, the kid has clean dishes or clean clothes. You know, that is, is that really true?
Right? You quite, you start quick. Cause that is that really the most important thing to you. So, and I'm not saying that my kids have dirty clothes and all of that, but I'm just saying, like, that's not tied to my worth. Like if my kids go out and they have a dirty shirt, like I could care less, right. If someone looks at me with a dirty look, Great.
You know, like I, I just don't even respond. And so that is, you know, I think that that life like that mission driven life will, will just, it, it makes all the other stuff less important.
Dr. Diana Mercado-Marmarosh: Yeah. You like, you bring up so many good points. Like again, when you don't stop slow down, ask, is this going to matter in five minutes, five?
Is it going to matter in five weeks? Right. Do I really have to do dishes like right this second? Or is it going to matter more that I sat down and I painted with my kiddo. Right? Like you have to like ask yourself what it is. And like, like you said, question, anytime you, the w you used the word should.
Like that is usually something that somebody has told you, you should be doing and you don't want to be doing right. And. And we use that to punish ourselves or to make us feel bad. Like I should be a good mom. Well, who says you're a bad mom? I don't have XYZ. Well, who say you need XYZ? Like all this things, right?
Like I recently got coached on in my mind. I was equating having all the clothes done and put away to define a good mom that if I didn't have it a way, not that it was just clean, but it had to be a way. That if it wasn't a way than it was a hot mess. And then that, that I didn't care enough for my kids to have like a clean house.
And so it's just, your brain tells you little things, and sometimes we don't slow down and question them. Are they thoughts that are really serving you or not let them go if they're not right. And so I'm just so intrigued by everything you're doing. And I'm just curious, what are like some of your big audacious goals that you have, like in the next three years?
Dr. Weili Gray: Gosh.
Dr. Diana Mercado-Marmarosh: I know, but I know you, you're the physician who dares to dreams.
Dr. Weili Gray: I'm going to put you on this.
Ooh. Yeah. You know, I have to say, you know, as a life planner, I'm not someone who necessarily like plans, you know, this or like this number or this, but what my audacious goal is to just keep using my. Because I actually, over a year ago, I, I couldn't do an interview like this. Like I would, you know, no way even with like a month preparation, not, you know, not like two hours.
And I didn't even before I went for a run right before, right before an interview, but it's just to be keeping. Authentic, keep speaking up, keep using my voice, keep advocating all the things that why I wanted to go into medicine. Um, and one of the things that I am so passionate about, and I don't exactly know how to solve this is.
How do we keep the physician patient relationship? How do we keep that alive? Because there's so many things that are getting in the way, right? Like reimbursements and, um, you know, the, the, the way that practices are being run and, you know, administration of hospitals, and there's so many different complexities in, in this, but what's so important is when we sit, like when we close the door and we say, Across the table from a patient and they tell us, you know, whatever about their health, that's really affecting them.
And we're able to listen intently and we're able to offer some words of empathy and hope, you know, walking them through how to treat this, that like, we can't, we can't take that away from medicine because it wouldn't be medicine anymore. And, you know, even the placebo effect where like, you don't even give them like a real treatment.
You know, but, but knowing that they're participating in treatment, like there is value in that. So it's, it's, we can't take away that connection in medicine. So I don't, I don't exactly know how that's going to look, but that's like, my life mission is to somehow keep that at the front and center of healthcare.
Dr. Diana Mercado-Marmarosh: Well, you are speaking it into existence because you know, there's a lot of ADHD physicians out there who are very creative and I'm pretty sure they'll come knocking at your door to help you do that. But I think this is how physicians get to decide how they practice medicine. Right? We've seen a lot of physicians do their own practices, uh, because again, they want to do it and have that relationship with their patient without being totally.
10 minutes are up. Let's go, right. Without being told you didn't do this, or you didn't do that or order this or order that, and then fighting with the insurances because they think they know which medicine is better based on the cost. And so it's all kinds of things. Right. So one more question, before I let you go, where can people find you?
Because I'm pretty sure they're going to be like what she has. She can dream. She couldn't help me, you know, with my planning. Tell me, tell me more. So where can they find
Dr. Weili Gray: you? Yeah, so I offer one-on-one life planning and I would love to work with any physician who is thinking. Oh, I just, I feel like I'm busy and overwhelmed and I just don't feel like I'm living this fulfilled life that I, I feel I deserve.
And, um, that's exactly, you know, what I like to help physicians with through life planning so they can sign up for a discovery call on my website, dare to dream position.com. And then I also have a podcast that anybody can listen to. It's it's the same name, dear, to visit a dare to dream physician podcast.
And I put it up. Usually it's interviews with, sometimes I do solo shows. Um, and, and we just talk about what is it, you know, how do we discover what your dream life is? And then how do we help you live that as soon as possible? Because we may not have 20 years to wait to live our dream life. We can start living that now and not take life for granted.
Dr. Diana Mercado-Marmarosh: Yeah, that's such an amazing point. You just made, we can't keep deciding that we're going to be happy when XYZ happens. We need to decide today and you have that power. Of deciding what you're going to focus on. Are you gonna find all the negative things that you think, you know, having gone your way today?
Or are you gonna look at all the things that you made happen because you decided you want it to happen? Right. So how you show up really does matter. And then realizing that none of us are a hundred percent all the time, right? We all need our breasts and we all need your time off and you need to be able to protect who you're around because it makes a difference for your energy, for your money, for everything.
And so I, this is a funny question that I always ask every guest at the very, very end, because you know, we're talking to sometimes two people with ADHD and we space out. Let's say they just started frayed attention, like right this second, what is the one little last nugget that if they just listened now, they would walk away with.
Dr. Weili Gray: You know, your life is worth it. We only get to live once. So get to know yourself. What, what is the life that you want to live? And what's stopping you because whatever is stopping you. There are ways to, there are ways to overcome that. So live your live the life that you want and live it now because tomorrow may not be there.
Dr. Diana Mercado-Marmarosh: So there, you heard it, Dr. Whaley gray shared all the nuggets. She gave you all the insights, but nobody can make the decision, but yourself, you need to be willing to decide that where you're going starts with you. And don't do it for anybody else, but yourself. And again, just like she said, it's not because X, Y, C is going to make us more worthy is that you already have been worth the all along.
Just didn't realize it. So start realizing it. And thank you again, it was a pleasure having you as my guest, and we definitely need to continue the conversation. And I hope to see you in person in a few weeks is that. Not going to be there. Ah, okay. Virtual hugs. All right. Well
Dr. Weili Gray: you take care. Thank you so much and keep doing what you're doing.
Cause you you're changing the world. Deanna.
Dr. Diana Mercado-Marmarosh: Thank you. It's been a pleasure. We are get to dream stuffed into existence.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
About Dr. Weili Gray:
Dr. Weili Gray is a board-certified sleep, integrative, and lifestyle medicine physician who practices in Vermont. She is also a Registered Life Planner and the founder of Dare to Dream Physician, where she offers life planning and hosts a weekly podcast.
Dare to Dream Physician Life Planning: https://daretodreamphysician.com/
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Dr. Adam Harrison: Well to our colleagues, who've suffered burnout. Don't bottle it up and suffer in silence, share your feelings and worries with a partner relative place friend or trusted colleague. And I think that action alone can make us feel so much better. Just kind of offloading that before we even get any professional advice on it.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Good morning. I am so excited. I have Dr. Adam Harrison today. He is a physician, a lawyer, and a leadership coach who, as a result of his own personal experiences, specializes in confidence and mindset coaching for physicians and other professionals who have been on the receiving end of workplace bullying. As the former medical director, he has also worked with medical leaders on developing kind leadership cultures based on the compassionate, servant and inclusive leadership model to replace.
Workplace bullying and replace toxic cultures. He strongly believes in doing work aligned with one's own core values. His are being honest, being, just having gratitude, leading with love and humor. Most importantly, though, he is married to an incredible female surgeon and is to father to two amazing girls who encouraged him to work towards achieving that work life balance.
And so today we are so honored to have him here all the way from the UK. And I would like to start, by asking him if he could please share any circumstances surrounding why he decided to help people with such as being a burnout coach or a bullying coach.
Dr. Adam Harrison: Thank you. Thank you so much Dr. Diana. And I thank you for that lovely introduction.
And thanks so much for having me a guest on your incredible show. I'm the honored one, honestly, I'm really privileged. Thank you so much. Anyway, back to your question, so, why did I decide to become a as a burnout and trauma coach? Well, I was bullied repeatedly myself as a surgical westerns and as a newly qualified family physician.
And I was also burnt out a couple of times when I was a surgical Western, and subsequently when I was arrested in family medicine as well. I've seen my wife, over the years of her training being bullied, as a maxillofacial surgery resident. And again, as a fellow. When we were in Australia for 18 months, fairly recently, I was tutoring female indigenous medical students in Darwin, between 2019 and 2020, and two of them separately came to me and told me they would be in bullied.
One of them was being bullied by a surgical resident and one by an attending in internal medicine. And then finally, I suppose the thing that really cemented it was. Yeah, during the pandemic, will we all observed what were already very high burnout rates. And, you know, a study that I looked at recently showed that over half of us physicians experience burnout as symptoms.
And that was, that was pre pandemic that was in 2018. So that the amount of, of burnout just kind of rocketed, I think, during the pandemic. From already really high values and several medical friends of mine have contributed to the great resignation in the last 12 months, you know, they've left left medicine.
And so it's, it's that kind of thing that I want to have a positive impact on if I can.
Dr. Diana Mercado-Marmarosh: Awesome. Yes. That's so amazing that you had already been working on this, you know, pre pandemic. I feel like pre pandemic, the term burnout was there, but it was not so obvious. And then COVID hits, and then all of a sudden, like the things that we had been doing or asked of us to do like 10 fold with like no compensation, like it just kind of expected of us.
And we don't realize that sometimes. The health care system can become a toxic environment. And while people sometimes mean well by kind of encouraging you and pushing you along, it's not always the right way that they do it. And so how do you think your burned out impacted you and like your family, your friends?
Like, how do you think you said you had gone through several periods in your life where you had burned out, how do you think it impacted you.
Dr. Adam Harrison: Yeah, well, actually, as, as you've already mentioned, you know, it's, it's only recently become a phenomenon that's in the forefront of our minds as physicians. And there's now a lot more kind of wellbeing offerings and things like that in our workplaces.
You know, some of it is tinkering around the edges for sure, but it, you know, it's only recently that it's come onto our radar, really. So. I think it's hard to say for sure is I, I don't think that I even knew that I was burnt out in 2005 and 2007, because, you know, as you said, it wasn't a recognized medical phenomenon, then the world health organization, didn't classify it as a medical condition until 2019.
So, you know, all I knew was that I was exhausted. I felt stressed. I was unmotivated and I had no empathy for or interest in some of my patients. And I don't think there's the can be any way really that a certain number of my patients didn't pick up on my disinterest in them, but thankfully they never made any complaints about me.
Cause that would have been. Made the burner even worse having to deal with that sort of stuff. I'm sure my family knew something was up. But I guess they just attributed it to me working long hours, studying for my postgraduate exams, being stressed out by all of that. And again, cause they, you know, they're lay people, they don't medics either.
They wouldn't have known about burnout. Particularly maybe they thought I could have been a bit depressed, but you know, I never saw that. Professional for, any mood issues. So it's really hard to say.
Dr. Diana Mercado-Marmarosh: Yeah, those are such good points that you make. You know, most of us don't realize we've been for burned out or walking around feeling that way.
We think it's part of the culture. Unfortunately, I remember when I first did my very first coaching thing that I got into, with Sunny Smith, she said, oh, this is to help prevent burnout. And I was like, I'm not burned out. And you know, I did the questionnaire and like complete denial. Like in my mind, I was not burned out.
I was just irritated and frustrated and stressed, and that was on normal. Right. And I didn't realize any other way. Cause it seems like we're always kind of chasing the next big goal or the next step in our career. And we don't realize that we should slow down enough or that we. Maybe being irritable that time is a sign of, I haven't slept enough or, I'm being overworked or, you know, I'm not eating.
Right. And so you bring such a great point that most of us wouldn't even tell you that we're burned out because we know that word, we will just tell you I'm tired or, you know, I'm irritable or moody, you know, Whatever. Right. So it's so good. Like you said that now, if anything out of this pandemic it's made us aware of how important mental health really is.
Dr. Adam Harrison: Yeah, no, I completely agree. You've raised a really, really good point there about the, the culture of medicine. Just normalizing those symptoms. It's like, Well, yeah, you're tired. You have a short fuse you're fed up. You don't want to do it anymore. Join the club, you know, join the, join the queue. We're we're all like it and that, and it's kind of like, if you work in medicine, you just have to put up with it. Just normalize it.
Dr. Diana Mercado-Marmarosh: Yeah. And they make it seem like you're the one with the problem. Like, well, why are you too tired? You should take care of you, like wrap that up. Right. And then it's like, well, we're all too tired. We're nobody's just saying it because you're almost kind of bullying me. Right. Or you're almost telling me that there's something wrong with me.
And then instead of saying, well, you look tired. Get tested, make sure it's not a thyroid issue or something else. They, all of a sudden are like, you're just going to skip out on work and not helping others and make everybody else more tired. So it's
Dr. Adam Harrison: You go to your doctor's appointment.
Dr. Diana Mercado-Marmarosh: Exactly. Right. So it's so funny about that.
So tell me, what do you think is the biggest challenge that can lead people? Like what I was just describing to burnout? Would it be this like people just normalizing. You know, this toxic environments normal, or what do you think are the biggest challenges that can lead people to the burnout?
Dr. Adam Harrison: Yeah, no, that's, that's a really good point.
I think that normalization of the toxic culture definitely, it's a work related phenomenon. We know that from the who definition. I think there were multiple work related challenges that contribute to becoming burnt out. Interesting recently did a group coaching session with some physicians and they were kind of talking about the things that made them feel like this.
And one of the biggest was actually lack of autonomy, a feeling of a lack of autonomy as a physician in a corporate and insurance led system. The fear of litigation, I think weighs heavily on physician's minds. For, from my perspective, workplace bullying is definitely a contributory factor, to burn out.
I think the, the biggest thing has been really the. Recently hasn't said, I think that the, the pandemic has magnified the problems that were already there and they were already really considerable, but it's just really, you know, as you say, shine, the light on them. So lots of things around the pandemic.
So our personal fears as humans. Worrying about getting ill from COVID, especially pre vaccine, you know, going into work and having all these, these patients who have COVID. So that, that obviously is kind of preying on your mind. Our patient's fears, ratings COVID so. Just your everyday patients are kind of coming through the door.
Not necessarily those who are on ICU, but those who are coming in very anxious and paranoid about it. The reduced workforce due to colleagues leaving their jobs, I've mentioned it before the great resignation, you know, for some people. The pandemic was just the final nail in the coffin. And it's like, that's it, I'm done with medicine now.
And obviously that puts pressure on, on the remaining doctors and then the sort of workload increases again, due to our colleagues leaving also due to how very, very unwell some of the patients were, you know, in the complex their illnesses have been. And the, the kind of, You know, the second victim staff and the, and the moral injury stuff, and kind of seeing so many patients kind of die and them not being able to say goodbye to their family and having to do things through, you know, iPdds and things like that.
I mean, it's just absolutely distressing and demoralizing. And then I think there's a. You know, our, our colleagues being ill as well from COVID, which is again, leading to gaps in the rotor. So I think the pandemic has basically conspired in a way to, you know, exacerbate, everything that was already there.
Dr. Diana Mercado-Marmarosh: Yeah. Like you make such a big, big point. Like, you know, when I decided I was going to become a physician, like I remember doing. The signing the oath, right? Like first do no harm. And then you wonder, like, does that apply to me? Like, do I do no harm to myself? Like, why do I have to walk into the line of fire, carrying a fork instead of like a protective gear, right.
Like, why am I going to the war with like a mask that's like cloth and. Like this doesn't make any sense, like what, we're just going to pray about it. Like, I remember being so mad and thinking, well, I mean, why can't they make masks? Like, I'm pretty sure that mass production, the cost of making that mass production versus replacing me and all my years of training, it doesn't make sense.
I am the limiting asset, not the damn mask. Like I was so mad. And then not like you just said, like, okay so fine. If somehow I'm supposed to sacrifice myself and I'm going to die because I've seen some colleagues dying of this. Why do I have to bring it to my family? I never knew I was going to put my family at risk in that sense.
I mean, I know that we drive and sometimes you can say, well, you're driving, you're putting them at risk every day. Cause you're driving. Right. But it's different. You hoping that, yeah, it's a choice. You're hoping that everybody on the road has a license and they know what they're doing. Right. And you're not hoping to walk into like a possible death sentence. Right. And then, and so it was like you said so many things that got you to question, like, who am I, why am I doing this? Why me? Like, I have what if I have predisposing conditions and I can't make it out alive. Or then seeing young, young physicians dying.
They're 30. Why did they die? They have nothing going on. Like, it was just such a place that all of a sudden you're like, well, wait a minute. Am I even sleeping? Because if I'm not even sleeping, like how am I going to have my immune system be up enough to even cover this? Like question your self-care and question everything about it.
And so, yes, I think it finally, like you said, boiled, brought it to like, What am I doing? What am I not doing? What needs to change? What does it have to change, and sometimes you don't realize that you do have a work environment that they mean well, but at the end of the day, they're like, well, we got to see them.
And I'm like, well, for who, like for you to get paid, or like, why do we have to see them at the same time, cost us to get creative. Right? Like you said, it was a double-edged sword because yes, you're using an iPad so that you're not in the room for such a long period of time so that you're not exposing yourself.
But like you said, who's comforting that patient, when a family cannot even come in or have a choice to come in, if they chose to put that risk on themselves in the last few hours of life of that person that they love, like, you know, coming into this world and leaving this world obviously are the most intimate moments in a person's life that some of us have the privilege of being right.
And then when you're not able to do that, like, oh my God, that's kind of. It stabs you, right. It pulls at you. And like you said, it adds further injury of like dehumanizing the whole process, right?
Dr. Adam Harrison: Yeah, yeah, no, I completely agree. Yeah, it's true.
Dr. Diana Mercado-Marmarosh: So what do you think are some of like the best resources that you think have helped you or your clients to like recognize how to decrease this bullying or how to prevent this burnout that, you know, it's finally being talked about.
Dr. Adam Harrison: So I think, firstly with respect to, recognition, of burnout, honestly, and I think it's just about, for me now having a more acute awareness of the clinical features of burnout. And if I began to experience anything like that, again, I now think about whether it's being caused by stress, anxiety, depression, or burnout itself.
And so obviously clinicians, although they have all this knowledge, they, you know, we do revert to kind of patient mode. So it's good to just kind of remind yourself there are resources you can look up, and you can, you know, you can go and see a health professional to get an objective. Opinion. You can also check yourselves with these questionnaires that I mentioned before.
We know the questionnaires, like the Maslach burnout inventory or the Mayo clinics, wellbeing index, which are both validated tools. So you can literally just say. Like you said you were in a denial, you did the question. I was like, oh my God, you know, almost a hundred percent of the day, the only test that you don't want to get a hundred percent on sort of thing. Yeah.
I was in denial , but yeah, it's, it's good things that people can do that. I think with regard to prevention again, it's back to recognition. I think for me, that's the first step. So having that insight or self-awareness to know that something just isn't right within yourself and then to acknowledge that and not be afraid to admit it.
I think that's the beginning of the journey to diagnosis, recovery and prevention for me. Recovery and prevention involves taking a step. I think looking at my work life and my non-work life reflecting and then taking back some control. So for example, I decided I didn't want to work full time back in 2008.
By which stage I was eight years post qualifying as a doc, I'd finally paid off my student debt by that stage. So I could afford to. Maybe what? Four days instead of five days a week. And then I, I personally went about acquiring other skills so that I didn't have to do purely clinical work and I could spend some of my working time being an educator and some of my time in leadership roles.
And obviously this isn't the right thing for every physician to do. There may be other things you want us to, you may want to carry on working. Full-time have a side hustle that kind of reenergizes some people or, start working part-time clinically and start doing some of the entrepreneurial as well.
But I think you've got to discover your passion or assignments in it puts it, find your one. And really forensically examine your personal values and beliefs, and then act in alignment with all of those things, because that's the only way you're going to achieve some sort of harmony in your life I think.
Dr. Diana Mercado-Marmarosh: Yes. I think everything you just said, like resonates a hundred percent. It was not, you know, in this last year and a half, it's been a journey back to myself. Like, like you just said, asking myself, like, why am I doing this? What's the point of this? Why am I saying yes to things I don't want. And then resentful to doing that, or like, why had I said no to things that I've always wanted to do?
Just because I thought that's not what a physician does or that's not what a mom does or that's not what a wife does, right? Like we have all this should or should not like manuals like that somewhere. We learn them and we pick them up. Yet, they're not really allowing us to step into the who, why, where you know what we want to be doing. Right. And when we slowly ignore those pieces, they lead us really south and we get in trouble because other sudden we wake up and you're like, is this what my life is supposed to be? And then not until you start getting quiet and like ask yourself if time and money was not really. An issue here, what would I really be doing?
And then you can spend a few minutes and all of a sudden the answers come to you, but you, you might feel afraid because you been ignoring those kind of all along. Right. And the thing is being afraid is norm, like, it's not like you were like, Ooh, I can't wait to do that spinal tap. Like nobody was like, let me walk into something.
I don't know how to do, right. Like, well, maybe a few were, but I think most of us, are always feeling nauseated at the sign of doing something new, but it shouldn't keep us from discovering who we should be. And so you're so right of talking about setting things that are aligned with you, because then they really allow you to come and work.
You don't have to work because it feels fun, right? Because it lights you up and I'm so glad that you discovered, you know, how to do it your own way and how to then empower other physicians and other professionals to be able to also do it their own way. Like how validating is it for a physician who can say, Hey, I've gone through this, but it doesn't have to be this way.
And so I'm so curious for you to tell me a little bit more about how you, you do set up this work. You said you do work place, you help, set up better environments. How do you do that? Do you do it like a group organizations or do you teach a leader and then they go and implement, like, I I'm so drawn to all the work that you're doing.
Dr. Adam Harrison: Yeah. It's, generally targeted at physician leaders. The thing is, you know, the C-suite, you know, they kind of, they kind of have their own agenda. I don't, I don't necessarily understand the non medical executives. But I get, I get physicians and they, you know, they kind of see something within myself as a fellow physician that they can kind of tune into as well.
So, yeah, it's, it is unfortunate that a lot of. Physician leaders are not very good leaders. And the simple reason for that is we're just not taught any leadership skills at medical school, or anywhere else for that matter. you know, any graduate is not taught to any leadership skills on their course, generally, you know, be their geography graduate or French language graduate.
You know, it's a. It's a, it's a real shame. And then something that's really needed. I think moving, moving into the future to have lots of better, better leaders. But yeah, doctors are not, they're just kind of thrust into the role. And I always say the all doctors are leaders because people are always looking to a doctor, even, even an intern, you know, the, a junior nurse, when, when something's, when a patient's going off, they're going to be looking at.
Intern for a stare as the doctor, right? So we're all leaders to an extent, but you know, you want these leaders to exude kindness and compassion so that people who are looking at them and, modeling on them, you know, the junior doctors who are looking to them for an example, are going to model themselves on like that kind of kindness and Rob, rather than, you know, aggression and, you know, command and control leadership and, and that kind of stuff, you know, so yeah.
I tend to work with them, go through, you know, their values go through their, their leadership styles are, and, you know, can do it one-to-one or as part of workshops. And group sessions. And that's this, I suppose it's a kind of a top-down approach. The people who are on the receiving end of unkind or even toxic.
Who are the junior doctors really? If they'd been on, you know, kind of recipients of that kind of bad behavior, then I want to work with them on their confidence and their mindset and how to manage the stress and the fear of those sorts of interactions. So, you know, I suppose it's a sort of a two-pronged approach really within the.
So toxic workplace culture, you know, teaching the, and training the leaders to be just much more kind and calm and considerate, and just basic things that people don't think about. Just common courtesy and civility. This incivility in the workplace is that is another thing. Another thing there's a paper in the Harvard business review by poor Athen Pearson about the effects of incivility in the workplace.
So it's, it's all important. It tends to be my approach.
Dr. Diana Mercado-Marmarosh: Thank you. That's so helpful. And so useful. You know, I feel like as you know, this is an ADHD podcast and this is obviously where I'm going to ask you this question, which of course I have my own opinion about it. You know, sometimes I feel like people with ADHD and sometimes physicians who have, are not even aware that they have ADHD because they don't even, like it's not talked about or they don't want to be labeled or whatever.
Right. And so. Most of us think, or now I've learned a lot more, but most of us when we're going through med school and going through residency, like they tell us that ADHD is something that people are just impulsive and people just can't focus long enough, but sometimes it feels like a misnomer with that because it's kind of like the spectrum.
You will focus on things that maybe you don't need to be focused on. And here we are like a three hour, like a history and physical. And you're like, what happened to all the other people, right? Because you don't prioritize. Not because we don't want to, but because we get so drawn into like that patient and we're so excited and we go down rabbit holes.
But then we don't complete all the tasks and we are labeled as lazy and we are labeled as, you know, not professional and not in showing up late and all kinds of things. And it's not. Because we're trying to put more work on you or do more things. It's just, we really are so intrigued and want to learn all kinds of things.
And so I feel like, and what is your thought on this? Would it be that people with ADHD sometimes might be at risk for bullying or might be at risk for feeling like they can burn themselves out because they're trying to do too many things in a way that maybe we're expected to do. And they're not giving themselves the opportunity to do it their own way.
Dr. Adam Harrison: Yeah. Okay. I'll yeah, I'll just sort of, address them separately, but a hundred percent. Yes. To both. So first little caveat. I'm not, I'm not an ADHD expert like yourself. I'm a family physician by training. But I've reviewed, The suggested diagnostic features of ADHD and adults from the national health service, a website in the UK.
And I can, I can see how some of the symptoms could very much lend themselves to people with ADHD becoming burnt out more readily than those without ADHD. So for example, this whole list, I'm not going to go through them all, but, You know, including, for example, some of these features are carelessness, lack of attention to detail, continually starting new tasks before finishing old ones, poor organizational skills, inability to focus or prioritize continually losing or misplacing things forgetfulness.
And I think all of those things, as you say, could be perceived by. Other people as, you know, laziness or, you know, just kind of carelessness or whatever, or disinterest or something like that. I think bringing it back to physicians. When you add to this, the perfectionist and people, pleasing traits that you see in the vast majority of us, the difficulties we have in saying no to requests by patients, colleagues, the administration, and the subsequent guilt we feel.
If we do say no, you've got a perfect burnout storm brewing in physicians with ADHD. And in terms of being bullied, we were talking before, you started recording about whether people with ADHD, whether it's classed as a disability in the states, and you said that it is, and I mentioned a study that was done in the UK and about 2018, I think it was a survey that was done essentially.
Workplace bullying. And then people with protected characteristics. So gender ethnicity, disability, sexuality, religion, you know, various things, whether these different categories of people. We're at a higher risk of workplace bullying. And interestingly of all of those, you know, at-risk groups, those with disability were reported the highest rates of workplace bullying.
So certainly someone who is neurodivergent. Would be, would be within that group. So they will be more likely to report high rates of workplace bullying. I think because of, some of the, you know, the symptomatology within ADHD. If, if you've got someone who's particularly unpleasant in your team or wider, working environment, Who thinks your, I said lazy or they think you're a bit peculiar or something like that.
You know, they have the kind of preconceptions basing, basing it on your behavioral traits, then that could definitely lend itself to being. So, yeah, it's very, very sad. But yeah, I think
Dr. Diana Mercado-Marmarosh: But I think it's so good that you're talking about this because you're bringing awareness, right? Because once you bring awareness, you can't unsee what you now have seen.
And then you can take steps towards getting help, either going to a therapist, going to a physician, going to a site, you know, to a coach. And in more specifically, you know, then you decide if you go to an ADHD coach or if you go to a trauma coach, or if you go to a bullying coach like yourself, like then you start to find the resources to heal, whatever it is that you're going through.
And realize that you don't have to normalize what has happened to you, right? And that every day could be a different way towards becoming who you need to become and showing up and practicing medicine in your own way. If you decide to continue that. Or you decide to do a different entrepreneurship or together you have now tools to help you, because it's not just as easy as well.
Let me remove them from that environment as is, as in you put them in another environment and everything's gone because while things might lessen. They're not going to completely be a hundred percent better until you have done the work in your own self. Right? And so it's so important that you, you bring all this up because sometimes ignoring things like this, unfortunately, you can see how that can lead to depression and hopelessness and shame and all of a sudden, it could even lead to suicide. I mean, you, you know, that some professionals such as lawyers and, physicians, you know, are up there dentists too, like up there with the risk of suicide, you know? We don't talk about this things because somehow we've been told all throughout, we'll just suck it up.
Like it would be okay, you're the one who's weak. You shouldn't be weak. You shouldn't be asking for help, but like, we also have seen how amazing it is to take care of a patient in a team approach. Everybody's working in their zone of genius. Like why can't we do that same approach to ourselves to take care of us?
Like we are worthy to have that team approach. We are worthy to have, you know, a physician who cares, who knows what you're on a therapist, a coach. Why not. You also just like you treat your patients, treat yourself with the same, like resources and why not us? Like we have no, like, excuse, like we literally have experts at our fingertips just because you're a physician like.
Are able to get into more spaces and then you can use and leverage that to help your patients and your community at large. Right. So I am so curious how your next three years look for you. What are you up for? Like, what are your goals? How are you going to continue to make an impact for us?
Dr. Adam Harrison: I absolutely love this question. Dr. Diana, so thank you so much for asking you you're a wonderful podcast host, what prep actually preparing for this podcast and having the questions in advance really forced me to think about this. So thank you for that because it's kind of focused me on that a little bit. So. I'd like to in the next three years I'd like to set up and run a retreat for physicians.
Who've experienced workplace bullying by the end of the three years that, that you mentioned within that time as well, maybe within two years, but two to three years. So now I'd like to have published a book on, you know, kind of my way of how I suggest people manage mindset, problems, and confidence, problems that have arisen out of workplace.
Within 18 months, I'd like to set up and hosted a conference on mindset, confidence, workplace bullying. And they're looking a bit bit closer by the end of quarter three of this year, I'd like to have completed my ICF accreditation. That's just kind of hanging over me. So it was one of those things that you just kind of defer, you know, it's important, but it's like, oh, something else has come up, you know, and deprioritize it by the end of June.
So by the end of quarter two, I'd like to have started my own podcast and have at least one group coaching program up and running. Certainly one for victims of workplace bullying and one for those interested in kind leadership. So yeah. Yeah. Within the next three months, podcasts and group programs are my aim fingers crossed.
Dr. Diana Mercado-Marmarosh: That's amazing. Now give us the insight. What are you going to do for fun? And the next three years?
Dr. Adam Harrison: So funny, my wife works very, very hard, but we, we do like our holidays and I suppose that's our main, our main family time, because you know what it's like the working week just goes by so fast, doesn't it?
And there's all sorts of stuff. And even the evenings, you know, the kids go home from school and we have a five and an eight year old daughter. And, you know, our eight year old is slight, right? Come on. You know, you've got homework to do. You've got to have your food, you got to have a shower. You've got piano practice.
And she started playing the guitar recently as well. It's like, well, you know, you wanted to play it. So you've got to do it. And you know, these evenings with all these things to do over in a flash, are they, so the week times. You know, the best kind of quality family time. So, so lots of holidays, I think. Well, as many as we can get in.
Yeah. Especially with the world opening up a bit more. That would be great. Yeah.
Dr. Diana Mercado-Marmarosh: What are your, like, places that you want to visit? Are you wanting to like visit any specific part of Europe or maybe come to the states?
Dr. Adam Harrison: Yeah, we love the states. My wife, and I've been to the states many, many times, would definitely like to come up to this. I've got in the last year or 18 months, I've, you know, accumulated so many good friends in the states like yourself and you know, it'd be, it'd be so great to come and have some. Well, it's not a reunion, is it? Cause like we've not met in person before, you know what I mean? Like I have a gathering of people, so, yeah, definitely, the states and back to New Zealand to see our friends there. So, yeah, they're probably the main.
Dr. Diana Mercado-Marmarosh: You know, I'm pretty sure you can tell all of us, Hey, we're going to have this like trauma conference and you see Lynn's and you want to come be a speaker and you know, we'll be like business expense. Let's go, you know, we're going to be like, well, a little bit. Fun and a little bit of play and a little bit of learning, like perfect, right?
Tiny bit of work. So I'm pretty sure if you also decided to come do a conference. And Vegas or somewhere, you'll get all physicians to come out to. So you, you would just give dreaming and you you'll make it happen. We'll show up.
Tell me where can our listeners get in touch with you so they can learn more. The amazing and great work that you're doing. Maybe they want to work with you and maybe they just gonna to tell you how amazing this was and you know, where can they get in touch with you? I know you're a social butterfly. Tell us all the things.
Dr. Adam Harrison: Yeah. Social media, butterfly. Thank you. That's good. So my, my website is, fairly, fairly new. It's still a work in progress, but it's, it's out there. That's just, www.DrAdamharrison.com. So Dr. Adam Harrison, all this one word and I can be contacted through the contact form on the website.
The website has web pages on how I can help individual physicians or their organizations through. My coaching, training workshops, workplace bullying, and kind leadership development work. So yeah, that's, that's the main thing. Everything is pretty much through my what is it? In your course at your HQ. That's my, that's my HQ now.
Dr. Diana Mercado-Marmarosh: And I understand you have a YouTube channel and Instagram and you have all kinds of stuff.
Dr. Adam Harrison: Yeah. I have all the, all the shiny objects. I think my, my LinkedIn and YouTube are my favorites. Hopefully you can put links to those in. But, but Instagram and Twitter are just like, yeah, I'm struggling with them.
Maybe I'll get some traction one day who knows, but they're, they're a bit of an enigma to me, but anyway,
Dr. Diana Mercado-Marmarosh: Well find him on LinkedIn. And if you want to work with him, please do reach out. And if you're considering my course is actually. One of my amazing, expert guests in there. So please join my course and have access to him or work with him directly.
Either way find the resources you need, because you're definitely worth the investment. Our brain is the most powerful asset that we have. And how much money did we put down to become a physician and how much money do we put down to buy our cars and buyer houses? Like there's nothing. Money that you can invest in you becoming who you want to and showing up for yourself, showing up for your family.
Right. And of course, for your patients. And so one last question, anything else you would like to share that maybe I forgot to ask? Or if people finally like woke up, they were asleep this whole time and they just now said, okay, what do I need to take away? What is one last thing that you would like to leave us with?
Dr. Adam Harrison: Okay. Okay. I think, well, can I have, can I be cheeky and have two things? Well, thank you. Thank you. So I think from , a burnout on bullying perspective, my, my kind of take home message is, I have, I have a mantra that I use for my victims of workplace bullying clients, which is you're not alone. It's not your fault.
And you have no reason to feel ashamed. And I think this is equally applicable to our colleagues. Who've suffered. As well, essentially don't bottle it up and suffer in silence, share your feelings and worries with a partner relative close friend or trusted colleague. And I think that action alone can make us feel so much better.
Just kind of offloading that before we even get any professional advice on it. So that, that would be my kind of, um, professional take home message and, um, yeah, and just. Finally, just going back to the contact details thing. I just it'd be, it'd be great. If people could follow me, keep an eye on my website for the release of my podcasts and group coaching programs in the next two to three months.
I think I'm particularly excited about my podcast show, which will be all about inspiring women leading. And, I've literally heard in the last few days that Dr. Una has very kindly agreed to be my first guest, so yeah, yeah. Really, really chuffed. But, yeah, I just want to say thank you so, so much for having me as a guest on your brilliant show.
I've loved it, and I'm really grateful. Genuinely.
Dr. Diana Mercado-Marmarosh: Thank you again. You know, being the source of inspiration and speaking up when nobody was, you know, like you'd start a pandemic. So you're definitely a pioneer doing this and, and doing it at the right time and continuing to do it and showing up. Right. So that's so important.
So. Guys listen up. Like even if you think that whatever your message is, is not important, know that there's somebody out there that's going to be so glad that you decided to share, and it's not gonna be as embarrassing as using ink or as shameful as it is. If anything, you choosing to be brave to speak up and to empower everybody else to do the same.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
About Dr. Adam Harrison:
I'm a physician, lawyer and leadership coach who, as a result of my personal experiences, specialises in confidence and mindset coaching for physicians and other professionals who have been on the receiving end of workplace bullying.
As a former medical director, I also work with medical leaders on developing kind leadership cultures based on the compassionate, servant and inclusive leadership model paradigms.
The underpinning philosophy to both my workplace bullying and replacing toxic cultures with kind leadership work, is mental and physical wellbeing, so I do a lot of work in that arena too.
I strongly believe in doing work aligned with my core values (honesty, justice, gratitude, love and humour) and I believe that shines through in my work.
I am a fan of social media, hanging out on LinkedIn (as 'Dr Adam Harrison'), Facebook, Twitter, YouTube (I have my own channel for which I create content) and Clubhouse, where I have co-founded a club.
I am also a budding podcaster (by mid-2022 hopefully) and future author of a book on how those who have experienced workplace bullying can change their mindset and restore and reinforce their confidence so they can stop dreading and start enjoying and thriving at work.
Most importantly though, I am husband to an incredible female surgeon and father to two amazing girls who changed my career trajectory to help me better work towards achieving that often elusive work-life balance.
Email: dr.adam@coachingmentoringdoctors.com LinkedIn: www.linkedin.com/in/dradamharrison Facebook: @coachingmentoringdoctors Instagram: @dradamharrison YouTube: Dr Adam, Physician-Coach Clubhouse: @dradamharrison | High-Performing Physician Twitter: @FutureExecCoach
Dr. Jessica Daigle: Having that sense of control and order is what allows you to be able to move forward. Like you need to .
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Dr. Diana Mercado-Marmarosh: Well, hello? Hello. I am so excited today to have one of my good friends. Dr. Jess Daigle. She's a board certified Pediatrician. She's an ICU doctor and founder of mom and me. By Jess Daigle MD and upcoming in-home virtual postpartum care service. This may, that will provide medical care to newborns and education to the mamas, along with emotional and practical support during their fourth trimester.
Her heart is towards mamas and their little ones. She loves to educate console and reassure families. She's on a mission to help moms ditch, overwhelm, and feel competent in their new lives so that they can reconnect with themselves and embraced motherhood with confidence and joy. So I am so excited. I want to her to tell us how she ended up being able to do all these things.
Dr. Jessica Daigle: Well, thank you so much, Diana, for having me. I'm so grateful to be here today and to share my story with moms, because I've really been there. I always wanted to be a pediatrician, which I think that was just a God given quality, but it became, it started to have more meaning after I had my own kids. Because essentially you have to go through something to kind of really understand someone else's experience. It's not enough just to have the education, the experience lends more meaning to how you can help. And so my first, baby it was a miscarriage, so that was hard, definitely for a lot of reasons.
It was my first clue into like grief dealing with grief and guilt and shame when it comes to losing a baby. Thinking about what if and what could have been. And then, God blessed me to have my second child. But he was all preterm. So he was born at 31 weeks and I actually was on bed rest with him for nine weeks in the hospital just to have him at 31 weeks.
And so, he had only been a later at first, but then he did fine acquire a feeding tube and things like that, which is typical for a new, preterm infant in the NICU. And then when he came home, I thought, you know, okay, But exhale, we can just kind of get on him growing and then he had to go back on tube feedings.
And so that was emotional because I was still finishing the last part of my training. And that was hard. And then, my third child ended up being a premature infant as well. So I've definitely had the experience of, of new mom and NICU mom actually at the same time. So my first baby that I brought home ended up being a NICU baby.
So, you know, on top of the newness of taking care of a baby, now you have a baby that has medical challenges. And so, that was definitely stressful and overwhelming, but by, you know, creating systems and understanding how to assess my knees and, and how to get what I needed, allowed me to get through it.
And so, but that foundation alone, coupled with the work that I do in the hospital, taking care of preterm infants and, just even normal newborns and seeing moms go through the concern and worry about being able to. Take care of your babies. You know, it is scary as new and unless you babysat babies before, you know, it really, you really don't know a lot about what you're doing and you kind of learning on the job training is what I call it.
And so just want to be able to be that guide for them, that mentor, that advisor, consultant, strategist, all of that, is what moms need to be able to set the right tone for their postpartum journey and their motherhood journey as well.
Dr. Diana Mercado-Marmarosh: That's amazing. So like you just said, you live this experience yourself, where you're already on track to becoming like a pediatrician and a NICU physician?
Dr. Jessica Daigle: Yes, I was actually, cause I, I read this book when I was younger. And my mom was like, why are you reading such a heavy book? But it was called The Long Dying of Baby Andrew. And it was about this family, Robert and Peggy Stinson who had this really extremely preterm infant. He was under 25 weeks gestation.
And like the heroic step, the doctors were, you know, medicine was changing at that time. Being able to allow babies that young to live longer. And, but we were right on the cusp of. You know, new technologies and medications and things, and they wanted to just be able to let their baby die dignity.
They didn't want all the heroics and all the procedures and things, you know? And so it kind of taught me that young about quality of life too. Like, cause I, I wonder what what's the, what is the right decision in those instances? So I said, I want to save the babies. Like I want to be. The person to help families navigate those harder, difficult times that young, I was 10 years old.
I wanted to do that. And so, as I grew towards it, and then I had my own kids, it became even more real to me. How important of a process that is.
Dr. Diana Mercado-Marmarosh: So, did you have your kids during residency or like,
Dr. Jessica Daigle: Yeah, my first one, my loss, my miscarriage, and then my son Liam, who's eight now who was 31 weeks. I had him right at the end and I was actually accepted to me in etology fellowship.
Right. When ever I was kind of going into, having him and having to, I was interviewed. I'm sorry, excuse me for fellowship at that time. And then my daughter, I was already working out as a physician in the NICU.
Dr. Diana Mercado-Marmarosh: Yeah. It's so interesting how sometimes whatever we're drawn towards, it's like, we've almost been preparing to walk in that step, right?
Like, it's so weird how your. Experiences like mesh with who you're going to be and what your zone of genius is going to be. Right. Provide that support for the families and you went through it. Right. So it's so crazy how sometimes you're able to blend them both together for the good of the humanity.
Dr. Jessica Daigle: I think the so special.
Dr. Diana Mercado-Marmarosh: Yeah. And you know, you and I have had this conversation multiple times, how females sometimes are diagnosed. With ADHD later in life. And probably because whatever things we were systems we were using were okay when it's just ourselves. But then when we all of a sudden have a baby or we end up like getting promoted and now we're managing other people, not just yourself.
All of a sudden, like, its ugly head comes up where you like your executive function, juggling of things is not like you, you meet kind of like, I want to say you get oversaturated. Like it doesn't matter how much you try you working harder is not going to help. Like you have to do something different in order to.
Then just figure out a different way. And so moms become diagnosed with postpartum depression or with ADHD sometimes after the birth of a child. And I can only imagine, like you're saying, when now you have. A newborn that's in, in the NICU that is requiring all those extra special attention to detail that needs to be there.
How that could be a little bit overwhelming as well. And so how would a mom who has ADHD or a new mom that it works, you know, that has a NICU baby. How do you think you could help?
Dr. Jessica Daigle: I think that the, it comes down to cleaning and I'm, I just posted a post cause I'm doing a workshop March 29th-31st about having a postpartum plan because I see a lot of moms come in with a birth plan, but they haven't taken time to think about how their life is going to be adjusted after having a baby.
And to be fair, no one can really a hundred percent plan for that. Because a lot of times it's not until you're in a thing that. How you feel about it, you may think based on some other values you have, or what you know about yourself currently, that you may want to do this and that. But I do think you can at least consider it and, and ride down an ideal situation.
Cause that's like if like life in general, we have goals and we work toward them, but something may come along the way in life and kind of shift you or you have to navigate or turn down a different path. But you still know where you're trying to go. And so, I encourage moms. If they are working with me, we would look at the, what I consider the five pillars of things that are impacted when you have a baby. You yourself is impacted you as a person. You have your identity. What you think about yourself as a woman, and then what kind of mom you want to be? A lot of times, you're just now starting to think about that. You know, I know, I didn't think about what kind of parent I want it to be.
I didn't compare it to my own childhood or anything like that until I had kids. I started to look back and think, yeah, I want to do that. And no, I don't think I want to do that. You know? So thinking about you as a woman what your goals are for yourselves feel even while having this baby. And it could be short term, like, I'm definitely about self care.
So having planned for taking care of yourself, making sure that you're all right as well, and then the babies. So learning what you can to take care of your baby, like where, where do you feel afraid or what are you worried about? Then okay. Who can help me, like having those systems in place for support that could be from the pediatrician like me, that's what I wanna do.
Help moms in the home. I would do go through newborn education. Cause some of them don't even know, well, what's the good way to change the diaper? How should I be feeding them are, you know, breastfeeding and or formula education is necessary. How do I even make the bottles and things like that. So I would even, I'm gonna do even those basics.
But knowing, like, what's your plan for the baby? Like, do you, what's your childcare plan? Like, do you want to, are you that person. Knows. You're going to have to go back to work in six to eight, 12 weeks, depending on your financial situation or your household. Okay. Well, who is going to be watching my baby?
That's a real concern and a big one. , I know that stresses me out still. And look, they're 83, but, but I have a system now. I have a mom, my mom and I have two of my family members and they come in rotation. And now that I know that I planned that. It doesn't change the fact that it is needed. Right.
And so that's the, one of the big things that you have to realize, like it has to be dealt with. They can't, you can't bury your head in the sand and it just magically gets better, you know, but by having the strategy, then you say, okay, I've already thought about how I feel about this. This is what I'm going to do to make myself feel like I'm in control of it. Cause that's what it comes down to at the end of the day, having that sense of control and order is what allows you to be able to move forward. Like you need to. And so you, the baby thing, your relationship with your spouse, right? So, you know, our partner, our, even if you not with somebody, like what is it that you're doing just to make sure you have support in place?
It could be. I say, mom and me, plus village equals three. Yeah. I said, no, you need to know what your village is. That threefold cord, like we hear people talk about that triangle that, that, you know, that that system of flow is important. So you may not be, the daddy may not be a partner. It might be your mom or an aunt or a best friend, but somebody else that is there that you can rely on and lean on because you do need community.
And then the fourth thing is your house. So when you have a baby. Nothing changes like every, your life as it was still, you still have a light bill. You still have a cable bill or Netflix bill or whatever you want to call it. Like the bills are still the same. The things that you need to do in your life are still the same.
But now you have to factor in. A baby. Like I remember the first time I was getting ready to go somewhere like, oh wait, no, I have to think about like, wait, it's not, it's just, you know, just pick up and go no more. It has to have a main looser has extra change of clothes and some milk. And then do they have some wipes?
Do you have, you know, some nameless, normal saline case, they knows, got little buggers, you know, like it's not just pick up and go with it. Or if you are trying to go by yourself, who's coming to the house to wash them. Do they know what they're doing? You know, it's so much that you have to think about.
And then lastly, return to work. So like I'm alluded to already, you know, some people don't are, they'll have the situation where, so if they have the baby, they either gonna to stay at home. More, they are taken off for a whole year or like in other cultures is they are supported that way. You know, a lot of people overseas have different, a lot different cultures are able to support their moms a little bit more in this way, which is something I think we can work on all over here in the U S.
Which is part of what my business is going to aim to do, to, to provide that personalized care, to help moms during this transition, because she's going through a lot, like, you know, every other procedure like surgeries or anything else, you have a recovery period that people are expecting you not to be having the hustle.
Well, we have babies, people were just kind of like, all right, you did that. You to be showing up next week to work. And you're like, no, like my body's recovering, like why are you having this expectation of me that you don't have with anybody else that under a major transition in life, you know? And so those are the pillars you, the baby, your home environment, community and your work career. These are the areas that, that you need to think about. What do I want my life to look like? So when it comes to a mom, ADHD or not, you know, what do, what do I envision for myself or what is ideally gonna make me happy and know that you have to be fluid and know that it can change.
So what I thought I wanted for myself was very different. Once I had my kids, like my priority shifted, my values, we're the same. I would say I, you know, I've always been loving and caring and wanting good will towards others and things like that. But when my kids came in, I was like, all right, I want to be my best self because now I realize they are relying on me.
They are watching me. So I view my world and even my life differently now, like even with my business, I'm like, I don't want to give up. My son is watching me too, you know, he's, he's going to need to know, Hey, I gotta push through when things are hard sometimes to get the good in it. And so that's what I would tell a family is really knowing.
And that's why, if someone like me is good, because I'm going to help them realize these things and we can work through it together about what is important to them now, what do they want to see in their life and how to best use them.
Dr. Diana Mercado-Marmarosh: Thank you so much. That's amazing. You know, again, I know when I had my first baby, like, luckily my mom came and she helped me with him, but not everybody has that support.
And you need to create that support. Like you said, like it does take a village and you do have to know, okay, who can come watch them so that I can sleep or I can shower or I can eat because like you said, You just delivered a baby. So isn't it all of a sudden what you're supposed to feed them on demand every two hours.
Like if you decide you're breastfeeding and like, when are you sleeping? Are you doing that every two hours? Right. And so there's so much stuff that can happen. Like. It can build resentment and all kinds of stuff. If you don't have conversations beforehand of what it is like, or let's say things already happened.
Okay, what can I learn from this experience? That didn't seem just right. And I correct it, right? So that we are not all making assumptions of. Things should be or not be. And then you modify that. And, and sometimes with ADHD, like it's kind of hard because we interpret things. To mean a lot more than they, they mean, and it's that emotional dysregulation that can happen.
And then you throw in lack of sleep in there, forget it. It's like a hot mess waiting to happen. Right. And so it's why this, you know, I joke around and I say, self care is not just you getting your nails done. Like. It actually means you putting your oxygen on yourself first so that you can be able to drive places with your kiddo.
Cause you're not sleep deprived and not going to crash somewhere. Right. And so we have to let go of this idea. Like I can do it all myself. Like you have to ask for help. And, and most of us have been taught that if you don't do it yourself, you're doing it wrong. But like you just pointed out, like in some cultures, like family moves in to help you, you know, it's a village is not just, okay, good luck.
You know, we'll pray for you. It's like, okay. Pray and send the food. Like, don't be just praying, you know, send me cooked food.
Dr. Jessica Daigle: I mean some extra behind that work..
Dr. Diana Mercado-Marmarosh: It's so important that you're pointing all that out and like what better than to work with somebody who this is what they do. Day in and day out and has to personally experience as well and can guide you for all those things. Because like the thing is, you don't know what you don't know, like you think, you know, and yeah, reading it somewhere 3:00 AM. This is not the same as being able to talk to somebody who lives. This is their zone of genius, right? Like this is what, how they can help you. And, you don't have to sit in overwhelm, like you could get the help. And so, yeah, this is so good that you're sharingthese things, because I think part of us with ADHD, we feel like we always trying to prove ourselves and we, and like, why can't I just human?
Why can't I just be a mom? Why can't I just, and that type of thing is not helpful. Instead you have to ask a different question. How can I help me to, you know, those are different questions versus you thinking there's something wrong with. And so tell me, what, what does it look like in your next three years for you?
What are your big plans that are going to be stretching you?
Dr. Jessica Daigle: So I am launching my own in-home care practice in May, where I will start to take a, it will be a cash based practice, but I'll be able to see, moms, and the home and I'll be doing like the newborn Sam and also provide a, and when I say the emotional, support is because, like you said, the moms, they're worried about the baby that they do often neglect themselves. And so you're right. Like self care is caring for someone it's assessing needs and then how those needs to be met. So in order to care for yourself, you need to see what are my needs and how can they best be met. And that's true.
And it does not mean that it has to come from you. It could be whoever. You know, if you say you need a massage right now, you're not beating yourself up because you can't give yourself a massage. You say, Hmm, that place down the street. Sure. Looks nice. Let me go check them out and you go and get what you need.
So, it's changing the narrative, normalizing the fact that itwas not right for anybody to expect, you know, nobody can be everything for anybody all the time. You can be everything for yourself all the time, you know, that's why we have community, you know? And, so take that pressure off yourself first.
And then, then you'll be able to open. It's kind of like opening up a fist. Like if you hold a tight fist, you can't put nothing in there, but if it's open, you can give as well as receive. Right. And so that's how we should be living our lives. So I'm starting with that in home practice, but I envisioned a center, um, for moms, that, will, you know, like holistically cater to them during this period.
Giving them everything that they need because as I've explored my own business, my mind has expanded into everything like moms are impacted in so many ways from this physically to mentally. So learning mindfulness, learning, life planning, learning, what, what kind of pair do you want to be?
You know, dealing with postpartum, depression and anxiety. Life skills, like almost like a little mom vocational center. That's like the, my center and lessons, amazing mom that you want to be yoga therapy. We got somebody that can help you with that too. You know, just that, just that kind of thought because you know, everybody's having to run everywhere for everything and. Like, you know, she, I want her to have a place, like when, like, when people go to a spot, I can get a facial in a males and a massage, you know, like, okay, that's aesthetic.
I want something like that for mind, body and spirit. So.
Dr. Diana Mercado-Marmarosh: And, what are your fun? Goals that you have for the next 3 years, are you going to be traveling anywhere?
Dr. Jessica Daigle: Yes, my son wants to go to Hawaii. So trying to do that, I, I want me and my husband we've neglected to hang out with each other just by ourselves with all of our.
Aspirations me getting this business off the ground, him with his real estate. So we used to go and cruise all the time. And so I want, us, you know, but then COVID happened too. So you know how that is, but once we feel, you know, ship ready again, I would love us to go on a cruise. Because we always had fun that way.
And that's definitely where Liam was created.
Dr. Diana Mercado-Marmarosh: So careful, Ms. Jess, you're going to come back with a souvenir.
Dr. Jessica Daigle: Oh no, no, no. I took care of that. You know how people say they got their tide? I had the bridge demolished, my uterus and my ovaries. United States of America apart.
My ovaries are California. My uterus is Georgia, they have no way to get there.
Dr. Diana Mercado-Marmarosh: Oh, funny. So, cruises, what else do you see in your fun to do things?
Dr. Jessica Daigle: I wouldn't mind. Thinking of driving cross the U S I love driving. And, we've done like Georgia. Towards like New York for like a thing, but I would love to do like a cross country type of road trip. I think that would be fun, like just stopping at different like sites and, you know, and then singing in the car and snacks and stopping, sleeping off different places. I think that would be fun.
Dr. Diana Mercado-Marmarosh: Yeah, that sounds like a good adventure. I'm also wanting to do at some point, I want to get in one of those railroads, those cross country railroads, like that sounds cool. Yeah. Where you just like, get it, you just get in there and you just, you know, they bring you the food, you just chill
and we can plan something together.
Awesome. Well, this has been so amazing. Tell us where they can find you and tell us where they can register for that webinar, that masterclass that you're going to be having soon.
Dr. Jessica Daigle: So. My workshop, Adjusting to Motherhood, Developing Your Post-Partum Plan is March 29th through the 31st at 8:00 PM Eastern time.
So that is three days. We'll talk about, all the different parts of some of what I talked about here today. And, kind of worked through it real time. So moms can start playing, especially are expecting moms. And then for those who already have a baby, maybe hadn't thought about it, but you know, it's no, it's never better late than never.
Like they say, because it's really something that you'll continue to revamp, like thinking reassessing those parts of your life now that you have had. But now that you have. So that workshop is, can be found. The link is on my landing page, www.momandmemd.com/stop overwhelm because that's my mission.
And we, we, that we don't want to live in overwhelm. We want to live in power. Okay. And so, my social media handles, I know that you're going to include there too, but. @momandme_MD on Instagram and Jess Daigle on Facebook. And I haven't new Tik TOK. That's at @momandme_MD.
But yeah, so like on my landing page is information about the business to come like the what I'll actually be doing. Also a flyer with the registration link to my workshop and just a little bit more about me.
Dr. Diana Mercado-Marmarosh: Awesome! Well, this has been so fun, but before I let you go, one more tip that you want to share with the people that maybe I haven't asked you about. If they just started listening, if they hadn't paid attention to anything else, they just woke up. They sold, what do you want them to walk away with, today?
Dr. Jessica Daigle: I want them to know that motherhood is on the job training. There, is no real manual for how to do it is a process. Okay. And, but you can plan and think about the areas of your.
Now and how they might be impacted when you have a baby and what you want it to look like, but just be willing to be flexible, that will serve you well, as a mom, because many things are not often what you think, and then what you desire over time may change and being, being willing to be flexible will help you to move forward in your motherhood journey with confidence and joy.
Instead of living stressed, we don't want to do stress. We want to do confidence and joy!
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you. This has been awesome delight. So much fun to talk with you. Every time I learn more tools that I can go and implement, I'm gonna put all your links on the podcast stuff so that they can come and find your workshop and they can follow you on Facebook and Instagram and Tiktok and everywhere, so they can learn how to empower themselves and stop
overwhelmed.
Dr. Jessica Daigle: That's right. We don't want to do overwhelm , it can happen, you know, in any moment we all can be stuck, but the goal is to get unstuck.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much again, and this has been a pleasure.
Dr. Jessica Daigle: Alright, you too dear.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Dr. Jess Daigle is a Board Certified Pediatrician. She's an ICU doctor and founder of Mom and Me, By Jess Daigle MD.
Stay connected with Dr. Jess through the following channels:
Webpage: https://www.momandmemd.com/stopoverwhelm
Facebook: facebook.com/jessica.daigle.1422
Instagram: instagram.com/momandme_md/
Tiktok: @momandme_md
Twitter: @drjessdaigle
LinkedIn: https://www.linkedin.com/in/jess-daigle-md-faap-67ab7b117
YouTube: https://www.youtube.com/channel/UC2iYUOQyQRNEG1RD2iVu2Gg
Dr. Andrea Bustamante: If they're struggling with any mental health issue or they think they may be struggling with something that they're okay, that they have the power to make the steps to move forward and to take it day by day and never compare your past journey.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
I am so excited today. I have a very special guest with me, Dr. Andrea Bustamante , she's a functional medicine specialist and, she is going to talk to us about medicine because she's also a behavior therapist, pharmacists. So it's such a unique trait to have her here. What she does is she helps people achieve their best mental and physical health beyond the medications, through functional medicine.
So we are in for an amazing treat. And so Andrea actually also has ADHD. So she knows all the ins and outs, but first of all, let me just welcome her. And Andrea, can you tell us a little bit about yourself?
Dr. Andrea Bustamante: Thank you so much. Yeah. So, I work in the behavioral health fields and also have dealt with ADHD, anxiety, all of those issues myself.
I wasn't diagnosed until a little bit later on into college when it got severe, where I couldn't do the normal things that I saw my peers doing, and then went through a journey of medications and seeing my other patients going through journeys of medications and finding another route, which is functional medicine that looks from the inside out and through that, I just fell in love with it and learned how to turn ADHD more into a superpower, versus something that is dreadful.
Dr. Diana Mercado-Marmarosh: Awesome. And can you explain to me a little bit about how you came to realize that you might be a little bit different with, from somebody else? Or did somebody pointed out to you? Like what happened?
Dr. Andrea Bustamante: So I, throughout school, I always had issues of not paying attention. Even in kindergarten, they made me go get a hearing test because they thought, I couldn't hear my mom.
She's like, she can hear just fine. I'm telling you she talks nonstop. And they didn't, you know, I always had difficulties in school with paying attention and, you know, not being present, but so that went on and my grades were okay. Nothing spectacular, nothing, you know, not an "A" student, but not a terrible student.
And then I, you know, went through certain anxiety and depression things, and I didn't understand where they were coming from because then no one in my family really had that. And I ended up going to college and all of these things. And my nephew actually was diagnosed with ADHD. And my sister will going through this process with him.
That was learning a lot about it. And I was on the phone with her, just talking about my struggles with school and how it was hard for me to clean my house, like simple tasks. And I didn't know why it was so hard and like, am I lazy? I'm no, I'm not lazy, but maybe I am. And she said, well, maybe you should talk to someone that you're very similar to my son. And so I went ahead and talked to someone and we went through everything and it was just like a light bulb went off and he was like, do you do this? Do you do this? And I'm like, yeah, I do that all the time. And I kind of explained to him what a week looks like. And, sure enough, it was great. We worked through things and he gave me the diagnosis and walked me through it.
And what that. And it was, it was a big light bulb and it made me relieved because I finally had a name to what was going on with all of these symptoms. And I met all of the marks cause they say women with ADHD are more prone to. Like teenage pregnancy. I had a teenage pregnancy. I had those behaviors.
I had those impulsivity is, you know, I had all, all of that too. So it just, it, it made me feel comfort, but then it also was like, whoa. Okay. So now what do I do?
Dr. Diana Mercado-Marmarosh: Awesome. So tell me, once you had that diagnosis, how did you end up with where you're here today with being this functional medicine specialist? Like how did you arrive there?
Dr. Andrea Bustamante: Yeah, so at first, you know, we went through, I guess, tools that could help. And, I was seeing not only a psychiatrist, but also a therapist. And so. Different rounds of medications. And then, the therapist was super sweet and gave me all of these great tools, but I wasn't going to read all of them too many steps.
Like it, it just, I tried to implement them, but I mean, you know how it is or they don't read directions, you kind of glance at it. And you're like, all right. And then with the medication. They, they helped a little bit, but there was trials of, um, you know, when your doctor changes or your insurance changes or that type of thing.
So there was those struggles and then finding the right one. And I ended up finding a regimen that somewhat helps, but I was on three different medications and I didn't like the side effects. And I was just thinking there has to be another way, like there has to be something. That I'm missing here. And so I just started diving a little bit deeper and I met some wonderful functional medicine doctors and they taught me a lot about nutrition and toxins and sounds, and lights and all these things that are, were affecting me that I didn't even realize.
So once I started. Listening more to that and diving into that. I said, okay, I think I can do this. And I just started making little implementations here and there. And I mean, it's still a work in progress, but I felt a lot better doing that. And then I actually came off my medications and I just. A lot better that being said, medications still have a great place.
They are still awesome. Like all the time. If I took them, when I was at my peak state of going through school and everything. And I can't imagine not having that tool, but there's a lot more out there that we can do for ADHD. Isn't talked about.
Dr. Diana Mercado-Marmarosh: Yeah . And, thank you so much for pointing that out. You know, like you said, there is 10 to 20% of people who do not tolerate medicines, you know, an 80%, you know, 80 to 90% do.
That they do. Sometimes you wonder if they're even optimized because they start to work and then sometimes people feel embarrassed or they don't want to say that it's not working that well. And they feel, you know, and so you don't really know me as a family medicine doctor, you know, the more I've got an educated, like every time they come in, I asked them the questionnaire and I don't just ask him to adult self questionnaire.
Make sure. I screen for anxiety and depression, like all three at once. They laugh at me because if they're an exciting patient, I'm testing them for depression and ADHD. If they're an ADHD patient, I'm screening them for anxiety and depression. Like it doesn't matter where they're coming from.
They're getting the three questionnaires, every single visit because to me, I really think you need to objectivize it. Because you're not going to remember what you answered the first time versus the next time we just don't. Right. And just like I asked my people with diabetes and high blood pressure to bring me their sugars, to bring me their blood pressure.
Like this is. The thing that I do for them, like I tell them to sometimes bring me their ADHD, like scale or like ADHD diary. And, and they laugh at me, but I'm like, no, there's certain times in the day where your medicine's going to wear off. If you don't even have awareness, how can I change it? How do I know?
You know? And so while some medications, like you said, could work or might work sometimes they're not even ideal. Like you said some of the side effects. Oh my God. Like the side effects, it's like, you could almost tolerate them, but I mean, are you going to have really have Tachycardia from it, like all day?
Probably not. Right. Are you really going to have a massive headache where you can't even move because you're withdrawing from it? Probably not. And so if it does work. It works to some extent, but they're not going to regulate like the emotional component, the emotional dysregulation from it. Right. And not only that, but they don't provide the tools.
Like you said, they don't, it's one of the many tools in your toolbox, but you need to understand all the other pieces. Now, can you share me some of the big insights that you have had as you're understanding all the other cool pieces?
Dr. Andrea Bustamante: Yeah. So, there's just so much in it. So like one of the biggest ones is nutrition.
Whether you're on meds or off meds. If you have ADHD, it's so different on how you view food, eat food, all of those things. And that was one thing where some days I, you know, you don't eat, you get busy, you get hyper-focused on something. And I, remember, I used to get stressed out because I would see people on social media making these beautiful, healthy meals.
And I was like, I don't, I can't. There's a block. There's a wall. I can't cook dinner right now. And then I would feel guilty. Will do I eat this like packaged food because it's not technically healthy, but I'm starving. And so it was this whole cycle and I had to almost, you almost have to like allow yourself to be like, Hey, this is what I'm doing today.
And this is a great step. And I think making sure, even setting alarms to check in with myself of, did you, have you eaten yet? Have you had water, those little things have helped so much with focus with mood. Oh my goodness. Because it's, I think it's a common thing and people don't talk about it. Sure. You talked about, if you're on stimulants, it can decrease your appetite, but on or off you you're distracted. You're not going to eat.
Dr. Diana Mercado-Marmarosh: I wish people could see that I will be here laughing because it's so true. Like I have some reminders, like at 2:00 PM. What are you doing? Are you doing something interesting or something that you're avoiding? Like, I'm I on Facebook? Like, you know, or am I actually being productive and the same thing, like you said, like checking in with yourself.
Why am I overreacting? Did I forget to eat? Did I not drink all day? Like what's going on? Right. And so that's so insightful that you're saying that. And it's funny because yes, like you say, some people always just talk about like, not eating, but sometimes we do eat because like that's, the sugar is part of the dopamine that like trigger us to like find more sugar or find more energy somewhere. So tell me about the lights. What were you wanting to say about that earlier?
Dr. Andrea Bustamante: Yeah, so even things with lights and stimulation in that aspect, making sure that, for example, like sleeping. It's hard, right? It's hard to turn your mind off. It's hard to sleep. It's hard to stay asleep, but making sure that, for example, like blue lights or anything like that, like I have my blue light glasses on at nighttime.
I try not to look at anything with light. You know, of course you have lights on in your house, but I try to stay away from that. And that really helps and getting into a nighttime routine of something very minimal, whether it's my glass of tea, I'm going to, you know, Not look at my phone for at least an hour before bed, things like that, which at first I was like, oh, that's silly.
But it actually helps in getting into that routine and getting sleep has helped tremendously too. So. Paying attention to all of those things, as well as even what we're seeing on our phone with social media, all of those things, too, that plays a huge role with anxiety. Like I always tell my patients and clients, I give them a news diet.
So if someone's watching the news all the time, I'm like, all right, try to minimize that because you're putting all of that into you and it's in your subconscious. And I think it's important to monitor what we're feeding ourselves, you know, with social media, with our mind.
Dr. Diana Mercado-Marmarosh: Yeah, you're so right. Like, you know, whatever you focus your attention to, like that's where you're going to go. Right. And I think most of us with ADHD, we tend to be like curious and learners and, we all of a sudden, we feel like sleep, oh my God, that's boring. Like, you mean I'm not going to be doing anything. And so it's almost like revenge, like against sleep and then guess what we pay for it the next day.
Right? Like, we're not whatever we were enjoying right there as we were doing it. It's not like it was amazing. Like the next day you're just like, oh my God. And then you forgot because you were half reading, half this half, whatever. Right. Or you went down a rabbit hole that you didn't even know how you ended up there.
Right. And so you're right. Like focusing on like, okay, let me put my phone away. Like making it invisible for the last hour or charging it in the other room or like, you know, so. It's not right there. And you have to take a few steps to like, get yourself to touch the phone. You know, it can make, make a difference when you separate that.
So when your clients come to you, like how do they usually find you? Like, because I hadn't heard about functional medicine being used for ADHD, so I'm so curious.
Dr. Andrea Bustamante: Yeah. So a lot of it, is through right now is word of mouth. A lot of people, it's word of mouth, social media. So Instagram, I have Facebook groups and, a lot of it is awesome there.
Cause you have community of just like hear other people supporting other people with these conditions because it's not, it's not like you can cure ADHD. Right. But you can learn how to live with it. And chances are, if you have it and you have children, they're going to have it too. And you can all, it's always like you're teaching.
But, so most of it's through word of mouth and just through internet meeting, other people that have this especially professionals that have ADHD or anxiety. That it's now starting to be talked about, but before it wasn't, and, I was even hesitant at first to come out with this and everything, but I love it now.
And it's, it's amazing. It's so, so amazing.
Dr. Diana Mercado-Marmarosh: So tell me. What do you think was like one of the pivoting points for you to be able to now, because you, you were kind of sharing with me that sometimes, you know, uh, prior to starting the podcast, you, you were saying that sometimes you weren't sure whether just to share.
I mean, I was there too. The first time I shared about it was about a year ago, actually. And then Tracy Otsuka's podcasts. Like that was the first time I talked about ADHD. I had told like five people prior to that, because in my mind, oh my God, I was broken. Like, that was what my brain was telling me.
And I didn't realize that, you know, it's whatever. Make it mean. And like you said, like she teaches you that it could be a superpower if you know how to share it. But what do you think was the defining moment for you where you're like, okay, I need to talk about this. I need to help other people.
Dr. Andrea Bustamante: I think it was the fact of getting out of myself and realizing it's not about me, it's who I'm going to help.
And once I did that and I said, imagine if I was struggling, if I had someone say. It's it's okay. And like you said, you feel broken, you feel like something's wrong with you. There are days, even still now where I'm like, I wish my brain would just be a normal brain. So I think it just came to that point of, I need to help others.
And it's not about me. It's about these other people. And when I would see patients at the hospital and they're getting these treatments and getting all of this. Yes, it can be helpful, but when you have something you can relate to someone on a whole different level. You know, like my best friend has type one diabetes.
She can relate to people on a whole nother level. She knows what it's like to stick herself every day to go through all her meds. When you have ADHD, you will and understand how the brain is, how everything is different. And I think that's what made me get out is like, Don't make it about you. Like this is about them and I think it should be talked about it.
Shouldn't be something to be ashamed of at all.
Dr. Diana Mercado-Marmarosh: Yes. You're so right about that. I think people with ADHD, you know, I don't know if you knew this, but I'm pretty sure you do. Like, we tend to think outside the box and we tend to be the risk takers and the, and because of that entrepreneurs.
Right. And like, we tend to. Say things before we even realized we already said it out loud, which can be good and bad. Right. But at the most part, I feel like we wear our hearts on the sleeve. And like you said, we tend to be brave when we realize it's not about us. Right. When we realized that sharing my story could make a difference in that person. So like, you know, when people get diagnosed, when I diagnosed him with ADHD or anxiety or depression, I think like you said, the first step is awareness and then normalizing it, like making sure that, Hey, you know, it can be genetic. It is genetic. And then like your whatever happens to us, you know, it, it might mean.
We might get diagnosed sooner or later or way later, you know, and then, and sometimes you don't realize that. And so it doesn't matter where you are. If you finally have gotten the diagnosis, become curious and figure out. What can I use? Can I use meditation? Can I use stretching? Can I use running? Can I use sleep?
Can I use low carb diet? Like what can I use to help compliment how I manage my ADHD? Like you said, it's never going to go away, but can you make it be? And like you said, sometimes the brain offers, like, why can't I just be normal? But I'm like, well, normal is boring. Like nobody ever made history by being normal, you know?
Dr. Andrea Bustamante: Oh yeah, absolutely. Absolutely. And I think too, There's so much where people say, oh, ADHD moment. You know, when people throw around the word, and I remember when I met my now partner, I told him, I said, I just want to let you know upfront. I have ADHD. And you know, he knew a little about it. Maybe. Maybe can't pay attention a little hyper, but now he knows it on a whole another level.
And it's that excitement that, you know, all of the, the enthusiasm and motivation and positivity, and let's go, let's do this type of thing. And it's funny, but it's great. And he's like, yeah, it's a whole, it's never boring.
Dr. Diana Mercado-Marmarosh: It's never boring. And you know, the other thing I wanted to point out, or what you said is that.
When we get out of our heads when we know why the why it's when it's so important, like you said, you are out here doing things that for most people might be uncomfortable, which is like, interacted in different social groups and in different Instagrams and in different things. But you're doing it again from a place of service to like empower others to then go and live their best lives. And so as physicians, I'm used to like always trying to have everything right. Because of obviously, we feel like if we don't have it right, we're gonna. You know, mess up stuff. And I'm not saying that, that puts us at risk, but I'm just saying medicine comes to us at a place where you always have to a hundred percent certainty know things.
The thing is life is never a hundred percent certain. And if we really wait to think that way we can like miss so much. And if we start to understand. You don't have to know everything that every single person in front of us, like we don't have one minute, like in the board exam, just one minute to figure it out.
Like you can keep bringing them up back and try different things. Try Eastern medicine, Western medicine, a mixture of stuff, and like, You're so much better for being a better listener and not jumping to conclusions. And so I think it's so nice to be able to have a conversation with somebody who can have an open mind.
Dr. Andrea Bustamante: Yeah, absolutely. And just like, like with a lot of psychiatric, even medications and things like there isn't one that fits everyone. I mean, it's so different and our bodies are made different and everybody is so uniquely and wonderfully made inside and out. And so I think it's just so important to do it.
So individualized, all of the options and if it doesn't work, that's okay. We can try something else.
Dr. Diana Mercado-Marmarosh: So tell me, what do you have? Like, what are your big goals in the next, like five, 10 years? What is your, what are you working towards that you're so excited that it's like lighting you up?
Dr. Andrea Bustamante: Yeah. So I'm hoping to transition my business to, full-time just me seeing my clients with my functional medicine business and doing group programs and diving in, and I just really want to help men and women who are frustrated and just tired and just want answers and don't want this run around. They're there ready? And I'm just looking to, to build that community with them and to, to change lives and to just continue learning, because there's so much that I've just learned in the past couple of years. I can't imagine the next five years what's going to happen.
And I think the COVID was rough, but it was also beautiful because I mean, look at me. Virtually interacting and making wonderful friends. And I think it's the next couple of years, it's going to be awesome. Just like that. To have a big community.
Dr. Diana Mercado-Marmarosh: Yeah, like you never in a million years would I had thought I'm just going to talk to people out there and be like, Hey, so what are you up to, you know, like never did I think that that was possible. And to be able to have, like you said, a new way of having friendships all over the world and not make it mean anything that we're just talking through the computer. Right. Like, and to understand that one day we might meet in person, out of conference somewhere and it's going to be amazing. And because you get to create that because all of a sudden, from the place of like, where do we go from here?
That's where COVID kind of put everybody at right to really. On themselves to realize like what was going on for them, because sometimes we live our lives. Like whether, you know, what did they say, blinders on? So you're not, you're just going through the motions. Right. And you don't realize that a week has gone by a year, has gone by whatever your kids, all of a sudden, a little older.
And you're like, what happened? Like when did this happen? And so I think COVID kind of makes. Everybody kind of like stop and reset and like figure out what's important. What is not, what do I let go of and how can I make a difference in this world? You know? And I think, I think like you said, it was hard, but it was also a beautiful thing.
What do you spend so much time on that you maybe want to let go a little bit?
Dr. Andrea Bustamante: Oh gosh. I think worrying honestly, I've I don't think I worry as much as I do, but when I confront it and I stay present and I realized, why am I worrying about this? You know, and even little worries, big worries. All of it. And I think letting go of that makes more room to being present and enjoying the moment.
And enjoying family friends like anything. So that's my number one thing to, to let go of for sure.
Dr. Diana Mercado-Marmarosh: Yeah. And so that's the thing, right? With human brain. Like it tries to trick us sometimes like it's main mechanism is to keep us alive. Right. It wants to keep us alive. And so by making you feel worry, it's telling you, Hey, you gotta think about situation a, B, and C and D.
When that comes along, you got it. Cause you're already worried about it. But the, but the thing is that when situation arises. Thank you are going to figure it out because it doesn't matter how much you worried about it beforehand. It can never prepare you for whatever is going to come, whatever curve, ball, life throws at you.
Right. But meanwhile, if you are stuck in that, What if, what if, what if situation like you have the adrenaline going, you have the cortisol levels going. So you're like an always high state of like fight or flight type of thing. And it does not let you, like you said, step back and then actually enjoy the people who are right here with you present.
Right. And so that's why it's so important to, like you said, become intentional. Who's in the room. What am I doing in with the people in the room? Let me come back to what's going on right now.
Dr. Andrea Bustamante: Absolutely. Yes. And it's, I mean, we people with ADHD already have, you know, higher levels of cortisol. So. Worrying only stresses that. And, and I've even tried to, like, I carry a notebook, one notebook I've learned to just one, but in this notebook I have, I can take notes. I can do whatever I want, but sometimes even if I'm in a meeting or watching something or say, my son said something to me, I'll write it down.
And that really helps me, even if I don't look at it again to actually absorb it and be present. And I think stuff like that help. That's what you remember. You don't remember, you know, worrying is never going to solve anything but memories. Those are the things that, that I really cherished.
Dr. Diana Mercado-Marmarosh: That's so good that you have that insight. And that's a really smart, trick and tool. You know, I had a patient today, actually today. She told me she's like, you know, Did she say she couldn't sleep well. And she says, she's going to sleep. She said, do you think it's because I'm taking my medication at 7:00 PM. She's on, on, an, a medication twice a day.
And I'm like, well, what time do you take the first one? She's like, well, I get up like at nine or 10:00 AM, but usually 11:00 AM. And so by that time I take the first one and I'm like, in what time are you sleeping? She's like, well, usually two or 3:00 AM. And I'm like, well, I'm like both, but what are you doing before that?
Nothing. And I'm like, but what are you really doing before that - worrying. That's what she told me. And so it goes back to worrying, right? And like the thing is that meds can help some, but if you don't take that moment to come back, But what am I doing? What's going on? Am I really in trouble right now? Or is my brain just telling me I'm in trouble?
Like, you know, just, you can't be like examining your brain and being your brain at the same time. So, so it just might give you that two second pause to just ask yourself, like, why. Angry. Why am I sad? Why am I mad? Like, just asking, but not judging. Just asking. It sounds silly, but it can bring you back and it can help you to be more present.
So yes, let's, let's let go of worry for you. We got to keep right. So how can my listeners get into. You, if they would like to find out more about you and your future coaching opportunities and all those things.
Dr. Andrea Bustamante: Yeah. So, Instagram is one way, so it's dr.andrea.bustamante, or I also have a website, it's avenahealth.online so event a v e n a, and then health.online. And you can see a whole list of ways to get in touch there too.
Dr. Diana Mercado-Marmarosh: How exciting. So one more question, before we let you go, if there was anything that. You could, let's say people just woke up and they just finally started paying attention.
What else would you like to share with them? What is like the one single takeaway point that you want them to have? Like if they just first started listening.
Dr. Andrea Bustamante: That if they're struggling with any mental health issue or they think they may be struggling with something. They're okay. That they have the power to make the steps to move forward and to take it day by day and never compare your past journey to.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you. I mean, that was a beautiful wrap-up. Yeah. It's like your past does not have to define your future. Your past can be, you know, it's not good or bad. It's just things happened. What did you learn from that? And what steps can you do to become the person you're trying to become? Right. And so it's never about who you finally become. It's about. How much fun you had becoming who you wanted to become, right?
Dr. Andrea Bustamante: Yes. Yes. Yes, absolutely.
Dr. Diana Mercado-Marmarosh: Yeah. Well, thank you so much. It was a pleasure to have you, and I'm pretty sure we'll continue this conversation.
Dr. Andrea Bustamante: Absolutely. It was a pleasure to be here. Thank you so much
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Stay connected with Dr. Andrea Bustamante:
www.instagram.com/dr.andrea.bustamante/
https://www.avenahealth.online/
Dr. Michelle Quirk: No matter what sport you're going to do, right. With exercise. Start low, go slow. You have to go into it, you know, almost with a marathon mindset. Like this will not happen overnight, especially if we have been on the couch for a while, or even if we do a different sport.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Okay. So this week I am super excited cause we have a very special guest.
One of my really cool friends. This is Dr. Michelle Quirk and she's a board certified pediatrician and a certified running coach. You heard it right. Running coach. And she is with the Road Runners Club of America, and she founded mindful marathon to help make running easy. Did you hear that? Easy and fun for busy professionals.
And so today she's going to show us how to be informed, how to, make this enjoyable and how to have a very effective approach as she, this is what she teaches her clients. And she coaches them to become athletes not just, you know, a shift of mindset, but go into it into a lifelong love for the running.
So she was going to teach us about how to be very informed and make this fun. So super excited to talk to Dr. Michelle, tell us, tell us all the thing.
Dr. Michelle Quirk: Oh, thanks so much for having me, Dr. Diane, I'm very happy to be here. Yeah, so, where should we start? Should we start with, the fact that maybe I wasn't always a runner?
Dr. Diana Mercado-Marmarosh: Yes, please do tell us, because probably everybody's thinking, well, she's probably like an athlete, like where she has 10,000 medals or something.
Dr. Michelle Quirk: No, no. I mean, I have quite a metal accumulation now, but that that's only within the last like 10 years or so, but yeah, I, I was not always a runner. I was not much of an athlete as a kid.
My sport growing up was dance. Like I did ballet and stuff like that, but, yeah, I struggled through the mile run. Never thought that, I would ever be a runner. I thought that they were made of something different than I was. And so, yeah, I found running about 10 years ago. I had tried it a bunch of times and quit a bunch of times for all of the reasons you can think of, you know, it hurts.
It wasn't fun. I was feeling tired. I was afraid to get injured. And about 10 years ago, I, decided to lace my running sneakers on again, and really give it a go because I was in this time in my life where I was going through, lots of difficulties. So it was, you know, I finished my residency, started a new job, moved to a new place, was newly married, like all of these stressors.
And my dad was diagnosed with cancer at that time. And so I found myself telling my patients and families like, Hey, you know, you need to exercise and eat well. And sleep. Well, and all of these things and here I was not doing it myself and I thought, you know, what better thing can I do then try to lace these sneakers up and at least just try again.
And this time. I'll just go five or 10 minutes around the block. See what happens because all of the previous times didn't work and I failed. And so this time
Dr. Diana Mercado-Marmarosh: You we're probably trying to do like the marathon every time that you started. Right?
Dr. Michelle Quirk: Pretty much. Yeah. I think not a marathon, but you know, you think that yeah.
That I would be able to go out and just run a couple of miles. Because this is what I would hear. My friends who were runners say, like, I just did my easy three miles, so why can't I do that? But if you're not trained to do that, it's very hard to go from zero to that first 5k, if you don't go about it in the right way.
So anyway, long story short is that I ran my first official 5k, like about a year after I started really consistently running and I've been running ever since. So it's it stuck this time?
Dr. Diana Mercado-Marmarosh: Good. So, you know, you're talking to an audience who can't concentrate at all sometimes right. With ADHD and, some people obviously do use running as a tool to help them focus.
Like actually I shared with you before that, I had no idea that I had ADHD till I was in my first year in medical school and, I was kind of surprised, but looking back now that I put the puzzle together, it makes sense that in high school, I had no idea because I was running like 10 miles a day, like with my cross country team or with my track team or whatever.
And so even during track, like, you know, I would do the two mile or like, you know, the long thing, right. You, it could make sense why that's where I was getting my dopamine from.
Dr. Michelle Quirk: Yeah, for sure. And I think when I started running, you know, like a lot of people, I would listen to music or really try to tune out, to what I was doing.
But as I went along. You know, really fell in love with the sport. Now I really, I try to go without any headphones and without any music. And I think that taking away all of that stimulus actually has helped me to focus more and I can get into, it's a clarity of mind, really. Like sometimes I don't think about anything and sometimes I get very, creative ideas for mindful marathons.
Where I'm taking things with my athletes, but for sure, you know, plenty of studies on running and, and dopamine. And I don't think I appreciated that, you know, at the time, but now, during periods where I have not been running due to injury or rest or whatever it is. I noticed the difference.
Dr. Diana Mercado-Marmarosh: Yeah. And so it's interesting you say that, that it gives you clarity. I don't know if it's just, everybody has a different thing of what they consider like peaceful and boring. And so I remember that the things that were boring. Listening to pathology for me during medical school, like I would put it on like, I would hear the lectures and I would run because I was looking at the trees.
I was looking at everything else. And I guess the stimulus of doing something, what like penetrated and make, make the information a little bit more easily to digest. When you sat down, you kind of primed your brain, but at the same time, like you said, you were getting oxygen into the brain because, and some days, yeah, you just turned it off because he didn't matter. Like you just needed that break.
Dr. Michelle Quirk: And there's not much out there, right? Like, yes, you're paying attention to nature or the cars if you're in the city, but, but there's not much else, but you and your foot falls. So if you are, yeah. If you're listening to a lecture, I could see how it would yeah. It, how you would pay better attention and how it would stick. I used to do that too.
Dr. Diana Mercado-Marmarosh: Yeah. It's so weird. How, you know, when you're listening to the lecture, you're just thinking, no, I just have to listen to the lecture. I just have to keep running through the lecture. Once the lecture is done, I'm done. Or even if you were not listening to the lecture, you would be like, okay, I just have to get to that street over there and then like you get to the street, you're like, okay, maybe I can do a little bit more. And so it's like a mindful challenge at the same time, then that nice sweat that happens afterwards. It's like that soreness, but you're like, okay, it's a good type of thing.
Dr. Michelle Quirk: Yeah. The sense of accomplishment, I think.
Right. And then you did two things, you exercise and you studied.
Dr. Diana Mercado-Marmarosh: Yeah. So what do you think is the key to getting started with running?
Dr. Michelle Quirk: I think the best advice I could give would be to start low and go slow, which is not hard for us. Because we all want very quick results. And so you have to go into it, you know, almost with a marathon mindset.
Like this will not happen overnight, especially if we have been on the couch for a while or even if we do a different sport, like I have a lot of athletes who do a lot of cycling or they have a spin bike and they're used to that workout, but running is it's a little bit different. So it's still a great aerobic cardiovascular exercise, but you use different muscles and it's just different takes time to adapt.
So, but I always suggest is really taking it easy setting aside, maybe, you know, two or three days a week when you, when you first start for just five or 10 minutes and maybe tack it on, if you already do some other kind of exercise, add it on. So if you like to cycle or you like to do yoga or you're more into weights or HIIT training or something. You can tack it onto the beginning or end of one of your other workouts to work it in gradually and not do what I did, which is go out and try to run three or five miles when you haven't done it before.
Dr. Diana Mercado-Marmarosh: Yeah. So, I mean, it seems like such common sense thing. Right. But the things that seem simple, like you said, you have to make sure you schedule it in, right.
Because. If you wait too, like you, when you feel like it, like, you're never going to quote unquote, magically feel like it. Right. But it's like everything, like once you start, like the motion will keep you going, like you just have to get over that 1%, just start something. And then the object emotion keeps going right.
Stays in motion. And the thing is like having realistic goals, like you said, I have a friend, oh my God, she, I love her to death, but. Like she has this mindset. Like, I can do anything, which is good, but sometimes it can get us in trouble. Right? Like she, again, signed herself up for a marathon. She trained here and there and then she just magically thought she was going to do this marathon.
Of course she did it. But what happened? She ended up with rhabdo, like for the next few days at the hospital. Right. So like, that's the thing, like, you can't just like reel your brain into like doing things. I mean, maybe you could, but then you pay for it, right?. The, the body keeps the score. And so it's so important to make sure that your mind and your heart and your body kind of match up with your goals so that you don't like overdo it.
And so we don't think that something like that would happen until it does. Right. So you just gotta make sure that if you're going to do something like this, that you do talk to a coach, like talk to you so we could make sure we're doing it safely.
Dr. Michelle Quirk: Yeah, you don't want to wing it for a marathon for sure.
But you know, one thing that has helped I work with a lot of, you know, high high-achievers, very busy, busy professionals. Right. But one thing that seems to work well with the training plan is like one is just to have something in writing. And two is to look at. The week ahead. So I usually sit with my calendar on the weekend and look at all of the things I have to do that are written in the calendar for the week.
You know, my work shifts, um, doctor's appointments, whatever it is, have to bring, you know, kids here, their family obligations. So you look at all of that and you say, okay, I have my three days for my. Workouts. Where am I going to put that, you know, morning, evening, like you have to figure out what works for you and where in your schedule.
It makes sense, but doing it ahead of time is really the key. And then you schedule your workouts in the same way you schedule other things. So if it's on the calendar with the time, you are much more likely to do it than if you leave it up to, you know, first thing in the morning, the alarm goes off and it's like, oh, Coach Michelle says I have to go for a run, I don't know.
Dr. Diana Mercado-Marmarosh: You hit exactly the point that I always teach my clients as well. Like you need to plan. Otherwise, it's not going to happen like out of sight, out of mind. Right. And the thing is, if you wait until you feel like it, you're just not going to feel like it like your body and your brain are going to tell you like all the excuses, why you shouldn't go do it.
Right? And it's the same thing. Like whenever we have to close some notes, That might seem like the painful or boring task. And you might be like, well, I don't want to do that. Like, I'll wait till I feel like it. And again, you're never going to feel like it. And so, but if you schedule it, like you just said, you don't make it mean anything.
You're more likely to make it happen because you already took away the decision of trying to even decide if you want to do it or not. It's in your calendar. It's Sarah, of course life happens and things come up, but if you at least have it on your calendar, the likelihood of it actually happening goes way up because no, no longer.
Is it just an idea in your brain? Like now it feels like a product it's it's in the open it's in the calendar. People can see that you have committed, you know, especially if you're sharing with your husband or your significant other or your girlfriends, and you're telling them, Hey, we're going at this time at this place.
Then it's more likely. Right. And, and like, I recently heard somebody saying like, you know, you have to show up for you. And sometimes we don't do that. Like, you know, you tell your friend, Hey, we're going to start running at 10:00 AM and then like nine 50 comes and like, your friend's not there.
And then it happens again. You're like, you're really mad at your friend, but your, your friend, you know, you're the one who's like not showing up for you. And so you have to decide the why. Do you talk to your clients about like, why they're running or why they're doing anything they're doing?
Dr. Michelle Quirk: Yeah, that's I actually, in my questionnaire, when I work with, my one-on-one clients, like one of the questions on the questionnaire is why do you want to run?
And sometimes we have to go beyond like the first one or two or three things, even that come to mind. But when you can really get into, um, you know, the deep reason for why you're doing it, I also encourage people to set, um, you know, Some goals for the near future and then some for the distance. So maybe you have a, you know, you want to run your first 5k, let's say, um, but you know, like your friend, like maybe you have an idea that you want to run a marathon, but that might be one or two or five years down the road.
So, you know, it's important to have those short-term goals that you can work towards. Right as stepping
Dr. Diana Mercado-Marmarosh: Not three months, like she did it and then like went to practice like five times. Right. She's like what? I run at the Navy all the time. I'm like, yeah, that time.
Dr. Michelle Quirk: Yeah. A marathon training cycle can be like 16 to 20 weeks.
So if you're, you know, and that's, you know, 3, 4, 5, 6 days a week of running, but it's a long time. It's half a year. So. Yeah, you don't want to just wake up and decide to do that.
Dr. Diana Mercado-Marmarosh: And you can, and, and obviously she was able to, but then she paid dearly for
Dr. Michelle Quirk: it. I'm sure it's right. And we don't want to get anyone injured.
We want them to enjoy the experience so that she wants to do another one. Yes, exactly.
Dr. Diana Mercado-Marmarosh: So it, so that it doesn't become something that was so exciting, all of a sudden at shore or a task, right. Because you are being unreasonable sometimes. Right. So, yeah.
Oh my goodness. Yeah. So you've been running for the last 10 years. Can you tell us some of your struggles with that? How did you overcome them?
Dr. Michelle Quirk: Yeah, but I think one, one struggle is what you alluded to. So just because I love running and I'm a coach does not mean that I am above the excuses either. Like I still sometimes wake up in the morning, the alarm goes off and I'm, you know, I don't want to get out, but I think what I try to remember is how good I feel.
While I'm out there. And it's really just the act of getting outside. Especially here I live in Pennsylvania, winter is a little bit of a rough time to be a runner. Like there's not that many hours of daylight and it's cold and you have to dodge the snow and the ice. So winter is always a little bit harder, but once I'm out there, I feel good.
And of course afterward, I feel great. So it's not as difficult anymore as it used to be to get out the door. But I still struggle with that. That's important to know everyone, I think assumes like, oh, you never have that trouble, but I do. I do. I just, I just go. And sometimes I don't write, like some days it just doesn't work and you have to rearrange things, but you know, I've learned how to be a little bit more flexible with myself, not to the point of laying on the couch.
Flexible in terms of shifting schedules as the needs come up.
Dr. Diana Mercado-Marmarosh: Yeah. And I think that's really important, like understanding what you value and what you think is important for you and then making time for it. And then again, like you said, staying flexible enough to not make it be like all or nothing.
Right. And then like, that's, it, it didn't work out the rest of the week is not going to work out. Right. Like you throw your hands and you're like Gord, so dramatic or brings like. No, everything went south, you know? And so understanding that that's just part of your brain and that your body easily forgets that you were just doing this last week and all of a sudden, like if you let go of it for a couple of weeks, it's like, you never did it.
Right. You're a sore all over again. But again, like getting back into. I think is so important. And, and sometimes even like taking a picture before and after, like can motivate you because it actually happened. Right. And, and yeah, like, so I hadn't ran since like high school. And then like, I don't know, I went through lots of shifts, like last year with like life coaching and discovering myself and all kinds of stuff.
And then I started running for a while there and it was so amazing. And I was like, oh my God, I can't be by just ran like a mile or two. And then I did it. 10 minutes, which is very slow, of course. But then you're comparing yourself to like, when you were to high school, you could do like a seven or eight minute a mile. Right. And, but I'm like, Hey, when you haven't done it in like, almost like 20, 30 years, like, it feels like crazy, right. And then of course, I had my injury with my, I dropped the 50 pound bag of cement on my foot and broke it in July. And then after that, I was like, I think I'll wait. And so I haven't gotten back to it, but I definitely want to, because it felt great.
Like you said, it's just you and the road and then just measuring each post or each house that you're passing it is just gives you that like competitive spirit of like, okay, I can keep going.
Dr. Michelle Quirk: Yeah, I think, I think that's probably. You know, talking about injury, that's probably the other biggest struggle are periods of time away from running.
Due to injuries. And, you know, like the first time after I had really, you know, run for, I don't know, five or six years without having any trouble and then had an injury, it was something like ridiculous. Like I was weeding the garden. Stepped off of the step into the garden, twisted my ankle. And I was out for two months, three months.
And so I remember just feeling very like defeated, how I was going to lose all of this fitness and it was going to take me. In my mind, I thought it was going to take me five years to get back to where, where I was by taking three months off. So that was, that was tough. But I think, you know, coming up with ways to just adjust your goalposts.
And during that time, I found that I liked swimming, you know, I was allowed to swim and I found that I liked that. And I ended up doing a triathlon after all of that. Done. So you can, you can turn the lemons into lemonade.
Dr. Diana Mercado-Marmarosh: Yeah. And like, not being afraid to go get a massage, if you are sore, if you just went for a round, you know, because, that's a good way to get all that lactic acid out.
And then you just feel so much better. I really think that doing my massages during the time of the injury was so helpful because you know, you're trying to be. The whole thing, and then they're like, they're working it out so that you still are getting back on track, you know? Yeah. So, yeah. So, um, so tell us, what are you up to like these days?
What are your current, big activities that you have going on? Or how can people find you.
Dr. Michelle Quirk: Yeah. So I, I always have, at least a couple of one-on-one clients. And I just started a group program, which is called ReadySet run. So that's going to run for 10 weeks and I'll probably offer that again in the fall.
We'll see. But I am actively planning our spring virtual 5k. So that's what is on deck next. So look out for that and you can. Find out all the information on my website, which is mindful-marathon.com. And if you are, you know, if you're a beginner, let's say you're on the couch. If you're on the couch, there is a walk plan.
So you can really like dip your toe into it. There's a walkway on the website. And then if you want to, you know, kind of get started with running, and make it stick. There is a workshop. So you can find those both on the website, just scroll to the bottom and you can get them for free.
Dr. Diana Mercado-Marmarosh: How exciting. So tell me, where do you see yourself in the next like five years what's coming up?
Dr. Michelle Quirk: Ooh, that's a great question. I would really like to help more runners. And I think that that may be in the form of races. I don't know if it will be virtual. I have visions of in-person races, and hopefully helping to bring this maybe to doctors, healthcare organizations like to help the problem with burnout.
So we'll see. It's, it's a little cloudy, a little fuzzy that vision, but it's. So I'm hoping to grow that portion of mindful marathon, like the race portion.
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So one last question. So let's say my, you know, ADHD, people come and go in or attention comes and goes. So let's say that they just started listening.
Like what is the one takeaway point you want them to take away?
Dr. Michelle Quirk: No matter what sport you're going to do, right. With exercise. Start low, go slow. Just don't overdo it. Good. Awesome advice.
Dr. Diana Mercado-Marmarosh: You heard it. You just got to start, even if it's slow, don't be trying to do the whole marathon at once, right? It doesn't matter where you are.
You can keep improving if that's what you desire. Right? You want to do things that light you up and be willing to try things that you haven't tried before, because you don't know what if that's your thing and you didn't know that was your zone of genius, right? So you just gotta be willing. So willing gets us, gets us places.
Dr. Michelle Quirk: Exactly.
Dr. Diana Mercado-Marmarosh: Well, thank you so much for coming today, Dr. Michelle, you're basing. I think I'm going to go in and look at that website myself, because I think I need to get back into that. Okay. Thank you for the motivation.
Dr. Michelle Quirk: Thank you for having me. It's always a pleasure to talk. Bye-bye
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Stay connected with Dr. Michelle Quirk:
Website: www.mindful-marathon.com
Facebook: http://www.facebook.com/mindfulmarathon
Instagram: http://www.instagram.com/mindful.marathon
YouTube: https://www.youtube.com/c/mindfulmarathon
Dr. Rashmi Schramm: Let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? Meditation is simply moving from activity into stillness, mindful. It is a formal way. It is a way to practice mindfulness and mindfulness. Most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
Hello? Hello. I am so excited. I have an incredible guest today. One of my dear friends and colleague and amazing guest coach in my group. And of course I am very biased. Right? Because I have outstanding people that I bring to you. So this is Dr. Rashmi Schramm, and she's a board certified family medicine physician, and she is. In her 21st year of practice. Oh my goodness. Isn't that amazing? She's a National Board Certified Integrative Health Coach with a specialized interests. And I'm going to mess that up. Can you help me pronounce that?
Dr. Rashmi Schramm: Yeah, Ayurveda.
Dr. Diana Mercado-Marmarosh: Ayurveda, and meditation and she teaches two easy types of meditation, which is mantra and yoga nidra. Okay. So she is a founder of Optimal Wellness where she incorporates evidence-based medicine techniques into individual and group coaching. And she helps busy women to ditch that guilt and tap into the inner peace and power so that they can live more energetic and. Purposeful lives. She regularly hosts live weekly meditations for those interested in easy and effortless way to dip into this type of meditation or to go deeper into their practice.
And so please welcome this amazing treat that we have for you today. So tell us a little bit, how did you get into this amazing practice? People probably don't know this yet, but yoga nidra, she introduced me to it and she of course has changed the way I see meditation because I used to think that I was doing it wrong.
And I, my brain just kept saying what you have to sit still. This is no way, but the way that she taught it to me, it was very relaxing. I even felt like more energized. So, which was weird. Please share with me about how you got started on meditation specifically. And how are you like able to share this gift with others through coaching.
Dr. Rashmi Schramm: Yeah. Thank you so much for having me, Dr. Diana, you know that I am so honored to be here with you and for, with all your listeners. So I actually was born in India and I grew up there. I was there until I was almost 12. And so I was exposed to meditation spirituality. That's sort of thing. Not that I was like a meditative kid or anything, but it was very normal.
It felt like home for me. And then we immigrated to the United States. We, I actually, my entire adolescence was in a very small coal mining town, where there weren't really very many other ethnicities other than, you know, Caucasians there. And so I kind of, at that point, like had abandoned all of my Indian essence.
As an adolescent growing up, trying to just fit in. And then when I went off to college, I really like, I found a group of people that were meditating. So it was like this on and off kind of love for me. And I was like a secret meditator. I was like a closet meditator because I was afraid people would think that, you know, like I was whatever, I didn't, I dunno what I thought.
Right. But it was my brain in college. I really loved meditating then. And then I went to medical school, completely abandoned meditation again. And then was like a very intermittent meditator until about 10 years ago. And I, you know, it was in my thirties, I had young kids, um, my husband and I had started this practice that was growing by leaps and bounds.
And it was all going very well from the outside world. I had these two beautiful girls, you know, they were like, they were, you know, I mean, it was, it looked perfect from the outside and it's not that it wasn't perfect on the inside, but inside my brain, things were not that great. I was really experiencing a great deal of, you know, now we call it burnout.
I didn't even have any language I wasn't on social media. Didn't really know a lot of other people. That was, they were openly talking about being in this really like, kind of like irritable state. I mean, I was just like this long burning, like, oh, somebody presses my buttons, it's going to cover it, you know?
And I would press my own buttons and it was like this ongoing. And I was, you know, I was like fixing all the things on the outside to make sure everything was perfect. Right. Like I was taking more and more exotic vacations. I was like, it's that hedonic treadmill that I, now I recognize it. Right? Like I cannot find that kind of content meant outside of myself, it doesn't exist.
And also that perfect life doesn't exist. And so, , I really began to question a lot of things in my life and I sorta just one day. Remembered my meditation practice and just kind of dipped right back into it. And I was, you know, I should mention that while I was feeling these, issues within my emotional mental states, I was, it was then translating into lots of physical illnesses too, for me.
So I was having digestive issues. I was having chronic daily migraines. Wouldn't talk. I wasn't tolerating medications. So all of that stuff was going on. So I kind of almost waited way too late. Right. Until I had a whole, a bunch of physical symptoms, then I was like, I gotta do something. And so, you know, I initially went to meditation because I was reading some things about how much it helped with migraines.
And so. And with insomnia. And so that's, and then I started to dip in and out of meditation for a while for a couple of years, actually. And, you know, I would meditate, my migraines would go away. It would sleep great. Then I forget about it. And then another few months would go by all of the same stuff.
What happened? It was like this, you know, like I called myself a crisis meditator back then, you know? So it wasn't like I grew up in an Ostrom and all of a sudden here, here I am teaching meditation. I, it was a really messy. Ugly start to meditation for me. But once it really took hold, it was like, whoa, it was like this massive personal growth, this space that opened up this evolution that began to happen for me.
And where I noticed that I could find contentment and live. In a different space and in a way that I dealt with my, you know, whatever emotions that were going on with me, not as like a fight kind of thing, but it just became a different way of being, and living it spread to my kids, you know, people were noticing.
And then I was, I wasn't really qualified to teach for a while. Obviously I didn't go to teacher training, but I was like, Every day, like I was grabbing my office staff, I was grabbing anybody that would, that would like to meditate with me. Like, come on, let's do this two minute meditation. So it started like that actually just with me, like being like, come on, I got to get you to come on.
You know, we'll do this lunchtime meditation and then it became kind of a thing with my staff. And then people will start to hear about. And then, they started asking me to go teach at different places. And I was like, I don't, I don't know. And I, then I started to look at how I can teach, you know, I wanted to have the deep knowledge.
So over the last several years, I've developed the ability and the certifications to be able to teach, those different kinds of meditations I was telling you about. So that's the long story.
Dr. Diana Mercado-Marmarosh: You know, it's so interesting. How exactly what you said like last year when I discovered coaching and stuff. When I, I remember I did the first program that I did, they asked us to do like a burnout questionnaire and I was like, why are we even doing that? I'm not burned out. There's no way I'm burned out. Like, I didn't even know what that meant, but. I laughed when you said you were irritable, because that was me.
Like they would ask me to do different things and I would get overwhelmed. And instead of say like, no, I need help. Or, or let me do that a little later, I would just kind of blow up and I didn't even know what was happening or I would come home. And I was so drained that I didn't feel like I could function or have extra energy to cook or do anything like that.
And it's funny how now you said they have words, at least to help you identify with what's going on, but you know, sometimes we're so oblivious to what is going on, that we are reacting to things that are happening, but we're not even aware that we're reacting, we think is just happening to us. And that we don't realize that through meditation, it could be.
Step into that little bit of a window that maybe I could control it maybe a little bit. And we don't realize that that could be the case. If you don't realize what mindfulness is. I know that when I talked to you, I was telling you about my ADHD. And I was in a journey of trying to discover how to focus and things like that.
And you shared with me that that meditation can be a way to help people who had problems with concentration or with procrastination, or even with like task initiation. Have you noticed that to be the case for people that have ADHD or no ADHD, like does that type of method, can they, can it help anyone?
Dr. Rashmi Schramm: Yeah, absolutely. And we've got now hundreds and hundreds of studies that have been done and in adolescents and in adults as well. That show that practices of meditation, mindfulness practices, all of those things can definitely strengthen those neural pathways that require more focus that require more concentration.
And so before we get too far, let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? So meditation is simply moving from activity into stillness and mindful. It is a formal way. It is a way to practice mindful. And mindfulness, most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.
So it sounds really simple, right. And it actually is the way that we all were as children. So I think you've got a four-year-old right. And so, or she's three or four. She's always mindful. You don't have to teach her mindfulness. In fact, she's going to teach you how to be mindful. She's going to teach you how to be in this present moment and not be as judgy as our brains are, you know, I'm 47. And so like, I've had that many years of conditioning of me going like, this is good. This is bad. I like this. I don't like this, all of these things, but if we free ourselves from that amount of judgment, for even short periods of time and just stay curious instead like a three-year-old would then magical, wonderful things begin to happen.
Really, truly. I know it sounds that way. But there's more openings. There's more, there's more freedom, in that mindfulness. And so it doesn't mean you have to always sit down to meditate. So for example, you can have a mindfulness practice then, you know, you're, you're either just doing breathing cause I've had, you know, when I work with one-on-one folks, there are some that are coming in 15 out of 10 anxiety.
Right. And that's all right. That's okay. What we do then is we just work within the breath. That's all we do. We do some breath work for a week or so, and then we can move into some kind of meditative practice. So there's so many different ways to go about that, you know, kind of changing those neuropathways.
But to answer your question, the way really. Neuro, you know, kind of physiologically that, you can imagine that meditation would help, whether it's concentration or focus is that during meditation, let's say it's five minutes of meditation and we'll take, for example, a yoga nidra, because we mentioned that already, which is fully guided, right?
So all you're doing is you're listening to a guidance and sometimes, it's the guidance is saying breathe a different way. Sometimes the guidance is saying, put your attention on different parts of your body. There's different, you know, there's different parts of the guidance. There's guided imagery, there's all kinds of different things.
And so what's the brain going to do when, when you're, when you've decided, okay, I'm going to spend 25 minutes inside this guided meditation. Your brain is going to be like, no way. I don't have time for this. Oh my God. This woman has no idea how busy I am. Listen here. I got two young kids. I work full-time, I'm a coach.
I have a podcast. I also have this other program. I got deadlines coming up. She didn't know what she's talking about. So all those things are going to happen. Right. And that's okay. They're supposed to happen. So your only job once you've decided I'm going to just do this. Nidra is then to notice all those thoughts and come back to the guidance.
And then there's going to be something else that shows up. Oh, crap. I forgot to email that person. Yeah. That's a thought you come right back to the guidance, then it's going to be like, oh my God, I forgot about the form. I think it's due today for my kid's school. That's all right. That's a thought you come back.
Right. And so. Each time you do that, where you notice that you're in the middle of a thought or a thought train, they're usually trains because they sweep us along, and your job isn't to be like, oh, this sucks. I'm not doing this right. Your job is really simple. You just come right back to the guidance.
And the more times you do that, the faster you can do that the next time. And so think about how that can be useful if you're trying to chart. I mean, how many people need you the minute that you need? We're going to finish a chart. It's going to be 15, maybe 20. Right. Everybody needs you all the time. And so your ability then if you've been sharpening it and training your mind to come back to the task at hand is literally you're rewiring the brain to do so.
And so. In a, in kind of a fun way, because those nitrous have all kinds of other, and same for the mantra too. They have all kinds of other, you know, benefits, like as far as neuropeptides and all these other things go in kind of a fun way. You can train your mind to really come back to the focus and use our ability for the concentration that we already have.
Dr. Diana Mercado-Marmarosh: Yeah. You know, one of the short sentences have been very helpful for me is just thinking right here right now. Like when my mind is like in a thousand places and the patient's right in front of me, I have to just tell myself right here right now, like right here right now. The patient is the most important thing right here right now, or if the kid's having the meltdown, right.
It's like right here right now, I have to validate their feelings. Or I have to ask the question that is not, instead of me screaming back at them as. Uh, or, or awarded in the way where I'm like, okay, um, you know, you're a great kid having a hard time. How can I help you? Right. Like, so it's about their behavior and not them.
Right. But the human instinct is to screen back. Right. And so just the right here right now. Like if my husband's mad at me or if I'm mad at me or whatever right here right now, Bringing it back that I'm not, it's not really that bad. Like I'm not in the middle of the street, naked in the car is running over me, even though the brain wants to tell me that.
Right. And so I think because of the yoga nidra that you have helped personalize for me, I've been able to realize that I can focus at will or that, I think part of it says just. Let it go, let the universe take care of it, which sounds nice. And it makes you feel supported, but our brain doesn't want to let go of anything.
Dr. Rashmi Schramm: Yeah, we have that. And I love that. It's kind of a mantra that you use, right, right here. Right now. I might start using that too. Sometimes I'll use, I'm like, oh man, I have this ability to really go back in the past. Like I made kind of a large mistake. I mean, it's not a mistake if you learn from it last week and who as you know, like for a while, uh, you know, like the next day I was like, I could recognize what I was doing.
I wasn't spending that much time on it, but it was still happening for me. Cause it was thoughts still kept showing up. So I started to just go to past past, or what's done is done or, you know, it's just good to be able to remind ourselves what's done is done. What's done is done. Um, I mean it wasn't like horrible, terrible.
I didn't hurt anyone. I just made a mistake in a purchase and that's okay. Because we all make mistakes. That's okay. And so it's like, all right. And what's done is done. Let's, let's be right here right now, like you said. And so the more we practice that, the better we get at it. And if we have those precepts, like the kind you're talking about, where you can just come right back to it, where you don't have to explain a whole, you know, series of events, then your training is like, you know, of your mind is even more powerful.
Dr. Diana Mercado-Marmarosh: Yeah. And it took a while because the brain wants to tell us all kinds of things. Like obviously when we're doing our notes, right. Or we're trying to close the encounter, it's telling us that we're so slow. Like we're like really, really slow. Right. And it's probably not the case, but our brain is telling us that.
So like, I've learned to acknowledge that. But at the same time, I tell myself I hurry slowly. So it tells me that I knew move on with it, but not so much to where I'm going to make a mistake and put the order on the wrong patient, or I might miss a big thing. Right. So it's enough to tell my. Okay, let's go, but not get outta here. And then we missed the whole bowl.
Dr. Rashmi Schramm: I know. And that's the danger, right? Is there, there are so many opportunities for the wrong click and the wrong chart. And, and we are really tasked as physicians. We are tasked. Something that I think is nearly impossible, for the brain to sometimes do where sometimes most of the time doing the job with three or four people.
And on top of that, all of the emotional and, the complexity, the, of the social aspects of all the things that we're dealing with our patients, and then what's happening with our staff, let alone whatever hospital system or clinic you're in. I mean, it's a lot, it's a lot to manage for sure. And be. That way of just reminding yourself and then, like having your own back and reminding yourself of that self compassion that can, that can take us a long way.
Dr. Diana Mercado-Marmarosh: And you know, people with ADHD, we even though in the U S it's not recognized as emotional dysregulation to be a thing that is used to diagnose ADH T in Europe. It is. And so it makes you wonder whether people having society or depression. Along with ADHD or if it's just part of their ADHD, because they're so irritable that they can't accomplish a task because they, you know, their brain has 25 tabs open and can't prioritize which one it is whenever things are gonna happen throughout the day.
You seen as mom meditation, a two or three minute meditation, when you feel like you're about to lose your shit. Right? Like I, excuse myself, I go to the restroom and I do a little micro meditation and it's my way of telling myself I can't. Sit and overwhelmed the whole rest of the day. Or I can sit in this uncomfortable overwhelm for two or three minutes and try to rewire how I'm going to see the rest of the day.
So maybe this encounter went to shit, but I still have five other patients that I would want to show up at a better place. I'm still a human being. I'm not a robot, but acknowledging that, how I show up in how I'm choosing to show up. Sometimes you can control it. And sometimes you can't because there's so many things where we're human, right.
We might be dealing with the worry of a family member who is sick or a neighbor who is dying, or you don't know. Right. Or you're going through a divorce, things happen. Right. And so. That's the beauty of understanding that we're human and understanding that meditation can be a tool for us to regulate us.
Right. And to support us because to me it's a very strong, self care form because, nobody's going to be like, oh my God, you look tired, good. Sit down. Like you have to be aware of how you're feeling so that you can. Recharge yourself, right? Because I keep saying this, you cannot give what you don't have.
Like, you can try to pour from an empty glass, but nothing comes out, you know? So you gotta make sure you fill that cup up. And that way you do give from a place of abundance, not from like, you know, a feeling of having to do things.
Dr. Rashmi Schramm: For sure. And that minute that we start to do that, we start to get resentful and that's like a big red flag for me.
Like when I noticed it was that meant showing up, I'm like, whoa, what is, what is happening here? Just slow down for a second and notice what's going on. It doesn't have to be that, you know how to fix the situation, but just bringing awareness to something can be really powerful in and of itself.
Dr. Diana Mercado-Marmarosh: So tell me, what are you goals for the next year or two?
I'm so excited to hear. I know you're a trailblazer and you're everywhere. So just share with me.
Dr. Rashmi Schramm: Within Optimal Wellness, I've got a whole bunch of things in the works right now. So. We've got a small group program, which is almost full. It starts on the 31st and that goes for 12 weeks. That's going to be amazing.
You're actually going to be coming on as a productivity coach, Dr. Diana, and I'm so excited about that. And so were all the women that are registered already and all the ones who are going to register from now until then, and then. So have my one-on-one program and that is actually full with a wait list. Right now I have two retreats that are coming up here locally, where we're going to do meditation, some yoga we're going to do like some workshops. It's going to be a whole lot of fun. Really my bigger goals are to do more in-person retreats. That's my goal. We all know that that is not under your controller, my control that is under the COVID control.
So, I have big dreams and big goals, and I know where I want to host these things. But, I'm working cautiously. So right now the retreats that I have in person are all outdoor and they're one full day retreats. So which we can still do and require vaccinations and all that. But once you start to get into the multi-day retreats, then it can be a little bit tricky.
So that's definitely on my mind. The, you know, sort of offering to help, really burned out and not even if they're not even burned out, but just in general, women who need community who are ready for personal growth, who are looking for personal or a spiritual journey. That's what I want to be able to, provide in a larger scale.
Dr. Diana Mercado-Marmarosh: Yeah. Like at some point in my future, of course, you and I have talked about this doing retreats, like all over the world. I love to travel with. So I'm like, Hey, we got to go hang out in Croatia or Spain or Italy, you know, how amazing would it be for people to come and like figure out their systems, figure out their way of taking care of themselves.
And then we can offer CME and they can be a business expense or a medical. Professional developer expense. Right? And then again, like you taking care of you, it's the ripple effect, how amazing you show up as a parent, as a daughter, as a physician, right. As a neighbor, right? All of a sudden. Have you're functioning from a place of peace and embodying it, not just like, you know, having the thought about it, but actually living it.
Right. So it's very different. Tell me, if our listeners are wanting to get in touch with you, how can they find you? Where can they find? Yeah,
Dr. Rashmi Schramm: I'd love that. So I'm on Instagram and Facebook and, the handle, there is just doctors, Dr., and then my name, which is Rashmi Schram. And then, my website is optimalwellnessmd.org, and I'm on LinkedIn.
I'm also on. Ah, clubhouse. So wherever people are, come hang out with me and, we'll have a lot of fun together.
Dr. Diana Mercado-Marmarosh: Awesome. So if there's anything like one final takeaway point that you want the listeners to hear, what advice would you give?
Dr. Rashmi Schramm: Yeah. You know, I think it's that normalizing the idea that whether you've been identified as somebody with an ICD 10 diagnosis or DSM-5, you know, meet the criteria for ADHD or not.
Every human being in 2022 has ADHD tendencies, period. If somebody doesn't recognize that they're not living in our world, we live in a distracted distractable world. And so to normalize. This notion that it is really hard to focus and concentrate because we carry a computer around in our pockets. We then we, we have so many ways of dings and beings and all this other things that, to like, have that sense of self-compassion that, that nobody is alone and that nobody is just born.
I think with just this like laser focus and that we can all get there and the systems that you provide, you know, there's so many different tools that are out there that to just continue to, you know, again, just a curious and bring back, come back into that self-compassion and just keep growing. That's what I would say.
Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much for those that are obviously my clients and have worked with Rashmi already. It's I mean, what do they say other than life-changing and she teaches him how to do breath work and she teaches them how to meditate, but. I am only bringing you people that I trust and people that I myself have worked with.
And of course I am her client. So I want you to know that I'm not just here making a podcast about XYZ. I am giving you the tools that have helped me to be able to function. You know, tapping has been one of the tools that was helpful for me. And that in combination with yoga nidra have been really supportive for me, because like I mentioned, if you guys don't know what that is, you can go to YouTube or you can find Dr.
Rashmi's information and try some of her meditations. And then you'll see that you're going to come out of it. Refreshed. Energized. That's what we want. We want you to feel refreshed and energized alive, right? Not numb. So please give, give it a try. If you have never tried something, you can't, you don't know if it's gonna work or not until you try it.
So give it a go.
Dr. Rashmi Schramm: Yeah, I love that. Thank you for reminding me about YouTube. I actually have several, I have a, I have a meditation for focus on YouTube. That's perfectly free. So you can just go to YouTube, Google my name. And that would be a great one to try.
Dr. Diana Mercado-Marmarosh: Don't worry, guys. I'll get the links and I'll put in the comments.
Okay, thank you again. I know that time is your most valuable asset and I am so grateful that you gifted that with us today. And so thank you.
Dr. Rashmi Schramm: It's my pleasure. Thank you for having me.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Connect with Dr. Rashmi Schramm
Website: https://www.optimalwellnessmd.org/
Social Media Handles:
facebook.com/Dr.RashmiSchramm
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Rosemary Nichols: I have boxes of boxes in this storage area that I didn't see visually. That were just postponed decisions. Like I had many years of caregiving and I don't regret it for a second. I loved my family and I still love my family, but I just kept putting things to the side. That's really, when I dug deep and really had to deal with my own inability at times to create the system that worked for me.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
All right. I am so excited this week. We are talking with one of my star guest coaches in my program. So I am so thrilled to have her here. As you guys know, time is our most valuable asset. And so I'm so humbled that she's here today. Her name is. Rosemary Nichols. She is a woman with a mission. Her aim is to help individuals, especially those with ADHD, to overcome disorganization and create beauty and order in their environment and in their lives.
Using self-compassion approach, her background is in education and she's been a special ed teacher, a health educator. A speaker and a trainer, a child advocate in a crisis center, a career development specialist. And now she is being a blessing to many, many people around her by being a professional organizer and an ADHD, decluttering coach.
You probably are starting to put the picture together. She's the Jack of all trades. Right? And she is one of ours. She has ADHD herself. So that's quite, she's probably going to be a life learner. Like most of us are. So I'm very excited that she's here today. Rosemary. Do you mind sharing some of the circumstances around your diagnosis of ADHD?
Rosemary Nichols: Absolutely not and as you, as I explain it, you'll see that it could help someone out there. And why I say that is that my journey to being diagnosed is rather humorous in one respectand the fact that I spent 22 years as a special education teacher in the classroom. And I taught students that had learning disabilities, behavioral issues, developmental delays, and ADHD.
In the beginning of my career, we called it hyperactivity. But as time went on, we called it ADHD without realizing that I had ADHD. And I think part of that story is that along the way, as both a student and then as a teacher, I kind of unconsciously develop these what I, what we call the special ed compensatory strategies that helped me with some of the challenges.
But yeah, I was still plagued with self doubt and frustration when it came to time management procrastination, keeping my home, you know, in good order. And there was always something nagging at me that said, why can't you be with like other people who have their act together? I mean, I must have read countless books on organization and time management, but back then, let me just tell you.
The books that were written were written by people that didn't need help in those areas because it came naturally to them. So it was only after I lost my mother, I was 57 and I was working as a manager in an educational agency that I just couldn't shake the feeling that there must be some reason why I was having such a hard time focusing beside, you know, the normal grief. And so through some reading and exploring, I sought the help of my counselor at the time, and she referred me to a psychiatrist within her practice to discuss this issue of ADHD. And so I taught, I was in the first session with the psychiatrist and he asked me a few questions, but one of his main question was, did you have, a problem or struggle learning how to read when you were a child or reading in general?
And I said, no. And he said, oh, well then you don't probably have ADHD. And I was okay. So he begrudgingly. Agreed to give me some medication to see if it helped, but I just didn't feel comfortable working with somebody who didn't believe that I had ADHD when at that point, my inner voice and my counselor both knew, you know, this is something that makes so many things in my life makes sense. So I got another recommendation from the same counselor for a different psychiatrist who is more holistic in his approach. And that proved to be a better match for me. So I do suggest advocating for yourself because this is my opinion, but I feel like ADHD. is a spectrum just like autism.
And some of us are on one point of that spectrum. And some of us are another point. And just because we're not on an extreme point of the spectrum, first of all, it doesn't mean that we don't have ADHD, but it also means that the issues and challenges don't affect us just as great. And the other thing I do want to add is, I've listened to some of your podcasts and people talk about, you know, especially the idea of female students.
And sometimes we look different than male students have ADHD. So looking back, school career, I didn't get into a lot of problems at school. I do remember in third grade though, being told, being talked to because. Talk too much, which is not a shock to people with ADHD or to my friends, but it was interesting.
So in school, I didn't have a lot of behavior problems, but at home I was always punished for talking back to my parents. And I just look back at that now and say, well, the impulsivity. As someone with ADHD was always there from the time I was little. So that's kind of my journey to, to being diagnosed and to start dealing with how to deal with this.
Dr. Diana Mercado-Marmarosh: And how old were you when you got diagnosed? Were you in the middle age or towards, later on or was. It wasn't in childhood, right? You said.
Rosemary Nichols: No, no, no. I was 57 years old.
Dr. Diana Mercado-Marmarosh: Oh my God.
Rosemary Nichols: That's what I'm saying. And what I think is I always have a sense of you or the fact that I was a special education teacher and it took me that long.
Now let me just tell you. Maybe about 10 years before that, when I was working in this educational agency and I was surrounded by people, you know, a lot of people that dealt with special education, I would say jokingly, oh yeah, I'm a little ADHD, but it didn't really absorb into me until that issue with losing my mom.
And it just felt more dramatic. And then it was just. Wow. I can't focus many. I should look into that. And then I remember very clearly the day that I was in Barnes and noble with my sister and I had picked up this book and this book about ADHD, it described the different types of personalities. And I looked at the one that sounded like me, and I read it to my sister and she just like.
Their eyes and she's like, yeah, that describes you to a T. So, so I just think everyone's journey is a little different. Do you know what I mean? And my journey of being diagnosed officially late in life. It gives me more empathy for people that again, have been struggling with this without a label and also without the knowledge of how our minds work and how we tick, because that's the beginning.
Dr. Diana Mercado-Marmarosh: I think of dealing with it effectively. Yes. I think you're a hundred percent correct. . And the fact that not until somebody else kind of recognizes it, right? Because like you said, we've been doing what we've been doing for years, and this is the norm for us. Right. And we look around and sometimes our family's a little bit like us.
So we consider that to still be the norm for us. And not until somebody else outside of you can maybe pinpoint something and then you're like, oh, well maybe. And then, like you said, opening that curiosity. And then finally, when you do get the diagnosis, it's understanding how you tick, like you said, because for me, I was sitting in shame.
Like I didn't want to talk about it. I didn't want to share it with anybody because in my mind it meant I could no longer be perfect student. I could no longer be like the role model that everybody was looking up to because I felt like I couldn't be perfect. Right? And so for some reason, my brain was equating perfect with worthiness, which obviously now I've come to understand that some females and sometimes people with ADHD, like they have this imposter syndrome and they don't realize that their thoughts are not really them, like, it's something in there that is telling them, you're too loud or too slow or too, whatever. But it's not really the truth. It's just an opinion that our brain is there to try to protect us from like messing something up or being fired or whatever. Right. For getting the keys and like locking ourselves out of our house or like something like that.
Like you just said, you tap into curiosity, you start to see, huh? Maybe there's a different way of thinking that I'm having, and it's not necessarily a bad thing that I'm thinking differently. So tell me now that you have the diagnosis, do you feel like it ever impacted your life? Like, do you feel like it impacted your family or your friends around you?
Like, because you had ADHD.
Rosemary Nichols: Yes. Yes. Yes. But also I also will temper that with saying that it I'm sure it still affects anyone who knows me, but to a lesser degree because of my knowledge and my strategies, but yes, chronic lateness. Which has dramatically improved doesn't mean I don't run late sometimes, but I mean, chronic lateness, like, oh yeah, Rosemary.
She's never going to be here on time. Impulsiveness. Sometimes interrupting people when they speak, oh my God. I became so aware of that. It was so ingrained in me. It was like, I felt like I had to add something in at that point, because maybe I wouldn't remember it, or many times it came from a place of supporting the person, like acknowledging them.
Oh yeah. I understand what you're saying. I know what that means. But I really had to really consciously work on listening to people until they finished and then making a comment also at times, not listening as carefully as I could to someone, not because I didn't want to, but because my mind was like, And about all these things.
Like they would say something and my mind would go to a lot of different places. And this is one, the last one I feel definitely, I saw it maybe more as my manager and education, but over committing to projects and events, and then not following through or getting too many things on my plate at the one time, because for those of us, with ADHD, we have a lot of interest and we have a lot of, you know, that's how we, we sort of get excited because like, oh, something new, you know?
And so I feel like the knowledge of those things, and it came at different points in my life, really supported me working on these. So. I was less affecting those around me in a negative way, but I always say to that, you know, I am like kind of gregarious. I'm a talker. That's going to be who I am. I just need to temper that in a way so that I'm respectful of the people that are around.
So, yeah, definitely it did impact people and you know what my mother passed away, but my God, she would be laughing so hard now. When we would look, if we were looking back at my child to through the lens of ADHD, because she was a bright person, but back then, there really wasn't a lot of knowledge about it and she would go, I know she goes something like, oh my God, that's why you never could.
You know, stop talking and just say, yes, mom, blah, blah, blah. I mean, I had friends, we were a little, what do you call get together with people that grew up in my neighborhood? And I said to this one woman who lived next door to us, I said, oh yeah, I was always being punished, you know, sent to my room. I said, but you know, really?
How often did that happen? A lot. She's like, oh yeah, it happened a lot. Just said, yep. Come over. Can Rosemary come out to play? Nope. She's up in her room. She can't come out. So, it's always humorous to look back at things in retrospect.
Dr. Diana Mercado-Marmarosh: So tell me, how did you end up like using your ADHD to help. You know, with this successful business of yours, that now you are helping other people. So, you know, sometimes clutter is an area that is so shameful for us. We, we keep telling ourselves, I should know better. I should be a better blah, blah, blah, blah, blah. Right. Either with paper or with stuff that we don't make decisions.
We just have a pile of somewhere, either laundry or different things. And I think you shared at the beginning that it was after your mom passed away, but how are you able to be such a successful coach now with decluttering? Tell us about that.
Rosemary Nichols: You know, I think part of it is I just want to reinforce something that you mentioned too.
I had a lot of shame about the fact that I could kind of go to my job and sort of manage it. It didn't mean that I didn't have struggles, but then I come home and it's like, I'm an intelligent person. Why can't I keep my house neat? Why do I create clutter? You know, it was really, I was never a happy, messy person to, you know, what I'm saying are people that are like that.
They don't mind the mess. It doesn't bother them. They don't feel ashamed of it, but I was never one of those people. But I think part of my journey in this, aspect that we're talking about was after my mother passed away, but then a few years later, my dad passed away. But a few years later after that, my younger sister. I was very, very close to passed away and I was the executress of her estate. So I needed to go through her condo, which was originally my parent's condo. So there was still some remnants of my parents' possessions, but not a lot. I had to go through it, you know, to clear it out and put it on the market and sell it.
And. Oh, my God, she loved to shop. She loved gadgets and she had a lot of stuff like people that knew her and knew that she had a lot of stuff, had no idea how much stuff came out of that. So I really focused on that process and I had help from friends and I have to say at one point I hired a professional organizer for like the last month or two, because.
It was such an emotional, a loss for me that I don't think I would have been able to do it as successfully. If I had my best friend or her best friend helping me, I needed somebody who was compassionate, but they didn't know my sister. So what I say is I went through that process. We, you know, got it on the market.
And then I came back to my point. And I have a three-level condo. And I realized, especially in my basement, which is a combination of an office and a family area TV, and that kind of thing. I had boxes of boxes in this storage area that I didn't see visually. That were just postponed decisions. Like I had many years of caregiving and I don't regret it for a second.
I loved my family and I still love my family, but I just kept putting things to the side. So that's really, that's really when I dug deep and really had to deal with my own inability at times to create the system that worked for me. So why I feel that I can be successful and am successful with the clients that I serve is that first of all, I have experienced some moral different, but some of what they've experienced and I have found success in creating order and beauty and systems that work for me, for me as an individual.
And I think that lays the foundation for trust. An openness to experiment with me to finding the strategies that work for them. And many times it isn't just me saying, try this. It's a collaborative process where we come up with a strategy together. And I also think that my nature. I love to be creative and inventive, and also both as my experience as a special education teacher, but just general.
I love to problem solve. And that really helps me in customizing strategies that work for the clients uniqueness.
Dr. Diana Mercado-Marmarosh: So then tell me a little bit about how are clients working with you. Are you going to their house? Are you doing virtual? How have you done it or what are you currently doing? I know the pandemic has obviously caused us all to think very creatively nowadays.
How are you doing your thing?
Rosemary Nichols: Primarily working with people virtually, to be honest, I have over the course of the last year, worked with some close family and friends that are like in my pod type of thing, but I really, you know, it's not just about my safety. It's about other people's safety. And, you know, it's like what they say when one door closes another opens, I'm really finding that when you help somebody virtually it really reinforces them developing the skills and the knowledge to continue to do it when you're not around or when you finish your work with them.
So I actually have been pleasantly surprised with the changes that I've seen people making. And even from, I would say from session to session, do you know what I mean? Starting out with that total overwhelm and where do I begin to seeing the pieces that can get them to where they want to go? So yeah, primarily virtually at the moment I do.
I do want to start developing, some online courses and possibly a podcast, because I feel like that can reach more people than just my one-on-one clients. As you probably know, from the work that you do.
Dr. Diana Mercado-Marmarosh: Yeah, that's great. You know, I was a teacher myself, even though it was, I guess, for a short time before I went into medical school.
But I feel like as a physician, you're kind of still a teacher you're still kind of still teaching them different things about their health. And now with this coaching program that I have, it's like, you're still kind of a teacher in a way. So that ability, like you said, can help us to connect with different individuals and not, not make it mean anything if they're just think a little bit different than us, because that's like you said, it's a spectrum, right?
So learning how to communicate is so helpful. And then being able to, like you said, you can't do it for them. Like you're there to be a guide or a coach or whatever, but you cannot run the marathon for them. This way, like you said, you're empowering them to create their system based on what their needs are and implementing them.
And then it is a privilege to be able to see our clients or our friends take into account ways to invest in themselves and help if they feel like that's something that is important for them, right. It begins with an intention. So, how do you feel like you're making a difference in the world? I mean, to me, that's obvious you're helping people get empowered, but how do you see this to be something that is front and center?
I think you kind of already shared with me with four, even asked a question about what your goals are and the next year you were talking about setting up courses and stuff.
Rosemary Nichols: Well, you know, I have to say looking back, I don't think when I was younger, I thought of it as consciously, but I am just the type of person that I need to be in service to other people.
I mean, that connects to my work with students and it's not to put down somebody in the business world. That's just working on a specific project. I just need to be of service to people. But I also want to use my creative nature. And I have to say that even when I began as a special education teacher and this was a while ago, so it was a little bit, it was less programmed and prescriptive in the sense that if the principal start looking into your room and he knew that you could control the kids.
They closed the door and you could, you've got the objectives done, but you could be very, very creative. It's a little bit different in education now. So I think that's why it was a good match for me at the time. But really at the moment I specifically feel like how I can help, make a difference is continuing my work, helping and supporting individuals.
Especially women with ADHD to lead better lives, to support them in their decluttering and organizing and setting up an implementing systems so that they can lead their best lives. And with the energy that was previously spent on self criticism and doubt, it can now be focused on their dreams and aspiration.
And as I mentioned, I really have been thinking that, this year I really would like to be able to do. To a larger amount of people. And that might be through, developing some online courses or programs and maybe even creating a podcast like you have.
Dr. Diana Mercado-Marmarosh: And I mean, now you're already coaching my group, right?
Like you're one of my guests coaches. So you already part of a group and you're already obviously doing a really good job at leading the class. Now, can you tell us a little bit. About the, the clutter bugs. I know it, that's probably going to take a whole thing and itself. Can you just give us like a minute explanation of what that means and like how that is just one more way of triggering your personality type, right.
Rosemary Nichols: And, what it is is what, uh, Dan is referring to. Is there as a professional organizer, one of my favorites, whose name is Cass. Her website is clutter bug dot, I think M E that's how it is. When I got exposed to her, I was so refreshed by the fact that she differentiated between people that look at organization in different ways, because maybe from my background as a special education teacher, I mean, one size does not fit all.
So she created this system, which is kind of adorable. It's called clutter bugs and there are four different types of clutter bugs. There is a butterfly. Butterfly is somebody who likes in their environments, visual abundance, but organizational simplicity, there is a lady bug and that is someone who likes visual simplicity.
They like things hidden. They don't want to see everything out and they also want organizational simplicity. They don't want complicated system. Then there's also a bee and that is the person. To make a generalization. It could be the person who looks like they are naturally organized. They have visual abundance and they have lots of detail in their organization.
And then there's the cricket and that's the person who they liked the visual simplicity. But within that, they like the organizational abundance like, they want things maybe hidden from site, but within that, they want a very detailed approach. So what I do with my clients is I have them take the quiz, which is on her website.
It's like a five minute quiz. And to me, it's just a starting point. It's not like, I don't think any system is black and white and everyone doesn't fit into one bucket perfectly, but it just gives me an idea of. Kind of the way their mind works related to organization. That's why I think some of the approaches that just take a sort of single approach don't necessarily work because unless you're that type of person who wants that type of organization, you're going to try to make yourself into that kind of person or force yourself into systems that are just not going to work for you.
Yeah. So, yeah, and I just also feel like for myself, I'm a quote butterfly, but there are areas like with my paper and maybe it's because I'm an educator, I'm information is important to me. I like a more detailed system. There were in other areas. I just want a simpler system. So we were, this is a starting point that we work from.
Dr. Diana Mercado-Marmarosh: Yeah. And so that's really good that, you know, you're able to go do a whole class on that and then explain to each person how their stuff might be different from the, like their way of organizing is different from their children's or their significant other or their partner. Right. And so that's why sometimes we get into ourselves into trouble because in your mind you want to organize it one way and then their mind, they want to do it another, and then y'all can sometimes clash.
And that's where it's so beautiful when you come in and you're like, well, duh, he's not trying to sabotage you. That's just the way his brain thinks. Right. It's so good with that.. Rosemary. Well, I am so glad that you came today. Can you tell us how it, where people can find you?
Rosemary Nichols: Sure they can go to my website, which is Rosemarynichols.com. And that's spelled R O S E M a R Y N I C H O L s.com. Or they can email me and it's very simply rosemary@rosemarynichols.com.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much. Now, if you could give us just one takeaway point or one thing that you want people to like walk away with today, what would it be?
Rosemary Nichols: It would be that to ask for help or support is a sign of strength, not a sign of weakness.
And understanding your ADHD and how it affects you is the first step to creating a life that truly works for you. And again, I am so passionate about practicing self-compassion because it will make this journey as someone with ADHD so much easier and so much joyful and more, I mean, more having more joy in the.
Dr. Diana Mercado-Marmarosh: Awesome. Well, I think you stated it beautifully having self-compassion and choosing joy instead of overwhelm is the key. Right? And like you said, asking for help because your sown of genius. Might not be somebody else's zone of genius and vice versa. So why not use each other's gifts to make sure that, you know, the universe supports you, right.
Why not? Awesome. Well, thank you so much again for coming. I know time is your most valuable asset and I am very humbled that you decided to invest your time in us and all our students who are wanting to be less cluttered.
Rosemary Nichols: So, well, I just wanted to say, Diana, it was a pleasure talking to you this afternoon, and I greatly admire the work that you're doing as a physician on the frontline, in the pandemic, but also.
As a coach and a mentor to physicians who have ADHD, because so many of us look at ourselves as we're functioning professionals, why can't certain areas of our life work for us. And I say it from the bottom of my heart, but knowing you. Continually inspires me. So thanks so much. I really appreciate.
Dr. Diana Mercado-Marmarosh: Thank you. Well, they say you are the average of your five people, so your network really gives you your net worth and you know, you've been, you helped me declutter my house. So I had to bring people and share my goods with them too. Right. So. All right. Well, thank you so much again.
Rosemary Nichols: Thanks so much, Diana. Have a great day. Thanks so much for this time.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Ways to connect with Rosemary Nichols:
W: rosemarynichols.com
E: rosemary@rosemarynichols.com
Dr. Diana Mercado-Marmarosh: Myths about ADHD, how females can sometimes be underdiagnosed and the fact that you can hyper-focus, you totally have ways to help yourself. And you just have to stay curious.
Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Okay. So today I want to talk about some myths with ADHD and some of them are the fact that only little kids who are super hyper active have ADHD.
The thing is that females tend to be a little bit more calm. We tend to be the daydreamers and sometimes you could be sitting there and your brain can be in 10,000 other places and not necessarily focusing on whatever the teacher is saying. And what happens is that if you were one to be hyperactive, as you go through menopause, If you are a kid who was hyperactive at some point, and then you go through your period stage, then you all the sudden can become more calm.
And so there was some misconceptions that people outgrew their ADHD as they got older, especially females, because all of a sudden they don't see this hyperactive activity happening. The thing is that now we have come to understand that you don't have to necessarily be hyperactive in order to be diagnosed with ADHD.
There was a lot of talk. There's a myth that says that, if you're smart, you can not have ADHD. Which of course, now we have come to understand that that's not necessarily the thing. The thing with ADHD is that. Tasks that sometimes seem boring or in important to us can be the reason we don't find the keys can be the reason why out of sight, out of mind, if it wasn't in our schedule, we tend to forget that.
And sometimes that can get us in trouble. Like when we forgot to pay our taxes or we forgot to pay a tuition or we forgot to turn in an important paper. Right? And the thing is that a lot of people think that if you go through college or you got through medical school or law school, or if you even got into that, there's no way you can have ADHD.
And that's not the case because whatever you have that interests, you. We tend to hyper-focus on that. And sometimes we spent so many hours doing that and we don't realize that it's like two or three times the amount of hours that other people invest in doing something. We don't make it mean anything because to us that's what is driving us or that's what feels right.
What's aligned with. What happens is that you end up having both male and females who have ADHD, but they're just working a lot harder than they need to be. And they don't realize that they're doing that because they have found their body finds ways to overcompensate for that dopamine that is low in their system.
How do they do that? Well, sometimes that looks like using too much coffee or using sodas. Or using, unfortunately, some people end up using like cocaine or different things like that. Alcohol, smoking, anything that gives them dopamine food, fried very sugary food as a way to try to find the dopamine.
Feeling like if you're smart, you know, you don't, you can't, there's no way you can have ADHD. That's a myth because as a physician right now with somebody that I have ADHD and, somebody who's currently has seen my patients in practice. Plus I now have a group coaching that I have physicians and medical students in..
I see it every day that all ethnicities, regardless of their social economic, and regardless of what specialty that they're in can have some problems. Right. And again, this is ADHD as a genetic condition. That is about how. Process information. It's an executive dysfunction that is also tied down to emotional dysregulation.
And even though in the US, it's not used as a way to, to say that you have ADHD, emotional dysregulation is not something that is used to diagnose that in Europe. It is it's one of the six characteristics to diagnose ADHD. The point that I'm trying to get at is that you can totally be somebody who is smart.
You can be an engineer, you can be an accountant, you can be an ER doc, you can be ICU nurse. And being smart does not mean that that's automatically going to, um, rule out ADHD. So instead, what you need to look at is, are you somebody who forgets the keys?
Somebody who has no time awareness, somebody who has the best intentions and sometimes regardless of what you think you are not able to accomplish a deadline. Right? And so you have to just see the whole picture. Are you somebody who talks out of turn because you're afraid that. You're gonna forget what the other person was talking to you about.
And you're gonna look like the dummy because you didn't get in to say what you want it to say. Right? There's so many things that you have to look at. It's not just whether you can focus or not, but look at the whole strategy. With it. And that's the other myth. People think when they hear the word ADHD that you just have problem focusing.
And the thing is that not so much, like sometimes you have problems focusing on the things that to you are boring or too big of a task where you have. Find the task, but sometimes when you do get into whatever you're doing, you weigh over hyper-focused and you have a problem getting out of that stone to be able to come back and live with the rest of the humans in the world.
I will explain what I mean. So I have to use timers in the last year when I started understanding myself and I started to realize that I had no time awareness. And that's why, if I tell you that it's, something's going to take certain amount of time. It might take a lot more than that. I didn't realize until it was pointed out to me that the way our brains work is that we have places.
We have to think of a recipe when you ask us like, Hey, how long is this is going to take you, I'm going to tell you the time that it's going to take me to do something, but I don't tell you the time beforehand. Like, I don't tell you what I have to gather all these materials or make sure I'm at the right place at the right time with whatever I'm going and then the cleanup part of it.
So for example, I always use this example because it's real. If I have to cook a pasta, you're going to ask me how long does it take? And I'm going to tell you six minutes, but I'm not going to tell you that I don't even have the pasta in my house. I have to get in the car, drive to Walmart, go get the pasta.
Then I get the sauce. Then I get the bread. And then I looked at flowers and next thing you know, 2 hours has gone by that. Uh, by the time I started cooking the pasta and then I realized that I don't even have the pot that I needed because last time that I cooked pasta, I took some to my neighbor and then I forgot to get it.
All of these steps that I hadn't accounted for, when you asked me how long it was going to take me to do something. Right. And so the time awareness factor, because you didn't plan out what you wanted to do because we tend to live in the moment. Sometimes can get us into trouble. For me understanding that five minutes or an hour can feel the same sometimes when I'm enjoying something that I'm doing was a big revelation, because that gave me the opportunity to start to use timers so that before I walked into a patient's room, my nurse can come and knock and give me a heads up that certain amount of time had passed by so that I can start to wrap up appointment.
It's amazing when you're the one who's having the appointment with me, because you're the only thing that is in right in front of me. And I'm so excited to be talking to you, but if I'm not aware of the time, if you're the person waiting to be in the other room, you're gonna want me to hurry up. That's the thing like having that awareness that sometimes it's not that we have a community or a personal flaw that we're lying to people or that we don't care about people.
It's just the awareness that there is some other parts of us that we need some extra little help on so that we can create systems to support us and be more mindful of what we're doing. Understanding as well, that ADHD is not something that you caught. You know, there is some data out there that shows that it's obviously genetic, but it also shows that the environment that we grow up in makes a big difference, because it can be in our genes and it can be asleep or dormant.
And if the environment is such where your parents help you create good systems so that you can support yourself, then that works out great. And it might be that your ADHD does not get manifested until way later in life. But if you're in an environment where maybe there's some abuse or maybe there is some financial hardship, or you don't have the best schools or different things like that, it could be that your ADHD gets manifested a lot sooner rather than later.
Like for me, I didn't get diagnosed until I was in medical school. And I knew I was working a little bit harder, but I didn't realize that in high school, you know, I was running 10 miles. And so in the cross country team, that was probably giving me the dopamine that my brain needed. And I struggled a little bit when I got to college and it was because I wasn't running, I didn't put the two and two together today, which are myths about ADHD, how females can sometimes be underdiagnosed and the fact that you can hyper-focus and sometimes.
The things that are boring and makes us seem like we're under focusing and the fact that, you know, you totally have ways to help yourself and you just have to stay curious. I did end up having some tutors and different things like that because I knew that I worked best by talking it out with somebody else.
You have to understand that it's not just that you can't focus on something, but it's that sometimes you way over focus on something and you stay for too long of a period. So you have to have some tools to bring you back into like, present moment so that we don't become like over perfectionist on certain things and dwell and little details that can get us into trouble.
It is obviously a real condition. You know, a lot of people always say, oh my God, people are always overestimating it. Actually, the fact shows that it's way under diagnosed, especially for females. Sometimes they don't get diagnosed until the birth of a child or after they get to college or even like get a job promotion and stuff like that.
Well it's because of all the changes that happen with executive and organization and emotional and all that stuff that can really bring it out. And sometimes they don't even get diagnosed until they get into the menopause years because of the change in estrogen. So it's so important for you to just have an open mind if you have ADHD or if you know somebody with ADHD so that you can come curious and get to learn more about yourself.
I hope you enjoy the tips that we share today, which are myths about ADHD, how females can sometimes be underdiagnosed and the fact that you can hyper-focus and. The things that are boring and makes us seem like we're under focusing and the fact that you totally have ways to help yourself. And you just have to stay curious.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
If you are a physician or medical student who is always taking work home, never keeps up with charting and feels their frustration with themselves building every day, it’s time to make a change.
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Dr. Lara Hochman: Most of us in medicine are perfectionist. Something I see all the time is doctors get stuck on making the right decision when. You can't really make the right decision. You make a decision and then you make it right. But you got to know that you're not going to make the right decision every time. If it's not the right decision.
That's okay. We tend to feel stuck in our jobs in medicine, and you're not stuck. You can absolutely make a change.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
Hello? Hello. So excited today. I have an amazing friend and an amazing physician. I want to introduce her.
Her name is Dr. Laura Hochman. She is a family medicine physician, and she's an advocate for fellow doctors wellbeing. Of course, this burnout and dissatisfaction has taken a toll and she's here to save the day. She founded Happy Day Health, , a physician recruiting agency to match doctors with well run private practices where they can enjoy practicing medicine again.
And so it's such a great treat to have somebody who is looking out for our well being and more importantly, helping us get a job that fits our environment, but please tell me, how did you get into this? How did you decide this was what you were going to be doing? It seems like a big adventure.
Dr. Lara Hochman: Yeah, it's certainly a big adventure. Yeah. And thanks for having me on today. You know, I essentially fell into this job, or into this business. I was helping friends find practices where they'd be happy. They were burned out. I was doing it anyway on the side, just for fun. And I was helping friends who had practices find doctors because they could not find a doctor to join them.
I already had the thought of, I want to do something to help physicians. I can obviously see with my own eyes what's going on in medicine, and I want it to be a part of the solution. And so in doing what I was doing anyway, that's when I realized that I can make a huge impact by helping doctors find places that they're a better fit.
And, rather than trying to fit a. Peg into a square hole, it's find to fit the peg into a pink shaped hole. So, and so that's how I got started. I realized that I could make a big difference and you know, there's a lot that needs to be done and this is the way that I can play my part in us taking back minute.
Dr. Diana Mercado-Marmarosh: That's an amazing thing that you saw the need and you realize that this is what you enjoy doing anyways. So why not make it official? And everybody wins, right? Like private clinic, we'll get an amazing doctor. And the doctor knows that this is what they want because you, yourself being a physician, you are.
Gonna be trying to make a quick buck and just placing somebody somewhere, but you understand the ins and outs. So you have that deeper understanding that other people don't sometimes.
Dr. Lara Hochman: Yeah. Being a doctor. I totally get it. And, one of the things that makes us unique as a profession is that we go into medicine because we care and we want to help people.
And, I mean, I absolutely bring that into this business because that's who I am.
Dr. Diana Mercado-Marmarosh: So tell me, I'm sure there are some residents that are listening or even some medical students, or even some attendings that are already have a job, or maybe they're in between jobs. What would you tell them, how can one choose a job or how can they decide what they should do now that you know, there are that stage.
Dr. Lara Hochman: There's so many things to do. You know, the first thing to know most of us in medicine are perfectionist. And so something I see all the time is, doctors get stuck on making the right decision when. You can't really make the right decision. You make a decision and then you make it right. And you want to make the decision that's best for you, but you got to know that you're not going to make the right decision every time.
And so if it's not the right decision, that's okay. We tend to feel stuck in our jobs in medicine, and you're not stuck. You can absolutely make a change, but there, you know, there's so much to do. I would say if you're a medical student or just starting out your residency, or even if you're an attending and you're not ready to leave your job, the first thing to do is just.
Notice what you're good at notice what you're really good at notice what you're not so good at and really take note of those things, because that will absolutely play into what kind of job you should be looking for, what kind of job you would enjoy and what you absolutely want to avoid.
Dr. Diana Mercado-Marmarosh: People with ADHD sometimes tend to think outside the box. We sometimes tend to spend a little bit extra time with our patients because we don't have that time awareness sometimes. But at the same time, we're willing to be, you know, run diabetic groups or we're willing to do something else that's a little bit different or procedures or different things, right.
Like you just said to. Inventory of what your strengths are and what you want to do or not do, or if you want to do research or if you want whatever you're wanting to do, or definitely not do, like if you don't want to be on call, you know, then knowing, okay, that environment is not, or that job maybe is not the best fit.
And like what you just said about making decisions. That's the fastest way for us to move ahead. Like you said, because, not making a decision is still a decision that you made. Right. And so, we, we want to forecast innate at times because we're like, whoa, what if I messed it up? But what if there's no wrong?
Right. You just now have more data when you make the decision. Right. And like you said, then you make the decision, right. Either you signed a year contract and you go forth and conquer or you decide, yeah, this is not the right environment. And then you call Dr. Hoffman and she helps you out. Right?
Dr. Lara Hochman: Exactly. I mean, you know, like you said, there's so many things that, that doctors can do with ADHD. It can be a superpower. So, you know, don't, don't get stuck doing something you hate and that you won't thrive in find those things that you'll be great at. And more than likely. There's tons of doctors who don't want to do those things.
If it's business development or hiring or setting policies. Your ADHD can be an absolute superpower with the hyper-focusing and being able to get excited about all the different things and making something boring into something interesting. You know, that's thinking outside of the box is what we need in medicine.
So we really need more of these innovative things.
Dr. Diana Mercado-Marmarosh: Can you tell me a little bit, I know you've worked with so many amazing clients and I know you've been able to help them find the right environment for them. Like what have you noticed when you're working with clients that have ADHD? What kind of environment do they tend to thrive in?
Have you noticed any patterns?
Dr. Lara Hochman: Yeah, so,, with ADHD, you know, there's that distraction. Issue where you get distracted very easily and evolutionarily. It's been very beneficial and we've, we've selected. We've selected out for that because if there's a tiger running for you want to be distracted and run from the tiger.
So there's certainly benefits to that, but you want to make sure to maximize that. So. You know, in the back office, if there's one big office with lots of doctors, lots of nurses, medical assistants, back office staff on serving patients questions and calling patients with lab results. And people bombarding you with questions all day and prior authorization is being done and, you know, nobody can focus in that environment and, and especially if you have ADHD, so.
Typically, you know, if you have ADHD, you'll do better if you have your own office or if you're away from a window, and if those things aren't necessarily possible, what accommodations can you make? You know, without necessarily making accommodation. So is it that you need sound canceling headphones?
Do you need to set better boundaries where your medical assistants, if they have questions, they don't come ask you every time they have a question, they batch those questions and every day at 1:00 PM, before you, while someone else is rooming your patient, that's when they come to you with that batch of questions.
And so rather getting a scheduled, scheduling it into your schedule is far better than the constant distractions. So part of it is, is this practice better set up for you? Do you absolutely need a scribe? Do you need someone like Dr. Diana to help you with, with how to manage your ADHD, um, in, in a practice setting?
Or is it. Not the right environment for you at all. And is this perhaps not the right practice for you?
Dr. Diana Mercado-Marmarosh: Yeah, you're so right. You know, whether you have ADHD or not, we all get distracted. With distractions, right? If somebody is knocking at your door, which they, they would, for me, they would knock on my door as I'm seeing a patient and they will pull me out so that I could sign like a referral or I could sign like physical therapy order or something like that was obviously not an emergency.
That would distract me. And then you go back into the room and guess what? Your patient has five additional questions. When you thought you were about to close the encounter, right? Like you just said, learning to set boundaries from a place of like, no, I made this decisions ahead of time. Do not distract me.
Unless, literally the, the window is like on fire and the whole building is on fire and then I can't escape then come distract me. Right. But other than that, send me a text and I will get to you at certain time. Right. If it's not urgent and having that understanding of how your brain works, that if you have some boundaries, like if you already said, okay, we're not going to take every walking patient, like we're going to, set up some urgent care appointments, sort of say like shorter 10 minute appointments at the beginning or at the end of the day, or we're not going to see like double books, because then I don't need understanding if that environment is feasible. If they respect what you're asking them to do. Like you're not asking them for anything other than a lunch. Right?
And sometimes. It doesn't seem like you have that environment and it could be very different. Like I know when I was at my first job and that's another thing that's important to point out that sometimes your first job is not always going to be your last job, right. Sometimes it's just, you're there for a year or two, and then you learn what you like, or don't like, And then you can move on to another job.
And it's not just about the money. We all know that because it's how they treat you. Right. If they respect your opinion, if they give you your boundaries, if they give you your vacation, what kind of benefits you have? I know in my first job that I had. They had amazing maternity leave. Like you could be out three months, like paid and then you could be half paid for additional three months, which I, like, I had never heard of something like that.
Of course, when I came to my current job, they didn't even have like anything. Like it was, you get FMLA and that's it. Like you are not going to get paid, but of course I was able to negotiate and that's something that is important to know that sometimes. You can negotiate things that are not necessarily in the contract.
If it's something that. Important for you. For me, I didn't have kids at that point. And it was very important for me to have three months paid off. Now I didn't get three months paid off, but I got eight weeks paid off. And then I could use my four weeks of my own sick time, which win-win, you know, I was still going to take it, but why not take it paid right?
The point is that again, you have to understand. Your environment. And like, I was able to tell them up front, like sometimes you're not even supposed to be talking about that. If you're going to get pregnant or if you're pregnant or whatever. But to me that was so important and I told them, Hey, listen, I am going to get pregnant at some point.
And I want time off paid off. And so they gave me a one-time deal, but of course, then the second one came around and they came and they offered it to me without me asking. And so that's amazing that type of environment. Cause I, assumed we already had a contract, then that's what it was. But again, an environment, when I finally got pregnant, they send me flowers and they're like, congratulations, you're pregnant. Right. Which doesn't happen in some jobs. Right? Like in other jobs, you're just like one of 200 doctors. And even though you want to change or provide a way to change, you're easily replaceable and it doesn't matter what you say.
Dr. Lara Hochman: Absolutely. Yeah. And you bring up so many good points in there, you know, you don't want to be one of 200 doctors because then you may not have those opportunities to use your strengths strengths. And as far as finding a new job goes always negotiate. But before you even get to that point, you want to think about what are your deal breakers?
So if a fully paid maternity leave is a. Is an absolute must. Private practice may not be the best option for you because you don't have the entire hospital system to support your maternity leave versus in a small private practice. If it's you and one or two other doctors, that's not really financial feasible.
So you really need to weigh the pros and cons of each, you know, how important is a paid maternity leave versus how important is an office. That'll send you flowers and, and that's like a family, you know, there's so many amazing private practices where they function essentially as a family.
And you can get that. In some hospital-based clinics. But it's certainly a lot more common, in private practice because everyone's invested in the practice for sure.
Dr. Diana Mercado-Marmarosh: And yeah. And of course, I asked I was still going to assign, regardless whether they said yes or no. Right. But you don't lose anything by asking.
Right. And so that's a thing. And even if they would have said, no, we're not paying, I still wanted to make sure I could take the three months off. Right. So like those sorts of questions. To ask and, and you don't know what they're going to say until you ask, so don't tell yourself no, right? Like that's the no, no, like don't just assume things because that's the fastest way to make an asset a you and me assume that's what it spells out.
So just ask and, and then if it's not meant to be no worries, but at least you asked right.
Dr. Lara Hochman: Exactly and that's something that was kind of beaten out of us in medical school is asking for what's important to us. And that's so important because if you don't ask you, the answer is definitely no, it may still be no, but it may be a yes. So definitely ask.
Dr. Diana Mercado-Marmarosh: Let me ask you a question. Like, what else should they be thinking about? Should they be like looking at if they have 401ks or if they give three weeks vacation, four weeks vacation CME, what other benefits should somebody be looking for?
Dr. Lara Hochman: You want to look at, so certainly paid time-off, that's an absolute must. You need to decide how much is good for you. I had one candidate that I was speaking with, who she went to go visit her family in Canada at least once a month. And so needed a minimum of one Friday off a month. But didn't want to use up all her PTO doing that. So that was something important to her.
And she was able to negotiate that in addition to her paid time off. So that's really important. Non-compete is something that's an absolute must that you have to look at. So I've seen. Non-competes that are very fair. The most fair I've seen as you have. I don't remember how many miles it was. 10, 15 miles.
Non-compete for your first two years of employment. And after that, there's no, non-compete, I've seen non-competes that are absolutely outrageous 30 mile non-competes or, you know, something. It's closed systems here where I live have a non-compete that's 10, 20 miles from every single one of their locations.
And the locations span most of the big cities in the state and I'm in Texas. So that's a fairly large,
yeah.
Dr. Diana Mercado-Marmarosh: You almost have to move out of state or be ready for lawsuits. Right?
Dr. Lara Hochman: Exactly. And so even though it's technically not enforceable, the hospital can still come off to you and fight you for that many years.
Essentially enforcing the non-compete. So you really, really want to take a close look at that and keep in mind, you know, I don't love non-competes and I, I do see them essentially as a little bit of a bully tactic, but that's really when it's unfair. To either one of the parties from the practice standpoint, every practice I speak with is afraid that the person that they pick the doctor, they choose will open up shop next door.
So you really want to see it from both parties. What's fair. What's not fair. Is it, you know, five miles, 10 miles. Those tend to be more fair. Of course it depends where you are. Is it 30 miles. That's not fair. That's not fair at all. So, and sometimes what I'll see is candidates think, well, if I were to leave this job, then I'll probably just move back home.
But a lot can happen in a few years. You can, you can get married. You can. Get divorced, you know, so much can happen. That can tie you to a city. You can fall in love with the city and never want to leave. So if you have a non-compete, that's preventing you from working in your city, that's not. Okay. So, you know, take a very close look at the non-compete other great things to look at our benefits like health insurance. Dental vision, all of those things, but don't only look at what the practice is providing. Also take a look at what can you get on your own, because you may be able to actually get a job that pays great and pay, pay for your health insurance on your own, on the side, which is very expensive, but you don't want that to be the reason you don't take a job that you love.
You may, this job may pay. $1,500 a month more and your health insurance costs $1,500 and that may even be tax deductible actually. So, you know, there's, there's things you can do as far as that goes, be flexible and really think about it from all aspects as well. Other things to look at. So we have non-compete salary, the hospitals are able to usually, provide a higher salary because they're also making money off of the tests that you order, the referrals that you make. All of the other things that you're doing in addition to just seeing patients. So is salary the number one, absolutely most important thing. ' And you're Okay with taking whatever may come with that versus the you're OK with taking a little bit of a salary cut in a position that's better suited for you. And some people love hospital-based practices and they love academics because with that comes, research, it comes, you know, all sorts of really cool opportunities.
But for a lot of people who want to get in there and see patients and spend time with patients. Private practice may be a better, better fit for you. So take a look at all of those aspects and really think through what the caveat being like we said earlier, where you are now does not have to be where you are 40 years from now.
It would be wonderful. And that is what we all aspire to is to be in a job that we love and never need to change, but life happens and things.
Dr. Diana Mercado-Marmarosh: So curious, what do you think you're then it'd be up to in the next year or two? What are your goals? What are some fun things that you can't wait to get yourself or continue to do
Dr. Lara Hochman: My goals for this coming year? You know, I, I have a goal of I'd love to place at least two doctors a month. Business-wise this year is I just want to hear back from doctors about how I'm helping them, whether it's placing them in a job or maybe even something they learned from a podcast that I listened to. But that's one of my big goals is being able to make an impact, being able to spread the word that we don't need to settle.
We don't need to be unhappy and we're not trapped. That's something that I feel. A lot of us feel as retract and there's no way out and there's no way to go. So my hope for this year is to spread that message. You're not trapped. There are options. Fun things I'm doing. I have a trip planned in April to go to the EntreMD conference, that'll be super fun. Right?
I get to see classmates and, Dr. Una who inspire me and who pushed me to do greater things every day. And I love watching everyone's progress and seeing what they're doing. I right now at the time of this recording, when the middle of the Omicron surge. So I took a break from exercise.
I take gymnastics classes and not doing it is just killing me inside. So couldn't wait to get back to gymnastics. I'd love to be able to do a press handstand this year. It's been my goal every year for four years. So
Dr. Diana Mercado-Marmarosh: Are you getting closer?
Dr. Lara Hochman: Maybe this is the year. So this year I hope to really just thrive and, you know, become a better business woman, become a better parent and do that. Gosh, darn press handstand.
Dr. Diana Mercado-Marmarosh: I am so gonna root for you when this happens. And even while you're trying, because let's face it, it's who we're becoming right along the way, getting those goals met.
Right. So. Where can the listeners get in touch with you so they can learn about all the great stuff you're doing and maybe you could help change their life as well.
Dr. Lara Hochman: There's a few places you can find me. I'm on LinkedIn. My LinkedIn name is Laura Hochman MD. You're welcome friend me or connect with me and message me there.
You can go to my website. There's a contact form on there that you can reach out to me. It goes directly to me that is www. happydayhealth.co. It is not.com and I'm on Tik TOK and Instagram. My names, there are happydaymd
Dr. Diana Mercado-Marmarosh: Awesome! If you could leave us with one thing, what would be the take away point that you would want us to have?
Dr. Lara Hochman: I would say having ADHD does not need to be a liability. It does not need to get in the way. Who you are. Don't see it as a bad thing. It can absolutely be harnessed to be an asset. So use that and learn how to really harness your superpower. It can create great things, the best entrepreneurs. Art have ADHD because they're able to harness their creative thinking and their risk-taking abilities. And so it's a superpower. Use it.
Dr. Diana Mercado-Marmarosh: Thank you so much. That's such an amazing way of pointing that out. Now I have to ask because everybody's going to probably be like, oh my God, I love her accent. Tell me. Tell us where's this accent from,
Dr. Lara Hochman: I was born and raised in South Africa.
Dr. Diana Mercado-Marmarosh: Amazing, and now you said you're in Texas, huh?
Dr. Lara Hochman: Yee-huh!!!
Dr. Diana Mercado-Marmarosh: I am so glad to have you as my friend and as my classmate and everybody, please reach out to her. She as, you can see has your best interests at heart, and she can help you get placed in an environment that's going to help you thrive. So don't waste this opportunity. She might just change your life.
Dr. Lara Hochman: Yes. Please reach out. Don't ever hesitate at all. I'm here. I answer all of my emails, I answer all my messages and I would love to hear from you.
Dr. Diana Mercado-Marmarosh: Thank you again so much for sharing your wisdom with us today and your time. Because to me, time is the most valuable asset that we have. So I am so privileged that you shared that gift with me today.
Dr. Lara Hochman: Thank you for having me.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Guest Speaker:
Dr. Lara Hochman MD
Website: Happydayhealth.co.or https://larahochman.weebly.com/
Linked In: Lara Hochman,MD
Instagram: @happydaymd
Tiktok: @happydayMD
Dr. Diana Mercado-Marmarosh: If I only had 24 hours to live, how would I live? What would I do? What things would I take off my plate? Who would you call? What would you eat? Where would you go? What would you not do anymore?
Hi, welcome to beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas.
I am a mother to two very energetic toddlers or three and four years ago. And in the past year, I have undergone radical transformation after discovering ADHD coaching and that coaching for the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects and a lack of time awareness.
I didn't realize that I was not filling my own cup. I was running on fumes the last year. The secret learn to stay in your lane. So now my mission is to help others develop systems that tap into their sown of genius. So they too can reclaim their personal lives back, like I have.
So another topic that I was asked about was how do you have an unlimited time?
I always see you doing this, doing that, doing that. I don't know how you do everything. What's your secret? The thing is there's no secret. I mean, I used to be somebody who always had like, oh my God, not enough time always had like 90, a hundred projects that were all uncompleted. And I always felt like. My worth was tied to my productivity.
And if I wasn't productive enough, I wasn't worthy enough. And it was just some shennanigans that was happening. So those types of thoughts are not very helpful. But what I have learned is that there are certain things that will create more time and there's certain things that will deplete your time.
And so having an abundance of time is really. Your thoughts about it in the night? I know it sounds weird, but really when you, you start to understand what coaching is, coaching is understanding that there are certain things that can happen in the world, regardless of what we do. And it's always how you react to that thing that it happened that gets you to your.
Outcome. Right. So most of us do what we do because of a fee. Like we either get married, we go to medical school, we go to law school, you know, get a job, buy a new house, buy a new purse because of the feeling that oh, having that my make me feel more happy or will make me feel like I've arrived or make me feel like accomplish the thing is.
We always feel like there's not enough time. There's always this question of how, can I fit everything in how, how, how, how I'm always so overwhelmed if you're thinking that. There's not enough time. Like if your thought is time, like that's the fact that everybody would put in their thoughts, time is there.
And if you're thinking I don't have enough time, you're obviously going to feel very stressed and overwhelmed and you're going to feel like life is just not. You might feel like there's a pressure on your chest. You might feel conflicted. You might feel like a lump on your throat. And the actions that you might take is delaying things like putting things off or doing other things that are not as important as to stuff that you needed to do.
Like we are professional buffers, meaning where we might start cleaning the house. And we might start doing laundry or making phone calls instead of the actual things that are more important that could save you time. Like if you just paid, let's say, your daycare fee or your tuition fee or your motrgage or different things like that, there are certain things that we need to do firsthand and we don't do because they seem a little bit complicated.
Like maybe the taxes, right. Tax season is coming up. When we are doing other things we're buffering because we're thinking, oh, I'm too stressed. I'm too stressed. I'm stressed. I don't have time to exercise. I don't have time to eat right. I don't have time to sleep. I don't have time to, you know, sit down and read a book with my kids.
I don't have time. I don't have time. I don't have time. Then the results ends up being that you give all your power away. Like you just let life happen to you. Instead of you realizing that you get to decide what is important, what should have your attention? You get to decide how you handle time. If you're more intentional, and if you had a different thought, like I have plenty of time, or time is abundance.
Oh, you have, you're like me, you have no time awareness sometimes. So whether it's one minute or five minutes, they feel the same to me, which is wonderful when you're my patient in my room, because a time stands still. And. The only thing that's in front of me. And you're the only thing. That's the most precious thing in that moment in time, but it's not so great when you're the one waiting to see me when I've taken so long with that other patient.
Again, the thought, the thought, the thought is what's going to get you to how you're feeling. So you're thinking I have plenty of time. Then you feel like content, you feel happy, you feel alive, you feel limitless, right. You then decide that you focus on what's the most important and you execute. And then the result is you feel like you have an endless, endless amount of time. .
So with that being said, like, I want to share some things with you of ways that I have learned that are sometimes we're not really so easy for me to learn, but they have definitely shown me that when life just keeps happening, right. When you make decisions ahead of time, that helps. Things that will make you have more time is making decisions.
A lot of us don't want to make decisions. Sometimes we don't trust ourselves that like, maybe your taste is not as good, or like, let's say you're building a house and you're like, oh, I don't want to make that decision. That's too much of a decision. Let me just wait for my husband or let me wait for my friend.
Or let me ask what they think about the color or what they think about the cabinets. The thing is it's going to be your house. So why don't you decide what you want, make a decision. That decision is going to move you forward. You're going to move on to the next step. Don't get overwhelmed that there's so many decisions to make.
What have you make the wrong one? Like that's what your brain is going to tell. But I truly believe that everybody, when they make a decision, they're doing it from a place of how can I make this simple and easier for myself in the long run? Like nobody wakes up and says, oh, how can I make this so complicated today?
So that the rest of the day I spin out and I try to figure out how to undo all this mess that I just did. Right. And nobody wakes up thinking that. So honor yourself, make a plan, make a decision, trust your gut, trust yourself, and know that sometimes we might not get what we want, but the universe will give us what we need.
And sometimes what we need is better than what we even wanted. It, we didn't even realize that constraints. Just say no to things that are not for you. And, and I know we all tend to be people pleasers and some of us are a little bit better than others, but when we decide that you have the right answer and you've had the right answer all along, it's just different.
You learn to say, no, you learn to say. No, two things that don't like belong with you, and that causes you to feel like you got your own back and you trust yourself. So creating time is important from the decisions that you make. Sometimes failing, failing royally is important. It's still creates time because now you know that that didn't work out and now you can make the next big decision.
And now you can move on instead of sitting there and indecision and confusion and regret and and judging yourself, all those things, they don't give you more time. They take away time. It's silly how sometimes we will think about how to do something for long, long, long. Like when I was shopping for a house, like sometimes those type of purchases, obviously you have to be a little bit more give and take and you have to take your time examining like where it is in what neighborhood. What school, your kids might go to, it might take a little bit more time to make a decision, but other decisions such as like, what food am I going to eat today? What am I going to wear today? Like all those are decisions that you should make them quickly and move along because. You don't have time to dwell on all of that.
Let me tell you, I used to be somebody who wake up and be like, okay, what do I feel like eating today? And like the whole day was consumed with the thought, like, what am I eating? What am I not eating? And it was just, it was just a hot mess. And so when I decided last year that I was ready to lose weight and I've been able to lose 20 pounds, I decided I was going to make as many questions.
And answers beforehand. And I decided I was going to try to make things simple. So for, for a while, I would bring like a loaf of bread, peanut butter and jelly to the clinic. And that was going to be my breakfast every day. I had decided. I had made five decisions already. I didn't have to think every single morning, what am I going to have for breakfast?
I already decided ahead of time. And then for lunch, I was lucky enough where I could go to work. And in my work, we can go to the cafeteria. So on Monday, I would just see what menu was there. And I would just write it all. I would check, check, check, check, check, check boxes. I wouldn't remember what I checked, but I had made the decisions.
Right. And then at home, my husband and I like on a Sunday would figure out what I needed to order on Instacart so that they can come and bring me the goods so that he could cook for the evenings. And sometimes he would cook. One day and then we would have extra food, like leftover for the rest of the days and stuff like that.
So anytime that you make decisions ahead of time, you're using a part of the brain that is called a prefrontal cortex, which lets you be conscious and objective with the way. Things can go and it could be easier and smoother for you. So that's going to create a lot of time because if you think about it, instead of me trying to make 20 meals in a week, all of a sudden I just, I didn't have to.
It was quick, right? Not judging yourself or sometimes going through the drive-through or sometimes a reheating stuff, or sometimes. Doing things your own way is it's still very valid. Like you need to make sure you meet yourself where you are and that you stopped doing things that you think you should be doing because somebody else told you because whatever and, and do it your way.
Because when you start to do things that aligned with you, That are your intention that you're living out your values. All of a sudden it becomes so much easier to say no to the things that are just not really aligned with you. And, don't get me wrong. It's human nature to want to fit in because we want to be, you know, in a community where we're all accepted and everything is peachy.
Right. Our brain is going to tell us that if we don't come form, if we don't do exactly what everybody else is doing, we're doing it wrong, but that's not the case. Like everybody has a way of doing things. And so we just got to make sure that we trust herself enough and that we do things from a perspective of, of just wanting to be ourselves. Right. And so it's so important that you stop pretending that you don't have enough time. If you were to get in a car accident today, if you were to get a phone call today that your kid was, on the playground and passed out or whatever you would drop, everything you would find time for, what is the most important thing with the pandemic, it has really gotten me to think if I only had 24 hours to live, how would I live? What would I do? What things would I take off my plate? And you got to think that way, like who would you call? What would you eat? Where would you go? What would you not do anymore? Ask yourself those questions. If I had 24 hours to live, what would I do?
Well, what have I had a week? What have I had a month? What if I had a year? What if I had five years? It doesn't have to be hard. Don't complicate it. What do you really want? What is really important? Is it important that you pick up your kid every day and spend time with them reading? Is it important that you went for a walk?
Is it important that you started to learn how to play the guitar? Is it important that you went for a massage? Is it important that you talk to your. Is it important that you had dinner with a friend? Is it important that you had a date night with your spouse? What is important only, you know, so stop pretending like you're confused and blah, blah, blah, blah, blah.
And you don't have enough time plus excuses. It's time to stop making excuses and start living the life that you want to live.
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group Beyond ADHD Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends so they too can learn to live life and stay in their own lane.
Dr. Diana Mercado-Marmarosh: So today I want to talk about a question that I get all the time from my clients. And it's a question that was also always on my mind.
Hi, welcome to beyond ADHD, A Pysician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
I would constantly ask myself, how can I just stop procrastinating? What is it that other people are doing? That they just do what they need to do and they don't think about it twice. And why can't I do that? I would ask myself what's wrong with myself. I don't understand why I have all this best intentions and they just never happened.
I had to get a lot of coaching on it myself, and really I had to do some reflection and I had to come to understand that sometimes we are not really procrastinating. Like sometimes we are just not having the right class. We think we want to do something, but we're not even sure of what that is. And so it's really hard to do something when you don't even know what you're trying to do.
I know it sounds silly. Listen, what I mean, when we are going to go somewhere, if we decide we're going to go to the store, we made that decision, right? Like we said, we're going to the store to go get X, Y, and Z. If we're already been to that store before, we might not have to look up the directions or anything like that.
But if we never been to that place, it would make sense that we would slow down enough to put the address in our GPS so that we can actually arrive to the destination that we want. However, most of us don't think that way. Sometimes we don't want to get off the spinning wheel because we feel like it's going to slow us down.
We feel like we have hit momentum and we need to keep going. But sometimes when you slow down enough, you get clarity. And so if you're putting off something that you have told yourself, you want it to be. For example, let's say as we're now in the new year, right? Like let's say, you've always had this intention of wanting to lose weight or of wanting to start to exercise.
If you are not clear on a lie, you want to do that and how you want to do that, then it's not really going to happen. And you're going to feel like, again, you're procrastinating. The one thing that you told yourself you would do. The lack of clarity. I keep going back to that when a task is too big or the task is too boring, it just feels like it paralyzes us.
It feels like too much work who wants to do so much work thing is people with ADHD. We're not afraid of hard work. Don't get me wrong. If that thing is motivating enough for us, we will do it. And we were burned ourselves out doing it because we're so excited about it. So it's so important to check yourself when you think you're procrastinating on something like, again, losing the weight, ask yourself, do I really know what I want?
Is the goal to lose five pounds or is the goal to be able to walk up the stairs or is the goal to fit on a specific size of clothes? Having that clarity just right there could help you take the next steps. So if it is that I, you just want to get more healthy that you don't want to be short of breath as you're going up the stairs, then deciding.
That I am going to start to exercise. What am I going to do? I'm going to walk. 10 minutes a day, Monday, Tuesday, Wednesday, and it's going to be at the park and I'm going to bring my music. And I'm going to listen to a podcast as I'm doing that. If you're that clear on what it is that you're doing and why you're doing it because you don't want to be short of.
Then it's a lot easier for you to stop putting off the things that you kept telling yourself you were going to do. So you have to put it on your calendar because people with ADHD, you already know it's only two types of time now and not now. And so if it's not on your calendar somewhere, it is just not going to happen.
So you gotta make sure that you prioritize this. If this is something that is truly important for you and that. The next question is that sounds simple. Right. But the next question really is one that is so important that you ask yourself, is this really important? Like this task that I've been putting off, is it important?
Can it be done today or can it be done by somebody else or, or should I just let it go? That it's not the right time to do? Why wouldn't it be the right time? We are so used to doing things sometimes because we feel like society has, um, this expectation of us to do it, but we don't realize. Sometimes we didn't even rest.
Right. We haven't slept. We have been, uh, taking a shower. We haven't had a day off from work. It's been three months and you haven't had a day off yet and your kids were sick and you had COVID, you don't realize that your body is not trying to be a rebel. Your body's just tired. There is not, it's not just procrastination.
Like you really have to check your. Is this the right time for me to be doing this? How are things in my energy field? Did I sleep last night? Did I eat, you know, on my frustrated about something else? That is a live situation that happened, right? Life happens. We're not robots. We're not meant to just keep going, going, going, going, just like the battery in the car that needs to get charged black, the gasoline in the tank that needs to happen for the car to keep going.
You two need to rest you two need to refill that energies. And so whether it's spiritually, whether it's by exercise, whether it's nutrition, whether it's by singing a Nancy, like you need to refurnish your cup, it goes back to the same thing. Was I being like unmotivated or was I procrastinating on something that I wanted to do?
Is that a character? I'm not trying to give you more excuses. Cause believe me, we all make those. But what I'm trying to get you to do is to have at least some awareness that sometimes your body's doing what it's meant to do. It's pushing off things that are not considered an emergent type of thing. And it's trying to give you the, a warning that you need to rest, that you need to take care of yourself first so that you can help care of others.
So, if you really want to stop procrastinating, you need to get clear. You need to know what your intentions are for that day. How are you going to accomplish it? Ask yourself, do I have everything that I need to do that task that I want to do? So if you decided you were going to exercise. Do you have the sports bar?
Ready? Do you have your water bottle ready? Do you have your tennis shoes? Ready? Do you have everything that you need to accomplish? The tasks that you were set out? If let's say you have to stay for your board exams, do you have your question back with you? Do you have your journals? You were going to do.
Do you have a babysitter who's actually taking care of your kids so that you can study. Did you block off time? So there, you're not trying to see patients in between. I know it sounds silly, but you need to do the basics. You need to make sure you have the tools that you need, that you're in the correct environment that you need.
And that when the time comes, you just do it. Don't second. Guess yourself, do it. And then re-enact. Hey, what worked well? What didn't work? Well, what can I use going forward? And then ask yourself, have I really taken care of myself? Did I sleep? Did I eat, did I, did I ask for help? Because asking for help is a big strength.
A lot of us want to think that we're just going to do things on our own. No, you need to ask for help. Nobody. Nobody is their own island. I hope you take some tips to. I hope that what you can come away with today is that your mindset is everything. If you are feeling overwhelmed, if you're feeling like you're not enough, ask yourself, why am I having these thoughts?
Is my brain trying to protect me from something? Did I even eat? Did I sleep? What's going on? Just ask yourself. You cannot be in your head and be a detective at the same time. Take care of yourself, take care of each other and nature. You reframe the question. If you are brain asks you, how can I stop procrastinating?
Ask yourself, am I really procrastinating? Is this something that I want to do or not? Am I trying to eat the whole elephant at once? You need to take a bite size of that elephant and eventually. You will, you will take care of it and make sure that you ask yourself, what is the one thing I can do to move forward.
If this is a project that I am really trying to do and who can I ask for help? Because remember everybody has their own sown of genius. I would go to a specialist if I needed some. So that's how you should see it. What DIA, can you ask? What friend can you ask? What neighbor can you ask? Because everybody has their own sown of genius.
You have to tap into that so that you too can get the answers that. They're all there. The universe is waiting to give them to you just have to be willing to ask the right one,
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Emotions
Dr. Diana Mercado-Marmarosh: Emotions. A lot of us tend to think that we should always be feeling happy that we should not have any pain ever. We always feel like the pursuit of happiness is, should be something we strive for, but emotions, whether they're good or bad. They all teach us something.
Hi, welcome to beyond ADHD, A Pysician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
A lot of us tend to think that we should always be feeling happy that we should not have any pain ever. We always feel like the pursuit of happiness is, should be something we strive for right? But emotions, whether they're good or bad, they all teach us something. They really happen, based on a thought. And we don't realize that the thought is what eats to the emotion and then the emotion guides, some of the feelings and some of the actions that we take.
And so this week I want to bring into a discussion, emotional regulation and people with ADHD, even though the us DSM five diagnosis does not count emotional dysregulation as one of the six Fundamental features of ADHD to get to be diagnosed with. And it is used in other parts of the world, like in Europe.
And it makes sense, right? Because we all can get flustered. Whenever we get frustrated with a task that we're not able to complete. And I don't know about you in the last year when I started to get curious and discover about my ADHD, I started to realize that there were certain behaviors that I was doing.
I sometimes felt like I just could not bring myself to stop doing it. I would say little lies because I felt like I didn't want to displease anybody. I didn't want to upset anybody. I didn't want to hurt anybody's feelings. I didn't want to feel rejected. And I remember there was one episode with my husband years ago, before I had kids that I was like, so excited about cooking.
And I remember baking a chicken and I don't even know all the specifics about it, but I think he had told me like, don't use that Rosemary spice because it was expired or I don't even remember what, but I think I forgot, you know, how it is. They tell you something and you're like, well, yeah. And then you forget.
And then of course I was so excited to have cooked this chicken that I was going to show him that I should have done it. And he asked me whether I had cooked a chicken. And even though internally, like my voice was saying, yeah, just say, yes, I couldn't like I had this like immediate sense of fear that if he knew that I had used the rose mary, he will no longer like me.
And she had like the chicken, like all the thought and effort that I was, I had put into this meal with a little sh**. So logically I could have jumped, answered Yes. I did cook the chicken and then allow him to make the decision. To decide if we wanted to eat the chicken or not. Because I had used a rose mary that he had inquired me about, but I could not get out of the loop of lying.
I couldn't say yes. I just think he gave me multiple chances, and I just could not. And so he knew I was lying. He could obviously see that the amount of the. That was used and it resulted in like us not talking for a few days. And it was a very painful experience because I'm an extrovert. And of course, with ADHD, you make things seem like worse than they are.
And so at that time, I didn't realize like, there's a name for that. There's a name for it. It's called Rejection Sensitivity Dysphoria (RSD) which is something that. shifts or if they're short lipped sensations, it's an emotional dysregulation that is triggered whenever you feel like an intense pain, because you feel like you might be rejected.
You might be cheesed. You might be criticized. You might start to judge yourself and you don't realize that you're lying to try to avoid feeling those feelings. And so I ended up, like I said, it was horrible for me because he wasn't talking to me and he ended up saying like, why are you lying about that? What else are you lying about?
Of course I wasn't lying about, to me, like a small little lie didn't mean anything because I thought I was trying to protect them, but he made up a good point. Like, why do I have to lie? I can touch it. Say yes. And then if you do whatever. And so the point is that when you don't know any better, you do.
Thank you need to do to protect yourself, but let's not an immediate danger, but my brain could not associate that. And this week I want to talk about emotions and why some things trigger us and how to be able to tap into what we are feeling like right now. And what are the top three feelings that we always have?
And whether those are the three feelings that you want to continue to feel, or whether you can choose another three things on purpose to be able to support you better with whatever goals or whatever things are doing throughout your day. Yeah. So that's the topic of this week and I want to go back to emotions, right?
People can internalize or externalize sometimes emotions. Like when you have this emotional dysregulation and you internalize it, you can send any change. Right? You can call yourself all kinds of names. So negative self-talk you can go from feeling like fine to like immensely sad. And sometimes you might even look like you're like severely depressed and suicidal, but then all of a sudden, like a few minutes later hours later, you're like back to.
Bizarre. Right. You can also externalize it. And I didn't even realize this was time times because you're in like overwhelm or anxiety. Like that's what the feelings that you think you're having, you become like immediately angry or irritable and frustrated, like from zero to nothing. And you just can't seem to control it.
But then again, I can sit back and just be a few seconds. So having those emotions and you not being able to regulate them, long-term can really lead to low self-esteem to self doubt, self criticism, to rumination and your, and it can affect relationships. Not only like with yourself, it can affect relationships with your coworkers, with your family members.
And so it's very important to like really recognize the importance of emotions and to realize that emotions. Because of a thought that we having, many of us want to think, I feel happy just because they're all I feel. Well, I feel happy because I have a husband ended up, but neuro is not that you have a husband it's because of your thought of whatever the husband is doing or not.
Or some of us. I think, oh, I feel lonely. And you still have a husband. So it doesn't matter what the fact is. It's whatever your thought is about the circumstance. Right? Because I have heard many people tell me, doctor, I don't understand. Like I was in a room with all my family members there. They were treating me like we, and yet I still felt lonely.
Obviously that person who was having a thought about something, it was not the fact that everybody was around her. She was still having a thought about something. So I really want us to give the importance of emotions. It's important because if you are feeling like. You're probably going to do like a lots of other actions that you probably thought you weren't going to do.
We go back to the same thing of exercising. If you think you don't have enough time, if that's the thought that you have under 90, your feeling is going to be, and from defeated or hopelessness, you're not going to be like, oh yeah, I'm going to go exercise. You already have the thought I'm coming at time.
So you're probably going to say, ah, just tomorrow, I'm not a big deal, but if you have. I take care of my body. Then you're likely to have a feeling of like being focused or like being excited or being motivated. And that's going to lead you to different actions. So I really want you to tap into what are your top three feelings?
Are they supporting you? And again, this exercise is just to bring awareness. Most human beings don't even pay attention to what their thoughts are and when they don't pay attention to them. Then they just wonder why they can't figure out why they feel the way they feel, but you have to be willing to look at it on purpose, to become aware of it.
On purpose. We really are not taught about emotions and a lot of us don't even have lots of vocabulary with emotions. And there is things that are considered like an emotional childhood versus an adult childhood. And that's a very important distinction when. We tend to think that if we behave well, if we get good grades, then we are worthy of love.
Like our parents are going to treat us well, they're going to love us. They're going to acceptance. And when we come, we become adults. We in, we just continue doing those behaviors. We think that if we treat others, which I'm not saying you shouldn't treat others as well. But what I'm saying is that when we do things for others, But even though internally, we don't think that's something we should be doing.
We don't set boundaries or are just people pleasing because that's what we got taught, like when we were kids and maybe we didn't get taught that, but that's what, just what we learn to be. And so when you, it's natural for us to continue to want to do that, but nobody ever teaches us that it is not our job to make us happy.
Your spouse's job to make you happy is not your best friends' jobs, make you happy. It is not your mom's job to make you happy. It's your job to make you happy. It's the relationship you have with yourself that should make you happy and be aware of that. It's okay. To feel all the spectrums of feelings, be aware that the good feelings and the vaccines, they all teach us things.
And sometimes we are very afraid of the bad feelings, because we are afraid that whatever thoughts we are having, like they mean that about us. And I can, we're having a thought, like I'm too stupid to read a book. What is that going to cause that's going to cause pain, right? And most of us don't want to feel pain.
We don't want to feel like a failure. We don't want to feel ashamed. But the thing is that if you are not willing to. Or to even question that feeling, you're never going to realize what is the thought that is making that feeding and whether that feeding is actually serving you or not. I'm not saying that the job is to change the fee.
Right? A lot of us are going to think like, okay, I'm just going to change the thought that way I have a different feeling. No, you have to be willing to process a FINI. You have to be willing to sit with it. And many times when we just become the upstairs. Of the feeding. If we tune into where it is and our body, is it in her chest, isn't in her stomach.
Is it on. How does it feel? Does it feel that it constricts or does it feel like it relaxes? Will you just become aware of it? You become aware that lean on any emotion is just a vibration in our body. And many times, you know, I have now made the connection that when I was lying a lot, like I ha I was lying.
And to me, they were baby. They were white lives. And I didn't think that was wrong because I thought I was genuinely saying babies are genuinely sparing. Somebody else from that disappointment. I'll give you an example. Let's say somebody invited me to a party pre COVID and one, I was too tired or too, I just didn't feel like it instead of just say no, I don't feel like interrupted tired.
Like I would say something like, oh, my kids are sick. Or, oh, I'm on call. I can come even though I wasn't on call or something. Right. And January. And so I didn't want to hurt their feelings. I didn't want to say, oh, I don't have time for you. And I'm not saying that's how you should say it, but in the last eight months or so, and really more and more I've been working on just saying what it is that I need to say and staying true and not worrying.
About me trying to control how the people are going to react. It's not my job to control how other people are going to react. When I try to do that, I don't show up from that place of integrity to myself. I lie to myself. So I think it's more important that you speak your truth. So for example, when there is something that me and my husband disagree on, he tells me no, don't do this.
And I still do it. And I tell him, look, he told me not to cause this. Something in me told me that was the right thing to do. Of course, I didn't want to disappoint you, but disappointing myself was something I was not willing to do. So it's about communication, right? Because we don't know the present with us or not with us, whether it's a coworker or.
They might be with us for a lifetime or not. They might be with us for six weeks, six months, who knows six years. But hopefully you and the relationship with you is going to be for a lifetime. So you really have to know you don't die when you just are willing to feel all the emotions. You just feel so much better.
What I made the connection was that whenever I was saying those little eyes, I was feeling like stomach issues like constipated and just not well. So all that out there that paying attention to our thinking and noticing what you're feeling. It's not something that people do on a regular basis, but it's something that can be very beneficial and especially be willing to not just feel good emotions, but also bad emotions.
Because when you do that's when your life really starts to change and transformed, because you are willing on purpose to create and sign the life of your dreams.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Elisa Chiang is an Ophthalmologist, Oculoplastic surgeon and Life Coach. Elisa primarily works with physicians to master their money mindset so they can build wealth and practice medicine on their own terms.
Dr. Elisa Chiang: I think there's different levels of budgeting for some people having a strict budget really stresses them out. And I don't know that you have to have a really strict budget. I think you do have to have a sense of what you're spending and where your money is going.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, A Pysician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
Good evening, I am so excited today to talk to Dr. Elisa Chiang, is an Ophthalmologist Oculoplastic surgeon and life coach. Dr. Chiang primarily works with physicians to master their money mindset so that they can build their wealth and they can practice medicine on their own terms. So today you all got to pay attention because this is going to really change your life..
Dr. Elisa Chiang: I'm so happy to be here. Thank you.
Dr. Diana Mercado-Marmarosh: Can you tell us a little bit about how you started this and money mindset? How did that come about?
Dr. Elisa Chiang: You know, so in the beginning of. Yeah, everyone. When they're starting to love, coach business tries to think about like, well, who are my people and what can I specifically do to serve my people?
And so being a physician, you know, it's natural to want to coach other physicians because that's, you know, our people. And one of the places where, I have a lot more, you know, knowledge and just, experience is with. Investing and partially with money mindset. And I have to admit it's not because I've had to overcome a lot of, money mindset issues, but I, I guess was blessed with parents who actually talked about money and you know, not everything.
It's not like it was a perfect money upbringing, but. My parents, when I was young, like, you know, money was discussed in the household. When we got allowance, it was very specifically to kind of teach us how to manage money. When we want to kind of bigger ticket items like a bicycle, we actually would go 50 50 with our parents.
So we understood the value of money, the bio of working for something that we wanted and how much things like actually. And so that continued, you know, in college, like there was always talk about like saving for college and how much, , you know, college cost. And then when we're in college, like actually managing our money, like my sister and I literally had like independently, I don't even think it's like, my parents told us this, but somehow we just independently like had spreadsheets where we actually put all of our spending and like, yeah, like who does that?
But like, literally she did it. I did it. It's not like. It's not like we were ever told to do it, but somehow it just came up like, well, we should be tracking everything we're spending and making sure that like, it falls in, you know, the budget that we have so that, you know, we can, you know, I mean, freshman year we were all on meal plans, but after freshman year we were no longer on meal plans and we had kind of a budget.
And so we wanted to make sure that. Yeah, we had food.
Dr. Diana Mercado-Marmarosh: That's amazing. You know, I remember I'm the oldest of my family and I'm the first one to go to college and education was always like something that my parents were like, this is how you're going to get ahead. This is how you're going to have money security.
Right. But I remember like, I would always, because we didn't have excess money. So to say, like, I got scholarships and I was also on financial aid. I remember I was choosing like the biggest loan, like not knowing that eventually I was going to have to pay it back. Right. And so I would always choose the biggest loan and like, Use it to go on vacations and like all this other stuff, instead of being mindful.
Oh, I should be careful. But it was, it was silly because I remember always looking to see if I could find like a cheap book, because those were expensive. They were like $500 or something crazy. Right. But at the same time, I wasn't really careful with buying all these clothes and purses because I was like, oh yeah, I'll pay it back.
Eventually. I wish somebody would have told me, like, you know, if you don't need all that money, that all that exess loans, like don't take out that, all that excess loan do you know? And so, yeah, it's interesting. Sometimes realize that yes, while money can help us, it can also get us into trouble.
Dr. Elisa Chiang: Yes, it certainly can. And I definitely saw, you know, there was a reason why credit card companies always have booths at college campuses to get people, to sign up for their credit cards. Right.
[00:05:12] Dr. Diana Mercado-Marmarosh: Yeah, exactly. So I have ADHD and I tend to have some type of limiting beliefs. Something like money is too hard or something like, I don't know how to manage it.
I don't know where to invest or maybe I should just let my husband take care of that. Like, why do you think those are things that we shouldn't just wait for others to manage? Like why do you think it's important for us to try to understand like how much money comes in or where to save or all that.
Dr. Elisa Chiang: Because honestly, no, one's going to care about your financial security more than you yourself care for. Right. Everyone's out to get money and you know, people in the financial industry, they want you to feel like it's hard so that you give them their money. That's how they make money. Uh, most financial advisors are really just glorified salesmen, and they're not doing what's best for you. And if you don't know what's best for you, then.
I mean, maybe yourselves like can handle it, but you don't ever actually want to be in a position where your spouse is. The only person is the person handling all your finances. Know, I don't want to have to cite the divorce statistics, but I mean, it's really high. Right. And you may be in love with. It might be great, but literally first marriages are 50% and in divorce and with each subsequent marriage, it's a higher percentage.
And of course, we don't want to go into marriage thinking about that, but there is a point at some point where you may not be with that spouse anymore, and it may not even be divorced. Right. I mean, we're physicians. We see young people, you know, die. Like, you know, like I said, you don't want to think about that, but you want to be in a position where if your spouse dies, that you can still manage the household finances and if your spouse dies, I mean, like that's going to be even more pressure financially in general.
And the thing is, I think a lot of physicians feel that. Well, not just physicians so that people in general feel like money is hard, but I can say that if you got through medical school, you can learn personal finance, right? Most people who are out there in the personal finance world. I mean, yes, they probably graduated from college, but not even necessarily that, right.
I mean, we know so much. More, we have, we have all the brain power that's needed. The difference I think is that we forget how much training. We went through to learn medicine. And we all went through four years of med school, a minimum of three years of residency. A lot of us did fellowship. I mean that's years and years of training where we learn medical language and medical jargon.
How many of, I mean, there are lots of physicians. Who've never read one financial book, right? So the financial world has its own jargon. It has its own language. And if you don't spend any time learning that jargon and language, it's not going to make sense. So like, if you go to France and you don't know any French, like nothing.
There, right. You go to Spain and you don't know Spanish. Nothing makes sense. There all you go to the talk to financial people and you don't know the financial language, then nothing makes sense. So you think you're stupid, but you're not, you just don't know the language. Once you learn the language, it's actually really simple.
Dr. Diana Mercado-Marmarosh: Is there like one book that like you think would like be the first starting step that somebody might want to at least dive into?
Dr. Elisa Chiang: So there are a lot of bait financial books. I think for physicians, you know, the white coat investor and the physician philosopher both have on their books on personal finance.
And so if you are a physician, I think that is a good place to start because we, as physicians are generally a little different than the rest of the population in the sense that we typically have these very large loans. And while we do make a really great income, we went through a long time for, we weren't actually making that much money.
And then. Start making a lot of money. And, but when we start making a lot of, we may still have a lot of those loans. So that's not, you know, the normal situation for, a lot of other professions. I mean, law, I think might be an, a similar situation dentists. But other than that, people are spending so much money in professional school.
Yeah, we're just kind of in different situation and that does affect what we're going to do with our finances. Right? Because now some of us started having children and med school or residency and, you know, may have even had to pay for help, like nannies when really we didn't have the financial ability necessarily pay for it.
But when you're working 80 hours a week, like, what are you going to do? Right.
Dr. Diana Mercado-Marmarosh: Yeah, exactly. And, and do you think it's important to have a budget, like to have budget enough for like the nanny, like you're saying, or for like a basic stuff, right. Like paying your car or paying your rent or making sure you're not on the negative every time with the credit cards and stuff.
Dr. Elisa Chiang: Yeah, I think there's different levels of budgeting for some people having a strict budget really stresses them out. And I don't know that you have to have a really strict budget. I think you do have to have a sense of what you're spending and where your money is going. So you don't necessarily have to say like, okay, I am only spending.
$600 in groceries a month. And then if you spend 701 month, then you freak out, right? Because it's going to fluctuate. There might be, you know, a month that's 400 months, that's 800, you know, if you know, Thanksgiving and Christmas, 10, you know, to have some bigger meals, potentially involved or family coming over for meals, there might be some months where you travel more.
So. You also have to look at, you know, your personal mindset, if having a specific number for a budget isn't going to work for you, then you may just want to, kind of just have a sense of like, okay, how much am I spending? So in general, you want to have about 50% of your spending. Fixed spending. So that's going to be things like your rent or mortgage, right?
That's the same every month. And then about 20% to be your fluctuating spending, the things that really, you can kind of control the difference. And then that last 30% you actually want to put towards investing in growing your wealth and retirement.
Dr. Diana Mercado-Marmarosh: Perfect. And then can you tell me a little bit how you are making an impact with how you're coaching physicians to, understand their mindset with money.
Dr. Elisa Chiang: Yeah, so. I'm not a financial advisor, you know, I can certainly help people, with, how to think about investing and how much to put in different places. But what I've, I've worked with some clients where, you know, they've gone to a financial investor, they got their financial plan, but they don't understand it, or they don't have the mindset to follow it, or even.
Just doing simple things, like getting their disability insurance in place like own occupation, disability insurance is one of the most important things for a physician to have because one of our most important assets after we've done all this training is our ability to earn income. And you know, that own occupation, disability insurance.
I mean, even if you go to a non-clinical position that still covers yourability to bring in income, right? It covers anything. Prior you are making money from the value you're putting out in the world.
Dr. Diana Mercado-Marmarosh: And, and where do you think they should, do you think they should have gotten it as a resident or do you think even now, if they're in their fifties, they should still go and do it. If they haven't done.
Dr. Elisa Chiang: Unless you are financially independent, you should have own occupation, disability insurance, and yes. I do think you should get a residency because you want to get it before you have any health issue that might prevent you from getting it now also as a resident or potentially as a fellow, some of hospitals actually have special, arrangements with different insurance companies so that you can get a own occupation, disability, insurance, potentially without medical coverage.
That actually saved me. So I, got diagnosed with a medical condition in medical school where it made it where I can not get, I mean, I could get a own occupation, disability insurance, but it would only pay out a max of five years, which obviously is not ideal because there is a possibility that, of getting disabled and having it last longer than five years.
And so luckily when I was a resident, the last year you're in training, You could get an own occupation, disability insurance plan through standard, which is one of the five big companies that do a good own occupation, disability plans without a medical exam. And so I know like that is the best plan I'll ever be able to have and not switching out that plan for anything.
Dr. Diana Mercado-Marmarosh: Awesome. Well, I am guilty that I don't have one and I'm going to look it up after, after today to make sure that I get that in place.
Dr. Elisa Chiang: Yeah, definitely. I mean, any, any physician, and even like my husband's a teacher, he has disability insurance, you know? Yes. Could I cover him if he knows I'm working or got disabled?
I could. Honestly, I went part-time recently. And so his income does really contribute to our household this point.
Dr. Diana Mercado-Marmarosh: Yeah. And can you tell me, like, what you like to do? Like how do you feel that you're making a difference in the world lights you up?
Dr. Elisa Chiang: Well, the number one thing I love doing is traveling, especially international traveling, which, 2020 is the first year of my adult life, that I did not leave the country or get on a plane.
I did get on a plane in 2021, but it was only domestic. And so I'm hoping that 2022, I can finally go somewhere outside the country, even if it's just Canada, because frankly, you know, Canadian U S border has even been closed for less, much of this pandemic
Dr. Diana Mercado-Marmarosh: I know you from, other places and I know you love to travel, but could you share where you've been?
Dr. Elisa Chiang: You? So I've been to over 40 countries and six continents. I actually did have plans to go to Antarctica December, 2020 that obviously didn't happen in the end. I also, had a scheduled vacation to Croatia, Bosnia, Herzegovina, and, Slovenia. In June of 2020. So I'm really hoping to build, to do that trip at some point.
But yes, I've traveled. Most of Europe, traveled through Asia through China, Japan, Singapore, Malaysia. I've been to Australia, not yet been to New Zealand, really like to go there. Iceland is also
Dr. Diana Mercado-Marmarosh: Did you do this you while you were in college or like in med school, or like in like after you done or a little bit of all throughout.
Dr. Elisa Chiang: Yeah, all throughout. So, and you know, this is one things about money is that I was doing this in. So I did do it. I'm a PhD program. So I had eight years, the MSTP program and I did this during medical school and residency and graduate school. Like I do remember. I wanted to go to Ecuador. I actually, my best friend from high school, was in Ecuador.
She was working at a nonprofit. And so I was trying to find other men's another med school who might want to, you know, come on the trip. And I remember people like, oh, I can't go there. That'd be so expensive. I'm like, well, I know the plane ticket gets a little expensive, but once you get there, it's like super cheap.
And the same person I was talking to ended up going to Vail for vacation to go skiing. And I was like, that vacation is definitely more expensive than when I went to Ecuador. I did go to Ecuador. I just didn't go with anyone else in med school, but I mean, you can enjoy the world and, you know, and have it be affordable.
I mean, even Europe, I did do some hostels, but actually I'm at my husband pretty young. I'm actually met him when I was a senior in high school and he was, a first year in college. So, because in hostels you tend to have either a, you know, a male or boys room and a female and girl's room.
We did that once and then we're like, you know what? We can spend a little bit more to just get a two-star. But yeah, I mean, really you can travel on a budget and there are lots of young people traveling, you know, across the world. You know, you're not going to stay in five star hotels, but you can stay in really comfortable, you know, situations.
And the experience is really what you're going to carry home with you, right? Like you don't need to, I mean, certainly buying things and having, souvenirs can some people happiness, but typically, stuff like that, you know, five, 10 years later to like listen to trash.
Dr. Diana Mercado-Marmarosh: Yeah. Like what you remember are the pictures. Right. And you remember like the food or the friendship you had over, and sometimes you do hang out with those people later on.
Dr. Elisa Chiang: Yeah, definitely. And the food. Definitely. I remember the food. There are definitely places in the world. I'm like, man, I want to go back there just to eat.
Dr. Diana Mercado-Marmarosh: Exactly. Yes. Yes. So I'm like, I love to travel and we all have our beliefs about money. Right. But when you understand. That money can get you experiences or something that you value that is more than just the cash, right? Or the money that you're thinking, that it allows you to be more of who you are, right? Like it's like an energy exchange, at least in my eyes.
And so it allows you to grow as you go and explore other countries and other cultures and other foods. Oh my God. And the music, of course, you cannot forget the music and all those different places. And, and I think it really. Allows you to realize that, you know, life's too short and yes, of course you can spend $5,000 on a purse, but you're not, to me.
It's not going to be the same as spending $5,000 in that two week vacation, like somewhere in Costa Rica or Ecuador. Thailand or, you know, somewhere where you're like, oh my God, I just got a $7 massage. It was amazing. Right. So I don't know, it feels like you've got a bargain, but at the same time, it's the experience.
Of course I would pay $70 for that massage, but it's the experience of like the culture. So I think. Knowing how to use money to allow you to become more of who you are is so important. And if you don't know how to come talk to Elisa here.
Dr. Elisa Chiang: Yeah. So I loved how you talked about like spending for your values are because I think that is really, the key is spending for your values are, and not for other people's values are right.
Because if you are having the Dr. House or the doctor car, and you don't really actually care about cars and. The smaller house, like, what are you giving up? Are you giving up? Like, you know, that vacation in Costa Rica are you, where you can have a great experience and really have memories that you cherish and spend that time with your family and, you know, get that experience to your children.
Dr. Diana Mercado-Marmarosh: Yes. So important. And like you said, like, Your traditions are your tradition. So of course, right before COVID we had just said, okay, for Christmas, we're not going to buy each other any more gifts like me and my family said, we're just going to spend Christmas, like traveling somewhere. And of course, before that happened, like, we went to Disneyland and that's it.
And then of course it's January that we went for Christmas. And then of course, January happens. Here we are 2020 that Nimbix. So we didn't get to really do that afterwards. But as things slowed down, that's definitely something that we're looking forward to doing, having the experience. And in fact, like for my, for my sister's birthday, like I gave her the experience of buying her a like three sessions with a declutter coach, I think is like, better than me sending her something she might not like, and this is something she can do the experiences of something else.
Right. So, investment in yourself. And of course she told me that was what she wanted and I just didn't put it on her. Right. But this is something that she said that it would be amazing to learn, to have her own systems of things. Feeling like she wasn't doing it. Right. And, and sometimes that's the most courageous thing, right.
To ask for help when you feel like you almost got it, but you don't have it quite, or it just seems too complicated. Why don't go talk to an expert so they can at least advise you, this is their zone of genius. Why not go talk to them and save yourself the hassle? Yes. Probably read all those financial books, but who has all that time, if that's not your zone.
Dr. Elisa Chiang: It's true. I mean, to some extent, you know, you do want to do like yourself education, but other than the others extent, if you don't work on the mindset part. You're not going to have the motivation to actually even finish the books. Right? Know, it all comes down to your why and, you know, for a lot of people, their, why is, really wanting to have a better life.
But when you think about. Being financially independent, which means that your investments are able to pay for your basic expenses. Now, what freedom does that give you? Right. If you're in a job where you really feel tied to that paycheck and you wish you could leave where you wish you could cut down the hours, but you can't do it because of the money.
Well, what freedom would you have if you did actually know that the money that you've invested can actually be enough to support you. And, and that might mean, you know, maybe not support you with. You know, every luxury that you're currently used to, but that freedom of being able to cut back, maybe, well worth giving up that, you know, Louis Vuitton purse.
Dr. Diana Mercado-Marmarosh: Exactly. Thank you. So what is one thing that you would share with our listeners today? Like one nugget.
Dr. Elisa Chiang: Yeah. So anyone can learn how to manage your finances. It is not hard. You just have to learn a little bit of the language and it just, it does take a little time and then a little investment. But if you can just get over that money mindset and really, start living a life of abundance in it.
So it's just like with weight loss, right. We all know how to lose weight to some extent, but you know how to do it without. In a way so that you keep the weight off and, you know, you're happy with where you are. So it's the same thing with money, right? Like, and, you know, initially you may feel levels of discomfort as you're trying to learn how to invest.
And when you make those first few investments or, or it may be, you know, learning to cut back on some of your expenses and really looking at, you know, what do you value? Where do you really want to spend your money? But once you get to that new place with that new mindset, You know, you can really be in a much better place where you're financially secure and able to, you know, do what you want when it comes to your job and working.
And I think it's a total game changer in that.
Dr. Diana Mercado-Marmarosh: Yeah. So the thing is, like you said, how do you eat the whole elephant one bite at a time, right? You can't just do it all at once, especially when you don't have that stamina. Right. But when you start trying that and you keep going and then you get help, then you might actually get somewhere.
Right. So tell us, how can our listeners find you? Cause I know they're gonna come and they're gonna say, Hey, help me get that financial freedom that you talked about.
Dr. Elisa Chiang: Yeah. So my website is www.growyourwealthymindset.com. You can sign up for a free consultation call with me, right on the first page. And you can also follow me on Facebook and Instagram.
My Instagram handle is grow your wealthy mindset and on Facebook, you really is probably easiest. Just look me up. E L I S A ELisa, last name C H I A N G. Chiang.
Dr. Diana Mercado-Marmarosh: Thank you so much. So you heard it here. Get financial freedom.
Dr. Elisa Chiang: I love to help you get there.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Website: www.GrowYourWealthyMindset.com
Youtube: https://www.youtube.com/c/WealthyMindsetMD
Facebook: https://www.facebook.com/GrowYourWealthyMindset
Instagram: https://www.instagram.com/GrowYourWealthyMindset
Dr. Janeeka Benoit AKA Dr. J, a Board Certified Internal Medicine physician specializing in Sports Medicine and the founder of Medfit DO. Dr. J is passionate about caring for not only the athletic population, but also passionate about teaching the general population on how to live healthier lives by living up to their optimum health, fitness, and wellness.
Dr. Janeeka Benoit: Instead of telling yourself that you, we just said it, I can't do something. Ask yourself how can I do it? And that is very powerful because the word can't places us in a position of being stuck.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado -Marmarosh. I'm a family medicine doc with ADHD, practicing in a rural setting in Texas
I am a mother to two very energetic toddlers, four, three, and four years of age. And in the past year, I have undergone radical transformation after this. ADHD coaching and not for the past sticky. My typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects and a lack of time awareness.
I didn't realize that I was not filling my own cup. I was running on fuels the last year. I figured out the secret learn to stay in your lane. So now my mission is to help others develop systems that tap into. I don't have genius, so they too can reclaim their personal lives back. Like I have.
Hi, everybody. I'm so excited that you're here at our podcast. It's beyond ADHD, A Physician's Perspective. I am the host, Diana Mercado-Marmarosh a family medicine physician, and I'm an ADHD life coach. And today I am so honored and so thrilled to bring a good friend of mine. An amazing physician and her name is Dr. Janeeka Benoit, and she's better known as Dr. J. So that's a little bit easier to say she's on social media and she is a board certified internal medicine physician and a sports medicine specialist. Interestingly enough, she's also the founder of med fit DO. She's a runner, she's an exercise enthusiast, and she's a former a certified personal trainer.
Not only does she enjoy caring for all her athletes, but she has passion for making sure that those chronic conditions are originally taken care of through exercise. So they could live holistic, healthier lives, not just mentally, but of course, physically, as we all know, quality of life really, uh, gets us going, right.
So she's an osteopathic physician. Dr. Jay is focused on treating the whole body so that people can live more fully and have a life transformation from the inside out. So I am so excited that she's here today and let's ask her about her unique story, how she got here and why she's, getting us to exercise.
Dr. Janeeka Benoit: Yeah. So thank you so much for that. Great intro, Dr. Diana. So, stories. I remember one specific day during my second year of residency, I was in the clinic and I just couldn't wait to get out of there because my day was just so hectic. And, as I got home and I sat on my bed with the covers on my head, I was thinking to myself, I was very much like my patients, because just like my patients were overwhelmed from taking so many pills, I was overwhelmed with having to constantly be filled them and prescribed them.
Just like them, who sometimes they didn't even know why they were on certain pills. I didn't know my, why. I felt like, I didn't know my purpose of becoming a doctor in the first place, because I felt that I was just, I felt like, you know, I was like in a machine, I was just prescribing and refilling pills and I wanted to get to a point where, I can discover more to me and more that I could provide to my patients and just like them.
Sometimes I feel in control of their health. I felt like I didn't, I was not in control of the trajectory of my career. And it was like looking down a dark tunnel with no end. And, I basically came to where awakening because, I was pretty much a regular avid exerciser. And even during residency, through the rigors of residency, I made exercise a habit.
It didn't matter. You know, if I was busy, you know, even just five minutes, 10 minutes. Made that a priority. And because I made exercises, what habit I've learned to develop, to make other aspects of my life as habits as well. And I wanted to get to a point to not only teach people about physical activity, but also how there's a huge mental component that is involved in it as well.
There is a mind and body connection that I think sometimes gets, maybe not dismissed, but not given as much attention as it needs to. And I wanted to help people discover that.
Dr. Diana Mercado-Marmarosh: So tell me what were your thoughts or what did you notice when you did make that five to 10 minutes a priority for you? What kind of exercise were you doing?
Dr. Janeeka Benoit: Yeah. Well, you know, even like before the exercising, this type of exercise before I was doing it was really my thoughts, but I had to focus on because I thought that because I was a resident, I had to devote all my time and energy to being a resident that this was going to, this is going to be a new phase in my life.
And this was going to take over and I did not have time. At least that's what I told myself. I don't have time to incorporate other parts into my life such as like exercising or journaling or, just hobbies that I enjoy that make me feel human.
Dr. Diana Mercado-Marmarosh: Oh, so your thought was, I don't have enough time, so I'm just gonna do what I can to get through the space in my life.
But eventually you switched your thought, right? Because you said all of a sudden you started doing five or 10 minutes in there, even though your brain was telling me you didn't have time, you kind of said, well, let me just give this a try.
Dr. Janeeka Benoit: Exactly. So, and that's exactly what it was. And you know, sometimes I didn't have an hour to dedicate to an exercise routine, but I was just like, Hey, what if I dedicate 10 minutes?
And I like dedicate 10 minutes consistently throughout most days of the week, what happens. And that's how I made it a habit. It was your small bursts of exercises.
Dr. Diana Mercado-Marmarosh: So what did you notice when you were giving yourself those 10 minutes? Like, were you able to focus more? Were you less irritable where you, what did you notice? Why was it beneficial? Even just 10 minutes?
Dr. Janeeka Benoit: Oh my goodness. Okay. So for me it was my mood. So I was just, just more energetic. I was happy. I was cause you know, the fact that I was doing something for me, I think. And so I think that's what it was. I was doing something for myself and because I was doing something for myself, I was able, I was better able to then provide to my patients.
Right. Because, whereas before I felt like I was not, I wasn't making time for myself and I, and I felt depleted, right. Because when you're seeing patients all day, you're taking all their problems, taking all that with you and then going home. And then there's no outlets, right? If there is no outlet, if there's no care that is, then we send it back to you, you feel depleted.
So that was the major shift for me. It's just like, I need to make myself a party. I need to, no matter how much time it requires, I need to make it a over a priority because when I make it a priority, I'm better able to show up for my patients.
Dr. Diana Mercado-Marmarosh: That's amazing. I'm so glad that you were able to discover that in residency, you know, some of us, it takes us many years after we finish our training to figure out that our time is just as important as our patient's time as our family time, as you know, our community time.
Like, it really is important that you do take care of you, because like you said, how you show up. It's a ripple effect. If you show up with a mind that is focused or with a mind that is not so irritable, then you're just a little more pleasant to be around and in your, just a little bit easier to manage tasks.
So obviously I invited you here today because as you know, I'm an ADHD life coach, but people that work with me don't have to have ADHD. They just have to feel like they want to get some type of organization or feel like they want to tackle their time. And I figured exercise would be a way for you to explain to us how you think that fits in with people who have ADHD or people who feel like they want to manage their schedule a little bit better or manage their emotions a little bit better.
Do you have any insights about how you think exercise could help people with ADHD or time awareness?
Dr. Janeeka Benoit: Physiological level exercise. Can really release neuro-transmitters such as neuro epinephrin, epinephrin serotonin dopamine, and all of that helps to improve the executive functioning of the brain.
So in addition, exercise, can help with really two major components of ADHD. So that's inattention and inhibition. So with ADHD, there's, you know, inattention to like specific tasks. And there's also a lack of inhibition too. There's that impulsivity that's associated with ADHD. So those are benefits that exercise can provide.
In addition to that, with any ADHD, sleep quality is diminished as well. So, sleep quality is improved in terms of. The duration of your sleep, your sleep onset, your sleep efficiency, all of that can help with, um, ADHD symptoms from exercise.
Dr. Diana Mercado-Marmarosh: Do you know, if there's a specific type of exercise that would be more beneficial with ADHD or not?
I will tell you, I personally, I think I didn't get diagnosed until I was in medical school because running was what I was doing. In high school and, you know, I was in the cross country team. And so I know. Yeah. So I always joke around and like I made the varsity team, not because I was the fastest, but I was the only one passing.
So, and then I was so embarrassed. I was like, do you really want me to run this race? I like I'm finishing it, but like way back there, but you know, it's so interesting how sometimes exercise teaches us all kinds of things about life, about showing up and running the race. Even if it's different from everybody else's race, right? Like keep improving yourself and beating your own self. Right. But I was wondering if you thought maybe something like gymnastics or karate or something they have to kind of pay attention to detail, like if that's more beneficial than just running or walking or that does matter?
Dr. Janeeka Benoit: So I would say with ADHD, it's important for it to be fun and stimulating so that the person with ADHD can be engaged. in addition, HIIT, which is high intensity interval training. So it is, pretty intense depending on the type of exercise that you're doing and may require a more motor control.
But I would say HIIT once a person with ADHD, pass some progression in improving motor control. And, they get to a point where that they feel comfortable performing epicenter exercises. Then high intensity interval training, could be beneficial because. Short exercises for like intense periods of time.
So that is great for some, with ADHD because it's short and intense and that requires, you know, focus attention on that specific task and then onto the next movement. So that's another exercise that would, that could be beneficial for someone with ADHD.
Dr. Diana Mercado-Marmarosh: That's awesome. So, you know, we tend to have problems. Like we don't want to initiate tasks.
I think that they feel overwhelming sometimes, but sometimes when we finally do start a task or we have problems like with hyper-focus where we're like three hours have gone by, you're like, oh my God, three hours went by and you thought you were going to spend an hour. And sometimes we don't realize that we're spinning,
like, just because we're sitting there for a longer period of time, it doesn't necessarily mean that we were efficient and focus those three. I think it would be really good to integrate, like, let's say, put, put a timer and give yourself like 20 minutes to do a task, but then do like a five minute something.
And that's where exercise could come in. Right. Because it would give you that dopamine and norepinephrine surge, like you just said, and then you could go back and continue to do it. Most people think that if they step away from what they're doing, they're going to forget. But I think there's probably ways to give yourself a little nuggets where you left off and still be able to come back because now your brain is refreshed because you use like the exercise or the HIIT, like you said, even sometimes just turning on music might be okay to get you out of the zone of frustration or doing a task that you didn't want to do right there.
Dr. Janeeka Benoit: For sure. For sure. Those are all great.
Dr. Diana Mercado-Marmarosh: Yeah. So tell me more about what you think is important or what are some tips about? I know you said you got yourself thinking, okay. I need to make this a priority, but what were some tricks that you use to make it a priority? Like sending you reminders? Did you tell a friend, did you have somebody like via your accountability partner?
How did you integrate exercise? So that he could feel like a routine and not like a task.
Dr. Janeeka Benoit: Yeah. So I think one of the one thing that I really focused on during residency was to make sure that I got really good sleep. Right. So, and you know, just, just like an ADHD sleep can be impaired. So, , what I did, I went to sleep at the same time.
And I woke up at the same time and I would even do that during weekends. I may not necessarily wake up the same time I would during a day that I was working. but I'd make it a point. Well, on weekends, I'm not going to wake up at noon. I'm going to make sure that I wake up on the same, around the same time, during the weekend and wake up at the same time.
So that helped me create like a regular circadian rhythm with myself. Right. And it just naturally, my body just knows that, okay, I'm getting sleepy. Cause sometimes I may not even need my alarm clock. It's just like my body knows, like it's getting sleepy. It's it's time for me to go to sleep. In addition, it also teach other people that I go to bed at this time and I wake up at this time. So, you know, that was a boundary also, like I created, it's just like, this is time for my sleep. And so, because I mean, my sleep a priority, I was able to wake up, refresh to then exercise.
Dr. Diana Mercado-Marmarosh: So did exercise was you did it first thing in the morning.
Dr. Janeeka Benoit: So I did it in the, in the morning and I knew that because I knew that for me more mornings were the times that I was most efficient in terms of, mental clarity. I was, I had the most mental clarity in the morning and I wanted to optimize. That time for myself in the morning. So, because after work, oh, no, I'm just like, I don't, I don't want to exercise.
So I had to really take advantage of that time for myself in the morning to get my workout routine in. And then the third thing was not letting those limiting beliefs like, oh, I don't have time to make exercise part of my routine. You know, that I took out the way because I was like, I can't just have my whole life be my job.
Right. I have to also pour into myself as well, and I need to do things that keep me energized that keep me be charged because when I'm energized and recharged, I can then provide care to my patients in the way that I want to. I don't want to be tired and, you know, lacking sleep and irritable when I'm seeing my patients, I want to be my best self.
So I want to show up as my best self. So. Three things that I did is just making sleep a priority, recognizing that I was most efficient in the morning and also getting rid of the limiting belief that I don't have time to exercise, because I'm a resident.
Dr. Diana Mercado-Marmarosh: Thank you so much for sharing that, you know, that believes that I don't have time is such a belief that gets us all into trouble or another thought, um, I'll do it tomorrow or I'll start Monday. Like, or I'll start the first of the month. Like, it makes a difference, right? , every day is as good as the day to start. And so you don't have to compare yourself to everybody else and you don't have to do the, you know, 50 minutes that everybody says you should do like five times a week, you know, blah, blah, blah.
Sometimes you just start where you are. And if it's three to five minutes that you start and you commit for like two weeks, and then next two weeks, you go up to 10 and then you just keep going. That's working on your mindset because it's who you're becoming. It's not how much you did, but the person who exercises.
Right, right. And what might be great for one person might not necessarily be for others. Right. Because we all have our uniqueness and our gifts and some of us functioning, like you said, amazing in the morning. That's me now, my husband he's the opposite. Like, he's like, don't talk to me until like 11 and I'm like, what the hell?
Like the kids have been up since six. You know, and like the kids will come in and they'll be like, mommy, don't wake up daddy. And I'm like, so why am I okay to be woken up? But not here. Like, it's just people, you know, like you said, you train them. Right. Like he's trained them not to bother him, quote unquote.
Right. But then he's the one who wants to stay up late with him at night when they they're full wired. Right. And so, again, knowing how you best function and then taking that into account. When you're trying to set up a technique, like exercising, setting up your system is important because otherwise, if you're not a morning person, all of a sudden you're like, yeah, well, I need to exercise in the morning.
You it's like trying to push a whole car up the hill. Like it's kind of hard, right. Versus if you know that you want to do this and how do you make it make sense into your system, then, then it's a little bit more doable. So, yeah, so it's so important to do it your way, and it's important to start. And as we know, like with ADHD, of course, Some of us who have the 80% of us are able to take pills and that helps us, but they don't teach the skills.
Right. Those pills don't do that. So that's, it's so important to be able to use exercise or meditation, or like you just said, sleep to get that executive function going. And there are those other 20% of people who can not tolerate medicine. Right. And. They use exercise as their medicine. And it's so important to see it as such because then you're not going to neglect it.
Right. You're not going to be like, well, I'll do it tomorrow. If you know, Hey, if I do this, like if I exercise for 40 minutes for an hour or whatever, and I feel like I can focus, then why wouldn't you take your medicine? If that's what could help you write? Yeah. What else do you think, like exercise can help somebody with ADHD?
Like, can you think you said that you noticed it helped your emotional state. Did you notice it helped with, impulse activity or, anything else that you noticed, like you were less likely to do something if you had already exercised like less likely to go get, go nuts or like something like that?
Dr. Janeeka Benoit: Well, I would say for me it helped with, you know, energy.
It helped with focus, clarity. , and it helped me be charged. I think those were, you know, the main things and, and because I knew I had to create time for it. It also helped with planning as well. So it was just like, okay, I have to exercise in the morning. All right. So that means I need to go to bed at this time.
So I wake up at bed at this time to exercise and then create time to eat breakfast. And so it allowed with the planning as well. And that's, you know, people with ADHD, they may have some difficulty with planning, which, you know, which is, one of the executive functions could be organized and planning. So the fact that I have to put it in my day and schedule it, I had to also schedule other things. So it helped with that aspect.
Dr. Diana Mercado-Marmarosh: Yeah. And so that's very important what you just said, because. When we have a goal or when we want to start something, if we don't know where it's going to fit in our schedule, it's not going to fit. Right. And the thing is like, you have to be very specific. Like you have to say, I'm going to walk for five minutes a day at the park next to my house, like on Monday and Tuesday, like you have to know exactly what you're doing when you're doing it. 'cause if you don't give yourself that intention with the goal, it's not going to happen. It's just going to be like, oh, someday I'll start to exercise. And it won't, like you said, and then if you're not aware, like, Hey, do I have clinic at that time? When I said I was going to exercise, then you really like, you can't be in two places at once.
Right. We try believe me. We try to bend time all the time, but we always get ourselves in trouble. Right. And so that's where it's so important. Like you said, talk about the planning, because most of us don't want to go into that. Let almost sounds like we're, you know, it's a sin to try to make somebody with ADHD, pin them down to commit to something.
But again, if it's a priority that you focus. Is what actually happens. Right. If you don't focus on it, it's not going to happen. That's so good. So can you tell me, like about your coaching? Can you tell me about your med fit programs that you have?
Dr. Janeeka Benoit: Yeah, so, Medfit DO is a coaching program that I'm working on to help women prevent chronic disease through mental and physical fitness.
And, and the reason why I say mental, physical fitness is because I can't just focus on. The physical aspect of it, you know, there's like, as we've spoken about, as we alluded to so nicely, there's a mental component as well. Right. You know, there are limiting beliefs that get in the way there's a finding that's part of it.
That's all part of creating a physically active lifestyle. Um, the beauty, is that not only are you taking care of your yourself, um, you're creating a, a life for yourself where you are able to then show up for others. Right? Because I am working on my mind and I'm working on a body. I am now at a point where I'm excited, I'm more excited to go to work because.
Poured all this energy myself, I've worked on my mind. I've worked on my body. I'm excited to then give back to other people, um, and you know, feel happy to do so. Um, so that is the whole goal of MiFID, Neo. And, you know, my underlying mission is to help prevent chronic illnesses because, you know, in medicine, you know, patients sometimes will come to the doctor where they need medicine.
And I want to really stress that. Let's not wait to come to the doctor, let's start all of this like beforehand and let's start things, lifestyle beforehand. So we don't have to get to that point. And also be at a point where we can then create habits for ourselves that we can teach all children. And we can allow this to propagate from one generation to the next.
And I call this generational health. You know, you think you're a generational wealth and I believe in generational health as well. So that's the whole mission behind that video.
Dr. Diana Mercado-Marmarosh: That's awesome. Now, Dr. Jay, tell me. What does not exercising cost us. You told us kind of like, it cost us to have chronic conditions. Right? Like what else does it, what can it lead to if we don't exercise?
Dr. Janeeka Benoit: Yeah. So, so not exercising, leads to a, I think, you know, honestly, I feel like it leads to a life of, feeling unfulfilled, right? Feeling that you can do more, but you're not taking the steps to do more, not making yourself a priority.
And, the lack of not making yourself a priority allows you to then feel depleted and irritable and victimized. And exercise allows you to be in control, allows you to be in the driver's seat, allows you to show off as the person that you want to be. So lack of all that, you're not able to show up in the way that you want to be. And it leads to a life of scarcity.
Dr. Diana Mercado-Marmarosh: Yeah. So what if somebody says, well, Dr. Jay, I, I have really bad knees. I can't even like walk for a long period of time. Like I can't exercise. Is there anything that I could do?
Dr. Janeeka Benoit: Oh, yeah, for sure. So instead of doing weight-bearing exercises, they can do, exercises lying down. So for example, they can, work on their core and they can do core exercises. Another thing is that they can also do strength exercises, maybe with like weights. If you don't have weights, then you can use like water bottles. So you can sit down and do weights. And another thing that I want to stress.
I hear this a lot. Right. I don't have Binny's I can't exercise, but I like to invite people to think about what can they do because the first thing is I can't do it and I invite them and I said, well, okay. And that allows them to be creative and really think about what they can do, because just because, yes, you have bad knees, quote unquote does not mean that you cannot exercise.
I mean, if you, if you can use your arms, um, you can, work on your core in a supine or lying down position. Set up for crunches, or if that's not your cup of tea, you can use ankle weights and do leg raises. There's so many things you can do. There's so much creativity. And, so that's what I, you know, like to focus on. What, what can you do? It makes me think about.
Dr. Diana Mercado-Marmarosh: With that being said, it's like what, you're basically what I keep trying to tell people, like you have to create your own system that allows you to support you in your zone of genius. It might be that your exercise is a sitting down Zumba. It might be that it's laying down Yoga. It might be that. You're on a stationary bike. It might be different things, right? You'd like you say, you have to think, what can I do instead of what can't I do, right? Because if you tell yourself you can't do it, you're not going to do it. If you tell yourself you will do it, then all of a sudden, your brain starts to think of all these other possibilities.
Right. And so, I don't know if you know, but I recently learned that in Colorado, they actually have a system that it's not, when people are misbehaving. You know, they're not focusing or they're getting themselves in trouble, like they're irritable or they're disrupting the class instead of having a timeout where they send them to go to the principal's office or whatever they have a time in.
So they actually have them jump on a stationary bike or do some pushups, or do some turn on some music, like do something to actually engage their dopamine levels, to calm, like in a healthy way to be able to. Focus in instead of punishing them. So to say, oh, gold, they actually letting them have a time in instead of a timeout.
And the teachers are reporting that their students are being so much more efficient, so more, so much more effective. They're like, almost like they want to purposely just behave so they could exercise. So they are now making sure that it's in their routine, kind of like what I was telling you, like give yourself that boost.
Exercising so that in between strategically so that you can focus more. So that's so interesting how. People just have to keep thinking outside the box. They just have to see what works for them and turn it around in a positive way so that it could benefit them. Yeah. So awesome. So we're getting to the point where if my listeners didn't listen to anything else, but there's one Pearl that you want to give us, maybe something I haven't asked you or something that you just want to emphasize so that they walk away with this Pearl and they can implement today.What would you tell them?
Dr. Janeeka Benoit: Yeah, I would tell them, instead of telling yourself, if you just said it, I can't do something, ask yourself how can I do it? And that is very powerful because the word can't places us in a position of being stuck. And it makes us seem like there are no other possibilities. There are no other options because I cannot do something.
However, if you rephrase that statement and ask yourself, well, how can I do it? Whoa. You now have. So many possibilities open to you and the world is now your oyster because you rephrase that statement, your reframe your mind as well. So, yes, I wanted to leave that tip because, I can't, it's a very dangerous word and I really would encourage your listeners to ask yourself how can I, instead of telling yourself I can't do it.
Dr. Diana Mercado-Marmarosh: Yeah, so whatever you've done in the past, you've done it or whatever you haven't done it, you haven't done it. It doesn't mean it's going to define your future. Right? You have to ask yourself the right questions to get the right answer. How can I become somebody who is going to use exercise as my medicine?
Right. What can I do to do that? Like where am I physically emotionally able to. What can I do today to start that journey, right? You don't have to have it all together. We're not talking marathon style yet. Right? So where can my people find you so that they can come to your masterclasses or to find you and see what else? Pearls you have to.
Dr. Janeeka Benoit: Yeah. So, you can find me on my Instagram page. That's Medfit DO, M E D F I T D O. And if you had to my link in my bio, I have my YouTube channel there. In addition, I have a free webinar. That's going down on Saturday, December 18th at 11:00 AM EST, 10:00 AM CST. And the registration link is in my bio just to learn about, ways of course, your fitness goals for the new year.
Dr. Diana Mercado-Marmarosh: Awesome. So good. Well, thank you. Definitely check her out. She's going to have so many more tips to give us start where you are. Don't compare yourself to anybody else. Just keep leveling up.
Dr. Janeeka Benoit: That's right.
Dr. Diana Mercado-Marmarosh: Thank you so much for spending your time with us today. We know time is the currency.
As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook beyond ADHD physician's perspective so that you never missed an opportunity to create time at will. Do you share this podcast with your friends, so they too can le
Dr. Meriam Salama is a Psychiatry Specialist based in OH. She has great passion to improve her patients quality of life; she's a very energetic mom and does Peloton and loves to travel.
Dr. Meriam Salama: It comes from a place of wisdom where we have to lower our expectations of ourselves lower, the demands that we put on ourselves, lower the world's demands on ourselves and be able to just do the things that we can do. And then those things that cannot be done, they will be another day or another way to achieve.
Forgiving myself and changing my expectations on myself is a huge part of where I am today.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physician's perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
I will be sharing with you physically. Some who have asked to remain anonymous and their names have been changed and others who have decided to tell us who they are. And so we're here to share their wins, their challenges and tips that they have learned themselves to become to where there are and be achieving and overachieving in this.
So my aim is to stop the mental stigma that is associated, unfortunately, with this disease. And to show you that ADHD is not just those kids, that we sometimes think mainly males running around distracting everybody, but it can be anyone. It could be male, female, they can be the J dreamer. They can be the very smart person across the room and they can be that overwhelmed mom or teacher or physician.
So let's do this together. Let's learn from me. So before getting started, I want to say something it's a little disclaimer while me and my guess who are both physicians? Yes. We're medical doctors, but we are not your doctors. Anything that you learn here is not meant to replace or substitute your own physician's advice or therapist or ADHD.
What we're sharing for you here are our opinions. Okay. So they're not meant to represent our own employers or hospital or any health system or any organization. Okay. It's just, we are just two physicians having a conversation to help you get more educator. So this week, I have a very special guest that I am super excited to share with you.
Her name is Dr. Miriam Salama. She is a psychiatrist and who lives in Ohio and she strives to improve her patient's quality of life. She has a great passion for this. Now she juggles being a mom of two boys who keep her on her. Entertained at all times. And she has to keep up with a very energetic, very successful private practice.
And she promotes some evaluations also on the. And on top of all this, she has high energy. She likes to do Peloton and she loves to travel the world. And she's a very social butterfly. That's why you have the treat of getting to know her today. Dr. Salama tell me, what were the circumstances of you finding out that you have ADHD?
Dr. Meriam Salama: So I struggled with difficulty sustaining attention and just remembering things and misplacing things since elementary school. And I struggled really hard. I struggled through high school. I struggled through medical school and I compensated for it by. Sending so much, so many more hours than the average person, just rereading material over and over walking four miles within wherever I was residing, reading things out loud coming up with schemes to remember things.
And so when I was a psychiatry resident during my child rotation the child psychiatrist attending that I was working with. Noted down how I was working really hard that I really cared about my work, but I had great difficulty remembering anything he said, unless I was writing it down and to how he had to repeat his instructions many times and the how I was there much later than all the other residents he has, we had worked with and he told me, you have ADHD.
You need to go. And being treatment. And that was my turning point.
Dr. Diana Mercado-Marmarosh: What did you think when they told you that?
Dr. Meriam Salama: I felt relieved that someone else recognized what I had been going through for very long now. I knew that I did have ADHD inattentive type. I knew all along. I just didn't have. The, either the encouragement or the opportunity or the window to address
Dr. Diana Mercado-Marmarosh How early did you know? Or you always knew?
Dr. Meriam Salama: I diagnosed myself that I had an attentive problem when I was in middle school. I knew it all. Wow. And then in high school, I decided I have to come up with all these structures in place to.
Dr. Diana Mercado-Marmarosh: Did you ever try to ask your parents like, Hey, maybe I need some help or you just thought I'm just going to create systems.
Dr. Meriam Salama: So I created systems and because I was a good student, they were not going to be able to communicate and understand or be in my spot because. I really cared about my schoolwork. I knew I wanted to become a physician. And then when I started medical school, I knew I was going to become a psychiatrist.
And so I was also a very opinionated child. And so of course there was some rebellion and my parents. Weren't going to listen to my opinion, because I am already up opinionated to start with.
Dr. Diana Mercado-Marmarosh: So did you grow up in Ohio?
Dr. Meriam Salama: No, I grew up actually in the middle east. I ha my parents were both professionals, both hardworking people who we went to British schools and I had a lot of resources, but that the diagnosis of ADHD was not very it wasn't spoken about wasn't identified around me at all.
And through medical school, I worked so hard to work against it. I learned ways how to also. Put my distraction to use so that I can roll with my drive. So I'm also a very passionate person and I'm also a very persistent person. So one of my strengths that helped me overcome ADHD is my stubbornness.
And I kept fighting to get what, where I was going. So I kept fighting to become the physician I was going to become. And then the psychiatrist. Going to the cop.
Dr. Diana Mercado-Marmarosh: Do you mind sharing your ethnicity with us? No, I don't mind.
Dr. Meriam Salama: I am Egyptian. I grew up in Kuwait and Canada. I am a Canadian and American by immigration.And I've been in Ohio now for around seven around 14 years.
Dr. Diana Mercado-Marmarosh: Perfect. Yeah. So I ask you this so that the listeners can see how it affects all cultures, right? Like all over the world. It doesn't matter where you are, like I'm Mexican American. And I grew up till I was in Mexico till I was 10. And then I moved to the U S I have the same thing that you just described, like this passion of I'm going to get this done no matter what. Because you were aligned with what was moving you, what was exciting you that was allowing you to like work above and beyond, like more than you had.
You just found it. Even though maybe somebody it would have taken them 40 hours, it'd probably take took you like 80 to 120 hours to do. Somebody else would have taken them 40 hours who didn't have ADHD, but the fact that this was your dream, you didn't care how long it was going to take you and you didn't care that it might take you a through C to figure it out, but you are going to do it right, because that's what you wanted.
Yes. Exactly. Yeah. So it's so crazy how sometimes it's takes somebody else to point out how hard you are working, because most people always say, just study harder or just sit down or just stop, like distracting yourself. Like you can do that, right? If you could, you would, why would you, and listen, how you found the trick, you found that walking or moving.
Was going to stimulate your brain to get more dopamine into and be able to make those connections. And you found ways to set up systems that worked with the way your brain was thinking not against you, right? Correct. Yeah. So all those are things that people with ADHD learn to do without even knowing, but sometimes like, When I got diagnosed in medical school, I was just told here's some pills.
luck. Like I wish somebody else would have told me, Hey, you could probably hire like a therapist to walk you through whatever you've been through or an ADHD coach to show you that there's different ways of planning. So sometimes we don't know that there's more resources. Okay. So here you are, you get told you have ADHD.
What do you do next?
Dr. Meriam Salama: I went to my primary care physician. My primary care physician of course, is leery of my presenting my sentence, especially as the psychiatrist who I know these symptoms, like the back of my hand, because I treat patients who have ADHD. So it, I think it was one of the hardest days ever for me to go to my primary care as a society.
And say, this is really what I'm going through. Will you believe me? And she did her due diligence. She said, you probably do have symptoms at this point in time. I want you to go through neuro psych testing. I did two days worth of neuro psych testing, and I brought it back to her and she went ahead and started me on a stimulant.
And that truly. Truly helped me do less spinning of my wheels and air less checking less repetitive. Work to make sure that I didn't forget something that I, now I still have checks and balances in place. I still have to have, I have to have a lot of structure. So I say this all the time to myself and to patients that medications lower some of the intensity of some of my symptoms, but they don't eliminate.
And part of the symptoms are part of who we are as a character. So part of the symptoms are being able to think outside the box, being able to be creative, to be innovative. And those come along the same lines as someone who is not just doing what they're supposed to do whenever they're supposed to do it.
So part of our ADHD symptoms are ingrained in our kids. And that is part of our strength and tapping into that strength, being able to put those symptoms to work for us and so that we can flourish instead of always beating ourselves down because we don't fit into those boxes or we don't look typical, or we don't align with everyone.
Dr. Diana Mercado-Marmarosh: What do you think are those successful traits that have allowed you to do as a physician, I know you said you were stubborn, but you were also very intelligent an entrepreneur
Dr. Meriam Salama: One main thing that I had to learn throughout my journey is how to forgive myself for not meeting the standards that I'm supposed to meet.
And. To not hold myself to those standards. I know this sounds so outside the box and probably not popular at all, but it doesn't come from a place of. Laziness or a place of not being aware of how our world works, but it comes from a place of wisdom where we have to lower our expectations of ourselves lower, the demands that we put on ourselves, lower the world's demands on ourselves and be able to.
Do the things that we can do. And then those things that cannot be done, they will be another day or another way to achieve them. Forgiving myself and changing my expectations on myself is a huge part of where I am today. Also choosing to be flexible, choosing to not. Fall apart when things don't go as planned, always figuring out the next step in the moment and trying my best to just do what I can in the moment.
Knowing that not everything is going to rely on me meeting those specials.
Dr. Diana Mercado-Marmarosh: Yeah. So actually, that's something that I myself learned this past year and it's been like such a relief to know that, Hey, I'm just a human being like everybody else. And like the things that my brain keeps telling me that I'm not good enough fat.
It doesn't know, it doesn't know that I'm super optimistic and I want to do a hundred things and really manageable things are 10 things, not a hundred. And like you just said, having that self-compassion that awareness that you are doing the best thing that you can and what is important will get done and what is not, why am I so spinning out on it?
It's just not. It's just not the point. So that's so good that what you're sharing. I totally understand everything you just said. And the fact that you just said being flexible. So most people just think a, B and C. But with us, we're like a, B, C, D E F, like we're everywhere because it doesn't matter which one is as long as we get to what, where we need to.
And so that's so good because that makes you such a dynamic team player and such a leader too, because you don't just shut down when something didn't go exactly. As you thought, but. Ready to pivot and from a place of mindfulness, which is so different than just oh my God, I'm brand sick right now.
I think you've got some of this stretch TGS from your, you said you have two kids, that help you pivot a lot. Tell us about that.
Dr. Meriam Salama: So I do have two kids who also have ADHD. One has hyperactive type, one has inattentive type. I have the inattentive type and therefore being flexible, being open to plans, changing working with them.
Yeah. At the same time, doing parenting at the same time, giving them that place to be themselves. Where maybe outside our home they could be judged if they're moving too much or they could be judged because they're not paying attention. So I've created that space for me and them that they can just be who they are just like, I had to learn how to love who I am and create that space.
Dr. Diana Mercado-Marmarosh: Do you have any resources for the mom out there? Who's oh my God. Okay. She has it. And she has kids. How does she manage it? Do you know any, like any books or any websites or anything that you could share with us?
Dr. Meriam Salama: So one of the books that I used as a mom is it's called smart, but scattered I don't, these.
Are not connected to me in any way, shape or form. But it's called smart, but scattered boost Annie child's ability to get organized versus impulse to stay focused. Use time wisely. Okay. By peg Dawson and Richard Greer. So this book did help me kinda create some lines and put into words.
Some of the ideas that I had flying around my head on how to approach, especially my son who has inattentive type also supports. Friends connecting with friends, granite, correct thing with other families. It does take a village to raise our kids. So having a supportive network and having people who truly care about me, like truly care about my family and kinda like partnering with them.
I have one of my friends that. Call her up once a week. And I just bounce ideas off of her on how to manage things, because sometimes I need someone who's outside of me. It's because I'm inside the family. And just, have more patients and. Do more waiting regarding the changes that need to happen.
They're going to, they're going to be later bloomers. They're going to, their brains are gonna grow in a different rate than everyone else around them. So learning how to not compare learning how to embrace who they are now, treasure, those moments, spend that quality time with them. And then, whenever they, transform into who they will become at whatever.
I will enjoy that one. That comes too,
Dr. Diana Mercado-Marmarosh: Yeah. That's so important. It's having a friend or several friends who are. What's the word blunt who are willing to tell you with love from a place of love that, you have a blind spot right there, or you could do this a little better or you're doing it just right.
Why are you punishing yourself? It's so important to be able to come to somebody with like your biggest dream, your biggest fears, because when we say them out loud, like we process them. And just hearing somebody else outside of you, it just brings it to a better place. Even in. I don't know, it just helps me verbalize it and sometimes write it, it's just a way to get it out and work on it when it's meant to be worked on.
Yeah. So that's so healthy that you share that tip. So one more question. Is there anything that if our listeners had to say, okay, the only thing I remember today is this thing, what would you tell them? W what would you tell them?
Dr. Meriam Salama: I would say that one of the hardest challenges I said I've had is to just accept myself as I am.
And I know we, we touched on that. Loving who we are as we are. And that is still
a journey for me. Yes. For all of us, because I'm always wanting to do more and wanting to be more. And and I think it comes with the driven part of ADHD or very driven people. And we're very passionate people.
And we, with things we care about, we truly, really care about. And so sometimes that crushes us within ourselves and. And, just setting aside time to actually be okay with who we are is I think the greatest takeaway.
Dr. Diana Mercado-Marmarosh: One more thing. Tell me about your goals for the next year. For the next five years.
[00:21:25] Dr. Diana Mercado-Marmarosh: You say you love to travel. I'm now that COVID is starting to calm down. Are you getting the trouble bag or what are you doing? What are your goals? And it could be your goals for travel, or it could be your goals for work. Just share with us.
Dr. Meriam Salama: So at some point in the next five years, I want to go to the Galapagos.
My oldest is a. He wants to be a zoologist or herpetologist. He is into reptiles and Marine life. And just being outside and seeing that level of wildlife, I, this is on my bucket list. So I'm going to do that at some point before he's all grown and gone. How old is he now? He's 13.
Dr. Meriam Salama: He currently wants to be an exotic reptile.Okay.
Dr. Diana Mercado-Marmarosh: Yes. What about for you practice or anything professional that you are inspiring to do in the next five years?
I have a side gig. I do evaluations for probate court and their forum. So working with the state hospital on coming up with. Outpatient programs that maintain patients outside the hospital setting.
And so that's also part of my dream and I'm starting to open up that door with working with the state hospital here locally in Columbus.
Dr. Diana Mercado-Marmarosh: That's amazing. You feel people with ADHD, just think outside the box, they follow their passion and it leads them to making a change, right? Like we're not people who just said this is the way it's always been.
No, we ask how can we improve it? And how can we move it forward? Even though it can be a little hard sometimes that doesn't prevent you from doing what you want. Yeah, that's amazing. Okay. So I know our listeners are going to be like, how do I talk to this amazing mom and doctor? Where can they reach you?
Dr. Meriam Salama: Anyone who wants to reach me can use my email Meriam salaam@aol.com and it's M E R I a M dot S a L a M a at AOL.com
Dr. Diana Mercado-Marmarosh: Perfect. Oh my God. So thank you so much. That was an amazing interview. As you see, this is a lifelong disease, and. Just because you're smart and hardworking. It doesn't mean that you don't have it and it can affect any culture.
So if you suspect that you or somebody, may have ADHD, please seek out help. And just like she said, medication helps, but try all the other different things, exercise, sleeping, doing different things, and be willing to think outside the box and follow your dream. Thank you.
Dr. Meriam Salama: Thank you.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Dr. Brittany Davis-Schaffer is a pediatrician in Concord, New Hampshire, she has 2 kids and a proud mom to her fur babies. Join as today as she shares her wins and overcoming challenges.
Dr. Brittany Davis-Schaffer: The, definitely the talking it out was a big part. And, um, I was, I feel very fortunate. The group that I was with and the attendings that I had, and a lot of hands-on learning, which made a huge difference in comparison to just having to read it out of a book
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physician's perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
So as we know ADHD, is in depth, it's just going to show up in different people, but it's going to affect us sometimes the same, sometimes a little different.
So I created this podcast to bring awareness that ADHD is a lifelong disease and I will be sharing with you interviews with many great physicians and some of them have asked to remain anonymous. And their name has been changed, but some have said, they're cool with telling us who they are and what they're all about.
So we are super excited about that. So we're going to share their wins and their challenges, and some tips on how ADHD can be a gift that can be unwrapped if you just know how to handle it. Right. So my aim is to stop the mental stigma that is associated with this condition. When most people think of ADHD, sometimes we just automatically think of a hyperactive boy running around.
Maybe with a lot of energy that we wish we could bottle. They are pretty smart. And sometimes we don't realize that an adult mother, a teacher, a physician can also have it. And so that's what we're here to talk about today. And before I go further, Give you the awesome speaker that we have today. I have to just give a small little disclosure while me and my guests are medical physicians.
We are not your medical physician. So the advice that we share here is not meant to substitute any of the advice or treatment that you are receiving from your own physician therapist or coach. In addition, anything that you hear here is not representing any of our employers or hospitals or any particular healthcare systems or organizations who that was a handful.
I just had to make my lawyer happy. So here we go. We got that out of the way. So today I have the pleasure of speaking with a very special person. Very excited about it. Her name is Dr. Brittany Davis-Schaffer and she grew up in New York and she went to the American University of Antigua College of Medicine.
And then she went to Crozer-Chester Medical Center for her pediatric residency in Pennsylvania. And now she is practicing in New Hampshire and she is married has 2 kids and lots of fur kiddos and she loves the New York Yankees and she's actually coaching her son's baseball team. So exciting.
All right. So here we go, Dr. Brittney, tell us all about you. How are you this morning?
Dr. Brittany Davis-Schaffer: Good. I'm great. Thank you. Thanks for having me.
Dr. Diana Mercado-Marmarosh: Awesome. Tell me, we all want to know what were the circumstances that led to your ADHD diagnosis? Did you suspect anything yourself when you tell us the story?
Dr. Brittany Davis-Schaffer: So mostly when I was a teenager, I did feel like something was just off and I didn't know what it was. I honestly did not know much about it, hyperfocus, hyperactivity, any of those types of things at the time, I feel like it was looked at very differently than it is now. And much more recently it's been know a lot more.
I would notice that, I could study for a test. I could read something and I knew I had read it. I had done some highlighting and then I would go back and look at it and was just not remembering what I had read. And there were certain subjects like math that I just got and did well in. And it didn't take a lot of effort.
There were things then like reading English, language, reading comprehension was the big thing. Like I said, that I could read through and it just, it felt fortress. You know, doing the passages where you had to answer the questions afterwards. I remember as a kid crying about this and just how stressful and frustrating it was.
And that's kind of funny because I had talked with my dad about it and the frustration. And it turns out years later that he also has ADHD, but we didn't know at the time. And so he told me that that's normal and that's how people feel about reading comprehension. And so, like I said, I had gone to my physician.
Well, you've gotten this far and you've done well, so just work harder. And so I took that as, okay. Then I just got to work harder. This must be me that, and I graduated from a high school. I did have a tutor for a verbal, for my SATs, because that was just so difficult for me. And he didn't know why. And even with that, it was okay.
It wasn't great. And then went onto college and struggled in certain areas that require that with the memory piece there and other subjects where were perfectly fine and required, very little effort. And then I, I did. Okay. You know, I always did well enough to, to keep going, but, I had a lot of trouble with my.
And a big part of that is the things that required longer studying longer memory were very difficult. And so I'd gone there, which I was grateful for. I loved my experience. I learned a lot, a lot of hands on experience and, um, and then when it came time for my step one exam, the first part of the boards and was having difficulty with that.
And just prior to then my dad, had been diagnosed with ADHD. And so they had mentioned in passing about what was going on with me. And so I met with a psychiatrist and spoke with them and they had seen some signs while we were talking and they sent me for official testing. And so I had the testing done, and this was in my mid twenties now.
And I remember, in a nice way, the psychologist who had done the testing kind of laughed, and I have this done because. It was, it was pretty bad. The significance of the ADHD from the diagnosis was definitely obvious. And so from there, I, we talked about medication and we talked about, some management at the time and I had tried the medication and then was able to sign up and take the board exam again and did really well with it.
And it just felt so different to sitting there for that all day exam on the medication. Versus not where, you know, towards the end of the day without it, I just wanted to be done. I needed to get up, but it was like painful to sit there any longer. And then with the medicine. It felt okay. And it was amazing to me that that's how other people felt naturally.
Right. And so I tell people, even now, like I can pair the day of the diagnosis and just that affirmation of knowing that I wasn't stupid. And there was something going on up there it's with the wedding day with the, having the kids day to day changed.
Yeah. So, you know, it's, I guess at that time, sometimes we don't, we didn't realize how genetic it can be.
Right. And so I remember when I myself got diagnosed, like it was, I wasn't sure if I was just anxious because of, you know, your, I got diagnosed in medical school. So I wasn't sure if it was, cause I'm just putting all this pressure and wanting to do so well. And then you don't or your grades, like you said, do not reflect how much effort you're putting into what you're doing. Right. And like you said, it can be so frustrating and irritating cause you keep questioning yourself and your, at least for me, I would question my self worth and I would wonder why can not just do it. I'm sitting here, I'm trying, but it's so frustrating.
And, and you know, you, you had the opportunity as a teenager to get the diagnosis, but unfortunately they said you're doing well enough. Right. But they didn't realize at the expense of how much effort. Put forth to be able to do what you were so passionate about. Right. And I think this is what makes and breaks people, you know, were you an athlete at all or did you do dancing or anything in, in high school or in college?
Actually both. I had done dance like growing up and then I got into softball and played from when I was about six until I was in like middle of high school time until I was 16. And I had gotten injured, so I had stopped, but then I got back into dance and did that through college and medical school too.
Dr. Diana Mercado-Marmarosh: Yeah.
So, you know, it wasn't until like maybe the last year that when I finally started to like, get curious after having ignored my diagnosis, I read that book ADHD 2.0. And it talked about how females tend to be under diagnosed. And once we are diagnosed sometimes undertreated and they say is. Uh, we tend to do things that UN unaware, like it's helping us like exercise.
And so sometimes that's kind of healthy, but sometimes like some other people unfortunately end up using drugs or other things that are not as healthy because they don't realize that that's how sometimes people use food. You know, they don't realize that that's a dopamine. That is increasing our capacity to be able to try to semi function.
And so you were probably speaking , it sounds like you were using that energy from exercising to try to get it better. Did you get any tutors during college or no?
Dr. Brittany Davis-Schaffer: No, not at all. It's just discipline at the library studying a lot.
But the talking it out and discussing what we needed to learn actually made a, bit of a difference. And, the type of learner that I was, without even realizing it. I guess why I was doing it or what I was doing at four. Yeah. We made a big difference.
Dr. Diana Mercado-Marmarosh: Yeah. So that's exactly also how I feel like I ended up learning stuff. I was just as frustrated, like reading paragraphs and paragraphs. And I was like, what, what, like. But you go back and do it again and again, but when you would talk to somebody about it, all of a sudden to be able to, you grasped it a little bit longer, to be able to like put it into sentences or them telling it back to you, and that made a difference.
So sometimes did you notice that, like if you had a written exam that was like, you could explain your answer versus a multiple choice, that was that a little bit easier for you or if you had like a presentation or how did you do with those type of tests?
Dr. Brittany Davis-Schaffer: So it depends on what it was sometimes. Honestly, just a quick answer was better because I, I found that keeping all of my thoughts in order was very difficult. So getting them out in a way that was easy for others to understand.
Dr. Diana Mercado-Marmarosh: Great
Dr. Brittany Davis-Schaffer: Even remembering in residency and presenting, you know, the patients that we were talking about and being told by a wonderful attending, you know, just tell it like a story and thinking, well, that's really hard to do my stories, go all over the place.
And I think, you know, having a lot of thoughts and, and trying to organize them into something that flows well is something else that was really difficult.
Dr. Diana Mercado-Marmarosh: Yeah. So how did you do it? Like in residency you were taking meds then?
Dr. Brittany Davis-Schaffer: Yes. For most of it, actually, I did stop when I had gotten pregnant with my son, which was the beginning of intern year.
- And, oh yeah, when we do things we do all whole bunch of the time we had gotten married and started, started residency and then had gotten pregnant. And so I went intern year without completely. And then my second year I wanted to breastfeed. That was something that was really important to me. And I feel like part of it too is, is knowing I'm in control.
Different things. And that helps me. And so that was something I wanted to do to help me feel in control, I guess. And I knew it was important to me. So a lot of my second year, actually, I hadn't died there because at that time, and I know things are a bit different now, but I was told that I definitely could not be on medications for either pregnancy or for nursing.
I was studying for a first step three throughout there. So once in a while I would take the medication, but, but usually not. And, uh, it wasn't until my third year that I did. And. But then I had gone for not too long after that. And so stopped again.
Dr. Diana Mercado-Marmarosh: Yeah. So I know life happens and that's the thing, right? Like you just go with it. So what strategies did you find, like you were able to implement during your first and second and third year? Because, uh, you know, The knowledge that was there at that time. And the fact that, well, you made a personal choice, which was a good one. And did you keep doing what you did and, uh, like just talking it out with other people, did you learn a way to like visualize it?
Did you learn to tell stories? How did you, how did you do it? What strategies did you use at that point?
Dr. Brittany Davis-Schaffer: The, definitely the talking it out was a big part. And, um, I was, I feel very fortunate. The group that I was with and the attendings that I had, and a lot of hands-on learning, which made a huge difference in comparison to just having to read it out of a book and, and try to imagine that real life experience, it's a lot easier.
It's, it's maybe more exciting and, and just the way it works differently than just reading it out of a book, but it's, it's good to my husband's really supportive. I was diagnosed after we had started dating. So he was always supportive and I could go to him and say, listen, I need to read this. I need to remember this.
It's really important. Can you just listen to me, talk about this or talk about it with me or I'd make flashcards and he'd help me go through them or just big poster boards or whatever it was. You know, any tasks I knew I could go to him too and ask for his assistance with it. And he was always there for that, which was right.
Dr. Diana Mercado-Marmarosh: Yeah. That's really, that's really good to have a support system and to feel like you could be yourself, right? Like that's the beauty of it. Not feeling like you have to feel, you know, less of or anything like that. Right. How do you think, like your diagnosis might've impact like those people around you, either like your family, your friends, or any of your patients, like, do you think it made a difference? Like, did you, did, what do you think happened?
Dr. Brittany Davis-Schaffer: So I think it in the different areas like that, there's definitely been a, a difference in how it's had an impact. Patient-wise I try to use it as a helpful tool. And especially when there's behavioral concerns or learning concerns or anything like that, I try to keep in mind how my experience was with my physician and not say, oh, you're all right, you're your bed just work harder. But to listen and, and realize that individuals. And then of course the parents as being in pediatrics, know that person best. And if they're saying something's wrong, something's wrong. And so talking it out and trying to figure it out and, and letting them know too.
I have ADHD because I've had some that have verbalized or have shown that they're worried about this diagnosis and what, how this will impact them and what effect it might have on their future and telling them that their future is not over. In fact, it's maybe even easier to get to where they want to now, because they've been working extra hard and struggling potentially.
And so to provide encouragement and say, you know, I have this too, and I'm feeling. It's okay. You can do anything that you want to do. Anything is possible, you know, so I try to be open and honest there and provide support in different ways. And then with my own family, I think it's, it's been a great thing because we all have our own quirks and our personality traits.
And, um, I've certainly gotten to know myself. And then, like I said, my husband's wonderful. He's gotten to know me very well over the time too. And sometime can anticipate something that may be tougher for me before I even do. But knowing the scenarios that could be more troublesome for myself, kind of preparing for that or, or just, you know, if I get stressed out over something, he knows why, and we don't have trouble because of it.
I think that's been very helpful there with, with marriage and then with my own kids, my son was diagnosed with ADHD probably a couple months ago. And it's something that we've seen over the last couple of years and we've kept an eye on and we had agreed my husband and I that once we got to a point that it might be causing some difficulty, we certainly didn't want him to get to the point that.
And that was my big fear was that he would not enjoy school or learning or would get frustrated with himself. And I didn't want him to feel that like I did. And so as soon as we got to that point, we had the testing done and, and so he had started medication and just even seeing the change in him and the change in how he feels about himself too.
He's six. Like, it just, it breaks your heart, but I'm so glad now. And that's been, I feel like having my diagnosis has helped him so that he won't have those years of struggling as well. And then just relationship wise with friends and, and so forth, you know, we go, we go way back to before diagnosis time. And so they just, they know me.
Dr. Diana Mercado-Marmarosh: And it's so good. Like you said, to have that diagnosis and to have that awareness, not just like you said for yourself, but like, to be able to be everything for your kid. Right. And to advocate, and to also, like you just said, be able to. To the parents of our patients when they do get a diagnosis and take that extra step to not just say, oh, it's just anxiety or it's just depression, or they're just being a kid or, oh, they're just stressed.
Right? Because sometimes as we now know, all those things could correlate and sometimes they can exist at the same time. And sometimes. Just ADHD, but they're still frustrated that it's making them depressed. Right. And so it's so good to have that insight. And like you said, now, be able to channel it and be aware that this is normal in the sense that it's genetic and how can we, uh, work with it. Right? Instead of against it. And so that you could support, have you come across any like resources to help yourself or to help your, your kid, uh, or any of your patients that you think that people should really know about?
Dr. Brittany Davis-Schaffer: Their habits, some books that are talked about and some other resources, there's some research that's going on too. I think the thing that's most helpful have been these stories or a little bit of research explaining because everyone's different. And I, I usually explain ADHD diagnosis similarly to an autism diagnosis in that it's very much a spectrum of how people feel and how people will react in certain situations.
And we're not all the same by any means what you may see in one person. You may not see another person with the same diagnosis. Doesn't mean, one of them doesn't have it, it, they do. It's just, there's a range in how you feel and how it affects you. There's also a huge range in what will help and, you know, so kind of getting to know yourself over time.
And so I always tell people to be patient with yourselves and, and, you know, over time this will will get better too, but certainly counseling and someone who is experienced with the diagnosis can be very helpful to help point those out. Um and then tools for those particular concerns. But just for myself, reading more about the diagnosis, talking with others in a similar scenario has been helpful too.
And then giving some of those resources, like to my husband to read or to those close to me to read so that they can see, you know, like if I go into a crowded supermarket on the weekend, I am stressed out. So stressed. And from that I can, you know, a shorter fuse. Kind of all over the place and distracted, and that's not, you know, in a bad mood or anything like that.
That's just how I feel because of so much stimulation going on around me. But someone else may feel fine with that. But seeing and reading different things that. So many scenarios and how someone may react has been so helpful in, uh, in showing that it can be with a diagnosis too. And not just, you know, me being a pain in the tush.
Dr. Diana Mercado-Marmarosh: Yes. I know what you mean now. How are you with time? Like some of us, he attempt to like, not be aware of time. Like I know like my husband would sometimes ask me, how long is that going to take you? And I would say like 15 minutes and then. Okay. So like an hour and I would look at him like, are you crazy? And then like, sure enough above almost an hour later, he's like, you ready? I'm like, yeah. I was about to finish. I'm like, how long has that been? And he's like an hour and I'm like, oh, okay.
Dr. Brittany Davis-Schaffer: I'm definitely not fantastic. I feel like the whole concept of time, it's very a variant, but I feel like that's one of the things I've gotten to know about me over the years. And so like, if I know, I need to say leave to be somewhere at nine 30, I have to tell myself nine 15, because then I will leave by nine 30.
Whereas that always used to be an issue. And it's hard because I get very stressed if I'm late. I don't like being late, so it's just, it's a lot of pressure, but certainly with tasks too, you know, I sometimes depending on the medicine does help a lot, but I can do the one task I set my mind to most times though, like if I want to, you know, put away something, you know, put a, hang up a code or something, I'll pick up that code.
That's probably lying on the floor from one of the kids and then keep walking and be like, oh, I need to put this away too. And oh yeah, I was going to do that. And so that one task that could have taken 30 seconds. Usually it takes more, my hands are usually full by the end of it, but certainly it, uh, it takes a little longer.
Dr. Diana Mercado-Marmarosh: So one of the things that I learned, I actually, this past year, I, I got more curious and I invested in an ADHD coach myself so that I could understand what other strategies. And one of the things that they pointed out to me was that people with ADHD, we tell you the time that it's gonna take us to complete the task, but we do not factor.
Kind of like the pre-task and the com and the post task. And so we only look at like the middle, like if you're looking at a recipe, like we don't tell you, oh, I need to go gather all the ingredients. And then I got, gotta clean up the ingredients. And like, to us, we just tell you like the middle, like, if we somehow magically all the ingredients came and somehow magically everything after whatever you were going to do.
Magically taken care of. And so, so now having that awareness and having that explained to me, it's a lot easier now, because then now I can give almost a little better estimate, but still not quite, but it's still a lot better. And now I'm aware of it. And now I've actually used timers and different things to give me like an external cue.
I say this because a lot of people think, oh my God, like, how do they stay? So calm as a , you know, as a cucumber, if there's like an emergency going on. And it's because for us, there's only two times like now and not now. Right. And so, so if it's like, now it doesn't matter. It was just like, what was like five minutes ago. Right. Even though everybody's freaking out, you're just like, oh, it's okay. And that's also why we can't take. So long and aware of how long it's. So it's so good to have that external queue. And sometimes, like you said, it could be a husband or a friend just calling you to make sure like you completed a task or whatever you had set out to do right now.
Another thing that they also taught me, which you might want to implement if you're not doing is, the five minute pickup. And so it's supposed to be a fun way. Everybody gets involved. Like your husband, your kids, literally just for five minutes, like you put the timer and like everybody tackles like a part.
So like maybe somebody will put away the dishes or somebody will pick up the shoes or whatever, just for five minutes. And you do that every day. And if there's like three or four people, you know, That's 20 minutes, times seven and ends up saving you like two or three hours of your week, which is five minutes.
So yeah. And so it can make, it can be helpful. Like you just said, you picked up one thing, they should have been 30 seconds and somehow you ended up everywhere else. Right? Like
Dr. Brittany Davis-Schaffer: Exactly. And we try to do that, you know, each day, especially. With having the kids and the dog and the cat and all of our other furry feathered kids.
And it makes a big difference, Trying to work with my son too, on that. My daughter's a little young she's three, but, but with my six-year-old and each night, like the playroom or, or his, his things that are out or getting his bag ready, or, you know, doing those types of things that that can be helpful. And I got to say too, I have a few different apps on my phone, but to do list apps and, and reminder ones and things like that too, which if I know that there's tasks I need to do, I set a time for it.
Dr. Brittany Davis-Schaffer: And I have it remind me and remind me so that I make sure that I get it done at that time, that I know will be clear that it'll work for me. And so I don't forget, or don't stress out about knowing I have this to do. And, um, and that's made a lot of differences as well.
Dr. Diana Mercado-Marmarosh: Yeah, that's very helpful that you understand, again, that you understand yourself and you're not judging yourself, but you are just becoming aware of how can I enhance what I need to do and make sure I have a way to try to do it, you know?
Dr. Brittany Davis-Schaffer: Exactly.
Dr. Diana Mercado-Marmarosh: So do you think reflecting back, is there any specific, you think ADHD characteristics that has, has been so helpful in your success and becoming a physician? You think
Dr. Brittany Davis-Schaffer: I, you know, I don't know if it's the part with ADHD diagnosis. And myself, or just the years of struggling with it and, you know, trying to do the best I could and not wanting to give up and that trait stuck. But I definitely, you know, I don't want to give up on, on anything. I pushed myself and me to complete it and me to succeed, show myself, you know, sometimes that I can or know.
Dr. Diana Mercado-Marmarosh: I guess what I'm asking you is like, do you think, like, as a physician, maybe sometimes you're more like intuitive or if like maybe you think outside the box a little bit, or if you tend to be like flexible and on your feet, like, you know, sometimes ADHD can give us lots of different gifts.
Like we tend to be, uh, a little bit more daring, a little bit more impulsive. So times, you know, a little bit more spontaneous, right. Also.
Dr. Brittany Davis-Schaffer: Yes, definitely all of that.
Dr. Diana Mercado-Marmarosh: And I think you mentioned, to me, not, not now, but the you're going to go camping. Right? You get outdoors. Yeah.
Dr. Brittany Davis-Schaffer: Oh yeah. Yeah. We, we definitely love to stay active and, and do different things as a family.
And, so we're going camping this coming week. And, very fortunately I have off on Thursdays at the moment. And so I'm trying, especially during the summertime. each week do something with, uh, with one of the kids and where we get out together and they're active and get to spend that time. And we certainly keep busy, you know, and coaching my son's baseball and he does Karate and Cub Scouts. My daughter does dance and I do that with her and, you know, always busy, but it's a lot of fun too.
Dr. Diana Mercado-Marmarosh: Yeah. That's a little bit the beauty of it, like learning to do the things that are passionable for us. And that keep us you know, aligned with their family and with our goals. Do you have any big goals or anything that you're thinking the next five years that you're striving for either like with your family to travel somewhere or just with your practice or, or you're still thinking about those things
Dr. Brittany Davis-Schaffer: Still thinking about those are good amount, always the family time and is really important to me and spending time with them, what we can do together and learn, and being there for them.
Is number one for sure. And similarly with my, with my patients, my kiddos in their families and supporting them and seeing how they all grow and change and succeed.
Dr. Diana Mercado-Marmarosh: Do you work inpatient or outpatient or both?
Dr. Brittany Davis-Schaffer: Outpatient
Dr. Diana Mercado-Marmarosh: Okay, perfect.
Dr. Brittany Davis-Schaffer: I love that. A continuity idea and seeing them grow. Yeah.
Dr. Diana Mercado-Marmarosh: So if our listeners wanted to get in touch with you and ask you some questions, or just send you a hello, this was an amazing episode. How can they get in contact with you?
Dr. Brittany Davis-Schaffer: Probably the best way. I guess, it would be an email to start with.
Dr. Diana Mercado-Marmarosh: Sure.
Dr. Brittany Davis-Schaffer: So the email had given you the DavisBrittany2@yahoo.com. It's a D A V I S B R I T T A N Y, the number two, at, yahoo.com. And, yeah, I'd be happy to chat or experiences or questions or anything. Yeah.
Dr. Diana Mercado-Marmarosh: Awesome. Well, Brittany, Dr. Brittany, it was such a pleasure meeting you and learning about how you became diagnosed and how you have been able to take your own experiences and enrich the lives of everybody else around you. And likewise be an advocate for your patients and for your own family too. Continue striving and continue living a fulfilling life that we're able to share or gifts of ADHD with the world.
Thank you so much for coming today and to our listeners. Thank you for tuning in and please come join us next week as we continue to talking to the amazing physicians with ADHD.
Dr. Brittany Davis-Schaffer: Thank you so much again for having me. Appreciate it. Thank you.
Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Dr. Sarah Tehseen is a Pediatric Hematologist based in Canada, and a Blood Bank Doctor. Apart from medicine, her interests include, volcanoes, dinosaurs, quantum physics and painting. Join us today as she share her journey; her challenges and wins!
Dr. Sarah Tehseen: Approach, cubit, curiosity, whatever you do approach with curiosity by the side, the why is going to be your saving grace.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physician's perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers for three and four years of age.
Dr. Diana Mercado-Marmarosh: And in the past year, I have undergone radical transformation after discovery, ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished. And a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.
Dr. Diana Mercado-Marmarosh: Hello, welcome to the overachieving ADHD physicians.
Dr. Diana Mercado-Marmarosh: As we all know, ADHD is a spectrum. It affects people in many different ways and we all deal with it a little bit differently. I created this podcast to bring awareness that ADHD is a life long disease. I will be sharing with you many physicians who along there lives have had wins and challenges, but they have learned to overachieve in life.
Dr. Diana Mercado-Marmarosh: So my aim is to stop the mental stigma associated with this condition. When most people think of ADHD, they picture a little boy maybe running around and knowing people are distracting others. They don't picture somebody super and smart and intelligent and gifted or somebody who's daydreaming. So it does not have anything to do with your mental intelligence.
Dr. Diana Mercado-Marmarosh: It's just a different way of thinking. So I want to share with you that we can be adults. We can be professionals, but before I get to my very important guest today, I have to disclose something that my lawyer makes me say, which is that while today, our medical doctors, we are not your doctors. So the information that you learn here today is not meant to replace or substitute any advice of your own physician, therapist, or coach in addition, Everything that you learn here.
Dr. Diana Mercado-Marmarosh: As we share is considered our own views, our own opinions. It's not meant to represent any specific employer, hospital or healthcare system or a particular organization. All right. That was a handful. So today my special guest is Dr. Sarah Tehseen. Thank you. Hi. Hi. Tell us all about you.
Dr. Sarah Tehseen: I am Sarah. I am originally from Pakistan.
I have been in Canada for two years now. I have two boys. I have a one and a half year old and a five and a half year old. And I am a pediatric hematologist and, , blood bank doctor. Oh, wow. I enjoy painting, singing, astronomy and quantum mechanics. Oh my God. That's amazing.
Yeah. And that is once again, the fact that my brain can hold five things at the same time, but usually not one thing at a time that does not apply.
Dr. Diana Mercado-Marmarosh: We have that special gift. Yes. Yeah. I give telling people that ADHD is a gift that we just have to learn to unwrapped, but it can be a beautiful gift. Tell me, how did you get diagnosed? When did you get diagnosed here?
Dr. Sarah Tehseen: Absolutely. I, when I looked back, so I was the kid who got in the most trouble, but my parents, it's not a big end.
Like it wasn't a big population and only the person with my brother, but I got in trouble with every single adult who took care of me? I got angry very easily. It was very hard for me to self sued. I was very emotional. I lost an insane amount of things. And when I say insane, Cell phones. Cool bags. You name it? I lost it. Important documents once I got to med and stuff. Yes. I was this smart kid in the school. Who would I belong to a school system? Coming from Pakistan, like that celebrated smart, but I was always an odd smart, because I would be saying inappropriate things or talking too fast or walking too fast or stimming, like constantly moving when I'm trying to tell people something or like doodling in the class.
I'm moving my legs too much wind seemed to annoy our teacher in what? Her grade I couldn't stop myself. And yeah, so like, it's, that was how school went. And then I came, as I grew older, it became more about being very daydreamy and missing details in med school and in high school, the actual content of what I was studying was always super interesting.
It still is. And that enables me to overcome. That daydreaming aspect, but there were certain aspects of my life, which were extremely difficult for me, like personal hygiene, having to lock my door in all of my dormitory, losing things, having relationships with people, being able to keep secrets where I would blurt stuff out, not, because I meant to hurt somebody, but because.
I'm excited, any missing body language, missing social cues, being unable to, um, like lacking that, almost lacking almost that emotional intelligence, which I saw in my peers around my age. And that was something that became very prominent in med school. And I struggled a lot because of it.
Dr. Diana Mercado-Marmarosh: So did you notice that in med school, that was the first time that you notice that?
Dr. Sarah Tehseen: The story is not over yet. So in med school, in my final year, I, would extensively, I would almost say it was, I was with a group of friends that was very, difficult for me. And I think some of, a lot of my own rates made it difficult for me. A lot of their traits made it difficult for me.
So it was, it was combined activity. I ended up getting depressed for the first time clinically depressed and I received Sidella brown for about five months or so. And it really, really helped. Let's go a little Lord by then. Everybody moved away. I started studying for my exams and that was a very good place to be because studying was something which was always relaxing.
You know, in my residency, I got even going into pediatric residency. I think paying attention to the girls was a big thing. I struggled a lot with, especially in the first few months of my residency, I had moved to a new country. I was learning a new system and I had the smarts to understand the content, but I did not have the emotional intelligence almost, or the ability to pay attention to detail part.
Dr. Diana Mercado-Marmarosh: How, like, were you then more or less in your twenties? 23, 24.
Dr. Sarah Tehseen: Yeah. I was able to overcome that by being extremely anxious and telling myself I'm doomed. If I don't and they will talk me out of the residency program that they didn't add. By just triple checking, quadruple checking my work.
[And that's how it meant to in fellowship. And I did, I was, I stopped my medication. I was not medicated. I was not aware of my diagnosis then. And my fellowship, the content in a pediatric hematology-oncology fellowship tends to be obviously for very understandable. More complex, more complicated as a fellow.
Your responsibilities are a lot more than there. Even as a resident where you are expected to know a certain amount of content and then a subspecialist will help you out. Now you're training to become a subspecialist. The stakes are high, the expectations are high. The people around you relate to you different because you are different.
And I was different. Not only because I was a woman, I was also a woman of color. And I was a woman of color with an accent because I was from a different country. I had all this. It was a very difficult year. The one thing I had always relied on was being smart and being a very capable overachiever kind of a person.
And that was a year that that part was. Criticize the most. Right. And it was difficult. I started therapy. I was still not mitigated. I still did not have the diagnosis. The next year that helped a lot. Once again, I fell back to my old coping mechanisms of bringing extreme anxiety. So like when I'm on regular therapy for a patient, I learned, I didn't check it seven or eight times obsessively before I would actually put it out.
And I still do that. That is just hard to the goals. Um, uh, and, um, the other thing which developed as a consequence of all of that, because the thing I think that I struggled with the most was the anxiety that developed as a result of that constant, never ending. Criticism. Right.
Dr. Diana Mercado-Marmarosh: Would you say it was self-criticism or others criticizing you?
Dr. Sarah Tehseen: Everything? I think it was initially a lot of other criticism, right? Like, but then for the longest, for as long as I have known my inner voice has been self critical, it just got more and more and more worse. The higher I went up the chain of becoming a subspecialist and.
Dr. Diana Mercado-Marmarosh: It did for me too. Yeah, exactly. Like your voice tells you, you better get that. Right. You're going to look dumb or you're going to get somebody in trouble or yes. Or you can really harm somebody. You better double check that you better not get distracted. Like, it just keeps telling you that. And it's like, you said, it brings up fear because you're trying your best and you're in an area where you're supposed to be perfect because, do not be perfect. Exactly. Somebody's life is at stake. Right. And so, like you said, you check seven or eight times just to make sure. Did you have like a checklist that you would do?
Dr. Sarah Tehseen: I feel, I think the anxiety component of it was so strong that it was able to kinda make up for it. I did make, yeah. Then, lot of times I would make, because then I would make checklists, I will lose them when I would make checklists. I would never have the capacity. Even if they're sitting in front of my face, on my computer, I would never be able to open the folder, click on that document to look at the checklist. It just didn't happen.
I wouldn't be too much in that moment of, okay. I have to figure this out or okay. I have to get this right. Like, and that'll help me to. Yeah, that makes sense. I hope it makes sense to you because
Dr. Diana Mercado-Marmarosh: Yes, it does make sense because if you think about it, if you step back, you know, you were using your adrenaline drive and your cortisol level as a way to boost your dopamine, like you were always in like chronic, like really?
Dr. Sarah Tehseen: I have been an adrenaline junkie as long as I can remember, like when I'm studying and even now when I'm painting or when I am doing anything, which is giving me adrenaline/dopamine, I won't eat, I won't sleep. I would leave. I would be on the go.
Dr. Diana Mercado-Marmarosh: Yeah. So it does totally make sense that your body was trying to function. Any way it could to like self preserve what you want it to do, because here's the thing, like, you're, I'm guessing you went into medicine because it's a lot of work because you're passionate about it, right. Because not everybody, but I think at the end of the day, you know, nobody stays in something. They don't like, so it's like a love, hate relationship, right? Because like, you love what you're doing, but at what cost sometimes, right?
Dr. Sarah Tehseen: Absolutely. No 100%. And, I love my patients. I love my patients. I mean, their children and I have always related the best with children. Like it doesn't get better after that. It kind of gets worse as far as I'm concerned, unless you
Dr. Diana Mercado-Marmarosh: So were you diagnosed in fellowship?
Dr. Sarah Tehseen: No. That was very interesting. So this is an interesting, because, then I came to Canada. The first job that I had was not as a pediatric hematologist only. It was a part general pediatrician and part pediatric hematologist. Oh. And when I was doing Gen-ped's I just got a lot of ADHD because in Canada, gen-peds becoming a general pediatrician equals being a pediatric psychiatrist in certain outreach areas where you don't have Pete psych support.
And we have amazing pediatric psychiatry support, but it's on the phone. Like the lesser insane nobody would ever get. And what I began to realize was my ADHD boys, the most, they're the most fun. And. Like the more I hang out, this is weird. You're like crazy. I was doing my three coordination disorder question, every one of the families and not the moment.
Like my child is a bull in the China store. And I said back to him after the mall, I don't want any.
So that got me thinking that was the first time I was like, okay, this is making sense.
Dr. Diana Mercado-Marmarosh: Ha that interaction triggered it. Huh?
Dr. Sarah Tehseen: Yeah. And then my own get triggered it like my five and a half year old is exceptionally smart, but hard to self-regulate hard to self suit. Nothing seems to work in, like I was dealing with his anger and I would get quite angry myself and that was just not working out.
So I think a big trigger was that was my kids big trigger because I was like, I have to think. myself oneway or another, because if I don't, I'm not a good mom, I cannot like, I cannot do that to them and that's not fair. And the other thing was just this understanding that this is a spectrum and that on the spectrum, a lot of behaviors that I'm seeing in the children bird behaviors that I still have, or I still had, and that got me to seek the diagnosis.
So when my second son was born, For my first and I only got six weeks matleave. So it was not really a matleave, it was a recovery period. It wasn't mentorship. So it was like you were on the go. Drains tangle ever since my son was born, the older son, my, I think he became, he became somewhat of my dopamine source.
So that was actually, even though it made my life incredibly stressed and hard because of the fellow, you don't even have the money to pay for an appropriate amount of appropriate care and all that. It compensated for that someone still continues do, for which I have been very thankful . Do whatever made him my dopamine.
When my second son was born, I had a reasonable matleave because by that time I wasn't attending and I was making money and I was in Canada where matleaves are really not looked down upon or considered that six weeks is enough.
Dr. Diana Mercado-Marmarosh: Right. And that's a blessing.
Dr. Sarah Tehseen: That was the time I actually went to a psychiatrist. I got referral to the SMA, like our medical association. And I went through the psychiatrist. And start it over just saying, yeah, I've struggled with anxiety. I know I have it. I had been on SSI to a family doctor for a good two years and it made a difference and I was like, Hey, this is my life history.
And he was like, yeah, you definitely sound like that. No question asked. She did a few long questionnaires. I did a few more questionnaires and. I started, that was what I was still nursing my kid, pretty extensive. He said that was like when he was nine months and 18 months.
We're now. So almost nine, eight months ago.
Dr. Diana Mercado-Marmarosh: This is very recently.
Dr. Sarah Tehseen: It has been the last year of my life, basically that it fit together.
Dr. Diana Mercado-Marmarosh: And then I can only imagine, you know, the pandemic might've just like boiled it over, like.
Dr. Sarah Tehseen: Okay. That's interesting part. Pandemic was very suiting for me because I was not required to mask. I was not required to interact with other people that you are socially required to interact with because then ever I find interacting with people that I'm not close friends who were, let me like, do daydreaming and twiddling and fidgeting and talking about random things and laughing about random things or being so excited about the movie that I watched and looked at it.
And if you are from a small entity, you're required to keep those relationships. Right? So the fact that I had the excellent excuse to not meet with people, Well, actually good. Yeah. So I'm dreading the fact that that is over now. The fact that I could attend meetings from home meant that I could be nursing my baby and I sent him the meeting and saying,
Dr. Diana Mercado-Marmarosh: So would you say you're an introvert?
Dr. Sarah Tehseen: I don't know, but it comes to that introvert/extrovert spectrum. I do know that masking makes me very exhausted and being in situations when I'm required to be a certain way, makes me very exhausted. Pediatrics is amazing because pediatrics has not requiring me to mask. Yeah. I can talk to that teacher about the schedules that they are doing, or the Netflix show that they're watching, which probably am watching at the same time.
And real guys, I know as much about dinosaurs as my five-year-old, so it's just so much more fun. And he went with the parents. I mean, even if they are very. Like properly people up over time because it's because when they can see that I care a lot, which I do absolutely 100%. And also because they see the kids bonding.
And that provides me an avenue and my blood bank job. I'm blessed to have colleagues who are very accepting of my quirks, extremely accepting of my quirks and valuing me for my strengths and. I never thought that I will get this environment in my work ever. And especially with my experiences in fellowship and residency, I thought this would never happen.
These are the, like, I'm truly blessed. I'm truly blessed. And one of them is going to be retiring soon-ish and I think it's the circle of life. She is going to be missed very, very dearly. So that's, kind of,
Dr. Diana Mercado-Marmarosh: But I want to have you there and, and really emphasize something that is so important that you had an amazing mentor, right? Who welcomed you the way you are not having to like, be any different than yourself and you saw. Being in medicine that you could be, you, you could be human, you could be Sarah
Dr. Sarah Tehseen: quirky and loud and funny and late to meeting and still do a phenomenal job and be celebrated. Right. I, that, and that part is so hard to find so hard to find.
Dr. Diana Mercado-Marmarosh: But the more important thing is that you saw this role model and now you too can be a role model for others, right? Like you can, you, can
Dr. Sarah Tehseen: I can celebrate those strengths and take them where they're at, rather than expecting them to be something that they're not absolute.
Dr. Diana Mercado-Marmarosh: Yeah. And you see, I think that's a beautiful photograph.
That ADHD has because we tend to be flexible and outside the box
Dr. Sarah Tehseen: and we that's how we do it, but that's what happening. Okay, we'll do this. Oh, this happened . Like my nurses would come to me in panic. This happened, this happened, this happened this moment and I need that story. You don't want to be like, It's so easy and so natural to trouble to think on your feet, then it is to sit down in a meeting and be proper, or, um, write a note or review a part of, because of it being elaborate like in the lab aspect.
It's very interesting. It's very fun. But the part with enjoy involves looking at like operating procedures and doing quality stuff. You will have died, is difficult. And what I have noticed that ever since I have been on the stimulant, that part is getting done on time. That part is becoming a lot more easier.
So the parts of me, which we're not getting, like I'm getting enough dopamine out of my medications to get the required work. Getting up in the morning has become a lot easier. And I will say I switched from consider to dextroamphetamine. Um, right now that's what I'm because, and what I have noticed is that even with the SSR I's onboard, that combination has helped the emotional regulation a lot.
And help the, obviously the focus and attention by this there, but the emotional regulation part is also settling. And that, for that I'm very thankful. The fact that it worked, obviously, that makes you look back on your family and who has, might have it. And, and I have my opinions about it, but I talk about it at some other point, this has been a year, year and a half of discovery. I was ever, since my little one was born, it has been a year of discovery.
Dr. Diana Mercado-Marmarosh: How different is it now? That you're embracing it with a curiosity point of view, right? Like having more self-compassion for yourself and loving the way your quirks are. Like you said, what makes you, you and not having to use that internal voice telling you, like, you're going to do this wrong? Like, what if your thoughts. I'm just very thorough. I just want to make sure, like, it's always how you look at things. Right? What if you're thinking I'm just double-checking and that's okay.
Because nobody's going to ever fall to you for double-checking. But hopefully now, as you have been doing things more often, It becomes second nature to you. And hopefully with your medicine, you don't have to double-check seven times, hopefully you're double checking three times, but it's a process, right? Like you said, some things are ingrained. Right.
Dr. Sarah Tehseen: Yes. The other thing is also that I'm able to say that to people. Hey, people, I tend to forget to let me just quickly look at it and make sure I'm not missing anything. I just say that out loud. I say that to my residents. I say that to my students. I say that to my colleagues and I'm just not.
I don't hide in shame because I think that has been the biggest gift. I don't hide in shame. That's why I struggled with driving for the longest of time, because it's just so much sensory integration and it's so much stress and I would just try to put it off as much as I can. I mean, I have a license, I can, to my life, but I have a husband who loves to drive in a single car house hold so I avoid it as much as possible. And I think a big part of that had been number one, I learned really. You don't like, it's not the right of passage in Pakistan. So I learned in my residency with a woman who, whoever she from, she goes to somebody somewhere in Eastern Europe and you go like,
Hey, she would be yelling at me. When you yell at me like, like this, I go into massive shutdown. So yeah, of course, because your driving instructor is screaming at you. When you're driving here, you're not going to panic. Yes, exactly. So that was the background. And then, like I can see that I struggled with it all the more and other people do.
And I'm sure if I put in the time and effort, I will get good at it, but couldn't bring myself to, especially with so many other things in life, I just can't bring myself.
Dr. Diana Mercado-Marmarosh: Sure. Yeah, no problem. I mean, I didn't learn, to drive till I was like 17, 18 also. And I remember like, my dad was teaching me to drive and he was
So, he didn't want to pay for the course. Okay. He didn't think I should drive. But then he like wanted to, evaluate me, you know, as I was driving, to the store where I worked, I was a cashier at a grocery store and like, it wasn't even two miles away.
And I think I, it was an, like an orange light and I like ran. Like, I, I just went like curved and he was like, pull over. That's it. You're taking the class I'm driving. I was like, okay. Like, I guess. I had to be more careful, you know? And so it is what it is.
Dr. Sarah Tehseen: So I think there are two kinds of people. There are people who find joy in it.
And the ones that you find joy in it, like who actually enjoy driving, it becomes a hyper-focus just like procedures become a surgeon's hyper-focus and they're able to be really in the zone and have a good time with it. And then. Who start over. Yeah. Right. So it just, it's just what grabs your attention.
And it's so difficult for you to do things which are not your attention. And with my son, I am recognizing this more and more that, you know, when he struggles with
I'm like, okay, it's gonna be hard for. It's going to be hard for him because he has no dopamine to brush his teeth in the morning, or he has no dopamine to take a bath, or he has no dopamine to what does that he struggled with? To do whatever, like multiple things, for example, we were doing some reading and he has to use his brain for it.
Right? Like you have to make an effort, you have to make mistakes, you have to figure things out. And he's not really good at it. Nobody is right. And I'm pushing him over to, I'll be honest, but he was all excited. And I was like,
Dr. Diana Mercado-Marmarosh: But what a big gift it is for you to be his mom, because one, you now understand like, how, like that there's nothing wrong. It could be that maybe there's some dopamine or maybe he's just being a kid, but at least you're now more in tune and more aware and not going to judge him a call him lazy or whatever. Like sometimes parents, sometimes our parents mean to do well.
Right. But sometimes what they say can be kind of hurtful because they're just.
Dr. Sarah Tehseen: Say it was act and it was not just your parents, it was everybody else in your community, in your friends. Right. And it was not just one year. It was 30 years old, 35.
Dr. Diana Mercado-Marmarosh: Exactly. You internalize it. Like, it's like a character flaw, right?
Like, like you're doing it on purpose, but you're not like, this is just our brain and if we could help it, like, why the hell would we make it harder on ourselves? Right. Like, oh yeah. I love losing the keys 30 times and you know, like nobody..
Dr. Sarah Tehseen: First thing I did and the first job I got was lose the keys and those keys had the car keys on it, but not only did they have the car keys and everything else, those keys were like, , one of them would be the common keys for an office where we have our facts.
Yeah, totally. Oh, great. New job. New boss, new boss.
Dr. Diana Mercado-Marmarosh: I cannot tell you how many times in residency and in my, um, where I was working, I went to residency at Baylor college of medicine in Houston. And then I started working at strawberry clinic, which is like an underserved clinic. Do you have to Baylor, but they had lockers, you know, and you were supposed to use those like little things too, like combination.
I don't know what the combination, but if I would forget my combination. So like the janitor would come with their big flyers. Break it up. So I, so I could get into damn locker so that I could get like my coat or my stethoscope or whatever, like, you know, I would go on vacation and then I would come back and like, I forgot the code, like one week or two weeks or whatever.
Like how do you just forget that? Finally, my husband was like, okay, you need to download an app where you put all your passwords in there and that way you just need one password to get into there. I said, okay.
Dr. Sarah Tehseen: , I think, I think the other part. Which is true for a lot of ADHD people, and especially the high-functioning ones, I feel like we rely on our spouses a lot to run the life, picking kids up from school or dropping gets to school, making sure we are on time for our taxes and our appointments and our deadlines.
And, the bills are paid on time and all of that, like. I think me and my husband worked out well, that aspect very well, because he is unnaturally organized person. But think about it and that he's got that by now, but I'm going to think about it. I think that. It's probably because he has ADHD organization as is hyper focus, but that's, and that's part I definitely want to put out there ADHD can cause dysfunction in any form, just because you are organized at work does not mean you're organized in life, just because you're organized in life does not mean you're organized at work.
Some people with ADHD will have organization as a hyper-focus, which gives them dope. So they are going to be organized for the heck of it. So for some people, and that includes me, this organization and emotional dysregulation is the hardest thing to deal with for other people. It's their jobs or addictions or, learning to read and write or doing math or being hyperactive. So it's, it presents in every person differently. Even if you are a mom with ADHD and you have a child with ADHD, you're going to look very different from your kids. And that's okay. The underlying. That pathways are the same. And I think if you are a parent of a child who is struggling with this, or you yourself struggled with this, you have to, I think, it's a good idea to learn and understand how yours present versus how theirs present, because in any relationship be it. And I see that with my colleagues and my nurses, my residents, my patients, my son, my husband, my friends, anybody, if you approach things from a place of, I'm trying to understand why you're like this.
And compassion. It's lot easier both when you and for them.
Dr. Diana Mercado-Marmarosh: Yes. That's a very big point that you're bringing out that I don't want a listeners to miss that when you approach somebody from love with love, then you really are being under like curious and not judgy. And when you're curious, Then the other, person's able to share how they're thinking because they feel safe in that space and they don't feel judged because remember we already judging ourselves.
So, and then it feels horrible to be judged by the people we love because. We want to be loved, just like every other human being and to spend out for the wrong reasons, like makes us like freak out and almost shut down sometimes. Right. And so that's so important to understand, like you just said emotional dysregulation, even though in the DSM 5. It's not like seen as one of the components of ADHD in Europe.. It is okay.
Dr. Sarah Tehseen: That I didn't know because it should, because that's the biggest problem. And, I'm going to jump because I'm going to interrupt. When I was looking my son is not diagnosed at, but when I was looking at the diagnosis, diagnosed children who ended up having it, there was a study.
I don't know that it came out of, and it talked about the fact that as a preschooler or as a toddler, as a baby for them, the hardest thing was self-soothing. And that makes sense. This is the one thing they struggled with and they struggle with it as they are little babies who are not here to the night, to the point where that 26 year old and somebody tells them they don't do a good job.
This is a lifelong thing. And, and the sooner they realize that somebody is holding space for them and giving them a chance to work it out, the easier it is for them to actually learn to work it out in their way.
Dr. Diana Mercado-Marmarosh: Yeah. That's so powerful. Tell me, what are your goals in the next five years? Do you want to travel somewhere?
Do you want to go to the Hawaiian? Did he didn't want to go to Hawaii? Just want to see those plants that are able to stand right next to the volcano. And they actually stopped. They're actually able to close their forest when the knock system like a mob. So my son is very science driven. And I got science driven as a result of it.
So all the stuff about quantum mechanics and astronomy came out, and we'll just keep asking questions. And when somebody asks me a question, I have to find an answer like there is no other option and that's it, it has to be given an answer as to be fact-based, because now I'm thinking about the question.
So, that aspect of parents find annoying. I find it fun. It's caters to my natural curiosity. We already interested in volcanoes. I wanted to go to Hawaii. So are you thinking like Maui, is that what you're thinking? I'm thinking actually, I don't know, but I learned to look at a semi active Volcano or maybe like the, is it the big rock?
I don't, I don't know. Good geography. I know I've been, I've been to Maui and I've been to Honolulu and in Maui, we did see some volcanos. I'm pretty sure there's different parts in Hawaii that you could fly to, but yeah. Do your research don't take me.
Dr. Sarah Tehseen: No, no, no.
And for the short term, I definitely want to go to Victoria. I'm getting a week off in August because I have, I, I miss the ocean. I haven't been there in a while, so, and I think everyone moved here. So that's do, in terms of like goals, some of them are funny and some of them are. Passionate. I want to, as a part of my job, we did a lot of very grassroots groundwork here in Canada, which was very.
But it was a lot of work, but was very accomplishable because all the systems were set in space, but it was still a grassroots work. It was still ground work of developing something from up top. And I want to take these skills and I want to use them and maybe other countries, but definitely back then.
So I am. I'm connected with some people in Paxson who are already doing some of it and just kind of working to make it a better, better place. Obviously I keep forgetting to schedule meetings, obviously it's difficult to accomplish, but it's in the works. That's all I can say that these are two kind of this is the not so funny goal. I've wanted to have more time to me because I have finally learned that when I have more time to me, I can spend it in ways which are enjoyable because for the longest of times when I would get vacation, I'd be like, I don't know what to do with myself. I would be all over the place and I would be miserable.
And I'd be like, what's the point? And now that I know that I can do certain things and have a good time in my vacation, I want to be able to have some myself. I want to, and there's something that's skilled scares me. I dunno how much of it I can do, but the medical students and the residents and the fellows and the trainees who I see, and I think this will be true for every physician with ADHD.
I want, if I see them acting the way I acted, I want to hold space for them and give them compassion and tell them that, Hey, there is a way out of it. I may not, I don't know how I'm was. Yet disclosing my diagnosis, but I definitely want to hold space for them, even if I'm not giving them a diagnosis and maybe share skills with them that helped me and did not have, but as are on having a self-feeding inner voice..
Dr. Diana Mercado-Marmarosh: As you know, that's part of why we're doing this podcast, right. To like bring awareness and to help normalize it and to help our fellow colleagues, right? Because to you or to me, like we just knew we had to maybe work a little harder and we liked what we were passionate about what we were doing, but why do we have to work so hard?
Right? Like when there is a way a medical way to get diagnosed, right. And to help, like you said, all aspects of your life. And so, that is very important that you are going to hold space for them. And like you said, you will know at that time, what you share or don't share. But I don't know if you're aware, there is a journal that just came out the Canadian ADHD, put out the leadership journal.
July 4th was when it got published. and it's talks about physicians with ADHD and the work in the workplace. And if you haven't read it out, I'll send it to you so you can look at it. But it's really good because it really shows like. On one side, it shows like how to diagnose ADHD kind of, but then it implements, like how would you see it in yourself or in colleagues in the workplace?
So it gives you like the connection with each, each symptom and each like way of presentation. And then it just says that, Hey, be in the lookout because who you might think is unprofessional. They might be struggling and they might have ADHD and they're not trying to be unprofessional. If anything, they're putting in probably 20 or 30 hours more than you are trying to just stay on top of things.
And just having a conversation with them can like change their life. Right. And so I thought it was such a powerful journal. It was like a really good like call to action saying that as leaders, it is our responsibility to like look up. Each other, because at the end, everybody wins that person wins. Their family wins, their patients win, the whole institution wins.
So it's just, it's just a beautiful journal that I'll share with you. You haven't read it, but I think it made me feel like validated. It made me feel like, okay, finally, somebody is talking about it and it's out there, you know?
Dr. Sarah Tehseen: Yeah. I mean, and just because somebody comes across as hyper organized does not mean that they don't have it. 'cause some people will be tremendously organized, but how they it's.
Dr. Diana Mercado-Marmarosh: Yeah. Some people do have ADHD plus OCD on top of it. It's just spectrum
Dr. Sarah Tehseen: Yes, exactly.
Dr. Diana Mercado-Marmarosh: Cause that's their overcompensation mechanism. Yes, exactly. Yep. Awesome.
Dr. Sarah Tehseen: I think that's all I want to share.
Dr. Diana Mercado-Marmarosh: Awesome. Oh my God. You know that you and I could probably talk for hours.
That's the way we are. We tend to be like into everything and understand each other without really having to explain much, you know, and even though we're a little bit different, we're still kind of the same and it's so nice to see that across cultures, like this is something that is seen like, and this is something that it's okay.
And, it brings us closer. Just one last question, in case like somebody wanted to reach out to you, maybe they wanted to ask you a question or something. Would you be comfortable giving an email address or a website where they can look you up?
Dr. Sarah Tehseen: I think if there's a website, I would prefer that, , the website have to be linked to by email. Otherwise I will never check the website, but yes, that should be fine.
Dr. Diana Mercado-Marmarosh: Okay, perfect. So we will get that information out to you guys. Is there any one last piece of advice you would like to share? You gave us lots of awesome advice. But if there's one last thing.
Otherwise, we will close it up because I loved everything you said.
Dr. Sarah Tehseen: Oh, thank you, approach cubit, curiosity, whatever you do approach with curiosity by the vibe, the vibe is going to be your saving grace and the ones who have kids. And they have ADHD, the first words that get thrown around are conduct, and they're going to be an addict in the future.
They're going to be sociopath and they're going to be this. They're also Einstein. They're also scientists. They're also anyone that I know who is like exceptionally successful in their field. And when I say successful, I don't mean like they're making a lot of money or have a big house or a car or a stable job.
I mean like people who actually broke the grounds of discovery. I am sure they were on the new neurodiversity spectrum somewhere. Find what you love, find what your kid loves and then grow it, grow it with every single piece that you have, because I can promise you that it will, it will change the world.
Yes. I've started speaking very well. And that's between you and me. I mean, you can say whatever. I did not use to speak like that. I was a very stumbling over. Stumbling over myself, making sure that I am not saying something which is offensive. It that's changed a lot. That's amazing because you stepped into yourself, you, started to be curious and you embraced yourself and that made the whole difference.
Yeah. Well, we made part of the difference because of the work in progress.
Dr. Diana Mercado-Marmarosh: And that's the thing, right? Like that's the part that we're here to keep it real. Like we're not here to pretend like life is perfect, but at the same time, we want to say, we are passionate about what we're doing. You can do whatever you want.
Sometimes it can be a little bit challenging, but anything that's worth pursuing can be challenging and it's not that you're going to become better or the person once you accomplish it. Because if we keep trying to get to a destination, you're going to miss the journey. So the point is trying to live in the moment and keep remembering, like you said, why am I doing this?
when you live in the moment, Then you're already happy that whether you accomplish it or not, it's who you had to become. To pursue whatever you were becoming, that's going to make the whole difference. And like you said, taking time for yourself is going to be how you feel your own cup, so that then you can turn around and be present for everybody else.
And make the world a little better. Right? Some days it's awesome. Some days it sucks, you know, it's 50, 50, but that's okay. That's part of being human. As long as we keep showing up, that's all that has to happen. Right. So it was such an honor to talk to you today. There you have it guys. So please tune in.
[If you want to give me any feedback or ask any more questions, please reach out to me at overachievewithadhd@gmail.com. And we will see you next time.
As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Dr. Emily Shaw is a Family Doc in Sonoma County in CA. She does Lifecoaching in Community Minded Docs. She also has ADHD and winning it! She has many inspiring experiences along the way and is proud of what she is today, what she has been accomplishing to doing to help her community and peers.
Dr. Emily Shaw: But my ADHD wasn't causing a problem in my day to day work as a primary care provider, my brain just sort of, I I've, I own the way that my brain works and I like, and I love myself. And I have this journey for, for me of not just accepting who I am and how, you know, the tendency that my brain has to do certain things.
That really just like loving that part of myself and knowing that's part of who I am.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physicians for. Podcast. I am your host, Dr. Diana Mercado-Marmarosh . I'm a family medicine doc with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age. And in the past year, I have undergone radical transformation after discovering ADHD, coaching, and life coaching.
For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year, I figured out this. Learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius.
So they too can reclaim their personal lives back, like I have.
So I created this podcast to show people that ADHD really is lifelong and that the people I'm bringing are awesome physicians who are going to share with you their wins and their challenges, and some tips and ways how they are overachieving in life.
So my aim is to stop the mental stigma associated with this disease and to re, to remember that. It's not ADHD is ness, not just our kids, but it's also us as adults. And we are here to provide that service to you today. So before introducing a wonderful physician to you, I have to disclose that little disclaimer while me and my guests are medical doctors.
We are not your medical doctors. So. Please do not substitute any advice that we share here today, uh, with those of your own physicians, therapist, or coaches. So any advice that you do learn here, please remember that those are our own views and opinions. Okay. If they're not meant to represent anybody that we are employed by any hospital or any particular healthcare system, or we're going to station.
Well, that was a handful, but my lawyer made me say that. Okay. Onto the exciting things today, we are going to meet with Dr. Emily Shaw. And let me see if she can introduce herself, Dr. Emily's job. Please tell us all the things.
Dr. Emily Shaw: Hi, so yeah, I'm Emily Shaw, I'm a family doc in Sonoma county in Santa Rosa, California, and I am a life coach for community minded docs.
And, that's a little bit about me. I, I also have ADHD and, you know, just like anybody else, I've had it since I was a very little kid and. And, you know, have had many different experiences along the way, but, uh, but I'm proud of who I am today and what I've been accomplishing and what I've been doing to, to help my, to help our community and to help my peers.
And honestly, being a, being a coach now for, for docs who really care about service and who are really service driven has honestly been now one of the most fulfilling things I've done.
Dr. Diana Mercado-Marmarosh: That's awesome. When were you diagnosed? Did you kind of already feel like you perceived that you might have something that was maybe a little bit more different than your classmates?
Like, were you a child or were you a teenager or what did you, do you remember?
Dr. Emily Shaw: Yeah for me. My sort of diagnosis journey was, cause I also have a reading disorder, so it's like, you know what people used to call it dyslexia. And so I think my parents were always concerned growing up in school that I was, I was a very slow, like I, I didn't learn to.
Until much after a lot of my peers. And when I did learn to read, I was super slow and reading out loud was always something that I was a little bit embarrassed about in school. Growing up. I wasn't the, as much, I guess my parents would maybe say that I was a little hyperactive, but I don't know that I met the hyperactive, criteria for the diagnosis.
I've always been like super extroverted person. So I was always like bubbly and you know, that kind of thing, but I have more of the inattentive. type. So I was, I, my parents didn't actually, get me formerly tested until I was in high school. And at the end of high school, I don't remember exactly how old I was, but I remember the whole process.
It was like three days. It was very interesting for me as, as you know, slightly older person being tested. It was really an interesting process to go through. but, and I was always in like the, the gate classes, like the gifted and talented classes growing up and everything. So I, I always, had been able to compensate to a certain degree, like just by, I guess working harder, you know, or reading things over and over and over and over and over again, and like literally highlighting, oh my gosh.
My, all my textbooks growing up were like highlighted in like five different colors. Cause I missed the highlighter in order to like actually read it. You know, and then I, my light, like the part that was important. Oh my
Dr. Diana Mercado-Marmarosh: So did you happen to have a system with your highlighters? Like was blue, like meaning one thing or red mean something?
Dr. Emily Shaw: Yes. Yes. I totally had that. It was the yellow was just to like read and then it was the pink or the blue or the orange. That was like the actually something more important and then I would underline it if it was even more important. Yeah.
Dr. Diana Mercado-Marmarosh: It's funny you say that because I actually did the same thing, unaware that I was trying to help my brain.
So like I would use a green one for anything, like when I was studying for medical school. The green one was anything like positive or good. The red was anything negative. And I would try to make like list of things like opposites to each other so that I could spatially remember the information, but the color was what would like trigger the memory.
It was so weird, but our brains just work a little bit differently. Right. And they, we find tricks of how to enhance it. Yeah.
Dr. Emily Shaw: So I wasn't diagnosed until I was a little older and, just sort of like worked out my own coping things. And I started using medication when I was in college or maybe senior year of high school.
And no, I think, I think it was actually in college. So, I remember that it was like, I went to brown. It was the, like the school psychiatrist that I met with.
Dr. Diana Mercado-Marmarosh: And, how did you, did the medication work? Did you have to try different ones in order for you to feel like that was?
Dr. Emily Shaw: Oh, I felt super lucky because I only tried two things.
I only tried one thing before then I tried another thing that ended up being the thing that worked. And so for me, I tried Adderall first. It like made me so dry. I couldn't even, it was like, whoa and interrupted my sleep too much. And the, and so, and actually the second thing that I tried was the methylphenidate, the Ritalin.
And even at relatively low doses, it actually was working well for me and in a short acting pill because I found that. For me personally, I didn't like the medication definitely worked. Like I could feel it kick in and I could be. Then concentrate on what I was reading and actually, and actually like pay attention in class, which, you know, my classmates were shocked at how much, I didn't know.
They'd be like, oh, so-and-so like the teacher said this and it'd be like, I don't remember that at all. It was shocking how, when I would take it, I would like, actually know what they said. And then when I didn't, I was missing like half the lecture, but I love. That instead of taking a long acting thing, I could take something short acting so that, so I could be, you know, more myself, you know, when I, when I didn't feel like I needed it.
So that's what helped for me, you know, even like 10 milligrams was, I think what I took for, for awhile, through residency and, but I haven't actually taken any medication for a long time. I only use it for myself now. Like if I have to study for the boards or sit there for the boards tests on the computer for like a million hours.
Dr. Diana Mercado-Marmarosh: So what strategies are you using to cope? Are you doing exercise or do you have to plan? What are you using?
Dr. Emily Shaw: I mean, I don't really know how scientific this is, but honestly I've really felt like. Two, major things for me have made a difference. One is that I actually switched jobs. So, I mean, before it, wasn't my ADHD, wasn't causing a problem in my day to day work as a primary care provider.
But what I found challenging was that, Like getting my notes done, not because of a time thing or anything, but just, like, you know, my reading stuff, like reading through documents or different little things were just sort of piling up and not because of like what everybody else, not everybody else, but like a lot of the common things that other people experienced, like there's just not enough time to do this.
Or like, uh, It was, I've just never been efficient. I've never like my, my brain just sort of, I own the way that my brain works and I like, and I love myself and I have this journey from, for me of not just accepting who I am and how, you know, the tendency that my brain has to do certain things.
But really just like loving that part of myself and knowing that's part of who I am, the me switching out of primary care and actually not having like the in-basket stuff and, the notes to write in the same sort of way, and working in a more acute care setting where the visits are targeted has created has made that a lot easier.
So like I'm getting home on time and I, right. There's like things don't weigh on me and I have two little kids. I have, my older daughter is turning five next week and my younger daughter's two. And, so switching to like a shift job. In an acute care setting where things are really narrowed and focused, was really great for me.
The other thing that has been really great, I think, but I don't actually know what the evidence is, is that we're like a whole foods, plant-based diet sort of family. And, I really do, my experience has been that, I'm a lot more clear generally if I eat healthier.
Dr. Diana Mercado-Marmarosh: I eat healthier. Yeah. I mean, Again, you are highlighting how you understand how your brain works or your tendencies and you're using those strengths, right? You administrative work sometimes can be boring for us and repetitive stuff can be boring for us. So you have found a way to use those gifts, of like acuity and targeted and to work for you. And at the same time, you're going to share with us about your coaching, how you're doing something that is really driving your passion, which that together really motivates you so that you have a reason, like you said, you have a reason to go to home to your family, right? And you don't want to come home and continue doing in-basket stuff. Right. You want to go home and be fully present. And so all that is very important. And there is evidence out there that I've been reading about in the last year that the low fat, sorry, the low sugar diet.
Makes a big difference because we get, so sometimes we don't realize that. We're drinking alcohol or we're eating sugary stuff to try to increase the dopamine in our brain. And when you eat a clearer, healthier plant-based diet or, not so much sugar, you are able to, like you said, don't have that brain fog so you can think better and make better decisions.
Yeah. So, I think you really are figuring it all out. Can you tell us about your program that you have coming up?
Dr. Emily Shaw: So, I run a 12 week coaching program for, like I said, for community minded physicians who are looking to sort of improve the way that they experience life. Like, you know, basically I want people to be able to have it all. You know that quality life, the balance, the getting home on time, the, like all of that, you know, the relationship with their spouse that they want. Honestly the relationship with themselves that they want. And so my program is a CME approved and so people can even see any money for it. And it's a combination of, weekly groups and, individual one-on-one coaching every week as well.
Uh, it's called my first 24. It's like sort of the first 24 hours of the rest of your life. And it's been, like I said before, I mean like really the most fulfilling and amazing thing that I think I've done professionally, which says a lot because, you know, I was doing primary care for the underserved before, and that, like, that filled my cup, you know? But this is so fun and it's so amazing to see people become the person they want to be. And, I'm like really up right now.
Dr. Diana Mercado-Marmarosh: Yeah. And it's coming there's one coming up soon, right?
Dr. Emily Shaw: Yeah. So I just literally started recruitment, like enrollment for this next group. That's starting, August 29th, yesterday I had my first two consults yesterday.People who want to sign up, so I'm excited about that, but, and the current group that's is finishing they're graduating tomorrow. Today's Friday. They're they're graduating tomorrow. so I'm really proud of them and I'm really excited for the next group. And, I also have an alumni program, so it's not just like we have this program and then, and then, you know, you're, I want people to fly. Right. I want people to fledge and, and, you know, but at the same time, it's really helpful for people to have sort of like, continued support in some capacity. So I also have an alumni program for the people after they graduate.
Dr. Diana Mercado-Marmarosh: Okay. That's awesome. So what are your big goals in the next five years? If you don't mind sharing with us?
Dr. Emily Shaw: Oh, geez. I've been having multiple, multiple people asking me about like an in-person retreat, you know, like one of the lovely things about, all the virtual stuff that's been going on since COVID has made it, so that. That I thought when I originally was going to be a life coach that I was gonna just like help local Sonoma county docs. And I was going to have a little office that I could just walk to and, and like group space and, you know, be outside. And, what has happened now is that like, people from Canada are coming to my program. People from all over the country are coming to my program and I'm getting to meet people from all over the place.
It's so exciting. But now, so because. Of that sort of more global sort of thing that's happening or the opportunity that presents itself. So many people want to get together in person. And so one of my goals for the next couple of years is actually putting on, an alumni retreat, like a family retreat.
Cause, you know, people get to know each other over the course of 12 weeks and they really like each other, you know, and we'd become like their little family and, and we have a, you know, continued community. We have a Facebook community. And, so that's one thing I want to do. Another thing I want to do is actually do like for people who actually aren't in the program to do some sort of in-person like weekend thing or something like that.
Another goal of mine is to actually work less at my regular job. Because it's not that I don't want to stop doctoring. I love doctoring. I like really love what I'm doing and the service that I'm providing. But I really love this stuff too. And this has been my hustle year, sort of like, you know, I've been doing this now for a little over a year. And I don't want to be working 40 hours a week anymore. You know, I like I'm, I'm thriving in it. I love it. And I feel like I'm present with my kids and everything, but I actually don't want to be doing this much.
Dr. Diana Mercado-Marmarosh: Did you, uh, did you go to the life coach school as well? Yeah, so I just completed it, uh, in July. And I really want to say, like, in the last year I feel like going through that process and being coached, has really like opened up all kinds of like limiting beliefs that I didn't even know I had, and it's been such a growth year. and like, when you say that you go through these courses and, you know, most people are like, what are you going to do? Talk about feelings. That's so weird, right? It, but you don't realize that your feelings are really coming from that thought that you think it's a fact, right? Because that thought keeps coming up multiple times throughout the day on different things you're doing. And when you start. Have somebody hold space for you and tell you, Hey, you know what? It's just like an opinion, right? Like that's not really, that's not really true, right. Just because you're thinking it, it doesn't make a true all of a sudden, your world just starts to become like endless possibilities. And like you said, now you are getting to realize you can create your life on purpose by design.
Right. And now you're getting to share. With all these people and they themselves are having a transformation that ripples, right. It's not that they just changed themselves. They changed how they show up for everybody else around them.
Dr. Emily Shaw: Yeah. And people can, I mean, the other story here is that like, I I've wanted to be a life coach for like 13 years ever since I was in med school. And so like, you know, part of my story. Like you can do what you want to do, like that dream that you had, like on the back burner for a long time, that you know, maybe isn't as like fancy or sexy as being a doctor to some people, that you can do the thing. And I'm going to make like over a hundred thousand dollars from coaching this year and right.
I can make a living as a life coach for docs who like work at community health centers and who, or, or who are specialists who like really care about, about the people that are serving, you know, I never would've thought that.
Dr. Emily Shaw: And there's more and more and more of us, we are really going to change the culture of medicine. We really are.
Dr. Diana Mercado-Marmarosh: And you know, and I don't know if you had this, believe it or not, but. At the beginning when I started, like, I would get so nauseated, like saying out loud how much I was going to charge somebody. But like now I've come to realize that, you know, it takes a special type of person to become a life coach. You already know you're going to serve like you just gonna serve. Right. But in the process of earning the money, and even if you give it away to charity, who do you become to become that person? And so it's such a beautiful thing that you are doing. So happy that I have a chance to share this with the world.
Now I know people are going to be like, how do I get in touch with Dr. Emily Shaw? Can you give us a webpage or an email so that they can hear about your program?
Dr. Emily Shaw: Sure, so my website is pretty simple. It's like www.emilyshawmd.com. So E M I L Y S H a w md.com. I think that's the easiest way. You know, people can reach out to me via email, like it's Emily Shaw, M D coaching@gmail.com.
It's really long, so people can reach out to me via email. Like they can look, they can follow me on Facebook or Instagram. Yeah.
Dr. Diana Mercado-Marmarosh: Awesome. Well, there you have it. If you're ready to change your world and everybody's world around you come talk to Emily Shaw. Okay. thank you again for tuning in take care.
Dr. Diana Mercado-Marmarosh: Bye-bye, someone who understands that time is your most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group beyond ADHD if Physicians Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends, so they too can learn to live life and stay in their own lane.
Dr. Arundathi (Arun) Rao is a medical director of Sarasota Memorial’s Bariatric and Metabolic Health Center, she oversees the full range of medical, surgical and support services provided by Sarasota Memorial Hospital and its bariatric team. She has 3 kids, and into photograph; just like our previous guests, who have ADHD, she’s also overachieving in her career, and life in general.
Dr. Diana Mercado-Marmarosh: Hi, welcome to beyond ADHD, a physician's perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers or three and four years of age. And in the past year, I have undergone radical transformation after discovering ADHD, coaching, and life coaching for the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own. I was running on fumes the last year. I figured out the secret learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back, like I have.
So today what we have is a very special guest, but before we go to all of that, I need to give you some pointers. So as we know, this podcast is to explain awareness of ADHD and how it's a lifelong disease. And I will be sharing with you physicians who will share their wins and their challenges along with any tips that they've learned to over achieve with ADHD. My aim is to stop mental stigma associated with this condition. Most people think of ADHD. Sometimes they think of a hyperactive child running around, but I want to bring to you that perspective that sometimes it could be adult mom, a teacher, a physician.
With this in mind, I want to show you that ADHD is an infinite and it's presented in many different ways with different people. So we will talk about the latest scientific data. We'll talk about different books and resources that have helped us. And like I said, I will bring you amazing physicians to share their life stories.
And just like I've shared with you guys before, I need to give you a disclaimer while me and my guests are medical doctors, we are not your medical doctors, meaning that, anything you learned here is not meant to replace or substitute any advise of your own physician therapists or coaches. In addition, anything you hear here doesn't mean that it is being represented by other people.
Meaning it's our views. It's our opinion. It's not represented by the people that we work for. The employers, the hospital, or any particular healthcare organization. I know I have. Say that my lawyer is proud when I say this part. So I have to get that out of the way. But today we have a very special guest Dr. Arun Rao, and I want to introduce her. She is in Florida. And so let's talk to her today. Tell us about yourself.
Dr. Arun Rao: Hi. So incredibly thankful to be a part of this podcast. I am a bariatric surgeon in, , Florida, , actually in Sarasota. I'm the director for bariatrics of a major hospital. And, I'm also a general surgeon, but my passion is truly, , bariatrics and I've got three little kids, seven, seven and 11, but me through my paces when I'm not at my paces at work.
Okay. I am blessed with three ADHD children that I have had to manage along the way, but they teach me more and more about this every day. They, they show me that every day that the, basically there are different versions of ADHD and how they present symptom-wise things that happen during the day. It's very much an individual thing. It's not a blanket statement if you will. So, but I am blessed to be their mom and they're amazing kids. And yeah, those are my big things. So I'm excited to be here.
Dr. Diana Mercado-Marmarosh: So you have twins cause you said seven and seven.
Dr. Arun Rao: Yeah, they're a handful, but interestingly enough, the way that their ADHD manifests is completely different. I mean, they're boy, girl twins, and my son is he's. He is, gosh, he's a joy. But he is probably my biggest challenge, a lot more issues with temper and, you know, early on, I could just tell something was going on when even when he was young, young, where he couldn't communicate. And I think initially a lot of his problems came from the fact that he.
Communicate, but he is very much someone who with medication can accomplish a lot. And I have to maneuver my way around things when he's not medicated. And, , my seven-year-old daughter is amazing, but she does require a very low dose of something in order to really get, get things accomplished in a meaningful way.
So amazing kids. And my 11 year old was my first dip in the ADHD pool or when it came to kids. So we've grown through the process. And while there are difficulties here and there overall, it's been such a blessing to just have amazing kids that do amazing things.
Dr. Diana Mercado-Marmarosh: Now, can you tell me about your diagnosis? Like how did that come about?
Dr. Arun Rao: I gotta be honest. I wasn't, I was younger at a time when ADHD was not really something people were looking at. And the first time as an adult that I can look back and go, well, that explains, that was, I was thinking it was like in the second grade, I think my teacher's name was Ms.
Gretchen, and she was this, she might've been an amazing teacher, but I knew she was gunning for me, and I can see it in my head where I was at a desk and it was one of those. Tiled floors, vinyl, tiled floors. And I kept tapping my feet, like the whole time, just tapping my feet. And I just, she would say stop and I would keep doing it.
And eventually she got so angry with me that she moved the table, my desk, and my chair in one fell swoop. They weren't attached. And she just pushed me all the way to the back of the room up against the wall. Like, because I, so you know, it wasn't, I didn't want to listen to. It's that was what was going on then.
And you know, of course all the report cards. Oh, she's really smart. But if she could just focus or she could just, you know, it just, all of these report cards fell into line. Unfortunately, I didn't figure this out until right before my surgical boards. And so, oh yes. You want to talk about. It was it my whole life.
I mean, high school was no big deal college. I tanked, I completely tanked in college. There was nothing I could do. I just felt so helpless and I felt really dumb. I felt like everybody could get it, but me and why did I need to read it eight times? And I really just kind of, I kind of gave up and I was actually told my mom, pre-med counselor.
I needed to find something else to do with my life because there was no way I was ever going to get into medical school. So heartache after heartache, after heartache. And, you know, after talking with a number of people about just my frustrations and wanting to share that with somebody, which was really difficult, you know, they said, you know, you have all of these symptoms, have you looked into this?
And then I started doing my own research and, then I finally like, literally I was studying, I had got like six weeks of studying for surgical boards. And I just had basically hit the ceiling on this and went and discussed it with somebody and sat down and teased it out. And, and that was the tipping point for me.
But I went through a lot of bad stuff before I got to that point.
Dr. Diana Mercado-Marmarosh: So in college, you said you tanked. Like where you, I understand you said you were reading and like trying to do everything as much as best as you could, but you felt like frustrated and they told you, forget it. There's no way you can be a physician.
You need to do something else. Like, what were you trying at that point? Like, were you trying like extra tutors? Were you talking it out to people to like, understand how to learn different things? What did you do?
Dr. Arun Rao: So I, you know, I basically tried to isolate myself in my room and I had all of these grandiose plans and it would always end up like I would read the same page.
Like I would get to a certain point cause I, I wouldn't be able to tolerate to a certain point and then there'd be this huge gap and I would read it over and over and, and, and it just, it never penetrated. If there was nothing at a certain point. Now I will tell you the other thing that I didn't realize is that the majority of meaningful studying occurred after 11 o'clock at night, which is not great.
Right. I mean, it's not great, but when I talk about that with like the therapist and. You know, people that I had spoken to, they said, you know, a lot of times ADHD, people do better when they're exhausted because they don't have the ability to tolerate all the noise that usually gets in the way on a regular basis.
So the fact that I was exhausted or I was tired or sleepy actually led my lent itself to doing better learning, because any time before 10 or 11, Nothing was getting in the door, nothing. And so I actually, I really did very poorly in undergraduate and I took time off. So I basically, I did research at a hospital.
I waited tables. I was, you know, I was always doing multiple jobs because my parents were furious. I've got those typical Indian parents that are like, what are you talking about? You know, you know, they didn't understand me. They didn't understand. They thought I was just this goof-off that just wasn't ready to be serious.
And so it made it even more difficult. And then I just said, you know, I can't. After having such a bad experience with college after really trying to give it my all and not getting anywhere with it. I said, I just need a break. It doesn't mean I don't want to still do this, but I need a mentor for like two years or so.
I basically just, I did some research at a hospital. I, you know, kind of, and finally, one day I was like, now I'm ready. I really need to get back to it. This is what I was meant to do. And I went to, I went to a program up in Boston for a year. It was, I definitely engaged in more ways and I did much better.
But I, again, I kind of overloaded myself with work and the majority of studying came at night and because I lived in an apartment by myself, there was no other influences really, but that time became my golden hour was late, late nights studying and. I still took a lot for me to do, but eventually I was able to kind of bring up my GPA, bring up my science GPA and I applied and I didn't get in, in the states.
And so I ended up going to a foreign medical school and, you know, again proved to be harder. But this time I had a roommate who really helped with the process of learning because I started incorporating multiple other ways of getting the information. So it was like, I would sit and we would discuss it with them when I had more.
It was almost weird when I had more distraction and more conversation going on. It also absorbed better. I did more study groups. I did more, there was definite I'm a more visual learner. I figured that out a little bit better. So it was multiple things that allowed me to kind of get through the process in medical school.
And I think as I got older, you know, it just became a little bit easier, but I think it was because I had people in my life who lived with me, who were all going through the same process. And, you know, we worked together a lot to get things like that done.
Dr. Diana Mercado-Marmarosh: So did you ever think like in college or in medical school, like, it shouldn't be this hard.
Like, did you ever think there was something wrong with you or did you just think, well, this is just the way I am.
Dr. Arun Rao: I just basically got to the point where I'm like, you're just not smart enough to do this. Like, that's what, it never ever dawned on me. I mean, at some point when you go through the stuff, like you go through psych and you go through these different things and, you know, it's kind of, you're like, this sounds awfully familiar, you know?
Like, why does this sound so familiar? But I first went to the point where I just wasn't smart and I was just going to have to work harder, but I wasn't smart enough and I wasn't going to do it. Like my roommate in medical school was, she was like a book. Like she could just read something and it would be in her head.
She didn't have to, you know, work as hard obviously. I mean, she just, she could absorb it like, that. And so even more. So I was like, and now I was blaming it on age because of course all my med school people were younger. So I was like, You know, it's just not coming. So for the majority of my life and even now, and it's one of the things that really pushes me to get my kids treated and to have the therapy they need, as I never want them to think that this diagnosis equals loss intelligence, it really does.
It's quite the opposite if you know how to reign it in and control it in a productive way. And so. I mean, I think my kids have really taught me so much more about this than I ever got as an adult child, et cetera. It really, through my kids, I'm learning so much about how this works.
Dr. Diana Mercado-Marmarosh: And so finally, somebody told you, okay, maybe you have ADHD.
So you went to, was it a general doctor or did you go straight to a psychiatrist? Do you remember what that was like?
Dr. Arun Rao: I went to a general doctor and the workup is not, obviously is not as thorough as if you were to go to a therapist or a psychologist or psychiatrist rather. And the only reason I know that now is because my kids see a psychiatrist and he really teases it out.
I'm like, oh, okay. That makes sense. You know, but I went to a general doctor. I almost felt like the diagnosis was too easy. Like they're like, oh yeah, here it is. You know, because quite honestly, I do think that there are people that aren't really ADHD that take the medications because it gives you hyper-focused.
If you're not really. You know what I mean? If the diagnosis is really isn't there, it can give you that hyper focus, but it's not the right way to go, obviously. So I just felt initially I was like, this is too good to be true. This can't be working the way it is. I mean, it was like, I mean, just the tables flipping the way that they did and me sitting there going wait, did I just studied for an hour straight and actually not have to read something three times?
Get it. Like I had to almost, it was so funny cause I did all these no cards. Like I was trying to sell hard for surgical boards to just get it into my brain. I wrote it, I looked at it, I drew it. I, everything that worked in medical school, I really was trying to just cram into my brain and it just wasn't going. And then I got this medicine, I was like, this can't be right. So I would go back to the flashcards and like quiz myself to make sure I didn't just read it and was focused, but that I actually was absorbing it. And it was just. I mean a light bulb went off and I mean, it was just amazing. It was just amazing.
So yeah, I mean, it was definitely, it was a life changer, really?
Dr. Diana Mercado-Marmarosh: So, you know, I don't know if you heard of this book, ADHD, 2.0, it's by Dr. Hallowell, on there, I read it in the last year, maybe in the last six months. And for me it was also life changing. Like I finally understood like myself and the diagnosis and like a lot how I treat my patients because I'm a family medicine doc, and I do see patients with ADHD and I finally got what he was saying.
He was saying that, you know, adults that are diagnosed, that we've had it all along, but we tend to compensate because either something's interesting or we just, you know, Some people call a stubborn or some people call it as determined. We like find ways to get to it, but then you reach a point to where either you have the birth of a child or you have, you get to college or you get to like medical school, law school, something that really challenges you, or you get like, you become like the boss, or something where you, your executive function just tips over, even though everything you were doing before you were finding ways, it's like gets oversaturated. There's doesn't matter what you do, how many more hours, whatever it, you just can't. And that's why it's so hard sometimes because they're like, I see you doing all these other things and you do it so well, but you can't do like something simple sometimes it's really weird because. What might be simple to you is complicated for somebody else, but first something complicated for somebody else, it's like a walk in the park. So that book, if you haven't heard about it or read about it, you might want to look into, it might help you tease out a lot of this stuff.
And he talks about like, How in the last five years, they realized that they can use MRIs to pick up the different areas in the people with ADHD versus not ADHD and how they light up in different, right. Versus the left side of the brain. As we know, some of us are like, we think, and we are creative. Right.
Okay. So it lights up differently for ADHD. So now there's a lot more evidence and, it's just not like you're saying how some people are like, oh, I just can't concentrate. Give me a pill. No, but like now they're finding all these other way. Of course they're not using that to diagnose right now, but at least it's really cool to see scientific data coming out and all that. Are your, are you a first generation here or you always been here?
Dr. Arun Rao: So I was born in India. Moved when I was three. So I've lived here most of my life.
Dr. Diana Mercado-Marmarosh: The reason I questioned that is my I'm Mexican American and my, and I was born here, but, I lived in Mexico. Tele was 10. I was born in Texas and I lived in Mexico. I was 10, but there are studies that show that ADHD is genetic.
And it's also, it shows that the immigrant parents usually, you know, because it takes Coronas right. To like, move out of your country to go somewhere else, to start a whole new life, not even knowing how, but the belief that you're going to do it. Like. So there's a lot of information that is showing that immigrant people, and it's usually genetic because you have to really like it. Make sense. You have to be the Explorer and be creative and figure out. When you don't know how you're going to figure it out, but you're going to figure it out. So, I asked that because you know, I've been interviewing different physicians and some of them like, you know, they come from Egypt, they come from all over.
Right. So it's just, it's so interesting. How ADHD is a spectrum. Like you said, you can see it in your own kids, how it presents differently. And at the same time, how there are certain things that are. Our traits and it's not like a character flaw. It's just, that's the way it is. You know, you take the med and then, like you said, it's not like you were not smart.
You were it's just that the way your brain was functioning was not letting you. Do it all at once. It's like having 25 tabs open and you're trying really hard, but we all know how slow the computer can be. If you have 25 tabs open, lower it down to one or two, it's so much better, right?
Dr. Arun Rao: Yes. And you know, my three kids, I think my oldest is more like I was as a kid.
And when I speak with her, it's interesting. Cause I can almost see it happening. She'll have something to tell me, but she'll have four sentences and they're all trying to get out at one time. So, you know what I'm saying? Like, she, she knows what she wants to say, but because they're all trying to cram out at one time, it just comes out as this kind of like, well, I, and you could just see it all working.
So yeah, I a hundred percent get that. And interestingly, my dad ADHD, my sister is a physician. Mom's a physician. She doesn't seem to have this issue, but I'll tell you, I mean, it is just, I mean, it's crazy. And I think that. Understanding the fact that it is not a sign of intelligence or lack of intelligence in fact it's a sign of higher intelligence that even the product or the ability to get there. And I will tell you with my oldest, one of the things that confused me for a while is if I put her in front of a television set, she has focused, like there could be a bomb next to this child will not notice it at all.
I mean, if that's the way it is when I told the therapist, I'm like, I don't get it. I mean, I think that she just doesn't want to focus. I think she just he's like, that's not how this works. There can be things that will focus you like that. It's the majority of other stuff that you just can't seem to bring yourself to.
So that's also was a part of me that felt like I couldn't be ADHD. Cause there were some things that could hold my focus. Like surgery could hold my foot, you know what I mean? Like it can hold my focus, but.
Dr. Diana Mercado-Marmarosh: Because you're so interested in it. You love it. It's aligned with your passion.
Right. But how about you? But I'm not like, Ooh, I can't wait to do my dishes and my laundry. Like, those are just things that I'm just like, ah, you know what you're doing them. Right. But it's not like it's in the area where your passion is aligned. Right.
Dr. Arun Rao: Yes. A hundred percent. So, but that was the confusing piece for me, especially with her.
And it explained also for me, cause for, you know, after. Training. And I say in training and when I had my kids, I wasn't medicated. After, after my exam, I was for a little bit. And then I was like, do I really need it? And honestly, I don't know that I needed it because I was in surgery all the time and I was good.
I was focused. I didn't feel like I didn't feel like there was anything specific that required that much attention that I couldn't give it. And then things kind of changed, you know, like I, as I get older and I was like, what I realized is that the piles on my desk were piling up. Because I wasn't finishing things completely.
So my ADHD issues led to significant anxiety, lack of sleep at night because I just could not finish things unless it was specific to, so I mean, even at night when I'm like in bed and we're watching TV, I'm into what we're watching, but I'm playing games at the same time on my phone and texting, you know, it's just this constant drive. I don't know. It's crazy.
Dr. Diana Mercado-Marmarosh: Looking for dopamine from different places so you don't get bored.
Dr. Arun Rao: Gosh, I mean, it's, it's crazy and there's, there's very rarely a time. I'm not doing two and three things. And I feel like sometimes I actually feed off of that, which isn't great. You know, so I've had to go back to the medicine in order. Cause now I'm a director, I've got more responsibility outside of the surgery suite.
And so. Not only that, but even just being a parent, who's a surgeon and having to schedule and keep organized. And I don't know how I would do it at this point without having the medication that's necessary to be able to, you know, get me through that day.
Dr. Diana Mercado-Marmarosh: That's what was going to bring me to this question is like, how do you think your diagnosis impacts or affects those around you?
Like your family and your friends? Like, so you notice when you take the med your. A lot more there
Dr. Arun Rao: and I'll tell you, my sister is not medicated, but she'll like, she makes fun of me all the time. Cause we'll be in the car and she's, she'll be having a conversation with me and we're talking and she's like, it's like, you're sitting in the car, you're talking the next thing you go in depth in a conversation, you'll be like, squirrel.
Completely unrelated, not even close to what we're discussing and I'll sit there and I'll go. But when you said this, it made me think of this, which may lead me to this. And she's like, you just need to stop.
Oh, well, hers is not as difficult to manage as mine has been. And I think the more stuff I've got to juggle actually feeds into it and makes it more difficult to focus, you know, in life in general. So yeah, it, it makes a difference. Yeah.
Dr. Diana Mercado-Marmarosh: So I'm in that book that I was telling you about, they talk about how ADHD has two times.
It's now not right now. And usually the not right now, like we forget about it. So unless we write it down or we keep a, like a little nugget somewhere that's. Like you said, like, if you were doing a paper, , filling out some work and then you didn't have all that information. Right. Then you're like, oh, I'll do it later.
But then later, like you just it's out of your mind that you forgot. So like, oh, dang. And then it could be months by the time, like, oh, there are, the papers are still there. It's almost like you become blind to them, even though they're right there, right in front of you.
Dr. Arun Rao: Oh my gosh. It's so true. You know, the other thing is like I carry a patient phone, I carry a personal phone and the patients are like texting me throughout the day, or if I'm in the operating room and I'll be like, okay, I'm going to answer that phone.
And sometimes I actually have to do something physically to my phone or have them wrap it a certain way. So it triggers me after the case to make that phone call or communicate with that person. So you do kind of compensate that and that's even with the medication. So it's not always going to be a perfect scenario, but it's definitively better.
You know then that, and I'm gonna also say that recently I took up photography. Like it's always been something I've enjoyed, always something that like in the, like, I try to take these interesting pictures and I never, I sat down. I'm like, Hey, I don't have any hobbies. Like I'm either a hundred percent doctor, a hundred percent wife and mother there's like literally nothing in between.
And I'm like, I really want to be more three-dimensional with my own, you know, with me. And I was thinking about it and photography popped up. I honestly think that I would not get to a point where I want to think about a hobby for myself. If I didn't have good control over the things in my life right now, I would feel overwhelmed and incapable of adding anything.
But this, that, this allows me to be far more dedicated to things, because I know I can accomplish them as opposed to adding things to a list that you know is going to be forever growing.
Dr. Diana Mercado-Marmarosh: Right. And, and I think that's a very important trick or technique. Really, I call it self care because when you are doing things that, again, go back to what brings you passion or something that intrigues you because it's different, or you're wanting to learn about it.
Then you are prioritizing what needs to stay on your schedule and what can be delegated right. Making sure that you do make a commitment to yourself to have that specific time to do that, that, that photography, right. Or for some people is running or sleeping or different things. But it's important because, I don't know about you, but with me before learning how ADHD work in the last year, I had no time for me.
Like, it was always like kids, you know, or work or whatever. And like, I didn't know. I could ask my husband, Hey, can you watch them for 30 minutes so that I can actually go for a run or like, I can meditate or I can journal or something. I just. Like, you know, that's not something I can ask for because I haven't done all my other jobs, but like now I'm like, okay, well, if I have to prioritize me, because when I prioritize me, then I feel my own cup and then I can show up more mindful and more present with whatever I am doing.
So, like you said, it's kind of like having a structure for the thing that you love. Can do everything else more efficiently.
Dr. Arun Rao: That's the thing is like, I don't want to be like, I don't want my career to define who I am. Like I see this all the time. I see people wanting to retire, but especially there are some older surgeons, older doctors in the community that are trying to retire and I see them come back after a retirement party.
What are you doing? They never develop that side of themselves. And, you know, as ADHD folks, I'm sorry, we are creative. Like that is definitely one of the traits. And I see it in my kids, my son, oh my gosh. He's got a million Legos, Amelia. My daughter loves to draw my seven year old will get on the computer and draw amazing things just from a little tutorial.
And Maya's always been like taking pictures or, you know, painting. They love it. I, you know, I dropped them off. You know, one of the local art places and make for two hours, there are good. So I feel like I want to foster my own growth. And, one of the things I've realized about ADHD is it doesn't even in a particular person, it changes as you get older, as you move into other parts of your life, it's not a black and white.
It's not like here's your diagnosis, here's your stuff. This is how you fix it. Go ahead. There are different aspects to this, even as an individual that you go through. Based on how you manage before you ever figured out something was, was not right. You know, so,
Dr. Diana Mercado-Marmarosh: And just like you've said, like, based on whatever's going on in your life can lead to anxiety and depression, in addition to you having your ADHD right.
Or life sometimes happens, you know, we're grieving something, you know, so. Take us in different places. And like recently I've been learning about like hormones and stuff. So like menopause, like can really affect people with ADHD. So it's, unfortunately, some people don't get diagnosed until then, which, you know, it's hard, but it's also important as we're learning more things to keep an open mind and to be curious, because.
Even then people are like, well, they're 50. Why do they need their meds for you're like, dude, some of us lived to be 90, like 40 of them, like being able to do like a productive life. Like I still have some people that I've diagnosed like later in age and they still tell me, doc, this was life changing.
I can't like finally write my music or like do all these things that you just that's the thing with our brain. Like, we're still curious. I feel like we're long term students, like we are constantly learning because we're curious.
Dr. Arun Rao: Yes. And that's the thing is adds quality to life in retirement, right? Like I know, I remember I can clearly remember my dad taking like a glass class when we were, we lived in like Arizona and he had this little work bench and, but he would never finish.
Any of his product. I don't recall ever seeing a finished product and you now he's older. He doesn't really want to do it. And I'm like, when, you know, you can finish something to completion the impetus to want to start both so much higher and you know, your desires improve. Quite honestly, the directorship here has led to so many cool developments because they've given me kind of a cart launch to develop things.
And I kind of made a mental list when I first got here, what I wanted to accomplish. I've literally in four years I have, I actually have created two other clinics. I've been able to hire, dietician, just different things to make the clinic better, to give the patients things that can support them. I mean, by making.
By giving myself the opportunity to use that creativity and see the need and fill the need. It gives me the opportunity to be a better doctor to fulfill the needs of my patients. I mean, it's just, it's awesome. And I go forth with that and I become even more persistent when I know it's a good thing. And it allows me to accomplish so much more on a regular basis.
Really. It does.
Dr. Diana Mercado-Marmarosh: Yeah, that's a wonderful that you're bringing that up. Cause that's what I was going to ask you. Like what are some, , reflecting, like what characteristics make you a great doctor? And like you just said, it's your ability to see the big picture. You don't know how it's going to get there, but you just, we are dreamers.
Right? And we are changers and it doesn't matter how long it take, but this is how I want it to look. I don't care how the details don't tell me what the details, just make it happen.
Dr. Arun Rao: That's ahundred percent because it's all, it all starts with vision. Right. And maybe the vision isn't what the final, but usually the final picture is better than the vision because all of these pieces just start to come together.
And so, I see when I first came here, I begged, four years ago, please get me telemedicine, get me telemedicine. Because one of the things in bariatrics that ends up happening is the patients just disappear. They feel like either they feel overly confident. They've got it. They don't have to worry, dah, dah, dah, dah, or it's just too hard or they've moved somewhere and they can't find the person that will help take care of them and keep them going.
So I begged for telemedicine for four years every year. Oh no, we're not ready. We're not ready. And then, and the funny thing is they gave me telemedicine before COVID hit. So it was really that just persistence of look, neurology's got it. Why can't we, I really think this is important. And the next thing you know, I'm helping to spearhead the initiative when COVID hits, you know what I'm saying?
It's just, it's crazy. So, yeah, it's pretty crazy. It's awesome.
Dr. Diana Mercado-Marmarosh: What are your goals for the next five years? Have what are you envisioning like in terms of traveling with your family maybe, or, , anything in your career or any new hobbies that you would like to do?
Dr. Arun Rao: So, you know, I literally, I mean, when I say I just started with the photography thing, I mean, my camera came in the mail last week.
So it's like really new. And I met an amazing PMG with, you know, with our process that has actually mentored me in the process of photography. Cause she's a photographer, so it's been great. But I really, for me, the, the key is to make sure that I am, assisting my kids because of course with children, you know, it's an ever-changing situation in terms of the meds.
Is this working? Is this not? And as a parent, you know, I can honestly say I've had a parent in my office, boo hooing. I mean the big tears telling me that she just found out her child has ADHD. Why are you crying? She's just looking at me like you're crazy. And so I started saying, listen, your child is probably well above average intelligence, do not take this as a negative thing.
You're you need to empower your child to use this diagnosis to do great, great things. So, you know, I mean, I really, that. Journey with my kids right now and really making sure they're on the right meds and the right dosage. It doesn't change their personality. They're getting the most out of school.
They're pushing ahead. Like those things are going to be critical in the next five years for me, as they move forward in their education. And as far as work is concerned, oh my gosh, sky's the limit. So I opened a medical weight loss clinic. Designed to help patients who already had surgery. I take all comers.
It's been an incredible experience already, but my last goal, which I haven't quite accomplished, but I'm starting to kind of step towards that is I wanted to create a family program. You know, I wanted to develop a program where it isn't just the one family member who has diabetes and has the issues coming to me for surgery.
And then I'm putting them back into a situation with an entire family that has a similar problems or headed in that direction. But have no guidance. So my goal is to start very small, maybe five families a year where we take the entire family and change their thoughts about nutrition and lifestyle changes and their thoughts on how food works.
So that maybe the next generation won't find themselves in my office, you know? Yeah. That's and I'm actually, you know, I've actually got a book that I'm contemplating and it's interesting. Cause it's one of my patients, is I've been thinking about it forever, but my patient came to me and said, I he's a well-known person, so he's come to me.
And he said, I want to write a book with you. And so although pieces are starting to slowly kind of come together, but I mean, man, I'm just excited. You know, ADHD did not bring the excitement for a very long time, but, I don't look at the climb anymore. I look at what the view's going to look like at the top, because I finally feel like I'm going to get through the climb and I'm going to be able to see at the top, whereas before I did not feel that way I could only see the obstacles.
Dr. Diana Mercado-Marmarosh: It's so wonderful. How you, you just described the mind shift that has happened. That has. Instead of feeling like, man, I have this, what the hell? It's not like I have it. Yeah. Guess what's going to happen. Right. And start to just visualize the possibility of being able to do whatever you want to do.
And having people around you to support you in doing what you're doing, because it does take a village, right. To be able to help us with our kids, to help us with, um, the vision of, of empowering the whole family. Like you just said, not just that one person that came and was your patient, but the culture so that, like you said, going forth, this is just not something that happens again, because your culture, that's how you eat or that's how you share the love with each other. Right. Learnings at the, excitement should be from the activities that we do, not the culture of eating, because like, I don't know about your family, but I'm sure it's like my family, we eat. Cause clearly we're happy.
We're sad. Like somebody was born, somebody died, like, you know, our everything, right? Yeah. And, so you celebrate other people's like holidays, not even your holiday. right. And so you just have to learn like being in a family, like together, playing board games or different things. It doesn't have to entail all the foods.
Dr. Arun Rao: It engaging. I tell people all the time, the people, you know, it's not the food that's on your table. It's the people around your table exactly. To change that focus. And when it comes to ADHD, you go from being. You know, over basically overwhelmed and overpowered to be, to being empowered, which is such a huge shift.
Dr. Diana Mercado-Marmarosh: Yes. Awesome. So tell me if my listeners wanted to get in touch with you to either ask you something about your kids or just to ask you about how do I get in touch with his family thing that you're doing or to become one of your patients?. Where can they email you somewhere or do you have a website to share with us where they go?
Dr. Arun Rao: You know, my practice is at Sarasota Memorial hospital. It is the public hospital. It is the biggest hospital in Sarasota. And, I, if you just Google my name, the, page, all the pages kind of come up and we're still in the midst of developing these pages, but you know, the beautiful thing is with telemedicine the reach just grows and I'm not here to say I am the best out there. But it's imperative that people. Fight for themselves and their, for their life. And the interesting thing about Sarasota has changed my thoughts on obesity and bariatrics and health in general, because I went from a population that was really 50 and under to a population.
The majority of my patients are 65 to 80 years old. I'm talking about going into surgery at 79 and 80 years of age. Doing just phenomenal, phenomenal things. And so I encourage patients no matter where you are in your life to fight for your life, fight for that quality. And if it means, having the conversation starting the discussion, you know, you can always sit there and be discouraged where you're at or realize that if you don't move, you're going to be here in the same spot for years to come.
It's a big journey. I'm not going to lie no matter which way you go, this is a big dream, but it's going to be worth it. And if you start that journey, You're going to be so much further along and then you get to look back and go, oh my gosh, I'm so glad I started. So definitely, you know, there are great providers, great bariatric surgeons in every community.
You certainly want to search for somebody who has an ASMBS certification. That is a quality designation. Our program is meant to help as many people as possible. We are, by the way, very excited because in October, we were initially doing that one clinic for three days a week, we went from two days to three days administration just called them and said, we want you up to five days by October.
Dr. Diana Mercado-Marmarosh: That's amazing. Awesome. Well, there you have it. Is there one final piece of advice you might want to share right before we close? I know you dropped all kinds of amazing, you know, advise already. And especially what you just said, like that can be applied for anything, like fight for your life, whether it's for exercise, for getting an ADHD coach for, getting a family physician or a cardiologist or some therapist, anybody who really understands you. And if you don't like what happens, go get a second opinion, right? Like that's the part that is really important until you find somebody that understand where you're going and both together work as a team to get there, because I mean, you are great and I am great as a physician, but that doesn't matter if the patient is not ready.
Right. And so when the patient is ready, the teacher shows up. So, so that's how that happens. So, thank you so much, but anything else you want to share really quick with us?
Dr. Arun Rao: I mean, I just think that, you know, the power of the mind is something that is just, and I tell people all the time, even as a bariatric surgeon and I say, you know, we have people who gain their weight back definitively true.
But if I operated up here, Nobody would ever gain their weight back. And that goes for everything in life. And you know what nobody's going to fight for you. You have to fight for you and you only get one life. Don't say you're too old. Don't say you're too young. Those are just excuses. You've got to find the right doctors to help you to be the best you at every stage in your life.
And so I encourage people to just be advocates for themselves. And if you're not happy, that is so critical. I can't tell you how many people I've met that have seen another physician who was. Oh, oh, I don't know. And I'm like, whoa, my goodness. If it doesn't feel right. Don't give up, go find somebody. You, everybody has that sixth sense.
You got to listen. So, you just, you gotta fight for yourself. And, I'm so glad that I had a chance to talk with you. I hope that, you know, our, our discussion today helps somebody make a better choice or, you know, search for something better in their life. I think that's critical.
Dr. Diana Mercado-Marmarosh: Yes, you so much, Dr. Rao. It was a pleasure to talk to you. You're such a delight and there you have it kids, and adults, as you see, we're all kids at heart, we all always want to be, empowering ourselves to try new things and challenge yourselves. But just like that, you have to remember that new things are new for a reason.
So don't be so hard on yourself. Start with a beginner's mind and explore it and have fun with it and keep trying to empower yourself because that's the only way we improve. It's not to compare ourselves to others, but to compare ourselves with ourselves so that we improve. Our own quality of life so that we then show up better for everybody else because we are happy.
So thank you again for listening to this week's episode with the overachieving ADHD physicians. I really enjoyed, my awesome physician today that I got to share with. And if you guys have any topics you all want to talk about, or any feedback you want to share with me, send me an email at overachievewithadhd@gmail.com and y'all have a good one.
As someonewho understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, a Physician's Perspective podcast. I am. Dr. Diana Mercado-Marmarosh, I'm a family medicine doc with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age. And in the past year, I have undergone radical transformation after discovering ADHD, coaching, and life coaching.
For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year. I figured out the secret learn to stay in your lane. So now my mission is to help others develop systems that tap into their sown of genius.
So they too can reclaim their personal lives back, like I have.
So as we all know, ADHD can affect people in different ways and people deal with it in a different way. So this podcast is created for adult professionals to have a community. Where they can come and share whatever their wins are, whatever their challenges have been and how they've learned to over achieve.
And strive. Right? So when most people think of ADHD, usually their mind goes to that hyperactive kid who can't stay still in a classroom. Right. They're kind of annoying and distracting others, but they never remember the females who are sometimes calm and sometimes just daydreaming and they're trying really hard to focus, but they just can't. And guess what, both kids can become adults. And this is where the data gets lost. Sometimes people think that as adults, you out-grow this, and that's not the case. So I am going to be talking to you guys about ADHD, how it can be a gift. But you need to learn to unwrap it. So throughout this podcast, I will be bringing you the latest scientific data.
I will bring you different strategies and I will bring you amazing human beings who have, and are striving in their fields. But before getting started, I have to give you a disclaimer. Well, me and my guests today are medical physicians. We are not your doctors. What that means is that the information that you will learn here is not meant to replace or to substitute any of the advice or information that your own physician there best or coach gives you.
In addition, any advise share here is considered our own views and opinions. They're not meant to represent. Any other employers, hospitals, or particular healthcare organizations. I know that was a handful. I hate to say that, but I had to, my lawyer's going to be so happy anyways, now that we got that out of the way this week, I am so excited to talk to you about a very special guest.
I have Dr. Nina Mara Di Nicola is a former Physical Therapist, turned Emergency Doctor. Who has completed her residency in emergency medicine at my Gill university and Montreal, her diagnosis of ADHD was given to her in her first year of residency. It triggered a journey into a world of pharmaceutical and non-pharmaceutical management to optimize her functioning and overcoming.
Her special interest reside and wellness led to complete a fellowship and physical health and wellbeing at UC Davis and her former research on resident mistreatment. She founded ADHD peer group for postgraduate medical alert. Where she facilitates months, monthly meetings to share resources and practical tips and tricks. When she isn't studying for her Canadian emergency medicine, Royal college exam, she can be found running on the lashing canale, playing the piano. Learning Cantonese doing yoga and meditating with her cat Livo fed. So I probably butchered a lot of those words, but don't worry. We're going to hear it from her first hand, please. Everybody woke up. Tell us Dr. Nina, tell us all the things.
Dr. Nina Mara Di Nicola: Oh, thank you so much. That was a very kind introduction. Thank you, Diana. So they call you Diana. So I guess the one thing, the one thing you, uh, you got wrong was my fellowship. It's physician health actually, that's important. So it's actually about, helping other physicians and supporting their wellbeing, and that was a fellowship year I did, or a six month program I did through UC Davis last year. Okay.
Dr. Diana Mercado-Marmarosh: Amazing. Thank you for clarifying that. That is a very important distinction. Okay. So two. What were the circumstances that led you to get this diagnosis? You, found that in your first year of residency, tell us all about it.
Dr. Nina Mara Di Nicola: So, I had suspected it many years ago, but I, you know how it is with ADHD, I sort of put off or did not make my way to access the diagnosis. And like it took literally. Probably 10 years between that moment where I started to really suspect it. And as a matter of fact, my father is a child psychiatrist and my father. He's the one that suggested it in me, but really in my mid twenties. And that was sort of, despite the fact that I had very typical symptoms as a child, like, you described that kind of very active child, often a boy, but. I was that very active child in the classroom. Interrupting all the time. I actually had to be put, like I got a separate desk that was sort of behind a wall, that they created in my classroom just to keep me physically separated from the group.
What happened though, with, since I was doing very well academically, they just kind of pass me through. And there was always a mention in my report card that, you know, I should, not talk so much or kind of control my behavior. But since I had A's everywhere, they just kept me going and nobody thought.
At that time to actually look into what was happening. So what happened was finally in residency. I guess I just wasn't really performing like at the expected level and not because I wasn't trying and it, something just seemed really off to me. Like, why is this so difficult? And, at that time I met with a psychiatrist and after one session together, just listening to my story of my childhood and like throughout my life, she diagnosed me with severe mixed ADHD. And, that's it. That's how I got my diagnosis.
Dr. Diana Mercado-Marmarosh: Perfect. You know, it's interesting what you just said. It, I kind of followed the same, scenario. Like I too was that kid and, who like both my parents had to come and sit in the classroom because I was disrupting everybody. And they would give me extra homework and I would do the homework. But then I was still disrupting. So like you said, I, academically I was doing fine, just like you were saying. And so they didn't think anything of it. I'm curious, whether prior to your diagnosis, like, did you perceive it, like you said, your, your dad had kind of mentioned it to you and you kind of thought maybe there was something, but did you always think there was something off or no?
Dr. Nina Mara Di Nicola: You know, I think I really didn't put all the pieces together. Even, when I received my diagnosis, it took another really another two years, two, three years, like I'm now in my starting my fifth year of residency. So I would really say it took that long. It took three, four years for me to really understand how much. What I just assumed were my own character traits and flaws. How much of that was reflected in this diagnosis. And it's, it's amazing, like so many parts that, I just, you know, it's, you're so used to living in your brain and you just think this is, this is life. This is how it is. And you know, other people might get frustrated with me for certain things, but I never really saw them as a problem. And it really wasn't until I was medicated for the very first time that I started to pick up on these little details and I started to understand, oh, okay. I see how that could be frustrating for someone else.
I could give you an example. It was, I had, I had this recurring argument with my Partner at the time where I would, you would get home. I would reach into, well, I would look for the keys. First of all, which you know is very, it could take like a couple minutes to find my keys. I'd be looking at all my pockets. I didn't know where I put it in somewhere in my backpack. I can't find them.
Finally. I get all my stuff out of my bag. I get my keys out. I would, so we have this like key, this electric pass at the front door. Just to open the main door. So I would get it out. Finally open up the front door. Then from that front door to my actual door of my place is like maximum 25 steps. Okay.
And somehow between the front door and my door, I would lose the keys again. So I would put them back somewhere in my bag. I wouldn't be thinking about it. My head is somewhere else. I'm totally like absorbed in thoughts and conversation when we get to the front door and now I have to start the process again.
And my partner at the time was like, what is wrong with you? Why do you keep, like, why don't you just keep them out? And I was like, what are you talking about? Because in my head, So much time had passed and so much had happened in the 25 steps that it didn't even make sense to me. Why you would expect someone to do that?
Like, it seemed crazy at the time anybody would have that much. Awareness. Right? So, it was like literally the same argument every time. And the first time I actually started my medication, my stimulant medication, I came home from work. I, took my keys out of my bag. I tapped them on the door. I held them in my hand.
I walked up to my front door and I unlocked it. And then I just started laughing because all of a sudden I understood why that was like something frustrating. Right. And I could not have imagined that. So taking the medication was one thing that opened my eyes in a major way that I could not have understood before.
And then on top of that, like it took years of reading about it, listening to podcasts, reading books, and seeing what other people were describing as symptoms that I actually started putting all the pieces together.
Dr. Diana Mercado-Marmarosh: Right right now. Let me tell, let me ask you this. Did you feel like prior to your medication, like you had 25 tabs open?
Dr. Nina Mara Di Nicola: Oh yeah. And
Dr. Diana Mercado-Marmarosh: And then like you take this medication all of a sudden there's like two or three. There's not like 20.
Dr. Nina Mara Di Nicola: So I remember, I was home. Like I, so I had to go through a lot of different medication adjustments to figure out. The right dose, the right medication. I had a lot of side effects, so I really went through lots and lots of, medication changes.
And at one point I was home. I think I needed to study or something. So I took, I took like an extra dose to see if that would help, like a kind of short acting dose and all of a sudden. I realized that I could hear my fridge humming and I had never heard my fridge humming in my life. And I realized that the reason I could hear my fridge is because all the noise in my head actually quieted down.
And it was like, it was such an amazing moment. I remember I went and I made a post about it on our group that we have like a private group, right. For physicians that have ADHD and. And it was like, guys, I can hear my fridge. I had no idea that my fridge made noise. So there were a couple moments like that where, you know, really when I was very optimally medicated that I noticed the thoughts would completely quiet down.
But I have to say that's rare. Like even now with medication, most of the time, there's still a lot going on, but I can. I can focus on a conversation, a task way, way, way, way better than before. So, yeah,
Dr. Diana Mercado-Marmarosh: So that's very interesting because yeah, it definitely makes a difference when you're able to hear other things outside of you, because you actually don't have your own thoughts running, 10,000 times.
And it's so interesting. I don't know if this happened to you, but when, prior to medication, like, or maybe on the days, I don't know if there's days that you don't take medication, but when you're talking to your friends, like, you're so busy trying to like, listen to what they're saying, because in your mind, you already went to 10,000 places and you're trying not to interrupt them because then you're going to forget what you, what the connection you were going to make with them.
Dr. Diana Mercado-Marmarosh: Did you notice that?
Dr. Nina Mara Di Nicola: So I do want to say I take my medication every single day. And my psychiatrist was really very, felt strongly about this. And the first thing she told me, because I asked her, I said, okay, so I take these when I go to work. And she said, Nina, your relationships don't take a vacation. Your relationships don't have a weekend, right? So you need to take these every single day. Because at that time, when I was seeing her for this, I had just gone through a major breakup. Like it was clear from my just listening to my story, that ADHD had really strongly affected my relationships and that, insight that she had to tell me, no, you take these every day. I think that was really genius of her actually, because I, really, I do that. I mean, you know, sometimes once in a blue moon, I might skip a dose. Sometimes if I'm switching over to night shifts, But almost like I'm very diligent actually about taking my medication
Dr. Diana Mercado-Marmarosh: Thank you so much for pointing that out. You know, a lot of people have this, this thinking that like what you just said, like, oh, I only take it when I'm going to take a test or I only take it when I'm at work or I only take it when whatever right. But like you just said, you have to come home, you still have to be a friend. You still have to be a daughter.
You still have to be a girlfriend or a wife or a mom. Right? And why does work only get to have the best version of Nina? Right. No, like you just said your relationships do not go on vacation just because you think you are. Right. So that's very important to point out. And why do you think people don't want to take their vacation, their medicine?
I think it has to do with they’re thinking that they're going to get addicted right. To stuff.
Dr. Nina Mara Di Nicola: It's really interesting. So I've never personally had this concern about getting addicted. I know some people have this concern, but I didn't have. In my mind, but what I've noticed is myself and pretty much everybody I know, and I do run a support group for residents with ADHD.
So I'm in contact with quite a few other people, you know, in my position that have ADHD as well as a whole network of physicians. And I think what happens is it's this tricky thing where the ADHD brain, is a little sneaky. It's like, it doesn't like to follow rules, right. That's kind of one of the big issues, right?
So there's this real tendency. Not because they don't want to take it, not because they don't like it's, it's like this little rebel voice in your head saying like, oh, you don't really need that today. You can skip. And I find almost everybody I know at some point, especially early on will try to skip their medication or stop their medication.
Like I stopped my medication for almost, I think, six months of my residency, because I was having a lot of tolerance issues and they were trying, like, I was trying to non-stimulant medication to see if that was sufficient. And then at one point I just realized that. What have I been doing for the past six months?
Like I haven't been studying, I haven't been doing my research project. Like this is not okay. And I sort of woke up and I would say it really took, it has taken like three, four years for me to accept that I need this every single day I take it. I wake, I wake myself up one hour before my alarm clock is supposed to wake me up.
Like the real alarm clock. I wake up, I take my medication. I can't even think about it. I'm half asleep. I take it, I go back to sleep and when I wake up, it's working and that was like the single most. I mean, there's a lot of things that, that made a huge difference, but that made a huge difference because instead of getting up, having to think, do I need it? Should I take it forgetting to take it or not? I have some time, some days I just, I didn't know if I had taken it. And then, yeah, so it was never, it's funny, like my brain off-meds sort of doesn't really think there's a problem. It's like, oh, everything's fine. I'm fine. And then sometimes it would be like someone else that was pointed out to me and I'd be like, oh, oh, am I acting different?
And they're like, yes, you just spent like 20 minutes opening one time. It was, I literally, I was supposed to, my mom was coming over and I needed to clean my place up. And for some reason, Off medication Nina decided it was time to open my piano. I have like a beautiful, upright channel, open it up and start, like, I don't know what I was doing.
I was like looking at the chords and I was like the cords inside the account. And at the time my, my partner was. Okay. Um, I think we need to, like your mom's going to be here in the hour. Like you need to clean up and, and then, and then the next question was like, have you taken your medication? And it's like, oh no, I have not taken my meds.
Like, that's why, so you know what it did. It was a lot of external input in the beginning. People noticing the difference. And it was enough that eventually I convinced myself, like I had to convince myself that this was it. I have to take it every day. I have to be disciplined about it. And I think it's funny, this concern about being addicted because.
If you're addicted to something, you don't try to convince yourself not to take it. Right. Exactly. So that really goes against the whole addiction theory. But I'm not, I'm not an addiction expert I share.
Dr. Diana Mercado-Marmarosh: Okay. But I just bring this up because I feel like part of the community always brings. Question to me, like I know when I have patients who have ADHD and they're starting on their meds, they always ask me, okay. I just give it to them when they're at school. Right. Well, you tell me, do you want them to clean the room on the weekend? Like, do you want them to be able to play in the tournament on Saturday and Sunday? I'm like, no, you'd give it to them every day. I wouldn't take away the medication for somebody who has diabetes or high blood pressure.
Why would I take away a medication on a weekend for somebody who clearly has been diagnosed as needing it? Right. So, thank you so much for pointing that out. That is so important. Because we are impulsive people. We are very creative and very spontaneous people and sometimes accidents can happen. If we are not, you know, all there so to say.
Let me ask you this, what do you think are some of the best resources that have helped you in this last three or four years that you told me that you've been discovering yourself?
Dr. Nina Mara Di Nicola: Great question. So I have a list. I had to sit there and I thought about all the, all of these little things that helped me on my, on my journey. One of the first things was, you know, I went to the library I'm, uh, I went to the bookstore. I'm I'm a reader. I'm the kind of girl that as soon as there's a problem, I want to read everything about it. So I went to, this bookstore and I just started looking at all the books on ADHD. And I came across this one called ADHD friendly ways to organize your life.
It's by Judith Kohlberg and Kathleen Nadeau. And this is a fantastic book. It goes through every chapter and it's totally. Written for people with ADHD, the way they format things, the way they like highlight things and there's boxes and it's super like fun to read. And each chapter is just a short chapter where they focus on one little issue, that's quite common with people with ADHD in terms of their organizational abilities. And it was through that book that I recognized that so many of my lifelong struggles we're actually not stubbornness, but common traits associated with ADHD. One of the, one of the big ones there is not opening my mail.
So I have a habit of opening my mail maybe once every six months. Now let me tell you Diana. Probably my most expensive, bad habits
Dr. Diana Mercado-Marmarosh: I was about to say that's a very expensive ADHD tax you're paying their girlfriend.
Dr. Nina Mara Di Nicola: The last time I did or a couple of. I think a year ago, I went through this process of opening all my mail for the past year that had accumulated and I had to pay thousands of dollars in late fees for things like my property tax. And just like so many things I hadn't paid my license. Thankfully I hadn't driven. So like, oh my gosh. These little, like, I don't actually, I don't actually know how neuro-typical people remember to do all these things because it's, to me, you know, we have this, very interesting sense of time, which is now, or not now as you, as the, you mentioned earlier,
Yes. So, but what was comforting to me, I really thought this was like a Nina problem. Like Nina doesn't, whatever it is. It's the rebel in me. I don't like to open my mail. It's just strange thing. And then when I read this book, they talked about this, about mail backlog, about how it's common for people to not open mail for like months and months and years.
And I was like, oh my gosh, This is not just me. Right. And there was such a freedom with that. And like, it made me feel better. It made me feel like I was less broken, less stupid. Like I used to think it didn't make sense. Right. Because I, was a physical therapist. I had gone through all this education, all this university, you know, then med school.
Well, before med school, I remember thinking like, I know I'm smart, but I act really stupid sometimes. Right. I lose things. I can't figure out how to like wash dishes and sort them properly. Like these little simple things. We're complicated for me and really complicated things were easy for me. And it was always like that my whole life I would get, I would score top grades on the hardest exam.
And then I would make little mistakes on the stupidest things. So that, you know,
Dr. Diana Mercado-Marmarosh: They would tell me this, like I would do similar thing. They would tell me the Diana you are booksmart. But you're not street smart. And I would always get myself in trouble. Like you just that like the complicated things. No problem. I got it. But the common sense things. Forget it.
Dr. Nina Mara Di Nicola: When I got into med school, I remember more than anything feeling like, oh good. Now people will believe me that I'm saying. Like how sad is that? It's so crazy that I felt like I had to prove something because something didn't quite make sense. I felt like I wasn't really living to my full capacity.
So that was, so that book was one of my big resources, a couple more, I'll mention the ADHD for smart ass women podcasts that Tracy Otsuka that you were on. That podcast, you know, I remember. I don't know how I found out about it, but I, I think I probably just found it on Spotify because I, I love Spotify.
I love music. I like, I have music playing almost 24 7 if it's not actually playing it's playing in my head. So, and I discovered that podcast and, you know, every episode she's interviewing people and she's talking about, knew about different concepts associated with ADHD. And I, I completely identified.
Almost everything she talked about in that podcast. And it blew my mind, like how much of who I thought was me. And like, this is my personality. Like those are ADHD traits.
It's, it's fascinating. Um, you know, and then my other resources where the people around me, I have an amazing ADHD coach. Her name is coach Maddy or Madeline Cote here in Montreal.
She really helped me reframe my challenges, uh, challenge my negative self-talk and really learn to believe in myself. Because, what we've discovered is that children with ADHD because of their ADHD gets so many negative messages, they get way more negative messages than the average child. And that has an impact on you.
And you start to talk to yourself in that way. And I see this all the time with my, um, my co-residents with ADHD is that people just start to. Doubt themselves and blame themselves and think like, oh, what's wrong with me? Why did I do this? Whereas, my coach really helped me understand like, oh, that's my ADHD.
Why did that happen? Exactly. Like getting curious, as you said, get curious, ask questions and don't. Don't judge yourself, like, Accept that that's, that's part of who you are. You're a human being. Even if you're a doctor, you're a human being right. At the end of the day, we're all humans and humans are going to make mistakes.
And that's how we got. So I would say those are my, my best resources and my psychiatrist. I don't know if I can name, drop her, but her name is Dr. Valerie... She's been fantastic. She's walked me through like so many medication changes. She's gone so far as to treat my migraines, which no doctor has ever treated in my life.
I've had migraine headaches since I was seven years old. And it took a psychiatrist to say, Hey, maybe we should treat these migraines so you can tolerate your stimulants. So that's been amazing. Now I have migraine treatment and she always advocated for the non-pharmacological management in the form of sleep diet and exercise, which is not easy to implement as a resident.
Let me tell you that. But the more I pay attention to those things. The better. My life is 100%
Amazing! Let me ask you this because some people don't don't understand what the difference is between like a physician and like a coach. Could you differentiate those for me a little bit?
Dr. Nina Mara Di Nicola: Sure. Well, obviously a physician is somebody who has medical training. Um, if you're talking specifically about, well, I guess the physicians that would be involved with ADHD are physicians. So family interests and, well, my psychiatrist really. So I've had. Lots of, meetings with my psychiatrist. So first of all, they diagnose, right? So we're the ones who are actually giving you this diagnosis after evaluating you and applying, uh, the clinical criteria.
And I would say my psychiatrist directs my care, especially with the medications. So she's finding everything, responding to whatever changes, that need to be done. But ultimately, and I think early, very early on, we identified that I would need more, like I would need more coaching, something more, behavioral, and she doesn't provide that.
So at that point, I used, I think initially I was doing more therapy, like psychology, work with, with, actually I was lucky and my therapist actually had ADHD and told me, like, I was very open about it and actually had training in ADHD. So that was, that was quite, interesting. But even then therapy is going to be more like reflecting and maybe going back to previous issues in your life and trying to kind of cognitively work through problems and feelings where coaching is much more strategic and like, okay, let's, let's implement strategies now. Let's, analyze what needs to be done now. And sort of, she would really help me like look at the big picture, figure out what I needed to take care of and then, and then try different strategies. And it was just in the beginning with my coach, it was a lot of trial and error and, and a lot of it was this reframing.
So. My therapist did that with me to that work of like, okay. I would say, oh, I had a really bad day. And I remember my therapist saying, what does that mean to you? And I was like, you know, it's just really distracted. And I did a whole bunch of stuff, but I just feel like unsettled. Like I had done laundry and done some cleaning and done some studying and like, I did all kinds of stuff, but I didn't feel good about it.
Just my, like I felt chaotic. And I remember her saying to me, Nina, a bad day is when you don't get out of bed. And I was like, oh, okay. Like the, I feel like we put the bar so high for ourselves. We put ourselves like, oh, you didn't like run a marathon today and right at the five hours, that's a useless day.
Right. So there's that reframe. So does that help kind of separate
Dr. Diana Mercado-Marmarosh: So I wanna thank you so much for pointing it out. What I want to point out here for our listerners, is that there's not one right way of helping ourselves when we have ADHD, right? Like I am not like pro or against medicine. I am not pro or against exercise, I am not pro or against coaching. Of course, I'm going to be biased and tell you to do all the things, especially to do coaching because I'm a coach too, because I have now seen how it has transformed me. But what I want to say here is, they can all beautifully work together and compliment each other because they all have a part that helps to unlock our brain and gets us to the next place of where we want to be.
Not because we have to, not because that's, what's going to make us like, feel like we're finally on broken, but because. We people with ADHD are like the dreamers and the shakers and the ones that don't just think, oh, well that's the way it's always been. Let's just leave it that way. We're the ones who are like, well, that shit ain't working.
How do we change that? Right. And when we start asking those questions that other people sometimes don't ask, we think outside the box and we need to have the ability to. Take into action without judging ourselves. Like you just said, like as kids, because we weren't maybe doing, or even asking, we come up, those, we weren't fulfilling our potential or where we thought we could.
We learned to use the inner critic or the judge voids in us to motivate us, to keep growing, to keep up, to keep up. Come on one more thing. You got to look at the big picture. You're going to become a doctor. You can do this two more hours. Oh, you have an eight for five. It's okay. You got this. Like, like it pushes you, but not from a place of like, oh my God.
Look how amazing Nina’s doing it. Look at everything she just got done today. No, your brain's like, what the fuck girl? You haven't done all 20 things. And like everybody around us, it's like doing two things. Right. But we need to do 20 things. Right? So the coach allows you to see what thoughts we think are helpful, but really are not.
And to see how much you are actually doing, how much of a bad-ass you are like, oh my God, look at everything we shared. You have established a way for residents to feel supported, right. For the wellbeing of not just yourself, but those other people around you who have ADHD. You don't really even talk about like, because of stigma or whatever.
Right. And you are allowing people to really voice and grow right. And empower them. I have to make, I'm going to just ask you a couple of more questions cause I want to value your time, but I'm pretty sure that the listeners are like having a ball, listening to everything you're saying. Tell me, what is the key to living successfully with ADHD?
Dr. Nina Mara Di Nicola: So I think the key third, two keys. Okay. And we've touched on them, but to bring it all together, number one is learning about your brain working with it and not against it. Don't try to fit into what society expects. One of the resources I didn't mention earlier, but I love is the How to ADHD YouTube channel. This is hosted by Jessica McCabe. She's a young woman who has ADHD. And she actually gave a Ted talk that blew my mind. You guys have to watch this Ted talk and she talks about how he took her up into her twenties to like mid twenties, late, late twenties until she got her diagnosis and then started to really use, be able to use all this untapped ability. She had, she had actually been labeled as gifted as a child and was writing like high school grade exams in grade school. But because of her executive dysfunction, it wasn't coming together and she wasn't able to kind of make something of herself. And in this talk, she says, if you judge a fish by its ability to climb a tree, it will live its whole life believing. It is stupid. And, and she says you're not a failed version of normal. And I find that that's just so key to recognize that. For fish, we need to swim. And if everyone else is climbing a tree, like that's cool, but we're going to be over here, fishing, swimming. So that's really important. And then the number two thing is building community.
Having other people with ADHD. To turn to when you experienced the unique challenges that come with this diagnosis, it really is a lifelong journey of finding strategies to manage symptoms. And it really helps to be surrounded by others who are on that same path. Something my coach always tells me or used to tell me a lot in the beginning, but now I got it, was you have ADHD, your brain seeks variety and novelty. So don't expect the systems we put in place today to work forever because in a couple of weeks, your brain's going to get pretty bored of your systems. And that's when you have to, which he says is re-sparklize it, make it sparkle again, shake it up a little bit, make it pretty right.
And I think approaching it as this lifelong journey. Is the most important part, because if not, you're going to get really frustrated. If in three months your perfect system didn't work anymore. Be like, expect it, expect that you're going to have to keep working on this. And that's kind of all the fun. So just keep going.
Dr. Diana Mercado-Marmarosh: So what are your goals for next year? Tell us.
Dr. Nina Mara Di Nicola: I have so many goals. Diana. I am like. Yes, this is very ADHD, but I will tell you so many goals. So number one, I need to finish this residency I'm in and I want to finish it really strong. That means ACEing my Royal college exam, which is in eight months. And I also want to do some moonlighting so that I get to experience being an independent practicing physician before I have to go out there in the world completely on my own.
So, those are like my major career goals right now. I'm also learning Cantonese. So that's been, you know, that's a journey. I definitely want to get better on that. I had originally told myself six months, I had six months to become conversational in Cantonese. I'm not quite there yet. I'm now, like about seven months in, but you know, it's amazing.
I do it a little bit every day and I've picked up. Quite a lot. And then my major, if I go beyond the next year, but kind of moving forward into the future, I would say my major goal is finding a career path that will allow me to integrate my passion for physician health and wellbeing with my emergency medicine training.
I really want to keep working with physicians with ADHD. I'd love to develop like a screening tool that we could apply to residents to help them identify who would need further testing. Because I think so many, like I've seen so many residents who get picked up in residency and sometimes it's because things aren't going well.
And by that point, you know, they've already, some might have some negative, stereotypes about them or perceptions about them. So if we could pick these people up earlier, maybe medical school or when they get into residency, I think we could really help them. Also, I have this longer term goal of just working towards changing the culture of medicine.
And that's what you're trying to do with your podcast. Right. I think, medicine is trying to fit us into little boxes and is not really celebrating the diversity within the community. You know, rather than having us have to apply for special accommodations. Like in my residency program, you can go to. Specific, you know, office for students with disabilities and apply for special accommodations.
And let me tell you, Diana, some of the accommodations, some of the residents I work with have been given, okay, you have the right to take notes during a patient interview. You have the right to look at your notes when you are reviewing a case, those sound to me like pretty normal things that people would.
needing as he can be with a diverse set of strengths, not everybody has a perfect memory. And the fact that we have to ask for accommodations and go through a process to be given the right to take notes when someone is giving us their detailed, complex medical history that we have to get right, because we're using that information to treat them. That actually blows my mind.
Dr. Diana Mercado-Marmarosh: Yeah. I mean, when you go to the restaurant, when a waiter comes and tells you what you want to order, right? Do you look at them like they're stupid because they can't keep straight. Whether you want jalapenos or cheese on your burger, like come on, right?
Dr. Nina Mara Di Nicola: I used to be a waitress. So I'm nodding over here so hard because. The first thing they taught me was, Hey, you take a piece of paper, you draw a grid, there is your table, and you have to write the meal that each person at that table ordered, I worked in a buffet and they would have like 12, 20 people tables.
And if I didn't write it down, then nobody's going to get their salad and their soup. Okay. Exactly. Well, that's normal and it's normalized. So why to normalize this in medicine, normalize the fact that. We are human beings and we forget things and that's okay. And it doesn't make you a bad doctor and it doesn't make you anything. It's just makes you human. Right?
Dr. Diana Mercado-Marmarosh: Dr. Nina, it's been such a pleasure to talk to you. I know you are going to be changing medicine. I know your fireball. I can hear it. So I know our listeners are would be dying to get in touch with you to put you on their YouTube channels, to put you on their next movie, to put you on their books so that we can change ADHD physician's world.
Okay. How can they get in contact with you?
Dr. Nina Mara Di Nicola: So you can, I'm pretty old school. I have an email address and I have a Facebook account and that's pretty much it for me. So you won't find me on any other, I honestly, I don't, I couldn't handle having any more social media accounts. So, basically you can find me on Facebook at Nina di Nicola, and my email address is nina.dinicola@gmail.com. I could spell it out. It's Nina, N I N A and Di NiCola is D I N I C O L A.
Dr. Diana Mercado-Marmarosh: And I will put that information on the bottom of the podcast so people can reach out to you. And I would definitely list out all the resources that you said, because those sound amazing.
So there you have it, guys. You heard a rockstar. She is here. She is making noise. She is changing medicine and. I want to thank you for joining us for the overachieving ADHD Physician podcast. It was such a pleasure to talk about everything that Dr. Nina had to share with us today. As you see, sometimes the symptoms are there, and even when we do get diagnosed, it takes us a little bit of time for us, become curious with our brain and use all the resources around us. And even when we get it just right, our brain knows it likes to spice it up. So re sprinkle it like she, like she said, and keep on doing the best that you can have a good. Thank you.
Dr. Diana Mercado-Marmarosh: Someone who understands that time is our most valuable asset. Please click the subscribe button and join my Facebook group beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time, at will. Do share this podcast with your friends. So theytoo can learn to live life and stay in their own lane
Hi, welcome to Beyond ADHD, a Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh, I'm a family medicine doc with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age. And in the past year, I have undergone radical transformation after discovering ADHD, coaching, and life coaching.
For the past decade, my typical day consisted of having 300 charts, backlog, a graveyard of unfinished projects and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes the last year. I figured out the secret learn to stay in your lane. So now my mission is to help others develop systems that tap into their sown of genius.
So they too can reclaim their personal lives back. Like I have. Name it to tame it. Name your fear. Mine was not being good enough. I was afraid others would find out I had eight. I was afraid that I will be judged for not having my own shit together. The pandemic did a really good job at amplifying that belief.
I share my story in this podcast so that you can see that I'm no different than you it's been less than a year. Since I first went on a podcast and shared with the world that I too had ADHD and that I got diagnosed during my first semester of medical school and that as a physician, having ADHD could actually be a gift because it allowed me to figure out I didn't need to have the answers in one minute.
Like the standardized tests make us feel like we do. I was able to take my time listening to the patient's story. And analyze it in different angles. And sometimes yes on the fly. I would tell them, let me look this up. So the thing is that having ADHD is a neutral situation. It's whatever thoughts you're having about the diagnosis that is going to cause you to feel a certain way.
For me, I was feeling ashamed. I felt imposter-like, I felt like. People were going to know that it was just a fluke, that I was in the room. I went to a medical school where only 20 of us were minorities and the rest of my 200 classmates were white. So I felt like my grades were not stellar and that I compared myself to them. And I thought that, you know, they might've made a mistake. Why did they let me in? And so having ADHD was never in my radar, having ADHD for me meant I was no longer perfect when I grew up. I've thought that by doing everything right, like getting good. I was going to earn people's love. And so when I got diagnosed with this, I thought, oh my God, that's it I'm broken.
I'm never going to be perfect. And again, what does perfectionism mean anyways? Um, as a kid, it man's acceptance. Right? And we all think that we're going to go a certain way. We're going to get the perfect job. We're gonna have the perfect house. We're going to have a perfect marriage. The thing is that nobody tells you that life is a journey and that getting to all those goals doesn't mean like life is any easier. You have to enjoy the journey along the way. So when I was finally diagnosed to me, instead of being a relief, it was more like, like a shock, I guess. And I didn't want anybody to know. So, like I was saying, like, if I looked around, everybody in my family behaved the way I behaved, so it was never really in my radar and it makes sense.
Right. It's genetic. So I did really well on the things that I enjoyed. I excelled in high school academically. I remember being pulled in and being told you're number two, out of a class of 700. When I was a junior in high school, and I was a little surprised by that, honestly, because I thought I was doing what everybody else was doing study.
I didn't realize that I was, you know, quote unquote on top of my class. But looking back, there was always signs that I had ADHD. I mean, I was, I remember my dad one time was, driving with me as I was learning to drive and I almost ran a red light. Well, it was orange, it was yellow. Okay. It was yellow.
And I knew I could make the turn. And I remember him being so flustered with me and he was like, pull over, pull over, pull over. I'm going to drive. You're gonna, you're scaring me. And so it is that we've lived life on the edge. It is that we're always under minding how much time things are going to take. And of course I was running late to work like always, right.
We tend to be the dreamers. We tend to always tell you how long something's going to take you, but we don't tell you the time that it takes before and after the completion of certain tasks. So in. You know, I excelled, why probably part of the process was that I was running 10 miles a day. I was in the cross country team and yes, I made the varsity team as a sophomore, junior and senior.
Not because I was fast, but because of the fact that everybody around me was not Passy. And I was the only one who kept showing up to the practices. And I was the only one who kept doing what. So I am a first generation Mexican American student who attended college and medical school. And I remember when I first got diagnosed, I was being evaluated for anxiety and for depression, because to me not passing.
Test meant I was letting down, not just myself, but like all my family. Like I had to be a role model when I was the oldest of three. And I felt like I have to set the example. They did tell me during my testing, I had a neuro psych testing. They told me that I was at that point, performing like two, two years, I guess, below where I should be.
And because of that, They told me that, uh, my English was a little bit behind, but they said that I was doing okay. Everywhere else. So I didn't have anxiety. I didn't have depression. It just seemed to get worse. Whenever I felt like frustrated because I couldn't complete the tasks that they wanted me to complete during those tests or in any test for that matter.
So, um, I learned to speak English when I was 10 after my family moved to Texas from the border and here in south Texas. And you know, I looking back, I was always a kid running around. I was always getting in trouble. My dad had to come and sit down. My mom had to come and sit down in the classroom because even though they would give me more work and more work, I would complete that work.
And then at some point they just started promoting me every four to six weeks, they would up me up a grade, and so eventually I, matched where I had to be. The thing is with people with ADHD, we always keep showing up. Right. And I think that the fact that you keep showing up and that you keep saying what other people are not wanting to say, sometimes this promotes you and this makes you a leader..
And so, you know, I was a high school vice-president of the NHS club. I was the secretary of the honor society in the, in St. Mary's university. You know, I was the chief medical officer at the residency. I was the 2013 resident teacher award, a resident for teaching others. You know, you just keep showing up and you are willing to put in those small steps and eventually they add up.
So sometimes, you know, we forget that we need to put ourselves first. And during this whole pandemic, I came to realize that I did not do that, that I had a love, hate relationship. Right. Like in the sense that I love my patients, but I didn't know how to set boundaries with my time. Like, I didn't know how to, not how to ask politely for me not to be interrupted at certain times. I was just not aware of the time management aspect. So in this last year, I've actually discovered life coaching and ADHD coaching. And that has led me to a growth that has been transformational for me.
And so all this is an introduction to explain to you why I am putting together this podcast.
My goal here is to show you how I, Diana Mercado-Marmarosh, Family Medicine Physician is able to give you the ADHD perspective. As someone who understands that time is your most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook Group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends, so they too can learn to live, life and stay in their ow