The Over-Pathologizing of ADHD with Rae Jacobson
This week, I’m joined by Rae Jacobson, journalist, ADHD expert, and host of Hyperfocus at Understood.org, to talk about how we make sense of ADHD when it feels like it’s everywhere. Rae has spent over a decade reporting on mental health and neurodiversity, and she brings that blend of research, lived experience, and sharp humor that makes big ideas actually relatable.
This was honestly one of my favorite episodes that I’ve recorded this year - while Rae and I were brainstorming ideas that two ADHD podcasters could talk about, I think we hit on a very salient topic, the over-pathologizing of ADHD within the community. While we love to find all the things that are from our ADHD, it’s also true that not everything is because of our ADHD.
In our conversation today, we dig into the ways ADHD often gets pathologized, how everything from losing your keys to getting a song stuck in your head can get blamed on ADHD, and why that can actually make it harder to understand what’s really going on. We get into “symptoms of symptoms,” the tricky overlap between ADHD and other conditions like depression and anxiety, and why community spaces like Reddit can both help and hurt when it comes to self-diagnosis. And of course, we also go down a few very ADHD side paths about clutter, shame spirals, and why having too many pens is basically a personality trait at this point.
If you'd life to follow along on the show notes page you can find that at HackingYourADHD.com/258
YouTube: https://tinyurl.com/y835cnrk
William Curb: I'm so excited to have you here. We already had fun talking before this because I got all the fun Legos behind me and stuff, which if you're listening, I have this on YouTube now so you could see the backgrounds now. So how about we get started just hearing a little bit about you and about hyper focus?
Rae Jacobson: I'm excited to be here. I'm sorry. Like I said before, I have a cold and when I have a cold on top of my ADHD, it makes me feel like I'm like sort of underwater a little bit, calling up from the bottom of a well. So you're like, you asked me the most normal question, you can ask a person. And I'm like, could you repeat the question? Like that's the functioning I have today, which is great as a podcast guest. I'm sure you're really psyched to have me here in this state.
William Curb: It's a very common ADHD state where you're just like, could you repeat the question? Like the question is, who are you? And they're like, what's your name? Yeah. And it's like, oh, yeah. Wait, what was the question again?
Rae Jacobson: Just just one more time. This time of the moment, my name is Ray Jacobson and I am a lot of different things, but most of what I do now is focused entirely on getting to write about report on, focus on and podcasts on ADHD, which I have. I am working at understood.org and I host there a podcast called hyper focus where we do basically initially whatever I wanted, but it turned out that letting someone with ADHD decide any type of episode, whatever it was all the time, resulted in a pretty eclectic mix. So now we're more focused on my background, which is journalism. So we're covering a lot of what's in the news, a lot of research that's coming out about ADHD and neurodiversity. We're very kind of focused on making sure that the stuff that feels really opaque to our community is made clearer and more understandable and easier to digest. That's the short version. But I think it's pretty good, right? Yeah.
William Curb: I mean, I do know that when you have the option to do anything, it gets very easy to go into anything with ADHD, although it's sometimes that it's also really nice to have that structure of like, oh, this is what we're doing and I can just sit down. I don't have to be like anything.
Rae Jacobson: Yeah. Anything can be a lot, especially when you're like, well, I have eight million ideas. How exactly would I bring those to fruition? Yeah.
William Curb: And so one of the things that we were talking about before the show is that, which I think fits in with this idea of anything, is this pathologizing of ADHD and how we find so many things that people are like, oh, that's ADHD. And you have someone come up to you and be like, hey, is this an ADHD symptom? And they're like, I get song stuck in my head all the time. And you're like, well, no. I mean, it can kind of be like a symptom of a symptom, but no.
Rae Jacobson: And I don't know if you experienced it. I hear that question a lot because if you do this work, if you're visible in this work, people are going to be like, hey, I think I have ADHD.
Here's my question. And what I like to fall back on is I have a master's in counseling. I don't practice. I have a background in ADHD and writing about ADHD, but I'm not a doctor. And if somebody comes to me with things that are like, I have a song stuck in my head or like, I can't stop scrolling on my phone, part of me is like, well, a lot of music is really catchy. And phones are designed to make you keep scrolling. However, that doesn't mean you don't have ADHD.
It just means that those two things aren't symptoms of it. And if you're concerned about that, are there other things that are going on that made you ask me this question? It can't just be this. Like I feel like there's always more behind the question when you get it. But I also am always reluctant to shut anybody down. But I want to remind them that like, I can't necessarily provide that type of help. Do you experience that?
William Curb: Yeah, I was, I mean, the song example came from like, three weeks ago when I was at the phone store and a guy there asking me, is there like, oh, what are you doing?
Oh, do this pocket? Oh, is this a symptom of ADHD? I feel like I have it. I'm like, okay.
Yeah, no. But I often do like that idea of symptoms of symptoms being kind of like things to look for. Because often, what's the exact like misplacing your keys, not a symptom of ADHD, but our forgetful nature does make that more likely.
Rae Jacobson: Yeah, well, I feel like misplacing your keys every now and again, not ADHD, probably, misplacing your keys over and over and over and over again. And I think that's the point that the locksmith knows your name might be something different. Like all of these things to me, and this is like one of my issues with a lot of the like pathologizing of ADHD like traits that aren't necessarily a debt, like it wouldn't necessarily mean you have ADHD in any specific way is that it dilutes a lot of what you do need to know to find out if this is something that you could benefit from help for, right? Like, if you lose your keys a couple of times in an unbelievably busy week because your daughter was sick and the news was stressful and you have 16 people calling you because there's a huge project at work, that's just overload. And everybody experiences that. If you're experiencing this every day for months or years or your entire life in my personal case, that's a problem. And that's something where you do want to seek help. But if it's like, oh, I lost my keys, maybe I have ADHD. It's like, well, sure, maybe. But is this something that's like causing your life to be unmanageable for you?
Because that's the question that is the actual question behind the question, right? Like it's not, does having this like small issue mean that I have ADHD? It's, is this small issue something that's so repetitive that it's caused me genuine difficulty?
William Curb: Yeah. And it's, and also like as a chronic condition. So, you know, when I was, we were starting up, I was telling you that, you know, I was a little out of it today. And that's because I realized I don't have my documents for an appointment I have later.
And I can't find them. And all I could, well, I was like searching through where it could be. I was just kept thinking, I can't believe I did this to myself again.
Rae Jacobson: And it was like, I did it again.
William Curb: And I'm just like, oh man, that is that ADHD shame there. And it doesn't help that I know that it's not helpful because it's also just like, I thought I had this put together. And I was just like, oh, it's not where I thought it was.
Rae Jacobson: I have a question for you. Do you think people who don't have ADHD had that reaction when they forget or lose something? Because when I do it, I go down your road, like, I can't believe I'm doing this again. I can't believe I screwed up like that immediate like slip slide right down into self loathing. As much as I understand why it happens, as much as I have learned how to talk about it and try to talk myself out of it, it's still the first mental move after something happens. And I genuinely don't know if people who haven't experienced this in the way that we have have that response. Like, do you think that that's everyone or do you think that's mostly ADHD people?
William Curb: I mean, I think a big part of the shame response comes from the fact that I'm like, this is happening again. This is something I should have foreseen happening. This is something I could have prepared for where if you don't have that like lived experience of this happening again and again and again, like, you know, I'm 40 now, I should know better is there. And if you don't have that built up wall of shame, then it's not, I don't think you have that same reaction.
Rae Jacobson: That's what I think the same. But then I got to wonder because it's like, I don't know, I'd like to meet the person and then also, and I mean this in the least murderous, disgusting way that I can say it, like open up their skull and look at their brain and understand how this works. The person who when they don't have the papers for the appointment, when they forget their passport on the way to the airport, although everybody finds that stressful, so maybe bad example, but you know what I'm saying, when they make that mistake is like, you know what, everybody makes mistakes and I just was so busy today.
I'm just going to call ahead and tell them I don't have the papers. What can we do about it? Like who is that person and how does their brain get there? Because I would like a little of that juice. Yeah.
William Curb: Although I don't think they have quite that reaction for me. I just think they're like, oh man, this is awful, but not the, wow, how can I be as awful as a person? Yes.
Rae Jacobson: Yeah, it's true. They don't immediately blame themselves. Although I feel like I think there are some contingents. I've seen them in the wild a few times. The people who do have that like, now I'm doing hand gestures, I'm sorry.
I have this little fidget toy to keep me from doing so many hand gestures because I am, I have a day she and I'm from New York City, so I do a lot of moving up my hands. But I feel like there are people who have been through whatever the process that you need to go through is to not have that like intense reaction and simply maybe not every time, but like most times deal with that kind of setback from a place of rational response rather than like catastrophization or self-loathing or whatever it is. And I know, you know, like everything we're taught to try is supposed to lead us there, right? But sometimes I take comfort in the fact that although our responses are more extreme because of our ADHD in our history, like every time, every single time, William, that I'm going to the airport, I have a nightmare that I forgot my passport before I get there. Every time, like clockwork, to the point that it is like a part of my flight routine now. I don't think everybody has those, but I do think that there is some place of like a middle ground where the like, I'm 40, I can't believe I did this. But then there's these people who are like, all right, you know, this stuff happens, let's figure it out. I want to go there. I want to go to there.
William Curb: Yeah. And I think part of it is just the like, I'm like, oh, if I had been more organized, not in this instant, but just in general, even if like, I have like 12 different piles of paper that I have to look through, because I'm like, maybe it's one of those.
It's probably not, but I have to look through them. And it's one of those things where I'm like, oh, if I had just not let things get to this stage, if I had been more organized for, if I had been chronically organized, things would be so much better.
Rae Jacobson: I love that chronically organized would be a great state to have.
William Curb: Without the OCD aspect of it. Yes.
Rae Jacobson: A healthily chronically organized person. Not something I've ever found a way to do. You do, I mean, I get into, I don't know about you, but I get into periods of organization where I'm like, everything is great. You know, maybe maximum a month, this last of like, everything, you know, a place for everything and everything in its place. And that's wonderful. And I feel like I have ascended to a higher plane of existence.
And I'm just doing so well. And then, you know, it starts with the misplace suck, and it all comes tumbling down. I haven't figured out like the to the chronically organized point, how to find that groove that some people seem to be in so naturally. And I think that is because of ADHD.
But to be fair, I know a lot of people who have ADHD, who aren't the type of disorganized that I am, or that it sounds like you are. So it is possible for our brains, but it isn't something that I have ever been able to like see the path towards.
William Curb: Yeah. And I think there's like, building this right system so that you can get there, downsizing the amount of stuff you have is obviously one of the things because I'm like, oh, well, it's like those drawers weren't bursting with stuff that I don't need, but can't find a way to get rid of. I'm like, oh, yeah, because I, so I'm thinking back to, I went to boarding school and I was in middle school. And I didn't have like any stuff in my room.
It was so organized because there was nothing to get disorganized. In fact, I had the teachers come in and be like, are you actually living here? And I'm like, I don't need I go home on the weekends. I just am here five days a week. Wow.
Rae Jacobson: What was that like to be like, in an uncluttered space?
William Curb: In general, that was nice, because it was just like, I could I didn't have to ever look for anything was either in my backpack. My desk had two comic books in it.
And, you know, I had a computer that I used and that was like that was it. And it was nice to be this is all I need. And sometimes I'm like, I should go back to that. And then other times I'm like, but I like my stuff.
Rae Jacobson: Sentimental items and I need all my legos. Yeah. What about Todd with 3ds? How will you keep him? I know what you mean. There have been times in my life, usually when I've just moved to a new apartment or I'm just moving out of an old place, where all the superfluous things are briefly gone.
And it feels like you could completely see that as a life. But and I don't think again, to the pathologizing of things that aren't necessarily related. I think a lot of people do this for various reasons. But I like my stuff. I don't have like, you know, a billion things, but I don't like to get rid of things. I question for you, because I do wonder if this is an ADHD thing.
Or if I'm participating in exactly what we're suggesting people not do. I don't have a very good memory. I never have. And it really it's, you know, I'm forgetful in the ADHD way. But in general, like I will sometimes have conversations with people. And they will describe to me entire things that we've done together. And I will have no memory of it at all. And my sister conversely has a fantastic memory. She remembers every family thing I'm very grateful for her. Because otherwise I don't think I would know what happened for most of my childhood.
Rae Jacobson: But I like to keep these little objects around because they're like talisman, they're like touchstones for me, where if I look at something that jogs my memory, then I have the memory. It's helpful to have something that makes that part of my brain act up like it lights up. And then I remember the middle school friend who passed the note or the day my daughter drew the thing that I've kept in my dresser drawer for now five years, you know, and it's not, I do worry that without those things, I wouldn't have the memories that go with them.
William Curb: The thing that comes up, a friend of mine recently asked me about, they're like, oh, yeah, do you remember this like high school talent show thing you did? And I'm like, no. And like, there's this video of me with these other people. And I'm in drag doing Tarzan and Jane song. And I'm like, what? I feel like I should remember that.
Rae Jacobson: I'd like to see this video one, two, exactly, where you're like, how could I have forgotten that? And there's physical evidence.
William Curb: And you're like, yeah, I remember just like, yeah, we have them. Like we just found this video.
Rae Jacobson: And I'm like, but without the video, you wouldn't have the memory. I mean, granted a video, I suppose, we're old enough that for a long time videos were tangible objects, but not so much now. But you know, I do worry about that. And the mass decluttering that is sort of required to become chronically organized. If you lose some of these things that provide you, I don't know even the word like the memory structure, like the memory palace that you live in.
And for me, and I do think this is partially an ADHD thing. Without them, I don't think I have access to all of that time that is like sort of kept in the object. Yeah.
William Curb: I mean, I do think there are workarounds to that. Like that's like, I mean, that is something that we are known for doing this like very visual thing out of sight out of mind stuff, you know, so like, we're like, oh, yeah, I have that important thing I need to do. I'm going to put that right there on my desk. So that's the first thing I see.
So I remember it right away. But it's not a very good system either. And I think like a journaling and doing that kind of thing can be a good like workaround for it. I've got this neat, like one line a day journal that is like a five year journal. And so like every day, it just has like five entries one for each for like, you know, 2020, 2021, 2022, 2023, 2025.
Rae Jacobson: I think you're the second person in a week to tell me about this. To be fair, I kind of remember who the first person was to the memory point.
William Curb: Yeah. But so like, you know, I write like, a sentence or two about the day. And then, you know, next year, I get to be like, oh, yeah, that's I talked to that person or we went to the pumpkin patch or any number of things.
Now, I'm not great about doing like I have a lot of years where I'm like, I didn't do that for three months in a row or but I get my mom my fourth year of it. So there are a lot of entries now. And it is a really neat way to like be like, oh, yeah, I don't have to just physically hold on to everything. I can kind of get rid of stuff and put it into a form that like makes it easier for me to remember it. Because I mean, I'd also don't want to be, you know, go another 40 years of collecting stuff in my house. And then being like, I have objects that now I don't have memories of, but I know they were supposed to be sentimental. Yeah.
Rae Jacobson: No, it's true. I feel like that is kind of the refuge for this stuff is like creating souvenirs of your life that you can keep in a smaller box. Like it doesn't have to be the whole object. It doesn't have to be, you know, the record.
It can be a picture of the record or whatever it is. Like it's possible to preserve things in a way that is less chaotic and less just space consuming. And I think that's like, that's the kind of project that for me, when we talk about like pathologizing ADHD stuff, it's helpful for me to see that as as useful as like keeping a planner, you know, like the clue symptoms, the things that are symptoms of a symptom. A lot of those are the things that my systems are built to manage. Like, of course, I have, you know, they all go to a larger executive functioning or organizational thing, I suppose that's part of executive functioning. But it's more that their their reactions to my very much day to day symptom of a symptom challenges, like having too many sentimental items, you know, like your journal is in your way, a way to manage that symptom of a symptom.
William Curb: And then there's also just the repeated objects kind of thing where I'm like, oh, I have recently collected a lot of my pens into one space and I'm like, this is too many pens.
Rae Jacobson: I have the same problem. What did you do about it? I put them in a box. I have them in a tote bag. That's superior. I think your box is better than a tote bag.
William Curb: Yeah, but it's it's I'm like, and I'm like, because I'm like, well, I don't want to get there. Still good pens, right?
Rae Jacobson: Exactly. They still bright. So what if I want to draw with that color? But if I can't find another pen? That honestly, I do think, and I guess in some ways we've veered from the original topic as people with our type of brains do into the ADHD and clutter topic, which is really just always precedent, you know, it's always prescient, it's always has value. But I think a lot of times when I have the repeated object thing, it's because I don't trust myself to have only one.
It's because I assume that that one will get lost and it will get lost at the worst possible time for it to get lost. Like if I could have a duplicate passport without being a spy, I would. It would be fantastic. Exactly. Note to spies in general, this is a service you could provide for people with ADHD, just saying.
William Curb: We would love it. But yeah, I mean, but I do think, I mean, it's still kind of on topic here because clutter is that symptom of a symptom. It's not ADHD doesn't inherently make you more clutter prone.
It makes you more likely to forget things, more likely to have the executive function difficulties of putting things where they go. So you're doing the, you're not putting it away, you're just putting it down.
Rae Jacobson: That I mean, I guess you're, it's true. It's all sort of like, I mean, with everything with ADHD, it's all part of one larger whole that is manageable in some areas and not manageable in others. It's what makes it such an interesting and complicated type of brain to have because there are certain things where my systems have 100% working wonderfully.
Like they are really, they're saving whatever that trouble from happening is. It just, I'm no longer struggling in that area in that way. My symptom is not causing me challenge in a way that it used to, or it's just something that was never a huge issue for me in the first place. Like, you know, we were all different, right? But these things, like the journal, like the memory boxes, all these things, that is obviously a space where it's still really hard for both you and I. But I feel like one of the things with these symptom of a symptom is this ADHD, is it not ADHD things that makes it challenging?
Is that variety? We all have different challenges. And so it does kind of make it feel, if you're unacquainted with it, or if you're maybe just not sure you're on the fence about do you have ADHD, do you not? That like almost anything that's causing you trouble could maybe be ADHD. And that is where I think we get into a much stickier, more challenging side to this.
William Curb: Yeah. And then to add on to it, the just level of comorbidities that ADHD has. And you're like, one of the things I see very commonly, so you have things groups like the like ADHD Reddit where there's like, you know, a million people there. And so someone can be like, hey, is this an ADHD symptom? I'm experiencing this.
And you can have like, you know, 100 replies of people being like, that's me too. But you don't know if they are, you know, like what examples I think of are often like, since autism is so common with ADHD. And you have a lot of like people being like, that's an autistic symptom, not an ADHD symptom. But if you look at it from people online, they're like, no, it's both.
Rae Jacobson: It's the problem of communal diagnosis over specific diagnosis. I also feel like one of the things that I think about when you bring that up is we've interviewed, I don't know, in my life I've probably interviewed over a hundred clinicians about ADHD, over 15 or 20 years that I've been doing this. And one of the questions that comes up a lot around comorbidities is comorbidities like anxiety or depression.
And how do you treat that? One of the big questions people have is, do you treat the ADHD first if it's the stress from the ADHD is fueling depression or do you repeat the depression first and then deal with the ADHD? 100% of the time, clinicians will say you 100% treat the depression first. You cannot get to the ADHD before you deal with the depression because that is the more threatening, more overwhelming, more life limiting issue in that comorbidity.
Then you get to the ADHD. And I think about things like the clutter problem, right? Like in my life when I have been depressed and people I know, that is not the time where your house is usually the cleanest, right?
And I think it would be very easy to go on Reddit, to go on TikTok and say like, oh my, you know, I can't get my house clean. I'm so exhausted. I can't finish anything. And someone's going to be like, ADHD 100% man, you're good. And sure, that can be part of it. But it also might mean that we're missing something more important or not more important, but equally important and that needs to be addressed quickly or more intensely right away. Yeah.
William Curb: Well, and one of the ideas I've seen about this idea too of like, what's driving the symptoms to is really important. So you like, oh, I think I got this from Dr. Ricardo Alverdea, where he's like, who's driving the bus?
Yeah, he's fantastic. But yeah. But like this idea of who's driving the bus on the symptoms? Like, is the clutter coming from the ADHD side of thing? Is it coming from depression? And if you're trying to fix the clutter, you need to know who's driving the symptoms. Exactly.
Rae Jacobson: And I mean, of course, he's going to say it right. He always does. But I think that kind of thing makes this type of sort of speculative. Hey, I have this thing going on. Do you guys relate type of back and forth?
A little bit trickier, right? Because of course there's value in finding community. And of course, getting an accurate diagnosis is not as simple as just saying you should get an accurate diagnosis because as anybody who's ever tried to interact with this system knows, it can be challenging. It can be costly. It can be uncovered by insurance.
There's a lot of challenges that can come into the way of actually getting appropriate diagnosis, right? Which is the reason so many people turn to the internet, but also for community. And for the chance to say like, hey, does anyone relate? Because not feeling alone has a lot of value. Especially when you're like, God, I am like the one of these things that is not like the others and I've spent my entire life being that. And then all of a sudden someone's saying, like, no, no, no, no, no, no. We're all like this. It's OK. Welcome home.
That feels really good. But there is this other side to it where you're no longer able, you know, without that piece where somebody like Dr. Alla Bardia is stepping in and saying, like, OK, let's slow down and figure out who's driving the bus. There can be a tricky thing that arises where like, yeah, you might be getting validation, but are you getting the treatment and help you really need to overcome what's causing you genuine deep distress?
William Curb: So I know like self diagnosis is so tricky because yes, it's very accessible to people. Like because, you know, I mean, I've talked to people that live in countries that like, yeah, we don't even recognize ADHD as a condition in my country. And I'm like, yeah, that makes it very hard to get treatment. And but at the same time, yeah, if you're treating the wrong thing, it's really tricky.
Rae Jacobson: Really hard to get better. It's really hard to feel the improvement that you're looking for from that. I mean, it's one of these irritating, not irritating. I mean, genuinely awful things where it's there is no simple answer, right? Like self and community diagnosis is not a panacea, but interacting with the medical establishment for a million reasons, deeply dependent on where you live, including state to state is very tricky. And it doesn't necessarily mean you'll even get a good diagnosis because it depends on the health care provider. It's something that I feel like is like sort of the secret back talk of the entire ADHD diagnosis conversation, which is like, this isn't as simple as we want it to be.
But it is important to have a conversation like this where you can call out the fact that just because something seems like it's ADHD doesn't necessarily mean that's what it is or that's all it is.
William Curb: One of the fallbacks I try to go back to for people is I'm like, sometimes it doesn't even matter is what you're doing helping. Are you doing things that can help you manage your day that are not, you know, you're not like abusing drugs or, you know, that kind of thing. Like there are things you can be like, yeah, this is definitely helping.
But like, oh, that is not helping. I think one of the symptoms of symptoms idea for me is I have a lot of anxiety about being late to things. And anxiety is that symptom of a symptom.
It's not. I don't have a lot of anxiety about a lot of other things, but being late, I have a ton of anxiety about. And so, yes, so treating the anxiety there, not the right call.
That wouldn't help. But helping build systems so that I don't don't have to worry about being late to things that works a lot better treating for the ADHD. And so it's can I do things that will help my brain regardless of what's going on? What the because, I mean, when you go down to it, ADHD is a collection of symptoms that this is what happens. But it could also be even if it's the exact same symptoms, you could be like, oh, this is, you know, CPTSD or depression. It could be anxiety, something else that you're like, oh, that's why we want clinicians involved. Yeah.
Rae Jacobson: Well, that's that's to me, the tricky thing is like some of it is that self manageable stuff. I'm back to the hand gestures can help it. But some of it is the stuff that we can see and try to build systems around and try to, you know, like I too have a lot of anxiety about being late from decades and decades of being late for literally everything and having all the fallout that comes with that. But you can do something with that knowledge, right?
Like I can acknowledge that that is one of my most prominent challenges and do things to mitigate it, like show up half an hour early for everything. Is it great for me? No, but it does take away the anxiety and it does mean that I'm no longer late for almost anything anymore. It's challenging, though, I think when you get to the stuff that you were talking about afterwards, which is the stuff that does need other people to step in or other systems to step in for help, like CPTSD is not something you should be trying to system your way out of.
There are things that may help and lighten the load for a little while, but that is something where there's a lot of people who are blaming themselves for not being able to just shake it off or figure out a way out of the tunnel. And that's not what it is. I think that's what makes this so challenging. It's like, it actually does not exist in a vacuum.
Like we said, it is a constellation of symptoms which can make it hard to pin down. And it also, and I think you were the person who said this to me, it brings friends. We have all these ride-alongs in the bus who all want to drive, because who doesn't want to drive a bus? And it's really tricky.
It's really tricky to know what are the things I can work through on my own what are the things where I need help and how do I know the difference? Yeah.
William Curb: And it's just so many things that are also like unexpected. Like when we were talking earlier, the hypermobility being something that's a very common mobility. And I'm just like, when I saw that, I was like, that's not real. And I was like, I got that.
Rae Jacobson: That was my reaction too.
William Curb: And then I was like looking where I'm like, oh, there's studies about that. And I'm like, oh, maybe that explains why I've dislocated my shoulders like more than 10 times. Okay. Okay. Hmm. That's okay. That's interesting.
Rae Jacobson: It's absorbing the knowledge and bringing it into the fold. It's that kind of stuff is so fascinating though, like the hypermobility piece. Or I think I was talking about this a while ago, we interviewed this woman, Dr. Sandra Koy, who is a psychiatrist, psychologist out of Sweden. And she conducted a study on women and heart issues related to ADHD, which found that women who have ADHD have significantly higher levels of heart challenges, heart disease, which is like, you know, as a woman with ADHD, pretty unnerving, but also something that like, I would never put those things together. You know, and when she's, I sort of saw some rumbling about it and was like, really? And then you read it and you're like, oh, okay. You know, because it's some of its stuff where you can be like, oh, wow, I did dislocate my shoulder a lot. When I was getting other things, you're like, oh, it's nice to know what I need to be aware of for the future. These comorbidities that are invisible and genuinely dangerous. Yeah.
William Curb: Cause yeah, it's awful that I've dislocated my shoulder slapping my friend on the butt, but like that's not the, uh, the worst outcome that I could have.
Rae Jacobson: I have to say that is a little funny.
William Curb: Oh, it is. It was even at the time where we were just like, that's how that just happened. I like that. Yeah. But yeah, I mean, I was thinking, I was talking to someone recently about Dr. Barkley study that like showed like lower life expectancy for ADHD, but not because of ADHD, but because of this symptoms of symptoms of things where you're not taking care of yourself. You're not being conscientious in all that aspects.
Rae Jacobson: I mean, there's so much that goes with it. I mean, I don't know about you, but one of the challenges for me in terms of health and ADHD is that I hate making phone calls. I hate it. I hate to call anyone. I don't even like calling the people I love. I don't want to pick up phone and press any button.
I don't like it at all. You know who you have to call on the phone? Doctors.
And then you have to show up on time and remember to do the digital paperwork or the regular paperwork or whatever it is. And all of that stuff to me for a long time was like, maybe I don't feel sick. So maybe I just won't go. And at some point that is no longer a viable choice.
I mean, not that it ever was, but these kinds of things, the symptoms of symptoms can cause genuine harm. But at the same time, when someone's like, well, I have a song stuck in my head, you're like, oh, come on. Yeah, like this.
William Curb: And I mean, I think that's, I mean, this also comes back to this conversation of like people talking about ADHD, you know, as the strength or as disorder. And it being like, OK, I can see there's like the strength approach, but there are chronic things with ADHD that make it like a issue to that you need to be taking into account because I mean, it's a disorder. It is something where I have problems living my life the way I want to live because of my condition.
Rae Jacobson: This I'm glad you said that because this is something that I feel like is, you know, when you're like in a conversation with someone and you have a thing you want to say and so you sort of try to like draw them to your little area where you'll get to like stand on your soapbox. This is my soapbox thing. That's so much in this conversation, but almost all the time because I find it very frustrating to the symptoms of symptoms point when we get those questions that are like, hey, like, you know, like I, I don't know, lost one of my socks or I was late to something or usually it's more like I got so spaced out that I couldn't do this and or mostly phone stuff. Like a lot of stuff is like I'm paying too much attention to the internet. I feel like my attention's banished or all this stuff. The question that I want to ask, and I try not to, because like I said, I don't like to like gatekeep or keep people from asking more questions that they might need to delete themselves further down a path of whatever it is, whether it's figure out that they have ADHD or simply like understanding why they're doing a behavior they don't like or whatever it is. Is, am I allowed to swear on the show? Has it fucked your life up or not?
Because that's the real thing, right? Like when you cross, like, if you look at the DSM, what it is is significant impairment is the thing that means you have this or you have maybe traits of it, but not the disorder piece. And I know a lot of people have differing feelings and understandably so. All the sides to me are genuinely understandable.
I go with disorder because for me, that's what it has been. Like I failed out of high school. I failed out of multiple colleges. I took drugs. I had a significant challenges with depression and anxiety, postpartum depression, which we now know is a huge issue for women with ADHD, something else that we don't talk about that much. This has been for me.
Job loss, challenges with family and friends, issues being able to live my life. All of the things that come on the plate, right? And some wonderful things.
Like I get to be here today talking to you and, you know, enjoying the fact that this is a neuro type also and that it comes with some wonderful things. But I don't, I don't like it when people throw out a bunch of kind of like, what a draggy day kind of symptoms and are like, maybe I'm ADHD and you're like, OK, you know, like I don't think people do that about other things in the same way. Although I do know a friend with OCD who is just talking about how if she hears somebody else saying they're so OCD, she's going to flip, you know, like what like organize their sock drawer or something. You know, this thing that's caused her immense difficulty throughout her life. But to me, there is this thing where you're like kind of stuck when you get those questions because I find it to be like a two roads diverged, right? Like you can be like, OK, like let's walk down this path together. And then the other part of me occasionally is like, shut the fuck up.
William Curb: Yeah, like this is this is awful some days. Like, yes, this is awful some days. I mean, and I think that's part of the thing too. It's like you're some days you're like, yeah, I'm doing fine. I'm doing great. I'm I'm cruising. And then some days you go, this this this is what ADHD is. This is the day that everything happens.
Rae Jacobson: You know, on the show on hyper focus, I ask every guest who we have who has ADHD this question because I am obsessed with it. And it's very interesting because these are all people who are, you know, in the community, happily talking about ADHD, very interested in it, very engaged with it, you know, and I feel the same. But whenever I ask this question and I'm going to ask it to you, if you could get rid of your ADHD, would you do it?
William Curb: I don't know is always what I come back to when I think because I'm like, how much of my personality is based around this? How much is it? Um, because I'm like, there's got to be some aspects of me that are just me, but my experience like, do I like myself enough to be still be myself? Or is that just existential dread that I'd stop existing?
Rae Jacobson: Uh, that's my issue too. I, because there are certain days where I'm like, yes, please take this from me, Lord. And then there's other days where I'm like, I, I genuinely, I mean, most days truly, I don't know how much of me is ADHD and how much of me is just me.
Or if there is no difference between the two. And I think that last option is where I feel like I don't have a good answer for that question. And usually our answer is the answer that most people have. I don't know, but depending on how bad of a day they've had, sometimes it's just a flat yes. And that's hard. Yeah.
William Curb: I mean, and I'm, so I'm like, today I'm like searching for all these papers. I'm like, would not having ADHD mean I wouldn't have problems like this ever again.
Rae Jacobson: No, but, but also I had them less. Yeah.
William Curb: Maybe, maybe I wouldn't feel like a night group of people who's like, I'll just call the doctor's office and make it, you know, like maybe you would be one of the pop people who is just like living their life. You never know. But would you have all of the things that make you you?
William Curb: Would I become a podcast bro?
Rae Jacobson: Having spent only this short time with you, I can tell you unequivocally no. And I mean, that is the highest compliment. Yeah.
William Curb: Cause I always love being like, oh, just another white man with a podcast. That's okay. We don't judge. I judge myself a lot. But in this case.
Rae Jacobson: That's harder. That's a harder.
William Curb: Yeah, that's a harder. Yeah, I mean, that's that comes with the territory. But yeah, I think that question of giving up ADHD, if we just separate personality, does the good outweigh the bad? That's really hard to say. Like, yeah, it does. I feel like no, no. Yeah. Yeah, I'm like, not at all. Yeah, it'd be, I'm like, sure there's like creativity aspects of it, but.
Rae Jacobson: But that's back to me comes down like, again, this is a challenge I have with it, which is like when people are like, well, people with ADHD, because you know, like, I don't know about you, but I've written many, many, many articles about ADHD, right? Like, and when you do it or when you talk about it, there is always like this pressure to find the good, right? Like, and the good always sounds like people with ADHD are more creative. People with ADHD think outside the box.
People with ADHD see angles. Others don't, etc. etc. etc. Right. I do think that a lot of that is true. But again, that kind of comes to the can you separate ADHD from those things? Because there are plenty of people I know who don't have ADHD, who have those abilities as well. I don't know. And I genuinely don't know. This isn't like I have a thought and I'm not sure. I don't know sometimes if I feel like ADHD is this thing that is inextricable from who I am and that's something that I need to come to love and embrace and appreciate.
Or if it's kind of unreasonable to ask us simply because we have this constellation of symptoms that is hard for other people to understand and hard to pin down and something that is tricky for non ADHD people to get to ask us to love this thing, to celebrate this thing that has caused so much harm. And I don't know which one of those is right. Or if they vacillate between being true for me. But sometimes it feels like the symptom of a symptom of a symptom stuff is away for us to kind of like dance around the center, which is this thing that is really serious and has real impact and changes everything about the way that you live your life if you have it or you don't. And I don't really know where that lives in the conversation now.
William Curb: Yeah. The metaphor I like to stick with here or that I have played with a bit and bunch is this idea that and it does separate the ADHD from me a bit, which is we're one and the same. But the idea of like climbing a mountain while I'm tied to someone else and that someone else with my ADHD. And we have to find a path up the mountain together because if either of us try to go our own direction, it's not going to work. And it doesn't mean that I necessarily have to love that person I'm tied to. It just means that I have to work with them because that's the reality. I don't get a choice.
Rae Jacobson: Exactly. I think there's this thing where it's like there's a speculation on the reality. And I think when it comes down to kind of what you were saying before, which is this understanding of what ADHD is or means or how it exists within us, whether we can separate it from ourselves. That is to me almost like a philosophical line of questioning, you know, something to be debated in pubs and, you know, the inevitable late night conversation, right? That's for that.
And podcasts, apparently, of course, what can't be on a podcast. But the other thing, the mountain and getting up it, that is the day to day work. That is the living of your life. That is the thing where you're like, all right, I gotta get these papers somehow.
So how am I going to do it? Because I do think that after the panic and self-loathing period of forgetting, I usually fall into a period of intense practicality. Does it always come out the way I'd like it to, you know? But there is this thing where you're like, all right, well, this is the reality. So what are we going to do? And then you have to go from there. And I feel like that thing is where you're like, all right, let's get up the mountain. We got to do this. And like you're here and I'm here. And if we try to go two different directions, it's not going to work out. So what's the path?
William Curb: Yeah. And that's not always easy to see. Some days it doesn't appear there's any path. All right. Well, we're kind of coming up on time here, which is shocking to me because I was like, oh, wow, we're 45 minutes in already. Do you have any final thoughts that you want to leave the audience with?
Rae Jacobson: You know, you asked me this at the beginning. Well, I should say you warned me that you would ask this. And I got so caught up in talking to you that I didn't plan final thoughts. So these are not as well rehearsed as I might like. But I do think when I think about what a final thought after our conversation is what I'm going to be walking away with is if ADHD is your reality, however that reality looks finding a way to acknowledge what's hard and acknowledge the things that you can and can't change. And the things that might require a little more investigation is always going to have value no matter what it looks like for you, whether it's keeping that journal, whether it's, you know, reaching out to a friend and saying, like, Hey, do you do this too? Or calling a clinician and saying, like, Hey, I have something that is genuinely outside my control.
I need help. Those things are all the little steps up the mountain because it's not going to be straight line and it's not going to be a clear path. And at this point, I don't think anybody with ADHD would expect it to be because we've been walking it for a long, long time. But it doesn't mean that it can't be enjoyable along the way, maybe not all the time, but sometimes. And getting to talk to other people who have it can make a lot of difference, like sitting down and wasting, not wasting, but like. Having 45 minutes evaporate because this has been fun talking to you. That to me is like the genius and the joy of being a person with ADHD.
William Curb: Yeah, absolutely. It's the getting caught up in what you're doing because it is enjoyable. I mean, we got the hyper focused show title and it is something that people love about ADHD and can be a double it short, but it is something that is can't like it's very close to that flow state that people, you know, dream about getting into. And for us, it's like, oh, yeah, that's every day.
Rae Jacobson: There are worse ways to go. Thank you so much for having me on. Thank you.
This Episode's Top Tips
When considering what is and isn’t ADHD, it’s important to remember the context of ADHD as a chronic condition - as in it’s something that we deal with all the time. Everyone is going to lose their keys every once in a while, but with ADH,D the difference is in the pattern and the impact. Without the systems I have in place to make sure my keys go into the same place every time, I would be losing them every day.
Not everything annoying is an ADHD trait; sometimes it’s just being a human in a busy, overstimulating world. While there are a lot of comorbidities with ADHD, if we try to label everything as ADHD, we lose the ability to tell what actually needs attention. Instead of asking, “Is this ADHD?”, try asking, “Is this making my life unmanageable?” That’s the line that separates “normal chaos” from “I might need help with this.”
But when ADHD does show up alongside things like depression, anxiety, or trauma, those conditions can feed into each other. You need to figure out who’s driving the bus. Treating the wrong “driver” means you’ll burn energy fixing the wrong problem. So before building systems or blaming ADHD, step back and ask what’s actually behind the behavior.