ADHD and the High Achiever with Dr. Jennie Byrne
This week I'm talking with Dr. Jennie Byrne, a board-certified psychiatrist and neuroscientist with over 20 years specializing in high-achieving professionals and adults with ADHD. She has a PhD in Neurophysiology and an MD from NYU with her psychiatry residency at Mount Sinai (pronounced SIGH-nye). Now she runs Constellation PLLC, a concierge telepsychiatry practice where she helps busy professionals manage their ADHD. In her most recent book, ADHD in Professionals: Embracing Your Brain, Dr. Byrne examines how ADHD shows up at work, and why some individuals thrive while for others everything looks great on paper, but underneath they're struggling.
In this episode, we consider why the idea that "you're too high functioning to have ADHD" isn't a diagnosis and how often that same high performance at work can lead to a crash at home. We also play with the ideas of using anxiety as fuel and the costs that come with that, how productivity advice built for neurotypical brains can backfire for us and our environmental fit can make all the difference.
If you'd life to follow along on the show notes page you can find that at HackingYourADHD.com/312
YouTube: https://tinyurl.com/y835cnrk
William: All right. I am excited to have this conversation. I've been looking about what all the things that we can go into today, but, how about we s- kind of start hearing a little bit about your book?
Dr. Jennie Byrne: Yeah, sure. so my most recent book is ADHD in Professionals: Embracing Your Brain, and it's really what the title says. It's about what ADHD looks like in professionals, which can be doctors, lawyers, CEOs, entrepreneurs, teachers, people who are really typically very high achieving and whom typically everything looks great on paper, but underneath they're often struggling
William: Yeah, I imagine that's just there's so much masking involved in doing a lot of those professions where you either feel you can't, show off or you just really don't want people to know about your struggles at all.
Dr. Jennie Byrne: Yeah, most people keep it quiet. it's interesting though, the folks that have learned to really thrive with their ADHD brain are the ones who have chosen, either intentionally or unintentionally, work environments that really suit their brain. So, for example, the physicians I've worked with who have ADHD work in typically high-adrenaline situations like the emergency room, the operating room, or intensive care, and they are amazing in those situations.
they're very sensitive to stimuli. They work very quickly. They connect the dots, but then you put them in front of a pile of email, and they completely fall apart
William: Yeah, it's one of the things that's always important with ADHD is like, okay, how can we focus on our strengths and mitigate some of these weaknesses we have? And for some professions, that's something you just can't do, but for others, you d- there are ways that you can find a way to, like, really lean into those strengths
Dr. Jennie Byrne: Yeah, definitely. And I've chosen with the book to take a strengths-based approach. I do talk about challenges, but I do focus on what thriving looks like. And I know there's some debate out there about whether to take a strength-based approach or a disorder approach, but I've chosen to lean on the strength approach
William: Yeah, we'll often find like, yeah, you do... You can only increase your weaknesses so much often. Like, you wanna like shore them up so that they're not like gonna like flatline you or anything. But you gotta have, some... If you lean into that strengths aspect is often much better for working with your brain
Dr. Jennie Byrne: Yeah. And often people can make more changes to their environment than they think they can, or there are other tools where they can learn how to better use their brain and their body to make it easier to perform at a high level
William: Yeah. And so You mentioned some of the, career places that people with ADHD go into where they have, like, this higher stimuli. What are, you know, some of the ways people might, like how they actually show up in these professions? Like, what are some of the signs that they might recognize in themselves?
Dr. Jennie Byrne: Yeah. So often I hear a lot of folks who are successful professionals, and they've gotten there by kind of either, either using anxiety to overcompensate and push them to achieve, but that requires a lot of anxiety to get them there. Or some folks do very well through a very rigid, structured, schedule, where they literally are mapping out, like, almost every minute of their day.
which works, but then, you know, it's very hard-- it's not very sustainable to be rigid like that, and it's not very enjoyable sometimes to have to be so rigid. So they, they do it and it works, but at a cost. often what I hear about in the workplace is the folks with ADHD are very hardworking. they actually put in more work than their peers, typically 'cause they're having to do work at home at night where it's quiet, or they're having to spend more time on reading or things like that.
they tend to be creative. Now, I know there's some debate about, you know, creativity and ADHD, but they do tend to be, I would say, overall more creative, kind of able to connect the dots in unexpected ways. They are often sensitive, so they're sensitive to different kinds of stimuli in their environment, but they're also sensitive to other people.
So sometimes, the person with ADHD in a professional setting will be the one that reads the room really well and can pick up on slight nuances of interpersonal dynamics. and they tend to be, overall, I'd say as a group, fairly optimistic compared to their peers. tend to be a little more optimistic and future-looking.
So I know that's like a gross oversimplification, but those are a couple of the traits that I've noticed.
William: Yeah, and I could definitely see that with the people that are, like, thriving in their job. That's kind of like the, you know, like, oh yeah, they're optimistic because yeah, they're- they've been through all these trials and stuff, and they're like, "Oh, I know how to get to the next step. And even if I don't, I've done something similar before."
Dr. Jennie Byrne: Yeah, and just to get to where they are, you know, if you have an ADHD brain and you've become a lawyer or a CEO, I mean, you've, you've clearly been resilient and come up with a lot of ways to cope with your stress of your job. So I think inherently the ones that succeed and who are out there in professional roles are really resilient and, and they have done a lot of really tough things.
Again, sometimes at a cost, but they, they can- they've done really amazing things
William: Yeah. I mean, when you were mentioning anxiety, I was like, "Oh, that's me." I been... Something I'm actively working on trying to do less of is driving myself on anxiety 'cause it is, you know, it takes, it's a huge cost
Dr. Jennie Byrne: Yeah, and it has an impact on your health, right? Like, we know that if you maintain a high sympathetic nervous system level all the time, eventually you're getting a little nerdy here, but the cortisol axis in your body, starts to get activated, and then you can have chronic health problems. So one of the, the sad statistics about ADHD is it tends to be associated with poor health outcomes and actually decreased lifespan.
and that may be because of some of these things around stress and anxiety. It may be just difficulty navigating the healthcare system, which is hard for everybody. and it may be just they don't get into the preventative care they need because their ADHD brain forgets or they're late or, you know, who knows what happens, right?
But it is, it is really sad and, and I hope that, you know, people, learning more about their ADHD brain will really embrace the, the idea they need to take care of themselves. It's not just enough to, to get by. Like, you know, you really need to take care of yourself
William: Yeah, and it's one of those things where y- absolutely, ADHD makes it harder, and so then you don't take care of yourself, and then not taking care of yourself makes it harder again. So can have this snowballing effect that it's kinda hard to get out of. But it is definitely worth putting your effort towards
Dr. Jennie Byrne: Yeah, and I think another complicating factor is because ADHD is so heritable, meaning that, it's a high genetic factor. So if you're an adult with ADHD and you have kids, good chance at least one of the kids has ADHD. Or your siblings, good chance one of them has it, or your parents, good chance one of your parents has ADHD.
So sometimes you have to navigate your own neurodivergence and try to navigate the rest of the family, the people you're taking care of. And I think that's another one of those snowballing things, right? Like, when people take care of others, it's hard to take care of themselves
William: Yeah But that is an interesting thing to think with, uh, professionalism, 'cause we do see a lot of ADHD going up into leadership roles, r- right?
Dr. Jennie Byrne: Yeah, and I think from my experience, there's a couple reasons for that. The, the folks, again, with ADHD brains who, whether or not they even knew they had ADHD, came up with really good supports for themselves, really put a lot of attention into hiring teams to complement their neurodiversity, people who are very self-aware and comfortable saying like, "This is how I work the best."
they make for really good leaders because they are very thoughtful, they're very, direct. They tend to be pretty honest, and they can be very charismatic. A lot of folks I work with ADHD just have charisma. You know, in leadership sometimes there's a lot about just the energy that you show up with, and that charisma sometimes matters a lot
William: Yeah, I can imagine just having, yeah, the very charismatic, very empathetic person being like, "Yeah, I want them to be in charge."
Dr. Jennie Byrne: Right, and all of the tasks that ADHD brains have difficulty with, like, you know, all the detail work, doing the same thing over and over and over again, I mean, that's not really what leaders typically should be doing. They're not there to manage the minutia of the project. They're not really there to track the forms.
You know, you want them to lead. And so if they can get to the leadership point, sometimes they do really, really well in that role
William: Yeah. And I can, I mean, it's one of the things I often talk about on the podcast is how important it is to get help with things that you need help with, because we don't have to do everything alone. And that's exactly the leadership mentality is like, "I'm gonna do what I'm good at, and I'm gonna get people to do the things that I would be terrible at doing."
Dr. Jennie Byrne: Yeah, and I think they just kind of intuitively understand that a team is made of different people and different brains, and you wanna hire the team to fill out all the gaps, right? You don't want 20 of the same kind of person. That diversity is really what helps the team. And I find that people who have neurodiversity themselves kind of get that at a more intuitive level than folks who don't have that, where they may just hire, you know, carbon copies of themselves, which isn't very helpful when it comes to building a team.
William: No, and it's... I mean, it is tempting 'cause you're like, "Oh, that person's so much fun. I wanna be with that person." It's like, yeah, but we are gonna have-- we're just gonna double our problems
Dr. Jennie Byrne: Yes, definitely
William: which is interesting too, 'cause yeah, there's this, stigma to ADHD in the workplace too. and 'cause I know a lot of people are like, "Hey, should I like let my boss know, you know, disclose my ADHD?" And I'm just like, it's such a hard question to answer because it depends so much on who you're disclosing it to, what the business is, all those things, and it can't just be a blanket answer I give anyone
Dr. Jennie Byrne: Yeah, I mean, if your workplace has psychological safety and trust, and you need something to change in your environment to suit your brain, or you could call that an accommodation, whatever you wanna call it, it may be to your advantage to disclose because once you have the disorder label, and again, that's debatable, but if you have that label, it gives you an entitlement to ask for certain things.
So it can be helpful, but like you said, if the environment is not trusting or not safe or not willing to work with you, it may... unfortunately, it, it can backfire. And that's a shame because when people don't disclose and keep it quiet, others around them end up keeping their issues quiet as well, right? So, you know, most people in their workplace, we think that 5 to 10% of the adult population has ADHD.
So if you have 10 people on your team, good chance one or two of them have ADHD, and you probably don't know it. So when everybody stays silent, it just makes it invisible, when in fact it's actually very common, and most teams probably have a good amount of ADHD on them
William: Yeah, especially if they're, yeah, as you were mentioning earlier, like the creative side of things that are like really trying to push those limits on things. You, you're gonna see that, those traits come out there
Dr. Jennie Byrne: Yeah. And the nice thing, again, once you get... If you do get to a leadership position, then you have more power to create that psychologically safe space and to be self-disclosing once you have that inner confidence. And once you do that, then it makes it so much easier for anyone else to disclose whatever kind of diversity they have.
So it's really nice when people are in a leadership position and they can do that, 'cause it opens the door for other people who may not otherwise feel comfortable
William: Yeah. And it's, also nice when people can have these examples of what ADHD is, 'cause often there's so many people that are undiagnosed going through these things, and they, the only sense of ADHD they have is pop culture, which gets it very wrong
Dr. Jennie Byrne: Yeah, one of the saddest things I've heard over and over, and one of the reasons I wrote the book, was that so many people who came to work with me have been told when they went to get help to their primary care or to a therapist or y- you know, a psychiatrist or someone else, and they were told, "You're too high-functioning to have ADHD."
I have heard that quote literally like 100 times, the same quote. And how sad is that? Like, when you finally feel ready to, like, say, "Hey, I wanna learn more about my brain. I wanna figure this out," for somebody to invalidate you in such a direct way who is trusted, you know? And it's not that they're trying to be mean, but a lot of these clinicians, they actually have a lot of misinformation themselves, and they are inadvertently sharing misinformation with so many other people.
So that's, again, one of the reasons I wanted to write the book, to get more high-quality information out there.
William: Yeah, and it's wild to think about people, like you're not going out for this diagnosis unless you're struggling somewhere in your life. And so even if you're like, "Yeah, I'm great at work, but like I've, you know, never cleaned out my car in five years," like that's a struggle and you, you need to solve that
Dr. Jennie Byrne: Yeah, and that's a big, I write about this too. Like, I think when you're a high-achieving person at work with ADHD, typically where things will fall down is at home, right? So, like, you, you put all your energy to hold it together at work or mask or cope or whatever, and you do well, and then you come home and things really just fall apart.
If you-- A lot of people who take stimulant medicines, they're also wearing off at the end of the day, so those people are crashing. They're coming home. If they have kids, they're trying to deal with kids who may have ADHD too.
I mean, it's really just a setup for emotional meltdowns, which is often what ends up happening. especially with a lot of the women I work with, their ADHD has really shown up more emotionally for them, and that's where they're struggling is at home having emotional meltdowns.
William: Yeah, I was always just kind of shocked that the, diagnosis didn't include anything about emotions, 'cause it's like, w- why would that one part of my brain not have ADHD? Of course, it affects everything
Dr. Jennie Byrne: Yeah, and the more we learn about ADHD, the more we see how tightly linked it is to emotions and the amygdala part of our brain. And we're seeing that when ADHD brains, take in a stimulus, that it tends to have a more of an emotional connection. So when the amygdala is firing, it has a more emotional connection, and that's why it may be like they're more sensitive to stimuli.
And then also there's this mood, we call it like lability or instability, where if something's good, you're on top of the world. Five minutes later, something's bad, and you're just super depressed, and it can look really variable through the course of even a day. And many people are getting misdiagnosed as bipolar disorder.
So if, if you're listening and you've been told that you have s- you know, ultra-rapid cycling bipolar disorder, that's a big red flag. There, there really kind of is no such thing. if your mood is really labile, I, I think about it as being kind of like an impulsive mood. The way that you can have other kinds of impulsivity in ADHD, your mood can also be very impulsive and, and go up and down very, very quickly
William: Yeah, I really Russell Barkley's model of, like, ADHD being, like, self-regulation, and I'm just like, "Oh, yeah, that makes total sense." If I can't like, where I'm focusing my attention on, I can't regulate how my emotions are responding to things, and I'm... have trouble just understanding how I'm feeling.
My, like, interoception's not great. That's going to lead to all of these things happening
Dr. Jennie Byrne: Yeah. A common story I heard was, when there's a couple and one person has ADHD and the other doesn't, they get into a fight, the ADHD person just explodes and has this very big angry outburst, and they, they stomp off and they leave. 10 minutes later, the ADHD person is al- is over it. They're back to totally normal, like, as if nothing happened, and then the other spouse without ADHD is just stewing in it for hours and hours, and they ca- and, and they're totally disconnected.
And the non-ADHD spouse is like, "I can't believe... Like, what's wrong with you? We just had this big fight, and, like, you don't even care." And it leads to all kinds of, relationship issues. So again, I think understanding if you have an ADHD brain, even if you never take medicine, you never go to therapy, whatever, like, it's still just helpful to know, and that way the people in your life that you have relationships with, it gives you a framework to explain to them, like, why you react the way you do
William: Yeah, I find just knowing about ADHD and applying that to your problem-solving is such an important step. Because if I'm trying to solve a problem and I go like, "Why am I, can't I do this for whatever reason?" And then I go, "Oh, I can't do this 'cause of ADHD. I need to think my solutions with that in mind," it makes it so much easier to, like, try and work through it
Dr. Jennie Byrne: Yeah. Another common example I hear is like the house, and, typically if you have an ADHD brain, if you don't see it, it doesn't exist, right? So if your house is tidy and everything's tucked away, you don't really... You forget about those things if you don't look at them, so you tend to like have them out so they're visible.
And the non-ADHD partner or person living with you, it just looks like clutter and visual chaos, and it really can upset them. And so you have to come to these compromises about like, "Okay, this, this visual seems like clutter to you, but it really helps me remember things. So how are we gonna make our house look so that it works for both of us?"
William: Yeah, it's so funny how that works too, 'cause I'll have like some s- hobby thing I'll have out, and then I'll put it away to be like, "Oh, I'm gonna just clean this up," put it away, and then like two months go by and I'm like, "Oh, I haven't touched that thing that I was doing every day just because I just forgot that it existed
Dr. Jennie Byrne: Right. So that can work for or against you. So an example, I was working with a doctor with ADHD who read EKGs, and he had, like, two or three computer monitors at his station, 'cause that was, like, the normal setup, and so you'd have, like, an EKG here and this and that. It was terrible for him. You know, I had to help him turn off all of his monitors and just have one so that he wasn't distracted.
But the good thing was, once the visual clutter was all gone and he just had this monitor, he could actually hyperfocus because he was so in the zone on this monitor. Whereas for another doctor, you know, having three monitors was much more efficient for them
William: Yeah, it's funny how you can, yeah, think that like, "Oh yeah, more information is gonna be good for me." And it's like, it's too much. I can't focus
Dr. Jennie Byrne: Yeah, the, the organ- the productivity books and hacks and all that stuff that work for non-ADHD brains can actually backfire on ADHD folks, and it's so frustrating for them when, when they're trying to implement all of these strategies and it's just making things worse, and then they start to feel like something's wrong with them, when in fact the strategy is just not a good strategy at all for your brain
William: Yeah, things like I've heard, like, people, like, doing the, like, eat the frog strategy of doing the hardest thing, and it's, like, often so hard for people with ADHD. And, oh, there was another one that was just in my head, that... Oh, yeah, just if it takes less than five minutes, just do it right then because
Dr. Jennie Byrne: that's a terrible one for ADHD.
William: Yeah, it's like, "Oh, this is gonna just lead me down so many rabbit holes."
Dr. Jennie Byrne: Yeah, the, a lot of folks in more corporate settings, I find that email is just a huge challenge, and part of the reason is that philosophy of like, "Oh, I have five minutes. I'll just go check my email," and, you know, that is just a recipe for disaster, for people with ADHD
William: Yeah, I know if I try and like do a quick email check, I'll like see some e- messages. I'll like look at them. I won't have time to respond to them, and then I'll mentally have been like, "I've done that."
Dr. Jennie Byrne: Yeah, and there's even for non-ADHD brains, there's a huge cost to task switching
William: Mm-hmm.
Dr. Jennie Byrne: between multiple things, and then you throw ADHD on top of there and you just have blown all your productivity for the day
William: Yeah, it's really... And like multitasking feels like it's such a good idea. It's like, "Oh, I'll just get two things done at once." And, mm, yeah
Dr. Jennie Byrne: I, I have-- my first book, I talked a lot about this, and I, I said that multitasking is a myth.
William: Mm-hmm.
Dr. Jennie Byrne: It, you know, if you look at your brain, it doesn't actually ha- you're not actually multitasking. You're actually switching between things, right? And there's a cost every time you switch
William: Yeah, and it's, well, and it's funny too 'cause like they took the term from computers, and computers don't even multitask. And like some very fancy things it's possible, but m- most of the time with normal computers it's just switching so incredibly fast it seems like it is
Dr. Jennie Byrne: Right. So there's a lot of cultural, you know, a lot of these things are bound in our current culture, and sometimes you have to take a step back and get a bird's-eye view to say, "Oh, wait, this is just our culture. Like, I don't really need to do any of this," or you know, "I can do things differently. And just because our culture does it this way doesn't mean I have to do it this way."
William: Yeah. Well, and especially 'cause there are certain things with multitasking, like driving while being on your phone. Like, it's incredibly dangerous. and like I've d- had to explain that to my kids, and I'm like, "Hey, I..." They're like, "Oh, can you look this up?" I'm like, "No, I cannot look at my phone while I'm driving.
This is dangerous
Dr. Jennie Byrne: Yeah, and again, that's another common, you know, for folks listening, some of the common ADHD things are that impulsivity. So driving is another big risky situation, right? 'Cause if you get distracted or you're impulsive, like you can get into a lot of fender benders, a lot of tickets. You can lose a lot of money.
That's a real common area I see ADHD pop up, especially again, when you're going home from work. And if you take medicine and your medicine's wearing off, and your masking is exhausting you, like that's-- You can have a lot of trouble that time of day
William: Yeah, the, uh, afternoon traffic is, I didn't... I work from home, but, you know, sometimes you have to go out in the day. I'm just like, man, I am so glad I don't have to deal with this every day.
Dr. Jennie Byrne: Yeah, and I think one of the good things about the pandemic was it really did open minds to different ways of working. And so people either working at home or working hybrid or working non-standard hours, it did open the door to more of that than we had before, which can be great for ADHD or it can be a challenge, right?
'Cause you still need the structure, but maybe you can make the structure match your brain better
William: Yeah, because I, yeah, I find there's so many With my natural inclinations on how, like, I'm like, "Oh, I should just do it this way," I am going to completely have a terrible day where I just don't get it. I'm going between tasks and I'm not, you know, there's tr- I'm like, "Oh, I need to take this off my desk," and I, and I'm like, it's just gonna be a mess.
I really need to build structure in. But as you, like, I can't have the, like, super struct- super, like, minute at, by minute structure. It has to be s- like a loose scaffolding for the day
Dr. Jennie Byrne: Yeah, I've heard different, um, ADHD people describe different ways they've found that work for them. some of it h- is kind of like the loose scaffolding. Some of it is kind of like my, like my big three for the day. Like, I just need to make sure I do these three things for the day. some people rely on others in their environment to help them stay kind of on structure.
A lot of families with kids, you'll hear where the ADHD kids do a lot of sports and things after school, so they're like getting the physical activity, which first of all helps a ton with your ADHD. And so by the time they're coming home, they're physically calmed down, and then they have to do their homework right away because there's no other time to do it.
So I know with kids, sometimes the parents will put that structure into place
William: Yeah, I just recently thinking that with Mike. I'm like, "Man, I need someone to be my parent."
Dr. Jennie Byrne: And you know, that exists. Like, actually you can get executive coaches and folks to help do... I mean, it's not the same as a parent, but you can get folks who, who can help you. And I've had a couple people I work with now have been experimenting, with some of the different AI to kind of create their own mini coach to tell them kind of.
So that's been interesting to watch
William: Yeah, I've, uh, I've looked into a few of those things, and the things that I've always found for me is I'm like, I can just completely ignore it and there's no consequences, and then that just ruins it
Dr. Jennie Byrne: Yep. Yep. yeah, so everyone finds what works for them, and that's where a coach can come in and be really helpful to help you, like, figure out what's gonna work for you and keep you accountable. And also, you know, help you celebrate wins so you're not just beating yourself up all the time
William: Yeah, and I think that's a really huge issue for a lot of people with ADHD is I've, I've been talking to a number of my friends recently about the things that, like, feel like you're just like, "Oh, I'm just, I'm moving past this." But you tell someone else and they're like, "Oh, that's really cool. How, how are you celebrating?"
And you're just like, "What?"
Dr. Jennie Byrne: ' Cause your, your, your, if your mind is quick and you're moving quickly to the next thing, the new novel, exciting project or, you know, the next cool thing, you, you, you do move on very, very quickly. And, you know, I think there was a statistic, I forget, it was like 10,000 negative critical statements that ADHD kids get before they graduate school or something like that.
And so, a lot of people have internalized that negative criticism. and there's this idea which I find really interesting about rejection sensitivity dysphoria kind of as being part of that internalized, you know, sensitivity to rejection and criticism. so I think that's been really interesting for me to learn about.
That's a little bit of a new concept
William: Yeah, and I, I've been wanting to look more into the research on that 'cause it is, there is finally, like, research coming out about rejection sensitivity. And I do find, I mean, there has to be something to it with so much of the community that, like, just they go like, "Yeah, that matches my experience."
Dr. Jennie Byrne: And I guess the question is, if you have a, a kid who got an early diagnosis, got, you know, sports they needed in a really positive environment and, you know, would they still have that? Is that part... You know what I mean? Is it part of the ADHD brain structure, or is it more a result of a lifetime of conscious and subconscious criticisms?
William: Yeah, 'cause I think, I mean, yeah, with the amount of, yeah, br- either real or perceived for rejections and stuff, it is very easy to just be like, "Oh yeah, I'm going to be hypervigil- vigilant about this."
Dr. Jennie Byrne: Yeah. And, and you know, again, when you're, A lot of these things I feel like our brain is doing to protect us. It's being vigilant 'cause it's trying to protect you from future damage or harm, and so it's, it's, it's trying to be helpful, but in the end it's, it's not actually being very helpful.
William: Yeah, I try to remind myself that, yeah, my brain is not out to get me sometimes. It's trying to do... It's doing its best job, but sometimes its best job is pushing me in the wrong direction
Dr. Jennie Byrne: Yeah. And sometimes there's some cognitive behavioral strategies where people, if they have insight when this is happening, that you actually tell your brain, you know, you kind of have this image of it and you're like, "Okay, thank you. Really nice. You're trying to help me. I appreciate you, but I'm okay.
I've got it. You don't have to worry about me right now. We're all good." And kind of finding a little humor in it. humor can be a great tool as well. I know there's some stuff out there, humor around ADHD and, I think sometimes I really like the humor because it can be a very serious topic and sometimes finding the humor in it, is very refreshing
William: Yeah. I've had some, ADHD comedians on the podcast. There's always
Dr. Jennie Byrne: Oh, yeah
William: a pleasure. I'm just like, "Oh, this is..." Because, yeah, they're... Being able to see the humor in the condition is, can be very helpful. Like, where I'm like, the day where everything goes wrong and I'm like, "This day is so ADHD, it's kind of funny."
Like, it's way, it's way more than if I had, like, written a story, people would've been like, "That's not real
Dr. Jennie Byrne: Yeah, humor is the, considered a mature defense when you think of all the ways our brain can help us and defend us. Humor is actually considered a mature way of handling with difficulty
William: Yeah. As long as we don't s- slip into, like, the self-depreciation stuff, which I know a lot of people use as a defense mechanism as well
Dr. Jennie Byrne: Yep, exactly
William: Yeah. 'Cause it's so easy to be like, " I'm going to hurt myself before anyone else can hurt me," which is again, your brain trying to protect itself
Dr. Jennie Byrne: Exactly. Exactly. So, you know, psychotherapy can be helpful for some of these things, like learning about the automatic thoughts in your mind, learning about how it connects to your emotional state and your behavior. Psychotherapy, I think, can be really helpful for those things. It's a little less helpful for the coaching aspect of executive function, and so sometimes people go to a therapist expecting to get more of that coaching, and, and sometimes they're disappointed because it's not really as good for that
William: Yeah, I often recommend people like, yeah, you can have, and you can do both if you need to. Like, it's all depends on what you're struggling the most with and how you wanna try and find that help
Dr. Jennie Byrne: Yeah, exactly. And I, I love working with coaches, I work with therapists, I do coaching myself. it's really just, you know, ADHD is your brain, it's a lifelong brain, so it's gonna change over time. There may be times when your brain's doing great and you don't need a ton of help, and then there, life is gonna throw something at you, and all of a sudden you're like, "Oh gosh, my coping strategies aren't working anymore.
I need a little extra help." So very normal if you need to change your approach or change your medicine or change your lifestyle. Like, it's very common that you need to change your approach every once in a while
William: Yeah. And I do know that makes a lot of people like, they're like, "No, I just wanna have the one thing and just do that." And it's like,
Dr. Jennie Byrne: Of course
William: but everything in life changes, and that's why. Like, you know, like my situation a decade ago is so vastly different because now I have, you know, children that are that old, and that's like, those are new challenges that I have to deal with
Dr. Jennie Byrne: Yeah, and sometimes people say, "Oh, I've had ADHD since I was a kid, and I've been taking this medication for 20 years, and now it's not working." And then they were beating themselves up like, "It must be me." And I'm like, "Well," like you said, "things are totally different." You know, you have this job, you have these kids, or maybe you're taking care of your parents, or you have a health issue.
I mean, that's a big one. A lot of, like, women hitting perimenopause, they were doing fine, and now, wow, they're not doing fine. Their hormones have really taken them for a ride, and you need to change your approach. you know, and then later in life, maybe you retire, maybe you're doing different work. You know, it may change again.
Maybe you don't want to take as many medicines when you're older. so I really just think it's, it's, having that flexible approach and just keeping an eye on things and then getting help intermittently when you need it. That's, again, I think people who thrive are really good at that.
William: Mm-hmm. Obviously, with that kind of ideas in mind, where do you kinda see ADHD care going in the future?
Dr. Jennie Byrne: Oh, I'm glad you asked. So I really nerd out on this stuff. I'm very excited. my PhD was actually in neurophysiology of attention, and up till now, we haven't had a lot of treatments that aren't medicines. So, right, we focus a lot on pills because, again, culturally, that tends to be what we focus on. But in reality, there's a lot of things you can do with your own electrophysiology of your brain and your body.
So for example, there are devices now coming to market where you can measure the EEG or the electrical pattern of your own brain through headsets like the ones you're wearing or a pair of glasses. and you can put sensors on your skin to measure how your... I mean, I wear a ring, right? This little thing can measure all sorts of things.
So some of the new treatments coming will be, I think, more about modulating your brain activity and your body electrophysiology, and that's not a pill. It's really like you can train your brain to enter into certain rhythmic states. Another area I'm excited about is using sound and music. I'm a musician, and I've always thought that music was really powerful, and I've found some success already with my patients, who are sensitive to music using binaural music, different types of music which are free.
You can get them on Spotify or whatever for free. Um, and they can really help and train your brainwaves into focus states or relaxing states. So I think we're just at the beginning of understanding all of that. And then there's also the mind-brain, the mind-body connection, which I know personally, it's been a long time for me to, like, acknowledge and start to work on that, 'cause again, it's not our culture.
But understanding the brain-body connection and how we can use our body to actually help our brain, I feel like that's another area that we're gonna see just a lot of new activity. So I'm hopeful that, yes, pills are helpful and, and they're good sometimes for some people, and they're not good for other people.
But there's way more out there other than pills, that I think is coming, and I'm very excited about that
William: Yeah. And it's the... I, I s- come off very pro-medication on this podcast, but it's also something where I'm like, yeah, you, if you can start there and then build your skills with that, because often we're coming with such a deficit when we start that it's, without having that boost, it can be very hard to even do anything else
Dr. Jennie Byrne: Definitely. And a lot of these things are habit-based or repetition. And so one of the things with ADHD is it's hard, it's really hard sometimes to get a new habit going, and it's really hard to consistently repeat something over and over. So for example, if there is a neurofeedback device that's gonna help your brain, you, you have to use it for it to work.
And so, like you said, maybe medicine or whatever is gonna help you get into the repetition and the habit-building for the other things that will help you too, or physical activity, right? Like, that's another notoriously hard one. But we know it makes a big difference. So getting in those habits is not easy, right?
For anybody. And so having medicine to help you build up your habits is a great example of using medication as a tool.
William: Yeah. And I think, yeah, it's, there all sorts of other stigma that there's attached with medication, but it is something where it's like, yeah, just try meeting yourself where you're at
Dr. Jennie Byrne: Yeah, I think a lot of the misinformation around medicine is kind of shocking to me as somebody who's been specializing in ADHD for, like, over 20 years, because even fellow psychiatrists and, and others who are really smart people, really good at managing other things, they don't even know about ADHD medications.
And so I really want, if anyone's listening, just to know that yes, Ritalin and Adderall and the families of Ritalin and Adderall are the ones we hear about the most, but that is not the only medication. In fact, I probably use, you know, at least 50% of the time I'm using other medications for ADHD, which are non-stimulants or alpha agents or sometimes you get a little creative.
so people should really understand that yes, these are the mainstay that's been around since the '80s, but there are other non-stimulants as well. If you can't take stimulants or you don't wanna take stimulants, there are other choices. So you really need to find somebody who knows what they're doing, who knows about these other medications.
William: Yeah. and do you have any suggestions on how people might go about finding someone? Like, what are the, like, green flags to look for, for?
Dr. Jennie Byrne: Yeah, it's hard. Honestly, I'll be, I'll be straight with you. Like, it's hard to find experts in ADHD, especially on the medication side, 'cause there just aren't that many of us. But, I have a free resource guide, on my website that people can get for free, if you-- it goes to your email. Or I also recommend-- I don't recommend people go to their primary care unless the primary care knows about ADHD, and some of them really do.
sometimes going to a really good coach is a first step because that coach will know physicians and therapists in their network, in your geography that are a really good fit for you. 'Cause, you know, physicians practicing across state lines is very tricky. I have twenty-five state licenses, but that's extremely unusual.
So most of the time you need to find a physician who is in the state you live in or even more close to you. So sometimes a coach is actually a really good place to start with, like, a coach who really knows a lot about ADHD. there are also resources like on the CHADD website, of people, in your area.
But I'm happy if people wanna reach out to me, I'll always try to send you in the right direction. if it's not me, someone else I can get you to.
William: Awesome. Yeah, 'cause I do know there's, it's such a tricky topic to talk with your doctor if you don't know how it's gonna go, and it's because of, like, the stigma around ADHD medication and ADHD itself. You're just like, "I'm..." You feel nervous bringing it up
Dr. Jennie Byrne: Yeah, I have a whole section in the book because that was a common theme I heard over and over was people didn't want to say the wrong thing to their doctor. They're worried like, "I'm gonna say the wrong thing. They're gonna think I'm trying to get meds. They're gonna think I'm some-" you know, and so they don't get help, or they shade what history they're giving because they don't want to say the wrong thing, and that's really sad.
I mean, that's the person that you should be able to trust with how you're feeling. but I hear that a lot and, and it's understandable because people are told you're too high-functioning to have ADHD, and a lot of these docs unfortunately just have not had training and they really, they just have misinformation, honestly
William: Yeah, which is wild to think about considering with the going like, "Oh yeah, this is 5 to 10% of the population." You're like, that should be really in everything that they're learning
Dr. Jennie Byrne: Yeah. Again, another reason why I wanted to write this book was to get that information out there. You know, when I trained in psychiatry, we do a four-year residency program. I had about 45 minutes on ADHD, and it was about kids. Now, that was a long time ago, but still, like, it's pretty much nothing. All I learned about ADHD was after I graduated, and I just started teaching myself because I, lived down the street from the University of North Carolina, and they started sending me all their ADHD staff and students.
And I was like, "Wow, I don't really know as much as I should. I better go educate myself." And went to conferences and talked to experts and read a bunch of books and articles, and that's how I learned, was really just teaching myself because, I didn't get much training at all
William: Yeah, I, I have the, my primary care doctor is from where I used to live, and it's like an hour away from me now. And so I'm j- but I'm just like, "I don't really wanna switch doctors 'cause I know he already knows stuff."
Dr. Jennie Byrne: Yeah. And, and again, that trusting relationship is just so important. So again, I'm happy to help people if they reach out to me, try to help them get to the right place. Another thing you can do is, use the Psychology Today website, and search for people who have ADHD specialty, and those will be often therapists.
Sometimes it's psychiatrists, but you can ask the therapist who is a psychiatrist they recommend who is knowledgeable about ADHD. So it's a little bit of a roundabout way, but sometimes that's another way that you can find somebody
William: Yeah, 'cause you do want to have the recommendation from someone that you trust. You, like the, it's too easy to like go online and be like, "Oh, this I have no idea if actually this is true or not."
Dr. Jennie Byrne: Yeah. And so, you know, people who say they're an AD- ADHD expert, at least that's a good starting place because they're kind of proclaiming to the world that they know what they're talking about. So at least in theory, they've done some extra, some extra work. but yeah, like I said, if people wanna reach out to me, I can try to send them in the right direction, but it is hard, and I hope that the book and others who are doing this work are able to get rid of some of that misinformation and teach our colleagues, you know, my colleagues who are primary care or psychiatry.
You know, a lot of the time I have to teach them about ADHD and give them resources
William: Yeah, I imagine 'cause yeah, there's, it, and there's a lot to learn, so
Dr. Jennie Byrne: And it's changing. We're learning so much more, right? Like you said, there's a lot more research. People are more interested in the topic. So I'm, I'm hopeful in 10 years from now, you know, the stigma should be improved. It has not improved in the last 10 years though, which is very discouraging to me
William: Yeah. Well, we're kinda coming up on time here, so I was wondering if you had any final thoughts you wanted to leave the audience with
Dr. Jennie Byrne: Yeah, I would just say if you're out there and you think you have ADHD or you're not-- or you have a diagnosis, I hope that you think about thriving in your life and not just getting through the day. And if your treatment, if you have ADHD and your medicines and your treat... If they're not helping you thrive and you feel like you're just surviving, there's definitely more that can be done, and I would encourage you to, to, you know, educate yourself or reach out for help because everybody deserves the chance to thrive.
And if you see folks with ADHD when they're thriving, I mean, it's just, it's wonderful. They can do such amazing things, and we need you. We need you to be thriving
William: And if people wanna find out more about your book or, uh, find you online, where should they go?
Dr. Jennie Byrne: The book is on Amazon, so just search for ADHD in Professionals with my name, Jennie, J-E-N-N-I-E, Byrne, B-Y-R-N-E. And my website is called constellationpllc.com, and there's a link to, to chat with me or, there's that free ADHD resource guide you can find there too
William: Awesome. And I'll incl- include all of that in the show notes so people can easily get there. Thank you so much for coming on the show. This has been really fun
Dr. Jennie Byrne: Yeah, thank you
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