ADHD Interplay Overview: Physical Pain

Episode 137

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Individual context matters and no more when we start to look at the interplay of ADHD and other areas of challenge like trauma or depression. A recent Canadian study that reveals factors and obstacles to succeeding with ADHD is the prompt for this week’s episode. Cam and Shelly talk about how listeners can read between the lines of a study and look for information that is actionable. 

At first glance the study reveals fixed qualities like gender and marital status that contribute to happiness and satisfaction with ADHD. Looking deeper we see the impact of comorbid conditions, trauma, history of abuse and chronic pain, and the importance of support in these areas. 

Cam uses his recent back injury to highlight the interplay of ADHD and pain. ADHD is often an X-factor when it comes to managing other challenges, exacerbating something like depression or deepening a depressive event. Cam and Shelly talk about the significance of effective supports and what happens when those supports are taken away. Those of us with ADHD tend to downplay the challenge or whether we deserve to address the core issues. This is just the start of exploring the interplay of ADHD and individual context.

Episode links + resources:

Summary of Canadian Study –
https://link.springer.com/article/10.1007/s41042-022-00062-6

ADDA Event –
https://homecoming.add.org/

For more of the Translating ADHD podcast:

Episode Transcript:

Shelly: Hi, I’m Shelly. 

Cam: And I’m Cam. 

Shelly: And this is Translating ADHD. Quick announcements: Cam and I found last year when we took six weeks off in the summer, we really benefited from that break. And so we’re doing it again, starting on August 1st. We will be re-releasing some handpicked old episodes through September. September 19th is when we will come back with live episodes. So taking a break, but not going anywhere for long. We’ll see you all in about seven weeks once our break begins on August 1st.

So, Cam, this topic today has you fired up? We’re definitely gonna be taking this topic into the new season of the podcast because there’s a lot here, but let’s start with what it is and what’s got you so fired up.

Cam: It’s some of the information that is distributed to us and how to read some of these studies. I was looking at a recent Canadian study that was talking about factors that contribute to flourishing with ADHD. And, I was sharing it with a room full of non-male ADHD coaches and they were pretty livid. They were pretty fired up themselves. And the reason they were fired up is because the factors that they talked about in the study that contributed to quote-unquote flourishing with ADHD, which is another issue I have, Shelly, we’ll get to in a second. Is that the four factors that they were being male, married having some kind of physical practice, an exercise and a spiritual practice. So those were the four factors. And you and I have a lot of clients, we know a lot of coaches who don’t fit one of those categories.

Shelly: Or several of them at once.

Cam: Or several of them at once that, you know, if you are single and you are not a male, what are you to do?

So the thing that we’re gonna talk about in the new season is again, how to unpack data, how to unpack something like this study, where they’re giving certain information and what can we do about it? We think there’s a lot that we can do, and it’s actually something that we’ve been focusing on in this podcast.

It’s why this podcast has been so successful is because it’s not so simple, right? It’s not about checking these boxes and saying, okay, I got these on board and I’m good to. I imagine there’s a lot of males who are married with a spiritual practice who are not doing well with their ADHD. So we’re gonna look at that of kind of how to unpack that. Where to focus because that’s one of the difficult things with ADHD is well, where to start, where do I focus? So something I had my own experience the last couple weeks that got me focused in one specific area. So those were the four factors that talked about flourishing. They also talked about factors that stood in the way and the primary factors that stood in the way were any kind of trauma. History of abuse or chronic pain in there also is any kind of suicidal ideation. But those three got my attention too, because we’ve also talked about doing your other work. And in the last couple weeks after I got COVID, quarters of my family got COVID recovering from that. I tweaked an old back injury and tweaked it in a way where sitting is extremely uncomfortable and I found it really hard to do anything, but the bare minimum. In my work with this aggravated back and it just it brought it front and center to me of, I can’t imagine what it’s like for those people out there who have chronic pain. And they’re having to deal with that on top of ADHD, I’ll say one more thing. This is a bit of a teaser for our next season.

Many of you have been asking about, hey, can you talk about ADHD and autism or ADHD and depression or ADHD and anxiety. That’s the thing that she and I have been talking about for so long is that ADHD never operates in a vacuum. We have our environment. We talk about the people around us. We talk about our history, our situation, and there’s so many different factors in play and it’s being able to pull that apart and see how they interplay with each other.

Shelly: As we always say to new coaching clients or new course participants, your context matters. That’s the bottom line here is your context matters. And. Studies like this completely miss that point. They miss the point of individual context mattering because they’re trying to take individual context and put it into these buckets. Be this,

Be this, do this, don’t have this, don’t have this, don’t have this. You’ll do better with your ADHD. And it’s just not helpful, even if it might be true. don’t think that the findings of that study are untrue, Cam. Women are often underdiagnosed or misdiagnosed, and the expectations put on us by society, both in terms of what we’re responsible for and in terms of how we behave are much different than those expectations for men.

Married men because of those expectations and those gender roles tend to have better support at home. Not always, not every married man, by the way, but in general, a married man with ADHD is going to have more supports in place than a single man with ADHD. Right. And we could continue on down the line with each of those factors.

Both on the flourishing side and on the struggle side and say that yes, individually, those are true, but it doesn’t say anything helpful because it doesn’t say what to do. telling us what we already know. If you’re a white man who’s married and has a good exercise practice, You’re probably in a higher socioeconomic bracket. Again, there’s more supports there. And so to sort of couch this as the individual with ADHD is flourishing or not flourishing, it’s so much more than that because individual context matters and that context includes the people around us. It includes the supports that we have, the resources that we have.

Whether or not, we recognize them as supports or resources. And so I think it’ll be interesting to illustrate this point by diving into your experience with persistent pain. That thankfully sounds like it didn’t turn into chronic pain, but there was a persistent pain that wasn’t there before that was affecting.

Your context and affecting what was supportive and what wasn’t, what works for you in a vacuum, maybe didn’t work so well here. So say more about that cam, just what was the experience of the interplay of pain and ADHD in the last couple of weeks?

Cam: that, but actually. I want to talk a little bit about, again, my own supports, So as you’re talking, I’m just realizing about all the supports that were there for me. Right. That I tweaked my back, the beginning of, helping my mom. downsize and move and pick up this large rug and hoist it onto my shoulder and carry it across this campus when I could have easily used a cart, but I’m not thinking cause and effect.

Right. I’ve just like, yeah, I got it. Hoist it. And aggravate this old injury. Now my sister is there. My mom has support. Some people helping her, my brother and sister-in-law are coming to town and they’re all helping. And so I was able to step back and help in different ways. But I was able to stop.

And I think that a lot of people don’t have that option. Right. If you tweak a, a back or you have chronic pain and you’re in some kind of work situation and you don’t have the ability to take time off, I was able to go back to my old PT guy who helped me with the injury before I emailed him right away over the weekend, he responded quickly, got me in, started working on my back.

Getting that improvement and relief. And my spouse, like just, was like, saw me in pain and just like, how can I help you? So it was helping and supporting, but also prompting me to listen, buddy, need you back in the game. So prompting me to do my exercises and be proactive with the back as I was suffering through that.

So just wanted to, again, here are those supports that are there, where others, if you are by yourself and you don’t have resources available, then might not be able to really get proactive and create the change that needs to happen there.

Shelly: Cam, if you take everything you just named and talk about an absence of that support or that resource. Guess what starts to happen? Those become bricks in a wall of awful for dealing with, or managing or taking care of this same challenge. Had you not been able to stop helping?

Had you been the only person there helping that day could have been a worse injury? If you didn’t have decent enough health insurance, and I’m not gonna make any assumptions about how great your health insurance is because we’re both self-employed here, but decent enough health insurance, that’s not so much of a factor that you already had an established relationship with a physical therapy person, so that having to research and find. do I need here? What does support even look like? You already knew that because you were already familiar with this injury, but my clients who don’t know that and are trying to answer. An injury question or a medical question, or even a mental health question. When we talk about doing other work, my clients who need to do trauma work, some of the hardest steps involved are finding a professional that they click well with because that’s so many steps and one that takes their insurance adding complication to the equation.

Again, every step of the way where you had support an absence of support, not only makes it that much harder, it throws up barriers that mess with our ADHD that might prevent us from getting the help we need at all.

Cam: Yeah. And to, speak to the healthcare piece is that my spouse is a nurse practitioner at a large teaching university. Right. And so one of the things that we have is excellent healthcare. but recognizing that, there are compromises and challenges in other areas to make that happen, there’s limited players in, in town where she can do her work as a cystic fibrosis, pulmonary nurse practitioner for children. there’s certain things that are in play there. And if you change any one of those factors, then it changes my immediate experience. So just this coming back to that study and these areas we’ve always talked about like doing your work. And so again, this sort of interplay of just came front and center for me, this interplay of this other thing that. So immediate and so debilitating. So to answer your question earlier about like, how did the ADHD come into play with the back? I’ll tell you it came into play in a couple different ways first and foremost in how the back really.

Limited my ability to do my self care activities. So I like to bike. I like to walk. I like to hike. I like to exercise and move and it’s not just about the exercise. It’s about my mindfulness practice is a moving practice. I am mindful. I cannot sit still and be mindful. I get present and curious when I am out in the woods, walking out in the woods, riding my bike that was taken away from me.

So immediately one of my primary bandwidth management tools has been removed. my ability to generate dopamine has been taken away from me. That’s number.

Shelly: And here again, another ADHD hurdle, because you have the awareness to know what these supports are for you and what they do for you. Well, So you’re coping with an absence, but there’s an awareness of that absence. I’ve had clients who come through my door with very similar stories. Something happened that derailed a practice, but the thing is, is they weren’t aware what that practice was doing for them. They weren’t aware how that practice was supporting particularly a physical practice beyond just physical health, into executive function, ADHD and mental health. And so something happened injury or otherwise that derailed that practice, and it just doesn’t come back. That episode was years ago or not years ago, maybe years. I don’t know. How long have we been doing this now, Cam? Could have been years ago.

Cam: We’re coming up on three years in November Shelly, three years.

Shelly: Years ago, at least I’m sure at this point, where I talked about the client that came to coaching overwhelmed by her to- list, just a complete frenzy. And the end result of that coaching session was. Rediscovering this missing practice of being in nature, hiking and meditating. She didn’t need me to help her organize her to-do list. She needed to reengage with a supportive practice that she didn’t fully understand how it was supporting. How does a hike in nature helped me deal with my overwhelm? Well, for that client. It puts her in her own language, in a place where her brain is accessible to her in a useful way, but she didn’t know that.

So again, just kind of pointing out, you’ve done your own work here. So you’re, you’re missing these supports and that’s tough, but you at least know what you’re missing. Whereas so many of our newer clients, newer listeners, people who are not familiar with doing their work in this way, who haven’t cultivated a lot of individual ADHD awareness would have the consequences of the missing practice and wouldn’t even know. What they needed to get back on track.

Cam: There was another factor too, was that. I had a couple deadlines. I was wrestling this sort of two unwieldy projects. One actually is gonna happen, I believe this weekend, right? If this is dropping the 18th so on the 23rd, the, a. Global gathering and we’ll put it in the program notes I’m presenting on work and expectation.

Well, I’m here to tell you that, trying to wrestle my big idea generator into a 15-minute PowerPoint presentation, Shelly, you know, that’s a struggle to begin with.

Shelly: Yeah, that’s tough on your best day.

Cam: So then I have this sort of tweaked back and it’s just like any little tiny movement. And then it shoots this pain up through my spine and down my legs. So I’m having to kind of sit still, and try to get through this process. And, and by the way, the people there are amazing. And the individuals that I’m working with John Hassell and his whole crew just fantastic, but just that kind of doing hard work. If it was a different kind of work where I was just doing my, the stuff that I typically do it wouldn’t, maybe it wouldn’t have been such a challenge.

I also have this large entity of a class that I’m doing by myself. And remember, remember this, I do best in collaboration. And so here I am doing stuff on my own. So it was a bit tax. But just that constant reminder, like it was enough of this distraction. And I think distraction is just not the appropriate word here because you know, you have a distraction and it’s, oh, something distracts me.

It was something more than that. Shelly. It was just so hard to cobble together information. Barley talks about this idea of playing with information to kind of take an idea, contemplate, play, kick around synthesize process. And you’re, it’s this constant handoff, right? It’s like you take something and you move it along in this process to distill it down into something that you can. That whole process was absolutely disrupted because every 17 seconds, this pinch of pain shoots up and all the things that I’ve gathered from my ALA carte and put on my little platter, half of them fall off just from this reminder of, oh, tweak, you know? so then I’m now frozen. I can’t move. When you see me, I’ve gotta move around a little bit in my chair, all the.

Take that for granted. Now I can’t do that. I’m just locked in. Like I’ve gotta be absolutely still anyway. So it just is like really weird how the a D D interplayed with the back and I can’t tell you exactly. Right. It’s a kind of a new experience for me. I can’t tell you fully what that is. All I know is, wow, it’s a big impact for me.

Shelly: I know you said it wasn’t distraction, but it does sound like there was this constant disruption by way of stab of pain. And again, some supports. Missing even though you are an inattentive type, you do move around a lot in your chair. I’ve been watching you week after week for three years. Now, as we record this podcast, when you teach, you’re very animated, right?

You speak with your hands. And so yet again, adding these restrictions and that persistent disruption. You start to get on a train of thought, you get a tweak and it’s pain. It’s real pain. can’t play with thoughts and be in your creative process when you’re in pain like that.

Cam: Right. And let’s just add emotional regulation, right? So there’s the pain, there’s that pain response. And then the emotional regulation of ah, Amit and then the whole narrative of you F up brother, how could you. Would it could have shoulda have, why did I lift that rug, you know, better. So it’s that, there’s the, the emotional regulation aspect on that. And it’s like, and then I kind of reel that in right. Reel in like, okay, come on, stay, stay with the game, stay, finish it out, finish it out. Where can I get to a completion point? You’re absolutely right. I think it’s that word of disrupt? There’s more than just a distraction. Right? I think of a distraction as something that’s like, oh, something got my attention. This is a disruption, a disruption of flow of thought of building constructing, developing, and delivering.

Shelly: Sounds like each tweet, maybe knocks you into the valley a little bit. That’s storytelling of how could I do this, that frustration of not being able to stay on task. Those very much sound like limbic brain valley moments to me, cam.

Cam: Yeah. No doubt. And, oh, by the way, like with COVID put me a week behind. So there’s that whole, time, piece of. I’m behind and there’s pressure here. Right. And I, can’t afford to keep dropping into the valley. I can’t afford this right now, but what it did for me, Shelly above anything is getting back to this idea of, I have to be proactive with my back, right. that. these exercises are not just to mitigate pain, they’re to make my back stronger and I stopped doing them. And if I had continued to do them, I probably wouldn’t have tweaked my back. So I gave my wife. I give her uh, subscriptions, to awesome things I think are awesome. And she never used them and one of them was to yoga. And I bet it’s probably two and a half years old and I think, you know what I’m gonna do. I’m gonna walk into that place and I’m gonna take those sessions.

And even if I don’t take those sessions, I’m gonna sign up for some yoga or Pilates or some kind of body movement. Because again, it has to be proactive. My son was like, ah, really down dad. I’m like, why? He’s like, well, I’m almost 20, that’s halfway to 40. I’m like, brother, I’m almost 60 man. You know, And it’s like, wow, look, you know, anyway, so it’s like being there for my young kids 10 years from now, 15 years from now, 20 years from now, it’s just a reminder to me of this is something I need to be proactive about.

So goes to the next part of this whole idea of when the pain is not active. When we’re not feeling anxious when we are not feeling that old trauma we tend to tolerate, we tend to dismiss, we tend to downplay. And so, as Shelley said earlier to kind of be thinking about what’s that thing that is persistent in your life, that kind of puts bricks in your wall of.

And to take a look at it. And is there something else you can do to address it, to break the cycle of abuse, to do some work there, to do some couple’s work? If your primary relationship is not in a place where it can be to be proactive. To address the issue or these challenges that are exacerbating your ADHD.

That was the big learning for me now. Couple weeks, Shelly. I bet. you asked me about back pain and how you doing? Did you get to that Pilates class camera? What, what, what are you talking about? Right. So I gotta make a note here and get that down. But again, that sort of that tolerating, it’s like, okay, we just will tolerate and not see the impact of that negative thing.

I have a client who, when his back is tweaked, his mood drops and his ability to do anything, but the basics goes to near zero. But he doesn’t necessarily have the awareness of that until we bring it up in coaching. So back to this whole thing of cause and effect, getting to causation and seeing the impact of these things and how they play out.

Shelly: Cam really our whole show has always been about showing our listeners that your contacts matters and that cultivating awareness, not just about your own ADHD experience, but about all of your context and how ADHD is showing up in impacting is really the way to do this work. Whether you do it, listening to the podcast, you do it with a coach.

You know, I have clients that show up that have incredible amounts of self-awareness cultivated in any number of ways that spiritual practice. one of the indicators of flourishing, right? Big way. A lot of my clients cultivate awareness recovery is another one. I’ve had a number of clients in recovery, cultivating awareness.

We have always been on this drum beat of your context matters, but next season that’s really where we’re gonna dive in because in the past we’ve taken topics like time management or other hot button ADHD topics, and we’ve introduced how your context might be showing up. Next season, we’re gonna talk directly about context, how context varies with ADHD people, and why trying to treat ADHD people as an amalgam doesn’t work.

It does not work. If all we all had to do was get a planner and set a timer and show up a little sooner and take our medication.

Cam: That’s not it, Shelly that’s I thought really?

Shelly: no cam three years later, still not the answer. Uh

Cam: Yeah.

Shelly: But we’re just gonna take a slightly different perspective next season, instead of taking the behavior or the challenge first, we’re gonna go straight to the context and look at all of these different ways in which individual context can affect an ADHD person.

Cam: Like, what is it like to have ADHD and depression or ADHD and anxiety.

Shelly: Cam. Here’s one that I can’t wait to talk about with you, ADHD and PMMS because that is a tough thing for most of my clients who men ate. If not all.

Cam: Yeah.

Shelly: All right. So let’s wrap here and rather than going through the whole spiel people, here’s what I’m gonna do. It’s time for a new review. The last one was posted in May.

Cam: Yeah.

Shelly: You can do it. We believe in you. Drop a review wherever you listen to the show, those really help us out almost more than anything else you could do.

We’ll see you next week for one more episode. And then, like I said, we’ll be on summer break, but don’t worry. We’re gonna rerelease some old handpicked episodes for you to listen to in the meantime, if you are somebody caught up and listening in real-time. So until next week, I’m Shelly.

Cam: And I’m Cam.

Shelly: and this was the translating ADHD podcast. Thanks for listening.

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Episode 137