The Collective New Normal with ADHD

Episode 180

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Ash and Cam continue to discuss the topic of disruptions in the context of ADHD. They reflect on previous episodes where they talked about daily hiccups and bigger life disruptions. In this episode, they explore the concept of the new normal all of us are facing, especially post pandemic, and the challenges it poses for those of us with ADHD. They address a paradox with change, where we crave novelty and spontaneity but struggle with unexpected disruptions. They also discuss current disruptions in the world today, such as supply chain issues and medication shortages.

Both hosts share client stories regarding the medication shortage, touching on the frustrations and the difficulties in obtaining prescriptions, as well as the impact on individuals’ executive functioning. They mention the importance of tending to one’s nervous system and finding ways to relax and reduce stress in order to navigate the constant disruptions of the new normal. Finally, they encourage listeners to take stock of their experiences and consider the challenges they have overcome over the past five years.

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Episode Transcript:

Ash: Hi, I am Ash.

Cam: And I’m Cam.

Ash: And this is Translating ADHD. This week we’re gonna continue the topic that we’ve been pulling on the last few weeks, talking about disruptions. Cam, you want to say a little bit more about where we’re going with disruptions this week?

Cam: Sure, Ash. So two weeks ago we talked about the daily hiccups, right? The little speed bumps that can feel like Jersey barriers. Last week we talked about bigger disruptions. We talked about a couple of your clients and having to go support a child in need and how that can be a disruption, but also an opportunity for change.

The term we landed on last week was this idea of pivoting to a new normal. And it can be, again, for a spontaneous bunch, it can be kind of challenging for us. This is one of those paradoxical things about ADHD. We crave novelty and we like spontaneity. But growing up something we’re not anticipating, and it can really take us off our game, offline.

And so this week we’re continuing to broaden the scope and look at disruption just in the world today, right? Disruption as the new normal. You think back five years or so, and just the difference it is between then and now. And we were just talking about all the different things that are struggles and disruptions from supply chain to meds disruption. +

And the thing that you said, too, and I fully agree with you on this, is how it’s really hard for us, those of us with ADHD, to have this awareness that we will often just in the words of a client I just spoke to, is we will diminish disruptions. We will downplay disruptions. So this is this whole understand, own, translate thing is that as we’re going along, for some reason it’s really hard for us to see disruptions to do the yours, mine, ours thing. Right. What’s in my control and what’s not in my control, and take ownership of that and then pivot to translating or creating change. So that’s what we’re gonna do today. We’re gonna talk about what’s going on in the world, people.

Take stock and step back and just consider: You think about a five year snapshot. Where were you in 2018 and where you are now, and how has disruption come into play? Right. We can go out to the existential element of, again, as you said, social and political tension in the world. There’s Ukraine, there’s drought in Africa and Sudan, civil war. And then on state-side here is, again, the challenges that we face. And it just seems like it’s a daily constant occurrence.

So then, listeners, what is the opportunity there? What can we do about this, given that disruption is a part of the new normal?

Ash: Cam, I have lots of thoughts about what you just said, but first I have to ask, what in the hell is a J barrier? I have never heard that term before.

Cam: Yeah, you’re a product of the Midwest.

Ash: I am. True.

Cam: Yeah. Jersey barrier – they’re the barriers that are concrete. They’re about three feet tall. They’re wide at the base, and they’re used to divide lanes on a major highway. They’re temporary. I believe they’re called Jersey barriers or Jersey barricades because they’re synonymous with the experience of driving on the New Jersey Turnpike.

Ash: Aha.

Cam: Right.

Ash: This is an experience I’ve never had, and one I’m not looking to have in my lifetime. I think I can live without that one.

Cam: That’s really fascinating. Now we talk about lived experience: I can’t imagine a world without Jersey barriers. So I guess that metaphor doesn’t really work, but the idea there with our episode two weeks ago, uh, these smaller disruptions, right? That can be like a little speed bump, turn into a larger speed bump. How about a larger speed bump? Does that work for you, Ash? Is that okay?

Ash: Sure, sure. Jersey Barrier works now that I know what it is. I have seen those before, to be clear, just never heard them called that. 

Cam: And also, you don’t have a young driver, right? So it’s sort of like you… 

Ash: Ooh, not yet, but… 

Cam: Yeah. I’ve got a 20 year old who likes to drive fast, and so I’m like, beware of the Jersey barrier, son. Oh, you didn’t think I’d pull that out, huh? The old pirate.

Ash: The pirate voice.

Cam: The pirate voice. So where we’ll start, it’s like one of these larger topics today and there’s a lot of different places to begin. Where I’d like to begin is, what’s going on where we will do this automatic diminishing, right? Discounting, downplaying of something that is a disruption or we are tolerating,

I’ll start there, is that I think that it’s that frog in the water thing, right? You turn up the heat and it’s like the heat comes slowly up, and it’s like we’re not really, you know, recognizing the change that is occurring. And so we have this fascinating ability to tolerate. Tolerate, you know, things around us, but then we don’t necessarily see the change that is happening, so that’s one thing.

Ash: I can’t tell you how many clients I’ve had in the last couple years who show up to a session, and they’re frustrated, and we’re starting to pick apart what’s going on. And then there’s this, oh, by the way, my ADHD medication has also been disrupted or changed due to medication shortages. I’ve had clients who recognize it right away as a challenge, but I’ve also had clients who sort of discount the impact that that might be having, and it’s really understandable that that happens. I did the same thing.

Around the time that I started hormone replacement, I had to switch from Adderall XR to the quick release version. So my doctor prescribed it twice a day so that I still had it over the course of a day. And I thought, okay, that’s gotta be relatively apples to apples, right? So as I started to struggle for a number of reasons, and we’re gonna talk more about that next week. I just wasn’t taking that medication change into account, and it was having a pretty significant impact. When I switched back, I really came to appreciate just how differently that medication worked for me than the medication I was on previously. That works better. It just works better for me.

And yeah, it was there. It was having a pretty big impact on my ability to show up and attend. It wasn’t the only thing, but it was there in the mix. And even with what I do for a living, even with the fact that I coach clients about medication when they’re curious about their experiences on medication, is it helping? Is it not helping? How is it helping? How else is it impacting? What do I like, what don’t I like? It just didn’t even occur to me, Cam. It just didn’t even occur to me that that switch would have such an impact. And it’s something so many people are going through right now, not just with ADHD medication.

I run into it with my HRT, too. I have other clients running into it with other routine medications where they’re simply not available, they’re just not available. And so then what do you do? And no matter what the answer is, it’s not an easy solve.

Cam: It’s not an easy solve, and I was just anticipating this topic today. I was checking in with a few of my clients, and they all had different experiences around the disruption. But one in particular had the same thing of this recognition of, oh wow, when they got back with their regular meds that were working, that was when they realized this really does make a difference.

And I’ve had that experience myself, not only with meds, but other experiences too where sort of correcting something to realize, oh wow, I have some functioning back I didn’t have before. And here’s the difference that made that happen. I wanna read one to you here. But you’re absolutely right. It’s like, I gotta back out for a second. The sense of, just to comment on what you said of, you know, here are these things, these types of disruptions that are recent, right? We didn’t have these meds disruptions, and so these systems and protocols, and you get into this routine with your pharmacologist and, you know, that rhythm of figuring out how to do it. And then all these different disruptions.

Where one of my clients was telling me if, you know, he couldn’t get it at one pharmacy, so he had to go to another pharmacy, but that script is not transferable. So he has gotta go back and chase his pharmacologist to get a script for that new pharmacy across town.

All of this is executive function demanding. These things, they’re so task intensive to follow up to, you know, keep looking for these different things. And that’s the real challenge. I’ll come right back to you. I just wanna read an excerpt from one of my clients.

“It’s frustrating that due to people using Adderall recreationally, the folks who need it can’t get it and are treated like drug addicts by the healthcare system.” This is one of my clients speaking…”plus making us amp up our executive functioning just to get the meds is a cruel joke. I shouldn’t have to call my doctor every 28 days to get a refill. They should auto refill, right?” This is sort of, again, this misunderstanding, this skepticism around this where it makes a real difference. So I appreciate that we’re talking about this particular disruption.

Ash: Cam, it’s interesting because the points that your client brings up that you have to manually renew, that you can’t transfer the prescriptions, that you can be treated a certain kind of way by medical professionals, be it the professional treating you, be it the pharmacist giving you the prescription. Those all existed. Those were actually the biggest complaints about ADHD medication prior to the pandemic. I remember being delighted when I switched from getting my prescriptions from a psychiatrist to my general practitioner, and he was able to do electronic prescriptions because previously I had to go to my psychiatrist once a month and pick up a paper prescription and then take that over to the pharmacy because of the way that the laws are written.

All of that is still a problem. I still have clients that have to deal with paper prescriptions when it comes to their ADHD medications, and now you have these shortages on top of it. And I will tell you my experience, calling pharmacies to see if they had my prescription in stock was not great. I was not treated well on the phone when I made those phone calls, so that added yet another layer of frustration.

And so what do you do, right? it’s a rock and a hard place thing with medication. Do you wait it out and go a few days without your meds? To get the medication that you’re on, do you call around like I did, which isn’t real fun either. And not only requires you to find a pharmacy that has the prescription you need, but then you have to get in touch with your physician to change that prescription over to that pharmacy. Do you change medications? None of these options are great. All of them are disruptive in their own way.

Cam: That’s a tough question to answer in that situation. Like what do you do? One of my other clients was talking about, again, this recognition of the role of medication. And he talked about how he was in his quadrant. One has all these work related deadlines that are impending. He’s like, you know, I can just elicit hyperfocus and crush this stuff, and the meds are great, but the meds, I use ’em for those long-term projects. The Q2 important, not urgent stuff.

So what he did was like kind of recalibrate and he just said the timing had as such that when my meds were disrupted, I was in my season, and we talked about seasons. He was in his season of really key completions. He was like, again, this recalibration, this awareness of, alright, the meds are helpful for this specific area of working on these long-term things that have no deadline. So we just saw that as a window and an opportunity.

Not the case for one of my clients who’s a writer and really counts on those meds to give him clarity of thought to sit down and generate pages. So he just had to really let that go for a bit and focus in some other areas. I’m enjoying this conversation about meds and I’d really like to pull back a little bit again, back to this idea of disruption as the new normal and how we downplay that. Right. How we downplay.

And I think this might be related, Ash, to green light planning. This idea of things will smooth out. Things will get easy, you know, it’s tough now, but in six weeks it’s just gonna clear out. That magical thinking. And I think we all can agree that we’re in this time of continual change where it’s always change.

And so you asked the question about like, well, what are we to do? And so, yes, we’ve gotta get creative. We’ve gotta really look at different ways to smooth out the rough spots, especially around medication, but also noticing how your nervous system is responding to this constant barrage of disruption. This waking up and not knowing what you’re gonna see in the news, and that I’ve been watching this in our classes. I’ve been watching this with clients. In order for them to have agency, they really start with tending to their nervous system needs. Quieting down that amygdala, quieting down that fight flight center, right? We can get into this sort of agitated state, right?

You talk about the crouched and hunkering down, waiting for, and I think we can do that for a period. But I think part of what Ash and I are talking about today, people, is that tension gets tiring, and we can’t sustain that. How do we proceed when this is the new normal? I don’t wanna be a pessimist. I don’t wanna be the minister of dread and despair, but just to help you in navigating going forward. When you’re in that crowd spot, the last thing you wanna do is try to breathe and relax the nervous system.

But that’s the interesting thing, is my clients who are kind of tending actively to their nervous system to, we talk about needs and zapping stressors. When they’re actively identifying stressors and zapping them, they’re able to show up more resilient and resourceful in the moment.

Ash: Cam, that’s spot on. That’s something I’ve found to be true for myself during this period of time, is just doubling down on self-care, doubling down on what fills us up, finding outlets for that stress that we carry around in our bodies. Otherwise, this is all just become so important. And as people with ADHD, that’s why we started teaching the self-care class is you and I both recognize that doing good self-care lays such a strong foundation to navigate all of this other stuff that we’re talking about over these episodes.

But for today’s topic, I also want to toss this in there: I don’t know if you remember this client, Cam. This was a group coaching client who wanted to do some writing, and she would get up in the morning, and she would set up her writing area. She’d be feeling really motivated to write, and then she’d sit down and lose it. She’d just lose the motivation. And what we found out when we coached about it is she would sit down at her computer, and without even realizing what she was doing, the very first thing that she would do is open Twitter and see all of the news, all of the bad news, even before the problems that Twitter has now. Twitter has always thrived on controversy. Controversy is what’s going to get a lot of response, and so it would just send her into a mood without her even consciously realizing. It would completely just crush that creative energy, and she’d end up moving from her desk to the couch, spending the day on the couch in a bummer mood without knowing why.

I tell this story because there’s a lot wrong in the world right now for a lot of people, and it’s not gonna get better anytime soon. But that doesn’t mean that you have to consume it all. News breaks, social media breaks, those are hugely important for me. Those of you that follow me on Twitter know that I’m not really tweeting anymore, and that unto itself is an act of self-care for me. It’s just not a great platform for me to be on right now. I just don’t need to see all of the news and controversy. And not just relative to me and being trans, but just in general, how messed up the world is.

As somebody who is so empathetic, it just puts me in a terrible, terrible headspace and one that’s really hard to recover from. So I keep at a very high level in touch with what’s going on so that I know. But I don’t otherwise engage with social media or the news anymore. That’s the decision. That’s right for me.

And again, I think so often as ADHD people we’re such binary thinkers. It’s like I have to know, I have to stay engaged, I have to be involved. I invite you to consider what the impact is on you. And by the way, maybe it’s not that big of an impact.

I have a client who is on Nextdoor, which is probably the worst app for a progressive person to be on if anyone has used Nextdoor before, and she finds it rewarding, in a way, to take on those views, to challenge people that live near her in that way. It’s a good thing for her. Or at least thus far to the degree that we’ve talked about it, seems to be a good thing for her. Something that provides some amount of reward. It does not do that for me and never has. So just kind of step back and think about the impact of like, what are you taking in on a daily basis?

Cam: Also along those lines is looking at motivation. I just think about your client sitting down to write and opening Twitter. I can’t speak to her experience, but I know lots of individuals who will sit with intention of doing something, and then they’re sitting there and unable to engage with the work they want to do. So they go look for something that will engage them.

And what happens to be something that cracks the door open to social media, right. Something to activate injustice. Right. Or just to have an emotional experience. But then it has us taken offline and, you know, just activates that default mode network in a way that isn’t helpful. Right. We are creatively and with imagination going to very dark places. And so this is about limits. This is about, right, as you said, like not going the binary route of I need to know more about this. You know, chasing those rabbit holes.

I’m thinking about two clients in particular. Just this recognition of agitated and off center and not getting their needs met. One was picking up her phone – we use our phones for a lot of different things – and she would just happen in a moment, just slip over to Instagram, right. Or somewhere else. And it’s just like realizing, oh my God, I’m just noticing how many times she picked the phone up and she said, you know, in the morning I’m not gonna pick up the phone. I’m gonna sit with my coffee and just have some quiet time. Start the day with my own thoughts and to consider about how do I want the day to play out. Not just, you know, in what you’re doing, but just to be with yourself, and not having all these external signals coming in.

And there’s another client as we’ve been talking here, she’s been doing some remarkable work. That this is someone who we would be talking and you know, on a regular basis, she would come with the world is against me. And it would be one week she’d be fine, another week the world would be against me and this victim and hurt. That sense of feeling the whole world. And we just started tracking that, of looking at, you know, what’s going on? What are the different things that are coming in? And so when she had a lot of disruptions and she was tuned into those disruptions, it really agitated her nervous system. Recently what’s happening is she’s like, they’re these inconveniences, but they’re not impacting her the way they used to.

So it’s like, let’s dig in here. What is going on? What you are doing that you are having a different experience in the same world. So couple things. One thing in particular, she’s like, I identify the things I’m worried about, things that are stressing me out. I’m writing it down, and I’m writing down from one to five the level of stress, and I don’t typically do this as sort of like to give up, you know, a strategy. But I thought this was really cool because she was really elevating it to, all right, here’s the thing that I’m thinking about anyway, put it down on the paper. Assign it a value of this is a five versus this is a two. There’s a sense of, okay, it’s a five. How can I address this in a way to make this not be a stressor that is putting me on edge, agitating my nervous system.

So as she did that, and one thing she noticed was I’m working in four different offices, right? She’s a traveling orthodontist. And so going around and doing this special work, it’s really tough. And traveling an hour and a half to these remote offices and realizing, you know what, it’s not worth my time to go an hour and a half to go where it might not play out the way I think it is. It’s knowis, they do the root canal thing, people.

So, what she did was come back to what do I want to have happen? I’m overextended. And dialing back the number of offices she was going to, dialing back how far she was traveling and really coming back to seeing her herself in the picture and identifying her own needs. But there’s this resilience that she was building through her self-care practices. It’s really interesting conversation today, Ash.

Ash: I agree, Cam, and I think that there’s so much more that we could say if we had the time, but we are low on time for today. Glad we did this topic today, right? All of these little ways, and we didn’t talk about all of them, but all of these little ways in which the world is just very different than it was prior to the pandemic that we often forget about, or don’t take into account, or don’t see how they’re impacting us.

You and I included in that picture, right, despite the fact that we do this for a living. It’s a tough world to live in right now, but I know for me, one of the things that keeps me going is I think our work is almost more important than ever. It’s really excellent for me to see my clients start to thrive in a world that’s harder to thrive in.

Cam: That’s a great place to finish up, and I love that: Seeing them thrive in a world that is harder to thrive in. Is that what you said?

Ash: That’s what I said. 

Cam: Yeah. Good stuff.

Ash: Well, thank you. All right, so listeners, if you like what we’re doing here on the show, one way that you can support us is by becoming a Patron. Our Patrons cover all of the costs of running this show, which Cam and I are so grateful for. And in addition to that, becoming a Patron gives you access to our Discord server where our listeners are working together to do their own understand, own, and translate work. To find out more, visit the website and click on the Patreon tab.

So until next week, I’m Ash.

Cam: And I’m Cam.

Ash: And this was Translating ADHD. Thanks for listening.

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