The Biggest Challenge in ADHD Treatment — Transcript

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1. 0:00The biggest challenges in ADHD, in my
2. 0:01opinion, are not the first-level
3. 0:03challenges. They're the challenges that
4. 0:06we layer on top. If you look at the
5. 0:08comorbidity between people with ADHD and
6. 0:11depression, 3% of people who are
7. 0:13diagnosed with depression will grow up
8. 0:15to have ADHD. 70% of people with ADHD
9. 0:18will grow up to have depression. So,
10. 0:19this is how this goes. I forgot my
11. 0:21birthday card. That is a problem in and
12. 0:22of itself that could be fixed. Then our
13. 0:24mind does something kind of interesting.
14. 0:26I've forgotten 7 years in a row. So, not
15. 0:29only do I forget my friend's birthday
16. 0:30card, now my mind is keeping track of it
17. 0:33and it is making me feel worse. Treating
18. 0:35ADHD is not just about time blindness,
19. 0:38suppression of bodily sensations,
20. 0:40executive function deficit, emotional
21. 0:42dysregulation. It is also about the
22. 0:45consequences
23. 0:46of living with those things. I'm an
24. 0:49idiot. I'm unreliable. I'm this. I'm
25. 0:52that. We have the first layer of primary
26. 0:54symptoms and then we layer on top of
27. 0:57that things that are harder to beat. And
28. 0:59here's the tricky thing. If I start
29. 1:01someone on stimulant medication, it only
30. 1:03works on layer one. Doesn't really work
31. 1:05on layer two. Works on layer two maybe a
32. 1:06little bit because it regulates my the
33. 1:08amount of guilt that I feel. Reduces the
34. 1:10activity of my guilt circuit in the
35. 1:12brain. But it doesn't change my sense of
36. 1:13identity, which is why I really love,
37. 1:15and this is what really confuses people,
38. 1:17psychotherapy is equally effective to
39. 1:19medication. Works the same. Effect size
40. 1:21is the same. When I work with patients
41. 1:23with ADHD, I like to do psychotherapy
42. 1:25with them as well because we have to do
43. 1:26this identity component. You're not a
44. 1:28bad friend. You're not a bad person. You
45. 1:30have this problem.