Done with Dieting Episode #97: ADHD in Women with Paula Engebretson

There is a growing awareness around ADHD and that it is not just for little boys in school who can’t sit still and get in trouble and stuff like that. It’s for all of us. And so, I think there is this growing awareness which I’m so, so delighted about. We have that and people are starting to go, oh, it could be me. I resonate with this. And so, I think that’s part of it.

But then also, we have a lot of young girls who are overlooked in the diagnosis process right with in the school age when it’s usually coming up. The reason why this tends to be the case now is that this is a generalization but often, you will see that young girls will be diagnosed with ADD. It was called ADD which is now called the inattentive type of ADHD. And boys would be diagnosed with ADHD which is now the hyperactive type.

For the young girls who have the inattentive type, this is where they tend to be more of the daydreamer. They’re kind of off in their own world. They’re delightful to be around. They might be a little bit quote unquote spacey, right? It’s this type of stereotype that you might see in the media and things like that. But it’s often overlooked in the classroom, right? But she’s so nice, she just needs to apply herself a little more. She stares out the window sometimes. But for teachers, the ones staring off in the distance, that’s not their quote unquote problem. Their quote unquote problem are the kids who are running around the room screaming and blurting and distracting everybody.

You are listening to the done with dieting podcast. The podcast for women in midlife, who are done with dieting, but still want to lose weight and feel good in your clothes.

You know that diets don’t work long term. But you feel like there’s this secret that everyone else knows that you just haven’t figured it out yet.

I am your host, Elizabeth Sherman. And I’ve helped hundreds of women get off the diet roller coaster, change their relationship with food, exercise, and their bodies.

Through this podcast, my goal is to help you too.

Welcome. Let’s get started.

I have a few questions for you. Do you describe yourself as impulsive? Maybe you have trouble staying focused on tasks that seem like other people can do, but for some reason you just can’t follow through. Or if you get interrupted, do you have a hard time getting back on task? What about organizing yourself or managing your time?

Perhaps you’re an all or nothing thinker, struggle with black and white thinking, or maybe you just need a lot of time switching between work and home.

Now, although anyone can struggle with any of these things that I’ve just described. My guest today, Paula Engebretson is a coach for folks who have ADHD or who have recently gotten an ADHD diagnosis. And she helps her clients reframe how their brains work, and then teaches them tools and processes that can help them to work with their brains instead of against them.

Now, I have to tell you, I suspect that I have ADHD and much of my motivation for having Paula on the show was completely self-serving. So that I could understand if I in fact have ADHD. But also, I have several clients who I’ve helped in the process get the diagnosis. While we were talking, I had so many light bulb moments. And what’s fantastic about that is that now I realize that I’m totally not alone and there’s help.

So, if you are someone who wonders, why am I like this? What’s wrong with me? Tune into today’s podcast because it might just be that your brain is wired a little bit differently than others. And you’ve just never been taught how to work with it. So, without further ado, let’s get started.

Elizabeth: All right everyone, welcome Paula to our podcast. So, Paula, introduce yourself. Tell us who you are, who you help, and all the things that you do.

Paula: Yeah, thanks for having me. My name is Paula Engebretson. I am an ADHD coach and I help people with ADHD, essentially release their perfectionism, and learn how to work with their brains to get things done.

We find ourselves often in this box, right? This neurotypical box that we think we should be able to fit ourselves in and get things done using all of these productivity rules and tools, and I help us decide. First, step out of that box and decide what works best for your brain to be able to get things done.

Elizabeth: Okay. Now, you just used a term that I think maybe many people aren’t familiar with. Which is neurotypical. Can you talk about that and what does that mean?

Paula: Yeah. That’s such a good question. So, neurotypical is essentially, the typical way that many people’s brains work. And as a person with ADHD, I would fall under the neuro divergent category. So, we have neurotypical brains, we have neuro divergent brains. And this isn’t a medical criteria or anything. It’s a way that people describe different ways your brain working. People who identify themselves as neuro divergent, typically, we learn differently. Our brains work differently than a typical neurotypical brain.

Elizabeth: Okay. And so, what are some of the things or areas that people who have neuro divergent brains, how are their brains different? How do we think differently between the two?

Paula: Yeah. Again, there aren’t any medical criteria, but there are kind of conditions and things that tend to fall under the neuro divergent category. So, you’ll find ADHD under there. Autism spectrum disorder, down syndrome, dyscalculia, dysgraphia, dyslexia, dyspraxia, intellectual disabilities. There’s lots of different categories of brains that fall under the neuro divergent. And I can’t speak to all of them. I’m not well versed enough in them, and the list continues. But it’s a different way that our brains work so that we can thrive in the world differently, I should say.

Elizabeth: Yeah. Well, this is the second time that we are recording this podcast, right? Because the first time I forgot to turn on the recorder. And when we were talking last time, you were talking about some different categories under executive function. And that was fascinating to me how the neuro divergent or how the ADHD brain works differently than the neurotypical brain. So, can you go over those?

Paula: Yeah. Thanks for reminding me. So, that is one of the differences for the ADHD brain specifically, when we think of neuro divergence. The ADHD brain specifically, we have our prefrontal cortex which is the front part of our brain. It houses many of our executive functions. I talk about it as basically all the areas of our brain that allow us to do successful adulting.

So, this is our ability to focus and maintain attention. It’s our ability to stay organized, right? With clutter and papers and that sort of thing. It’s time management and planning and being able to block out time. Or if you have a project coming up, can you break down how long it takes and all the steps that you need to complete to get to that final project.

We have emotional regulation or emotional dysregulation. We were often dysregulated. We feel our emotions much more intensely than a more neuro typical brain. We have cognitive flexibility, which is our ability to transition between moments and activities. I’ve been working all day, being able to just leave my office and be in home brain is very challenging. And to be able to shift between those things. And then, cognitive flexibility is also where we find perfectionist thinking, black and white thinking, all are nothing thinking.

And then, finally we have impulsivity, right? I talk about it as doing the thing, saying the thing, buying the thing, drinking the thing, eating the thing without thinking about future you, right? You’re doing it in the moment without that ability to pause and we’re just doing it on impulse. And so, these are the ways that I like to think about. Executive functions, you can talk about them in several categories. I talked about six. You’ll see ’em listed in up to nine. But that’s generally how I tend to think about it.

With a neurotypical brain, their prefrontal cortex is frankly, it’s more developed. The ADHD brains prefrontal cortex is underdeveloped. And so, they have less struggle with those areas that I just mentioned. But with an ADHD brain, it’s much more challenging for us to navigate those different areas.

Elizabeth: Okay. So, yeah. Can we go through these a little bit and look at them through the lens of our health? Is that right?

Paula: Yeah. Yeah. I love that.

Elizabeth: So, let’s start with focus and attention. What are some of the signs and symptoms that someone, how would we talk more about focus and attention, and how we would then apply that to our health?

Paula: Yeah. So, you can look at it through a lot of different lenses. And I should also back up and say as a whole, they’re all interrelated, right? They’re all talking to one another. They’re all impacting one another. So, if you notice as we’re going through things, you might think. But aren’t they similar? Don’t they talk to one another? Yes. Yes, listener, you are a hundred percent right.

So, with focus and attention, this can look like for example, being able to stay focused on a conversation without your mind wandering off and drifting away. It could be reading something and being able to comprehend, right? Short term memory retention is very challenging. So, you might read something and then not even remember what the top of the page read.

It can be being able to sit still and watch a movie. I don’t know why movies are ever longer than 90 minutes. They shouldn’t be. I can’t sit still for that long, right? So, there’s lots of different things. It could be let’s say, you’re working on something boring at work, and so you just can’t maintain the focus on it. You’re jumping all over the place.

I think about that as well with health and that sort of thing is a long term focus of being able to stick with it and follow through on the plans that you’re creating. I think about with like meal planning and that sort of thing or the specifics. I’m not sure how all of your clients and your listeners do their food planning and all the specifics of health, but it can be very detailed. And it can be challenging to read it, and understand it, and comprehend it, and know it when it gets really detailed. And sometimes we can slip into overwhelm and be like, I don’t know, it’s just too hard. I don’t get it.

So, that might be a space where the focus and attention might come in too is too much information to take in and process all at once. We can’t maintain our focus, and then it slips away. Unless we’re in hyper focus where we’re all in and can’t think about anything else. But that’s not what we’re talking about right now.

Elizabeth: Okay. That’s really fascinating. And I don’t know how you do your coaching, if you do goal oriented coaching, or habit based coaching, or something else. But I know that with my clients, I do work a lot with goals. And what will happen sometimes is that we’ll set a goal, and when we check in the following week, they’ll say, yeah, I did it the first two days and then it just fell off. Might that be an example of that?

Paula: Yeah. And I want to be careful here too. This is also a perfectly human thing to do, right? So, if you’re resonating with a couple of these, that doesn’t mean you have ADHD or anything. If you’re resonating with most of it, then that’s something that might be a little bit different. But yes. And then also, I’ll just throw it in as an aside is that a lot of us with ADHD have a lot of thoughts about goal setting. Because we are people who never follow through, and I always drop the ball, and I can’t stick with it. And so, we tend to have a lot of thoughts around goals.

And then, also just the memory and the ‘oh, yeah, I did it for a couple days, and then I totally forgot about it.’ Like, I just forgot to do it. Or it took too much concentration for me to like meal prep, and put the things in the containers, and figure out, and cut the vegetables and do the things. Or I got really bored with the same workout over, and over, and over and I didn’t have enough stimulation. And so, I just like me, I kind of stopped.

So, you can come at all these different angles where that might come into play. Does that make sense?

Elizabeth: Yeah, absolutely 100%. Last time we talked, I had so many aha moments in my own lack of diagnosis, but I think I have ADHD. And what you just said at the beginning of the explanation about focus and attention of reading through a paragraph and forgetting what you read at the beginning. I was diagnosed with dyslexia, and I think that that was why I was diagnosed that way is because I had really a lot of trouble with reading comprehension because reading was boring to me. It was just words on the page. And it’s amazing that today I am an avid reader, and I don’t know how that actually happened but as a child, I really struggled with that.

Paula: Yeah. And it could be too you’re reading what you actually enjoy reading now. As opposed to when you’re younger, you’re given the textbook and you just have to read. And now, when you’re able to choose what you’re reading, that makes a big difference. Because again, another big shift with the ADHD brain is we have a lack of dopamine in our brain, right? It’s less than a neurotypical brain.

And so, if we’re doing something boring, it feels even worse. Like, it’s really hard. It’s physically painful at times. When you can read something that’s enjoyable, that’s actually providing some stimulation, it feels good for the brain as opposed to having to read something really dry. I was a professor before I was a coach and I sometimes have to read these theoretical texts or these articles that were just so boring. And I’d have to read ’em five times cuz I couldn’t remember what I read. So, yes. To that, that makes a lot of sense.

Elizabeth: Awesome. Awesome. Okay. And so then, organization. So, this totally makes sense. Just to back up for a little bit. The different categories of executive function that you went over, the ADHD brain does not necessarily look the same, present itself the same in every single person. Yeah?

Paula: Correct. Yep. So, we all have different areas of strengths, different areas where we have more obstacles, it’s more challenging. I might have a hard time with cognitive flexibility, which I do. transitions are not my sweet spot, but you’ll find lots of other ADHD brains who are like, What? I roll with the punches, not a problem.

And same with organization or planning. If planning and a calendar that is my jam, I love breaking things down. For other people, it’s like a nightmare. So, yeah. There’s strengths and areas you can tap into and lean into. And that’s where I love to figure out how to work with your brain to make these things work. So, yes. A hundred percent, no two ADHD brains are alike.

Elizabeth: Yeah. Okay. So, organization. Of course, when we’re talking about health, if we’re not organized, that I imagine just lays over time management. Because if we’re not organized, then we’re wasting a lot of time. Yeah?

Paula: Yes, a hundred percent. And when I think about organization, I tend to group like organization is the overarching thing. And then, we have organization of stuff and organization of time, right? So, I think of it in that way. So, with organization of stuff, that could literally be, where is this stuff in my pantry? I know, I got the groceries. I know, I went. Where the heck did I put them? Or maybe I left them on the bottom of the cart and drove away or whatever. So, there’s that component.

And then, also there’s an actual sequencing component of like step 1, 2, 3, 4, 5. And yes, we have recipes and things like that. But there’s a whole process before you even get to the recipe of getting out the ingredients and having the right pots and pans and like the enough time and that entire process can feel very overwhelming. Cuz we’re like, I don’t even know where to start. I have no idea. And so, we don’t. And we just don’t even begin.

So, we have the organization of stuff and then to your point, we have the organization of time. How do we make enough time? I’m running out of time. Many of us are time blind. For myself, I’m like, I don’t know if it’s been five minutes, I don’t know if it’s been five hours. Who knows. Or when I make a plan, I’m like, should probably take 20 minutes to write a book. It’s outrageous. Everything in my mind I think should take 20 minutes.

When you have a brain that doesn’t comprehend time is to be challenging to oh yeah, I’m going to make these healthy meals or I’m going to prep these things. Both those combine the organization and the time; it can provide an obstacle. I’m telling you, meal prep is one of my challenges, for sure.

Elizabeth: Yeah. Well, absolutely, it really is. And for all of the listeners and for you, when we talk about meal prep, I’m not necessarily a fan of making everything and putting it in the pretty like Tupperware container so that you’re eating the same thing every single day. I like doing minimal prep, so that when it comes to making your dinner, it just makes it easier. So, it might just be cutting the vegetables up, so that when it comes time to cooking, you just have to dump and heat, right?

Paula: Yes. What I finally got on board with is so like I can put some beans in the instant pot. I can boil some eggs in the egg cooker. I can roast some vegetables, and then I can mix and match when I feel like making food. So yes, I agree.

Elizabeth: And here’s a little tip for you and for the listeners that when I was on my journey, I loved Rachel Ray. I would watch her television show.

Paula: I did too.

Elizabeth: She really taught me a lot about flavors and things like that. And so, one thing that she used to say a lot which you’ll resonate with is need it twice, cut it once. So, if you need onions in two different parts of your recipe, you cut them all at once and then reserve the ones that you don’t need. And so, how I’ve applied that to other parts of meal prep is for things that take a long time like cooking beans, or cooking rice, or cooking anything that I don’t necessarily need a lot of. I will cook a lot of it and then I will freeze it, so that I don’t have to go through that process later. And just to your point of I can then reuse that later on.

Paula: I love that I had forgotten because my memory sucks. But I love that so much and I think about how wonderfully appropriate that is just for the ADHD brain way of life. If we’re doing it, we might as well do, get it done, and have a backup for the next time we forget. And it’s not a problem. I just think that’s brilliant. I love it.

Elizabeth: Exactly. And there are tons of things that freeze. Like I made soup. And so, I ate what I wanted, froze the rest so I didn’t get sick of it.

Paula: Yeah. Love it.

Elizabeth: Awesome. Okay, next one. Organization, I think about like my clients who procrastinate also. Now, is organization part of procrastination or is that something else?

Paula: Yeah. So, procrastination I think is a result of a lot of executive functions that are getting challenged. Procrastination, I think we’re not getting started. It’s part of task initiation, getting started. So, we bring in cognitive flexibility, right that transition of transitioning into the process of work.

But then, we also have the emotional dysregulation piece of feeling confused, or overwhelmed, or dread, or annoyed that we have to do the thing. And so, we have that piece coming in as well. And then, if it’s not organized, if we don’t really have a plan if we don’t have enough time for it. That can add further to like, well then what’s the point of even starting because I probably don’t have enough time.

And so, procrastination can result because we have so many obstacles that we’re up against with emotions, with time management, with transitions, with organization. It’s like, well, no wonder. It’s hard for us to get started. We’re climbing a mountain in flip flops, it’s a challenge.

Elizabeth: That is so amazing. Yeah, because there are times when I know that I have plenty of time to do something, but in my brain I’m like, well, I can’t possibly do that because I have this other thing that I need to do later. And so, I don’t even start on the first thing because for some reason I’m stopping myself before I even start.

Paula: I call this getting stuck in waiting mode. It’s like, oh, well the worst is when you have somebody, the cable company will be by sometime between eight and five. I’m like, Great. Well, then I will not do anything between eight and five until you get here because my brain can’t shut off because I’m in waiting mode.

Elizabeth: Right.

Paula: Yes, I hear that. Yeah.

Elizabeth: Okay. So, I’m not unusual in that respect.

Paula: No, absolutely not. And there are ways if anyone else resonates with this, I set a lot of timers for myself. So, I’m like, okay, if I know that they’re going to stick with this example. If I know they’re going to be here within four hours, I’m going to give myself 30 minute projects that I can work on and I can sit down and work on that 30 minute thing.

If they come, I’ll write a note to myself of where I’m at and that can usually get my brain into, all right, we can maybe get started because these projects are small. Because I think another thing is if we’re trying to gear up into a big project, the brain’s like, Well, why even bother getting into it because somebody’s going to just come interrupt me and I’m going to have to get started again. And that’s so hard. So, I don’t want to start because I’ll be interrupted. And then, I have to go through this.

And so, when we can have smaller increments to be able to grab onto it makes it easier for the brain to go. Okay, I can get started on that. Kind of similar to what you were saying of I can cut the veggies; I can do that. I don’t have to make an entire seven course meal, but I can cut some veggies and put them in the fridge.

Elizabeth: Well, and it’s really interesting what you just said in terms of getting interrupted. This past weekend, I went to Chicago to visit my family for my dad’s almost 90th birthday.

Paula: So fun.

Elizabeth: And to your point about everything takes 20 minutes. Like I thought everything would take 20 minutes to get around Chicago. No, it took way longer. I was late the entire weekend. But when I got back, that task switching that you were talking about. Like, when I’m at home from Friday to Monday, I can usually figure out what I need to do. But this weekend for some reason, whether it was just the switch in what I was doing and how I was thinking. But I really had a hard time getting back into what am I supposed to be doing this week? Is that normal?

Paula: Yeah.

Elizabeth: Tell me about that.

Paula: This is exactly the cognitive flexibility piece. Our brains are not flexible. We are inflexible brains. Many of us are, not everybody. But I’m the same way. So, if I travel, I now have a rule for myself and I need two days transition time once I get back. I can’t fly back and then start working the next day, that’s just a no. I need a day to figure out what day it is and then I need a day to get my routine back in place and then I’m ready to go.

We will see this challenge with the transition on the big and small scale. It might be somebody coming in and interrupting you as you’re writing an email, and then you can’t get back into writing the email because you lost your train of thought. But it can also be to your point, going on vacation. And some of us have a hard time getting into vacation mode because our brain’s still thinking about work.

But then also, getting back into our usual routines that we’ve worked so hard to establish, but we were off for a little while. And then, even on a bigger scale, you’ll see often kids going from summer into back to school mode, like that transition can be really challenging. Same with parents going from summer back to school. Those kinds of shifts on both the micro and macro scale can be really challenging for our brains. And so, when we can plan in some wiggle room, some flex space, and to have some compassion and awareness around it, can be really impactful.

Elizabeth: Yeah. Typically, if I was going on a longer vacation, I would’ve written myself notes of what I needed to do. But because it was just a little bit longer than a weekend, I didn’t do that thinking that I would be able to come back. What I hear you saying is regardless, go ahead and tell my future self what we’re going to be working on, so that I can get back into the swing of things.

Paula: Exactly. Because you’re taking care of your future self by taking a load off the executive functions. You’re like, hey, I got you. When you get back, you’re not going to have to think about this part. You just have to deal with flexibility, this transition which is going to be uncomfortable. So, you don’t have to think about what you’re actually going to do. You just have to soothe yourself through the difficult emotion of making this shift. But I’ve got you ahead of time. This is what we’re working on. You don’t have to think about that.

Elizabeth: Yeah, I love that. And going back to meal planning, I think that something that a lot of listeners right now are going to be struggling with. If you’re not struggling with it already is transitioning meals between seasons. Because when we go from summer into fall and then fall into winter, our tastes change and what we like to eat changes.

When we’re in summer, we’re eating salads, we’re eating fresh vegetables, we’re grilling, we’re loving all of those summer eating things. And then, when fall comes, we’re just at a loss. We’re like, what did I used to eat last year? And so, having a recipe book or recipes that you can pull from that you like season after season, that you can then retire, and then pull out again per season. That could probably be really helpful for them.

Paula: Yes. I love that. I think of it almost for people who live in cold weather states, right? You have your different wardrobes, and you pack them away for the summer, you put your winter stuff away and you pull it out and that sort of thing. I would think of it as kind of the same. And then, there’s always the fun excitement of like, oh yeah, these recipes. Or oh yeah, this sweater, I loved this one. To be able to pull that out again, that’s so fun.

Elizabeth: Yeah, I love that. Okay, good. So then, let’s see. We did organization, we did time management, and I love your idea of being blind to time. Yeah, because I totally get that. And what you said earlier about being hyper focused, it sounds like it depends on what your interests are. If you’re interested in something, then you’re going to be completely organized with it. You’re going to go all in, but if you’re not interested in it, that’s where we have a red light. Yeah?

Paula: Right. I think of it kind of like a light switch. You’re on or off. And you can’t control what that is which is very frustrating. And some people have learned to hone their hyper focus to get into it. But naturally, it’s challenging to be able to do that, this is what I’m going to hyper focus on even though I find boring and it’s death by paper cut. That’s very challenging.

So, yeah. Hyper focus, when you’re really interested or sometimes it might be there’s like a challenge, a puzzle to solve. And you’re super excited to be able to solve that puzzle. That’s really powerful as well. And this kind of all or nothing here that we’re talking about this kind of light switch component of we’re all in and we’re all out. This also plays into, like I said, that cognitive flexibility of the all or nothing thinking, the perfectionist thinking. I’m all in, all out. I love it or I hate it.

And this could probably tie into a lot when we were talking about goals earlier, to tie that back in. I’m terrible with this, I’ve never been able to stick with diets, or I’ve always had to do diets and I never stick with them. I can’t just eat intuitively. I don’t know, like I’m bad at that. All this kind of all or nothing thinking can slip in.

And I would imagine too, if this is coming out in the holiday ‘ish season time, you have your normal way of eating. But then, you go on holiday where you don’t have your usual food around, and it might be like all or nothing. Well, I can’t eat anything, who cares, I eat everything and then you feel terrible the next day or whatever. That all or nothing can be sneaky and show up in lots of different ways.

Elizabeth: Yeah. And as you were talking, I was thinking about, I was just reading a book, recently. And I can’t remember which one it was. But they were talking about our past selves and how many of us live in our past. Live according to what we remember and with good reason, right? That much of our future ability and what we can predict the future based on our past behavior. But if the past didn’t exist and we didn’t use that past evidence against ourselves, and we really only looked at our future, what could be possible for us?

I know that for myself, I’ve really spent a lot of time thinking about the future version of myself. It’s something that I work with my clients on. And I’m sure you do too. Is the future self-something that ADHD ‘ers think about less than neurotypical brains? Yeah, you’re saying this.

Paula: Yeah. That’s such a good question. And future self can be a powerful exercise, but especially with my clients in particular, who deal with a lot of perfectionism, and we’ve masked our entire lives to get by. The future self can turn into it Kara Loewentheil calls it the perfectionist fantasy, right? This perfect version and it’s impossible to get to this fantasy self. And we can start using it against ourselves as well.

Plus, ADHD brains, some of us can really struggle with visualization. It’s just hard for us to picture that and to get to that. We’re spinning in all the things around us. We’re like, I don’t know what’s happening in five years. I don’t know what’s happening in five minutes. And it’s hard for us to get there. And so, if we do future work, sometimes it’s like six months from now. Three months from now. How about next month? What do you think about that?

I talk about zooming in and zooming out. Like a camera lens where you zoom out if you’re feeling really overwhelmed. If you’re spinning about something, right? You can either zoom in or out to help create some clarity. And sometimes when you zoom out and you have the bigger picture, the details don’t seem so overwhelming. And then when you zoom in, like if you’re overwhelming, you zoom in, then we can go, okay, but I do know what I need today, right? I know what I need to do today. Or like I said, if you zoom out, it’s like, okay, well, all those things don’t actually matter because this is ultimately where I’m going.

And so, using that on both sides can help with that. But yeah, so with the future self. It’s a powerful exercise as long as we’re kind of using it for us in a range that feels accessible to the brain. And for each brain, it’ll be a little bit different.

Elizabeth: Got it. Yeah. I love that because sometimes we can get so hyper focused on, well this problem is really important to me. And it’s like, okay, but is it going to be important to you in five days, five weeks, five years, five months, whatever. And so, when we can look at the perspective of it, then that can help alleviate some of that drama.

Paula: Yeah.

Elizabeth: Okay. I love that.

Paula: And I’d imagine that’s the same too with eating and nutrition and that sort of thing of being able to zoom in and out of like, Okay, well what do you have control over today? Or if you’re spinning out about like the one meal or whatever it’s like, Okay, but let’s zoom out. Doesn’t really matter in the big picture that one meal. And being able to kind of zoom in and out in a way, whichever way is most supportive to make your picture the most clear in what you’re navigating.

Elizabeth: Yeah. There’s a phrase that I really love, which is ‘who you’re becoming is way more important than what you’re doing, yet it’s what you’re doing that determines who you’re becoming.’ And so, it’s kind of like that same thing, like this meal doesn’t matter, but do that same thing on a repeated basis and it will determine what your habits are.

Paula: Yes. I love that. I wrote down a note to myself and tried to remember how it fit in. So, what I wrote down was this idea of like containers of time. It might have been like the vision of like future self and stuff. If we have this vision of our future self and we’re having a hard time getting on board with that of five years out and I can’t think for future Paula five years. What I do like to think about are kind of I call it thinking in containers of time.

So, if we can’t think about how Paula is going to eat five years from now or whatever. How she’s going to move her body. Can I think about how she wants for the next 30 days. How does she want to move or how does she want to feed herself? Or for the next seven days, is she willing to try this? For the next two weeks, is she willing to try this? And like putting a container around it, gives the brain some kind of flexibility of oh, okay, we can try this. We can go all in, and we can reevaluate.

There’s like an out, if it’s not like forever, you have to do this for the rest of your life. Now, you might find you like it after that container of time and want to keep doing it. But using that can be helpful as well, if the future self feels too abstract or too far away for the ADHD brain, usually putting like a container around it might make it a little more accessible.

Elizabeth: Oh, I like that. Well, and the truth is that we can have ideas of what our future self is going to look like. Taking action on that will bring us towards it, but it’s going to change. Right? We never know exactly what the future is going to bring because things are constantly in flux and changing.

Paula: Yeah.

Elizabeth: And so, it’s being open to allowing that flexibility, which goes back to cognitive flexibility if we’re like hyper focused on. No, it has to be this way, then that could be a problem. I get that.

Paula: Exactly. Yep.

Elizabeth: Awesome. Okay, so let’s see, what else do we have? We have emotional dysregulation. Oh, that’s probably cravings and binge eating disorder.

Paula: Yes.

Elizabeth: Yeah?

Paula: A hundred percent. And in fact, there’s research out there that shows that. It’s a higher number of people with eating disorders or disordered eating who have ADHD. Especially, with bingeing eating. Because again, like when we’re lacking dopamine as well and if we’re not treated, we’re looking for it in different ways. We’re medicating essentially in different ways, whether that’s through food, or sugar, alcohol, different ways to self-medicate.

But yes. So, with emotional dysregulation, again, we feel our emotions more intensely than a neurotypical brain. We actually feel them more intensely. And for many people with ADHD, they cite emotional dysregulation as perhaps the most challenging part of having ADHD. We don’t really have that kind of pause of huh, here’s a strong emotion. Do I want to react to it or not? Does this warrant this level of emotion? We don’t have that pause there.

And so, it could be quick to frustration or anger or something like that. It could also be very sensitive sadness. That sort of thing. Like it’s not one type of emotion. It can also be very exciting, enjoyable, and the sort of thing which is beautiful. And then, many of us also navigate something called rejection sensitive dysphoria, which is this really intense feeling of rejection. Whether it is actual rejection. Maybe we went out on a date, and someone said, I don’t want to see you again. Or you break up in a relationship. Or it’s bad feedback from a boss or even constructive feedback. And there’s 10 positive things and one not so positive thing.

And we see that as like, I’m a terrible human. We really see this different layers of rejection in lots of different areas of our lives. And then, there’s also like the self-rejection of I don’t want to put myself out there because they might reject me, so I might as well reject myself ahead of time and not go. And then, we spin in the loneliness of no one else to be around me. And so, there’s an RSD that shows up in a lot of different areas.

So, with the emotional dysregulation, again, it’s going to impact all these different things that we’ve talked about because even things like confusion, right? If we feel really confused about where to start with food or we wouldn’t know we want to eat better. We hear that at all the places, but we don’t know what that means. And so, we feel confused or like we know that we want to follow this one plan and we can’t stick with it and we get frustrated at ourselves. We’re like, Oh, why can’t I even just get it right? Everybody says, this is the thing, and it doesn’t work for me. What’s my problem? And so, there’s lots of different ways that show up.

Elizabeth: So, my next question for you is what I’ve noticed a lot is that women over the age of 45 are really starting to get diagnosed with ADHD. And so, why is that? Is it just my impression or is this actually a fact?

Paula: Yeah. So, I absolutely love this question and I think that we can look at it from a lot of different angles and they all kind of play into it. The first is that I think there is a growing awareness around ADHD and that it is not just for little boys in school who can’t sit still and get in trouble and stuff like that. It’s for all of us. And so, I think there is this growing awareness which I’m so, so delighted about. We have that and people are starting to go, oh, it could be me. I resonate with this. And so, I think that’s part of it.

But then also, we have a lot of young girls who are overlooked in the diagnosis process right with in the school age when it’s usually coming up. The reason why this tends to be the case now is that this is a generalization but often, you will see that young girls will be diagnosed with ADD. It was called ADD which is now called the inattentive type of ADHD. And boys would be diagnosed with ADHD which is now the hyperactive type.

For the young girls who have the inattentive type, this is where they tend to be more of the daydreamer. They’re kind of off in their own world. They’re delightful to be around. They might be a little bit quote unquote spacey, right? It’s this type of stereotype that you might see in the media and things like that. But it’s often overlooked in the classroom, right? But she’s so nice, she just needs to apply herself a little more. She stares out the window sometimes. But for teachers, the ones staring off in the distance, that’s not their quote unquote problem. Their quote unquote problem are the kids who are running around the room screaming and blurting and distracting everybody.

It makes sense that those who have the inattentive type. And again, there are men who also have inattentive type. So, this is a generalization. But those who do tend to get overlooked. And so, I think that now that there’s greater awareness, people are catching this as well.

And then, finally, in addition to that for many of us who did not have an early diagnosis, I was diagnosed at 31. So, I had a later diagnosis as well. For many of us, we finally get to this, I call it this tipping point where all of our coping skills, all of our strategies just don’t work any longer.

We have all of these systems that we’ve just figured out and developed and put into place. Mine was I just worked really hard. I worked really hard and then I was a people pleaser so that I could smooth anything over, and I would be buried. And I didn’t know I was doing this. This is just how I made it through grad school, and I made it. You know that sort of thing.

And we all have these tipping points where things get too challenging, and our executive functions can no longer keep up with our coping skills. For some people that might be leaving high school and going to college. And now you have to actually do all this adulting on your own without support to help you remember these different things, and make sure you get to school, or to work, or to whatever.

For others it might be when you have children. And now, you have to not only take care of you but other little humans around. And now, your executive functions are extra challenge, plus you have no sleep at all. And so, that becomes more challenging, right? For me, it was at the end of grad school, I started my postdoc, and it was all over. I couldn’t keep up with the reading. Or it could be, I should say, a new job, maybe it’s a promotion, something with more responsibility. That sort of thing.

But then also, to your point around the 45 to 50, that sort of thing. This is often when we’re nearing menopause, right? That changes there and our hormones are all over the place and our estrogen levels are dropping. And there are some fascinating studies about the correlation between when you have your drop in estrogen levels. There’s a big impact on our ADHD symptoms, and they really come out much stronger.

Because again, our hormone levels have completely shifted, and I should say for people who do have regular cycles, a monthly cycle. You can track this even in each month. Like my final month, I got nothing left. Which is actually this week or this final week, which is why I’m a little bit spacey. This I usually got nothing in the tank. It’s more foggy.

And so, on a smaller scale for anybody who does have a cycle, you can track that and notice because again, your estrogen levels take a nose dive that final week. And then, when you’re nearing menopause, it takes a nose dive for an extended period of time. That really impacts your symptoms come out much stronger.

Elizabeth: That is fascinating. Okay, so then is there any correlation between diet and symptoms, or exercise and symptoms, or how we take care of ourselves and our ADHD?

Paula: Yeah. So, I’ll start first with one that you didn’t mention, but I do want to just mention it which is sleep. Because I think that’s kind of part of a holistic wellness sleep. And you can take as much medication. Some people don’t used to medications. I am medicated. But it doesn’t matter how much you take or whether you’re medicated or not. If you’re not getting enough sleep, your executive functions are just already taxed.

So, that’s like number one baseline is to focus on that. Which is much easier said than done. I will say to anybody who’s like, What? Come on, you don’t even know. I know, believe me.

Elizabeth: I have so much to do.

Paula: Right. Exactly. Don’t even get me started on like revenge bedtime procrastination, all the things that we deal with. But in addition to that, yes. So, exercise. And especially, cardiovascular exercise can be really impactful with helping our ADHD symptoms. There are some studies actually that show that cardio can be the equivalent of five milligrams of Ritalin, right? It can really release enough dopamine and that sort of thing to create some clarity and create some focus. And so, that is one of the best non medicine ways of support are getting in your cardio. So, that’s really helpful.

And there are different things with food as well. There are studies about fish oil that can be really impactful. I don’t know a whole lot about food, enough to speak super knowledgeably about it. But I know that there is some great stuff out there and Ned Hallowell in his book, ADHD 2.0 does speak about this and more of a whole wellness thing. He talks about sleep and movement and that sort of thing. Which could be interesting for people if they want to explore that further. He also talks about the fish oil and that sort of thing.

But there are definitely things that can help in that way. Yeah.

Elizabeth: Well, and it sounds like potentially, ADHD is more impacted on our food choices because of the dopamine. So, it could be that yes, a healthy diet is helpful for the ADHD symptoms but it’s more likely that ADHD is impacting our food choices.

Paula: Yeah. And again, I’m not able to speak enough of our food choice is helping. I do think that research is there too which is absolutely, I love to see that. So, if anybody’s interested in that, do look it up. I just don’t have the resources myself to be able to speak to it well. But yes, and this is the impulsivity component that we were talking about with the executive functions. It can really impact what we’re eating, right?

If we go for what’s fast, what’s easy, what’s quick. Because we’re lacking dopamine levels, we go for sugar, we go for sweets, we go for carbs, we go for comfort. Like that kind of stuff that is quick and easy and feels good and solves a problem. Not a problem but solves an uncomfortable emotion more quickly.

And so, yeah. That can impact because of the impulsivity and not being able to stop and think about future, us. And we’re like, meh, current ‘me’ wants this pretty bad, let’s just go with that.

Elizabeth: Yeah. Okay, I have two more questions for you. One is how would someone go about getting diagnosed and what’s the advantage to doing that?

Paula: Yeah. So, I would say first, if you’re resonating with any of this or if you’ve been thinking about or you’ve heard about is to do a little bit more research first. Only to give you further information to bring to your doctor or whoever you go to, which I’ll offer some suggestions there too. But do some research first.

There are some great things online with look for adult ADHD symptoms and your audience is primarily women. So, I would look for women symptoms with adult ADHD. Because again, people present a little bit differently, not always but generally. And so, when you can look through those lists of symptoms and find that you resonate with most of them. First of all, that’s I think really confirming and affirming for ourselves.

But then, it gives you language to bring to your doctor or your psychiatrist or whoever you go speak with, because they’ll ask you a bunch of questions. And if you haven’t given yourself the space to think about it and identify how it showed up in your childhood. Because again, with ADHD it’s something that we’ve had since we were young, right?

And so, they’ll ask about how did it showed up when you were little and when you have these resources to be able to bring with you. I tell my clients to literally print it out and bring it in with them and go through it with their doctor. That can be really impactful.

And I would also offer to your listener that if they really resonate with the tendencies and the symptoms of ADHD to trust your gut on that you will likely get pushback from doctors and psychiatrists. Not again, I’m generalizing here. But there has been so much new research out there on ADHD and it’s very challenging for people to have to keep up with all the things all the time.

And I think that we are in a moment right now where we want to educate ourselves so that we can bring that information in. And so, that’s the first part is educate yourself, know the symptoms, know what aligns. And then, from there you can go to your primary care and talk with them and let them know what’s going on. Depending on if you have insurance and how that works, it might be that they refer you to a psychiatrist who could do a diagnosis process. Especially, if you want to go with a medication route.

And like I said, I do use a stimulant. Some people don’t like to, there are non-stimulants, right? There are all the things, but if you want to consider medication, that is the route that you would want to go. But you could go do, you know, a full psych evaluation as well.

So, there are lots of different options. I would start with either if you have a psychiatrist, or if you’re working with a therapist, or someone like that talk with them about the next steps or your PCP, your primary care. That would be a great place to start and bring in the resources that you have so you can talk with them about what you’ve been experiencing.

And then, in regard to your question about, why? Like, why would we want to do this? So, first would be medication. Medication can really be a game changer for many people, not for all people. Some people don’t like it, some people it doesn’t actually work. It just doesn’t work with their system. Some people have other reasons why they don’t want to but if you’re a person who’s like, yeah, I would love this support. That’d be great. Then, having a diagnosis, that’s the first place to do that or the first step.

In addition, I think that there is just this kind of acceptance that comes with or if you work toward acceptance. But this kind of aha and so many things start falling into place when you get this diagnosis and you go, oh my gosh. That’s why it’s been like this. That’s why it’s been a challenge. That’s why this is that way. That’s why I always do it like that. And it’s like so many ‘ahas’ and it lets us go, oh, there’s not actually something wrong with me. This is just the way my brain’s wired. It makes sense now. Right?

I know for myself for the first 31 years of my life, I was like, oh, I guess I’m just too stupid. I can’t keep up; I can’t remember stuff. I’m too emotional, I’m too much, Right? All of these stories, because I didn’t know. Oh no, I just have emotional dysregulation and I have a really bad memory because of my executive functions. There’s something wrong with me. And so, that’s really powerful as well.

And then finally, the other reason why I think it can be impactful to get a diagnosis is if you’re in some sort of a work situation where you might need accommodations. That is another thing, right? When you have the diagnosis and you can bring that in, it’s a disability. So, being able to get the accommodations. Or if you’re you in school, if you’re going back to school, that sort of thing, needing extra time, or whatever those accommodations can be really impactful because we need them, right? And why not use what we need so we can thrive.

I think in our call or the last call that we did, I used my analogy of my glasses. So, I’m blind without my glasses, but I’m not like, ugh, I suck at life. I’m a bad seer. No. I just put all my glasses on and I’m fine. It’s not a problem. And I think the same is true with oh, I just need some more scaffolding for my brain, or I use some medication. Ideally, we use both, right? Or not. I don’t mean it that way. I don’t mean ideally, we use meds. But ideally, we use the supports you need for your brain to be able to thrive in the way that you want to.

Elizabeth: Yeah. So, you mentioned that you are on medication. And so, I can only imagine that there are different meds for the different types of ADD, right? And that certain meds will help with certain executive functions and others won’t.

Paula: Yeah. So, it’s really a trial and error process for and like if I take one type of medication, if you took the same type of medication, it might show up completely different in you. It might perform completely different. We could take the same level of dosage and depending on our body’s ability to metabolize and not like metabolize with food, but with drug. We might burn through it way faster and so we need like an extra dose or whatever.

And some people’s bodies don’t respond to stimulants. They do better with a different type of medication. So, there’s no like one quote unquote best medication or whatever. It’s really like finding the one that fits best for you. For me, it was the trial and error for a while that I worked on, tried different things with my psychiatrist for quite a while and then we got it locked in and it’s been the way for years now. So, it’s just kind of this process of figuring out what’s best for you.

Elizabeth: Yeah. Okay. So, let’s switch then a little bit to how you help your clients. Like in just hearing you talk over the past hour, I can only imagine how valuable reframing A D H D is as far as transformation in some of your client’s lives. Because I know that one of the stories that I have is that I am inarticulate. And I know that that comes from ADHD or me dropping my words and being unable to find words.

And so, I’ve made up this story or I made up a story when I was a child that I was inarticulate. And as a result, I have had this story that I have to prove myself and become more articulate, get all of the certifications and all of this stuff in order to prove that I am a good coach or a good employee or whatever it is. To be able to just reframe all of those stories that we have as kids and help us to put all of that together, makes sense. And then, come up with strategies to help us be more productive without the struggle is so valuable.

Paula: Yeah. And the way that you just described it is spot on. And the first thing that I do with my clients is we start uncovering these stories. It’s really a lot of self-concept work of what have we believed for years, and years, and years about ourselves. And how do we actually look at that through the lens of ADHD and how does that fit in? Is it memory or attention? Is it time management? Is it time blindness, emotional regulation, whatever it is.

How does it actually fit in here and how do we want to think about this, right? If your best friend or if your child or whatever was coming to you with these same things. Would you be thinking the same story that you have about them? And really, being able to separate ourselves from these stories is so powerful because I think a lot of us especially before diagnosis, it’s like, well, I need to be fixed. This is a problem; I’m broken, I need to be fixed. And that’s just not the case.

Again, back to the beginning of our conversation, it’s just a differently wired brain. It’s all it is. We’re trying to fit ourselves into this neurotypical box. But we’re not built for that box. We have a different box. We don’t have a box. And so, it’s really like you said, figuring out the stories and then unwinding them and then deciding and rewriting the story that we want to tell.

And once we get to that place of acceptance and that place of like, okay, this makes sense. That is when we want to go into supporting our brain, right? Okay, so this is where we’re at. How do we want to plan? What’s a great planning strategy that works for you? Are you a person who likes a lot of structure and you want to have specific tasks at different times of day in a time block.? Or are you a person who likes more flexibility and you want to choose two or three things and you’re going to try and get them done by the afternoon.

And that feels really good for your brain. What level of structure feels good? How do we want to prioritize for you? What feels good when we think about prioritization? Cause that’s another challenge for our brains is how do we prioritize, what’s actually most important, right? And how do we want to navigate task initiation when procrastination comes in? What tools do we want in our toolkit here to help you? When do we often get stuck here?

And when we can do that with such a much more gentle lens and a more curious lens of, okay. So, it becomes like a puzzle of okay, so I know that this is the challenge for me here. This is task initiation. I know that it’s probably some cognitive flexibility. It’s probably a little bit of emotional dysregulation, probably a little time management, time scarcity. What can we bring in to help with these areas so that I can get started more easily? And same with follow through finishing things, completing whatever.

Yeah, the first step is really getting to that piece of acceptance. And then from there, building up our own toolkit to be able to do the things that we want to do in the world.

Elizabeth: Okay. So, how would they then build that toolkit?

Paula: Yeah. So, they can join my program. So, I do have a group program. It’s called, ‘We Are Busy Being Awesome.’ It’s a small group program and we work together to literally do that. I have a three part framework where we plan, act, complete. How do we create this plan that works best for your brain? How do we act? How do we take action on this and stop procrastinating? And then, how do we follow through on that last 20% that we just want to put off, or perfectionisms in the way, or imposter syndromes in the way.

And so, I worked together in these small groups and helped these individuals create their toolkits. They create acceptance and understand in this community and realize, oh my gosh, it’s not just me. And it’s like, I’m not just broken. We all have ADHD together. And then, we get to learn our own toolkits and then share. Because again, what works for one person might be brilliant for another. And then, somebody else brings something in and they go, oh, and this worked for me, and that can inspire someone else. It’s this really powerful small community of 10 to 15 people working together to work with their brains.

So, if you want to learn how to work with your brain, I’d love to have any of you join us and we’re busy being awesome.

Elizabeth: Awesome. And when does that start?

Paula: So, the next cohort will be at the beginning of 2023. The beginning of the year. And yeah, that’s when the next group will launch. But if people want to add their name to the wait list or learn more, they can head to imbusybeingawesome.com/group. Or they can check out the podcast. It’s ‘I’m Busy Being Awesome,’ and I talk about the group on there as well.

Elizabeth: Yeah. And it’s an amazing podcast. I have learned so much from you since I found you just a few months ago. So, I’ve been binge listening to your podcast and it’s really helped me. And I am so grateful for you being on the show today because I know that I have learned so much. And the awareness and understanding of what you’ve shared and how I can apply it to my own life has just been so amazing. So, thank you for being here too.

Paula: Oh, thank you for sharing this space. I’m honored to be here.

Okay, y’all. I cannot tell you how grateful I am to have Paula talk to you about ADHD, not only once, but twice. Now, the story is that I interviewed her last week and I forgot to turn on the record button. I was mortified. But Paula just rolled with it and explained that it was just part of the ADHD brain.

I hope that if you’ve been struggling with any of these issues that we talked about today that you explore getting a diagnosis. If not for going on medication which can totally help but doing it so that you can make sense of how your brain works.

And of course, I’m going to recommend that you listen to Paula’s podcast. It’s called, ‘I’m Busy being awesome,’ and you can find it pretty much anywhere. Or follow her on social media or consider joining her program. If you do, you might just find me in there.

So, that’s all I have for you today. Have an amazing week, everyone. And have an amazing Thanksgiving. I’ll catch you next week. Bye-bye.

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