20: Diagnosing ADHD ft. Kelly Brändli

Kelly Brändli00:00:01

Hi, everyone. I'm Kelly Brändli and I'm today's guest on the So Frickin' Healthy podcast. I'm an ADHD coach and a relationship coach.I'm the mother of two boys with ADHD and the partner of a late diagnosed man. On this episode, we dive into the process of ADHD testing and diagnosis with a focus on adults who may be questioning their symptoms.We're going to discuss why so many people are misdiagnosed or under diagnosed and how that might be impacting you.

Megan J. McCrory00:00:30

Hi, Kelly. Welcome back.

Kelly Brändli00:00:32

Hi, Megan. Hi, Danna.

Megan J. McCrory00:00:34

Good to be back in the power of editing. Of course, we're still sitting here from last episode, but we're all fresh faced again.And this time we're diving into understanding the testing and diagnosis of ADHD. The last episode we talked about the basics of ADHD, especially with women and so on. So kind of a high level overview and this episode.So we're going to dive in not too long. Cause I don't think it's super interesting to have an hour episode on diagnosis, but I feel like it is definitely something that we need to cover.If someone is listening right now and wondering, is it me or is it ADHD? What is the very first thing that person needs to do?

Kelly Brändli00:01:20

I would suggest you go online and do an ADHD self test. That's where most people generally start. There's short versions, which I don't recommend, and then there's longer versions.There's a really great one linked on the ADHD UK website in English. If you go on there and go under resources, you'll find it and that's usually the best place to start.It'll give you an indication of where you might stand.

Megan J. McCrory00:01:47

Donna, you just did one, right? You and your husband did one. What was it like? What were some of the questions that they asked?

Danna Levy Hoffmann00:01:54

We did one for autism spectrum as well, so I might be mixing the two. There were interesting questions, like, typically in a meeting, do you get up when you should be seated?When everyone else is sitting down, do you need to grab water, open the window and shuffle the chair? That kind of question.There was another question about fidgeting with things, or do you often lose things like your wallet and youre he which I just death stared at my husband with that question because he cannot find anything ever.

Megan J. McCrory00:02:28

Kelly, Danna came over last week and we hung out for two days while my husband was out of town. We were talking a lot about ADHD and autism.What I've heard is that the symptoms of ADHD that we talked about in last episode, just briefly, hyperactivity, whether it's in your brain or physically outside yourself, or hyper focusing, rejection, dysphoria, these kind of things. A lot of people say, well, I get hyper focused, fixated sometimes, or I lose my keys sometimes, or I get fidgety sometimes. Do I have ADHD?Can you talk about how most people have some of these things all the time? And what makes that different for somebody diagnosed with ADHD versus someone who just occasionally forgets their keys?

Kelly Brändli00:03:16

So ADHD symptoms are normal human traits, right. When we look at executive function, which we talked about in the first episode, we all have the same eight executive functions.You might not have ADHD, but you might have trouble with organizing things and putting things in the same place every time. So you could forget your keys regularly. What makes ADHD diagnosable is having a certain number of these traits.So when we look at ability to focus and hyperactivity, you need to have five or more of each of those traits to classify. When we look at executive function, we're talking about people in the 96 percentile and above, which means you lose your keys.More than 96% of the population is how we would then diagnose it as ADHD symptom of that. Right.So if you're, like, in the 50th percentile, you might forget your keys more than your partner, but it's not impacting your life to that much of a degree. Part of the diagnosis criteria is it needs to happen for more than six months out of your life. It needs to impact your life in more than two areas.So it's not just at work, you're having trouble focusing, but you're also seeing it at home or with friends. So those are the criteria that differentiate an ADHD diagnosis from normal human traits.

Megan J. McCrory00:04:43

I heard a doctor, a canadian doctor, talk about it, and he said the difference is the impact on someone's life when it happens. So people who cannot stay in relationships, people cannot keep a job, people who run into financial problems or run into health problems.It's like, do you eat because eating is enjoyable? Of course, a lot of people have an ice cream because it's enjoyable.But do you have 50,000 ice creams and become overweight or have a heart problem because of the dopamine that you get from eating? I feel like that's a really good, simple way of saying that's the differentiation. Can you function?I really like that you gave it a number two of your areas in life where it impacts. Yeah.

Kelly Brändli00:05:27

Negatively impacts your life. That's what I was mentioning. In the last episode. This is the serious side of ADHD that I don't think the media is portraying.This does impact people's lives negatively. I've got a client right now, he's on his fifth marriage and he said to me, I dont understand why they never work. Thats painful to cope with.When you understand ADHD and how the executive functions play out, you think actually these are things that we can help with. Its unfortunate he didnt realize that through all these relationships that exploded on him because of the symptoms.

Danna Levy Hoffmann00:06:06

Maybe the 6th marriage will work now that hes working with you.

Megan J. McCrory00:06:10

There seems to be a growing trend, realization of ADHD, people with autism, people fitting together in relationships really well. I just want to put that out there as something to think about. I don't know if it fits in this particular episode, but maybe we can.

Kelly Brändli00:06:28

We can come back to that. There's a part of that we can talk about in terms of diagnosis of ADHD being like autism, a spectrum disorder.And we actually can look at ADHD almost on the same spectrum. When we look at autism, there's certainly different symptoms. But we used to have a diagnosis called Asperger's, which we don't have anymore.They don't use that term anymore. But people who got that diagnosis were often in between this sort of ADHD autism spectrum.We called them high functioning people of autism back then, which I think we don't use anymore because it's not. But that's how they used to define it.

Megan J. McCrory00:07:07

So that's the other thing that Donna and I were talking about last week. If everybody has a little bit of this ADHD symptoms, right?And maybe, you know, it's a little bit off topic, but autism is always, like you just said, a spectrum.Then do we also assume that kind of everybody has some autistic traits or is that not the same as ADHD in terms of being like, finding those traits in ourselves and saying when we.

Kelly Brändli00:07:37

Look at autism traits, people with autism often have difficulty with social interactions and eye contact, does that mean it's an autism trait? Not necessarily.When we look at the impact of autism, it's often, and that's why we've graded it differently now, there is a much different impact that we're seeing. So I don't think we can say in the same sense that autism is really those normal human traits like we do with ADHD.

Danna Levy Hoffmann00:08:17

Kelly, I have a question, because I got diagnosed 20 years ago, I am not as organized as Megan. All of our listeners know this as well, and I cannot find my diagnosis, let alone that it's in Hebrew, I was already starting to look into.Maybe I have to now get re diagnosed and all of that. And there are definitely some barriers. I wanted to ask you to prepare us for the worst.What are some of the biggest barriers that people face in getting diagnosed with ADHD, especially as adults?

Kelly Brändli00:08:51

One of the biggest challenges right now, and I think this is pretty much a global phenomenon, is the wait times. There are very few experts in this area that can do a proper diagnosis.In Switzerland, it has to go through either a psychiatrist or a psychologist working with one to get a diagnosis. In many countries, it is that way.In the US, you can do it through a GP, which opens up the potential for prescribers of medication, but it also risks misdiagnosis from people who are not experts on diagnosis. So two sides of the same coin. When we look at Switzerland, the UK wait times are huge and a lot of people are getting really frustrated by that.And you're waiting 912, 18 months sometimes. And that can be a barrier for a lot of adults, specifically. Getting a diagnosis can come across in two ways. For some, it can be a relief.Finally got an explanation for all these things I've struggled with. And for other people, it can be like their whole world breaks down because they're like, why did nobody figure this out?Why have I struggled my whole life? This is not fair.Like, people should have seen this and they get really angry, they can go into denial, they can really struggle through the diagnosis of, how do I reorganize my life now with this? I have ADHD and I thought these things that I were doing were normal for me. And now I look at them through a new lens and that's hard.That's hard for me to accept that I behaved in these ways because I didn't know anything else. But now I see it differently. So it can be super positive and it can also be quite negative for some people and it's a process of working through.

Danna Levy Hoffmann00:10:42

Right, and as overthinkers again, and unfortunately negative overthinkers because the entire world came at us going like, you should really be better at being human. And we were like, we're doing our very best. It is really difficult. I remember when I was 24 getting this diagnosis and being really frustrated.I was crying tears, just going like, what? I was being told that I was lazy, I was being told that I could do better.And now I get this statement of, look, you have something that you're struggling with and it is super frustrating.So I can imagine at 24, just trying to go through college versus women in their forties understanding this and how frustrating that might be and how also enlightening that might be.

Kelly Brändli00:11:32

Yeah. And as we said, we've got people who look back and go, oh, now I think I know why my first two marriages didn't work out.If I'd known this then, maybe I would have reacted differently. And that's, for many people, hard to accept. And so for some people, it can be a long process.For other people, they completely reject it, even though they wanted the diagnosis. It's too painful for them to accept.And so in those situations, it's really important to get support, expert guidance on how do you work through that?

Megan J. McCrory00:12:06

Yeah, I think for me, because I was diagnosed so early as a child, it was almost like I could distinguish myself from other people. You have to go down to the nurse and get your medication.It was something that was different, that was kind of coolish, but the teachers didn't have a lot of understanding or any programs or any kids that got help in school, meaning extra help, were kids that are diagnosed with learning disabilities. And at the time, I don't think I.The ADD and ADHD, it was a learning disability, but not in the same way as someone who just learns how to read slower or has dyslexia or even autism at the time, which I don't think I even knew about at the time.But what I look back on when I think I mentioned in the first episode, I kind of forgot that I had it after college again, since I was taking very small amount of stimulant medication, I effectively just was self medicating with caffeine. And it wasn't until about age 39 when I decided I don't think I can remember being an adult and not drinking caffeine every day.I'm going to stop drinking caffeine to see how it affects my body, because I want to be able to go for a hiking trip or an overnight camp without having a headache in the morning because I don't have coffee. That was the rationale. And also from a health perspective, I go off caffeine, and immediately my brain is everywhere and I'm going, oh, shit.Because I realized only then that I had been self medicating because my brain functioned so differently without caffeine. I ended up going back with caffeine because I don't drink an extraordinary amount, but it does help keep me a little bit focused.And I don't medicate at the moment. But I think about mostly not anger that the realization.But, like, how much have I been adjusting how I work, adjusting how I live to manage this without consciously doing it because I had completely put it out of my brain.And would I have done better in school and college if I had known myself better and be able to explain to my professor, oh, could I take a test where I don't have 15,000 people around me distracting me? Or can I take the test first thing in the morning when I have better functionality? You know what I mean?Just asking for small things that could have made my education experience better looking now it's great. I feel like kids now that are diagnosed are going to have a much better opportunity.I just hope that it's not, you know, the pendulum swings so far in the other direction where they go, oh, at some point, the pendulum has to come to a nice rest. Yeah. Where they get the help that they need, but it's not overblown and out of proportion. Do you know what I'm trying to say?

Kelly Brändli00:15:12

I see a lot of parents that come to me and say, I think my child has ADHD, but I don't want them diagnosed. I don't want them labeled. I don't want them to get special support in school and be different than the other children.Yes, there is this increase in awareness, and more people are getting diagnosed. There's still a lot of stigmatism around it.And I see especially parents of our generation who didn't get diagnosed when they were kids, who may not be diagnosed.They're very reluctant to get their kids diagnosed because they suspect they'll be called out in the process for them, then they have to face their own diagnosis. I get parents coming to me and saying, can you help my child? But we don't want anyone to know.

Megan J. McCrory00:15:59

Yeah.

Kelly Brändli00:16:00

Which I always tell them, the earlier you get support, the easier it is, the less of these negative voices get created for years and years of struggling. The energy, as you were saying, megan, that you need to function when you're not getting the right treatment is huge.I have other clients who come to me, and they say at 08:00 at night, I'm shattered. Like, I have zero energy left. I've used it all up.And it's no wonder, because you're having to compensate and work that much harder on everything throughout the day. Your energy's gone come evening time.

Danna Levy Hoffmann00:16:48

So, Kelly, I'm curious also, because I'm going through the same process at the moment. You've been through it yourself.What was your experience as the supporting family member, having your son your husband and his son getting diagnosed, and how did it change things for you?

Kelly Brändli00:17:07

That's a really good question. The first one I went through was my son, and I was quite clear at the age of two that there was something going on.His first diagnosis was done at the age of four, which I've now learned. You cannot diagnose a child at the age of four. But they took him through the whole process to say, we think it's a 50 50 chance that he has ADHD.Yeah, we went through that process and then he went through it again when he was eight. That was a very different experience.The process starts out with a number of questionnaires that parents fill out, teachers fill out for adults who do a self assessment as well.And then you go through a number of different exercises and tests, thinking exercises, how you deal with verbal cues, how you process information, memory, all these kind of executive function things you get tested on, and then there's a clinical evaluation. How does this impact your life?They interview the children, they interview the parents, and then they put all this information together to come up with the diagnosis. For my son, getting the diagnosis was massive because he was really struggling in school.He had a lot of aggression issues, and that allowed us to get him on medication. The medication was a game changer for us. He went from struggling massively in school to being excellent in school.We haven't had problems with altercations with other students. We used to have issues. He would threaten teachers when he was young, none of that. So that was a real game changer.My stepson got diagnosed about a year and a half after my son's diagnosis, so we went through the same process again. He has a very different version of ADHD. That was interesting within the family because we had that discussion. It doesn't look the same.How could it be ADHD? And of course it is. He's got more what we would have called the ADD. He's not so hyperactive, he's more the internal presentation.My partner and I were going through a lot of conflict. We got together, bought a house, started renovating, and the conflict kind of exploded.I just put it down to the stress of renovating a house together, which is up there on some of the most stressful things that you'll do in your life. But when the renovation finished and the conflict didn't go away, I started thinking, there's got to be something else going on here.I started researching adult ADHD and came across the statistic that when a child has it, there's an 80% plus chance that one of the parents does as well. So I proposed to him to get a diagnosis. His response was, well, it must be you, because it certainly isn't me.We made a deal that we'll both go through the testing. I've actually been through the testing myself.We went through it as a couple, and the doctor that did it said we were the first couple to actually go through together and get the results together. It was quite funny when we got the diagnosis, because I'm pretty sure that the doctor has ADHD and understood it brilliantly.Okay, I'm gonna make this really short and sweet. He's like, you know, you. Yes. Any questions?

Danna Levy Hoffmann00:20:17

I love it.

Kelly Brändli00:20:18

And my partner's like, no, I'm good. And I was like, no, but I want to know.

Danna Levy Hoffmann00:20:24

But how did he take it?

Kelly Brändli00:20:26

He actually took it really well. The funny thing was he sort of had, like, I don't want to say coming out announcement, but he kind of, like, announced it quite broadly.And as you said, all of his friends went, well, we've known that for years. How could you not have known it was to everybody else so obvious for him. He's like, you guys knew this? Like, why didn't nobody tell me?They would say everything was Renee style, and that was their way of saying, when it was different, it was Renee style, and they were saying, that was your ADHD symptoms. And he's become an advocate.He works in the building industry, where there's a lot of men with ADHD because they love the excitement of being on high buildings and walking over planks and doing all this high risk stuff. So it attracts a lot, and he talks about it. He'll go do presentations, and he'll share his experience with people. He's become an amazing advocate.

Danna Levy Hoffmann00:21:21

That's amazing, because, as we talked about before, it can backfire. So I'm really glad it worked out well for you guys. And there was something you said that I could really resonate with.I have two boys only 15 months apart. With the first one, I always said, always since he was. I don't know how old I was, like, wow, you're such a classic ADHD kid.Like, give him a little bit of sugar. The kid is bouncing off the walls and cannot finish one story without telling you about ten other ones.And, you know, just the classic, what we expected, what we knew 20 years ago.But when the teacher recommended that we go and do some testing, and the results came back from my youngest that he has ADHD, I was sitting there, my jaw dropped because I was like, huh? I never would have expected the kid can sit down, watch tv, be on his phone and listen to our conversation and clock everything totally fine.So it just took me by such a surprise. But then that's when I actually started learning that there are a lot more aspects to ADHD, as we discussed in the last couple of episodes.

Kelly Brändli00:22:28

Yeah. I just want to add one more thing about diagnosis. It's becoming more common that experts are using brain scans as part of the diagnosis process.You can't diagnose exclusively on this, but we're starting to learn more about how ADHD brains look different, and so the impulses in different parts of the brains show up.And there's some interesting research that actually, when we look at ADHD, there's one doctor that's done scans and sort of, he's been able to identify seven different types of ADHD based on the areas of the brain that get stimulated or understimulated.

Megan J. McCrory00:23:02

Wow.

Danna Levy Hoffmann00:23:03

Oh, cool. We should geek out on that for a while.

Megan J. McCrory00:23:06

No, I think we'll definitely have to make sure that we put the links to all these wonderful things and try to incorporate as many things that Kelly has talked about. I'm a little more surprised that there was a bit more to talk about with testing and diagnosis than I originally thought.So I'm also excited about our next couple episodes with you, Kelly, especially the medication episode that we have coming up.But as far as testing and diagnosis goes, I think the main takeaway I got from this is if you think you are and you would like to be tested and get started now. Yes. Better than later.

Kelly Brändli00:23:42

Exactly.

Megan J. McCrory00:23:43

Yeah.

Kelly Brändli00:23:44

Get yourself on a waitlist somewhere you can do a self assessment. If you think that you've got it based on a self assessment, you can already start getting support.Working with an ADHD coach, whether that's me or somebody else, can help you. Already starting to put in place strategies that can dramatically change your life and how you're coping with this.You don't have to wait for the diagnosis. Treatment involves medication is often first line. Then we look at coaching or therapy and lifestyle changes.The last two we can already do now and you can start to see changes in how you're managing it.

Megan J. McCrory00:24:19

Awesome. Thanks, Kelly.

Kelly Brändli00:24:21

You're welcome. See you soon.