Relationship of ADHD with parent and child with Dr. Totulope Alugo

Dr. Diana Mercado-Marmarosh: Come join me May 1st through the sixth, so that you can rest, rediscover your strengths, reconnect yourself and those physicians like you who are ready to leave, work at work and re-energize. This is the invitation for you. 2023 your year. Join me in Costa Rica in this really amazing, non-judgmental, intimate decision community.

I am gonna show you how to rest and how to recharge. Let's transform your brain up so that you can start to dream the life that you always wanted this year in 2020. I can't wait to learn all about what kind of year you're gonna have after this conference. Take care. Hello. Welcome to Beyond ADHD, a Physician's Perspective.

I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. See it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize that unlearning some of my beliefs and some of my habits were just as important as learning the new set of.

Hello. Hello. I am so excited today I have a very special guest, Dr. Ta Lupe au. A Lugo is a child and adolescent psychiatrist who helps to empower youth mental health by providing diagnostic assessment and treatment as well as educational to parents and caregivers about these disorders and how to ensure that they look after their own mental.

While caring for their children. She's the founder of St. John Kapp and the Emotions Ambassador Program, where she's actively involved in education and advocacy and our. Which is the area of youth mental health. She's the host of Walking on Eggshells with Dr. Talu podcast and has a YouTube channel under the name St.

John Cap. So today's topic, obviously, if you haven't gathered anything from what I just said, is very important because it always feels like we're walking on eggshells either with our kids or sometimes ourselves, whenever. A D H D is a diagnosis and so I'm so happy to have her here today to share her experience about why she is doing what she's doing.

Dr. Totulope Alugo: Thank you so much. Thank you for having me today.

Dr. Diana Mercado-Marmarosh: Awesome. You have a son, is it a son or a daughter that was diagnosed with a

Dr. Totulope Alugo: No, I don't. I just have I'm, cause I'm a psychiatrist, I deal with this every day in my clinic.

Dr. Diana Mercado-Marmarosh: Gotcha. So it feels like you have a thousand kids, huh? ?

Dr. Totulope Alugo: Yes. They're like my kids really

Dr. Diana Mercado-Marmarosh: Yes. Yes. Because you see them grow up. , you see them from day one and all the way till they're 18, so it feels like you, you have a thousand kids. . .

Dr. Totulope Alugo: I watch them go from elementary school to, they go to university. So I'm like a mom in that area. ?

Dr. Diana Mercado-Marmarosh: Yes. So tell me what got you into this special like niche, because I know you could focus on anything.

You could focus on why this tell me.

Dr. Totulope Alugo: I did a general residency in psychiatry, but then I did a rotation in child adolescent psychiatry and I just, Really loved it because I realized that I had an opportunity for early intervention because I believe that if you can intervene early, you can change a child's trajectory.

And you can also help a family really early by treating a child.

Dr. Diana Mercado-Marmarosh: Yes. Yes. You're so correct. I'm often. Shocked how it makes such a difference as we're growing up, right? Things that people might do can really. Enhance or sometimes not so much enhance how we ourselves interact with the world, and especially before the age of seven.

It can make a big difference, but that doesn't mean that you can't unlearn or you can't support them later on when more knowledge comes. comes along. Of

Dr. Totulope Alugo: course, of course. Whenever you get an intervention, it's always helpful. Yes.

Dr. Diana Mercado-Marmarosh: . What have you noticed that, when you do tell mom or dad, hey, your kid has a D H D, what have you noticed is usually the reaction.

Dr. Totulope Alugo: We get a variety of reactions. For some parents they already know because they already see the challenges at home school is telling them Your child is different. They're on the go all the time. Teachers are stressed out. So personally, for those kids who are hyperactive or impulsive, parents are almost always.

Already have a great idea. A few parents would say, oh, he's protect the younger ones. They're just boisterous. And so that way they bit up reluctant. But for the inattentive ones, I find they're being diagnosed much later and parents are saying things like, they're careless, they're lazy, they're just not paying attention to detail.

So it's really a mixed bag that I get.

Dr. Diana Mercado-Marmarosh: Yeah. And you're so right, like parents sometimes, , sometimes they know that their kid is, the way they tell me is my kid's high maintenance or they're have, they're a ball of energy and I know that, they're sometimes too much. When the kid feels like they're too much, that can also be

It could go both ways, right? But, When their kid, like you said, is just in the back of the class daydreaming, you label them as careless sometimes or not caring enough like you said. And it can be frustrating cuz they're like, how do I get them to get motivated? And sometimes, like you said, it's a neurological thing,

So it, it's so important to be able to have that awareness to even realize and then sometimes they're smart. And because they are attuned to whatever the subject is and they're passionate about then they have a mixture, right? Like you'll have somebody who does really well in one area.

And then another, not so much because they find it boring or they, there were too many steps in there that they couldn't follow along. And so you have a frustrated parent sometimes.

Dr. Totulope Alugo: Yes, I see so many of those kids who are doing really well at school, but at home there's so much tension because they're forgetting that chores, the living appliance is on.

They're just not meeting deadlines with, homework and stuff like that. Yeah. So it can be a real tension point between parents and the teenagers particularly.

Dr. Diana Mercado-Marmarosh: So once you have this awareness that you walk them through to make the diagnosis, what do you usually like? Tell the parent or tell the kid.

Dr. Totulope Alugo: I provide information on the disorder. It's a neurodevelopmental disorder, so I say, look, it's nothing that you've caused. It's not your fault. It's a disorder of the way your brain is wired. May have been inherited of your small, more than likely, and then provide practical steps to move forward.

One, I want 'em to educate themselves as much as possible on the diagnosis. So pro I provide them resources for them to understand the diagnosis, and then based on the impact on their functioning, then we then look at treatment options. But I always say there's some medication, there's some non-medication options that everybody needs because they're important for life.

So things like, Having lists, using alarms, reminders, those practical strategies, they're important. And then for the parents, depending on the age of the child, I really want to provide information on how they communicate with their child. So for example, for the younger kids, I would say to get your child's attention, you need to calm down to their level.

If that means holding. Getting down your knees, looking them in the eye, and then giving them the instruction, breaking the information into small, manageable steps such that it's not too longwinded. And then, providing information to school because you want the teacher to understand that this child has challenges and needs things to be done differently.

So really education is one of the key things that I like to provide after a diagnosis. .

Dr. Diana Mercado-Marmarosh: Yes. That's so key because that becomes an empowering tool, empowering method to be able to create systems for them and for the parent too, so that they can have strategies so that they don't feel anxious or mad or angry or overwhelmed and they have a way to take care of them, and take care of themselves.

Let's talk about emotions because I keep saying that emotions are a compass, right? Because emotions really can be helpful, but can they can get us into trouble also, when you're not aware that A D H D can have an emotional component to it, then it leads to some meltdowns or they could lead to some melt.

What have you noticed in this

Dr. Totulope Alugo: area? Oh, that's very common because you see a lot of e easy frustration. So for a child who is unable to focus, who is constantly in trouble they're anxious because number one, it's difficult to focus. The teacher is calling on them, they're losing chunk of information.

They're being labeled sometimes by parents or other kids, and so that is stressful. So you'd see a lot. Emotional outbursts, just, easily easy, frustration, anger. And don't forget, sometimes parents themselves also have a d h D. So even though they know that their child has h d, they know that this is not their fault.

But then before they can put the breaks on themselves, they've let rape, but they're yelling or screaming, so it can become a real negative situation. or if care isn't taken. So really providing information about, putting bricks on yourself. Self care, managing your emotions is important, but also helping people around to understand that this child is struggling and need support and not judgment is also important.

Dr. Diana Mercado-Marmarosh: Yes, those are all very important keys like, I have a pediatrician that works with me and she's been there for 20 something years. And so I'm so grateful that she's there because she's obviously a ball of knowledge, but she always tells me Dr. Mercado I'm sending you the parents because I'm sure.

I can see it, and I'm like thank you. Send them over. Because it's takes an astute person who's paying attention and who and who understands that this can be genetic. Yes. And while we might put all the interventions for the kiddo or try to, if you yourself are not putting your own max.

Your oxygen on or your, either you or your husband, or both, right? Then it might be a lot of, more of a challenge instead of an easier transition for both of you and the things that can help the kid could also help you, right? If you have an awareness that you need certain things before you walk out the door, like your keys, your purse, like X, Y, and Z that can. Deescalate how quickly the morning routine can turn into something stressful. , yes, . Yeah. And the same thing with like homework, right? If you know that exercise or play is gonna release some dopamine, like having room for that on the schedule on purpose, before maybe you do jump onto the homework.

Because if you went for a walk, even if it was 10 minutes with your kid outside in nature, All of a sudden you've increased some of their dopamine and then they're might able to come and sit down and jump into the homework a little bit more easier instead of you and them arguing that I can't do it right now, and it goes back and forth.

So yes, handling the emotions. That can come with the diagnosis. And then not only that, but how do you handle as you are implementing it, right? Because we keep looking at other people and sometimes we're like it's working in their household. How come it's not working in mine, ? And you forget that everybody A little bit different.

We all want to be doing certain things, but at the end of the day, how you do 'em is what is gonna make the difference in how then they have tools to do it later on.

Dr. Totulope Alugo: Exactly. I think we are really being intentional and realizing the individuality of your own family situation is important because we can't be comparing.

That's not always helpful. You can always get good information from other families, but not constantly compare. I think it's important to be intentional, to be practical, but also give yourself some grace. Because sometimes as parents we beat ourselves up so much for anything that doesn't go well. And remember your child doesn't.

Perfect parent. Your child just needs a good enough parent. And so I said to parents, you don't have to be perfect, just good enough. It's fine. .

Dr. Diana Mercado-Marmarosh: Yes. You're so right. Realizing that we're always trying our best and sometimes we didn't have information available to us. I'm Mexican American and like I didn't get diagnosed.

So I was, in my first year of med school because when I looked around in my family, we all kind. . That's the way we were, like, we were loud sometimes and we would get angry and then like we would be over it and then, we would be a little bit forgetful and sure, this at three o'clock for the party, but everybody showed up like at three 50 or four or whatever.

Everybody was on their own time and we weren't sure that was like a cultural thing or that was just an A D H D thing. Or if, we. Lost track of time somewhere, because we're always like busy people. And so it's understanding that, sometimes just the way our environment is.

It might also be like not hindering the diagnosis because I like the word that I'm trying to say is that there's evidence out there that, in minorities, Sometimes it gets diagnosed later on because we we don't realize that's nothing that they Nobody's diag. Nobody's taught us about it.

Yes.

Dr. Totulope Alugo: And I'm from Africa myself, and I would say the same thing, the understanding of A D H D, the stigma associated with any kind of diagnosis really delays things. And then there's a cultural aspect. We have this African time, any party, it's not fashionable to get there on time. . So is that because of a D H D or just because that's the cultural norm?

It's hard to understand. But I really see that a lot in the Africans who, whose kids have coming to see me. And parents just feel like they've being labeled, they've been unfairly targeted when it may not be the case. So that understanding in our communities definitely needs a lot of educating.

Dr. Diana Mercado-Marmarosh: Yeah. And I think you and I will get along just fine. We'll get along, we'll get them to the same at the same time. . But my husband my husband's white, so he jokes around all the time. He's whose party is this? What time is it on? Is it like on Regular time or like your time . And I'm like, be quiet.

And he's I just wanna go. He's cause because he hates being late. And not that I, I don't mind being late, but like you said it's a norm. Sometimes we go back and forth, right? Because there, there's this time blindness component to it that. Sometimes, like you said, could be culture, but sometimes we really have no idea of it.

And that can impact, right? If you are in a certain setting and you don't have flexibility of time in your work or if you're trying to get on a flight, right? That might not be okay at all. No.

Dr. Totulope Alugo: Yes. For a parent who probably has a D H D I think the way to figure out if this is a cultural habit or whether it's something more, is really knowing when you can be late. If it's okay to relate to a family gathering, but not to work, not to the airport, If you cannot make those, navigate those differences, then maybe it's time to get an assessment.

Maybe there's much more going on than just it's okay to believe because of my culture.

Dr. Diana Mercado-Marmarosh: Yes, exactly. Yeah. With a D H D sometimes, like if you ask us what time, how long it's gonna take to do a certain task, we don't have that awareness. I have to count on purpose the time before I gather the stuff to start the task.

like we go straight to the task. We tell you it's gonna take me 30 minutes or 10 minutes or whatever, right? But we don't tell you because we just don't associate it together they call it like the recipe, like you need the ingredients, then you need the middle part, like yes. And then you need the cleaning up, the stuff.

And for us, we just go straight to the middle assuming that we have everything and sometimes we don't have everything. And that's where some of that can get us into trouble. Yeah. Yeah. So sometimes my, my, one of my screening question, To my, to parents or is how many times did you have to reschedule this appointment before you actually got in to see me?

Because that could be a tall tale that, , they missed it three times or they didn't have it on their calendar or something like that. It's

Dr. Totulope Alugo: true, and I think just being aware of that for a parent is important. I have some colleagues, for example, who have only just realized that in their forties that they need to really schedule themselves, give themselves time, have everything written out, have a spouse that would remind them, have their kids, remind them, but that self management is important.

That definitely is important.

Dr. Diana Mercado-Marmarosh: Awesome. So tell me. What do you think is one of the key things to enhance the wellbeing of the kids? Like you, obviously you already told me, go set reminders and that, and talk to the teachers, but like for that kiddo who is like wanting to do the things, like what do you think?

you would really emphasize for them?

Dr. Totulope Alugo: Start with the basic thing. So for for every child, adequate sleep is important, healthy diet, healthy exercise is particularly important, like you said earlier on, to increase the dopamine, to burn energy. Strategies like using fidget stools, having a, like a Fiji or paper meat.

Then teaching them to, set reminders, set tasks for themselves, ask for help if they need to. Those are strategies I will be highlighting first and foremost before anything else is those basic pillars of health. And then the A D H T specific ones things to reduce hyperactivity tend to improve their attention.

And also for the older kids, if you know that you're gonna be, for example, an example is overspending. Some kids will say, oh, I went to the store to get one thing and I came out with 10 things. I'll say maybe leave your card at home and just bring enough cash for that one item. So those are some of this, the practical strategies that they could a child could.

To manage their symptoms and of course, talk to your healthcare professional. If all that isn't working there, all there may be an extra layer of help that may be necessary, medication and so on and so forth. The most important thing is talk to your healthcare professional.

Dr. Diana Mercado-Marmarosh: So where can people find you?

You are just a ball of energy and you have all those stuff that you have the right thing to support the parrot and the kid. Where can people find you?

Dr. Totulope Alugo: So have a blog at ww dot saint john cap.com and that's capital Double P. Then I also have a podcast working on eggshells with Dr.

Tolu on. Platform where you can find podcast. So Apples, Spotify, e t C I'm on YouTube at St. John Cap, also on Instagram and Facebook. So there's a lot of places where you can find me ,

Dr. Diana Mercado-Marmarosh: please go find her, follow her love everything she's doing. Okay. I always ask people this question, if people just started tuning in, because we have wondering attention, what is a one nugget you would want them to walk away with?

Dr. Totulope Alugo: Having A D H D can be a great blessing because I think, people are super creative, so you have strengths. So always think of your strength and not just the downside of having a diagnosis. Think of your child's strength. Your child has unique qualities. Focus on those unique qualities and not just on some of the challenges that you may be seeing that they.

Dr. Diana Mercado-Marmarosh: So Dr. A Lugo, tell me what you are hoping to do for fun in the next three years. In

Dr. Totulope Alugo: the next three years, I'm hoping to go on a vacation with friends. I'd like to go on vacation week, a girl trip, so I'm hoping for to do a girl trip in the next three years. We did one about seven years ago, so it's time for another one.

where do

Dr. Diana Mercado-Marmarosh: you wanna go?

Dr. Totulope Alugo: Probably Europe, the Mediterranean, maybe. Enjoy cruise .

Dr. Diana Mercado-Marmarosh: Awesome. Please invite me so I can come a lot . Yes. I love, I'm doing this Go trip . Thank you so much for your time and it's always great to chat with you.

Dr. Totulope Alugo: Thank you very much for having me. It's been great being here.

Have a great day.

Dr. Diana Mercado-Marmarosh: You too. Thank you for spending your time with me. I really believe that time is your most valuable asset. Please subscribe to the. Share with your colleagues and don't forget to check out my website@hdlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happy.