The safest most effective evidence base treatment for ADHD was under my nose!

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mecado. Marra. 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 the 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, and some of my habits were just as important as learning the new set of skills.

Hello. Hello. I am so excited to be here with you today. Um, a topic that we're gonna be sharing today is one that is very dear to my heart. Um, so October, right October if awareness, mark. And why is that so important? Well, if you have a family member who has ADHD or a coworker who has adhd, or you yourself have adhd, um, the diagnosis of ADHD can be life changing because.

It could go both ways, right? If you're like me, when I got the diagnosis of adhd, I thought it was the worst thing ever. . I thought that my life was over . I was like, Oh my God, everybody's gonna find out that I'm not perfect. Everybody's gonna find out that what I had going for me, which was being the oldest one in my family.

Meant I was the smartest one or the right one, or was gonna do everything correctly, and all of a sudden the diagnosis of ADHD meant that I was not perfect and that I was not the one that had all the answers as I thought I had. But to some other people, the diagnosis of ADHD can mean this is interesting.

Or Ha, I knew it wasn't all me. There was something else going on. Right. And whether you got your diagnosis when you were. Five or 25 or 55 or 75. Yeah. I know most of you are probably thinking, why would you even wanna know at 75? Right. The thing is, if you're like my grandma, who we have to be 90, well, one was 89 and the other one was like 93.

Um, you would wanna know, because even if you're 75, you still have like 15 years left of your life. That could be the next best 15 years. Right? Especially when we're getting to the. the stage of wondering whether this is all dementia , right? But when you look back, you're like, Uh, no. This is the way they've been all their lives.

Things start to make sense, especially when your daughter or your granddaughter or different people got diagnosed with it, right? It's a genetic thing. So I think it's important to realize that the diagnosis of ADHD can be life. And it provides you with the opportunity to see yourself having a blank slate to see yourself as, What do I do with this information now?

Like I can either go and hide and hope nobody finds out and develop the imposter syndrome like I did, right? Or you could decide. I wanna be curious. I wanna learn about it. I want to use it to my advantage and see it as a gift and see how I can tap into it so that I create a better life for myself and those around me.

Because the thing is that ADHD just does not just affect you. It affects everybody around you. And so by saying that, I wanna invite this conversation of trying to understand, of owning it because it's a package I recently heard, uh, Dr. Ramsey say that ADHD is considered the. Diabetes of psychiatry. It's a long, very long chronic, lifelong condition that you never outgrow, that you just learn to set up systems to manage.

it just like diabetes. You know, with diabetes you get educated, you get told these are what the meds you might try, you get told, um, you know, this is the way to check how things are working, and then you go and get blood work done and you get stuff done. Well with adhd, you get diagnosed and then you get informed.

The thing with the education, part of it is though, that sometimes, even though we think we know people without adhd, even even physicians, family medicine or psychiatrists, they don't teach us as much as. As we should know and, and I'm telling you from firsthand experience, I had ADHD and everything I'm sharing with you guys I didn't know.

I have now learned because I had hyper focused on it and gone and got curious after I got over my, Oh my God, this is a curse. And started thinking. ADHD can be a guest. I just have to learn to unwrap it. So today's discussion is about something that comes up every single day in my practice. I'm a family medicine physician and I treat adhd, and it's something that also comes up with my clients or potential clients through my coaching.

The question always comes up, What about medications? And so I want to tell you what Dr. Ramsey says, who is the ADHD guru? Okay. He says that ADHD medications are the safest and most effective evidence based. Treatment for adhd. Do you hear that medications are the safes and most effective evidence based treatment for adhd?

Why am I saying that? I'm saying that because there's so many myths around medication and. I want you to be aware of these because if you don't understand them, you might not be able to advocate for yourself. ADHD is a lifelong neurological condition. I wouldn't tell my diabetic patient. Okay, Good luck. I wouldn't say that.

I wouldn't say there's only. Right. I wouldn't say that. I wouldn't say well go exercise only. No. It's a chronic condition that requires one of many tools and all the tools, and it's a spectrum, and some people might need this, some people might need that. But if you are not aware or you don't have access or you can't advocate to get.

The safest, most effective evidence based treatment, which is medications, then you're already kind of crippled. Again, even though you have now the awareness that you have ADHD before, you didn't even have the awareness, right? So you didn't know what you didn't know. Now that you know, please educate yourself.

and everything I'm saying here, of course, it's my opinion, you have to go talk to your own family medicine physician or psychiatrist and have a, a discussion to make sure everything is safe for you. But in general, the evidence out there, the multiple studies that have done studies done, even with like preschool kids at the age of two and three, show that this is evidence based.

Okay. So I wanna talk about that because I think it's so important. So if kiddos, can take these meds and be safe, and these are meds that have been around, you know, probably what, like 60, 70 years? Some of them, right? And some of them at least 20, you know? Uh, so they've been around. Of course you have some other newer ones that haven't been around that long.

But the point is, is that all this has been studied, okay, Stimulants all or medications, just so there's different drug classes, which I won't go through. And again, not so that you can like, you know, have a whole discussion about this. But medications will work for like 80% of. 20% might not benefit from them due to maybe the side effects, or maybe there's a contraindication due to whatever other medications and chronic medical conditions that they have.

But in general, medications will help 80% of people. Why doesn't is this important? Okay, if you have a kiddo, right? Like if you, if you're a parent and that kid has. Being on medications is like having their own babysitter. What do I mean? Okay. We have a neurological condition that has decreased, uh, decreased effect, uh, if it like, Okay.

Has decreased executive function, right? An increased IUL sensitivity. So

how comfortable do you feel having your ADHD kid run around near this street? Probably not that comfortable, right? But if they're on their medications, they might have that two second delay to be like, Hmm, maybe it's not safe to jump out of the street. Right? So the point is that eventually they're gonna start to drive, right?

Eventually they're going to be at a friend's house. Eventually they're gonna be involved in. and if they are not aware or they cannot control, or they're doing their best, right? They're doing their best and they're still not necessarily fully embraced in their community because they're being impulsive, they're saying out loud, but maybe they shouldn't be saying, uh, they maybe they start being looked at as.

Being weird. Not that that's the wrong thing because hey, we gotta be interesting, right? But that, what I mean is that being on medications can decrease some of that

uncomfortness that can happen. It can also decre like decrease some injuries, like if they're in sports and they're not paying attention, they're doing their best, but they just can't focus. Right. They're more likely to get in trouble, right? And if they missed the ball or something, like, everybody's gonna be looking at them like, Oh my God, it was right there.

What were you doing? Why were you daydreaming? Right? So medication, like I said, if not, not, it's not something that you should. Not consider because you're thinking, Oh my God, they're gonna become addicted to this, or it's not effective. Or when they really need it later on, it's not gonna be as effective, or, you know, all those things.

Right. Adhd. Is less expensive than, you know, some of the therapies, some of the coaching, right. Uh, and it's readily available. Like you put it in their mouth right in the morning and you're good to go. Versus sometimes it's harder for us to get access. All those other resources that hopefully we do have access to, which is, again, therapy and coaching and, and all and all these other things, right?

With meds, just to use the meds. You are two times more likely to complete a task that you set yourself up to trying to do. It decreases the that task initiation. It helps us to transition from one task to the other.

And it, I, I always say it feels like going from having 25 tabs open to just five. I mean, it's still, I'm not saying I don't still squirrel, right. But now I have the ability to try to do things more. So before medi, uh, before medication. And, and I can tell on the days that I don't take them, for some reason, I decide not to take 'em.

I'm like dragging . Why? Because my brain just does not have that dopamine and that norepinephrine, that medications do that help me. Right. So there's different medications and you can talk to your physician about it, right? But you have some that are stimulant. What means that within 30 minutes of you taking the medication, you start to feel better.

And then there's some that are called the non stimulants, which mean that. Um, it'll take three to four weeks for you to start to notice. Right. And some of those are useful whenever, you know, you didn't tolerate the stimulants or whenever, you know, so, so they're all to consider. And then the third class is one that is actually for blood pressure.

It's interesting enough, in the 1990s they got. They, they got approved and so that, that would be like, uh, clonidine or uh, , right? And so those kind of help you to take the edge off a little bit like at night so that you can stop your overthinking brain and uh, be able to sleep and. So, yeah, again, I am not telling you what medication to get on.

I just, I'm facilitating that discussion that you might want to have with your provider so that you are aware of why you should be on medications or at least consider being on medications. Like don't just write them off. Right? And so there's a lot of data up there that says,

It's always mis misinformation that prevents you from getting on medications. Like some people say, Oh, they're so expensive. Like, I lost my insurance so I can't be on it. No, there's a lot that you can still on that you can use GoodRx or something else to try to get you the medications. And of course, right now we're going through a shortage, right?

With uh, Adderall. It's a national shortage, but there's other medications you can still try. So definitely talk to your physician. And I also want you to be aware of this, the fact that even if you started. Your kid on medications at the age of three or at the age of five when they're going to kinder, the medications can remain effective their whole lifetime now.

One, keep the stick there is that it doesn't mean that the same medication dose is gonna be used a whole lifetime. Like people go through changes, right? With puberty, menopause, and again, different conditions that you might have, they might need to get adjusted, right? Or different stressors that you have.

So I'm saying all this so that you realize that when you diagnose. It, it, it's a package. , right? You, you're gonna get the diagnosis. You're gonna have to own your diagnosis, right? You have to have buy-in, right? That means the education piece there, right? Then you try your medication, then you work on your accommodations, right?

getting your physical environment to facilitate you, helping you to understand how to create these systems and, and with medications. Now you have like a stepping stone to get all those systems right. That's where my coaching program comes in to. Uh, help. Okay. Now you can have like the ability to go from like 40 things to maybe five, and then we can like, make it a little bit better, right?

To, to teach you how to prioritize and strategize and how to not work against yourself, but use your strength as your strength. And so modification is where. Things get creative and fun because all of a sudden we start to see how to implement things. Ok. So I wanted to make sure that you knew that medications are, again, like I'm saying, the safest and most effective evidence-based treatment for adhd.

Did you hear that? I hope you did, but why is that important? Okay. I'm gonna give you some rapid bullet points and see if any of these make sense to you. Okay. So they're going to increase compliance of following the rules or. doing what is needed of you. Right? And now I don't want you to feel like, oh my gosh, it's gonna make you follow the rules because we know that people with ADHD do not follow the rules unless they make sense to us, right?

But what I mean is that maybe you'll drive a little slower, right? Maybe you will be in a hurry cuz you're trying to make up for the time that you didn't know you had lost. And there is studies out there that people without medications are like to die 10 to 20 years sooner compared to somebody who doesn't have adhd.

They're not gonna die from a heart attack. They're gonna die because they were racing, driving, or doing a Bunge jump or something that gives this adrenal. So medications are going to help with compliance of some of the rules that can keep us safe, right? Um, it's also gonna help us have a better working memory.

I'm not saying that, um, it's gonna make you smarter because you are a smart. With or without medications like that doesn't modify anything. Again, it just helps to facilitate how to prioritize and do your initiation of tasks and tasks machine, right, and actually it can also help your self-esteem. Okay, why do I say that?

When we have been told. Don't do that. Don't do that. You're too quiet. You're too, you're too loud. You're too whatever. Right? When we have been told more than 20,000 times in a lifetime, by the age of 13 or or 15, a person with ADHD has been told 20,000 times. Don't do that. Don't do that. Don't do. So, of course our self esteem is like nonexistent, right?

Because we know what we want to do, we just dunno how to do it. I mean, we're trying really hard and we almost make it, but we don't make it. And that really precious us. It could crush anybody, right? So, But then you have the other part, right, where we don't make it, and then we feel like shit for how many, how long, and we're making mean all kinds of things.

Even though the goal that we had to begin with was kind of unrealistic going up, it's going to decrease the punishment that we get for voters, right? Like, we're gonna piss off the principal or get ourselves in trouble for like,

Overreacting on some sort, right? Or not cleaning a room so we can go out

You know what I mean? It's gonna decrease punishment in some way or another. Right. And, and sometimes it could be decreasing, like the punishment of like not having to be the phone to be like,

Because you'll be a little bit more, have the ability to get organized and plan. And don't worry, I'll walk you through that in my coaching group on how to plan ADHD friendly. So, The point is that you're gonna have more awareness of your surrounding. You're gonna be able to play well in your sports or play, have, have a li more ability to read the room in your, uh, meetings and stuff like that.

And you're going to, like I said, decrease the risk of injuries. I, you know, I broke my, my foot in July of 20. 21, I'm, I'm trying to remember , and, you know, it was freak accident, whatever, right? It dropped the 50 pounds cement on my ankle, however, This is like just a day of my life, , you know, And yesterday, just yesterday, um, trying to go to the bathroom.

Um, I tripped to Cord and I like, I hit my left pinky, uh, toe. And of course I had to go get an x-ray. I mean, I was working and I, uh, I worked and then I went to go get an x-ray in between patients and luckily didn't, it wasn't broken. Of course, it's purple and whatnot, but this is just a day in her life, right?

And so medicines are important, . Now the other thing is that medicines can also. With those, uh, kids that have autism and adhd, and so it, it's important that you realize that medication can really help you in many, many ways. With that being said, I just wanted to put this plug in. Because this is a discussion that I have every single day with my patients, and I'm always surprised that they had no idea that it would affect their lives in, in all those ways.

That they had no idea that the reason that their coworkers are like, I mean, for praying for their life when they're sitting with them and they're driving, it's because of their adhd. Yeah, so I've had so many of my patients come back and say, Dr. Mud life has changed now that I have, now that you have helped me to optimize my ADHD treatment.

Like now I have my own business. Now I'm able to keep a job. Now I'm not told I'm a punk . Now I'm told that I'm actually listening. Not that I didn't want to listen before. Now I'm not that irritable mother or frustrated wife. Now I'm not being nagged by my husband anymore because he, you know, he's tired of telling me 10,000 times to do this now.

Now I've got enough promotion. Now I haven't gotten a speeding ticket or. Made my probation officer aware that this was something I needed. Did you guys know that 40 to 50% of people in jail have adhd and it's because. They didn't realize that medications were needed or because maybe they didn't even know they had that diagnosis and they didn't realize that they were, you know, they were just using the wrong thing, like they were using maybe smoking weed or they were using cocaine or heroin or getting themselves into trouble, right?

Alcohol, drinking and driving different things. Why am I saying all this again? Because this is a topic that is asked of me multiple times a day, every day of the week. To me, it's such a common knowledge thing that I'm like, You didn't know that. But when their face tells me that they get it and that they understand the importance of it, that they understand that the medication.

is one of the many tools that can help their future, that can help determine whether they will actually finish school, graduate. They can decide at that point what they want to do. They might wanna go and do like, you know, anything that it can impact whether they stay married or. That can impact the job that they have or not, that can impact whether they are able to pay their bills.

So medication, please consider it. Really consider it. Please realize that ADHD is one of the most rewarding. Conditions to treat in psychiatry because it has that 80% possibility of getting you to manage your ADHD and getting you to the life that you want. So again, I didn't learn this overnight myself.

They teach me this in medical school or residency. I. Had to focus because I got curious. And now anything I learn and read, I tell everybody because we all rise together through education. If you have any topic that you want me to talk about, please send me an email. Um, go to my webpage, life coach.com.

Let me know what you thought, or please leave me a review of this podcast so that other amazing human beings like yourself can also learn and get educated, and let's help each other getting power and really live the life of our dreams because life's too short. I would rather live an amazing life. Not them at all.

I dunno about you, but it's their term, right? Let's practice medicine in our own term. Let's become the CEO over lives. And, um, I wanna tell you these things. Uh, if you want to join my position group coaching, please come. Love to have you. Um, and, uh, let's be in touch. Okay? Thank you for spending your time with me.

I really believe that time is your most valuable asset. Please subscribe to the podcast, share with your colleagues. And don't forget to check out my website@dlivecoach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happen.