Beyond ADHD: A Physician’s Perspective

Interview with Andrea Wadley

Dr. Diana Mercado-Marmarosh: 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 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 I'm learning. Some of my beliefs and some of my habits were just as important as learning the new set of skills.
Hello. Hello. I am so glad to be here today. I have an amazing friend. From Dallas, Dr. Andrea Wadley, and she is actually the owner and head pediatrician at 1 27 Pediatrics. It's a really cool setup that she has going on. She is a home visit. Only direct primary care, pediatric and lactation practice, and she's able to provide convenient and really high quality evidence-based care.
In your house. Like how amazing is that? And she also helps with breastfeeding medicine consultations. So yeah, I'm so excited to have her here. And she does all kinds of education on breastfeeding, but this is probably her passion project and she's gonna share some nuggets about.
Some of the difficulties that can happen during breastfeeding time and how maybe taking some of those steps can be helpful to implement For any of us who have a D H D or any of us who feel like we might all of a sudden have something that feels like A D H D because of the new responsibilities during this amazing and exciting and challenging time of our lives.
Awesome. So thank you for coming. I'm so excited you're here
Dr. Andrea Wadley: today. Thank you for inviting me. This is exciting.
Dr. Diana Mercado-Marmarosh: Tell me how did you decide to do what you're currently doing? Because, I'm, did you envision this all along when you started off, like in residency into pediatrics, or what were
Dr. Andrea Wadley: you thinking?
Yeah, so I was. In pediatric training in San Antonio actually. And I had a pediatrician mentor, so my advisor was always telling me that I should start my own practice, and I told her she was crazy. So I never ever had that desire when I was in residence. C my husband and I actually met via the internet while I was in San Antonio and he was here in the Dallas Fort Worth metroplex.
So we met, we dated, we married and we were long distance for that whole time. We got married at the end of my intern year of residency, which was crazy. Why would anyone do that? And then we lived apart for the first two years of our marriage, so I moved back to the Dallas Fort Worth metro.
And it was. , it's really hard to find a job. As a pediatrician, as a doctor, you think the world will want me, and nobody wanted me, it felt like. And , I looked all around town and then I found this amazing job as a newborn hospitalist. I worked there for eight years. Loved every minute of it.
Loved helping moms and babies in the hospital during the first few days of the baby's life. But there was always something inside of me that was missing that I am pediatrician, so I wanted that. And as the corporate structure of medicine continued to press down on.
My heart and my soul . I had my own child during that time and just missed having time with her just because someone else was telling me what my schedule was gonna look like. So as a result of all of those things, I decided I wanted to start my own practice. So in the middle of that, having my own child as well and trying to breastfeed I was a physician.
I thought I knew everything, right? I'm a pediatrician. I take care of moms and babies, and I know everything about breastfeeding. Oh my gosh, I didn't. So it was soul crushing right to, to try and breastfeed my own child. All of those things mixed together and prompted me to want to start my own practice doing pediatrics as well as breastfeeding medicine.
So lactation consults. And then I looked at the horizon of medical care at that time, and it's only gotten. Maybe worse since that time. So about four and a half years ago, five years ago, I was like, I just don't wanna work for anyone anymore. I wanna do my own thing. And so in Dallas, Fort Worth, many of the practices, like anywhere else are owned by a big health system, which is not all bad, but just for me, that just wasn't what I wanted to do.
I wanted to provide a different thing for people. So I saw this model of direct primary care. It's like a membership, right? Think gym membership, Netflix, that kind of thing. But this, you're becoming a member of a practice. And it allows me to provide kind of care that. Is really outside of the insurance structure.
Insurance is, I do this, you pay me this, and then the insurance says whether or not that was okay or not, right? So this is more of a relationship between me and the patient. So each family pays me a set amount every month on the first and then it allows me to care for their kids in an kind of amazing way.
So a lot of what we do is over text message. I come to the house and see the. I schedule all their well visits in advance, I'm available to them when they're sick. So it's been a fun thing. A lot of growing pains, a lot of trying to figure it out. Cuz really when I started it was very unheard of.
And now thankfully, more and more pediatricians are getting out of the system and trying this out, and it's becoming a tiny bit more normalized. But also in addition to, a regular pediatric practice. So I see, kids. Big kids, little kids, babies, all the things. I've diagnosed a D H D more than I have ever in my whole life.
Being able to, see these kids for, and know them really well. But in addition to that, I wanted to do breastfeeding medicine cuz I think there's just such a void in. Care, from a physician's perspective. And there's a lot of things that I can do that a lactation consultant who, has a background in medicine but not necessarily medical.
Like a physician level type of education. So I can diagnose and treat and, all of that is best done. At someone's house. If you think about, I'm sure you, when you had babies, the last thing you wanted to do was leave your house. Yeah, I come to you for all
Dr. Diana Mercado-Marmarosh: those things.
Awesome. It's been fun. So I'm going to jump in here and say that there's so many things that you said that I a hundred percent relate to what you're saying. First of all, I also met my husband on the. So how cool is that? I met him back in the day. Gwen they had Yahoo Personals, , and it was meant to be like a joke type of thing because I, it was my first year of med school and I was just like, who can help me?
Buy lunch or dinner? Like I was a broke medical student, right? But it was more like a dare and. and here we are. But anyways, the point is that I could totally relate with that. The long distance thing. I've done some of that too. But yeah, that just shows you again how important it is to know yourself and to know.
What you want to do it and do it in your own terms, right? Because most people say, oh, no, long distance doesn't work, or da. But again, when you are mesh with what fuels you it becomes a no-brainer that you get to become a trail blazer in whatever you're doing. And it was so good. Like sometimes what we feel.
Like hurdles, like you said, oh, I didn't find somebody, somebody didn't, wasn't like, oh, I can't wait to hire you. Maybe it was like the universe letting you know to step into what you wanted to create and for you to practice medicine exactly in your own way. And again, to refuel you ended up tapping into an area that is so needed, like breastfeeding and I was, You couldn't hear me cuz I had my, myself on mute because my kids are running around like crazy here.
But when you, I was chuckling when you said I became a pediatrician and I had my own kid and I should have known everything about breastfeeding. I was laughing because, That was exactly my thought. I was like, oh my God, I'm a family medicine physician. Oh my God. I talk to people left and center about all the amazing things on why you should be breastfeeding.
In my mind, it was like peachy roasty, like they're just gonna get on my breast and it's gonna be up. Wonderful experience. And then I was so mad that I was like, what, I have to do this every two hours, like I have to, like what? And I remember also being frustrated and not having a lactation consultant to come and talk to me after breastfeeding.
They were like and I was only there 24 hours. And they're like, oh we'll set something up later. And that never happened. And so me going online and. On Pinterest or different places trying to figure out like, how can I improve my milk production or am I doing it right? Is it not and in my mind, again, it should have been just this peachy, rosy experience.
. But you don't realize, like you said, even though you've been medically told what the benefits risk are. Show you until you yourself go through it if you have the privilege of going through it. Or not , because some people decide this shit's too much work, , and so they really do. But what amazing it is that you're able to fill in the gap and teach people about how to do it.
Like you said, not. , like the medical version plus also your personal version. So tell me, when people reach out to you, what do you notice are like the most like challenging things or what do you notice? What do they usually ask you?
Dr. Andrea Wadley: Really. , it's mostly what we talked about. So they think it's gonna be easy so they don't prepare themselves.
So there's a lot with breastfeeding that happens and it's a lot of it is time sensitive. So our bodies do certain things because of the way our hormones work, right after delivery. And if we don't do the things that we need to do, really in the first week of the baby's life, breastfeeding for the long term becomes a lot hard.
Breastfeeding is very hormone driven in the first, seven to 14 days of life. And that's great. So every mom who's ever had a baby makes milk whether she wants to or not during that time period. But if you don't do the things that you. Putting the baby to breast really often, having an effective latch, all those things early on, then it becomes a lot harder.
So a lot of times moms come to me after they've done all of that, or not done all of that, or been given really bad advice. And they're. They're crying and they're in pain because they aren't able to breastfeed, successfully like they've wanted to. So cleaning up on the backside of that is a lot of what I do.
A lot of handholding, a lot of putting hands on mom's backs and saying, Hey, I cried every day and it's okay, we're gonna do this together. And changing their perspective on. You know what success really looks like, and maybe their goals are gonna be a little different now, but it's okay. And this is where we're starting and this is what we can do now.
So that's a lot of what I do. I deal, I see a lot of moms who are in pain and we talk through that and what to fix with that. I talk a lot of moms out of tongue tie is the reason for everything as far as problems go. And it is a big problem, but it's not the reason for everything.
Dr. Diana Mercado-Marmarosh: So maybe are you able to help with those tongue tie or do you refer them to. .
Dr. Andrea Wadley: So if the baby's young enough, I actually can do a pH autotomy, which is, clipping the tongue tie as a home visit, which is amazing. So I did a lot of them as a newborn hospital doctor, and I've adapted some of those techniques and I'm able to do them at the house.
So I do them on referral. So if I'm seeing a baby for the first time for breastfeeding problems, I tell them, I think maybe the tongue tie is an issue, but you. Giving them the options that they have. But yes, definitely a lot of the pediatricians in town will refer to me because they know that I'm not gonna do it for everybody unless I think it's necessary.
Dr. Diana Mercado-Marmarosh: Yes. Yeah, so it's so good that again you're able to bring all these tools and use them right there. And it's so good to have. Like I said, I think you're a trailblazer because a direct primary care is something that recently, like maybe the last two years I've heard more about, but you started this almost five years ago, and so you have really shaped it.
To be able to optimize how you take care of them. It's almost blending the old school doc, so to say. When, where they say yeah we're gonna. , you and I, were gonna do this way despite what insurances say or how long, or how much time they tell us we have to do to talk. And so you have that unique perspective.
And like you said, being in their home makes a big difference. For us to diagnose with adhd, we need to , look at not just one setting, not just how are they doing at work or how are they doing at school. You need to be able to be like, okay, how do they do at church? How do they do in their sports?
How do they do at home? How do they do at work or their environment? And so it, like you said, you have that perspective of insight. Tell me you have a D H D without telling me a D H D when you walk into their home. Yes. You're able to. Easily see maybe some piles of stuff that they haven't done or different things like that.
And I'm not saying that everybody has the same way, but you learn to pick up on things that are not so obvious. And us with a d h. You, we have this timeline is staying. So us getting to a doctor's appointment sometimes it's a challenge on itself. . So how amazing it is that you can come to my house and I just have to stay put where I was supposed to be and I'm always on time for your visit, so to say.
So that would be that. That's so good. Yeah. So I think it's so important with that. Now tell me. What have you noticed? Might be some tips that you could give. Many times when during the birth of your first kid or as you have more than one kid, , even if you don't have a D H D sometimes A D H D can get diagnosed then because again, the executive function and emotional regulation.
Is actually amplified. The needs are amplified and we don't realize that the systems we had for ourselves or for one kid maybe are not enough for for now. And then you throw in not sleeping or having the breastfeeding. Being a little bit more work than we anticipated and you can see why our brain can feel like it's in a fog all the time.
What are some of the tips that you have shared with your new moms? Do you have them through checklists? Do you have them? Ask for help from a neighbor or so they can sleep. What are some of the tips that you have noticed have been helpful at since you do this breastfeeding all the time, like to this is second nature for you.
Just walk in and do it. Most of us forget like. What we went through during those shows period of time because we were just trying to survive it.
Dr. Andrea Wadley: Yes, exactly. So I don't have adhd, but I do take care of parents most. I actually, I take care of kids, but definitely parents who have h adhd and I have a.
A chronic disease that kind of gives me that sense of adhd. Things that have worked for me and things that work for moms might be different. So as a new mom, I probably had some postpartum anxiety. You just feel crazy during that time. Just everything is just, Crazy. Your hormones are making your emotions amplified, your lack of sleep, your physical demands of being a new mom.
All of those things amplify anything that you probably already had. And like you said were coping with because you had strategies. So for new moms, for breastfeeding moms with a D H D, I would recommend some things that kind of I do to just manage my own life right now. But to write things down it's number one.
So that's my number one tip is to write things down. Which breasts did you feed from last? Write it down. Or put a little pin on your shirt, or, something that is a visual cue that will remind you. There are probably about 1.2 million. Apps or more for new moms now. So picking an app on your phone that can keep track of things like, your breastfeeding, your formula feeding your diaper changes, all of those things that your pediatrician's gonna ask you.
When you go to the appointment, you're like, I don't know, I just barely got up this morning. So if you have it all written down that will. It will help you to see your progress with breastfeeding as well. I'm feeding every two hours, I'm feeding every three hours, I'm feeding every hour.
Maybe there's something going on that's wrong and having that, written log will help your physician, your lactation consultant. Know how to help you better as well. Another tip for me would be, it's a big thing for me and it was a hard thing and it's a transition to a new mom, is protecting your sleep.
Babies are biologically designed to be awake at night because they're used to this. Dark environment all day and they don't know day and night and they like to party in your belly all night. , when you were pregnant, you remember that? Trying to sleep and the baby's having dance party.
Yeah. So that doesn't change much when they're born. Doing some helpful things with sleep for the baby as well as sleep for yourself will help your. Status a lot. I usually recommend in the first couple of weeks of life, the baby's out in the bright environment during the day.
Even though babies sleep most of the day in the first few weeks having them out in the bright sunlight in a room with light coming in, the noise of your other children or your animals or the phone or, all those things. So they're starting to get used to.
The wakefulness cycle and then at night making everything as boring as possible. Trying not to turn on too many lights, trying not to have this sweet, interactive conversation with them, but just doing the boring thing of feeding and putting them back down. In the early days will go a long way to reset their circadian rhythms.
And the other piece of it is babies need to eat at night, and breastfeeding, unfortunately, I unfortunately, the way it was designed is they have to eat at night. Their bellies are only so big, their breast milk is so efficient and they just need to eat pretty frequently. So you, in order to protect your sleep if this is something big for you in A D H D, which I know it is, and a lot of mental brain change sort of things.
Is to get help. So depending on your budget and your, support at home, maybe it's something your husband can get up and feed some pumped milk in the middle of the night so you can get a stretch of sleep. Maybe if your budget allows you hire someone like an overnight doula or like a newborn specialist I'm gonna be interviewing a newborn special doula overnight person in the next few weeks on.
Grand live and she does amazing things. She comes in and she cooks for the family and she helps the baby get into a sleep routine. And she helps you, whether you wanna breastfeed the baby and she does all the rest, or whether you want her to feed, some pumped milk or some formula even in the meal.
Fine. So it depends on your budget, but there's people that will help you. And then, maybe you don't have a supportive spouse or you can employ the help. A family member, maybe your sister can take a few weeks off and come help you, or maybe a cousin or, a teenager can come in as a mother's helper during the day.
Just there's all sorts of ways that you can protect your sleep and trying to get. Some consolidated sleep that will help your mental state. And then, the other thing the last tip which goes along with the protecting your sleep is asking for help. Having all those people in your life that can help you do all the other things, caring for your other child doing the laundry, cooking a meal, those kinds of things.
I think a lot of why women with ADHD or not, Don't succeed with breastfeeding is that no one helps them. Breastfeeding is a full-time job in the first few weeks. And so those are the big three things that I would say. There's
Dr. Diana Mercado-Marmarosh: more. So I'm gonna, I'm going to recap what you said.
And then you can chime in if anything I missed. But write it down. So writing it down helps you to not have to always try to remember what's going on, so it helps you just stay present in the moment and you touched on something that's so important, visual, something visual to have.
Like you said, put on a pin or something that says, okay, the last one I did was the right, so then when I'm gonna start breastfeeding, you don't, you put them on where the pin is not, and then after you're done, move the pin, so that if you're, you always start where the pin is, not because you already used that one last, again, it almost seems so simple, but when our brain can't remember, you're going off of which one hurts less? Oh, I think I fit with that one. Like you're like doing that type of scenario to try to figure out which one it was. And then, yeah, I remember them asking like, how many hours, how frequent.
You're like, I don't know. Why am I supposed to know they, and sometimes you're. Forever. It feels like they're just attached, like they never came off and you're already asking me to put them again. And so again, if somebody explains to you what you should expect or not, that can just make the awareness, makes all the difference.
And like you said It takes a village. It really does. Like you just said, it becomes almost a full-time job. I was so mad. I remember being so mad at, I was like, this is my maternity leave, it's a leave. And my husband's you're not on vacation. And I'm like, no. If I thought I was gonna have a little bit of break for me, like, when is my break?
And you almost, if you don't have, like you said, that help. I'm so grateful that my mom came and stayed with me. The first six weeks. That was such a relief because but I did not ask for enough help at night. Like you said. I have plenty of stored breast milk. Why couldn't I had s. Said, Hey mom, why don't you keep the baby right there?
And I'll sleep. Or why don't for that night I did not know to do that. Or I did not know to ask my husband to get up like my husband. I remember being mad sometimes cuz my husband's like, why I never sleep anyways. And I'm like, then. now it's so resentful because, but then I never asked.
So yeah, you don't know that you can ask for help. Again, now looking back, it's so obvious, but while you're going through it, it's not obvious. And then you have this sometimes physician complexity, oh, I can do all the things like you, blah, blah, blah, blah, blah. Or, Motherly instinct, or whatever you wanna call it, where you feel like you're responsible to do all the things.
But if we look back the way society is, like in, in some cultures, like you do have like multiple family members living in your household, so you have multiple hands to help you with childcare with. Nourishment of your kiddos emotional and intelligence, right? And so we don't realize that we were never meant to do all the things.
We weren't meant to be the, the cook, the cleaner, the nurse, the wife, the physician, the lawyer, the bill collector, the, we weren't meant to do 10,000 roles, but here we are and. Like you said, protecting your sleep. My God. That's how we recharge, right? Like when we, if we're able to sleep at least six or seven hours, like the next morning, we feel like we have a full battery instead of just at 20% and not aware why we're so groggy or so angry, or so mad, or so tired, or so bloated, or you name it, right?
And again, you don't realize that all that is normal. Because of the lack of sleep. And and sometimes, even if you've never had a kid, and if you're a physician who's gone through any type of residency, , or med school, by that means. During those rotations, you know what I'm talking about, like your brain sometimes becomes a fog or anytime you were studying for a board exam or something like that.
Like your environment is such where you're pulled in so many directions sometimes. That you don't realize that how important sleep is. And again, the importance of just writing it down, you have something to look at instead of trying to remember because our short-term memory is helpful right there and then you write it down long-term, forget it.
I have no idea. Like you said, I just woke up , what do you want from me? And yeah. amazing gift that you could give yourself by asking for help, I think that's the smartest thing. I, again, if I would could go back, that's what I would have done. I would have invested in a breastfeeding specialist who would've shared everything you just shared with me.
And I would've definitely have invested in having like you said, like somebody come help even for a few hours during the. So I can sleep or I can or even having somebody come do my laundry or anything like that. Because again, then it gives you time for you so that we don't feel guilty that we're we needing to do.
We, you are choosing to do all this for this baby, but at the same time you're like, where's my time ? And so it's that dynamic and I'm so glad that you're speaking about this because this helps to create boundaries, but it also helps to create a support system that is a healthy support system for yourself.
And the thing is, like you just said, throughout your life, you're gonna need boundaries and you're gonna need create systems. So why not start at the beginning to. To get it there, right? So it's so good. So where can people find you? Now I'm pretty sure everybody's gonna be like, I need that. I'm in Dallas
I need that. So
Dr. Andrea Wadley: I am on Facebook at 1 27 Pediatrics. I'm on Instagram at 1 27 Pediatrics, and it's spelled. . I am also working on releasing a breastfeeding course at the end of the month. So you can find that through my 1 27 pediatrics page, or you can go straight to breastfeeding.one 27 pediatrics.com.
My hope and dream and goal is, To, start with a basic breastfeeding class and then build from there and make a community where women can feel supported and, educated and learn about breastfeeding ahead of time, and then be supported during the process. And then I am on my 1 27 Pediatrics Instagram page on Fridays.
I call it Fridays, with Dr. Wadley. I'll be doing Instagram. This month, the next few months of, bringing in different people that help support breastfeeding moms. Looking ahead, I have a, OBN next week we're gonna talk about the hormones of breastfeeding, and then after that, a sleep consultant.
And like I said, an a overnight. Postpartum doula. So those are some people that are coming up just trying to support women in that. And then if you're interested in my practice, you need to live near Colleyville, Texas. So we're just outside of the airport here in Dallas, Fort Worth.
I also have a satellite office, another pediatrician who works based in Alito. So we're glad to take you into our practice if you're in the, those areas. As well as I do breastfeeding consults for women in Tarrant County, so the Fort Worth side of Dallas Fort Worth. Sometimes if you're a physician mom and you talk me into it, I'll go to Dallas and do a breastfeeding consult over there as well.
So I do those one time. Outside of my practice. But if you join the practice as a new mom, you get all of those benefits, within your membership as well.
Dr. Diana Mercado-Marmarosh: Okay, ladies, pull the strings. . . Yeah. What an amazing niche that you're doing. Again I wish I would've had this kind of support when I was going through it and what a great way to support your patients and the moms and.
It's such an amazing thing. But as the audience listening to this sometimes zones out and that's one of our gifts. But we do re refocus from time to time. So if we just started listening right this second, what are some like. What is the takeaway point that you would want them to have?
Dr. Andrea Wadley: Gosh, I think just knowing that breastfeeding is hard and it's hard for everyone. So everyone I talk to has a story about how hard it was and that it's okay, and then it's normal and still women succeed. And then the other thing is ask for help. Women, especially physician women, high function.
In society type women, we don't ask for help and we need it and it's okay. It's hard, but ask for help and you
Dr. Diana Mercado-Marmarosh: can do it. Okay. Quick question. What do you see yourself doing in the next three years? For fun? For
Dr. Andrea Wadley: fun. So as a part of the. Andre Amne Business School. We focus on having a life, right?
So I am planning vacations, so my 10 year old, my nine year old is turning 10 this year. So we're gonna do a 10 year old adventure somewhere probably in the mountains. Has to do with, getting in a boat and doing white water. It's one of her favorite things. Oh, fun. Eventually traveling abroad would be a thing for our family.
And
Dr. Diana Mercado-Marmarosh: then what plays abroad? Have you started
Dr. Andrea Wadley: brainstorming? Yes. So my husband lived in England briefly, so he's always wanted to take us there. So that would be our goal. Maybe not this year, but maybe next year.
Dr. Diana Mercado-Marmarosh: Cool. Yeah. It's so important for us to not forget to incorporate fun into our lives because, It drives us, it fuels us, it motivates us, and it keeps us on track. And we can't forget that, this life is not. Dress rehearsal, right? This is our life. We get one shot. So why not be intentional about it and why not enjoy it along the way? So thank you so much for coming today. It was such a pleasure to have you like again, some of the things that you shared today almost seems so simple, but it's those simple things that can make a world of difference and can really help us set up routines.
And systems to support us and to then the ripple effects that happens when you are supported. Everybody else went also. So thank you so much for doing what you're doing and the people in Dallas don't realize how lucky they are to have you. And hey, maybe later on we can talk you into doing texts wide breastfeeding course.
That's something for you to consider. . Or who knows, maybe you can do a course to teach the physicians as well so that we can turn around and provide care for our own people. All right. You take care. Have a good one. Thank
Dr. Andrea Wadley: you. You too.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time is your most valuable.
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Sluggish Cognitive Tempo Disorder

Dr. Diana Mercado-Marmarosh: I am so excited to talk to you guys today about something that is called Sluggish Cognitive Temple Disorder. They used to think that it, was a category of A D H D. They weren't sure, but now they're working on figuring out that it's totally separate from A D H D, although they can correlate.
And I wanna. Explain the differences between them and explain that because it's so important for you to be aware whether you have that in A D H D or if you just have that and not a D H D because the treatment that you use is different. And yeah. So I think it's so important. Okay, so sluggish cognitive temple disorder is something that is been talked about a lot or by Russell Barkley.
He is a clinical professor of psychiatry from Virginia Treatment Center of children in Virginia in Richmond Virginia. But anyways I learned about this sluggish cognitive temple disorder during one of his presentations while I was working to become a clinical certified life coach for A D H D.
He has a Barclay rating scale for the sluggish cognitive temple disorder. And on there he talks about some of the characteristics that really make it stand out different from A D H D. So when you think. The Barclay Rating Scale. He wants you to think, to wonder whether you have you're somebody who is daydreaming excessively if you're having trouble staying alert or awake during boring situations.
Whether you're somebody who is easily confused, whether you're somebody who is spacey or seems to be like in a fog. Mind seems to be elsewhere or who is staring off into stage, or whether you're somebody who feels lethargic or more tired than others, or whether you feel like you just. Have no energy.
You're slow moving or sluggish, or whether you are somebody who seems like you're having a hard time processing information as quickly or as accurate as others, or whether you feel like you are withdrawn like you get lost in thoughts, or you seem to be very slow to complete a task.
So the important distinction that he makes or that he wants you to differentiate this from A D H D is that it seems like A D H D is more of a productivity disorder and he wants you to think of sluggish cognitive temple more as. Accuracy disorder. I thought that was important to point out.
And what he was saying is that when you wanna think about this, whenever with a D H D, we know that it's not. One part. But with A D H D, it's more like the executive function. It's the emotional dysregulation, it's the processing and the implementation and the planning.
So there's so many other stuff, but people with a D H D, some of them, they tend to have Endless amounts of energy, and I guess that's what people usually say about me, but we also have to remember that it's a spectrum. But what makes this a little bit different from A D H D? It seems like there is a slowness to the behavior.
There is a slowness in the information processing, and there seems to be some mental confusion or slow activity instead of like impulsiveness that can be seen in a D H D. And I wanted to point that out because I know I had several clients and I've had several of my own patients where they just come and they tell me.
I am so tired I cannot seem to focus long enough what people are telling me. So I want you to be aware of this possibility because we might incorrectly label them as a D H D and give them the treatment for A D H D, and then that was not the right diagnosis and it might not help. And interestingly enough what Dr.
Barkley says is that we're not even sure if this naming of this disorder is correct because luggage cognitive temple disorder it might not be appropriate to be labeled that because it almost implies that you have a cognitive deficiency and it might not be, it's just that maybe the processing speed of it is a little bit slower.
And so he thinks like maybe it would be better to call it like a concentration deficit per se. But anyways there was a recent study in the Cincinnati Children's Hospital. They treated the kids with this disorder with Ritalin to help with their daydreaming sluggish symptoms, and it really didn't seem to make a difference.
And then there was another study that was published in an article by WTA at all in 2013. And there they noticed that the children that had a D H D or dyslexia. In addition, they also had this luggage, cognitive temple disorder when they were treated with stratera, or the other name for it is Atomoxetine that actually had a benefit to it.
So as you know that this is a non stimulant type of medication, and this type of medication will help with not only neuro it will help with serotonin and nor. Which is different from sometimes the stimulants help, right? And so it's important to realize this because we might have a patient, or you myself, may be somebody who is not quote unquote benefit from stimulants.
And if you are given a non stimulant like this, you might have a great benefit. So with A D H D, think more about it. Pro productivity problem sometimes versus with s e t or an accuracy problem. And so there is some data out there and this disorder just slowly started to get look into since the 1980s.
It's not like it's been around forever. There some of the data out there right now shows, it seems like kids are able to be more self-identifying. Like they can tell you that they feel that they're slow to processing or they feel tired or that something is. Wrong compared to when you're making the diagnosis of an A D H D, we usually tend to look at the external perspective.
Like we ask the parents, the teachers, like in different settings coworkers. But with s e t, it seems like you have more internal awareness that this. You are daydreaming too much. Your mental confusion or there's some, your hyperactivity is a heightened, you have more of that awareness versus with a D H D you need to rely more on external awareness.
And with that also being said, there's some correlation that says s c t there is some correlation that having some type of like family or child psychology or adversary can increase the likelihoods of you getting this. For example, if you have parents who are divorced or maybe they come from a low socioeconomic household or a low parent Education, those social stressors are more likely to lead to this S C T versus not necessarily the case that these same things would lead to a D H D.
So all those is all that information is of cool and interesting. And there is some data also that shows that 60% of kids with s C. Might have a D H D and interestingly enough, 40% of people with A D H D might have S c T. So the point is that it doesn't necessarily mean that you have both, but it could.
B that you have both and being aware of that might open up the possibility of maybe not only being on a stimulant, but being both on a stimulant and non stimulant to help you treat both things. So that would be interesting. And I actually, looking back now, I can think of a couple of my personal patients that I have them on, both stratera.
And also stimulants and now it makes sense why they're doing so much better, because both facets are being addressed. So anyways, I wanted to share that information with you. I was surprised to learn about these things. And, as adults It's more likely that the older we get, the more likely might have S C T and A D H D.
But interestingly enough, 55% of a D H D in attentive type might have the S C T. And again it makes sense, right? Because I just told you that this is more like a sluggish and. The hyperactive A D H D people are not going to necessarily have s e t because they're impulsive. And this is like the opposite, not necessarily impulsive.
Okay. One last thing that I thought was more interesting too. Sometimes with s e t it can affect it, it can give people problems with math. And so if you have a person who just recently. Diagnosed with a D h, ADHD, and they've always had problems with math. You might want to consider if they actually have sluggish cognitive disorder or both.
Okay. So it was so great to talk to you guys about this. So takeaway point here is that you might have. something else, not just necessarily A D H D or you might have D H D and sluggish cognitive temple disorder. So if you're somebody whose stimulants didn't necessarily work and you always feel of tired and you always feel like you're daydreaming excessively or you're confused easily, you might want to look into sluggish cognitive temple disorder.
And I hope you have a great one. And as always, I'm here to support you. Send me questions of whatever topics you wanna talk about.

3 questions to ADHD Declutter Your Life with Ease

Dr. Diana Mercado-Marmarosh:Hello. Hello. Welcome to Beyond A D H D 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 A D H D. 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 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. Uh, we are definitely in January, 2023 now, and I wanted to start out this year, right? I wanted to remind you guys why we do what we're doing. Um, we forget that. Our growth is optional. , we always think that, you know, we have to wait until the new year.
We have to wait till Monday. We have to wait until whenever to start making a change. But the thing is, you really don't, someday is not a day on the calendar, right? You really have to decide what your intentions are for 2023 and go for it. And so this. Um, my intentions continue to be, to grow and continue to be, to only do the things that like light me up and the things that will, um, give me peace of mind and the things that will make a big impact in humanity.
And as you guys know, I'm on a mission to really. Medical field, uh, to really disrupt the way a D H D is viewed, uh, so that people can realize that mental health. Really important and realizing front and center that our emotions, um, can be used as a compass is, um, I think one of the key things that people are not aware.
And so with that, I want to talk to you about three questions that I always, um, Teach in my A D H D course, and I want you to implement them. Ask them of yourself today so that you can gain so many hours back. Okay? And I'm gonna ask you these questions and I want you to really, they're so simple that you're gonna be like, really?
That's all . But I guarantee you that if you start to apply, You're gonna save at least three hours of your day, at least. Okay. And it will start to add up and you will start to be, um, in alignment with what you want to do. And yes, I know that change sometimes is hard and I know that accountability is one of the ways to really, um, bring it in.
Yeah. And so with that in mind, You know, I want you to be aware that I'm here to help you in any way and. The prize of my course, as you know, is going up. Um, well, they should already gone up. Uh, you know, January 1st I was gonna start charging a 4,500, but I've decided that, you know, I have a D H D too, and I've decided that sometimes we all need a little extension and that un unfortunately, life is not dress rehearsal, but being kind and being human and being generous is the most important thing.
Because, you know, life should be abundant and it should always come back. So because of that, I am going to extend the deadline of my, of, of charging. So instead of, uh, going up to, uh, 4,500, um, which it will go up, , it will go up by, um, February 1st for sure. Um, I want you to use this as an opportunity to invest in yourself.
I wish somebody would've given me this, uh, opportunity when I was a medical student. When I was a a resident. When I was a, an attending, I, obviously, this is why I created the course because nobody told me about it or told me how my A D H D brain works, and every day I see posts that basically say, Help, I'm about to get fired because of my A D H D or people with A D H D are not even aware that there's resources there.
And other colleagues are asking questions on different Facebook groups, um, what they can do to help their colleague out because they have a great personality and they're amazing with their patients, but the administrative stuff is getting in the way. And so I want you to be aware. Our internal environment, um, sometimes mirrors or external environment.
And, and some of you are already getting my emails, and in one of the emails, you know, I wrote about how you can change yourself, but if you don't change the environment, it's kind of hard or you can. Quit and go to a new job, which is essentially changing the environment but not yourself. And it's not gonna change, right?
Like it's not just magically gonna change. You really have to do both. You have to learn about yourself, and you start to implement what you're learning into the. Trial and error systems so that then now they can support you and, and it's, the magic happens when you do both, when you change yourself and you change your environment.
So why am I talking about this? Because again, it goes back to our environment, whether it's physically like how your office is, um, how it flows or it's. You know, if you have a clutter everywhere, it makes you feel like you're not productive, right? And so with that being said, Whether it's these questions that I'm gonna ask you, you can apply to anything and what I'm gonna be bringing up with you today, this is, um, what I use in one of my master in masterclass or workshops that I do, that I've done and I've gotten really great feedback.
So I figured why not share it with the rest of the world. We all need to, uh, be in the, in the same. Start somewhere, right? Progress is always better than perfection. So with that being said, um, the three questions that I ask myself is always number one, is this still useful? It sounds silly, right? But we all get things at some point in our life that we thought it was the best decision.
Maybe that jacket or maybe that dress, or maybe you bought like some fancy silverware or who knows, right? Or uh, so you have to ask yourself, is this still useful? Like would I. Go into the store today and pay anything for it, because I would want to have it again. Yeah. So is it useful? Is it outdated? So you really have to ask yourself that.
Does it still have a purpose in my life? And here's the thing, we're talking about things, but these type of questions you can apply to anything. Like you could apply it to your job. Is my job still useful? Would I choose it again? Is my relationship still useful? Like, I know some relationships you can't really walk away from, right?
Like you can't really walk away from your mother-in-law or from, um, your sister or from, you know, different things like that. Not that I'm saying that any of those are my problem because I love those, but, you know, and coaching clients. I've been asked these questions, they're like, but you know, da da da da da is draining me and the holidays are rough and being critique.
Here's the thing, like when I'm talking about decluttering your life, I am talking about on purpose setting boundaries and knowing. Heartedly what's gonna support you? Right? So would you choose that relationship again with your, with that so-called friend, or you know that it, all they do is call and ask you for X, Y, and Z?
And it seems like it's always one-sided and it's energy draining and consuming, and you feel worse about yourself. Um, or would you on purpose decide? You know, if it's a relationship that you really can't get away with, uh, because again, like it's like a relative or something, you could on purpose decide, Hey, I'm gonna limit the interaction instead of going to spend with them a whole week, I'm just gonna spend with them one or two days.
Or you can't tell them, uh, when you do this, I am gonna do that. And so, you know, I'm very proud of one of my, uh, clients. She shared with us yesterday doing our group coaching. She was able to tell one of her relatives that, while you might do this a certain way, and I do this a certain way, I want you to respect that this is a topic that we do or don't do here and, and I need this from you.
And so she, uh, she was able to, uh, state her boundaries and she said it was a wonderful holiday. So the point is, And I asked her, um, why do you think you were able to set those boundaries and. Necessarily sometimes set those boundaries at work. And you know the answer was the universal answer, which is, well, I know that that person loves me unconditionally and I'm not sure that they love me at work unconditionally, right?
And so here's the thing, like what I said, what if those boundaries are being placed from a, a place of love and from compassion and so respect to yourself so it doesn't, when you're taking care of you. Everything just falls into place. So with that being said, I want you to make sure that you're aware of what the questions are.
So the first one was, is this still serving me a purpose? Right? Would I walk again and buy it? Right. And then the last one is, Can I, can I help somebody else with it? Like, is keeping it gonna give me peace or not? So it's so important that when we are talking about these relationships, we realize that, um, some of us, so the three simple questions like I was saying, are so simple.
The first question is, is it serving? The second question is, do I really want it? And the third question is, is this current or outdated? So again, these three questions seem so simple, but they can really help you to tone in what is important when you ask yourself is, is this serving me? It means, is it giving you more energy?
Is it freeing up your time? Is it being a benefit to you? Right? The other one is, do I really want it? Like, would I choose it again? And the last one, like I said, is the current or outdated because we all have stuff that we've been holding on for for years and years and years, and we might not need it. For example, , I don't know if you have kids or not, but you know, I have a four and a five year old and I've recently was able to, uh, give all my stuff like I still had one, one.
Like a, you know, a crib. I still had a change in station. I still had like the clothes, um, for up to four years of age. And even though I have decluttered multiple times, I was holding onto stuff just in case I had a third child. But what I decided was that, If I do happen to have a third child, that would be amazing and I can acquire this stuff again.
And meanwhile, why not give it to somebody who needs it or, and help them, right? So I say all this because many of us hold onto things and I joke around and I say, you know, I was so grateful when my kids were being body trained that they were not. that they had diapers, right? Because imagine if they were peeing everywhere or pooping everywhere.
But that didn't mean that I was gonna hold onto the diaper forever because I was able to use it. Like the point is, there's certain things that have a chapter in your life and then you need to let go of it. So if you really ask yourself, is this item that maybe you just did the laundry, uh, do I need to put it away or can I give it to somebody else?
It's gonna save you hours of time, because later on. When you are sorting the clothes, the clothes that you have left is only clothes that you have been currently little by little in a system-wise approach have been keeping that currently fit them. You don't have to then spend like a whole two days or something going through other drawers or being frustrated every morning that their clothes no longer fit, right?
So, I really want you to ask yourself, is it serving me? Do I really want it? Is it currently you're updated? If you apply these three questions to anything, like I'm saying, you're gonna get endless hours back and you could ask yourself like, is it really helpful for me to spend five hours doing the laundry a week?
Maybe it's not. Maybe that could be something that you outsource to somebody. What would you do with those five hours? Do I really want to continue doing the laundry? What would it cost me to continue to do the laundry? So I wanted to consider all this and make sure that you're aware that you have opportunity to really change.
And of course, of course. Um, You know that I'm here to support you in any way possible. Again, while this system seems so simple, it is in the group setting, non-judgment, um, supportive environment where, uh, we all can thrive. So, I'm so excited that we are here together. 2023. Keep in. Send me a link, let me know what you want me to talk about, ask me any questions.
And I would love to, uh, create this content around you. Do tune in to next week's episode cuz I am so, so excited about what I'll be talking about. Um, I don't know if you knew until recently, I didn't know that. Um, there's something called the s Luggage, cognitive tempo Disorder. A lot of people confuse that with a D H D, and so I'm so excited to be talking about, uh, how Dr.
Barkley, um, Really, uh, tis those two things out because, uh, the stimulants that you use sometimes are not so helpful. And so if you have somebody who has h ADHD or you yourself have d h D and you're not really finding the right medication, I wanna make sure you have the correct diagnosis and the correct treatment for it.
So, tune in, talk to you soon. Bye. 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 at a D H D dash live. coach.com where you can find out about my upcoming coaching group classes, as well as free masterclass and other exciting events that are happening.

How My ADHD saved the Holidays

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond D H 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 A D H D, 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.
In the past two years, I've come to realize that I'm learning some of my beliefs and some of my habits were just as important as learning the new set of skills. Well, hello. Hello. How are we doing? Then? A couple of weeks since I joined and did a podcast. I would say that I'm. Blame it on the weather, kind of like Southwest did, uh, this holiday week, right?
But life happens and I am just gonna roll with it. But today what I wanna talk to you guys about is how my. Adhd and not just mine really, but I think my family's h adhd, uh, help salvage the holidays and how we have, we've been having an amazing time because of our h adhd. Probably most people would feel, um, very, very, uh, overwhelmed with the change and the fact that, you know, The fact that, uh, anything that we went through this week, so for example, um, my week started off, uh, our vacation started off on December the 22nd, and we left Austin and we decided this year there's 12 of us.
And we, this is something we've decided beforehand that we, we, we decided that instead of giving each other gifts, like physical things that we would try to give each other experiences, uh, to decrease clutter, to improve bonding time to, uh, improve connectiveness. And so in doing so of. During Thanksgiving, , we were, uh, planning our vacation for Christmas.
So just six weeks away, right? Uh, we decided we wanted to have, well, we, we've been talking about it, that we wanted to have, uh, snowy, uh, White Christmas. And so , typical a d h, adhd, uh, and of course some wine involved. Uh, we were looking, uh, places to go find this quote unquote magical snow, right? So when we were planning for it, we were planning, we started off looking into New York because my husband's parents are in New York, and then we considered a Denver, and then we considered, um, salt Lake City.
And so due to the fact that, um, maybe it would be too much to ring 12 relatives to visit my in-laws, uh, we decided, uh, and it was kind of like short. Notice type of thing. Uh, and also due to cost as well, we were looking at the price of the flights and looking at the price and the availability to go from point A to point B because we wanted to rent, uh, 12 passenger van or, or a van that would have the.
Capacity. Uh, we ended up using the, we, we outlined what we thought was important. We knew that we wanted snow. Uh, we knew that we wanted, um, a way to transport to get to the places we weren't so, Skiing on, like, uh, necessarily skiing. Uh, but we wanted to at least be able to go tub, be, uh, or to goat sledding and to have the ability to make a snowman.
So those were like our big things. And of course we wanted to be together. We wanted to find a hotel or an Airbnb, um, that would accommodate all 12 of us. So with that in mind, we ended up, uh, using Southwest and, uh, we were looking at flights and stuff like that. And of course, we all know that we, once we decide on something, we can like hyper focus and we can make stuff happen, right?
So what I'm saying is that our ADHD brain, while it doesn't sometimes. To go off the course of what we had decided to do. It is very good at adopting to whatever is currently in front of us and being able to, um, Adjust and pivot, right. So when we started our vacation, uh, on December 22nd, uh, we went from Austin and we decided that, uh, we were going to Salt Lake because in Salt Lake City we could stay, um, , you know, uh, a few in little towns kind of like Midway or um, park City, and, uh, we could get the snow that we wanted and we could experience the city and just.
You know, we didn't come with a full agenda other than what I just suggested we wanted. And again, when you are, we're talking about traveling with 12 people. We're talking about traveling with four kids under seven. Um, there is a 3, 4, 5, and seven year old. And then of course we had two, um, older teenagers.
Um, And well, one is 18 now, so that helped. And the other one's 16. And then of course my brother, my sister, her husband, my husband, my mom, and so 12 of us. So the point is that
staying overnight in an unknown hotel can be fun, right? But it can also become. a nightmare . For some people, if you know, the bed doesn't feel good or it feels funny or smells funny or people are, you know, having problems with each other. The, the point is that, um, we ended up choosing Salt Lake City because we were able to find a hotel that.
Could accommodate all three of us with the price point that was not gonna break the bank. Uh, we stayed in Midway, which was very close to Park City, and we did come in, uh, we came and, and, and did things right. So with that in mind, we were there for, uh, for, we were meant to be, be there for five days and then we were meant to go to Vegas for another five days or four days I think.
So we booked flights because, uh, to, to make it easy in travel. And we rented a van when we got to Salt Lake City. With that in mind, You know, life happens and Southwest was, is going through, uh, staffing issues and weather and all that stuff. And when we get from Austin to, um, Uh, to Salt Lake, we realized that our two car seats didn't make it.
And we also realized that our two big luggages, which had all the clothes for me and for my husband, didn't make it. And luckily, the two little suitcases where my kids clothes were. Did make it so at least we had clothes for them. And of course, uh, you know, we stand in line. Oh no. Oh my God. Like there was a huge line, like 20 or 30 families did not get their lu.
Well, little bit. We know that that was like just the tip of the ice. So to say that we didn't know the iceberg, but we didn't know how bad, uh, the southwest thing was going to be, and that it might be about a month before we get our luggage, which I still don't have my luggage six days later. And so I think that the fact that.
My A D H D didn't make it mean anything about the fact that we didn't have her luggage. I, you know, I see, I, I looked around. Everybody else didn't have their luggage either. Um, I kept telling myself that, you know, the reason we were there were to make memories. The reason we were there was to, um, to spend time with each other.
And despite the fact that. The plane took off an hour and a half later than expected, and despite the fact that, um, we were sitting in the taxi runway for another hour because there was not a gate for us to get off into, um, I, I kept thinking that we. Got to our destination safely and that we were, and, and at that point, I didn't realize we were in the 30% that had got into their destination.
And I didn't realize that we were in the 90% that was not gonna get their luggage right. But my mind kept going to the fact that things can be replaced materialistically. , right? And that again, we were at the place we wanted to be at. With that in mind, the day prior to us even flying. , uh, we almost didn't have a car that we were going to use again because of the weather and the situation that was going on, but luckily, uh, they were able to, uh, help us find a car, uh, that was useful and that weren't well, and that was so good that we were able to have a car, uh, to move around and to travel and to, uh, do that.
And, you know, again, because we didn't have a huge, um, itinerary and we were flexible, I feel like that helped us to not only survivor our holidays, but to really be more present and to look around and to experience the beauty of it, of it all. Like, you know, the, the beautiful houses with snow. Uh, it also allowed us to.
More on each other and lean on each other's strengths and reasoning. Um, and I feel like our ADHD helped to save the holidays. Um, we were able to, Um, plan, you know, while we were there, we were trying to plan, we really wanted to go, uh, experience anything. Like we wanted to go tubing, we wanted to do the dogs list.
We wanted to go to the ice castles one, unfortunately. We didn't realize that all these places you need the reservations like three to four, two, maybe six weeks beforehand. And again, we didn't do that research. Usually we do that research ahead of time, but this time around again, we were kind of flexed and we didn't know what, um, if we, we didn't wanna book for things that, what if we didn't even make it there and we couldn't, um, you know, enjoy it and it would be all this money invested.
So again, a D H D was good in the sense that we didn't preplan. Because then once we were in the area, we walked around and we saw an ice skating ring. We looked up the times we came to the ice skating ring. I finally got to ice skate. I've been meaning to ice skate. My husband, uh, Promised me to do this on our, one of our first dates.
And you know, we've been together for 16, 17 years. I don't even know how long. It's been forever in a day. And we finally got to do it. And he remembered. And you know, even through that whole ice skating thing, that also was something that I had to work through. Like, I kept thinking about the fact that, you know, A few years ago, I fractured my ankle and that I had to be more careful and that what if I damaged myself again trying to do this.
Sport and I kept seeing people fall. But you know, um, my husband was, um, gently persistent and uh, he came and asked me if I would skate with him and, and I said, oh, well maybe hold my hand. Well, I, first, I tried, I got on the ice and I couldn't. Like I didn't feel safe or comfortable. So I got off the ice skating ring and then he came again and then he's like, I'll hold your hand.
But he really didn't wanna hold my hand cuz he said he didn't wanna gimme a false sense of security or stability. And I said, I think you need to, for the first time around that I would go around this ring because otherwise I'll be on the floor. I'm not trying to be on the floor. And so we skated one time around on the floor, uh, around, and I didn't.
And then I said, this is good enough, I'm gonna go sit down. Uh, and I played with my daughter and we were doing snow snowball fights, and then he came back later and took my daughter to go try. Uh, and he was taking turns with the kids. And, um, then eventually he came back and he's like, let's try it again.
And he's like, I won't hold your hand. And. . And so the thing is that after that I went ahead and did it like I was right next to him. It, it took me a while, , but I did it. I went around and somehow I was like doing some circles. I don't even know how I was doing them because, you know, I wasn't trying, I was just trying to stay upright.
People thought I was dancing. I wasn't trying to dance. They came and commented on like, that's awesome that you can dance on the eyes. And I was thinking, But I just try to stay upright, . So the point is that my ADHD and not overthinking it allowed me to do things and to step into the zone of excitement instead of the zone of fear.
Because we all have fears, right? But we shouldn't let those fears paralyzes. Again, stepping into our H ADHD of like, well, why not, or let me try. That could be very, very helpful. Alright. Another thing that I say about our trip is that. Even though we try to, um, again, book two being experience and it was going to be $30 a person and again, we're 12, right?
Um, I couldn't find it, like there was just nothing available. So my sister got on the internet and looked up like where to go, a sledding or tubing by herself for free. And when she did that, um, that opened up another world of possibilities and. Uh, that helped us to then just go to Walmart and pick up some flats, go through a thrift store and pick up some flats.
And we found a place where we could go and it was amazing. And we did it. We did the experience without paying an Army Electric. and we got to go and Maker Snowman and have Noman Fi uh, small snowball fight. And that was really fun. And then at the other days, we got to just go and try the local food. And then we try, we went to the historic district.
So the point is that, you know, Spain and in the moment allowed us to enjoy the moment and. Absorb the surroundings and just be present and enjoy the fact that we were with each other. And that made all the difference. The, the cousins could be the Grinch on the tv. We could make cocoa, we could talk about our year.
Like it was just amazing. And then of course, . Um, when it came time to figuring out what we were gonna do for the next leg of our flight with Southwest, um, our flight was likely gonna be canceled. And so, um, and, and so we decided to drive, you know, it was like a six hour drive from Salt Lake to, um, To a six hours drive from South Lake to Vegas.
But you know, our Southwest flight was more than two hours delayed. And I think we had to make a choice. And again, we decided, okay, if we go through Southwest, we might get there delayed, but we, our luggage might not get there. And if we go. . Um, if we drive, even though it's gonna take us a little time, it might actually be better.
And, you know, we listened to our bodies. If we were feeling tired, uh, we decided to pull over and take a nap and. Listen to or drink water and eat and, and so what was supposed to be a six hour drive ended up taking about eight hours. But again, we did it in a way that was safe for us and we used our A D H D and we kept telling ourselves, we don't have, um, you know, any type of restriction.
We just gotta get there. We gotta get there safe. That was the.
So throughout this time, we made it enough so that we could just take time for ourselves if we needed to. Like nothing had to be perfect. Uh, we just had to lean on each other and. Make a plan B, make a plan B, make a plan D, you know, and prevent potential meltdowns by making sure that our kids were fed, that they drank, that we were communicating with them what the party was.
And you know, and we're still in Vegas and we've decided we're gonna go try an escape room and we're gonna lean on each other's strengths and just keep exploring and being fun. So what I wanna say, In order for us to have, um, good holidays, you've gotta ask yourself what your priorities are. Like we knew we wanted to see snow.
We knew we wanted to spend time together. We knew we wanted to bond, so then we just worked towards that. So I really think staying flexible and looking at the bigger picture makes a big difference and allowing people to do what they like. You know, some of us didn't wanna go see, uh, a magic. so they don't have to, some of us didn't wanna go dancing, so they don't have to, some of us don't wanna go drinking so they don't have to.
Some of us wanna chill with uh uh, you know, seeing a movie and that's cool. So I think. And being okay with buying different foods. Like last night I had a gyro and my mom has some chicken, uh, you know, from a different restaurant. And my, my sister had another had in and out burger. So it's okay to do your own thing and it's okay to also compromise.
So I really think our A D H D one was,
uh, was also. Important. So anyways, uh, I'm back and I just wanted to wrap up this year by saying that it's okay to have self-compassion. It's okay to have grace. It's okay to be present. It's okay to use your A D h ADHD as your strength. I don't know how the rest of the, um, ordeal, the Adventure is gonna go, trying to get back.
But when we get there, it's gonna work out because in our mind, you know, doing what we want is what was the most important thing. All right, well, I can't wait to connect with you guys. Um, and I know some of you are gonna be doing the January course with me, AB. So excited about that. Um, that's gonna start on January the 23rd, if you wanna do the Monday class or January the 26th if you wanna do the Thursday class.
So do take, you know, right now, this is the lowest you're gonna get the CME credit. Uh, Sorry, this is the lowest you'll get, um, this year's rate for the January course. So it's gonna be, uh, so take advantage of that because it's gonna go up in price. Um, it's gonna go from 3000 to 4,500, so definitely save that 1,500.
If you can, uh, and we can obviously set up payment plans. Remember, you are your best investment. Definitely don't forget that. Take advantage of the fact that, you know, We are professionals, that we have resources that we get to decide how we practice medicine and how we live our lives in our own terms.
Anyways, it was a pleasure chatting with you guys. And, uh, please send me an email. Tell me how your holidays went. Tell me how your d h d are your strengths. Which ones are the characteristics that are your strengths? Obviously for our family, it was staying presence, staying flexible, being willing to pivot, being, being, uh, AB able to have a plan B and C, and remembering what the holidays are really.
Uh, so use your ADHD to. Envision the rest of your 2023 and not just to envision it, but to make it a reality. And if you want help in doing that, I can't wait to help you to do that. So please do that. Um, in January we're going to be doing the procrast How to Procrastination and Overwhelmed, uh, free Masterclass.
And I will be giving y'all the. Soon. But if you are also looking for a vacation slash growth opportunity, don't forget that my Costa Rica, uh, physician retreat or healthcare retreat is gonna be happening in May, May 1st through the sixth. So put that in your calendar. Uh, some of the physicians have used, uh, some of the remaining.
CME funds now, like, uh, to give a down payment and lock it in, and then they're gonna use the rest of the CME for 2023 to pay it. So yeah, let's touch base, let's work something out. I can't wait to support you and keep being amazing. Take care. Bye-bye. 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 adhdlifecoach.com. Where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.

Ditch Overthinking

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mercado Mar. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my D H D, 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. And some of my habits were just as important as learning the new set of skills.
Well, hello. Hello. I hope y'all are doing well. It's crazy to believe that we are on episode 52. Yes. It's amazing. A whole year of recording the podcast. Um, why am I doing this? Well, because I believe that. , our stories really do matter. Um, a lot of times we don't realize that our self-talk, um, can really affect how we show up.
and how the rest of our day goes. So I've been listening to a book called, called the Soundtracks, and it's so interesting. Uh, he poses three questions, which he says that these three questions you can use to really stop your overthinking. He talks about the fact that, um, we all. Have, you know, some thoughts that are in our mind, and if we really took the time to slow down and ask ourselves these three questions, it could paralyze or overthinking.
So the three questions that he mentions are,
is this really true? The next question is, is this helpful to think about it this way? And then the last question is, is it kind? So let's go through like a story and figure out what I mean by that. So, you know, most of us always think, oh my God, I don't have enough time. And do, is that really true?
are you being really realistic with a number of things? Are are in your to-do list? Are you really choosing to do the things that are a high priority or are you not even aware that you're buffering with that because you are? On purpose, avoiding the other things that maybe would be having more bang for your buck if you did it.
So, you know, when we think we don't have enough time, like your brain does not go into like problem solving mode, , it just goes into like, kind of victim mode and it gets, you know, all stressed and overwhelmed and, and it does not take action. And try to, and try to find a solution, right? So you, you gotta remember that for it to be true, like 12 people from the court of law kind of say, would have to agree that yes, this is true.
Like, you know that you are five two, or that you know you're a female or that you're a male. Like that there would be like, no question about the vi fidelity or like, you know, the, the truthfulness of it, right? Okay, so you ask yourself that first question, so I don't have enough time you tell your, that's maybe not true.
Right. And then the next question is, is it helpful to think that I don't have enough time? Is it really helpful to think that? Probably not. Like, again, we just went through this whole exercise that if we're thinking we're not having enough time, we're not gonna take the necessary steps to. That we do whatever we need to.
We're not gonna ask people for help. We're not going to, um, you know, feel accomplished with whatever we did do. And then the last thing, uh, is. Is it health? Is it kind for me to think this way? You know, maybe you're thinking I don't have enough time and because I don't have enough time, that probably makes me like the worst mom in the world, or that makes me like the worst wife in the world, or that makes me the worst daughter in the world.
Like you can have all kinds of thoughts that not having enough time is maybe preventing you from showing up as like the best version of yourself. And because you're not showing up like that, you're thinking that you. You're horrible. You're not a good human. Or maybe you're thinking you're ashamed that, you know, you have the clothes from all over, um, you know, and you're like, oh my God, I'm not a good mom.
I don't have clothes put away. Like it's a mess. I'm a mess. Like, you're, is it really, I. Kind for you to think that way. Probably not. So it seems silly that those three questions would be, will create such insight. But you know, it, it's good to ask yourself those questions cuz you can really apply 'em anywhere.
Like is it, um, is it true that having h d means that you're broken? Is it true? Is it really true? Um, is it helpful to think that way? Is it kind to think that way? Probably all three don't really add up, right? But yet our brains sometimes have, have thoughts that we don't even like question that we, we don't even.
You know, wonder where that, where that came from? Like, why am I thinking this way? So like today, During our, one of our coaching sessions, we had our guest coach, um, and we were talking about decluttering, which of course, that's a part of my program that I totally love because, you know, each member gets three fr three sessions with my, with my, um, the coach.
And that's so amazing that they're able to then personalize it, whatever they wanna get rid of. But anyways, going off on a tangent, one of my clients said, I'm bad. Uh, you know, I'm bad. The house is a mess. Uh, I actually have to pay somebody to help me, uh, you know, come and organize my house, um, once a month.
And I, I'm bad, I'm bad with that. And so I quickly in the chat, I'm bad is, is not true. It's not helpful and it's not kind. I think. And then I put, um, badass is. True is helpful and is kind like I see her as her being badass, that she knows that this is an area that she has decided she want to, wants to invest in, to try to, um, help herself.
Acquire the tools that maybe she's not where she wants to be, but she, if she keeps thinking that she's bad and therefore she's broken, like that's not helpful at all, and that's not true. Like in my eyes, yes, she's badass, that she has gifted herself this opportunity for learning and growing and figuring that there could be a better way.
Again, you can quickly see how, uh, she then shared that, oh, she was ashamed of all the mess and blah, blah, blah. And I had to point out too that you know, you're not. You're not the mess, the stuff around you is the mess and you, you're separate from the mess. Just like we are separate from our thoughts and we're separate from our emotions.
Like we, we learn to deal with them and question them and try them on and see what fits and what doesn't fit. So we have to keep remembering, you know, that our A D H. is a gift, or it could be a curse. Your brain is going to lead you one way or the other based on what you decide. So again, your self-talk really does matter.
And at the end of the day, like your brain doesn't care. Of course it's programmed to kind of be thinking in the negative, uh, because it's trying to keep us safe. Uh, it's been like that for, you know, thousands of years. If you're too cool, calm and collected, I mean, we would've been eaten by the bear, right?
So, but using gratitude, um, as a way to hack it. Like if every day you wake up and you start your day with like three things that you're grateful for, and it doesn't have to be anything crazy, like it could be that, you know, Your kids are st are, you know, still breathing, that you have food on the table, that you still have a job.
Like you could think about anything that you're grateful for, and then you on purpose decide like, what is your intention for the day? Like, what are 2, 3, 2 or three things that you want to accomplish at the end of the day so that you could say that yes, this was amazing, or, um, at the end of the day, like deciding okay, what went well, you know?
So again, um, how you talk to yourself makes a big difference. If you are always telling yourself you're too slow, you could never change, like you don't have enough time, you don't have enough money, you don't have, you're too big, you're too small, you're whatever, like any. Anything that we are using against ourselves, it's gonna keep us from being who we are.
But anyways, I wanna invite you to come to my, uh, webinar that I'm gonna be having. Um, and you know, on there I'm gonna be talking about how to end procrastination. Um, because yeah, we all can end procrastination. We really can. and you are just a few thoughts away from it, and I want to support you in doing this.
I want you to understand that, uh, being able to, um, be all in on ourselves makes a big difference. So please join me on Saturday, December the 17th. From 11:00 AM to noon, uh, central, go to my webpage, a d h d live coach.com and that way you can sign up for my webinar. But, um, some of you already know my coaching program, uh, right now is $3,000 and.
If you get in, uh, in it now, you know you can reserve your spot for, uh, 2023 when it's actually gonna go up to 4,600. So don't wait. The time is now. The time is now to, uh, gift yourself the gift of time and to start to live and practice medicine in your own terms. Um, You know, uh, continues to happen and growth is really optional.
And so you gotta decide, you know, if you want a different result than what you've had in the previous years, you really gotta re uh, decide to do something different. So why not join my community for you can be a hundred percent fully supported. Come have fun, learn all the tools, all the hacks, and uh, yeah.
Enjoy, uh, you know what's to come. So like I always say, if you just started listening now, , the takeaway point is that there are three questions you should always be asking yourself. And those are I, um, those three questions are, is it true. Is it helpful and is it kind? So yeah, try that and send me a message.
Let me know, uh, what are some things you're working on or what are some things that you would like me to talk about? And, uh, we can, we can be in touch. Thank you for spending your time with me. I really believe that time is your most valuable. Please subscribe to the podcast, 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 happening.

Manifest Your Goals with Abbie Schiller

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Medo Marm. 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 some of my habits were just as important as learning the new set of skills. Well, hello. Hello. I am so excited today. Uh, I can't believe it's. Episode 51. It, it's crazy how you do things and you forget you're doing things and all of a sudden you get almost close to like a year of doing things.
So with that in mind, uh, I've had a couple of crazy weeks, um, the three sessions or. Workshops in the last six weeks and now I'm super excited to tell you that I have my physician retreat that's gonna happen in Costa Rica. Uh, yes. So it's May 1st through the sixth, so I will put all the information later on, but.
It's gonna be really fun retreat because you get to go have fun and get CME and it's gonna be divine half a day workshop at the actual place, and then the rest of the day you get to play. So, and of course at the end of the day, we have to do the coaching so we can reflect, so we can implement everything that we're learning.
So today I have an amazing, uh, treat for you. It's one of my good friends and, uh, Abby. Shiller and I might messed that up. And so she's gonna introduce herself and tell us all the wonderful things that she's up
Abbie Shiller: to. Hi, I, first of all, I wanna go on that retreat I honeymooned in Costa Rican. It's amazing.
And then did, gimme a break. Give me a break. .
Dr. Diana Mercado-Marmarosh: You know, we went for our first year, uh, for, for, for honeymoon, right. And then, uh, we went at 11 years for like to celebrate like in September. I was like, before they tell me that Monkeypox is a, a thing and I can't leave the country. Right. So Costa Rica's
Abbie Shiller: awesome.
Yes, indeed. I, I, everybody who goes on that retreat is gonna be, have the best time. Yes. Um, okay, so I'm Abby Schiller. I am a goal coach. I help, uh, women transform their lives from one change to another. I help them reinvent. I help them grow businesses. I help them love parenting more. I am also the CEO and co-founder of the Mother company, which is.
Has a, it's a media company for young children and we have, um, the mission of helping parents raise good people. So I've co-authored 12 children's books and I have, um, a TV series that I created and, uh, just really grown a media company for children.
Dr. Diana Mercado-Marmarosh: Awesome. Yeah. And tell me, how did you get into that?
Abbie Shiller: You know, I was a mo so my career actually was in brand strategy and public relations.
I had been the head of PR for Keels, which is a skincare company, and after that I went to become the head of PR for ABC daytime television. So I was the one telling Barbara Walters for the View, like how to manage crises, um, which is a hilarious chapter in my life. Um, and an honor to work with such a. Um, and I kept thinking, I, so I had a real view of what was happening and at that time, baby Einstein had just launched and then sold to Disney for like 180 million.
And I was like, these are videos of toys for babies, and I could do this so much better. And there hadn't been any television to really help children with the issues that I needed. To help my children with, which were, you know, sharing and communication and expressing your feelings and becoming a good friend.
And really the only option at the time, and this really dates me, was Barney and I hated it. Yeah. And I thought for a generation of women who are reshaping stores like Target, so that they're like, design first. Why can't we have media for children? Is, you know, the, what is the Whole Foods version of Media for children?
And so we created a series called Ruby's Studio, which still airs on Amazon Prime. And, um, it's, it won an Emmy and it's just a beautiful series for children to help them learn about feelings and friendship and safety. We have, I think, the best program. Young children understand body safety, not like car, car safety or bike safety, but like personal safety, um, without any cringe factor.
And then we also have a show on siblings. So we did some beautiful content.
Dr. Diana Mercado-Marmarosh: Awesome. And so, you know, we, we, in this podcast, it's my perspective on what I think about, uh, ADHD or, or whatever, right. Um, is there anything ADHD related with you?
Abbie Shiller: Oh, a hundred percent. I am like poster child . Um, and for me, the h is for hyper focus.
So I definitely have kind of the manic moments of unfocus and what did, where did I? Just like three cups of coffee or tea, like all over the house that I can't remember where I put, or, uh, I'm saying something and then I, my thoughts draw. I have, I am like the poster child. I'm also dyslexic, so I have a lot of neurodiversity happening, um, which is for me, a superpower.
You know, we grew up, I grew up in a time like seventies and eighties where they didn't really diagnose us with that. And so I just thought I had a different brain that like got to figure out things differently. And so like for instance, I was always in the slowest math group because of my dyslexia, but I'm the only person who can do math intuitively because I just feel the numbers because I've had to learn how to do that.
So it's been. Absolute superpower for me to have a neurodiverse brain. And I actually have a little card on my desk that reminds me of that, which says, I am immensely capable of achieving great things because my brain works differently. The world needs my solutions. Yes,
Dr. Diana Mercado-Marmarosh: that's so good. You know? Um, I'm so glad that you tapped into your brain and you didn't make it mean anything, that we needed three cups of coffee or we needed to do anything in that sort, or that maybe you were approaching it from a different way that your colleague would have or your friend would have, or.
Or somebody else would have, because I think that's part of the problem that gets us stuck. We just keep comparing ourselves to other people and wonder like, how come I can't X, Y, and Z? But you embraced it and that made all the difference.
Abbie Shiller: Yeah, I actually think the opposite, right? Like all the other people are doing X, Y, and Z and it's not working.
So what br, what can I bring to the table that they could never think?
Dr. Diana Mercado-Marmarosh: Yeah. So you're able to enhance it and, and be, and give yourself the permission to think outside the box, because that's what's gonna get the job done, correct.
Abbie Shiller: That's exactly right in a way that no one else is capable of. And I have proven that to be true over and over and over.
It's so funny because when people get a diagnosis, I think their assumption is, oh God. But I actually was like, Hey, that makes a lot of sense . How awesome that there's a
Dr. Diana Mercado-Marmarosh: name for this. So how old were you when you were told, Hey, this is what's going?
Abbie Shiller: I literally, like last year, , I got tested last year. I'm 50
And I just kept thinking this is like, this is not normal. Like my husband is like, what's up with the nonsequitors? And you know, finish the sentence. And what, you started to do this task and then you did three other like. Okay, let's, let's figure out why, which is really helpful. And also the other thing that's really helpful for me is to recognize how I'm constantly low in dopamine.
Ha. And so I'm always trying to like get a dopamine fix. And so awareness, yes, awareness has been so great because I'm like, I don't need to snack, I just need like dopamine and I can do that other ways.
Dr. Diana Mercado-Marmarosh: Awesome. So let me ask you this, um, And you don't have to answer it because obviously it's your medical information, but, uh, you're welcome to or not.
Um, are you menopausal, uh, in, in age yet, or no?
Abbie Shiller: Oh, yeah. I mean, I, I'm, I love that you, like, you're, you're a doctor and so you approaching this in like a doctor leeway. Uh, I am, I, I will talk about menopause all day long because I think that it is so crazily un under talked about and underrepresented. Why don't we know like 51% of the population is going through this or will go through this?
It makes no sense that we are so in the dark about this. Um, I am. What's called premenopausal. So I am still very regular. I love that I'm talking about this. Still very regular, but uh, but with occasional hot flashes or night sweats
Dr. Diana Mercado-Marmarosh: or heart flash. The reason I'm asking you this is because some women.
Like yourself, sneak away until you hit premenopause or menopause. What do mean? Sneak away? Like you never get caught. You never get given the diagnosis because you keep like creating systems until you know, like you've probably were doing something that you were so intrigued and it was in your zone and that was giving you the domine.
But then you hit, like for some people you hit the, you know, High school or college, right? For some people you get to like law school or medical school or something like that. Or some people you become like the CEO of something and all this, that other people, you get to premenopause or menopause and that's when the diagnosis happens.
Or when your kid gets diagnosed and you're like, wait a minute, those are mine too. And so I'm pointing that out because again, A lot of us, unfortunately are like, oh, you just made it possible. That's why, blah, blah, blah. But what if they are, have missed your diagnosis of ADHD all along?
Abbie Shiller: So my kid was diagnosed with ADHD 10 years ago, , and I totally brushed it off because she didn't, I didn't know a lot about it, and I just felt like, like, that's not a diagnosis that's gonna help her.
She's gonna use that as a crutch. So I'm not, I didn't even tell her. I didn't even tell her. And then the more I learned about it, and the more I started seeing the things in myself over those 10 years, I was like, whoa, this is crazy. And now there I, I feel like there are flareups, I just call them flareups of like certain days where like the smallest task is just like, Lugging boulders behind you.
Dr. Diana Mercado-Marmarosh: Yeah. And again, like you just said, being aware that every day might be different and not making it mean anything and having that awareness of like, where am I low end dopamine, or am I really supposed to be doing this task like at 9:00 PM or should I have done it like at 9:00 AM Right. Uh, or is this a task I need to do or can I delegate this to somebody else?
Abbie Shiller: Right. Love delegation. Love it. Yes.
Dr. Diana Mercado-Marmarosh: Yes. Yes. So tell me what has been one of like your. Moments where like you couldn't help but LA laugh and now looking back you could be like, yeah, that's totally my adhd. You know, without saying you have adhd, but at that point, maybe you never
Abbie Shiller: knew. I had a video that went viral on Instagram and just a, a simple reel where I videotaped my cup of tea sitting cold on the counter, and I said, how do you know you have ADHD without, tell me you have adhd.
Telling you have adhd and tens of thousands of people liked this one video, and I realized I, this is something I'd done my whole life. Leave it in the microwaves, leave it on the counter, stick it in the car, whatever, . I was just like, that was like the aha for me of like, oh, this is a connecting habit.
Dr. Diana Mercado-Marmarosh: Yeah, my husband says that all the time. He's like, were you going to have that? I was like, yeah. They're like, cold or ? I'm like, yeah, cold . So
Abbie Shiller: much, so much. But you know, it's interesting. I used to think that it was because when I was a new mom, I was like, oh, I'm breastfeeding. So now I'm sitting here and I can't reach.
but no, like most brains don't. I mean, typical brains I guess don't work that way. I hate the term typical, like Right. I maybe if maybe typical versus special.
Dr. Diana Mercado-Marmarosh: Yeah. , uh, radiant . Yes. Yeah. Charming. I don't know. Whatever you would wanna call it.
Abbie Shiller: I mean, it really works for us on so many levels though. I mean, we really are magnets and dynamic.
there's, you know, yes, of course we can't remember to do a gazillion things or are late to things, but, but okay. Like, cuz we make up for it.
Dr. Diana Mercado-Marmarosh: Yeah, I know. I'm like, well when I show up, I'm here. What, what was the problem? .
Abbie Shiller: Okay, that's right. It's funny cause my mom actually was ADHD and I never knew that and I was always the last kid to be picked up at school cuz she was always late.
And she would forget things or like whenever we traveled, we'd get to the airport five minutes before the plane took off and like, I just thought that my, my childhood was chaos and I never realized until I had a diagnosis and now I see everything from my child. It makes so much sense. Yeah, it makes so much sense.
It was like, it brought me so much peace. I literally let go of so much anger that I had had towards her of like, why would you pick me up last?
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. I mean, that's the thing, right? When you don't know, like we can interpret things in a different way, and especially if you have adhd, like we hold onto some crutches and we think like, oh my God, they're rejecting us.
And, and then when you understand it from a different angle, you're like, Okay. Like she was trying her best, but that was her best. Yeah.
Abbie Shiller: Yeah. So, yeah. So many fender benders, , so distracted all the time.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. That's my, my tells me sometimes she's like, Mom and I'm, I'm happy. Like he's only gotten one tardy bill.
Like, you know that, that, that's, that's
Abbie Shiller: accomplishment. , I will say that I, I am not that mother even though I have the same diagnosis and I think that we can, we cannot lean, we don't have to lean on the diagnosis as an excuse. Like we can do better for ourselves. Yeah. And that's partly what I do as a coach.
I help women really like live the lives that they.
Dr. Diana Mercado-Marmarosh: Yeah, that's right. Like ADHD can start and end with you if you have the right tools. And I, in this podcast, I keep telling people that, you know, I'm not gonna push one thing or another that only, you know, what would be, uh, helpful for you. But you need to really be open to trying all the things.
It might be that exercise is all you need, or it might be that a low carb diet is all you need, or it might be that you just need a very passionate job and some boundaries on Quin to like stop, right? Or it could be that you need the meds and the therapy and the coaching, right? Because with the coaching, uh, again, you start to realize that you're not all those thoughts that your brain has on re.
Abbie Shiller: Mm. Yes, I'm a big believer And love yourself the hardest. Yes. Just love yourself. You know what I love to do? This is a little off topic, but
Dr. Diana Mercado-Marmarosh: nothing's off topic on here. , you're in the right room. Girl.
Abbie Shiller: I really love taking time alone, like just solitude time. So like for my 49th birthday, I, I rented a little tiny place in, in Maine on the ocean, and I just spent four days.
And it was like heaven to just like listen to my wants all day long and answer them, and it, it got me out of an environment of like routine and I just was able to be like, Hmm. Do I wanna pull over to that lobster shack right now? Yes I do. Okay, let's do that. Am I hungry? Yes, I am. Let's do that. Do I want a glass of wine?
No, I don't want a glass of wine like, All day long. I was just like totally tuning into my brain's requests and my body's responses, and it was like just an absolute gift to myself for my birthday at that time. And I, I highly recommend trying this. If you can't, I mean, it doesn't have to be a cottage in Maine.
It could be, you know, a friend's house or whatever. Like, just get out of your environment and listen to your wants all day long. Get away from the kids, get away from the job, whatever, for like 24 hours and just like, Respond to
Dr. Diana Mercado-Marmarosh: yourself. You know, you brought up such an important, uh, topic. Like I'm, I'm part of a physician, uh, female group.
I mean, I'm in many of those, but I'm in one of them and somebody posted. At first it, it looked like an angry post, but she was more like in like awe, and she was more like, we should have the audacity to do what my nanny's doing. So apparently her nanny asked for, uh, a weekend or, or, or two days. I don't know what it is, like every two months to get like, kind of like what you said, to get away and disconnect.
So, She can come back and be fully present and everybody was like, oh my God, da da da da. And then they were like, but wait, that means she's taking care of her. And, and then she's coming back and she's, and she's like, she's an amazing nanny to, to them like they, she's always like, Ready to go and present.
And it's like what an awareness of a 20 year old to have that insight. So young, right? Like most of us tend to like figure out midlife crisis or something like at 35 or 40 or 50, like we start thinking like, oh my God, how did I get here? Right? Because we, somewhere along the way, forgot to love ourselves or ask ourselves what do I want?
And at first everybody was like, oh my God, she's asking for time off. And then they were like, oh, we should learn from her and ask for time off. Why not? And, and like you said, like check in with yourself, not just your brain, whatever your brain is telling you, but like, does it really feel at ease in your body?
Um, when did you learn to do that and like to tune into your.
Abbie Shiller: I love that question because I think I'm still learning to do that. I am fully a recovering people pleaser and perfectionist. I . Hey, shout out to all of you. Um, I, I feel like this is an ongoing process, but where I, when I think I first learned how to do that was six months after the death of my father.
Right. When, um, the administration at the time was separating children from their. Uh, in immigration and my heart literally cracked I, and there was a definitive moment in which it cracked. I was standing at the kitchen counter making dinner, and I literally suddenly had like the most horrifying suicidal ideation, which is so far from how I've ever thought in my life.
I just felt absolute despair and loss, and I, I am an empath. I felt. The who I, it makes me cry even thinking about it still, the horror of the children being ripped from their parents after this journey and I just realized I'd hit a bottom point and that I was of no service to my family. I was of no service to myself.
And I decided I need to check out, I did what your friend's nanny did. , I needed to fill good. I needed to fill my love bank. And I believe that in those moments, the universe responds and I didn't tell anyone, but I got on the phone with American Airlines and I was like, how many miles do I have and how far away can I go?
And I had to just leave the. And I went my friend, because again, the universe responds. Um, and I am really big on manifesting. Within five days, I had a flight to the south of France and a stopover in Portugal by myself for 10 days, um, at a friend's house. That she had Airbnb and somebody had canceled. So I, she needed to fill the room.
And then I just used Miles and I literally did a 10 day trip to the south of France and Portugal for practically free to fill myself up again and to remove myself from the despair and get some, I journaled and I cared, and I listened to myself and I slept, and I, ugh. It was like, and after that moment I came back.
Whole, you know, like when there is, when we jump in the pool with our clients or when people are drowning or we start drowning in an attempt to help them like we are of no service to ourselves or of them. And so that is what I did and that is what your friend's nanny is doing, and we have to do that for ourselves.
There's just so much going on in the world that if we don't put our oxygen masks on first, then we can't serve anyone else.
Dr. Diana Mercado-Marmarosh: Yeah, it seems. The big shifts that have happened for you and have happened for me have come from. Moment of remembering that we mattered, remembering that we matter first, like not in a selfish way, but like you said, put your oxygen first.
And so for me, it was that moment in time when I realized I was the most important patient in the room. That if I wasn't okay, like it didn't matter how much I could wanted to fake it or to pretend to be professional or whatever they had told me. I was like, not well because I had not been refueling my cup and I was just giving away, like you said, people pleasing and again, and sometimes people pleasing and we don't realize that it's a mechanism that helps us to survive in what we're doing because then that means it's smooth trailing, right?
But then at some point you use it one too many times that you mask and then. Remember, like you said, to check in with your gut, to check in with your heart, your soul. Right?
Abbie Shiller: And you know, the barometer of that is when you start feeling the emotion of resentment. Like for me resentment is like the, any twinge of resentment is like you, you're already too thirsty, right?
you should have hydrated a long time ago. You should have felt fell. Sorry. Oh my gosh. You should have filled that was the. Isn't that funny? Thanks brain . You should have filled your love bank long ago. So resentment is like a great aha moment of, and for me in that kitchen moment, it was despair. I mean, my brain, there are a couple times in my life when my brain has become fully unrecognizable to myself and I just had to like step back and just say who, what's happening?
Another, can I share another one of those of. So in 2014, I had a spiral of a, I mean, I was running a company. I had two little kids. Everything on on paper seemed amazing. And then my mother-in-law died and a number of circumstances happened that triggered a number of other circumstances that were financial and mental wellness and a whole bunch of other things in my family that created a life within six weeks that I did not recognize.
I mean, here I was going along and then boom, a circumstance and then all of a sudden who, what's happening . Um, and I. It actually was a life changing moment for me because I realized that I needed to take my life back, and I knew that there was a, like, it is I, I know people can take their lives back. And so the first step for me was to research that how do you change your life?
I literally Googled that, how to change your life, how to transform, how to goal setting, habit forming, change behavior, human potential coaching, cognitive behavioral therapy. I studied. Everything for three months. I just literally like, you know, that like Diane Keaton movie like where she just like goes into like writing and she's just like the, the thing is flowing out of her.
That was me learning, just like sponging it up and I decided January 1st. That I was gonna create a, a, a program for myself, and I invited a friend to a hotel. I was like, I again, I checked out for 24 hours, separated myself from everything. And we went into a hotel on January 1st, 2015. And we just did these exercises for 24 hours and we ate and we walked and we brainstormed and we meditated and we did all of these things and we put a plan in place.
So we went from goal to plan, and then after that I started implementing. The steps of the plan. So I, I call it a gps I goal plan steps, and I started implementing the steps and within three months my life had fully transformed. And that's actually what my visioning course is now. It stemmed from that moment of darkness and uncertainty where I needed to turn my life around, and now I have a profession around it and I turn other women's lives around.
Dr. Diana Mercado-Marmarosh: Yeah, it seems like we're on the same journey. You know, what was. Painful or what was not what we wanted. We used it to now give other people a gift of opportunity to do the same thing for themselves and, and not because we're gonna tell them how to do it. Because everybody's in their own journey and what might work for me might not work for you, and we don't want you to feel like we're gas lighting or something.
Right. But we're providing a community. Right. Where they can come and give themselves permission to change the narrative of the story that they are currently in. Right. That they can decide that, yeah. All those pages and all those previous chapters, it's okay. Like we can go forward and create either end this book or start a new book or decide what you want to do, right?
Yes. And, and, and it's. When you are aligned with that, it's like a product or a service of of love, right? That because you gave yourself that opportunity, you now want to give everybody else the opportunity so that you already did the heavy lifted for them. You know, that hyper focusing and tried to figure out the things.
Um, yes. And I think that's what makes us so. Um, I, I like time vendors, right? Or , because people are like, when do you have time for, do all that? I'm like, well, when it's driven by passion and purpose, it, it doesn't feel like work. Sometimes
Abbie Shiller: I feel like time is such an interesting concept. I, I don't know about you, but I struggled for a very long time with time anxiety.
And again, my mother was always late. She has literally whatever it's called when you have no sense of time. That is how, one of the ways her ADHD time, blindness time, yes. But there's actually a medical term for it, I believe. Anyway. Yes, it's time blindness. And she has, she will literally say, remember last year when you think and you're like, mom, that was 20 years ago.
Um, it's be, it's ama like literally a part of her brain is like blocked, I think , but. I think, you know, for, for us, our demand, like the demands that working women and especially working moms have in terms of time is, in my opinion, a systemic problem. There's just no way that the expectations of, you know, getting everything done, it is possible.
And so that really creates kind of a math problem. But in addition, we in. Dump on top of that, the mental problem of like the drama around it and the, I'm so overwhelmed, I'm so tired, I'm so busy. All of that really adds to the feeling of it. And so when with coaching, we can take it apart a little bit and just think, you know, what would it look like if I got this course done with ease?
What would it look like if I did? Halfway. What's a, what's a B level effort here? And is that enough? What if, um, what are they actually paying for? They're paying for results. Does that mean that they need to get 15 modules or 10 modules or no modules? And just me showing up, right? So just remembering the perspective of, and I always like to ask my clients like, what's your goal here?
What's the bigger goal?
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. That's the same thing I asked my clients. Like I asked them, how would you know that you, you're, you've been successful in this program? Like, what is your success measure? Because whatever that's framing that end for Exactly, because whatever I think is success might be different when you think it's success.
Maybe to use success means you left your chart closed at work, or maybe for you success means you showed up at your kids recital because you finally. Time off and the things that are really important for you. Or maybe it could mean you, you got away and did a book or, or something else, right? Like and.
and giving yourself the opportunity to ask yourself those hard questions. Because in our mind, time is a hard question because we're always gonna say there's not enough. Right? And, and it's not just like, oh, let me just think the opposite and magically that's gonna be better because we know that's not the case, but it's in learning.
How to use planners or how to do it in a way where it doesn't be, have to be so hard, like you said, with ease , and, and when you align it with your values, it becomes a little bit more with ease.
Abbie Shiller: Yes. And I think that ADHD people have a challenge with this, especially because we have trouble deciphering priorities versus what's important versus urgent.
Um, I think that, Obviously have incredibly distractable brains in, in an unbelievably distractable world. Um, I think that there's a number of challenges for those of us with neurodiversity in terms of time use, and then I, I love helping people find the solutions around that and, and the tricks and what works.
And, I mean, there's also really great resources in the world for, for people with that. Again, you know, what's the larger purpose? I had a, I had a. A couple summers ago, like in the height of the pandemic, 2020, and I was working, working, working, working, working all day long. And my little guy, we had bought him like an inflatable pool.
I tell this story in my vision and course we had bought him an inflatable pool and he was just out there splashing in the pool by himself, and he called up to me in my office and he was like, mama, come play with me. I was like, I'm so busy. That pool's freezing. I'm not getting there with you. And then I had a realization of.
Like what is important here versus what is urgent? And I did have some, some urgent deadlines, but 30 minutes, 45 minutes in a pool with my kid would would mean the world. And so I got my bathing suit on. I got in that bug filled little kitty pool and we threw a little beach ball for 45 minutes and he talked to me about Marvel and we just fully connected.
And in those 45 minutes, like I literally felt. Fullness. My heart fill. His heart fill. We related to each other differently. After that, things became easier. After that, it was a little investment that I paid. In terms of not getting, you know, my work done for those 45 minutes, but it was an absolute privilege to have that connection and that make that memory with him.
And that's what I mean by just tapping into the priority. Like what's, what's the priority here? And for me, a goal is to be a present mom. And so that was my feeling of that. And we just have to step out sometimes to realize the larger.
Dr. Diana Mercado-Marmarosh: Yeah. And, and to realize again, why are we doing this? Like why are we working so hard?
Like you said, it's probably to spend time with your family, but are you spending time with your family and are you present with your family? Right? So like, again, it's creating that awareness and then, okay. Now what are the action steps so that I can create the life that I want on purpose, not by chance.
And I
Abbie Shiller: wonder how many people don't know how to be present. I wonder how many people don't know how to meaningfully connect. I mean, we have a loneliness epidemic in this world, even when we live with other people, even though we are surrounded and connect. Accordingly to the, to our phones, more than ever, we are so lonely, and that's because we just are out of pr.
Our, our connection muscle has atrophied, and so we have to make conversation. We have to put our phones down, we have to engage with people, we have to learn how to listen. Um, I, I just, I just see this, you know, parents and kids at the table with their phones and it just breaks my heart so much because these are the moments in which we teach our kids how to connect.
And they're not getting
Dr. Diana Mercado-Marmarosh: it. You know, at the, at the chat conference, they had one, uh, workshop that I thought was so interested, it just blew my mind. So she got us, she asked us to get in a circle, and she asked us to then stand up and walk around and meet with somebody. But you couldn't talk to them. You just had to like, look at them like, uh, in their eye, like eye to eye or whatever.
And if you felt comfortable, you would shake their. If you didn't feel comfortable, you just walked away. How crazy was that? Like it was so uncomfortable because like you're, you're trying to be like, polite and, you know, it's, and one person wouldn't wanna shake my head, so I just finally started laughing.
They're like, okay, fine. She's shake my hand. Right? But like, it's so like, the meaning of like body language and like reading people is like not a skill that we. Can learn, right? Because like you said, we're so like glu to her phones, right? And then she had us do another thing where, uh, then we, she, she had us be like, person A and person B, and person A could not talk.
They just had to listen and she didn't tell us for how long, , it was only two minutes. But remember, we don't know. And so it was just like, and she didn't want us to say Aha or Mm, like you just have to be like a mirror, so to say, like, but not say anything. And so it was so interesting. And then she had that person who hadn't talked, reflect back what that person had told him.
And so it was such a gift to be heard. Yeah, totally. And, and so it's just mind blowing how, like you said, we don't, we don't have, uh, uh, awareness of how we're doing things sometimes.
Abbie Shiller: Yeah, completely. I get it. What an incredible, what an incredible, um, exercise. I, I love those. Have you ever heard of the 36 questions?
So there's something called 36 questions. Two researchers developed it in New York, and the whole goal of it was to have an exchange of these 36 questions that at the end of which would foster intimacy between any two people, any two people. So they. Um, you know, they do it with couples who have been married for a million years who have lost kind of that connection.
They do it with friends, they do it with two strangers. They do it on dating apps. They have proven that the 36 questions will create an intimate connection between two people. And then at the end of it, like what you just said, you have to look into somebody's eyes and then that's it. Like, then intimacy is created.
Dr. Diana Mercado-Marmarosh: Yeah. That's so, that's so interesting to know that we eventually, if we talk long, We might find some common ground. Right. And, and develop that relationship. Um, yeah, so it was just interesting to walk around the room with people that I would have never maybe talked to, you know, but all of a sudden you just had to see them for themselves or their humanness and oh, and then at the end of the workshop, They said, we're gonna frame each other.
So what that meant was I had to look at you and by just looking at you, I have to say she's bold. She's like happy, she's vibrant. Like based on how they were presenting themselves and that that was also very cool.
Abbie Shiller: Wow. Did anybody say anything like, She's really insecure. She's really traumatized. .
Dr. Diana Mercado-Marmarosh: No, they basically said, oh, she, you know, they're calm, or they're, or they're reserved or, but they never said anything.
It was always pleasant.
Abbie Shiller: That's wild. I have such, um, intuition about people. I would have to be careful in those moments.
Dr. Diana Mercado-Marmarosh: So tell me, where can people find.
Abbie Shiller: Uh, you can find me on my website, which is Abby Shiller, A b b i e s c h i l l e r.com. Or you can find me on Instagram, Abby Shiller coaching, and, uh, I'm launching a visioning course to help transform people's lives in January.
It's gonna be a three month course with a year of support. I'm so excited about it. We're just a, a relatively small group of people who do this work in community and it's.
Dr. Diana Mercado-Marmarosh: Awesome. So like, you know, my podcast is, uh, geared towards people who have ADHD and sometimes they don't pay attention. So if they just started listening right this second, what would you say are the takeaway points that you would want them to listen to
Abbie Shiller: from the course?
Dr. Diana Mercado-Marmarosh: From my work? No, from what we were talking about, like the whole Oh, from
Abbie Shiller: today, . Yeah. I wasn't listening. Just kidding. .
Dr. Diana Mercado-Marmarosh: Well, good then everybody's on the same page. .
Abbie Shiller: Um, if I were to summarize this conversation, I think that I would say like, fill your love bank. We can't, we can't be of service to anyone when we are completely dele.
um, manage your time, figure out what's a priority to you and what's, uh, important, and try and find the balance between the two. And I always like to just let people know, you know, make sure you're being aware, be aware of what your thoughts are and what the results are that they're creating.
Dr. Diana Mercado-Marmarosh: Well, Abby, thank you so much for coming.
You guys cannot see the ruckus that is happening in the background, but I have my two kiddos jumping around and she has kept herself composed through this whole thing, , but I wanna
Abbie Shiller: make faces.
Dr. Diana Mercado-Marmarosh: Oh my goodness. It's just
Abbie Shiller: working. Mamas are amazing, right? We
Dr. Diana Mercado-Marmarosh: are superheroes.
Abbie Shiller: Thank you so much for having. Yes.
Dr. Diana Mercado-Marmarosh: Thank you for coming, . 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 live coach.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.

Own Your Win, Boost Your Self- Confidence

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Dean Meow Mage. 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 I'm learning. Some of my beliefs and some of my habits were just as important as learning the new set of skills.
Well, hello, hello, hello. I'm so excited to be here with you today day. It's been a day. It's been a wonderful day today. I have met so many people here at the chat conference. and I just feel like my heart is full and. You know, one of the topics that kept coming up was about self-confidence. And, you know, somebody came up to me after, um, Dr.
Lola Day and Dr. NAA Bauer, and I gave our, our, uh, our speech today. Uh, during lunch we talked about how our programs. Bridging the gap where medicine is not able to, uh, we're talking about how skills. are gonna be taught and implemented, and that pills unfortunately do not teach you those skills. But of course they can definitely help so that you can get closer to what you want to accomplish and, and, you know,
People came up to us and told us that they felt like our talk was authentic and vulnerable, and that they felt the connection. And it's so important to realize that our stories. Really do impact how we perceive the world and how we see the world. And you know, somebody told me, oh my God, you made that look so easy.
And I own that compliment. You know, some, some of us don't want to own what our son of genius are, and I'm glad it looks easy, but sometimes we all know. Something looks easy because we practiced it a thousand times, right? . And so why do I say this? Well, because when we are doing something that we enjoy and we love that emotion can come through and sometimes you know that confidence comes through because.
You are aligned with what you feel like your purpose is. And I had so many wonderful conversations today, throughout the day, and you know, my intention for this conference was obviously to come share my ideas, but also to learn from other people and to learn from their stories and from their perspective.
And what I shared with them today was that, you know, three years ago, I would've never had said this out loud to other people that I had ADHD because of the mental stigma that I was associated with it. But now I say that, you know, adhd, it's kind of like the diabetes of, of psychiatry. Like you really have to.
Use all the tools in order for us to help us navigate this. Like you have to realize that yoga, that meditation, that, you know, sometimes paying attention to your God flora, , and, um, exercise, um, low carb diet. All that can be helpful in managing adhd. Of course, our sleep is so important, but I'm bringing this up because we don't realize that many times what we tell ourselves or how we talk to ourselves can really influence how we perceive ourselves.
We all have that innate need and want to be loved and accepted. Of course we do. And sometimes we misinterpret that our self worth, you know, is gonna always be measured with how productive we are. But the thing is, like if you go back to the essence of us as kids, um, we weren't like, We weren't in our heads when we were, you know, just born and people had to feed us and had to change our diaper.
Diverse. And, you know, as we were learning to walk, we weren't like judging ourselves for like stumbling and falling right? Like we were. So, you know, we kept going. And obviously when we had somebody there that was praising us and telling us to keep going, that was motivating. And so we had this conversation today.
talking about how praise can really motivate us to keep working and can improve our self confidence. And you know, before the age of 13, most of us with ADHD will have heard 20 to 40,000 messages compared to somebody without ADHD telling us We're not good enough. We're not fast enough, we're not tall up, we're not, we're too loud, we're too, you name it.
Right? And, and it's so important to realize that our confidence. Or lack of self-confidence sometimes can be shaped by those people around us, and a way for us to improve this confidence is to again, go back to what are so new geniuses For me, I really feel like it's speaking. It's really in speaking that I can portray a feeling and emotion and when somebody understands what they're good at and they're aligned with it.
That confidence just kind of radiates and lights you up. It, it helps you to keep going, right? It doesn't feel like work. It feels like play, and so criticism can really break us down or can really. Turn us off, and I'm not saying this, so that all of a sudden you can tell your husband or your wife or your, you know, your boss, stop judging me, right?
But so that you realize that when people give us feedback, listen to them, but you don't have to take everything that they're telling you. Ask yourself what part of that might be true or not. and do I value the person who's giving me this advice or not? You know, let them be wrong about you. If whatever advice they're giving you does not fit or correlate with you, it's okay.
You don't have to take their advice. We need to be able to praise ourselves for the wins that we. Because when we own those wins as little or as big as they are, then we don't wait to get to the final destination before we start actually feeling happy.
It means that you get to enjoy the whole journey along the. Because of somebody wise told me, once you are at the top of the mountain, you get to enjoy the happiness and the joy that you brought with you. If you didn't have it with you all along, you really can't enjoy it. And so I'm saying all this because self confidence is something.
That can really be practice, and you practice it by doing, like, by stepping in and being okay with a messy first draft and having choices and deciding whether whatever you're currently doing is worth your time or not. Are you enjoying it? Why or why not? And I really mean that. Like ask yourself, are you enjoying that relationship?
Why or why not? Are you enjoying that job? Why or why not? If we're not having these type of conversations, you're gonna one day wake up and think, what's the point? Because you weren't asking yourself all along if you were. In the right track. So when things come up, when you see something that is happening,
being willing to hold space, be willing to have conversations with those around you
and don't equate.
Failure
as being unsuccessful. You know, failure, I've learned it's the first attempt at learning. I. So go after your big dreams. Stop playing small. The world needs your zone of genius. This is literally how we function today. I've met so many wonderful people at the chat conference. People who are authors, people who are speakers, people who are of course physicians, people who are therapists, people who are doing all kinds.
in, uh, intuitive, um, biofeedback. I mean, we all need each other. I always say teamwork makes the dream work. So if you would like to join me in my course, come check it out. Come see what I'm about. Come join the non-judgemental community. Where you can learn all those tricks and hacks and techniques to leave work at work and practice medicine and live life on your own terms.
Please bring me any suggestions on what topics you would like me to talk about. Uh, send me an email. Go to my website life coach.com and tell me what you want me to talk about. I would be more than glad to talk about it and come join my course. There's gonna be a Black Friday special, so definitely be on the lookout for that and get yourself on my waiting list for January.
You wanna definitely purchase my course if you're thinking about doing it in January before then, because, um, the price will be going up after January 1st. You know, Christmas is around the corner. You need to invest in you today. I can't wait to support you in your journey. If you know anybody who. Would like to talk to me, spend in my way.
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@coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are.

Special Announcement!!

Check out My free Master Class Creating Time with Boundaries: Enjoy the Holidays.
Create Time With Boundaries: Enjoy the Hoilidays

A Conversation With Dr. Danielle Malano

Announcing a new Free Masterclass Soon!
Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Meha Marm. 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 some of my habits were just as important as learning the new set of skills.
I am so excited today. I have an amazing friend here and I can't wait
to hear all her story
in the full totality, or whatever. She feels like Sherry. Uh, I have Dr. Danielle Milano Milano. She, she tried to help me earlier, but you know, It's she, we forget . And, uh, she's a full time, um, family medicine physician and of course she's an amazing wife and a mother, and she is a, she's a coach.
I'm gonna miss. Pronounced, but she cooks amazing food. Okay. Culinary Coach . There, it's, And so anyways, I wanna hear about her story and she's gonna walk us through how she found out she had. Okay. Thank you.
Dr. Danielle Malano: It is so exciting to be here and I'm just such a big fan of yours. I'm really honored to be able to share the space with you.
Thank you so much. So I, at the ripe old age of 43 years old, just found out I have ADHD and . Uh, it was a long time coming and I never really knew that this is what it was, but I always knew, I felt like. Something was wrong with me. You know, I was bright, I got straight A's in grade school. Um, I had a very structured, you know, childhood.
My parents were super strict. All I was allowed to do was, you know, homework and that was it, . And then when I got into college and was pre-med, it got more stressful and I found myself just, you know, falling asleep, studying or procrastinating or, you know, cramming the night before and, you know, was. The grace of God was able to get into medical school, and I went from California to Chicago, far away from home, and being away again.
That was just another big struggle for me. I thought everyone else was smarter than I was and I didn't feel like I belonged, and I was so afraid of asking for help because then everyone would figure out that I don't belong there. But again, because of that fear, Decided I would just try harder, study harder, work harder, you know, And you know, it got me to where I wanted to be.
I landed my first choice for my family medicine residency, and then I became a lowly intern all over again, just starting over in a new place in California, back at home. And again, I was struggling a lot. Um, so I again studied harder, worked harder. At a cost, right, Of just this feeling that I had in my chest and in my brain and like tingling all over my body, like constantly in order to succeed and perform and, you know, get, you know, what I needed to get done and take good care of my patients.
So, um, you know, I continued to perform like I, I thought at like a high level. Um, you know, when I got married and had kids, you know, we threw in another human being and then two other additional human beings into the mix where, um, you know, my tools that I had in place to keep me in line or just thrown out the window,
Dr. Diana Mercado-Marmarosh: I know the feeling . I know, right? It's not
Dr. Danielle Malano: just me anymore, you know? So I remember getting into an argument with my husband at some point. This was before we had kids. I don't know, it was something about something silly, maybe. You know, things weren't in place or things were a mess. And I totally married my opposite.
I'm type A, he's type B, super relaxed and chill. And I was just getting so upset. And then at one point he was like, Dee, you didn't marry. And then I was like, Oh, light bulb. You're right. I did not marry me. And if I did, I probably wouldn't work out because, um, I, you know, need to find someone that balances me.
And thank goodness that both of my boys have two loving parents who show their love in very different ways, and they can get the best of both. And so, you know, My boys started school and my young, my oldest one was doing great. He was getting straight ass. I was like, Wow, this is great. Let's, you know, have another one,
You know? And
Dr. Diana Mercado-Marmarosh: so kid number two came along.
Dr. Danielle Malano: Oh my goodness. A little bit different, right? They're two completely different human beings, . And we're not supposed to compare, but we still do. Yeah. Right. And I noticed, you know, TK and, uh, kinder, the teachers would mention things that he would, you know, have these outbursts or be more active.
He's, I definitely thought he was more of an extrovert than my oldest one. And, you know, they're different. They're kids, you know. So, but in the back of my head, I was like, Okay, should I be worried? When should I be worried about, you know, possibility of adhd? And I reached out to the teachers starting in first.
When she had sent an email, this was like probably post pandemic, so I knew there was gonna be a transition coming back into school in person. So when I put the feelers out about, Hey, should I get my kid evaluated? She's like, No, let's wait. Let's, you know, put these processes in place to help and focus.
And I said, Okay. Things went well for a while and then they didn't. So it would be this back and forth. And then finally after multiple back and forth, it was almost towards the end of, um, the year that I. You know, hey, should, you know, should I get him evaluated? Just say the word and I'm all in. I'm all for, you know, giving him all the opportunities to succeed.
No answer. And so I just went, took it upon myself. Got ahold of our pediatrician and she got the evaluation. And of course there's a waiting process. And we went through that process. We got the appointment and we filled out some paperwork. The teacher filled out some paperwork and then we finally had the meeting with the behavioral pediatrician.
And during that interview I was with Johnny and they have to take the history right of both of the parents, um, and the history of the child and in gathering my personal history. Mid-sentence. I was like, Uh, do you think I should get evaluated ? And he is like, Yes. Without hesitation. Yes, yes you should . And he said, Oftentimes we diagnose ADHD late, especially in women because they're more sometimes of the inattentive type, but.
When you were diagnosed late, um, maybe in adulthood. It's often because of a couple of reasons. Number one, if you're very bright, that could mask it, or number two, you had a lot of structure in place in childhood that again, masked the adhd. And he said, Honestly, I think you had the ADHD spanked out of you, because that was the form of discipline that I got.
You know, my dad. Mm-hmm. , another light bulb went off. And so I was like, Okay, let you know if I am going to give my son the best chances to be successful in school and his, in his relationships and in life. Like, why don't I do the same for me no matter how late? Right. Right. Um, I think at some point in our relationship, my husband said, you know, why don't you just, you know, go on medication on for like depression or anxiety or something.
And I'm like, in my head I'm like, You know, I honestly, I don't necessarily think I'm depressed. You know, maybe like, there's definitely an element of anxiety there, but, um, I wanna know, I wanna know if this is plain old, you know, anxiety and or is this anxiety stemming from something else? And if it is, I wanna make sure that I'm treating the right thing or I'm addressing the right thing.
So, sorry, my alarm's going off, so. I called my primary doctor and I got an intake visit with, um, one of the, um, uh, one of the, um, therapists from our psychiatry department. We did like a preliminary intake, and then she sent me paperwork, and again, because of the pandemic. We, it was hard to do in person evaluations, and so she sent me like a four page thing to fill out.
I had to have my husband fill it out, and then I had to find a friend who knew me from when I was in first grade to also fill it out, wait for them to turn all of that in, submit all of that paperwork, and then wait for someone to eventually review those and then get back to me. They got back to me and they told me that my test was negative, and
Dr. Diana Mercado-Marmarosh: what I kind of knew.
Coming on because again,
Dr. Danielle Malano: I function at, I feel like I function at a certain level, and I think a lot of women diagnosed late in ADHD have this issue too. They function at a certain level. No one else sees the stress that they feel inside. Yeah. So when she told me that my initial testing was negative, she offered me an option to do the objective testing with the psychologist.
And I said, Yes, of course. Absolutely. So I made that appointment. I went in, I saw the psychologist I had to conduct. Uh, she conducted. Computer test, which was 14 minutes. I forgot the name of it, but it was like the longest 14 minutes of my life. . You had to stare at a computer screen and press the space bar every time you saw a letter pop up on the screen except for the letter X.
And so I was trying to focus and concentrate. It would go at different speeds and then there would be a lull and then it would speed up again and I was just, it was hard . So at the end of the test, she reviewed it, she scored it, and she. Congratulations on getting this far with undiagnosed adhd, I almost burst into tears.
Like it was just so validating. So much of my life made so much more sense. I like wanted to tell everybody in the world . Yeah, this is, this is why I am me. Like people are like, Oh my gosh. You do all the cooking. You, you're a doctor, you're a mom. Like you're, you're so fit. You do all the exercise, you make yummy things and dinner and treats and all the things.
They're like, How do you do it? I'm like, I don't know. I love doing all the things, you know, And I do do, I do love doing all the things, but you know, sometimes that comes at a cost, you know, and no one sees
Dr. Diana Mercado-Marmarosh: that. I feel like,
Dr. Danielle Malano: and I think, you know, it's finally time for people to know. . No matter how well you think somebody is doing, you never know the struggle that they may be going through.
So yeah, and I
Dr. Diana Mercado-Marmarosh: think that's such an important point that that's why I'm tossing you right there, because just like you said, nobody knows at what cost, because you pointed out so many different nuggets there of the facts that. You're gonna work your ass off for something that you feel aligns with you, whether it's to become a doctor, whether it's
Dr. Danielle Malano: to be a good mom,
Dr. Diana Mercado-Marmarosh: whether it's whatever it is that fuels you, you're going to pour your soul into it.
And. We don't want to know other people that are, uh, that were kind of struggling. So we're kind of gonna mask, like, like I would stay up late to do some charting for me. Like, you know, 20, 30 hours. I didn't want anybody to know how hard it was working because, you know, I, I thought it was the, what I needed to do to
Dr. Danielle Malano: be able to have the privilege to,
Dr. Diana Mercado-Marmarosh: to do that.
Right. And like you said, the question you, you, you, or the, the common stuff, like, they're gonna find out I don't belong here. Like, they're gonna find out. And so you have that. Little fear of them finding out, you know, of course we belong in the room. You were always meant to be there, but your brain, because you're so multi-passionate, it looks like a hot mess to other people.
But it makes total sense to you. And, and like you said, like maybe those people didn't realize, you just magically got shit done. They didn't realize that it took. 10 times as much. Like maybe it took you two hours to do that project and your friend took her five minutes and you didn't think anything of it because you first turned into project, so it wasn't a big deal.
And so that's so good that you decided to get the next thing. Even though they told you, No, this is negative. You're like, Well, is there any other things to find out? Right? Like to get the next step. Because most of us stopped there, we're like, No, they already said it's, That's it. Right. But you knew inside that you were doing these
Dr. Danielle Malano: things and.
Dr. Diana Mercado-Marmarosh: And yeah, exactly. Like they said, Congratulations, you got this bar. Now let's get better systems in. Cause that's tir ass yeah's t I'm tired. Can I, can I still be like me? Can I
Dr. Danielle Malano: still be my amazing self that loves to do all of the things and like if feel less of that internal angst that just. Tortures me sometimes.
Um, and I think, you know, people don't get that. When I was sharing with some of my colleagues, like, you know, Yeah, I'm getting evaluated. We're gonna see what happens. And they're like, You don't need medication. Like, look at you, you're, you're like, you finish all your charts on time. You don't do any of your charts at home.
You teach other people how to do their charts. Like you, you know, you exercise during lunch, like you're not doing your charts. What's, you know, you, you don't, you don't need it is what, you know, you don't need your, because
Dr. Diana Mercado-Marmarosh: you're exercising, that's why you're getting your shit done. .
Dr. Danielle Malano: Yes. Right. That's like, it's my, one of my outlets to get out my, you know, nervous energy so that I can, you know, Regroup and get back on it and you know, do the thing, get my stuff done, and stay.
And you
Dr. Diana Mercado-Marmarosh: might have been motivating yourself by telling yourself, do it right. Otherwise they're gonna find out. So it was not a healthy way that you were doing it per se, and like you said, your anxiety was through the roof and you were trying
Dr. Danielle Malano: to mask it, right? Mm-hmm. . Absolutely. So, you know, don't get me wrong, I feel amazing after I work out , but you know, there's, you know, there's more than just one reason people exercise, right?
And so, you know, when you hear from others, especially your peers or your family or your colleagues or your friends that, Oh, you don't need help, that's just not a helpful, a helpful comment. So what I would say to people who hear from others, May share with them that they're struggling or they have X, Y, or Z diagnosis.
Um, it's not always necessarily helpful for you to say, Oh, but you look great. Oh, but you look fine. Oh, but you don't need help, because it dismisses their suffering.
Dr. Diana Mercado-Marmarosh: Yeah, and that's, I call it the invisible. Invisible disability, right? Because, Oh yeah. I'm not gonna say that it's ing because now, I mean, it can be, It can get us into trouble, of course, for sure, but it can also be a superpower.
But in order for it to become a superpower, you have to first own the diagnosis and then learn about it and be curious. But in order for all that to happen, you need to feel confident enough in your. To know that you're worth the investment, whether it means medication or coaching or therapy or, or all of your exercise or all of the above.
Right. And like you said, like we would never tell a diabetic. Um, You don't need insulin. I mean, your A1C is at 12, but you know, you don't need that. Like why can't you just get over it? Right. Why? Why did you ? So it's like the invisible disability because nobody can see how hard you're struggling. They don't see a broken leg there, they don't see a broken nose that is bleeding.
They don't, you know, and again, like you said, some of those words can be almost traumatic to us. Right. They're not validating how you're feeling and they're, they're almost making you feel like whatever you're feeling, you shouldn't be feeling that because you look great, you look amazing. Like, what? What else do you need?
Like,
Dr. Danielle Malano: exactly. Like, I don't deserve help , you know, And I try to instill that in my son too, because when he was initially diagnosed with, I thought, honestly, That he was gonna get like a soft diagnosis, maybe if that, And then when the physician said, Okay, so he's got severe combined adhd, and then with a little bit of anxiety, I'm like, What?
I was, you know, I wasn't expecting that and no, at such a young age when he thought that, you know, the ADHD was already, you know, causing some anxiety in him, I just, I really wanted to make sure. You know, address that. And so I dove deep like you had recommended. Thank you so much for recommending ADHD 2.0.
I read it on Audible on all of my commutes, finished in, and then, you know, I let Johnny know that this is your superpower. You know, he's so creative. He's such an artist. He has so much fun. He's super popular at school. Everyone loves him. He's so funny. And I remind him that, you know, he's got like what Dr.
Hallal describes as a Ferrari motor for a brain with bicycle brakes. And he really took to that and now all of a sudden he's reading this, these books, um, Dog Man, and it's kind of a comic style book. And I had no idea that it's also the same author that wrote Captain Underpants, who apparently has Ethan ADHD and dyslexia.
So they really love reading that and I'm just really grateful that they have those resources and can see. And now Johnny's just enjoying reading so much more. His grades are improving now that he's getting the treatment and, and services that he needs. Yeah, and,
Dr. Diana Mercado-Marmarosh: and like what an amazing thing that it was, that you were open to finding a better way for your son.
Right. And in doing. Like you said, you deserve the same thing cuz hopefully you're like my grandma. I keep saying this line over and over who lives to be 93. One of 'em was, the other one was 90. So like you still have like 50 years of your life going forward, which could be what if that could be like the next best face?
Like you thought that whatever you had done was amazing, but like you had no idea, right? Like right. And. So, yeah. So that's so cool that you were able to use that and model and support him and continue to advocate for him because like you said, you kept asking the teachers over and over like, Hey, are you sure?
Are you sure? Are you sure? And that's the thing with adhd, right? That it's not just like, School, It's at school and at the playground and at home and at the birthday party. And it's everywhere, right? Everywhere. And so you just make sure that you are supporting your kids the best that you can and providing them the resources the best that you can.
And when you look back like. I don't know how, if you can tell your family who has adhd, but Oh yeah. , because like, we didn't know, I thought that was just north because everybody, like was doing the same thing, right? Mm-hmm. and so, So now tell me about this like coaching thing that you're doing that's really cool.
Oh yeah.
Dr. Danielle Malano: So, you know, when I was deciding at some point in my life, you know, I think it was right around the pandemic in March-ish, 2020, I decided, okay, am I gonna go to therapy? Or, you know, am I gonna try this life coaching that I, that I had heard about? Online and, um, I ended up deciding to go with life coaching and that's where I got connected with so many other like-minded, like-minded women, including yourself, um, who were going through a lot of the same things I was going through and I had no idea.
I just felt so alone before I joined empowering women positions and seeing other women physicians. Share their stories and then thrive after whatever it is that they're going through and continue to change and progress and dream and improve and then struggle still. It was just so inspiring and I, and I think that really.
Fueled, you know, another passion in me, like I already enjoyed cooking, you know, and I already shared some of this stuff on the internet, on my Instagram account. It's, I have this, I think I said out loud on one of the groups, like, I wanna have a cooking show. And somebody told me like, You already have a cooking show.
It just happens to live on Instagram. And the way that was frame. Borrowing that thought and looking at that way, I'm like, You're right. I do have a cookie show and it lives on Instagram. And so because I thought that instead of, Oh, I just have this little thing on Instagram. I started posting more, I started getting more connections and then, um, I was reached out to by Dr.
Monte Mantravadi, who is the creator of Ahimsa, the world's first colorful stainless steel table war for kids, and I was their first physician ambassador. I made some reels for them. We are continuing in collaboration. I was a representative for them at the AAP conference in Anaheim last month. It was so much fun.
And so not only did I connect with her, uh, because I started posting more and, uh, I was reach out to also by Cutco the knives that I love and used almost, you know, every day. And I'm, you know, Kind of like an ambassador for them as well. And just making all of these connections is so much fun. And you know, the next step is, you know, to work on building a website.
And I was trying to decide, okay, you know, do should I get certified in lifestyle medicine or should I get certified in culinary medicine? And, you know, those things definitely, um, are so valuable that I was just getting lost in where I should go or what I should do. And it end, I ended up choosing, uh, culinary coaching.
Because, um, it was more accessible for me at the time, and I went through that process and that program, and I finished literally just this year. And now I can say I'm a culinary coach and, um, include that when I share all of the delicious things that I share online, whether it's on Instagram or on my future website or maybe in my future courses.
Dr. Diana Mercado-Marmarosh: That's so amazing, right? Like when you start to borrow other people. Thoughts. Like you were already a chef and you were already having your show and you didn't even realize that. Right. And but it's, so again, it goes back to our human connect connections and understanding that words matter and thoughts matter, and feelings matter.
And even though we don't want to believe that, I mean, they do. And realizing that when you're in alignment, like when you knew that this is what, what fuel you like, you were able to take in, continue those steps, that that then opened up the opportunity for bigger things for you to be able to inspire and help.
Not just other physicians, everybody else on Instagram, like how appreci is that? And so, so what is your favorite things of like cooking or teaching people? Like what is your favorite things
Dr. Danielle Malano: you like to do? Yeah, so one of the best things that I enjoy sharing, um, that I learned in my Culinary coach, um, courses, you know, Something that I already did, but I just didn't necessarily have a name for, um, is batch cooking.
And batch cooking is a way to, you know, make a big portion of something that you will either use either the next day or save and, you know, freeze for later on. Um, so that it will save you time the next time you know that dish comes around. And so I show examples of that. Instagram and then a lot of other things that I share is, you know, I definitely have a sweet tooth, I'm not gonna lie, but because I'm also really mindful about what I put into my body, I went about trying to find different ways to modify and have substitutes for different things that I would put in my treats or my, um, pastries or, you know, in desserts substituting maybe coconut sugar or apple sauce for oil and or just cutting the sugar in half.
Like you can just start. Cutting the sugar either by, you know, 25%, 60%, 50%, whatever it is. Honestly, you will not know the difference. It's still gonna be delicious. It's still gonna be sweet. And then the more you do that, the more your taste buds will change. And then recognize how delicious food already is without all of the other processed stuff, and you can just continue on in your journey of being as healthy.
You want to be in terms of your own particular goals? I don't like, my Instagram is not like a weight loss, um, um, feed or a, you know, or, or an obesity feed or anything like that. I'm just, it's more of a wellness, like this is what you can do. These are some options that you can take in order to be, Take that one.
To be a healthier
Dr. Diana Mercado-Marmarosh: you. Yeah. So you're just, uh, facilitating the process for us to be mindful and still have a cake and eat it too, right, ? Absolutely. Absolutely. So tell me, uh, what ADHD hacks have you been able to, like, lean into or what have, have you noticed that now that you implemented some of these, you're like, Oh, thank God.
Mm-hmm. ,
Dr. Danielle Malano: So for. And, and I remember this, you know, going back into residency, I, I'm a list person. If it's not front and center in front of my face, I'm not gonna see it. So I notice that if I make a list on paper, it works better than if it's a list on my phone, because if it's a list on my phone that, that I get a popup about, I'll just swipe it away.
I'll swipe it away, swipe it away. Um, for most things, I mean, there are some things that I do put, like a big exclamation point red mark on that, that do live on my phone. Day to day, if I make a list on a piece of paper in front of my face, when I wake up in the morning before I do any of the things, I am able to be a lot more productive.
So that's one of the things that I, you know, I do. And I, I noticed that, you know, once I got the diagnosis and talked about, you know, the different treatment options, you know, there's medications, there's therapy. I went for both, you know, because why not? You know? Um, and then when I first started and I told my husband, Um, he kinda made a wrinkly face.
Like, he's like, Oh, okay, is this really gonna work? Or what? And then he did say, he's like, You know what, you do seem a lot more chill during dinner because sometimes I'm like stressed out and you know, the kids maybe not, you know, be eating enough or well, and, um, or they're not putting away the dishes. And he, he said, Yeah, you look a lot more chill.
And then after that I, I went to go do some laundry and I noticed that while I was folding my laundry, I noticed that in my body, I had such less anxiety that I usually have in doing such a mundane task. Like I hate folding laundry . And so I noticed that that wasn't there as much. And then after that, I went to go, like, make some edits and post something on Instagram.
And while I'm doing my edits, I, I usually feel like palpitations in my heart. Like, Oh my gosh, this isn't right, this isn't good. Like, how am I gonna put this together? How long is it gonna take me to do? And I didn't have those racing thoughts as as much, right? It's, I just noticed that. I'm like, Oh, this is nice.
And so, because a lot of that was diminished, I'm able to post more. I'm able to do more. I'm able to get more stuff done because all of that background anxiety is, is a little. Faded. I mean, it's still there, , right? Um, you know, and I, you know, like I literally just got started on treatment about a month ago, but I do notice the changes and I'm just so, so grateful.
You know, when I was first deciding should I go for life coaching or should I go to therapy? I started with life coaching. You know, you start by starting. So I started there and then through that, Learn to borrow the thought that it doesn't have to be, and, or it could be and right. I did the life coaching and I can do therapy and I could do, you know, medications, all of the above.
You know, we definitely, you know, advocate for any kind of self, um, you know, um, self-help behavior, um, for your own mental wellness, for your physical wellness, emotional wellness, all of the. Yeah, I, you know,
Dr. Diana Mercado-Marmarosh: everything that you're saying, like I can relate to mine is the cookie. I'm not the best cook, but that's a limiting belief that I'm choosing to keep hold onto because I'm making my husband cook.
But, um, and seriousness, um, he calls me out all the time about that. Uh, but a seriousness. Because I had no awareness of how my adhd, like, I was kind of oblivious to it, like for, you know, 10 years because I got told like, you're gonna
Dr. Danielle Malano: outgrow it. Right? Or
Dr. Diana Mercado-Marmarosh: like, you should know better, right? And so it was not until like I joined e wp, like all a sudden I'm telling everybody about it.
And, and it was because, Life coaching. I didn't even know what life coaching was, but I joined cuz of the, uh, it was gonna gimme credits. I needed to keep my license so I knew I had to kill two birds with one stone and it sounded kinda cruel.
Dr. Danielle Malano: Empowered women physicians, like, I wanna be empowered, right?
Dr. Diana Mercado-Marmarosh: And so, So, yeah, I think that naturally we jump from one thing to another, but it's because we're seeking to try to understand ourselves.
Like that's what we're seeking and, and we know that there have to be a better way because just like you, I was listening to podcasts on my way home and back, like remember listening to podcasts, like this lab comes clean or something like that. Like I wanted to really. Out how to adult, you know, , like, I was like, why can't I kiss adult?
Like people are gonna be like, she's associate. Why can't she just do her laundry? Why can't, Huh. She do dishes. Right? Right. Or why does she have to keep doing her laundry like three times? Cause she forgot to dry it and now it's, and now she has to go Google like the vinegar thing or whatever. Right. And so, yeah, it, it's so funny that, that we don't realize that our brain and our self care, and I didn't even know what that word was.
We are our best investment. Like we can spend all this money on cars and purses and whatever, right? But if we like, and we can have it all and we can look at it and they look pretty, but we don't feel like just right because we don't feel right. And, and so again, it's in this therapy, it's in this coaching, it's in this medications and, and it's in this discussions like what we're having that.
We realize, okay, I'm not the only one. And you realize that some of the things that maybe are annoying to you or you keep swearing, you're not gonna do it ever again. Like it's not that you don't want to never do it again, but you realize that it's part of like your ness and it's part of your. What you thought is like a human like, I don't know, defect.
It's not a human defect, it's just part of your adhd. And again, I'm not saying that to excuse you, but it's for you to understand it. So then you're like, Okay, how can I then, and do I want to do it or can I delegate
Dr. Danielle Malano: this? Right. Absolutely. Yeah. And I found that I've also learned how to give myself a lot more grace.
I was, I was at Costco and literally like. Five minutes. Was about to walk off with someone else's cart, . And then I was like, Oh, I'm so sorry. And then five minutes later I went to grab an item, put it in my cart, and then the person's like, Excuse me, that's my cart . I'm like, Oh, that's probably, I know why that's happening.
Now I know why. .
Dr. Diana Mercado-Marmarosh: I could've swear this was just right there. Why you keep doing it, . Why you do it now I know
Dr. Danielle Malano: why. Now I know. I have
Dr. Diana Mercado-Marmarosh: an answer. Awesome. So, uh, what do you think you see yourself doing in the next, like, three to five years? For
Dr. Danielle Malano: fun? For fun, I already do a lot of things that are fun. You know, I, I, I travel the world.
Like my kids, you know, when they were born, everyone said that, you know, we would stop traveling or, or slow down because both my husband and I have the travel bug. I think. Travel bug is more pathologic than mine. However, we proved everyone wrong and as soon as they were born, my oldest one is almost 10.
We've been on a plane almost every month, you know, except for the pandemic. , You know, I think by the time he was seven or eight, he's been to 30 countries because we maximize every single day of vacation that we have per year. To the point where some people have asked if we work, and I'm like, Yeah, we work full time, you know?
But we use those vacations, They're like little mini retirements because we work so hard. And if we have like a little thing on a weekend here in one month and a little thing on a weekend here, in that. We can look forward to those things to help re-energize us, bring us back together, and that's kind of our together time, that's our family time.
You know, both of us work full time. My commute's an hour, so by the time I come home, I have, what, two or less than three hours left with my kids before they have to go to bed, , and they, um, I don't see them again until the morning when it's circus hour and we gotta shoot them off to school. So the time that we spend together and travel.
One of our, one of our big things that we do. Um, and then, you know, with my exercise, I, I make sure that I have time to do that. It's one of my. It's one of my must dos and I need to move every single day somehow. And whether it's at work, because I leave a pair of dumbbells there and a pair of jump ropes there or at home, um, you know, I, I will make it happen because it's that important to me.
And. Again, cooking is another creative outlet that I have, and so I just find joy in doing all those things. And then because I get to do all those things, I get to be a better physician to my par to my patients. I get to share with them what I cook or how I, you know, um, organize, you know, my day and how I get to get things done and, you know, just get to, um, have a better connection with them because I'm in a place where I get to be more.
Dr. Diana Mercado-Marmarosh: Yeah. And that's so important, right? Like not waiting until someday , but scheduling it on purpose. Not waiting to like, Oh, one day I'll make a memory. No, put it in there. Make it a memory, right? Like and that sense of play and adventure. It's refueling for some people and I would totally be on the plane with you, , my kid, you know, uh, when he was born.
Yeah. Same thing. I got told, uh, yeah, he had done eight trips by the age of one. Like, like, they're like, Why would you take a three month old to, I'm like, Well, why not? You know, absolutely. And yeah, they're like, Why would you take a six week old to go see the total eclipse? And I'm like, Well, why not? You know,
So it, it's just like you say, you play hard, you party hard. Right. Or you on purpose decide what is gonna be important to you, and which is family is so important. So it, it's, it's good to live the values that we say we, we value otherwise. Then we don't feel like we are aligned and that
Dr. Danielle Malano: leads to burnout really.
Yeah. And that's why, you know, I'm continuing, you know, working on this website and, um, maybe one day I'll have a course to help other people, you know, get healthy meals on their table without, you know, getting takeout all the time. And, you know, if. Um, cooking or cooking demonstrations can eventually be incorporated into my workplace.
That would be amazing too. You know, having these teaching kitchens is something that is exciting, um, for me. And if that's a possibility, I'm totally going that route Also. And you know, it's
Dr. Diana Mercado-Marmarosh: a possibility, right? Anything with adhd, like we don't stay in no boxes, right? Like, we just invent and like think outside the box.
And again, if it, we might not know the how, but you know it's gonna happen, right? It's just a matter of time. I can't wait to, for you to send me the picture, like, Hey, guess what? And I'd be like, Of course. Of course. It was just a matter of time, right? It's in the. Uh, we just dunno when the day will get here, but it's in the mail.
I know, I know it will be. Okay. Awesome. So, as you know, uh, people with ADHD sometimes tune out. So if they just started paying attention like right this second, what would be the takeaway point that you would want them to have?
Dr. Danielle Malano: So, if you are curious or wonder if you have adhd, it's not gonna hurt to get evaluated and.
If you do have it, great. That is your superpower, and if you don't, great. Now you know what it's not. So let's go find out what else it could be so that you could still continue to be the best you. Thank you. That
Dr. Diana Mercado-Marmarosh: is the best advice. You know, again, be all on you. You know yourself. Trust yourself, trust your intuition.
Be okay getting a second, third, fourth, fifth, whatever opinion you need because. Once you know, then you can establish what the next steps are, right? And meanwhile, keep doing fun things and make sure you put on the calendar outta sight, outta mind. So put it on the calendar and uh, Danielle, where can they find you on Instagram?
Cuz I'm pretty sure they want to.
Dr. Danielle Malano: Sure, yeah, you can buy me on Instagram at Eat Rome, Heal, Eat, because I love to eat and cook roam because I love to travel and heal because I'm also a physician. Say it again. Eat Rome. Heal. Awesome.
Dr. Diana Mercado-Marmarosh: So there you have it, and I'm pretty sure you could send her an instant message through there.
If you have a way to set up her show, hey, let us know. If you can facilitate anything or you want her to come speak, let us know. Right. So we're all here to, uh, uplift each other and together we are right. So I'm so glad you were here. It's such a pleasure to, uh, be able to feature physicians who are living and practicing medicine in their own terms and how fulfilling it can be.
Yes, sometimes our road can be rocky and it can show us lots of patients that we don't want to learn. But you know, it teaches resilience and it really teaches us to continue to live in
Dr. Danielle Malano: alignment with our values and you totally
Dr. Diana Mercado-Marmarosh: embody that. So thank you so much for coming. Thank you for having me. I'm
Dr. Danielle Malano: so excited for being here.
And thank you again for giving all of us a voice. Thank you so much.
Dr. Diana Mercado-Marmarosh: My. 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@coach.com where you can find out about my upcoming coaching group classes, as well as free master classes and other exciting events that are happening.

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.