Beyond ADHD: A Physician’s Perspective

Forgiveness the KEY to Unlock your Limitations

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Dean Mecado Mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now. Made 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.
So today, I. Talk to you guys about how beautiful our brains are and how sometimes we can go down the rabbit hole and, uh, learn very useful things. And one of those useful things that I learned was about forgiveness. So, of course, you know, picture this, I am trying to, um, , I'm trying to do some of my notes.
And of course to try to help me concentrate. I turn on my candles, I turn on, uh, YouTube, and I put it, you know, on a sound that doesn't on, on a music that. That has just sounds that doesn't have any words. And of course after a little while, then you have an ad that comes up. And one of the ads that came up was, um, about a mom talking about forgiveness and how forgiveness could like help you re rely your.
And of course there I am, right? Like paying attention. , I should be doing something else, but there I am paying attention. And so then that takes me down a rabbit hole to go figure out like if h d could benefit from forgiveness and all this other stuff, right? So this shares a story and he says that his meditation teacher told them.
If I throw a stone at you and it hits you, like who are you angry with? Are you angry with the stone or are you angry with a person? And of course, amongst this, well, I'm angry with a person because the stone had like no intention of hurting me. It's like just an object, right? So then the teacher asks them, if we use that same logic, should you be angry?
The person, or should you be angry with the pain that that person might be going through and it's just maybe reacting and doing this because they went through something themselves. And so that got me thinking, you know, um, we. Tend to be your worst critics. Right? Like I remember, um, for the longest time, and, and this is something of course I've been working in the last three years to rewire my brain and, and coming to the understanding that, you know, for 6,000 years our brains have been conditioned right to.
Survive . They've been conditioned to think and like the negative, to think like, What's it gonna kill me? What's gonna kill me? Right. And I've been coming to understand that if I keep focusing on the gap instead of the gain, and if I keep telling myself that I'm falling short on stuff, um, that's not gonna get me very far.
The thing is, like the way we talk to ourselves really matters. If I keep thinking, Oh, they're gonna find out like I don't belong here, they're gonna find out I'm not good enough. They're gonna find out. Like that emotion is heavy and it weighs on me. And sometimes I would tell myself all kinds of things that I would not allow my.
Ran even my enemy to tell me, but yet I was doing it as a protective mechanism thinking that if I caused that pain to myself, there would be nobody else who could cause worse pain to me. So I was like protecting myself. So in this exercise, you know, then I went down the rabbit hole of Latino. If people are affected or, you know, become traumatized because of their adhd.
And then I found another statistic that said that 80% of people with ADHD have trauma and that that trauma can really limit their own, like self development and, and of course can affect their self worth and all self-esteem and all that stuff, right? So, One thing that caught my attention was that the act of forgiveness is not necessarily for that other person, but it's for yourself.
Like that it would benefit yourself. And that in doing so, it would help like your brain have a state of more like, um, coherent. And so I thought that was interesting. So I gave it a shot, . I was like, Let me, let me try this method that they're talking about. And what they say is that, you know, when you forgiving people or even yourself because there's so much stuff that the younger version of us did not know any better and it got us into trouble, right?
So, You forgive others, um,
you are the one that benefits and you can really forgive anything, and that
forgiving them does not mean that you're dropping the charges or ignoring what happened to you. It's just that you learned to deal with it in a different way, or you learn to maybe see their point of view. That other person never even has to know that you forgave them. Like you don't have to. Like that person doesn't even have to be or anything.
You don't have to send letter, you don't have to anything. So what they talked about was,
There was an experiment that they did. I'm telling you, I went down the hole. . There was an experiment that they did at an institution where they put, um, 12 electrodes into pe uh, so that they could measure like the different way brainwaves to see how coherent people could become if they process their emotions and they give them all.
Free reign. They said, Okay, you're gonna meditate for five days and you're welcome to do whatever you want. Like you could picture a number, you could visualize something, you could listen to sounds. And then they started to say that this one lady. Was having like amazing, like synchronicities on the, it seemed like the EEG was lighting up and they were trying to see, um, if they could reproduce, uh, the state of meditations that monks could achieve after meditating for like, you know, 40 years or something.
Uh, and so that's why they were using this EEGs and this one lady was just like, Pull outta the park . And so they up to her, they're like, Ma, what are you doing? And she said, I'm just trying to forgive my husband to be such an asshole. They were like, Uh, aha. Okay. So some people were trying gratitude, some people were trying like, you know, different things.
But this lady, as was trying to do. Forgive. Right? So then they went ahead and did an experiment where they asked the next five days for everybody to forgive something like forgive something that irritated them, like forgive their coworker, forget themselves, forgive, whatever. Right? And they started to notice that that had the most like growth, the rewiring of the brain and.
And I, of course, have to go down the rabbit hole and be like, Hmm, let me try, like, let me try this experiment not to go get the wires on my very place electrodes, but let me try to see if I can think of something or somebody that I can forgive. And here's the thing, like we all hold onto things and. Those things really do weigh us down.
We, we think they don't, but they do. And, and going through something like this could really be something that finally sets you free so that you can do more things. And so through the studies they were saying that, um, people are saying were able to like, Have more physical endurance or were more resilient, or were more understanding and, and could tap into compassion better and had become, um, you know, just more in sync with themselves how they really wanted to be.
And so, They went through like, uh, a way of doing it in an organized way. They gave a method, and so I wanted to share that with you guys to see if this resonated with you. I tried the meditation one or two times, uh, before sharing it and talking to you guys about it. And I felt a shift. So I mean, it might be worthwhile trying.
So remember, when you are doing something like this, it doesn't mean that you're excusing them, right? Like if they stole money from you, it doesn't mean that you dropped the charges instead of go to jail. It just means that you make peaks with it and. Then you're able to just show up different for yourself.
So we often get that we have adhd and that part of the emotional dysregulation is real. You know, in the US they don't really talk about it, but in Europe they do talk about emotional dysregulation. So I'm just trying to introduce a possible other new tool that can help like tame that emotional dysregulation that can happen when we are holding onto those little grudges.
Okay. So they gave, they gave a set of, of, uh, sequence to follow. So what they say first is to picture that person or to picture yourself, like if it's yourself, let's say your younger version of yourself. Okay? Um, once you picture that person, You invite them or yourself to your safe place. Like maybe it's to the beach where you usually enjoy being.
Maybe it's to, to a mountain, maybe it's to a park. Wherever you call yourself a safe place, you invite them there, you see them walking towards you, and then you start to feel like what they made you. Like for 30 seconds, a minute at the most, like start feeling that emotion of pain or anger or disappointment or frustration.
Whatever it is, start feeling it, but do not feel it for longer than thir than 30 minutes. 30 seconds to one minute.
Once you do that, you are the one who's gonna talk. They're not gonna say anything. You're the one who's gonna talk. You're gonna tell them how they did you wrong, tell them when you did this, this happened, da, da, da. So you tell them like you read them like the charge, right? So you tell them how they wronged you after doing that part.
You are then gonna tell them what you learned from that event or that experience.
And then you're gonna try to understand why they might have done that. Instead of you judging them and telling them what's wrong with you, try to understand what might have happened to them. Like maybe somebody like abuse them or maybe somebody. Cause them some type of pain that then they thought that this was the norm to do to somebody else.
Right? So try to see it through their eyes.
I know this part's gonna be hard, but you, it's an exercise, right? It's a muscle. You gotta try to see it through their eyes to, to think what might have cause them to lead to where they're at. Right. And then after you see it through their eyes and you tell them that you understand, you're gonna tap into compassion and you're gonna tap into love.
So you're gonna picture yourself giving them a hug and, and forgive them. If you are not able to do that part, that very last part, then you do this whole exercise again every day. It might take you a week, It might take you a year to finally get over it or to not necessarily get over it, but to trans mutate that pain.
Weigh on you. And again, you don't have to do this by ever even telling them that you are working on this. It could be that the person is already passed and they're not even around for you to tell them. It could be that they're in another city or whatever. You're not writing them no letter. You're not calling them, you're not doing anything.
You're just a dual. All this in your mind, in your own space.
And remember, sometimes the most powerful thing is to forgive ourselves because we didn't know any better. We didn't know what we didn't know, and. We have blamed ourselves for so many things that sometimes we were not even aware that it was our adhd, like for our tardiness or for, um, for getting the keys or for, um, forgetting to show up for a kid's event because we have forgotten to put it in our calendar or for not paying the taxes or for, uh, you name it, right?
So, Forgiveness is a powerful tool that when you combine it with compassion and forgiveness into love, you are the one that benefits. And so I tried it and one of the meditations, or one of the examples that I tried was forgiven myself for lying. So I think I shared this story with you guys before. Must have been about eight years ago.
I don't remember how long ago it was, but was still living in Houston at that time. And everybody who knows me knows I'm not the best cook. , I mean, our, my first date with my husband, like the fire firefighters had to come over because I was trying to cook a steak and it got burnt. And at that time, you know, Uh, , it set up the, the alarms and everybody came and the whole building had to be evacuated and Oh my God.
Yeah. So anyways, they give my husband the, the Chinese thing and said she's a medical student. Right. Call a Chinese place. Point is that about eight years ago I was Trent to have a better cook. I was trying to make this. Roast Ciy chicken in the oven, and I was trying to be fancy, trying to follow all the instructions from a cookbook, and part of it required that I add some rosemary, um, spices.
Well, I had forgotten that, that the day before, I think. I don't know if I forgot or I wasn't paying attention or maybe I half listened or I didn't think it would matter that my husband had told me not to use certain spices cuz he had done something to them. I don't remember what it was. And I used the rosemary that he had told me I guess not to touch.
And I was cooking the, the thing and it was done. And I was so excited. I, you know, we were gonna have a fancy dinner and. And he asks me, he's like, Did you use Rosemary ons? Like, no. Even though I knew I had, but I could not bring myself to say that I had, because if I said yes, then that meant that.
That he was gonna reject my chicken and therefore he rejected my chicken. It meant we were not gonna have this nice, fancy dinner that I have been trying to put together this romantic night and da da da, right? So I was trying to protect the romantic night.
What developed after that was that he was so mad that I had lied to him that. Now I did not, we not have a fancy dinner. He stopped talking to me for like almost three days . And anybody who knows, uh, I'm an extrovert, and so you not talking to me is like death to me. Right? And then you throw in the rejection sensitivity dysphoria, and then you throw in the fact that you bring condition once just to think, which is love and acceptance.
I mean, I was like, what the hell? Right? And of course my brain of saying, You're overreacting, you're overreacting, you're overreacting, right? Like, that's what it kept saying because I wanted to keep me safe, like I wanted to be taken care of. Why am I saying all this? Eventually, of course, that led to me, um, uh, going to counseling because he said I was a liar, , and I.
Too many people, it might be like, Okay, it doesn't matter. I kept telling myself, it doesn't matter that white little lies shouldn't matter because they're white little lies. And I was it. It's always the means to the end. Like I was just trying to please him. I was trying to do a nice thing, but the thing is that we should be okay to say what it is without feeling like we have to keep masking or people pleasing.
So I, I learned from that experience that a white little lie could become dangerous. Like to him, his point was like, if you're lying about this little thing, what else are you lying about? You're gonna be lying about the big things. And of course, like we didn't even have any big problems. Like to me, those little Li white lies didn't mean anything.
But through the therapy, I got to realize that I was using White Little Lies as as a defense mechanism, right? Like I didn't want to be that five year old who was. Like not accepted or loved. Right. And I did, and I had learned the mechanism that if I am just well behaved and quiet enough sometimes, or change myself enough, like, you know, I would be okay.
So why am I saying all that? Because when I went through this exercise and. Used at meditation where I pictured myself, you know, my younger version, and I created that space. And then I felt that I was angry at him. Angry at myself. Why? Can't just understand, Don't know . But what I learned from the event is, You have to just be honest and, and, and that my integrity really did mean the world to me.
And that of course his love for me was important. But more importantly, my love for myself was the most important thing. And me being able to be my full self, bring my full ADHD self into the picture was more important. Um, And I learned to see myself from what I now know, my wiser self now understands because I have deep dived into understanding my brain and defense mechanisms and understanding that that time I had no awareness that I was acting in, in what is called like childhood, like emotional states, right?
Where I was just trying to, um, Man, I don't wanna say manipulate the outcome, but I didn't realize that how he felt did not have any, or should not have any insight on how I felt, meaning I controlled whether I was happy or not. And I didn't need to necessarily have this perfect dinner in order for me to feel like I was worthy of his love.
But in that moment, I didn't know that in that moment. I was trying to do my best to protect what I thought was the right thing to do. So my wise self, my older self now is able to tap into compassion and say, Of course, you were trying to just have a nice dinner. Of course, you were using a white line mechanism that had helped you to mask so much that at some point you didn't realize could.
Lead to one too many white lies that could maybe derail you from where you needed to be, right? So I forgave myself for not knowing what I didn't know. And here we are. I'm sharing this with you because it sounds silly, right? All this like, um, Feelings that we're not used to talking about feelings in the medical field, but what I've noticed is that feelings are at the center of everything and that we all are holding on to little events or grudges or traumas or something that has happened, and in it, it weighs us down.
It really does. So try it for yourself. See what you think. We all go down the rabbit hole. You can , you can let it be something or learn something from it like I did and apply it, right, Because it's in the application where things start to shift. So there you, they heard it . I can't wait to hear what your reflections are on this.
And yeah, if you are interested in telling me any other topic that I should listen to or do, please let. Um, thank you so much. We be touch. 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.
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.

What would your 90 year old, Wiser self, tell you?

Dr. Diana Mercado-Marmarosh: Hello, hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my. 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, learning the new.
Hello, I so excited to be here with you today. So, um, I had a couple of interesting weeks. I went to Costa Rica, um, to celebrate my 11 year anniversary. Um, and actually we went for honeymoon, uh, to Costa Rica as well. So we decided it was probably time to go right now that we have. Little break from Covid and you know, I was like, we just need to go before, um, there's a new pandemic, like Monkeypox or something.
Right. And I booked the trip like maybe a month before we went. And you know, that's just so adhd, right? We're kind of impulsive sometimes, but sometimes those are the best decisions that we can make. Like life is too short. You gotta make sure that. You are living in alignment with what you think is important to you.
And so I wanted to talk about this week about how ADHD can be your superpower. How you don't let things kind of slow you down or get you in the way, even though life throws you some core balls. So, uh, I was hiking, um, All sudden I hear clunk. We were climbing the, uh, Ariana Volcano and I looked behind me and half of the hiking book booted had fallen off.
And my tour guide asked me the Laas, which means, are you gonna keep going? Are you. Play for it, or are you are like, are you out? Are you done basically for the trip? Right? And so that question
kind of like woke something in me. Um, it, it was such a quick question, right? It, it's funny how one question can change everything.
Can be taken in many different ways. It can be taken like, are you all in? Are you ready to play? Right? And so maybe some people would've said, Well, oh, I just have one boot. Like I can't keep going. Right? But the bottom of the soul still had something, The other part just fell off. And so, you know what I, I told them, See , which means like, yeah.
I'm gonna roll with it, see what happens. And so what happened was that I kept walking and 200 meters later, flunk here, the other part of the group fall off. And maybe some people would've thought, this is the worst thing ever. Right? But to me, like I couldn't help but laugh. Like I found myself in a situation that was so typical for me.
It just seems. First thing happened to me. For some people it might be paralyzing, but for me it would. I didn't make it mean a thing. Um, the thought were going through my mind where, you know, my ancestors probably climb the same volcano, their foot it. I'm sure I'll be okay. So our thoughts really make a difference on how we show up with the world.
Like maybe some person could have thought like, Oh my God, this is horrible. This is the end of the world. Um, but to me, I just kept thinking, this is another day, like not a big deal. And I just kept going. You know, I finished the rest of the hike. I think it was another 40. And I just kept telling myself, Hey, the universe just wants to a foot massage.
Interesting. On previous, like LA Rocks, right? And it just, it just tells you that sometimes life just happens. Right? And so at the end of the, of the excursion, I asked the tour guide. Hey, um, has this ever happened for you before? Like have people lost the whole bottom of their shoes before and he said, No, this is the first time this has happened in the last 15 years.
And you know, I was actually there with my friend Christina and her husband on this trip and. We were just laughing because my husband's like typical of Vienna, like some first time always happens, right? And so I remember when we went, um, it was prior to kids, we went to, um, a place in Australia and I think it was called Canes or something like that.
And it's supposed to be like the place to go and jump in. And scuba dive. My husband already had the scuba dive like certificate. I went through the course right there and then, um, and when it was my turn to actually apply what I had learned and go down, uh, I couldn't do it. Well, my brain was just telling me that it was gonna be one too many directions for me to follow.
I was panicking. I just could not see myself going underwater with like this oxygen. And it's so funny because like how many times do we do different things that you know, are not so scary for other people, but. Still do 'em right? But our brain is always trying to protect us in one way or another. And so yeah, I asked that same instructor how many people had like come all the way out here and they not go down.
And he said, Not many . And you know, when I was trying to, uh, learn how to ski, uh, down the mount in Denver, you know, I was doing a. Learning activity and I was one of maybe the only one who went down the slide, meaning I slid down the mountain like in the parking lot, like in the opposite end of where I shouldn't be going down the to be training.
So things just happened to me and you know, the. The instructors like, um, I think Deanna needs like one on one sessions. She does not need a group. She needs her own private instructor. And guess what? The next day I paid for my own private instructor and I, I got a little bit, I got the gist of it. You know, I learned to do some like, You know, but when I was going through the motions, the guy's like, Okay, you need to get off the, the, the cliff, like you need to get off.
And I was like, mm-hmm. I just stayed out there. And he got off and he's like, Oh my God, what is this lady doing? Right? And so it's just funny how sometimes her brain tried to, to protect us or we try to avoid the things that are getting, get us in trouble, or we still do it despite, So what am I talking about all this?
Because you know, today I am at a conference where it's, um, I'm part of a group that is a retreat where they teach you how to level up or how to, um, Practice medicine in your own terms and how to serve and how to earn and how to create legacy for yourself. Right. And we were given a cupcake that said happy 90th birthday, and we're looking around the room because you know, it's all physicians in there and nobody is close to nighty in that room.
Right. And it was an exercise. It was an exercise that said, um, what would people say at your 90th birthday? Like, what would they say about you? Right. And I'm pretty sure most of us had done this type of exercise, like if you were at your funeral, like what would people say about you? But you know, the 90 birth, 90 year old birthday celebration seemed like a more happier place because you're still kinda alive, right?
So, I describe my birthday as probably taking place on one of those cruises, you know, where you're six months out and. And it's perfect scenario because you have a Dr. Ward who's taking care of you, somebody's cleaning your room, right? You're getting off on all this different ports all around the world and you're being fed like amazing food.
And there's probably activities, I'm pretty sure they're probably make us go to sleep kind of early, but that's okay. Like. I would rather be on a six month floating a cruise all around the world than be somewhere like on a nursing home or something. Right? Why am I saying this? Because we don't know how many years we have left to live, right?
It could be one, it could be. 10, it could be 40. We have no idea. And so you need to decide what kind of life you wanna have in order to start working towards it. And in my, and she gave us like, Different categories for us to decide, like what would they say about us? Like what would family say about you?
What would like, um, you know, what would you have accomplished? And all those things. Right? And so to me, what came to mind was that, They, it is something that people tell me all the time, If we don't know you any better, we would think you're taking something because you have so much energy, you do all kinds of things.
You're the healer to everybody. You like to listen. Um, and then you, you like to disrupt shit, but it's not working. and you know, I really think that I came into this world. To share my story and to hear other people's stories and to find the amazingness in it and to collaborate together to make that happen.
So today I was listening to, um, to somebody say that it's okay to. sometimes not do the things that you think you want it because sometimes better things come your way and it's just so interesting how. what we think might be, you know, something hard, might be something not that hard because something better is coming your way.
Why am I sharing all this? Well, I guess I'm in an inspiration type of scenario. You know, I'm looking, we're in October. We really we're starting the last quarter, how you say it, right, the last 90 days of this year. And I'm wondering whether you have met all the goals that you wanted this year. Right. And last year when I came to this retreat, we had a similar, um, You know, projecting forward saying that writing out the date, like, you know, December 3rd or December whatever, 2022, like what would you have met?
What would you have accomplished? And I looked at my journal of what I wrote last year, what I wanted, and I wanted to have a long term nanny and a housekeeper. I still don't have those two things. Um, but I wanted to also have, um, date night with my hubby once a week and that is actually working. So, and I wanted to have more quality time and that is also working.
And, um, in terms of like my personal development that I wanted to do, it was starting a podcast or YouTube channel, which I am doing that. And in terms of fun, I wanted to have dances and I wanted to learn, um, How to do like a, like Suma or samba. Um, I already know Zumba, but I wanted to do samba, right? And so I, one my amazing position friends is, uh, actually teaching me to do that.
So, yes, um, I also wanted to schedule my massages and I am doing that and I wanted to paint more with my. And I am doing that too. And in terms of my business, I wanted to make an impact. Like I wanted to earn, um, at least a thousand dollars, right? Uh, sorry, a hundred thousand dollars. And yeah, I'm doing that too.
And so why am I sharing this? Why am I saying all of this? Well, you need to write stuff down that you want. If you don't write it down. You were not focused on it. The universe is not gonna match your vibration. You need to figure out whether what you're currently doing is important or not. And the systems that got you here, are they gonna take you there?
And you need to realize that in order for us to grow as a person, You need to have a network, You need to be in a community where people are growing themselves, and that takes sometimes investment in money, sometimes investment in time, that maybe takes a commitment to saying no to things that are maybe draining you and you need to have this talk with your yourself.
Like what would your wiser self tell you like. If you make a baby decision, like those baby decisions add up, like they can really be the difference between who you marry or who you don't, whether you are healthy in terms of exercising or not, whether you move to one place or another, whether you start your own business or whether you write a book or.
Go on a limb and go on vacation, you know, and plan in one month out. You get to decide what type of impact you want to have in the world. And so choosing you is important. You have the last 90 days. If you feel like maybe you need some help in getting you to where you're going and you don't know where to start, reach out.
I'm here, come to my group. You know, if you're a healthcare professional, I can totally get you there. Whether it's going home by three o'clock, whether it is, um, Coming to my retreat in Costa Rica, whatever it is, reach out if you have some, you know, um, opportunity where you want me to come and speak to your residents or come and speak to your, um, society or, or network event or whatever, like, let me know.
So this is where I'm at today. I am in the reflection mode. I am in the, what is my goal next year? What am I dreaming up? What am I gonna do the last 90 days? And how do I continue to prioritize and plan for myself, right? And for others. And, uh, realizing. Yeah, at the baby steps they add up and it's in that repetition that our habits become, um, you know, become our life.
So do decide that you're the most important person in the room that. Refilling your cup is important and that you are one unique you. There's nobody like you and that's amazing. And we want to, um, share any of your stories. If you know somebody who you think I should interview that could highlight. Um, any of our adhd, um, qualities, please let the, let them know.
Please bring 'em over. We all need to help each other thrive. 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 ADHD 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 happening.

Using Emotions As A Compass

Dr. Diana Mercado-Marmarosh: Hello. Welcome to Beyond ADHD, a Physician's Perspective. I am Dr. Deanna Mecado 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 a person. I was always meant to be both in my work and in my personal life.
In the past two years, I've come to realize, That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills.
So today's topic is one that we don't usually talk about, which is dealing emotions as a compass. I wanna share with you three tools that will help you to. To develop a way of opting out of overwhelm and to really tame your inner critic. So emotions as a compass. Everything we do revolves around emotions.
They're really the center of our life and most of us don't even talk about it. And the thing is, Coming from the medical field, emotions are not something we bring up like we have been taught or told that we should always just show up in a very professional matter, leave whatever's going on with you at the door and do not let anything dissuade you.
I'm not saying that's good or bad, but that's what we. Been told that's what it means to be professional. What I wanna offer you though is that emotions are a very healthy way of us knowing that we are still alive. Emotions are at the center of everything. I don't want you to think as emotions are good or bad per se, but the thing is that we need to see that emotions are helpful and are needed 50% of the time.
We might feel good, 50% we might feel bad. Vibrations in our body are just a way that emotions show up. Why do I say this? Emotions teach us something. They tell us if something is going on, like if we're angry, if we're mad, if we're frustrated, your body's trying to tell you something. If we're happy, if we are feeling blissful, joyful, your body's also telling you something. So emotions. Are a way for us to self regulate our environment.
The thing is that when we have adhd, there is, we don't have that two second delay that a person without ADHD has between the amygdala. And the prefrontal cortex. And because we don't have that delay, we sometimes appear to get more worked up or lose our ability to regulate, or we get mad over something that shouldn't have really cost us to feel like we are overreacting.
Example, if you're trying to get out of the door in the morning, And you're trying to get your kids ready and one is missing a sock, one is not putting on the shoes, and you're trying to give them all these directions and the kid just starts to scream and melt down. , it's probably because, too much information was coming at them at once.
They can't follow all those things. So I wanna explain to you that emotions, are just a way for us to also make decisions. And so what happens is that, As you, you sometimes don't realize that people with ADHD can, we tend to be a couple of years behind our peers in terms of our cognitive development and our emotional development.
There's studies that show that. We are about 25 years of age when we really become who we're meant to be. And for some with adhd, it's fun until the age of 30. So when you're asking a kiddo, to do X, Y, and Z, or even us, when you're asking us to do all kinds of things, we become overstimulated.
So the first tool that I want you to talk about or acknowledge is that emotions can be a way for us to gauge our environment. It's in awareness. It's a engagement of what is going. And then be aware of this so that when you do have that moment where a lot of things are being thrown at you and you feel overwhelmed or you feel stimulated, over stimulated, just knowing.
That we don't have that two second delay can keep you or prevent you from going into this self blaming, self hating, self criticizing reminiscence, where you're like telling yourself that what's wrong with me? Why am I so slow? Why am I doing this again? I told myself I wasn't gonna react. Being aware.
Can help you name the decision, can help you tame that emotion that you're having. So don't think as emotion as like something good or bad. Just look at it as a source of information and ask yourself like, Huh. I wonder if I, When was the last time I ate, When was the last time I slept? When it was the last time that I did something?
We as human beings are so unique in the sense that we are able to think about our thinking, and so the tool that I want you to give yourself is this pause, create. A safe ward or make the decision ahead of time that if you have this flat of emotion, having the awareness that this is something that is normal for ADHD people, now you can create a way to give yourself that gift of the pause so that you don't make it mean anything and you don't go down a rabbit hole.
Criticizing yourself and blaming yourself for not quote unquote having it together. The second tool to self regulate or to decrease overwhelm and stop this inner critic is by changing your environment on purpose. Create self regulating actions that are going to refocus your attention away from whatever just triggered you.
For example, if my kid is tired and crying and frustrated, I can tell him what's wrong with you, right? I can do that, but acknowledging the behavior of the person. and then changing it, it's more helpful to say, I see that you are very upset right now. You validate their feelings, but then you can change the environment by maybe introducing humor or doing something different.
I can, of course, scream or I could change the environment like, Damn. Or there yet, you sooth yourself, right? How you could give yourself a hug for five to 10 seconds. That's very calming. You could. A nice song that is going to reset you or change you. For example, I bounce to the beat of my own drum is one of the ones that I think is so fun.
It just reminds me that we can do whatever we want to and that people don't, we don't have to follow other people. And so when my kids are having a meltdown, I. Pause, I look to see if there is something that I can do to change their environment. Maybe they need to go outside and walk. Maybe we need to start jumping around and there is some.
Places in Denver, Colorado that the teachers, instead of giving people a time out for having this meltdown that they're doing, they give them a time in they right there on like bicycles and. It's amazing because now they're getting healthy, they're increasing their dopamine level, they're feeling happier, and they're focusing.
So instead of quote unquote shaming them for acting a certain way, they're giving them a time in. They're allowing them to process the emotion, be in the moment, but. Changing the environment, having them walk, having them run, having them exercise, can do a big thing, have a safe work per se. So the third point, or the third tool that I wanna share is that community is key in order for us to be able to.
Enhance the way we show up with when emotions happen, instead of feeling overwhelmed and feeling like we're that, we're the worst person or inner critic is gonna go wild, we gotta realize that we are worthy. That there are people out there who really want to help you grow as a. And sometimes we just need to do repetition.
We really have to find an environment that supports us, and while some medications can help with this, something maybe like claine and want the sink and help take the edge off, really it is. That community of either cognitive behavioral therapy or dialectic behavioral therapy or coaching that will help you to implement and do the awareness of how you can rewire the way that you're thinking about things.
You start to create systems for yourself. And it is in discussing things that things get normalized and you start to see that it's a spectrum, that emotions, they're powerful because how we do things really is at the center of everything. Like why do we decide to get married to somebody?
It's probably because we think that, that we're gonna be happy with them. Why do we decide to go to school? Because we probably think we're gonna have a financial security, right? And so the thing is that using these resources in your community where they can support you, will help decrease overwhelm and will help decrease all these things.
So to wrap it up, when something hits you outta nowhere and you feel like, Oh my God, I just overreacted this, I, you are embarrassed or something, just take a deep breath, realize that we are not the behavior. Realize you're not your thoughts. Realize that. You have an option. You get to decide what your next step is.
You can take a breather. You can try tapping to help you calm down. You can try meditation. You can do jumping jacks. Change the environment. Call a friend. Join your community. Choosing is the key. You can opt out of overwhelm when you acknowledge that, okay, I have a two second delay. I don't have that space.
My brain is just trying to keep me safe, but there's nothing that it needs to keep me safe from right now. Realizing you have that power to override it, realizing that you are. Capable of creating the life that you want. So awareness, engage in self-regulation techniques and make sure you find the people that support you and where you can be you.
And don't worry about emotions. Emotions are just compass and they're all useful because you know to understands. Sometimes you have to go through pain and they're all appropriate at the right moment in time because again, they remind us we're alive.
If there's any way I could help bring any of these topics to support your audience, either by speaking, by coaching, Please reach out to me@adhdlivecoach.com. 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@adhdlivecoach.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.

Beyond ADHD A Physicians Perspective: Dr. Tonya Caylor

Dr. Tonya Caylor: Let them be wrong about you. That was a powerful statement that the first time I heard it was like, Oh wow, okay. Because it just, it gave me freedom to let go of the control because I think we get socialized in medicine to really. Perform and we want good grades. We want the a plus with extra credit when the gold Star.
And and that performance based approach really highlights we are caring what other people are thinking, and so it's not that we don't care. It's not like we wanna have a terrible reputation, but it's like giving up control and trusting that if you show up as your best self, your reputation is gonna be fine.
Hello. 
Dr. Diana Mercado-Marmarosh: Hello. Welcome to Beyond adhd, a Physician's Perspective. I am Dr. Deanna Mecado Mage. I'm a family medicine physician practicing in rural. I used to be hindered by my adhd, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life in the past.
Two years, I've come to realize that unlearning some of my beliefs and some of my habits, I'm excited to.
Hello. Hello. I am so excited today. I have a very special. And you won't believe it. She is in Alaska today. So it was fun getting our time zones to line up. And her name is Dr. Tanya Taylor, and she's a family medicine physician. And I have the pleasure and privilege of meeting her actually last year.
And it was a very cool. It was the Physician's Coaching Summit and we hit it off the very first night over our doors and some wine talking about how Covid has really led us all to come to an awakening that mental health is there and that we would probably all sub functioning, but now we've realized that.
We've put ourselves through unnecessary suffering, and she's actually on a mission to help educate residents and physicians and all the healthcare industry to be able to realize that, they have choices and they can make choices. And so I am so thrilled to have her here today, and she's gonna give us lots of good tips and share with us her journey.
So would you like to give us a little bit more information about you? If I missed. Yeah. Thank you 
Dr. Tonya Caylor: so much for having me here, by the way. And I we really did. So I'm Tanya Taylor, family physician, academic physician coach up in Alaska, although I coach remotely throughout the lower 48. That's what, that's the term that we use out here.
And it was a great conversation because you and I, when we first met, realized that we had similar purposes and and you also had a very keen interest on. Academics, trainees who were struggling with ADHD and time blindness and those sort of things. And my passion has always been the residency level, academics and seeing that there were ways that you would be able to help that same population and with your expertise.
And it's an area that I love to coach in. And so it was a great conversation. I and we started like brainstorming. How could the people who follow and listen to me and the residents that I work with gain for those who have a d type tendencies or just time blindness or just want a little bit of a calm in the chaos.
And then me being able to talk to the followers that you have about. Ways to identify areas of unnecessary suffering and really begin to not only, survive, but flourish in their chosen careers. Yeah, that's how we got here. So thank you for having me. Yeah. 
Dr. Diana Mercado-Marmarosh: So I'm so excited about this particular topic because I, I think that we don't realize that we are just future of habit, right?
And sometimes, We think we have the most efficient systems. . Yeah. But we realize that some of those systems actually might need to be upgraded because some of the underlying beliefs, or they're old software, they need to be updated. And we don't realize that, some of the, because we haven't questioned some of those things like that we ourselves, Adding to the suffering that we were sharing with everybody else.
And we don't realize that, we have choices. So today I think I wanna hear your experience. What have you seen in helping residents is there anything that stands out to you? That, maybe to them is not obvious, but to you, because now you have this expertise and you're able to see it from a detached lens and you're not in it with them per se.
You have the ability to hold space and help them see that maybe some of those things that they're doing are, are not really true, and their brain is telling them that. Yeah, I think that's, 
Dr. Tonya Caylor: I kinda, you hit the nail on the head there with that description because not just residents but faculty and all attendings and whether they struggle with a d type tendencies or not.
We do have these habits and we have these ingrained thought patterns. That don't service well. So one of the largest areas of taking back like decreasing unnecessary suffering is actually our mindset. And I know there's probably, I think. Somebody has looked at the stressors in medicine and about 80% are systems issues.
And thankfully there are people now who are actively trying to improve the systems. But that 20% that we can control, a large percentage of that is a mindset and it can give you great relief just by that. So there's a few things there. One is identifying. I think just starting with the basics of when you find yourself frustrated, stepping back and looking at what are the actual facts, like not the story you have about the facts, but what are the actual facts?
Because we have these ingrained thought patterns that go and jump right onto different assumptions or put together stories that add to our previous stories that may or may. Tell the whole picture. And so just separating out facts and that I like to say it's a fact if you remove the adjectives, you remove any assumptions, you remove any loaded words, you remove any judgments.
Now, there's nothing wrong with those things, but for the sake of getting some clarity, when you take those things out and that is what you know, that by itself. Realize that you usually have a story and those stories about those, that circumstance, that set of facts is usually what leads you to the unpleasant emotions.
Now, this isn't about toxic positivity. You're not gonna look at a pediatric abuse case and somehow will yourself to, find the silver lining. This is just about. When you look at what you're thinking, how's it serving you? I think that is like an powerful thing and it takes some time.
And this is why you and I love coaching is because it sounds like an easy concept, but there's so many nuances that our brains really are attached to the stories we tell. And so that's where coaching really comes in handy to help you see what you're creating in your experience by. Not taking the time.
Once you have those automatic thoughts pop up to really looking at what you. That, 
Dr. Diana Mercado-Marmarosh: That's so important. One of the modules that I coach in my group is self coaching and self care, and I purposely put both of them in the same class because, They both seem very foreign to us. . 
Dr. Tonya Caylor: Yes.
Dr. Diana Mercado-Marmarosh: And like we have no problem, like self-sacrificing for our patients, for our family, for whatever. Even for the neighbor or for the people we haven't even met. Like we're Okay. Like busy, whatever we had going on. And it's so interesting that I walk them on how to do self coaching. And they're in awe when I tell them, Okay, only circle the.
They're like, There's no facts there. I'm like, I know. Isn't that thought ? 
Dr. Tonya Caylor: It's so true. . 
Dr. Diana Mercado-Marmarosh: And then we go through what they think are a fact, like I'm too slow or I'm always late. Or nobody loves me whatever your brain has told you like thousand times, right? , and you never question it.
And then I'm like, Okay, in comparison to whom? , , all 12 people in the court of law would have to say yes. Yeah. You were like 1, 2, 2 minutes late or whatever. And so it's interesting. Like what our brain offers because it's trying to protect us always. It's always trying to make sure that we don't look like a fool or whatever.
Like it's always trying to protect us. But sages us too, because it's no dramatic . Exactly. 
Dr. Tonya Caylor: No, and I think it's really true, right? So when you think I had too many patients today, and that seems very real and you could probably argue that. Half an hour, but just getting like concrete, like what are the facts?
Okay. I had 14 patients in a half day, okay? There are a lot of physicians who would say, Wow, that is a lot. And there are a few physicians out there be like, Oh, that's all on a day's work, right? A fact is one that everybody would agree with. And so yes, 14 patients, we could argue that. But when you think there are too many patients on my schedule, what, When you check in with yourself, what emotion does that bring up?
And once you realize what that emotion is, what do you do out of that emotion that actually helps you see those 14 patients? Because most of what you. Is not serving you well when it's coming from that emotion. And and so when you say, Okay, I have 14 patients and a half day, what might somebody else think about that?
Or what is a different perspective? And even, it doesn't even have to be something positive. It can be like I'm gonna do the best I can. Just that is going to like decrease that amplified limbic system where you're amygdalas all ramped up and help you to settle in and get started in a way that serves you in those 14 patients best.
Yeah. So yeah, I think that's one. And I love that you you started in on my, one of my second points. And I, this is kind. Like maybe some unnecessary suffering, but I like to think of it as like how we protect and rebuild our energy and rebuilding our energy goes along with what you were talking about as self-care and When I give a, I have this talk that I give to physicians about time management efficiency, and I have a slide in that talks about prioritizing your downtime.
Number one, everybody's first reaction is what? Downtime. And then the second is what is that even doing here in a time management efficiency talk? And so it gives me the opportunity to, number one, tell them there is going to never be down. If you do not prioritize it, it needs to go on your schedule first.
It doesn't, it's not the thing that falls off at the end of the day if you don't get through the other check boxes. And so by learning, and that's very uncomfortable when you first start doing it, but learning to do that and you are you're refreshed and be by being refreshed, you're gonna be more effective, more efficient, and more present.
With what you're doing. And so in the end it is incredible efficiency and time management step. So I love that you brought that up. Yeah. 
Dr. Diana Mercado-Marmarosh: Before we started hitting record, we were having a conversation and you asked me, How do you do everything? How are you? The secret. It's not a secret cause I tell everybody to do it.
But you just said you have to prioritize yourself. I had to decide that Thursdays I was gonna have a day off. Thursday was CEO day. I was gonna meet with the CEO all day. That's me. come to CEO all my life. Like I get to decide who I talked to. And it took me a while to realize that planning.
Really was important. And I don't mean planning where you have to put everything every 15 minutes. I don't mean that. I mean like the big things that you really don't want to miss. Like you don't wanna miss a doctor's appointment, you don't wanna miss your kid's recital. You don't wanna miss like what time you have to be at the airport, right?
Like the things that you really don't wanna miss, you wanna put and. I know usually when I say schedule your fun first, they look at me like I'm crazy. What you just said, right? What? Self care, what time For myself. But the thing is if you don't prioritize it, nobody's gonna be like, Oh my God, Dr.
You look so tired. Let's get you a day. Like, how many of us have Like probably needing to be in the emergency room ourselves. And we're still like over there trying to see patients. And it's so important that you realize you're human first and that as a human check with yourself.
What would any normal human be like? Would they like. Not call in because their kid is sick, or would they call in because their kid is sick? And we like guilt ourselves. We're like, No, but we're super human. And that's where I think people don't realize that. I'm not asking you to be super human, I'm just asking you to be human and that's okay.
Dr. Tonya Caylor: Yeah. I, as I'm listening to you just reflecting that I think this generation of medical trainees are a bit ahead of us where we were at that stage, right? Because most of them are now recognizing the fact that's not the life they wanna create, where they just go. And they want to intentionally build in.
This balance for lack of a better word, I like the word harmony, but they wanna have that built in and yet they're running up. The rub is that the medical culture is slow to change, and that's not just the attitudes of those of us who've gone before them, but it's also the systems that need to be in.
To allow that to happen. And again, that goes back to systems. And I am not a systems person. I'm a individual. I love working with individuals or small groups, but I do believe there's a lot of room and I really am hopeful that this generation of trainees will be able to take on that mantle of crafting the culture of medicine in a way.
They're still loving their job and giving to their patients, and they're doing in a way that doesn't mean they have to neglect everything outside of work. And so yeah, so I love that. Another thought I was, the other thing I like to really talk about in a manner of protect, protecting your energy so you can really enjoy and flourish.
Choosing service over people pleasing because I, there are a lot of altruism comes through in medical trainees and it's a beautiful thing, and then there's that piece of it that crosses over a line and it stops coming from a place of service that, that internal motivation. Like that's renewing, right?
It just, it's energizing when you're working from that place if it's what is driving you. But when you cross over to that, people pleasing, that is when you're doing it. And because you want them to be happy, you want to make sure they're not disappointed and you stop doing it from that service. That is draining.
It drains your energy. It leads to a lot of resentment, and so tapping back into. What your bandwidth is, what is coming from a place of authentic service? And what is you trying to co control other people's emotions and what other people think about you? Because you know what, that's what goes on in their mind is their business, right?
And you showing up as your best self, it doesn't mean that you have to be selfish and could care less about people and callous. But you're gonna be your best self when you're working out of that authentic service piece instead of that people pleasing piece. 
Dr. Diana Mercado-Marmarosh: Yeah. That's so important that you just said that because I think that was one of my aha moments that finally freed me up to really be me and embrace me because I'm not sure if you're aware or not, but people with adhd.
We, we don't take rejection well sometimes we have this thing that is called rejection sensitivity in phobia. And while of course nobody likes to be rejected, We'll just put it like that. But for us, it's almost like they're burning us. It's like we take it to the extreme and it lingers and it, because we all, I don't know, we all already self sabotage with some of the thoughts that we have, but this takes it to the 10,000 level.
And so we, I figured out from an early age, That if I was just not too loud, if I was just not too crazy, if I just got good grades like then I think I was people breathing because that's what told me that was gonna get me ahead. And I didn't realize that I was not just that and of course I did always want to be a leader and provide service, but I noticed that I was very, what's the word, Adaptable.
And so I could. But at some point you adapt so much that you're masking and you use sight of yourself. And like you said you cross a line that you didn't realize you're crossing. All of a sudden you're triple . All of a sudden I'm like, okay I know I asked for time not to pump. Like I can't be pumping in the patient's room.
Like, why do you have And so it cause us a line because you don't wanna say no, but at the same time, You still need to eat. You still need to be okay. And this is one of the things that we don't realize that like you just said If you go and give all your 140 at work and then come home, you drink, like you don't have that extra energy.
Why are we going to work to take care of her families, right? Like financially emotionally, all that, right? But then we come home and you're like at negative like 200, and then you're irritable and moody with them, right? And you don't realize. Them over there, you were people weasy. But then over here at home, you're not even people.
Weasy, you don't even care anymore cause you're so tired. And then it's it's so funny because I remember they would describe things to my husband and my husband be like talking to her about the same person. She's not that nice at home sometimes. And it's funny how you then have to realize, Okay, I'm gonna come and serve because this feels.
But I'm not here to self-sacrifice because if I self-sacrifice, then it is not gonna work out because you're only gonna get me at 20% instead of getting me at 90%, right? Because I said yes to something that really didn't want to, but I said yes because I felt like you asked me to and so we don't realize.
That sometimes we do have to say no, because I know that nobody wants us to be perceived as, Oh my God, the difficult one. But sometimes it's not worth the energy to try to convince anybody of any of anything. If you know you and you know your why, like it's okay. Let them be wrong about you.
You, you know why you're doing it. . And then like you said, you show up as yourself. And the moment that I learned that I wasn't responsible for my husband's happiness or my patient's happiness, but all I could do was control my own happiness. I was like, Oh, light bulb. I don't have to go and do things for others.
If it happens, great, I would love to provide joy for you, but it's not my responsibility, like it's 
Dr. Tonya Caylor: so free. Yeah, it's definitely freeing to realize that I like what you said let them be wrong about you. That was a powerful statement that the first time I heard it was like, Oh, wow, okay.
Because it just, it gave me freedom to let go of the control because I think we get socialized in medicine to really. Perform and we want good grades. We want the a plus with extra credit when the gold Star. And and that performance based approach really highlights we are caring what other people are thinking. And so it's not that we don't care. It's not like we wanna have a terrible reputation, but it's like giving up control and trusting that if you show up as your best self, your reputation is gonna be fine. And if somebody disagrees, they can be wrong about you.
So empowering. 
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. And I remember that when I had that shift, it was such a lightning thing because it's always one or two patients that are Coughing and ruckus, right? And you're trying to please one or two patients that are like draining the energy out of you. And I'm like, all the other 80 or 90 people that I saw this week didn't say a thing.
They actually said, Thank you. So why am I worried about those two, three people ? And so our brain, and this is something I always tell people, like I purposely ask them, To begin the class and end the class with their takeaways but their wins for the week. And you'd be surprised how hard it is for them to practice that skill because they think it was just luck that made it happen.
Dr. Tonya Caylor: like you, it's too true. I didn't have that 
Dr. Diana Mercado-Marmarosh: meditation and that's why I closed my notes. No that's not why you closed your notes. You close your notes cuz you're now following a system. Let's talk about your system . 
Dr. Tonya Caylor: It's so true. Like dismissing the positives is such a common great, and it's really interesting cause I do the same as a lot of times I'll challenge the physicians I'm working with to what is going well, or, Hey, that was a win.
Did you celebrate it? Or, What do you love most about this? And they'll say and they'll think really hard and they'll gimme something. And then there's. They do this, but they blah, . Cause we have that built in negativity bias that is just common to humans, right? That really ramps up when we're under a lot of challenging situations and can become a habit back to that, bring it full circle back to that habit of how we think through things.
And so I love that you and I approach that similarly in trying to point their brains in a direction that's gonna serve them even better. 
Dr. Diana Mercado-Marmarosh: Yeah. Yeah, I think we all eventually reached those awareness because we didn't even realize we were causing self harm to each other because we I remember the first time I heard somebody say, If you are not practicing self care, you're in self neglect.
And I was like, Whoa, . That was wrong statement and chill there. But then I thought about it and I. 
Dr. Tonya Caylor: Yeah, actually right, 
Dr. Diana Mercado-Marmarosh: like if I'm not prioritizing myself, like I'm choosing to think that it's okay for me not to like, see myself as somebody who needs certain things and desire certain things.
And most of us, like when we've done surveys like. We just wanna know that we mattered and that, we're accepted. But I think that it begins with you. If you think you matter and you think you're accepted, then like everything else follows. Yeah. That's so good. Perfect. Yeah. So tell me, I'm pretty sure you're gonna have everybody wondering where could we find this big for my residents this amazing, Where can they find.
Dr. Tonya Caylor: Thank you so yes, Anybody, If you know anyone that is, works at a family medicine residency cuz I partner with residency programs and individuals within there to work with both faculty and residents. They can find me at Joy and family medicine.com. I'm also on Facebook at Joanne Family Medicine Coaching and on LinkedIn as Tanya Taylor.
And yeah, so refer any of those to me that might want to have an external coach create a safe space to be able to have these kind of conversations and unpack both individually in a group. I would love to talk with them and see how we could partner together. Yeah. So thank you again, 
Dr. Diana Mercado-Marmarosh: Diana. Yeah.
Yeah. And we were talking offline before we started that it, it's so important to show up and ask questions because when we don't show up and ask questions it can lead us into a way where we end up in legal trouble sometimes. We're not doing chart, we're not doing something right.
And. It's so important to set up like environments such as what you have for residents to be able to come and talk freely without feeling like they're gonna be put in the spotlight and they're gonna be bluster and they're gonna be told that they're the bad resident or something. Right?
Because many times it could be that they're doing the best that they can, they just don't have the correct systems in place for them, right? And Please reach out to her and don't let it be a thing. Okay, . All right, great. I always ask everybody what they see themselves doing for fun in the next three to five years.
Where do you see, you're in Alaska now. I don't know. Are you gonna come to the States or are you just gonna go all over Europe or what are you gonna be up to? 
Dr. Tonya Caylor: Yeah. I have a few ideas. I think one is, I'm just gonna say that I really enjoy the coaching job. So that will still be that's in my ideal three to five year future.
Also traveling with my husband. We love to travel and I have two little grands. They are three and five and within that timeframe, probably being closer to them so I can spend more time as they're growing up. Thanks for asking. I'm super 
Dr. Diana Mercado-Marmarosh: excited about all of that. As some of the physicians that are hearing my podcast have ADHD and sometimes have wondering attention.
So if they zoom out and now they're back and they're ready to hear the takeaway message, what would it be for today? I think 
Dr. Tonya Caylor: the takeaway today is that they likely have a lot more control of how their brain works than they've been led to believe, and by doing some mindset work, as unsexy as that sounds, it really can give you the power to enjoy the day to day, despite the circumstances.
Dr. Diana Mercado-Marmarosh: Yes. So there you have it. She gave you the key really. Think about your thoughts and then set up a community that helps you to unwind some of those thoughts and you know it doesn't matter. Use all the resources. Go talk to a therapist. Go talk to a psychiatrist. Go talk to a coach. Go join a dance class.
Go paint. Go do something for you that's gonna improve your self care, and that is going to help you get you to where you're going. 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 ADHD Live Coach dot.
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 4 A’s That will Change Your Life

Dr. Diana Mercado-Marmarosh: Hello? Hello. Welcome to beyond ADHD, a physician's perspective. I am Dr. Diana Mercado-Marmarosh. I'm a family medicine physician practicing in rural Texas. I used to be hindered by my ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to meet both in my work and in my personal lives.
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.
I am so excited to be with you guys today, but he's been.
Before, I'm actually gonna start a group coaching program in October. It's gonna be on Thursdays at noon central, and it's gonna be for all the healthcare professionals. So that means like the nurses, physical physician assistant. And that means nurse practi.
And pharmacists and dentist, anybody who can benefit from being able to practice medicine in a team setting. And doing such that will free up their time as well as their energy and be able to develop tools and techniques to help them with emotional dysregulation and effective executive function techniques.
I am so thrilled to announce this new group that I'm gonna be happy. So I wanted you to hear about it today. And before that I want invite you free masterclass. That I'm gonna be on September the first at. 30 central PM. So please go over to my website, ADHD, live coach.com to register for that. If you're not able to come live you can obtain it in the replay the next day.
So that way you can still the one hour CME credit by listening to it and the topic.
Masterclass is going to be how there's certain tasks that we all have to do and why not get the in basket to zero without it being a pain in a career. So I hope you're able to come. And if you know anybody in your team who might like an amazing nurse practitioner or physician assistant, Or from this pharmacist, send them my way.
I am so excited to be able to provide this service to them as well. Okay. So today's talk is going to be about the four A's, the four A's that will
Awareness get freedom of time. Okay. And so for me, the awareness acceptance action and alignment are the four A's that I want you to think about. So any time we have to do any tasks, if you can apply these four A's, you're gonna save yourself a lot of time, a lot of headache, a lot of frustration and you can apply really in anything.
To me, I
apply it to my everyday life. Like I take it with a grain of salt. I realize that awareness is the first step. If we didn't know that there was something that could be done better, then obviously we wouldn't be worried about it. And so when you don't know what you don't know, it keeps us.
From growing and learning. And so awareness that what if there is a better way for me is so critical acceptance so the acceptance that things might be boring, that things might be hard that things don't have to be the way they are, might be that thing that you need in order to keep moving forward.
Action. You have to do something. Anything to disrupt the current habits that you have, because if you keep doing the same thing that you've been doing every single day, because our bodies in our mind want to preserve energy and we are in autopilot and don't question little, disrupt the system, then we're gonna keep getting the same result.
If you want to get something different, if you're not liking what you've been obtaining and you want something different, if you're tired of pajama chart, if you're tired of not having enough time for your family, if you're tired of not having enough money in your bank account, you need to take action to change.
Your result so that you don't keep living in the same past present reality. And so how do you do that? you go back to the first three, you have to become aware that something has to change you then have to accept that. Yes, you do have a choice. Yes. You get to decide that you are worth.
Putting in the work to get to whatever version of yourself that you want, and then you take action towards it. And guess what? In order for that to happen, you have to be in alignment. Like your mind has to be in alignment with your heart. I know it sounds weird, but again, if you know why you're doing certain.
Okay. I wanna lose weight because I wanna be able to like, see my daughter graduate. And I feel like if I lose weight, I am gonna be able to prevent a heart attack or I'm gonna live longer. I'm gonna decrease my chances of cancer. Then that tells you like the why you're doing something. And so then when you're doing every action.
Towards that you asked yourself, is this action that I'm about to do? Is it an alignment with the goal that I'm trying to accomplish? Yes or no? If it is a yes, then go for it. If it's a no, then ask yourself okay, do I really need to do X, Y, and Z at this moment? And then with all of that, you have to be willing to.
Do it messy to do it. I perfect because whatever we've been doing has gotten us here, but the next version of us, that's gonna get us there. Needs to believe that you can do it. And I know right now you're probably thinking I don't know. I haven't been able to do it and that's okay. You can believe that, but guess what?
I'm here to help you. I'm gonna hold the belief for you. And I wanna hear from you. I want you to apply this awareness. Acceptance action. And then alignment. And I want you to email me tag me on social media, either on my TikTok on Instagram. And tell me how you applied this and how this worked for you, whether it's for inbox zero, that you came to my master class, whether it's that you're signing out for my.
12 week healthcare professional course, that's gonna give you CME and transform your life. Let know how things go. And I can't wait to hear the amazing things that you're gonna do because you chose you. You chose to have an awareness you chose to accept this task and you are taking action that is gonna align you with the goals that you want long term.
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 at ADHD. 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 gonna happen.
 

Filling in the Gap Creates Financial Freedom with Cassandra Lopez

Cassandra Lopez: If you're not happy somewhere, or you wanna do something, don't stay there just because you don't know how you may make me and means meet your needs or different things like that. Just take the risk and. Very proud that I did. And look what has happened after that. 
Dr. Diana Mercado-Marmarosh: So, hello. Hello. Welcome to beyond ADHD.
A physician's perspective. I am Dr. Deanna mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered. ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize.
That 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. I am so excited today. Um, as some of you might have already heard, I am in a transition state a little bit, and I am starting, uh, here shortly, uh, in October. A new group.
Um, well new in the sense that it's gonna be a healthcare professional group. So it's super exciting. So I'm opening the doors for, um, you know, if you're a nurse, if you are, um, nurse practitioner, a dentist, chiropractor, anybody who used pharmacist, um, Anybody who uses, um, CME credits to come and learn how to use tools to regulate your emotional dysregulation and executive function so that you can leave work at work as the healthcare team.
Um, it's. Then everybody wins. So today I have a very, very special guest with me, very, very a dear friend and, uh, coworker. And, um, so I can't wait to share her story and I will also let her share her story, but today's topic is about how it's so important to be intuitive. And it's so important to look around.
And see if you can find a gap in healthcare and how you can spin it to help you get financial freedom. So my guest today is Cassandra Lopez and. She is gonna share her story with you. But, um, she was working at a nursing home since 2014 and now has her own, you heard it, her own, uh, company that she founded and it's called, uh, beloved community care.
And, uh, she's gonna tell us about it. So please, Cassandra, tell us, um, How, how did you know you had D and like, tell us about what you're up to now. 
Cassandra Lopez: Um, hello. Um, thanks for having me, Dr. Medo. Um, my name's Cassandra and I really didn't know I had ADHD at first. Um, didn't know really what it was growing up.
You know, it has the stigma to it and you see some kids taking ADHD medicine and it's because they're labor labeled. So I never, I didn't struggle through through school. I didn't really know anything about it until I was an adult. And I remember going to Dr. Mecado and not really know what was going on.
I was, I would forget things if I didn't write 'em down. And I remember I forgot to. And a very important bill that I couldn't set on auto pay cuz they didn't have it available. And I was like, what the heck? I forgot to, I forget to pay my bills. My what about bills got cut off? Like, I don't know what's going on.
So I kind of filled out a questionnaire and all the symptoms were there and then I got the diagnosis and it it's been helping. So. So 
tell 
Dr. Diana Mercado-Marmarosh: me, tell me, what was it like when you got the diagnosis? Like, were you relieved? Were you surprised? Were you shocked? Were you like, oh, thank God. Finally. There's something here that thought it was just me.
Like everybody has a different take to it. What was yours? Um, 
Cassandra Lopez: I think I was kind of like shocked because like I said, in the beginning, You just have this stigma, stigma of ADHD and different things, but you as a friend and a doctor, I really trust you. So I was, I was off for it. I was ready to know the things that can help me and everything kind of makes sense.
Um, I could look at somebody and people would think I'm rude or not paying attention, but I could literally be staring at somebody they're talking to me. And I have no idea what they're saying or my mind is somewhere else. Or, and that's just things that I thought that were just me. But coming to find out.
You know, there was a name for it and you could get help for it. So, 
Dr. Diana Mercado-Marmarosh: yeah. And what do you think has been the most helpful? I mean, everybody is different, right. But like, do you think taking meds has been helpful? Do you think reading or learning about different techniques online or exercising? Like what, what do you think has been helpful now that you have the 
Cassandra Lopez: diagnosis?
Um, I think it's just a combination of everything. Um, my medication does help, but also. Just being more of aware of things and learning how to slow yourself down and write things down and plan more and, um, know that there's, you have to tell yourself there's only like a right now and not right now. So if it's not right now, you need to write it down, cuz you are gonna forget.
It's just so just learning different things that you can help, uh, use to help your everyday life. And it doesn't feel like you're just going in circles and circles, all the. 
Dr. Diana Mercado-Marmarosh: So would you tell our listeners where you and I met? 
Cassandra Lopez: So we met at a nursing home where we both worked. So, um, she was the medical director there.
I was one of the nurses there and that's how we met and developed our relationship in friendship. And I knew I liked her from the very beginning cuz she, I didn't know, she had ADHD at that point, but I just knew that she had. Clear boundaries. She, she kind of, I mean, she was very helpful. She was compassionate.
So that's where we worked and very knowledgeable. So I kind of went to her for everything. So I built my trust with her and that's when I got my diagnosis. So I just, it was a, 
Dr. Diana Mercado-Marmarosh: but I mean, the point that I'm asking is that, you know, in healthcare, I think that when you're passionate about what you're doing, you're gonna do it.
And like you said, you said boundaries and all that. But your, your soul shines through, right? Like that, that's where you're drawn to be of service to others. I think people sometimes think that the healthcare, um, is, oh, there's the big bugs there. Right. But we all quickly see that the big bugs are really going to the pharmaceutical companies they're to somebody else.
And it's not necessarily the physician or the nurse, um, that is there. Right. But. As you were working in the healthcare. Especially, as you were working in the nursing home, what did you like about it? What were you drawn to it? What didn't you like about it? And what 
Cassandra Lopez: did you do about it? So, um, I think what I liked about it was just being able to serve, um, the community and.
We're in a small knit community. So you kind of knew your residents and different people there. And also learning. I learned a lot, um, from making rounds with doctors and, um, nurse practitioners and different things like that. But I also knew I wasn't a hundred percent happy. Um, I knew that I was, it was kind of like a eight to five sometime, but you on call and I had an office job where I was sitting a lot and just very.
I'm not really good at small details. So I would like forget to check my emails and stuff sometimes. So it was just, I knew I wasn't, that's not where I always wanted to be, but in my position, I also see that there was a need that a lot of people do go to the nursing home prematurely solely because they don't have, um, they don't have someone at home to care for them, or it's too too much for a loved one to be a caretaker.
So I just kind of took that in and. Created idea. And that's when we decided to start beloved community care. And that's when we, we have a home care agency that goes and takes care of the loved one in their home, or could be in the facility if they just want extra eyes on their family 
Dr. Diana Mercado-Marmarosh: member. So tell me, how is it that it's unique and you put your, your spin because it's not home home health, right.
And it's not, like you said, a nursing home. It's not a living facility. How did you come up with the idea, your idea, like, because that's important because people with ADHD don't realize that we are outside the box stinkers and that just because you don't see it, there doesn't mean it wouldn't be an amazing idea and you took off and ran 
Cassandra Lopez: with it.
Right. So I, um, I just, in the nurse home, you see a lot of the care comes from the CNAs and. Those people, the nurses are there too. They pass medication, they do treatments, but, and there's a lot of paperwork. Everybody knows in charting that goes with that. But the CNA or the person on the floor, that's, who's given the direct care.
And to me that's most the most important care. So me knowing that I can run a business like that in higher CNAs on my own and in care. I just took it and ran with it. I knew I didn't wanna be a home health because a home health does offer that skill need and the nurses and the physical therapy and different things like that.
But they're in and out to do their skill need, which is needed, but there's no one there to actually take the time and care for your loved one and give them the, you know, the extra care that they do need. So I just found that. Ran with 
Dr. Diana Mercado-Marmarosh: it. Were you ever like scared? Like, oh my God, like, I don't know what I'm doing.
Like, well, should I even do this? Is it maybe it's better that I just go to an H five job, like you said, there's more security there. Like what, what were your thoughts that you were having as you were trying to establish this? Um, 
Cassandra Lopez: well, when I first thought of the idea, I. I do have a business partner, so I called him up and, um, we talked about it and he, he was just like, give me a little while, let me think about it or something.
I don't know exactly what he said, but. He's not diagnosed and I can't diagnose, but he has an ADHD brain. Let me just say that so, so he can think pretty, pretty good too. So, um, we were like, okay, we're gonna go and just run, run with it. But the more research we did, we found out we had to be licensed through this state of Texas and have a survey and just all these policies that we have to come up with.
So at that point I was like, I wasn't discouraged. Cause I know I. I usually try to real hard to get what I want. So it was just kind of like maybe a speed bump. And I think I probably called you a few times and you never discouraged me. You were just think, you know, always think big. And so we just did our research and got, did what we need to get our license and, um, licensed through the state of Texas and different things like that.
So I think at that point I was, it made me kind of made me think a little bit. Is this what I really wanna do? This is gonna be maybe. Too many steps, but it wasn't, we just kept taking one step at a time, one step at a time. And we probably got it done in about four months. And that's pretty amazing when we, what we hear from other people.
Dr. Diana Mercado-Marmarosh: Yeah. So I really like that you share that, that you knew that there was gonna be some steps and you kept looking it. And looking it up and looking it up and you never gave up. And like, I think most of us want stuff like, you know, order it today. I get it tomorrow, like from Amazon. Right, right, right. But we forget that when we are really answering a calling, like for you, this was your way to, um, fill in that gap.
That was not being taken care of at the nursing home, or could not be taken care of a swing bed program or could not be taken care of at the hospital and like, or home health, you found the unique way to do it, but you kept being curious instead of being afraid, you kept stepping into curiosity and of course, Anybody will be lying to you if they pretend like we're not all scared at one point or nervous or worried.
Right. But we realize that that's not gonna really get us to where we're trying to be. So it's so good to just step into like, okay, well, I did that part. Let me do the little next part, the next part, the next part. So, um, I'm listening to a book right now. Um, eat that frog and. Like most of us are not like, oh, I can't wait to go eat a frog.
Right. mm-hmm but the concept is that if we start our day with the things that are like the most important, that could really make a difference. So like for you, it was filling in that paperwork, like, uh, establishing an LC, uh, uh, look looking through those licenses, like everything that you needed, getting a loan, getting a location, getting all that and having like a bigger vision.
Then, like the loan you just took off and you're like, oh my God, I'm in debt. Right? Like most of us wanna shut down at that part. Right. But you knew that you had a bigger dream and you just kept focusing on who you were gonna help. I know you and I had multiple conversations about like, well, who's your ideal client, right?
Like, who are you trying to help? And the more that we know who we're trying to. The easier it is for us to show up. Right. Right. And, and, and it's so good that you, if you didn't know something, I think this is the ADHD us, you just ask who else does know or who might know, or what training can I go do? Or what else can I do?
Right. Because it's in that faith, when you are doing that. You don't realize that you look back and you're like, oh my God, I made a lot of progress in four months. I got this thing up and up and running. Okay. So how long have you been doing what you're currently doing? Tell us, tell us all the things. 
Cassandra Lopez: So our year was, so it's been a year, so it's been, um, our year was in the end of August, I believe.
So it's been a year, a little over a year, so, and it's been. I wouldn't lie and say, there hasn't been small headaches, but they, there, there has been, but it's very, um, it has allowed some freedom that I didn't have before. Um, and we're just continuing to grow. So, 
Dr. Diana Mercado-Marmarosh: so tell us freedom of time, freedom of money, freedom of what your, your own loss.
Cassandra Lopez: Tell me, yeah. Being your own boss is, um, definitely different. So I like. I don't think I don't ever plan on working nine to five again. So I keep that in my mind, uh, to keep going, cuz I know that's not where I wanna be again. So freedom of time, freedom of money. Um, and the most important is time though. So you can, I do have time to be with family and not always have to work all the time or have to explain to somebody why I have to leave early or take a quick break to be.
My family or something for my child. So that's, that's probably the best thing. Do you have people working with you? Yes, I do have people working with me. We have about 25 employees. So that's also another thing that I do. Like, um, it's just a blessing to be able to provide employment for. For people and help.
And we have sponsored a few sporting events and uniforms for our community. So giving back to the community is also a good thing. 
Dr. Diana Mercado-Marmarosh: That's amazing. Right? Like, so the growth that you've had, that not only okay, now me and my partner are like, thinking about this idea, but this idea. So to say. And then you provide employment for 25 other people.
Like how amazing is that? Just because you decided to take a chance and decided that you were worth the opportunity to something better to provide a service. Right? Right. Yeah. Isn't that just like amazing. Yes. Ma'am. Okay. So, so what are some tools that have allowed you to like keep going? Um, 
Cassandra Lopez: probably to always remind myself that you are worthy.
I know a lot of people think that they're not worth some of the things that they see come in their way, or they're not allowed to live a certain lifestyle or want certain things. So kind of remind, remind myself that and some different podcasts than, um, books to. and also planning. I think I would learn that from you, so to kind of plan and set boundaries that that kind of keeps me going.
So I have a planner and with my ADHD, I know that I have to have it on. Of actual planner, not on my phone, cuz if it's on my phone, I might pick it up and play a game or do something instead of looking at my calendar. So, um, just planning is a good thing. So I try to write everything down if it's not on my, uh, calendar for the day or if it's not an emergency, I don't add it because I just, you need to have time for yourself.
And so just that's one of the main things that I think is having a planner and sticking to the plan. Okay. And if you don't know something. Ask somebody and you don't have to know everything. There's somebody who is like my business partner, he's financial business, he know everything. So I don't have to worry about learning all of that.
You. Partner with somebody and reach out and have resources to help. 
Dr. Diana Mercado-Marmarosh: Yeah. That's so important to realize that you don't have to be all the things you just have to realize. What are the things that you can do only you can do? Or what are your zone of genius or what is what you're passionate about? And do more of that and then whatever still needs to get done.
Who can you delegate that can actually do it right? 
Cassandra Lopez: right. 
Dr. Diana Mercado-Marmarosh: Okay. So, um, I know, you know, um, uh, I've seen you grown as a person. I it's been a humbling experience and I seen you make decisions, uh, for the betterment of yourself and your emotional health and your mental health and your physical health. Um, What is one of the things that you think you're one of like proudest stuff in the last three years or the last four years that you see yourself now as a different person, because you've been able to accomplish 
Cassandra Lopez: it?
Um, I would think just probably being able to let go of my full-time job. I think that's, uh, a lot of people think that they have to stay somewhere that they're either not happy with, or maybe getting mistreated or different things like that. Just. It's where you get your main income from or different things like that.
But really when you take the risk and just do what you need or what's on your heart, um, you might be scared, but it's definitely worth it. So that's probably the main thing I would say, if you're not happy somewhere or you wanna do something, don't stay there just because you don't know how you may make meet means, meet your needs or different things like that.
Just take the risk and. Very proud that I did. And look what has happened after that. So, 
Dr. Diana Mercado-Marmarosh: yeah. So, um, it's crazy how the universe just sends you messages. Right? So this morning during my meditation, um, I was in a meditation group with other physicians this morning. Uh, the leader was talking about, um, the law of intention and desire, and she was talking about how.
Like, whatever your soul is, journeying, like what it wants, like you can accomplish it. That's why journeying it. Like you wouldn't be desiring it if you weren't worthy or you weren't already on a path to receive it. Right. And so it's so interesting that. Like you just said, if you desire something bigger, something, not just your eight to five, not just like, okay, this is okay, but it's not great.
Like we only get one shot at life. Right. So why not like do it with something that is meaningful for us and meaningful for those around us and, and decide that it's okay to take the risk. There's only there. So recently you learned there's, uh, the same pathway for fear and excite. They go on the same one.
The only difference is that when we are in fear mode, like we're holding our breath. I don't know if you noticed or not, but when we're like, we're kind of like, like bracing for it, right? Yeah. But excitement, like, it's not like you're not a little. Scared you still are, but you it's that like, you know, think of when you get on a rollercoaster, you or you have that adrenaline rush.
Right. But you're kind of breathing through it or like when you gave birth to your kid, right. Like you, it's not like you are like, oh, well, you know, I have fear. I'm not gonna like push him out. I'm just gonna keep like, like you have to breathe through that. Right. Right. And so it's just understanding. When our heart is asking us to go all in, like we need to listen, like, and we need to trust that.
Sometimes we do have to take those risks because if we don't take the risks, we might not lose the weight. We might not find a boyfriend. We might not find a partner for this new dream that we are going towards. Right. Right. And just because we've been doing things the same way over and over for a while.
Right. It doesn't mean it has to continue to be the same way. Like we get it, like, we all wanna put the least amount of effort in whatever we're doing, because we wanna conserve energy. But sometimes whatever we're doing is actually draining our energy instead of like refueling our energy. Right. And we honest, we have those encounters that are like, oh my God, like, why me?
Right. But at the same time, it's like, Hmm. I wonder if I didn't put a boundary there or I wonder what is going on with that person instead of like making it about you, like figuring out what is the thing there. Right. Right. So with ADHD, I, I really, I think I'm biased, you know, I really think it's like a superpower.
It allows us to like define gravity. It, it, it allows us to think bigger and not make it mean anything that it hasn't been done yet. Right. Right. I mean, everybody is looking at me like, are you crazy? You're trying to set up a retreat in Costa Rica. And I'm like, yeah. Why not? Like, it's just right. 
Cassandra Lopez: Like, so it's just Rica 
Dr. Diana Mercado-Marmarosh: yeah.
I mean, it's just Costa Rica, then you just book a venue. I mean, and I did. Right. so right. I mean, and sometimes we that's what we forget that just because we've been going on a certain path for so long, it doesn't mean we can't pivot. Like, it doesn't mean that things have to always be permanent. Right, right.
That's. Yeah. I mean, for, I've been talking to you about trying to do a retreat or starting a group coaching for the longest time. Right. And right. Um, for four months I thought I was gonna have my retreat. Over there in Puerto Rico. Like , I really thought that's where it was going. And then all of a sudden something was, you know how sometimes life cur throws you curve balls and you're like upset.
But what if it's like life telling you. That's not where it was meant to be, or that was not right. There's something bigger for you. Right. And so, yeah. And in three days I pivoted and I was like, no, it's, it's in Costa Rica. And I found the venue and I booked it and here we, you know, so it's like, you have to always remember why we're doing what we're doing.
I mean, it hasn't changed. I still wanna help physicians and I still wanna help healthcare people, professionals. To be able to live life in their own terms. And obviously you are in a living example that you're living life in your own terms, and that you're creating an impact, a ripple effect because now you turned around and are helping employing 25 other individuals.
It's like the ripple effect. And, and this is just like what, when you're in, I can only imagine like what we're gonna be celebrating. Three years, five years, 10 years, right? Like how amazing that's going to be. 
Cassandra Lopez: Yeah, I can't wait. 
Dr. Diana Mercado-Marmarosh: that's so good. Okay. So where do you see yourself like doing for fun in three to five years 
Cassandra Lopez: traveling 
Dr. Diana Mercado-Marmarosh: where, tell me 
Cassandra Lopez: anywhere.
I'm ready to go anywhere. Just more travel. Yeah. That's what I, 
Dr. Diana Mercado-Marmarosh: yeah, I really, I really think that traveling, like exposing ourselves to different cultures is the, is one of the fastest ways to grow because right. It takes us out of our bubble. It, it makes us wonder what it might have been like for people in that town, like 10 years ago, 40 years ago, 2000 years ago, like, right.
Like it's just. Makes you reevaluate, whether what we're doing right now is important or not, or is it gonna matter in five or 20 or 30 years from now? So it just gives you more perspective. Okay. Right. You know, you, you know, I love to travel. Tell me where, where do you wanna travel? Like Costa Rica, like Thailand, Japan, Brazil, like, what are you contemplating 
Cassandra Lopez: everywhere.
I wanna hit em, all. I just, just, what am I go? Costa Rica is one for sure. I wanna go there. Um, I'm going to Jamaica pretty soon. So. That's one that I'm gonna knock out. So just everywhere. 
Dr. Diana Mercado-Marmarosh: Yeah. And you know, it's, I, I, um, I know I'm pressing you to tell me where, but the only reason I'm doing that is because.
Clarity and intention, like if you write it down, like right, then your mind is focused on that, right. It's going to find ways or opportunities or the universe is gonna provide 'em for you. Like for all, you know, you can go help somebody set up. But you are setting up over there, right? Like how amazing would that be to go teach your model to somebody over there or to just go hang out and like, forget about work for like 10 days or five days or whatever, and not be attached to her phone.
Like we usually are. Right? Yeah. So, um, Other than helping right now with your, uh, your business. Are you helping other businesses start up themselves? 
Cassandra Lopez: So that's something we're, we're starting. So we're looking into starting to create businesses like ourselves and then, you know, selling them or consulting and see if they needed help with anything.
So that is, um, our next plan that's in place. So we're. We have it written down. Well, I do. I'm pretty sure he, my business partner does too, but by the end of the year to have another business started and up for sale, so, and provide some consultation if needed. So that's on the, that's on their next to do 
Dr. Diana Mercado-Marmarosh: list.
Yeah. And again, like, look at you dreaming bigger and bigger and bigger, right? Like, right. That's what this is about. Like, um, I've learned to be in rooms where, you know, we are not the unicorns, like. We all say, add more zeros to that, like, right. Have a bigger dream, like create bigger impact for all the people working with you.
Like why not? Why not me? 
Cassandra Lopez: Right. And it's important to surround yourself with those kind of people. Cause not everyone's gonna see your vision. And they might think, you know, when I first started talking about beloved community care, especially in the nursing home, you know, people. Kind of roll their eyes or not, not really understand the vision.
So not, not everyone is gonna understand your vision. So even with us trying to create more of these businesses and maybe sell them and different stuff like that, um, it's important to discuss that with people that, that have the same mind frame as you, because you're gonna keep each other motivated versus someone who doesn't really understand it.
You know, so finding your service 
Dr. Diana Mercado-Marmarosh: is important. Yeah. So that, that is so important. Like we are the average of the five people we hang around with. And sometimes, I mean, I don't wanna say our family holds us back because they don't, but sometimes, like you said, the people around you, um, they just don't understand or, or they haven't seen it done.
So like that's kind of weird or. Just an idea or whatever. Right. But we are so good of creating stuff from nothing of being it up and then making it a reality. Right. Right. And so that, that also tells us that because we can come up with thousands of ideas being aware that not all the ideas are meant to come to fruitation.
Right. But again, if you are aware of your intention or, and you have clarity exactly. What you want to, uh, study what you want to go and, uh, visit what you want to go. You know, what you want for your, for your company then it's, it's just gives you a framework on how to work backwards to try to obtain what you have.
And like you said, find shortcuts, like don't do it all yourself. Somebody in a different method might have been doing something similar. Ask them questions and see if you can shortcut some of the trials and tribulations that they went through. Right. And so that way together you enhance and you also provide a win-win situation for them any way you could provide your services to them.
Right. So, yeah. Right. So fill in the gap has allowed you to. Become your boss and, and get your own freedom of time and your own financial freedom. And that's like, that's not an easy task. So you should be very, very proud of yourself and what you're doing in our community. Thank 
Cassandra Lopez: you. 
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So where can people find you if they maybe want to ask you about how to set up their own business, or if they want to contract you so that you can help their loved ones?
Like where can people find you? 
Cassandra Lopez: So my website is beloved community care.com. So that is the website. You can, um, have my email address on, on there. You can email me. Um, my email address is Cassandra L beloved community care, so they can contact me that way. 
Dr. Diana Mercado-Marmarosh: Awesome. Okay. So I always say my people have ADHD.
We have ADHD. Sometimes we know we tune out, but let's say like, right. The second is when they're like looked up and they're starting to pay attention. What is the takeaway nugget that you would want them to take away from our conversation 
Cassandra Lopez: today to, uh, take the risk. And don't be afraid if you have a dream, write it down and just know don't you don't have to tackle it all at once.
You just little by little, just every day, write down what you're gonna work on for that day. Get it done. And don't try to overwork yourself, just get that part of it done. And tomorrow's a new day. You start on the next part. And then four months later you'll have a business you could have a business.
That's what happened with us. 
Dr. Diana Mercado-Marmarosh: Awesome. So you heard it, break it down, ask questions, try again. Next day. Before, you know, it, breaking it down, adding of those steps they compound before, you know it, you're leaving your dream. And it's a reality because you wrote it down and you took steps and things happen.
We always forget that, you know, we have a. But we always have a choice, right. We could decide, oh, I'm just gonna skip work today. Or I'm just gonna skip exercise today, or I'm not, I'm gonna skip cleaning today. Right. But the next day, if we keep doing that, we end up a little bit further away from where we, where we wanted to be at.
So we have to be willing to try something new or something different. To obtain a different result. And so whatever quality of input you put in, you put quality input, listening to books, podcasts surrounding yourself, with people who are thinking, wanting to grow, then you're gonna grow. If you surround yourself with people who.
Are happy where they are, but not really happy because all they do is complain. , um, that's draining and that's gonna drain your energy. So you decide the choice is yours. If you're a healthcare professional that wants a different lifestyle that wants to learn how to create time. In your own way, how to, um, close your charts, how to just be more present at home.
how to quote unquote, become back to you and all of you and be inspired like Cassandra to live life in your own terms. Then definitely check out my website and sign up for my master class that is coming. Um, it's gonna be, uh, September 21st. It's a Wednesday at 7:30 PM central. So please join me or just listen to my podcast or listen to my YouTube.
We're using listen to, uh, TikTok anything, but keep listening, keep surrounding yourself with amazing people. I am so, so blessed to have Cassandra in my network. And so, yeah, I'm so excited. You're here today and thank you for. Thank you for having 
Cassandra Lopez: me.
Dr. Diana Mercado-Marmarosh: 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 ADHD. 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 happening.
 

Do ADHD medications affect kid’s Growth? -- with Dr. Sheila Perez Colon

Dr. Sheila Perez Colon: Parents will say, like we are concerned because my son or daughter has attention deficit, hyperactive disorder is on medication and that's why she, or he is not growing. Um, so we, I see it a lot at first I approach it like every other patient. Like we get a good history what's going on within the history we ask about the medication and when I find.
In this case that they're taking medication for that condition. I go, you know, into how long, how much is the dose, et cetera. Uh, because yeah, I have seen. It's very frequent visit to the pediatric endocrinologist when there's like short statu or decrease pro velocity. And they want to know if it's due to the medications or no.
Dr. Diana Mercado-Marmarosh: Hello. Hello. Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna Mecado mage. I'm a family medicine physician practicing in rural Texas. I used to be hindered. ADHD, but I now see it as a gift that helps me show up as a person. I was always meant to 
Dr. Sheila Perez Colon: be 
Dr. Diana Mercado-Marmarosh: 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 today. I have a very special guest. I have somebody who is gonna talk to us about how ADHD can affect or not affect your growth based on which medications you have and, uh, who better than a P. Endocrinologist who is double board certified. She's also a general peaks doctor and her name is Dr.
Uh, Shala fit. And yeah, we're super excited to have her here today. She, um, went to medical school in the university at they, and then she did her residency and her fellowship in New York. And so. She's been practicing about, uh, 13 years now and she just moved to Puerto Rico and is gonna start her direct primary practice there to help children and adolescents, adolescent.
Uh, but. She will tell you all about what she's into, but I know her specialty interests are puberty and growth and diabetes and, you know, thyroid and all that P C O S which sometimes a lot of us don't realize that polycystic ovarian syndrome can. Play a role with our insulin, uh, and our fertility. So anyways, she's happily married and she has a 10 year old daughter.
Who's already a fifth grader. And so we're gonna just hear her and see what she has to share with us today. 
Dr. Sheila Perez Colon: Thank you. Thank you Diana, for that introduction. I'm so happy to be here. Awesome. 
Dr. Diana Mercado-Marmarosh: So tell me, did you. Did you ever realize that, you know, growth, um, could be in a way linked to our sugars? Or, I mean, I know, you know, this is like, I'm asking you disguise blue because this is your specialty, but were you curious or what led you that down that route of interest when you were, you know, you could pick anything when you wanted to be, uh, a doctor, you that's the 
Dr. Sheila Perez Colon: field that you chose.
For me. I, I knew that I wanted to work with children because I always enjoy, you know, their energy that's so like it give me so much vitality, but in medical school I did, um, fell in love with the endocrine system. So when we were ex. Planning and talking about the hormones and how the endocrine system work.
That's when I say, huh, that really triggers me, you know, that, that, that emotion and that passion for what I wanted to do to be able to kind of fix, you know, I, I think it always, endocrine is like a puzzle. We, we try pediatric endocrinologist, we try to put a puzzle together. So the patient present with the sign or symptoms, then we do the exam and then we're like, okay, what could it.
But very interestingly, and for me, it's very regarding that when I say, okay, there's efficiency of a hormone, I just keep the hormone. And most of the time we kind of achieve that balance. And sometimes if that hormone is in excess, I can also work to bring it down, to bring the balance. So that's really what, what make me go into bits and the cream and yeah, I see it every day.
I enjoy bits endocrine because of that. It, it, it get me thinking all the. It's not . Yeah. 
Dr. Diana Mercado-Marmarosh: And then have you had any patients who have ADHD? Like do they come to you? I know they don't come to you because of the ADHD, but have you seen any correlations of the meds that they're taking, whether it would affect their growth or anything of that sort.
Dr. Sheila Perez Colon: So I have definitely seen it. I get a lot of consults for, for example, evaluation of poor growth or short stature. And some of them come directly from the pediatrician staying on the referral, or the parents will say like, we are concerned because my son or daughter has attention deficit, hyperactive.
Disorder's a medication. Why she or he is not growing. Um, so we, I see it a lot at first I approach it like every other patient. Like we get a good history what's going on within the history we ask about the medication. And when I find out in this case that they're taking medication for that condition, I go, you know, into how long, how much is the dose, et cetera.
Um, because yeah, I have seen. It's very frequent visit to the pediatric endocrinologist when there's like short statu or decrease of pro velocity. And they want to know if it's due to the medications or no. Yeah. 
Dr. Diana Mercado-Marmarosh: And then have you been able to then give them a treatment so that they can continue with medications if they need to, or, um, I mean, I know every person is, you know, different and you can't really tell me names, right.
Uh, It is what it is, but what would somebody expect? Like sometimes is it just gross supplementation? Is it like, I know, like we say that ADHD is a deficiency in dopamine, like, and that's like a simple way of saying it because there's a lots of factors involved with it, but, you know, To me when I explain that to some of my patients like, and I tell them, yeah, I'm not surprised that you have diabetes and you're using sugar as a way to try to get you to focus.
Or I'm not surprised that you are smoking or you are drinking, or you are having so much caffeine because that can give you, um, you know, the dopamine that your body's again, crazy. And, and when we do make the ADHD diagnosis and I do start them on medications, all of a sudden they didn't even realize that they stopped smoking.
They didn't realize that they stopped eating all the, the food at 3:00 PM. You know, the cookie that when they were trying to do an executive function task, they couldn't. So they would go reach for the 
Dr. Sheila Perez Colon: cookie to try to get them through. 
Dr. Diana Mercado-Marmarosh: Right. Um, so have you, have you noticed like, uh, Any supplements that sometimes you suggest or any things that you, you suggest 
Dr. Sheila Perez Colon: for them?
So for those patients who are on medication, um, again, I do the evaluation, like every other patients on C, like you mentioned, it's case by case, depending on, do I need to treat this patient or not simple way, just because you are, or the patient is on this medication. Um, do or, and they are not growing properly.
Is this a hundred percent due to the medication? Not completely. We need to rule out, like we say, medicine, making sure you don't have any other diagnosis, for example, that's my approach. So when they come, I do have it on mind that they're, they are taking this medication, but let me make sure you don't have like growth hormone deficiency, which could be contributing to your, um, short statu or just like slow down on your growth that you don't have TIAL disorder that you don't have any inflammation in your body, for example, an gastrointestinal conditions.
Right? Like having all those things. First, I make sure they don't have it. And once I, I don't find any diagnosis of that. I could say this could be maybe because of the medication Diana likely, you know, like through many years, over 20, 30 years ago, this has been studying and there's a lot of controversies within this medication.
That's stimulant or, uh, a D ADHD medications cost your stature or compromise the patient's adult height in the past. Many of them say, yes, they compromise the height. The patients end up having like less adult height and it varies. They say like one to three centimeter or two inches, however, more studies have shown like, oh, maybe it doesn't have relationship.
Maybe it's just like casual. Like it just happened to be incidental. Right. So as of today, if you still look on updated research, it there's a lot of controversy. So, and with AVO call results. So I, again, I don't blame you right away, but yes, I rule out other conditions and if they don't have dose, then I say, could this be due to the medication?
And, um, if I think it's due to the medication, then I always do it in a multidisciplinary team. I never tell the patient or the family. Right. Stop the medication. This is due to the medication. I always I'm like old school. Everyone say you're so old school. I always call the other physician who is giving the medication.
And I talk to them and say, what's going on? Why did we start. Do we need to have that medication or can we change it or no, this is what is working for the patient. And I'm okay with that because that's very important, but let me, then I, as an endocrinologist, who's following the patient, make sure they come like at least every six months to monitor their height.
Right. And make sure like the dose, if we C. if we can decrease the dose as possible, then we will decrease it. But there's, it's not a hundred percent. It hasn't been shown that yes, this medication for sure will affect the height. This is one of the, I would say one of the grace areas that we do have, and as an endocrinologist is something that I would like a clear answer.
There's different mechanism for that, you know, there's research that show that it inhibit like the growth release from the brain, right? The growth hormone is released from the brain. So it just stopped the release or the production. Of course, then they will be compromised height or they say, no, it's not the message directly through by the brain or blocking the, the brain message.
But it's through the liver. Like there's some conversion that happened with the growth hormone liver. So some research show, it could be that. And another proposed mechanism, it's like, it goes indirectly affecting like your bones. Um, but I do give advice like everyone else, you know, let's make sure that.
If we need the medication, we keep it. Let monitor you closely. Let me give you some straight, uh, recommendation for growth, making sure that patient is, is sleeping. And I know with this condition, you know, it's could be challenging at time, but ideally, um, 10 to 11 hours at night because we know the growth hormone is P and it release at night as well, uh, to make sure we're doing some exercise, exercise will help with the release of growth hormone.
So basic things, um, To help us, you know, like manage that kid. Not necessarily, we need to give growth hormone. Yeah. That's so 
Dr. Diana Mercado-Marmarosh: good that you just explained all that because I think there's a lot of misunderstanding or like you said, just mix information out there. Right. Mm-hmm and that might be part of the reason that maybe like patients don't even start on the medication or if they do start on the medication.
Uh, you know, they are quick to blame it for something, right. Um, I, myself was not diagnosed until I was a first year medical student. So me being, you know, five, one I'm really probably five, five feet, or who knows maybe four 11. And I, I tried to give myself more inches. Right. But. I didn't take any meds until then.
So like, it could be that some of us are just short, like you said, coincidence. Right. And you just don't know, but like you said, modifying it and taking a multi team approach so that you could figure out if there is a different type of medication, because, um, you know, it, it could be metabolized through the liver.
Uh, differently or it, you know, it could be different things. Right. And so I think it's so important. What you just mentioned that people really hear, because we all underestimate the importance of sleep and the importance of exercise. And so it's so good that, like you're saying you are treating not just like the little chief complaint, but you're helping them be set up to, to really thrive, right.
To really thrive and, and enhance themselves. Um, Because as you're exercising, like you just mentioned, you're, you're causing the release of both hormone. Plus you're also causing the release of oxytocin and serotonin and Rine, which are the feel good hormones, which can help you tame yourself so that you don't always feel so overwhelmed or feel.
Oh, I have plenty of time and I'm gonna procrastinate. And then the adrenaline kick in, which is kind of like me taking steroids all the time. Um, and so it, it's interesting how the body will try to compensate, but if you just sit back and ignore what might be happening, uh, it's just a lot harder. You don't even realize how much harder you're making it on.
Dr. Sheila Perez Colon: Yes. I agree. And with, for example, we do know that medications, all medications have side effect, right? Um, one of the side effects of this medication is like decreasing appetite, right. Because of how it worked, the medication. So it's decreasing your appetite and yes, decreasing appetite could lead to some, maybe weight.
And why I bring that because for us to grow, we need to make sure our height and actually, essentially our weight is in normal weight. So patients who have malnutrition or have underweight that by itself could compromise the growth. So not necessarily right. It's like, oh, it's the medication by it.
Directly affecting no, it could be that in some cases they lead to decreasing weight or decreasing appetite. We're losing some weight. And of course the, the body's kind of protecting itself and there's some stopping of some mechanism that happened. Um, and then you, your height could be compromised. So it's like, I again, recommend parents who have patients in this conversation with this condition, ADHD who are in medication, who, or who are not because actually Diana interestingly as well, like we mentioned, it's like some patients have compromised height already, even without.
Before starting medication. So they already come for evaluation. We are thinking, or the doctor is thinking to start, but they already have like decreasing growth velocity or they have, may have mature stature. So not necessarily the medication, it could be again, the condition itself or, or everything that the ADHD involved, or again, could be something else.
It could be familiar genetic. So that's why we evaluate and make sure it's not something else before we kind of say, this is the diagnosis. It's secondary to. Yeah, 
Dr. Diana Mercado-Marmarosh: that's so good that you also mentioned that because, um, and I know we're talking maybe about kids, but because I'm a family medicine physician, I see everybody see, I, I see the kids 
Dr. Sheila Perez Colon: and I see the adults mm-hmm and with the adults, 
Dr. Diana Mercado-Marmarosh: the way that works is that once you do start on some of them on sting lids, like I was saying, you do see the weight loss, like you're saying, and, and.
And now they feel so much better because. Think and function and do different things. Plus they're losing weight. And, and so it's good to realize that some side effects might be wanted because, you know, like I said, maybe you were carrying those extra, um, inches under abdominal area that was leading to cholesterol and was leading to metabolic syndrome or prediabetes or diabetes.
And now that you're. Some of that under control. And then sometimes we don't even realize I've had a conversation in, in another episode with a doctor, Rebecca, who was talking about the correlation of like venting because of ADHD and 
Dr. Sheila Perez Colon: that impulsive fee 
Dr. Diana Mercado-Marmarosh: that you forget. And then you remember, and then, you know, all the stuff that happens, the, the part is that you don't realize how we're all interconnected and, and it's all.
So 
Dr. Sheila Perez Colon: I. Yes. Yes. Agree. A hundred percent. And we do, I mentioned like a part of the workup just for everyone who is listening when they present with decreasing velocity concern for height or short stature, right. Already we say, oh, he's short or she's short. We do the evaluation. Like I mention of the block work, right.
That I mentioned all the hormones. We also do like a CVC to make sure there's not an chronic anemia. We look for everything. In blood, but we also do an x-ray of the hand that we do it in all patients, including patients with ADHD, it's called a Bon. And what it give us an idea is to see, okay, let me see where we are.
Normally the chronological age, meaning the age of the patient. For example, E hypothetically, it will be an H year old boy. So he should be the chronological age is eight, but the bonus could be either delay, like kind of behind like a six year old or could be advance. If we are concerned about, uh, slowing growth, technically if it's not, um, early puberty or things like that, it tends to be delayed for some conditions.
And it may help us say predict how tall that patient will be. Or even if it's within normal and the bone is not affected. He's like the bone are our ag at all and match tech chronological age. I can calculate like within, when you're like 18 or 20 years, it's called predicted height. How tall you will.
What will be your final height and careful, we all endocrinologists. We say, this is not a fit. You know, it's not set in stone because it has some deviation, but it give us an idea to see if it will compromise or not. Because some of the study have shown. Listen, when patients are started on the medication, it, depending on the, how long the patient has been treated for, is it a short course of medication or if its for a long time, right.
And some of them say like, oh, if it is just like a short time, then you will see at deceleration at the beginning, but then it will normalize and the patient will catch up. others suggest like if it is for a long time though, patients may have like risk, but again, going back to the same, even for long time, if you look the studies, uh, updated studies, there's like controversies.
Yeah. About that. And 
Dr. Diana Mercado-Marmarosh: so tell me, um, I know you're onto a new adventure, right. Um, now that you're in Puerto goal, mm-hmm , can you tell us a little bit about your practice 
Dr. Sheila Perez Colon: and what people can find you? I'm very excited. Diana I'm opening. I'm bringing this new model, which is common in, in United States and it's like kind of a movement and it is like known as, um, It's direct specialty care.
And what I do is like, I kind of, I got tired of the traditional system because I have been working in different states in United States. Like I work in New York, in Los Angeles and in Miami, which I love all my patients and my clinic, but I'm very devoted to my patients. And I realized that with the traditional, uh, System, I wasn't giving the time and the care that I wanted to give to my patients.
So now I'm joining that movement and in Puerto Rico, I'm bringing for the first time, the, the direct specialty care, the specialty one. And on that one, I'm gonna be offering to my patient, which I open next week. It's my first day in clinic. I'm gonna be, yes, I'm excited. Um, I'm giving my patients more time.
I'm gonna be giving accessibility to my patient. I will be able to spend as much time as I want to with my patients so we can, you know, Families and patient and myself be on the same kind of team. Um, so I think that's very important and definitely for endocrine conditions, most of them are chronic. So chronic condition like diabetes, uh, need a lot of time.
So I'm gonna be offering this in Puerto Rico. Um, you can find me, I will be working in two different location. One is in San Juan, uh, in the north of the island. The other is in Dorado. Um, and I will be having clinic there in my Instagram. I have a professional Instagram page, which I am. Is slowly like trying to give some, you know, advice or maybe like just what I think about the endocrine conditions.
Right. My learning, my experience, and it is known as elite endocrine MD, and then an founder score. And my name Dr. Paris is kind of long, but that's how I wanted to, you know, I want everything to be there, so people know who I am and what I, I am offering. Um, yes. And you can find me there always, you can write me, um, in private message and I always.
Dr. Diana Mercado-Marmarosh: Awesome. So, um, now I'm gonna do some rapid fire questions. Um, okay. So, um, where do you see yourself in the next three to five years? For fun? For fun. 
Dr. Sheila Perez Colon: Okay. I see, I see myself in three to five years here in Puerto Rico. I see myself like having, uh, time to enjoy with my family at the beach. I see myself like very happy with, with myself without how much I have grown professionally.
I I've see myself satisfied with the way I'm practicing medicine and the change that I did. And I see my patients driving. 
Dr. Diana Mercado-Marmarosh: Awesome. Is there any place you would like to go travel or something that you're like, you can't wait to do that you think, you know, it's a little crazy, but you're dreaming it. 
Dr. Sheila Perez Colon: I always wanted to go to Malif.
And couple of years ago, my husband did buy me the ticket and the hotel, but it depends of the seasonal, the season there. And like three days before we were leaving, they, they, they say that it was going to be severe thunderstorm for many days and they say it's better to cancel, so we needed to cancel. So yeah, I would like to go.
Okay. Awesome. So 
Dr. Diana Mercado-Marmarosh: thank you so much for sharing everything, uh, today. And the last question is that, you know, my audience has ADHD. So if they just started tuning in like right this second, what is the takeaway point that you want them to walk away with? 
Dr. Sheila Perez Colon: So for patients, um, right children and adolescent with attention deficit, hyperactive disorder, I will say like, if there's indication for the medication, if we need to start it and the doctor recommended it's okay to start it right.
Because there's some things that we need to address, but we need to follow closely either with the P pediatrician or the pediatric and endocrinologist, make sure that you go more than once a year, not just for the regular checkup, maybe go like every six month to make sure that we're tracking the, the growth velocity of your child.
To make sure everything is online. If there's any deviation or any concern, then a pediatric endocrinologist will evaluate. And then we will decide if anything needs to be done. Awesome. 
Dr. Diana Mercado-Marmarosh: Well, thank you so much for your time and for sharing all your expertise, your patience and their families are so lucky to have you.
And if everybody go get her busy in 
Dr. Sheila Perez Colon: Puerto Rico. Yes, I'm excited. Thank you Diana, for having me. Thank you for everyone who's listening or watching. 
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really. 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 ADHD.
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.
 

Beyond ADHD A Physicians Perspective: Dr. Leslie Golden

Dr. Leslie Golden
I just got to a point where I felt like I kept just prescribing and adjusting meds and adjusting meds and higher meds. Not really getting to the core of, what was going on with people, that whole comprehensive health, that whole person. When I started diving a little deeper and trying to help people.
Maybe not increase her insulin. I kind of unlocked Pandora's box.
Hello. Hello. Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna mage. I'm a family medicine physician practicing in rural Texas. 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 everybody. I am so excited today. I have my dear friend, Dr. Leslie golden. She's a physician and she also has a master's of public health degree, and she's not only a board certified in family medicine. She's also board certified in obesity medicine. So, so exciting to have her here today so she can share her, expertise.
And she's going to explain to us how, behavior can, can really manage, the patient's long term disease states. And so obesity obviously can be prevented sometimes, but sometimes it's genetic and sometimes it's. You know, just the easy thing to do when we're so tired at the end of the day to go through the drive through and stuff, but you have the real deal here today.
She, is gonna share all her expertise with us. And so we're so excited to have her, and she's gonna explain why, sometimes metabolic syndrome, can be something that, It's not so obvious just on labs. So please, please, please, tell us how you decided to go into family medicine and how you decided to do obesity medicine.
Sure. Well, thank you for having me so glad to be here. When I went through, med school, I was one of those people that I went into med school and I was pretty sure I wanted to be a radiologist. not entirely sure why. , and then went through and got in my first clinical rotation was family medicine up in Queens.
 It was this single practitioner owned his own practice. Everyone knew him. He knew everybody. And I was like, this is a great experience. This is fun. But I'm gonna be a radiologist. Right. And so went through my clinical rotations and as I went through, I just couldn't let go of that experience.
That feeling that really knowing people, a child would come in and he'd say, His mom had this and the grandmother, I took care of her too and had this. And, um, and then I think the truth really came out when I got to my electives and did my radiology rotation. And I was like star for interaction.
When people would walk by in the hallway, I'd be like, come hi, come talk to me. Went into family medicine, for that relationship, that connection., as I practiced family medicine, loved it, but it's so broad, you know, everything and which is fun. But I just got to a point where I felt like I kept just prescribing and adjusting meds and adjusting meds and higher meds.
And. Not really getting to the core of, of what was going on with people, this, that whole comprehensive health, that whole person. Um, and when I started look diving a little deeper and trying to help people. Maybe not increase their insulin. I, it, I kind of unlocked Pandora's box of, um, just diving into like their nutrition, their physical activity, their stress, their sleep, their behaviors, their relationship with themselves and others.
And, um, found a home in obesity medicine, because it's such a complex disease that you have to look at all of it in order to help someone. Yes,
that's so good that you PO you found those con connections because the way that medicine right now is unfortunately, like if you're working with insurances, they kind of dictate some how much time we spend some time with their patients and they kind of say quickly, come in, come out.
Right. Mm-hmm . Sometimes it feels like bandaids instead of like getting to the root cost of why is it that they have obesity or why is it that they're depressed? Or why is it that they're doing X, Y, and Z. And so it's so good that you found a way to be able to start to make connections and, and using those relationships to help you to do that.
Um, have you noticed any links with people who have ADHD and obesity or have you noticed any pattern.
Definitely, you know, I think what's interesting to me about obesity and ADHD is in, in so many ways I can see similarities, right. Because very behavior based, but not completely behavior based. Right. Just a lot of, you know, the, the neuro the brain chemistry changes and, um, that in.
Conditions that there's stigma about. Right. I, I think there's still people, even the medical community that still don't believe ADHD is, is a legitimate thing, right? They, they, oh, it's because of inadequate parenting or, or, or you should grow out of it. And all these misunderstandings and obesity is so much the same.
Um, so many people think it's, it's a choice and, and it very, it very much isn't that way, ADHD in the behavior. That often people with ADHD struggle with can, can be a lot of the behaviors that we work with with patients that struggle with obesity, but at a whole nother level. Right? So, so much about obesity.
We work with patients on, um, structure planning, um, sleep, you know, impulse control, processing, their thoughts, and then you take. And take the ADHD brain and put those together and, and it it's, it just adds more complexity to it. And it's just another great example of just you can't treat obesity in a vacuum.
Right? Um, it it's, it's just so many layers there. And I think it was back in, I wanna say 2015, the American journal of psychiat. Did a meta-analysis and found that, um, patients, the, the prevalence of obesity was 70%, uh, increased by 70% in patients with ADHD, um, in adult patients. And I believe like 40% in, in children with ADHD.
And I think it has a lot to do with. You know that prefrontal area, uh, where we, where we see those struggles with the planning, the organization, the attention, um, emotional reaction and memory, and, and also the neurochemical changes, uh, with dopamine being low GABA being low, you you're gonna see.
Physiologic drive in someone with ADHD to naturally seek a dopamine increase from the external sources, which comes in food. And sure. We're not aware that that's what we're doing. But Austin, that's what we're doing. Yes, that's
exactly like, I didn't realize why, like around two or three, like I wanted to go get that cookie or wanted to go get that chocolate because I was trying to get through the end of the day.
And I was trying to give myself a little bit of dopamine boost. Right? Mm-hmm or why it is that sometimes even though you are quote unquote, trying to lose weight, you go and grab the stuff. Give you the quickest, like energy boost and you're not. And it almost feels like impulsively. You don't have a choice mm-hmm but like you said, when you approach it from the point of view, like, oh, let's set up a plan, let's try to plan for what's gonna happen.
If you do say slip or whatever, like how can you get yourself back on track so that it doesn't become. Except, you know, a one time slip doesn't become like a week or a month or a year slip. Right. Mm-hmm because then our brain can usually be like, ah, what's the point? Right. And so understanding that, you know, you have a way to change if you want to, to help yourself, um, in your weight and in the way you.
Take in information and process information. It it's so helpful to have a physician who can walk you through those, through those things. Um, yeah. So have you seen any specific eating disorders? I know sometimes binge eating can be part of like, uh, they don't realize that, but it, it, again, because of the impulse problem, sometimes it, or you forget, like you're so hyperfocused on what you're doing, you forget to eat.
And then all of a sudden. Binging or, or then you feel guilty about it, or what have you noticed, have you noticed any
patterns? I definitely would say that there's a strong link there between binge eating disorder specifically and, and that, um, that ADHD tendency with that impulse control that, that the emotional reaction control and external sensory seeking.
And, um, that, that just encouraging that, that rapid pace and, you know, You're consuming at the rate. Um, based off impulses before the executive part of the brain really has a chance to like, process and be like, oh, that's right. I had these more significant goals that I was working on. I was trying not to engage in this.
Yeah, that's so good. Um, and I know that we're not the, the patients like, you know, doctors per se, so we can't really give them a specific medication treatment plan or anything like that. But what I have seen is that sometimes some of my patients do really well with like a medication, like by. Plus, like you said, uh, maybe a, an exercise plan or a personal trainer or a nutritionist, like kind of like in a group approach.
Yeah, definitely. Cause in, in both obesity and ADHD, you know, there, there are several tools out there. To treat it right. So I often feel like the behavioral approach working on your thoughts, realizing that your, your thoughts don't control you, that you can increase your awareness and, and take control back over.
It's a big part of it, but the medications are a huge part of our toolbox as well too. And it, when we're talking about obesity and ADHD, we're talking. Diseases. Right? So the, the abnormal physiology is there. The BR the brain chemistry shifts are there, and we do have medications that, that can help. And, and in that study, they did show that when, when patients with ADHD were on medical treatment, They were less likely to have obesity, just really showing the benefit of that control and Vivs is very helpful in, in binge eating disorder.
It's FDA approved for that. There are some other medications that are, um, used off label that can be very effective too. Um, And on the obesity side of things, a lot of our FDA, FDA approved medications, you know, like Leggo, um, are very good at reducing that, that brain interest in food, those, those physiologic drivers within the hypothalamus that are encouraging, that, that seeking out of.
I really, before what Gabi came into the picture, you know, some of my, my patients who were, uh, prediabetic or had a metabolic syndrome, like I was starting them on SIS because it was, I just understood how it worked. And especially my ADHD patients who had obesity, like when I saw like, when I did RSIs plus like their ADHD me.
Oh my God. Like some of them lost, like. 2040 a hundred pounds. And it was just such a life changing thing for them that mm-hmm, all of a sudden they could have one more tool to allow them to self, uh, regulate something that they didn't think they could ever do. And so it's so good to be just really like, see the person as a whole, right?
Because there, like you said, there's so many components that can come together and can make a big differe. Um, so tell us a little bit about your practice. You know, you help patients with obesity. Are, are you also doing family medicine or are you mainly obesity? A little bit of both. Can you share a little bit with
us?
Sure. I, I still do a small amount of family medicine, mainly because of patients I've taken care of for, for a while. But I'd say it's been about three to four years now that I've been practicing obesity medicine and it is just kind. Taken over my practice, you know, and, and, and I enjoy it. I love it. It's been wonderful.
So, um, it it's been a welcome change because it's happy medicine, you know, it, it giving people hope and really having such a change in their lives, um, helping them make such a change in their lives. It, it really is fulfilling and in you're you're right. You give them that sense of self worth back. You, you see their confidence growing and then you see the way it impacts every other area of their life.
That. A switch has flipped, you know, in their head and they have this power over, over their relationship with food again or over their behaviors again, in the, in this, in the case of ADHD. So most of my practice now is primarily weight, health related, um, or even patients who have obesity, but don't necessarily wanna treat the obesity directly, but they want a physician that's going to.
Treat them in respect them, um, and not make every complaint that they have. About oh, it's your weight? Um, so kind of a, a little bit of, of all.
Yeah. That's so good. Um, so where can people find you if they wanna be like, oh my God, I can't wait to talk to Dr. Golden. She's speaking my, my choir , you know, where can they
find you?
Right. Right. So I, I practice, um, at Watertown family practice in Watertown, Wisconsin, and. It's uh, between Madison and Milwaukee. And, uh, I'm able to provide virtual care to patients across the whole state of Wisconsin. And I have, um, Instagram and, uh, Facebook pages, weight and gold wellness, as in worth your weight and gold.
That's
amazing weight, gold weight in gold. That's amazing. So, uh, where do you see yourself in the next, like three to five years? Oh,
in the next three to five years, you know, I. Huge advocate, um, for equal access to care for obesity. I, um, work with the obesity medicine association, um, on their national advocacy team.
And I, I would love in the next three to five years to. Have a little bit more of, of a national platform and, and be sharing and, and helping more people understand obesity as a disease and help reduce the stigma around the disease. And what
about
for fun? What do you see yourself doing in the next three to five
years?
Oh, lots of bicycling in, uh, vacations with family. So. You know, a few years ago, um, in a period of stress and challenged myself and wanted to take something else more. I had not ridden a bicycle since I was a child. Um, and decided I would take on rag. Bri. I don't know if you're familiar with that. um, but it's a bicycle right across the state of Iowa.
So I'm actually leaving tomorrow to, to head to rag Bri. Um, and I will be riding my bicycle with my husband and 25,000 other, uh, wonderful friends, um, across the state. That's
amazing. Yes. You know, we, we often forget that fun can be really what fuels us and what really can, uh, replace what sometimes food gives us
Right. Sure. So we gotta find what gives us the meaning to our things. So, um, it's been so wonderful. So the last part that I usually. Is that let's say that people just started listening to us, you know, because we have wondering attention, what would be the little nugget that you would want them to take?
I, I would just want people to, um, take home that everything can change.
You have the ability to still change your behavior, find ways, um, to take back control of your thoughts and. Change your health. And there are more and more people that are open to helping in, in areas of weight, obesity, mental health, more and more than probably ever, ever, that we've seen before. So reach out for help.
If you don't find the right person willing. Keep searching. That's beautiful.
Yes. Keep searching. You're definitely worth the investment. You're definitely worth, uh, realizing that, you know, a second or third opinion sometimes is needed because, um, different people have different personalities and sometimes, you know, we don't.
Explain ourselves as well. Uh, when we're saying something, but you need to keep advocating for yourself so that you can get the help that you need. And, and you're right. There's so many resources nowadays. So it's, it's worth definitely exploring, but thank you so much for coming to be in my guest today.
It's been one.
Thank you.
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@adhd-livecoach.com, where you can find out about my upcoming coaching. Classes as well as free master classes and other exciting events that are happening.

Beyond ADHD A Physicians Perspective: Dr. Laxmi Naiki

Dr. Laxmi Naiki: realized that I am wired for addiction and that's a higher risk with ADD it wasn. Drugs per se, but my addictions tend to be typically work and food and perhaps impulse control shopping, things like that, that I didn't realize was part of the whole diagnosis. And I don't even, the word addiction is a little bit of a stigma for me, but it was in a sense that it was overwhelmingly doing it.
It wasn't just a habit. It wasn't just oh, I'm just shopping extra on a Friday night, it was like real. Hello? Hello.
Dr. Diana Mercado-Marmarosh: Welcome to beyond ADHD. A physician's perspective. I am Dr. Deanna 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 a person. I was always meant to be both in my work and in my personal life. In the past two years, I've come to realize. That unlearning some of my beliefs and some of my habits were just as important as learning the new set of skills. I'm excited to share all these.
Okay. So I am so excited today. We are gonna be talking all things holistic, so it's fun to talk about this topic. And I have a dear friend of mine here to talk about it and it's Dr. Lak NA and I might butcher that. So she'll help me out in a second. She is an ER physician and she's been actually practicing holistic medicine since 2015. And so I am so excited to have her come in and explain what her journey.
Been like, and she is from Atlanta, Georgia, or she's currently in Atlanta, Georgia. So yeah, this is gonna be such a good treat for everybody in Atlanta who can reach out to her and start to heal and start to integrate your health in a different way. Thank you. And please tell us your names.
So if I messed it up
Dr. Laxmi Naiki: so it's Lak and I practice in Georgia and our. My practice is spectrum integrative help. And, we take a really holistic approach to the healing, the journey for the person and specifically for a D there's so many different things that I had to learn about as I was healing, because, I self-diagnosed myself.
Back in, I think it was like 2010 when I started noticing just aspects of my personality. Whether it was impulse control issues, whether it was working memory, whether it was me being able to complete a task, but then unable to complete it. Or I add, I have a project on my plate and then I keep adding 20 more before the first one's done.
Classic. And just, I struggled with sleep. I was having definitely struggling, in relationships, boundaries, so many various different things that I just didn't understand what it was and I'm a physician. So [00:03:00] it was really, and eye opener and I started just looking up stuff.
And then, of course I researched came across the word D. And I started looking, reading more and more about it. And then I said, how do I start my healing journey? And I had other medical issues for which I went into the, holistic approach of healing. But only to find out that I think like 60, 70% of ER, physicians have a D D.
Our comorbid it's very high. Daniel Amman is the guru in add, and he talks about how ER, docs are perfect for the job, but at the same time, cuz you have this high stimulus, like encounters with people and then you go from test to test it really fast and before one task is completed, you move to the next.
So it's perfect for me. Like it's almost like it was drawn or calling. They should just call E. Add people apply, but but yeah, just through the whole process, really figured myself out and in a much different place now, a decade later.
Dr. Diana Mercado-Marmarosh: So what did you think when you first realized, oh, this might be [00:04:00] a D like, were you surprised?
Were you like relieved? Were you like ashamed? What did you.
Dr. Laxmi Naiki: It's probably a combination of everything. I was overwhelmed cuz I'm like, oh my gosh, what do I do now? Sure. The Western approach is here's your prescription pill, your, Adderall or Vivance or whatever you wanna write.
Sure. But the, I was looking for approaches to say, okay, this is what I have. We all have something probably. Yeah. And I'm not a big person for labels, but let's. The issues that come with it. And I was overwhelmed. I was just and that's also part of the diagnosis. I think the tendency to get overwhelmed very quickly.
And I was scared I was feeling alone, but, luckily I reached out to a couple of, clinicians that were trained and I said, Hey, what do I do? Unfortunately at that time, again, the approach was pretty much. The pill, this is how we treat a D here's a prescription and there's nothing wrong with prescriptions.
There's definitely a place for it. I think there's a lot of things that can be done as an adjunct or instead of, depending on the person, everything's different. Had a range of emotions. [00:05:00] And then I, I said, how do we, we're like clinicians, right? We look at the situation and we try to solve problems.
X is the problem. What's the solution.
Dr. Diana Mercado-Marmarosh: And so you said 2010, is that correct? Yes. So then five years later. So in, in this whole time you were in this whole time you were trying to do different ways of helping yourself,
Dr. Laxmi Naiki: right? Yes, I was trying to figure out. So for example, my relationship was struggling.
And so I was like, why is it struggling? How is my mind thinking versus my partner? And how, a lot of it was just, I needed in a relationship. For example, I needed to constantly do something new. Constantly have a new stimulus. And that was my brain wanting that dopamine perhaps.
And so I had to stop and say that's definitely not him. He's not wired that way. And so I needed to back it up and say, okay, how about we negotiate two new things a month? This was this negotiating process. As I was learning myself in those five years. And then clinically, I noticed that I needed to change many different aspects of my life.
I had a [00:06:00] tendency. I realized that I am wired for addiction and that's a higher risk with a D it wasn't. Drugs per se, but my addictions tend to be typically work and food and perhaps impulse control shopping, things like that, that I didn't realize was part of the whole diagnosis. And I don't.
Even the word addiction is a little bit of a stigma for me, but it was in a sense that it was overwhelmingly doing it. It wasn't just a habit. It wasn't just oh, I'm just shopping extra on a Friday night, it was like real, like my credit card bills were high, like scary high. And I was like something I just can't stop myself.
I can't control. And it was real. And so in those five years I was like, okay I need to now regulate all of it. And, thank gosh, I, I really worked hard at it. I'm at a very different place now and I'm able to regulate it and, I check myself all the time. I people have to plan when they work.
I'm the person that needs to plan fun. [00:07:00] Because I know where my tendencies are, yeah.
Dr. Diana Mercado-Marmarosh: Yeah. Yeah. So it's so beautiful that you say that because ADHD is the spectrum and like you said the labels. Yeah. They're there, but it doesn't matter really. You, if you don't understand how you are wired, like what you.
What like lights you up or what, can really derail you then it's hard for you to create those safety nets, to be able to guide you towards where you're trying to get at and where you're trying to avoid so that we don't get ourselves into trouble, right? Like you said the ADHD tax, either buying too much stuff or not even having what you need at hand, because you ran out because.
Forgot. And so what are some things that have helped you that you've noticed that now you incorporate and try to help your own patients?
Dr. Laxmi Naiki: Yeah. It's excellent actually, in terms of my life, for example, if it's work related, I have, [00:08:00] hard stops. I work in 90 minute blocks.
I only work three, four hours a day. I have a great virtual assistant, so I put hard stops and then I have a list of non-negotiables are, and I kid you not my non-negotiables. I have to exercise every day, even a walk like for 20 minutes in the sun, nothing, necessarily intense, but it's a non-negotiable the non-negotiable for me is sleep.
I have to get my sleep in because it helps me process things better. I'm not as impulsive. I'm more regulated. The body heals significantly during sleep during Delta sleep. Mono non-negotiable. It's exercise. I regulate, how long I work and my biggest one is actually, nutrition.
I'm very clear about what I put in my body stimulants, cuz I have a tendency for addiction. So I'm the person that just. Won't stop at the one cup of coffee. I'm the person that potentially can, excuse me, it's lightning and thundering here. So if it's noisy I'm the person that could potentially do the six to eight cups of [00:09:00] coffee and just not stop.
And so I knew my body and this is not everybody, but I knew my body and I have given up coffee and I do, more healing, herbs and teas that are more therapeutic for my body. Whether it's lemon brass or Rubo, or ginger turmeric tea, things that are highly healing for me, not necessarily addictive, but also feed the nutritional part of my body.
And so those are really my non-negotiables and I pretty much stick to it. And it helps me regulate the other aspects of my. Yeah, that's
Dr. Diana Mercado-Marmarosh: so good that you have that insight about the teeth. Some people, as might be using that, alcohol or smoking or different things.
And so I always say like the body's gonna get what it needs and we have to pay attention to see if there's a better way for it to get what it needs instead of causing us something long term. That can be more complicated. And now Do you in your diet, are you like [00:10:00] plant based or like low carb or what do you, or do you sometimes just tailor it like for your family or for your clients based on what they, what else is going on with them?
Dr. Laxmi Naiki: Yeah, it's, each person presents very differently because some people can have a D and diabetes. Some people can have add in autoimmune and there is a book, I forget the author, but there, he wrote a book called there's no such thing as a D. Which was very fascinating because I had to look it up because and that peaked my interest in the functional medicine approach to healing, which was let's go closer.
There's so many different ways to eat and people eat differently. So let's look at it primarily. I think a whole foods plant based diet is probably the best for most people. Almost everybody plant protein, generally isn't the most comprehensive protein. So you, some people do benefit more with animal protein or certain servings of protein limited, they do better with that, but in general, plants are the best way to go overall in general.
But more than that, [00:11:00] there's more emerging. If we were going a little more scientific in medical, there's more emerging data on the microbiome. And D so for people who have a lot of gut issues lot of bloating, gas, and D what we typically tend to do is we do a three month protocol to make sure that their gut is good.
What does that mean? We do a stool test that looks at their entire microbiome. to see what exactly is happening with all the bacteria. Do they have good bacteria in the gut? Because that's the source of all our nutrition. If whatever nutrition we eat uptake is due to the microbiome. So we look at exactly what's going on.
Majority, I would say are very depleted in fiber. Okay. We also rule out certain St infections that occur in the stool and it comes out the stool sample. If they're, parasites, if there's very high concentration of yeast can be in the microbiome. It's fine. But it's just the level to which it's there.
So we look at things like that. Those patients with the yeas, they usually have high sugar cravings, and we can [00:12:00] tell, and it comes out in that stool test. The other thing that's very very profound, which I'm seeing now compared to five years ago is 80% of the urines that we're collecting on.
People have herbicides
have, excuse me, have glyphosate in the urine. Wow. Which is yeah. 80% of urine samples. And I haven't really drawn the bell curve to see what percentile they're at, but they're pretty. And these are people that swear, they say, oh, I eat clean, I eat this, I eat that, but still we're seeing it.
So it's seeping in either through the soil, through the food, through all the exposure that we're having and sprayed on the food and all of that. So we're seeing much of more of that. Now. I don't know the impact of that, but I can't imagine it's not there on a D right?
Dr. Diana Mercado-Marmarosh: Yeah. That's so good to be able to have some.
Other type of tests and the usual. Oh, okay. Here's a questionnaire and okay. And even though. A questionnaire is okay, because then you have a [00:13:00] baseline, but it's you, the more that you compliment different things, the more that you approach the whole thing, because I keep telling people, medications are great.
Like it's the fastest way for the people that it, they work for. There's the fastest way. Within 30 minutes of you taking a pill, you can all sudden think a little bit better to do other things that maybe you would. Put out for weeks. But at the same time, like it's not gonna help you to do all those other tasks and to regulate your emotions and to be able to know how to prioritize like there's tools for everything.
And sometimes. The meditation or exercise or breathing techniques can help you to regulate some of that sympathetic overdrive that hits. And so if you then also have me food in your diet, that is not going to get you so worked up or, everything just compliments each other.
Yeah. And. [00:14:00] I was reading recently and you can tell me about your meditation journey, cuz I know you, you really use meditation as a way to cope. And I remember in our previous conversation, I was so intrigued by, how well it was helping you balance. And I think I shared with you like meditation.
I would love for it to work for me, but it's really tapping is what works for me. Emotional freedom technique works wonderful for me. So it doesn't matter what people use as long as they find something that, that works. That's where that, that goes with. But, with tapping I've had always been told like, oh if you have.
Trauma in your life, maybe you shouldn't do tapping by yourself. You need to do it with a tapping trauma coach. But I think, and a lot of people wonder whether ADHD is even a diagnosis or whether it's just right, like a trauma, or post-traumatic, or depression or whatever. But it's not. Trauma is not gonna induce ADHD.
It might just make your ADHD come about, [00:15:00] obviously sooner in age than it would have eventually come out. Because eventually our systems that we were trying to use to help us cope are no longer. Enough, like we hit like a saturation point. So to say, so what is your, what are your thoughts about this in terms of like meditation or like trauma?
And I know you, you have a lot of in your practice, you help with
Dr. Laxmi Naiki: this, right? Yeah. Yeah. So we see, it's really amazing points you're bringing up. It's actually pretty incredible. So thank you for bringing it to light, because what I am seeing is significant levels of trauma, obviously with everything going on in the country and the world the mental health crisis that we're at and it's presenting in various different ways now is a D due to trauma because of trauma, independent of trauma, because trauma is bringing up what already exists, it's interesting when they've done the brain scans, there's ation issues, there's connection issues that seem fairly similar in both states. And that being said, they both do exist. It doesn't, [00:16:00] to me, it's almost moot to see what caused what it's there both are there. I will say a lot of patients with a D have comorbid trauma.
Yes. High percentage due. And if that is the case, the highest, Impactful modality for me has been meditation and yoga. Now, Bessel VanDerKolk who I think runs the trauma. He's the head of one of the trauma associations. He also states yoga as being the one of the top modalities for healing. The yoga that I particularly practice is called inter engineering it's by Isha foundation and it's very therapeutic and it's really helped alter.
Energetically what's going on because I think the west, the con the limitation with the west, and it's beautiful, but it's still a limitation is that it's more scientifically approached. And it's the mind as the cause of a D trauma and the ease look at it. Like your energy is the cause of the a D it's a little bit different, cuz it goes a little bit.
In looking at why [00:17:00] this is happening. So trauma could be anything, right? Someone bullied you in fourth grade versus you've been persistently, emotionally abused by your parent, or you've been abused in a much more horrific way through sexual abuse or other things. And that imprint it, keeps scoring the body.
The body keeps score, right? According to that book written by VA Leonard, Paul, it keeps a memory. Of that in your body and you carry that and that can manifest as anxiety, depression, O C, D all these other things that come out or a D D. And so what do we do for that? A way to slowly resolve that is usually different modalities.
Do you do psychotherapy with therapist? Do we now need to put you on a pill, low dose of something. Do we try to address this holistically? And if so, yes, yoga is one approach. And if it's really traumatic and we're not able to get there with any of these techniques, sometimes there is very good data for plant medicine.
And there are patients that if I feel are. [00:18:00] Able to handle it, but are safe that we do recommend plant medicine for now. I don't do it as blanketly, as it's being practiced. Currently, I'm very conservative in my sort of choice and selection, because there's a lot of impact I can have when you put someone into a plant medicine protocol or ketamine therapy, because these therapies say stop the mind.
The mind is going all over the place with the a. Let's drop the mind. Let's go to the trauma. Let's figure out what happened in the childhood, the thoughts, the memories, the feelings all come up. When we drop the mind with all these plant medicines. And what happens is the person goes into this deep state, another world state, right?
Like it's with LSD and MBMA and those sorts of things. And they go into a different world and memories come up, which can be really intense, and they just can't handle it. So it has to be the right person that we recommend to. Somebody who has severe schizophrenia, who's unstable on multiple [00:19:00] medications.
It's not somebody I would recommend for this. And when they do go into these states and they come out, we make sure that they have really good integration in place, right after meaning there's a plant based integration specialist board that they can talk out all these memories that they just got flooded with in a day.
But it can be highly therapeutic from a trauma standpoint because what they tried to do with a therapist for 20 years, They were able to do within a week. And so there's many layers to it. It's very different. And only when you talk to your holistic provider or functional provider, you negotiate and talk it out as to what would work best with you.
Cuz each person is so different. Some people have seen remarkable results with doing intense yoga practices. And again, it's just certain types of yoga for me. The yoga has to have really good spinal alignment. It has to have, like you said, you brought up a beautiful point about breathwork as having an, a very kind of centering sense for the body, just to get centered because it's all over the place.
[00:20:00] Energetically ad. Breathwork spinal alignment and silence is a very big part of of doing a yoga practice, which typically not to say there's not beautiful yoga practices in other schools of thought, but generally in the west, they tend to talk through the entire yoga class. And when that happens, the body doesn't have a time to just get into that parasympathetic mode.
And so practices that are in a certain yoga practices that I recommend for people. It's just silence. You're just there with your thoughts by yourself and you get to integrate on your own what's happening. Yeah, we could talk about this forever. I'm passionate about it.
Dr. Diana Mercado-Marmarosh: And then like one of the ones that I like too, like yoga, like I, I like yoga Nira, that's really.
Call me, because there's also like evidence in that where it can rewire some of your brain and some of your subconscious like limiting beliefs and some of, and that it can [00:21:00] actually help modify your DNA. I was shocked by that , but I guess it makes sense, like different things that can be traumatic can also change your DNA sometimes.
And it's just interesting how much our body keeps to coping with our environment. And how we do have some sense of control if we are just taught about it. Because so much is how much we have to unlearn that self helplessness or just stepping into curiosity, to think about it in different ways.
Yeah. So a lot of people sometimes. The first thing they think, oh, okay. So holistic, that sounds great. But that sounds expensive. That's the first thing that they go to, but we have to keep remembering like how much is your health worth? Like it's an investment at the end of the day, right?
How much money did we spend? Trying to go to med school, how much money that we spend in our cars or in our purses or whatever we buy and. And if we don't have our brain working the way we want it to, or our [00:22:00] health aligned then what's the point, but I'm pretty sure this is the common question you get asked.
What do you usually tell people when they ask you these questions? Because I'm sure they're like, oh my God, what's due test is that expensive, but you know how they.
Dr. Laxmi Naiki: Yeah. We all, the way we work is yes, we don't take insurance currently. We're cash only practice. We give a tremendous amount of support, I think, above and beyond between appointments in terms of messages, emailing the cost, there's two ways to think of cost there's dollars, how much I'm spending and two untangible.
Quality of life, your relationships, your credit card bill, how much? And I'm not saying that coming to a holistic practitioner will solve all of those things, but you will definitely get the tools and direction that you need to go on your own. A lot of our patients come to us after nothing has worked.
And two they're highly. If I tell you some things about my patients, they are highly motivat. They are messaging me. Oh, I read this amazing book on I don't know, a macro biotic diet. What are your thoughts? Oh, I'm here. And I'm always [00:23:00] pushed to the edge because they are reading.
They are listening to podcasts. They're looking at, there's so much evidence out there. Not for everyone that I have to be on my toes. Constantly reading articles and stuff. So our patients are very motivated, very knowledgeable, and we're at, the cutting edge with some of the stuff.
Now it's also expensive because expensive, in a sense of, there's other add modalities that I often see come across my desk should we do a functional MRI for $5,000? I'm not sure if that's necessarily gonna impact, outcomes, but patients have gotten it. They don't necessarily know the evidence.
All of that, neurofeedback has great data for ADB, but you've gotta do 50 sessions you have to potentially, fork over, I think five, $6,000, if it's outta pocket we're nowhere close to that. And it's just important to make sure whatever practitioner you go to.
You really research their experience with a D you do your homework, get references and see what they're about, and then go to them. [00:24:00] And then it's definitely worth the cost because even if you're paying a little bit to, for the visits, you're getting a lot of tools. You're getting assessments, you're getting answers.
And if you have all of those, you probably don't need to come back. Most of our patients I'll be honest. See us about four to five times the first year. The second year they see us only twice because everything's been set up, they've figured everything out. We know what to do. And the second year is usually just a couple of blood tests and just following stuff through if they're very sick most of the labs are out of quest and lab Corp, which is through your insurance.
And then the specialty labs, like the stool tests and stuff. And food allergy tests, those are out of pocket. And they can range anywhere from, I think, a hundred, $150 to four 50 for the stool test. We've not really seen much resistance because we don't charge for the labs, they just pay the lab directly.
And they're just looking for answers. and if they feel better and they're getting outcomes, they're getting results, they're happy we see symptoms improve. But I do think that, I tell them realistically, before the first appointment, I said, it's gonna be a journey. [00:25:00] This is the investment.
Please don't start with us unless you can stay with us because there's no point in doing this for two visits and then just leaving it, doesn't help. And we're certainly not looking to, just take your money and not get results. That's not us. I will say that it is an investment, but in my eyes it's changed my life.
I've invested in it, invested in the functional medicine, holistic approach. And with ad dates, interesting something new will come up every. A new layer about my response to people who I am, how I am, and it's constant work for me, so I'm still learning. I'm still a student, but I'm definitely on the journey.
I am not currently on a medication because I feel that I can regulate myself without it. But there is a place and I use one, psychiatrist in Atlanta, Georgia, and she. Only trained in a, not train, not only trained, but she specifically focuses on add medications. That's all she does. I'm very specific about the [00:26:00] psychiatrist I sent folks to, even for that, because not every psychiatrist really knows the medications to that level of depth.
Dr. Diana Mercado-Marmarosh: Yeah. That's so important that everything you just said really resonates with me because. When you're doing it for the right reasons. And not that there's a wrong reason, but what I mean is that when you yourself are the product of your product, meaning you have gone through something that has. Been transformational for yourself.
And then you're like, oh my God, it worked for me. And you can't wait to tell everybody else how, like it might work for them. It becomes like a no brainer for you to like, be talking about it. This is why I got into this because I didn't know what coaching was like two years ago. And so now I'm like, how come?
Not everybody has a coach, like how come nobody's drinking the Kool-Aid. And so it's just funny how I. It feels like it's, everything's been peachy. But it really hasn't, it just started to become peachy in the [00:27:00] last two years. But your brain kind of forgets because now when you're at this other new level, like you're saying you're constantly learning.
So you're, everything's new, everything's exciting. And you just keep leveling up and you just. Like you said your clients push you to learn more, not in a bad way, push you, but in a good way, push you because you want to show up and help them. And in the same time you are helping yourself. So it's a win, win now.
For your clients. And that's the same thing I tell my patients or my cl my patients. I have that I do treat with ADHD, but I also tell them, Hey, go seek a coach. Hey, go seek like a therapist. Hey, go seek like acupuncture, go seek like holistic, like functional medicine. There's some people in Houston that I refer to.
Even though it's a two hour drive for them, like they go. You are gonna send them to people you trust you're. And I tell them who not to go to also. Yeah. And so it. It's important to be [00:28:00] able to in your network have people you trust so that you can help each other and communicate with each other.
And do you mainly see people from Georgia or have you seen people come from all over just to chit
Dr. Laxmi Naiki: chat with you? Yeah. So I'm licensed in Georgia and Tennessee. However I do a one to two kind of educational consult for folks across the country. Not we don't prescribe medicines. We don't order labs, but people will often almost always contact me and send me all their information, their labs, their diagnoses, just to get an idea from me on what direction to go.
For their treatments and therapies. And I will give my advice on what they need to do. Like for example, we had, somebody call me from Boston that had gotten an entire functional medicine workup and were given, I would say like 15 supplements, which was just too much for the patient to take.
And they said, can you look at our blood work? Can you look at all our functional tests? Tell us what we need to. Give us a [00:29:00] better direction. And we did this was the patient with, the glyphosate at the 90th percentile. She had a leaky gut. She had obesity which was not addressed. It was addressed more from a detox perspective, but not, I think she would've probably benefited from a GLP one at that point, she, we give our own take on what direction.
And then the patient's daughter who contacted me. Went back, took the information. We wrote a report up and she said, this is what we're gonna do. And it's not that the physicians were not doing the right thing. It's just in the current insurance paradigm. They also don't have the time to look at the case in its entirety, and there's no residency for functional medicine.
There's no residency, so you can get your certifications, but if you don't know how to manage those labs and read the tests and know really clinically what to treat the people with, you're gonna get protocols of supplements. And then the patients are like, what is this? This makes no sense. And and
Dr. Diana Mercado-Marmarosh: I think I'm also biased.
Sorry to cut you off. It's like when [00:30:00] you yourself understand the diagnosis enough to where you can complete your clients. Words it there's so many layers that they don't have to describe to you because you know where they're going and why, what might be helpful. Again, I'm not saying that only people who have ADHD can help people who have ADHD.
But if you happen to find that unicorn who does, like, why not go to somebody who really understands you and so that it could. Make it be like one more thing that you don't have to explain. Because so much of medicine, like we are always trying to make sure we're following X, Y, and Z, but like you said, if you.
Have that hyper interest because it totally pertains to you. It just gives it to a different level. Perfect. So where could people like reach you so that they can send you their patients or they could [00:31:00] consult
Dr. Laxmi Naiki: you. Yeah, our website is spectrum iHealth, I, as in India, spectrum ihealth.com and you can find us at spectrum integrative health on Facebook, Instagram, LinkedIn all the fun social media sites.
And yeah, we're we're excited. We're growing and we're having fun and we're learning. I don't. Necessarily see ADB, but I see, multiple different conditions. Us, which ones? Yeah. Oh yeah. A lot of obviously, lot of women reach out to me. So a lot of it is menopause and weight loss and autoimmune.
And interestingly enough, we don't keep this in mind, but with trauma and a D The number one, silent killer really is heart disease. I'm seeing a lot of really tough cardiometabolic disease and we have a full-time lipidologist on staff. We have a full-time dietician, so all our patients have to go through her first.
She's a functional dietician nutritionist. So because again, fun foundation, if we don't get that diet, what are we doing? We're just writing you prescription pills for what. The [00:32:00] foundation is always diet. So she sees every single case coming through and we have this sort of team approach.
We have also a full-time Aveta consultant she's on the world health organization, board for Aveda. So she's just joined us, joined on our team. And my vision is really to bring this. Evidence based integrative approach to medicine, because I feel a lot of it has been lost due to lack of standardized training.
And we're not really sure. And, holistic has become this catchall term, and my vision for the, the practice is really to bring evidence based stuff together and to have this authentic way of approaching holistic medicines.
Dr. Diana Mercado-Marmarosh: Awesome. So where do you see yourself in the next three to five years?
For fun?
Dr. Laxmi Naiki: That's a good question. I need to pencil that in with my my work tendencies. Where do I see myself for fun? I don't know if I need a vision three to five years. I'm having fun now. Yeah, I try to have fun now. I don't really consider any [00:33:00] I don't know in my mind I don't really, piece it out as work or fun.
For me work is fun. That being said, because I have a tendency to overwork. I make sure I have these non-work fun. But yeah, I definitely. Try to re you know, relax through my meditation. I go out with friends on weekends, we're going on a trip this weekend for a week. Just doing all the stuff that's needed,
Dr. Diana Mercado-Marmarosh: do you think you would go like to a retreat, like in India or Bali or somewhere? What do you think would be fun that you might do in the next, it's in your bucket list, say in your next three to five
Dr. Laxmi Naiki: years? Oh my God. That's a lot of stuff. I wanna go like hiking in. Like a remote region of the world.
I wanna go to Bali. I wanna do this retreat that I do in Costa Rica. There's definitely stuff I wanna go to. Yeah, definitely stuff, places I wanna go that I haven't been to.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much for coming. It's been such a pleasure. I always end this last question by saying that, Our listeners have ADHD and they probably [00:34:00] zoomed out somewhere
And so if they're about to like, just zoom in right now, and what is the one takeaway point that you would want them to walk away with from this episode?
Dr. Laxmi Naiki: Huh. I would say, look at, add as a gift, not as a diagnosis or a label. or an impairment. It's a gift. There's some incredible accomplishments I've made because I'm able to think quicker than people I'm able to do things much more than people I'm much more creative than a lot of people.
Those people have their gifts. I have mine, and definitely don't look at it in that way. Look at it as this incredible immense gift. And yes, there's potential that it may have some regulatory kind of issues, but you have tools. You have podcasts, you have books, you have coaches, you have therapists, you have tons of stuff now that you did not have 10 years ago or 15 years ago.
And there's a lot of help out there, but it's a gift. I consider it a gift.
Dr. Diana Mercado-Marmarosh: Awesome. Thank you so much. It's been such a pleasure and [00:35:00] yeah who knows, we might be doing a retreat together soon. Who knows? I love to travel. So yeah, we gotta integrate everything so that everybody has a way to tame their
Dr. Laxmi Naiki: in touch.
It's been awesome talking to you. Thank you for having me. Thank you.
Dr. Diana Mercado-Marmarosh: Thank you for spending your time with me. I really believe that time
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Beyond ADHD A Physicians Perspective: Dr. Emeka Obidi

Dr. Emeka Obidi: Realize that ADHD is not bad. It it's just different. Especially speaking to the parent who is struggling with that decision for their child. To pause and really question and critically think about what's making them put up that resistance. Is there a significant opportunity cost to not get in their child help with the need right now, thinking about what possible advantage they might be in the future. Whereas a child is so right now make the right decision for the child.
Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a Family Medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.
And in the past year, I have undergone radical transformation after discovering ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes. The last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back like I have.
Hello. I am so excited today to have a dear friend of mine, Dr. Emeka Obidi. He is a pediatrician almost 18 years experience.
And he's from Maryland or he's currently practicing in Maryland. Today we are gonna be talking about a conversation that sometimes it's a hard pill to swallow when you get the diagnosis, which is, getting diagnosed with ADHD. And he obviously has to give the talk to those parents when they get diagnosed.
And so we're just gonna talk about like how somebody who has. D might look like, because we don't realize that, you know, there might be something else going on, not just a kid being hyperactive and being a kid per se. And then what does it mean to try meds or not meds? Or what does it mean to get the diagnosis or not get the diagnosis?
Okay. So. Please, please welcome. And tell me, how are things going today?
Dr. Emeka Obidi: It is wonderful. Such a pleasure to be with you today, Dr. Mercado, thank you so much for having me on.
Dr. Diana Mercado-Marmarosh: Yes. So tell me, I'm pretty sure this is on a daily. That's what happens to me diagnosing different people on the, on the daily with ADHD or seeing how they're managing it.
What do you notice when people get that diagnosis? How, what happens?
Dr. Emeka Obidi: Yeah. I mean, the response is quite varied, right? You have parents who maybe already have ADHD themselves. So they've struggled through it and know that this can be a significant issue if not addressed. And so they recognize it in their maybe kids early and bring the kids in a happy to have that diagnosis made so they can start the process of getting the child, whatever help they need, right?
And you have parents who are not sure they know something is wrong or something may be coming up in school or at home, they think it might be, and they come and the kid is diagnosed and they have questions, but they're accepting of. The diagnosis and say, okay, well, you know, this is life as it is right now, let's see what we can do, what are our options?
And they can talk through that and ask very thoughtful questions and very like, you know, wanting to know really what's going on and how they can help their, their child. And I think parents who are also on the other end, who hear the diagnosis and immediately put up a resistance and. Honestly, those parents aren't necessarily bad parents. Right? They put up a resistance and not wanting to accept the diagnosis, maybe scared of the diagnosis, maybe not sure what that means. And, that can also be a more difficult conversation or situation to see because you know that, there might. Some significant barriers to this child, getting the help that they need in that scenario.
So, to answer your question, it really runs the Gama, you know, it's across the board, but, those other conversations where there are some resistance can be more challenging to handle because, oftentimes, you know, vast of, sometimes those parents love their kids as well and are thinking that they may be making the decision that's correct, or right for that child as well.
Dr. Diana Mercado-Marmarosh: Yeah, I know that my husband always tells me that even though he was told he had ADHD, his mom told him that he didn't need any meds, that he was just being a kid. And so he all along, he's never used meds. And it's just interesting how some people can do fine without meds but some people sometimes get themselves in trouble if they don't even understand that they have the diagnosis, right?
Because then you don't even know how to help yourself because all of a sudden, bad talking yourself, thinking that you are broken or thinking that you should be doing it a certain way. And blame yourself that you can't, but you're not even aware of where to even start, because you're not even aware that you have the diagnosis per se.
Dr. Emeka Obidi: Yes. That's so true. And I think that's where it's important for us to provide the best possible support for parents, you know, who are struggling with that decision to accept a diagnosis, or maybe even seek help for a diagnosis. Right. They may already notice something going on. Maybe you must suspect this might be ADHD, but afraid to get that diagnosis.
You know, I've had had a friend recently who had struggled through that with their daughter and some intimate conversations with him. It was difficult for them to come to that diagnosis and accept that diagnosis.
Dr. Diana Mercado-Marmarosh: So, if you are lucky enough to get the diagnosis at an early age during, you know, your pediatrician's able to help you find that out is sometimes if the patient gets started on meds, they might not take it the way they should, or sometimes they are undertreated. Right. And it could be a combo. It could be not being educated on how it actually can benefit them or thinking that they're gonna become addicted to them. Right? Or thinking that it's only something that you take while they're at school. And so all summer, they don't need it because they're not at school.
But then they come in and they're like, but they can't do anything at the house. And I'm like, no, really . So what have you seen?
Dr. Emeka Obidi: Yes, I've seen all of that, you know? I think that just to, to pick up on, on the last point you just made, some kids can't even enjoy play without. Proper treatment. Right? So they're on the ball field and they're just all over the place, you know, not paying attention to the coach, you know?
And they really enjoy the sport and want to be there, but are not able to perform to their potential because there's this other condition that is, you know, on treated that is affecting everything that's going on. Yeah. So I it's certainly. I think there's definitely a place to provide education. And, you know, I've been thinking about this more recently.
I think also, maybe when you encountered that parent who has that resistance paus into. Cause I think sometimes as. Clinicians. And I've certainly been there before. Also we almost put up a resistance also. It's like, no, you know, your kid really needs this cause you're advocating for the kid. Right. But I think it may be time for us to pause and meet the parent where they are, maybe help them see what might be going on because oftentimes there are other things that may be going on right.
There may be some cultural things at play. His friend of mine was from, you know, a different country outside of the US in a country where things like that are not, I consider that, oh, there's probably something seriously wrong here. Maybe all this is spiritual. Maybe there's, you know, this is just not. The child can have a headache.
The child can have whatever, something else, the ear infection, but when it comes to a mental diagnosis that has it own stigma attached to it, right? You may have issues relationally between caregivers, maybe parents is all on the same page, right? One thinks, or there's something wrong. We need to do one things.
Not has nothing wrong. Right? So all those things come into play. And I think maybe having a parent sitting them down and saying, Hey, listen, How about we, first of all, just recognize where you are, what your own personal feelings are with this diagnosis. Right? Just be more present, more mindful of your own possible bias and challenge it.
You know, challenge that assumption is ADHD truly different from another child who has diabetes or another child who has, you know, some kidney issue or whatever, right? Just constipation right? Whatever the issue is, just another medical condition. Is it really different and taking out time to think about your child.
And I know in most cases, parents feel they're thinking about the child. But maybe pausing and trying to think, am I really thinking about the child or is this somewhat about me also? What this maybe, you know, saying about me as a parent, right? How come I'm my kid? Isn't perfect. And I put that in quotation marks, right?
How come maybe accepting this diagnosis is saying there's something wrong with how I parented or something wrong with my gene pool or whatever. Right? So being sort of more recognizing that you may not necessarily be looking at child because you may wanna stop and say, okay, how is my child really doing?
Right? That is struggling and yes, maybe there are some marginal benefits to not having a diagnosis right now and having the child again in quotation, must labeled as ADHD. But is that gonna come at quite a high price also? Having a child who now has low self esteem, having a child who is having poor grades, having a child who maybe doesn't like schooling anymore.
Right? And so this path that they could have been on is truncated because of this horrible experience in the educational system. Right? So thinking that maybe there's more to look at here than just having a child who's labeled with ADHD in quotation marks and with the potential stigma that may come with that.
Right. Because they've also been studies that have shown that children who are not treated appropriately for ADHD have a higher likelihood of behaviors that get into trouble, whether it's behaviors with the law or not being able to hold on a job or having issues with their relationship and not being able to hold down a relationship and all these other things that could be unintended consequences for the child that you were trying to protect by not giving this diagnosis. Right? And so I think putting all that, just saying, you know what, I'm gonna trust myself to make the right decision for my child. I'm making that decision, not from a place of fear,
but from place of confidence and knowing and education, right. And just saying, this is what this child needs right now. And we're just gonna trust that things will turn out fine. You know, there's not a lack of examples of people who have thrived with ADHD, right. famous and otherwise. So that giving your child this diagnosis does not mean that you've just sentenced them to some terrible life..
Dr. Diana Mercado-Marmarosh: Yeah. So all those things that you just said are conversations that I have every day with my patients, both young adults or kids and parents or adults, because like you said, had they only known or had X, Y, Z like. Some regret that they have as adults. They're like, well, I wish I would've known. I wish of da, da my life could have been so much easier.
It could have been so much better. It could have been da, da, and, and I, what I always tell them is that, you know, who knows, like you think, but who knows, you might have had the diagnosis and you would've been like, no, I don't like that. Or da, da. Yeah. And you might have ignored it because some people do that.
I said, but. Now you're ready to understand. Now you're here, so let's go forward. Yeah. But there's still a grief that happens. Mm-hmm because you're like, what if or what could have been. Right. And so it's so important that you have this conversation and I'm so grateful that you're having this conversation, because like you said, we're always busy and sometimes mm-hmm , we don't slow down enough to like, explain the risks of not doing something about it, right? Yeah. And again, I think so. Not that you didn't want to, you just didn't know to like, you know, I grew up in Mexico till I was 10. If you look around my family, like that was the norm. Like we bicker at each other. We might say things we mean to, and then like in the weekend we're like kissing makeup and we're having a party. Right. And so you just didn't realize that those outbursts that you sometimes haven't say things impulsively. You didn't really mean because you still love each other. And so you just think that's just the norm. Like that's just my family and you don't realize that that's the emotional dysregulation that is happening.
And I think because like you said, in some cultures you just don't have those type of things in quotation marks. Right. You don't realize that. Yeah, you do. it's so obvious here, here, here, here and here. Yes. But you are not even aware that. Because of X here, here, here, and here. And then, and then you're like, oh, so that's why I crashed so many times.
Oh, that's why like I've eaten all this thing or I'm drinking so much, or I'm doing whatever...
Dr. Emeka Obidi: Self medicate.
Dr. Diana Mercado-Marmarosh: Exactly. Your body's gonna go grab what it needs, but it's so important. Like you said, that it could get you into trouble with the law and with your relationships. Right? Like I didn't get diagnosed until in my first year of med school and I think it was good and bad. I think it was good in the sense that I think had I had the diagnosis. I might have been all in my head that I'm no longer, like you said, " " perfect. Because I was the oldest one. Yeah. And in my mind, I was like, The role model, right?
Yeah. And so I think, because I didn't know any better, I did whatever I had to, to do it. And then once I had the diagnosis, I was all in my head like, oh my God, they're gonna find out that I'm broken. And da, da, let me work 10 times harder to mask how hard I'm working. Right. But again, who knows, maybe my life could have been easier or maybe not.
And so you just don't know. When or where, but. When you do the work and you understand, okay, nothing's broken. It's just, I always say it this way. It's being lefthanded in a right-handed world. So if you were given the tool, here's the lefthanded desk, here's the lefthanded pencil. All the sudden you might still be able to do what your peers and you need to do but in your own way.
So it's not wrong. It's just different.
Dr. Emeka Obidi: It's different. That is so true. And I think, you know, the, they, kids also need to hear that information as well. Cause I think oftentimes, like you said, sometimes they're the ones fighting against that as well. They don't want to take medication. Sometimes it's an issue with side effects and I always want to hear from the teen, you know, if they're having any side effects that the parents may not be aware of, because they may be feeling a certain way, that's making them you know, not want to take the medication, where it's a medication issue and that could easily be fixed by just doing something different, right. That doesn't have that side effect. But other times it's just, you know, how they think they're being perceived by their peers. And also what they feel is now they're not normal.
Now they have to take, you know, medication. Whereas they're friends don't have to take medication.
Dr. Diana Mercado-Marmarosh: Yeah. And what I say is that, you know, yes, we all been focusing right now on like maybe the negative things, like talking out loud or interrupting their friends when they're all talking, cuz they don't wanna forget what they're telling them and pretend that they're not listening. Right. But at the same time, these are the kids that tend to think outside the box, creative and figure out things. I always laugh at them and I tell 'em, you're like a tortured musician and they look at me and I'm like, yeah, you're probably really amazing at putting all these things together. And then you think it's crap and you wanna go dump it, but it's amazing.
And you don't see it because you're like the tortured musician. Like you can't see that you created this beautiful thing because you feel like you're not doing all the other things that society has told you you needed to do. Yeah. And therefore you discredit the gifts that you do have
Dr. Emeka Obidi: Yes that is true. Very true. And, this other friend I was talking about, the daughter is so creative, so creative, and they're always saying she just comes up with all this interesting, like when people are trying to figure out things, just sort of just here's the answer, right? Like, we've all been trying to hit our heads together, trying to figure out how to solve this problem in the home right now.
And you just blotted out the answer without even thinking twice. So I totally agree with you helping them recognize that that's a superpower in many ways. Can go a long way.
Dr. Diana Mercado-Marmarosh: Yeah. Because, because then you don't make it mean anything like now, to me, that's amazing. Of course, like you said, they're probably like, oh my God, there's a worst thing ever.
But then I'm like, this is the best thing ever. You can do whatever you like. Do you wanna be a doctor? Do you wanna be an ER nurse? Do you wanna be a policeman? What do you wanna do? Because whatever your passion is, as long as you're following your passion, you're gonna do it because people with ADHD, you cannot make them do anything.
Like, it has to be aligned with their values and their goals. I mean, they might do some stuff, but they're not gonna stay there. . That's why they jump from job to job, to job until they find what is really their purpose. And then like, it's the environment.
So again, if you know this about you, then all of a sudden you're not blaming yourself or anything. You'd be surprised. Like how many people are. Doc. I can't believe I'm now getting five times payment than I did before, because I realized that, you know, this was my passion, like you said, and now I'm doing this.
And, but again, sometimes we don't stop or slow down enough to really find out. what comes easy to you and like, why and then how can I help myself? And, it begins with the diagnosis, because like you said, it might be that they got the diagnosis and they never follow up because they're so ashamed of it and they don't, or they don't tell you why they stop taking it and you can't modify it.
It could have been, there's so many different meds. There's not just one meds. Yes, exactly. And again, what if meds are not the answer and that's okay. And, but we wouldn't know. If you don't come back
Dr. Emeka Obidi: Yes. We don't come back and sit that and have a discussion and a conversation. And I tell friends that all the time, too.
Yes. We have to look at all the possible ways to handle this. And like you said, it's not always meds, but where it is necessary, then it is necessary and that's what the child needs. And you open sometimes our run into is them not wanting to use an appropriate dose. I don't wanna increase it. I'm like, well, you're already taking the medication.
You know, there's no point taking an ineffective dose, right. Take the right dose. And they're afraid of, oh, but I don't want my child to be a zombie. And I'm like, well, that's why this is a partnership. You come and tell me if you're seeing a side effect you don't like so that we can or something that's happening.
Cause I'm not there 24 7. If you tell me this is what's going on, we can troubleshoot it and see if it's a medication issue, a timing issue, you know, and walk through it. Yeah.
Dr. Diana Mercado-Marmarosh: Yeah. So I give my patients like a handout, just like you give a blood pressure medication. I give them a handout and I tell 'em right there.
When you started the med, what time did you feel like it wear off. What side effects did you have? I treated like I'm treating high blood pressure and diabetes and whatever, because we're not gonna remember what, how you felt a week ago or two weeks ago. But if you have it in writing, then all of a sudden I can start to see if there's any patterns.
And then we can modify it if needed. And like the point that you just made is so important that not a lot of physicians are even aware of the fact that medications are processed through the liver, especially the most of the ADHD meds are. And so for some people, the extended release might not last as long as the regular, which is almost opposite of what you think would happen, right? And then you have some that are really fast metabolizer, so they might need to be on really high doses. Like you would think there's no way this little kiddo can like do this yet. They need it. And then you have this adult that you give them, you know, a medium dose and they're like, no doc, this is too much.
And like, they're like, I took half of it or I took one fourth of it, but it works for them. Like you just don't know. But if you have this in writing, then you have a little bit better way of managing. And what I was talking about, some of us think that we should just take the med while we're at work. And I'm like, well, I think you go to work so that you can provide for your family.
And I'm pretty sure your family wants you to be able to do things at home. Not just at work, right? Like I'm pretty sure they want you to also help clean your room or help you do chores. Right? Like it's a team effort. It's not just for work. It's something that we always have to like bring up, because for some reason, I don't know why people think that meds should only be used while you're doing work.
Right. In quotation marks. But like at home, if you're driving your kids around and you have ADHD, I mean, I hope you're doing something to get your ADHD controlled. Otherwise, you know, you're gonna be having an accident somewhere, right. Especially, cuz we're always late sometimes, you know, so, those are just things to consider that, you know, like you said, how much is it gonna cost you to not learn about it and not to provide or create systems with it?
Dr. Emeka Obidi: Yeah. And I think the more each person embraces whatever that diagnosis is in this case, we're talking about ADHD as they embrace that diagnosis becomes more and more normalized, right? So it's not like, oh, those people have ADHD and they are less than or different in a bad way. It's just, oh, they have ADHD, just like someone else has hypertension.
Right. And that we take away the stigma. But that doesn't happen. If we don't individually start to embrace what is and walk with what is and maximize, you know, what is in the life that that child or adult has.
Dr. Diana Mercado-Marmarosh: And what are your usual go to? Like, do you have any websites or books that you tell parents to listen to or do you just, what do you usually do once you tell 'em? Okay. Here's the diagnosis.
Dr. Emeka Obidi: Yeah, I have some, I have some, some resources here, practice, just, paper, resources that I give out. And those are very helpful for our parents. Yeah. And, can on top of my head, remember the, the source right now. But that's usually helpful.
Dr. Diana Mercado-Marmarosh: Sure. Yeah. So one of the things that I tell them is the ADHD 2.0 book.
That one is Dr. Hallowell's book, and he's a psychiatrist himself who has ADHD. And he's like one of the, I wanna say ADHD gurus because it's really good because it's written like how to help like a kid, but it's also like how to help an adult if you help. It 's super like validating because he talks about like the greatest and latest.
Functional MRI studies. I can show you like, you know, that you might have ADHD, although that's not what it's used to diagnose, but it's more to at least understand some of the stuff that is going on and to understand why females seem to be diagnosed a little bit later cuz of the, in a inattentive type of stuff.
But another website that I give my patients is, attitudemag.com because that website is all ADHD website. Like, it talks about how to help the parents with like a behavior or how to help the kids like declutter or like prioritize. And it also is for like teenagers or for adults. And it talks about finances, food and blah, blah, blah, blah, blah mm-hmm . And so they have free webinars and resources that are, they try to bring in like the therapists and the physicians and the, you know, uh, psychologists, coaches, all kinds of people.
Dr. Emeka Obidi: That's really good to know.
Dr. Diana Mercado-Marmarosh: Yeah. And then there is a conference called chat, C H a D D. That conference. And so that's really good because it's like two or three days of all ADHD. So it can really be very helpful for the parents or for the kids, if they're listening to it, to see that there's tools. So there's other people, like you said, normalize. You know, then it doesn't become such a problem because they're like, oh, okay, cool.
It's just different. But it doesn't necessarily mean anything. So where can people come and, work with you? Because, I mean, it sounds like you're a pretty amazing pediatrician. Who's able to explain, you know, ADHD and any other conditions that they might have. And I'm pretty sure they would, you know, win the lottery they came and worked with you.
Dr. Emeka Obidi: Oh, that's the kind of you? Well, my practice medical practice is in Hagerstown, Maryland, Western, Maryland. And, I do have a Facebook page and I do a Facebook live every, every Thursday at 1230 Eastern and talking about one topic or the other, I had a series I did on ADHD as well. And, name of the practice is Partners in Pediatrics And Family Health and, they can just Google pull that up on Facebook. P I P FH I think will pull it up also.
Dr. Diana Mercado-Marmarosh: Awesome. So. Where do you see yourself in the next three to five years for fun?
Dr. Emeka Obidi: Oh, boy is, well, I see myself doing some of what I'm doing right now. I really enjoy my practice. I also have another business that I run and it's an online education for new moms and, that information they can get at newbornprepacademy.com. And, I have an online course. I do that, newborn preparation course that just prepares new moms for their newborns. I enjoy that part of my practice as well.
Dr. Diana Mercado-Marmarosh: But for fun, what are you gonna, are you gonna travel the world? Are you going to..
Dr. Emeka Obidi: For fun? No, I missed that for fun. Look at me. Jump into, well for fun. I would love to do more traveling. My family and I actually just came back from Scottsdale, Arizona, and we had a wonderful time and went up to Sedona, to look at the mountains and it was beautiful and I certainly would love to do more of that. There's too many beautiful places in the world and, we're hoping we can do some more international travel next year.
Dr. Diana Mercado-Marmarosh: Awesome. What's in your bucket list.
Dr. Emeka Obidi: My bucket list? Oh, geez. These are hard questions.
Dr. Diana Mercado-Marmarosh: Where do you wanna travel? You said you wanna travel?
Dr. Emeka Obidi: I would really love to. You know, I don't know if I'll call it a bucket list, cuz hopefully I can get to do that very soon. I would really wanna go on a cruise in a Mediterranean and really visit some of the Mediterranean countries. I think that would be really cool.
Dr. Diana Mercado-Marmarosh: Yeah. That sounds amazing. yeah, I hadn't really seen Europe until a couple of, probably five, six years ago. I can't remember exactly, but yeah, I did a Mediterranean trip, cruise. Oh, really? That was wonderful. It was like a 10 or a 12 day. It was really good because it went, I think it, it took off in Spain and then it landed in Venice.
Like, so. Yeah. And so it was so good cuz I hadn't never seen Europe. So yeah. This was like a really cool way to like be in, in like pizza one day and be in, in Florence and be in like Greece and be like in Montenegro, all this places that you're in Rome. And then you're like in Venice and I'm like, oh my God, this is so cool. And it was enough ofcourse it was just a few hours at a time, but it was, but it was so cool
Dr. Emeka Obidi: Atleast still got a taste of each area, right?
Dr. Diana Mercado-Marmarosh: Yeah. You got taste and then you didn't have to like pack and unpack pack and unpack. Right. You just like, get off, see it maybe come back. Yeah. And so then you'd know later on, if you decide where you wanna go to.
Where you wanna go to where you wanna go spend some more time in the future, so, yeah. Yeah. So, cool. Awesome. Okay. So the last question, so, you know, our listeners have ADHD or know somebody who have ADHD and probably they just zoomed out like somewhere. So if they're just paying attention now, cause they just came back.
What is the takeaway point that you would want them to take away if they didn't listen to the podcast, but they just gonna walk away with this piece of information.
Dr. Emeka Obidi: I think it's to realize that just like you had said, ADHD is not bad. It it's just different. And especially speaking to the parent who is struggling with that decision for their child.
To pause and really question and critically think about what's making them put up that resistance. And is there a significant opportunity cost to not get in their child help with the need right now, thinking about what possible advantage they might be in the future. Whereas a child is suffering now and hoping that they can let down their guard.
Get that information. Think about it critically and make the right decision for the child.
Dr. Diana Mercado-Marmarosh: Well, thank you so much, Dr. Emeka. You just kicked it out of the park today, and I am so sure that people are gonna come and find you in Maryland, because it sounds like that's an amazing practice that you have over there.
Dr. Emeka Obidi:  Oh, thank you very much, Dr. Mercado, it was real nice spending some time with you today.
 
Dr. Diana Mercado-Marmarosh: As someone who understands that time is our most valuable asset. I am so honored that you have shared your time with me. Please click the subscribe button and join my Facebook group: Beyond ADHD, A Physician's Perspective so that you never missed an opportunity to create time at will. Do share this podcast with your friends they too can can learn to live life and stay in their own lane
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About Dr. Emeka Obidi
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