Just nerd out and explain all this and how it comes

together.

Love, love, love.

So basically...

ADHD stands for Attention Deficit Hyperactivity Disorder.

And I hate the name.

I think it's stupid.

Like anything really specific that you know,

Like, what are some of the habits that you think people should really look at regarding the relationship with their phone, sleep, exercise, social connection? Like, what are some of the other things that people should kind of look into before classifying themselves with having ADHD?

Yeah.

So I think just like, I don't know, I think this is just good practice for all humans.

I really, really want to emphasize the importance of sleep.

And that's like one of those things that I know that when stress hits or when there's a lot of things happening.

That's one of the first things that fragments for me because I'm like, okay, I'll just do more and then I'll sleep later.

That's like my, they should be etched on my tombstone at this point.

Now back to the show.

Yeah.

And they, you know, the estrogen kind of impacts the dopamine breakdown.

Having high estrogen helps with dopamine synthesis.

When you get that drop, and then it's harder for you to do things that require executive function.

It's hard for you to plan, it's hard for you to organize, it's hard for you to have cognitive clarity, so a lot of people complain of brain fog.

Motivation is impaired.

Emotional regulation is so impaired.

Okay.

... how likely would it be for that professional to know about RSD and could help that person?

It's tricky because I think depending on who you see, um, it's really varied.

Again, it's not in the diagnostic criteria, so it's really...

And I, even as a psychiatrist, it took me a second to get to this spot where I was researching, but I think it's becoming more part of the, uh, just public knowledge.

People are talking about it more, and I think that is trickling into, like, more discussions with physicians, so people are becoming better educated.

I think if you were to look at the spectrum, if I were to, um, put primary care doctors on one end of the spectrum and then, like, people specializing in psychiatry, like a psychiatrist or a therapist or some other mental health professional, I think that side would probably be better educated because they're more-

It is.

That I wanted to give people these usable skills, that they can pick up the book, open up to a page, start using them literally right in that moment instead of waiting months or years for an evaluation to have this discussion and possibly, because it's not in the diagnostic criteria, get a serious response back on how to address it.

And why do you think it's connected? Like what part of the brain science or neuroscience makes sense here?

Yeah, I think that's a really interestingly phrased question because I think if you go back, it all stems from wiring.

So when you're looking at highly emotionally sensitive people and you see a lot of this wiring that's present in people with ADHD, there's a couple of areas that you really focus on.

And the first one is the amygdalae.

And the amygdala is this tiny almond-shaped structure deep in the brain, and that is your emotional threat detector.

So it's the thing that really signals, like, is this dangerous? Is this not? For people who are highly emotionally sensitive, this area of the brain is hyper-responsive, hyper-active.

The second part of the brain that you have to talk about is the prefrontal cortex directly under your forehead.

The first part is about awareness.

Mm-hmm

...

I've, you know, when you are dealing with something like a, a narrative that you've been telling yourself for years, you're not likely to fix that because you're like, "There's nothing I can do.

That's just me.

I'm born like this, and this is how I'm gonna be." I think once you understand, like, no, I, you know, this is neurological.

This is something that happens to many, many, many, many people, and it's something that because the brain is so amazing and neuroplastic, you can do things once you recognize that this is happening.

You can do things to calm down your amygdala.

[laughs]

What are the benefits? Are there benefits of having a brain that's super sensitive to the world around us?

I think so.

I, and I tell people that I really want to keep a good view of this because the reason I wrote too sensitive is the goal was not to push on people that they should be less sensitive.

The goal is to be more in control.

And so I feel like some of the benefits of being like, I wouldn't trade being emotionally sensitive.

I know I got it from my dad.

I know that it makes me a better parent and a better partner and, And a better physician.

Could you help finish maybe with a couple of tools from the Calm Your Minds Toolkit?

They just have ADHD.

I think when you explain this interest-based nervous system, like your body is with ADHD, you respond to something that is interesting, something that is new, or something that is urgent.

So if you're telling me this homework is due in like... two weeks.

Like this book project is due in two weeks.

Like, no, I don't care about that.

I'm not going to start that.

No.

What did you

they just have ADHD?

I think when you explain this interest-based nervous system, like your body is, with ADHD, you respond to something that is interesting, something that is new, s- or something that is urgent.

So if you're telling me this homework is due in like two weeks, like this book project is due in two weeks, it, like no, I don't care about that.

I'm not gonna start that.

No.

If you tell me this is due by 8:00 AM tomorrow, I'll work on it all night.

I'll d- I'll, I'll get it done.

How does ADHD affect relationships?

Yeah.

Like, I've gone through so many different iterations of it, and I've distilled it down to what I really truly want to say without a lot of unnecessary barbs [laughs] or, or, like, just a lot of things that don't actually pertain to the situation at hand.

So I think it's a much clearer communication style.

That's one.

The other thing, uh, that I think a lot of people with ADHD, because there is that lack of self-trust in, you know, in, in your ability to emotionally regulate and, and just your ability to kind of function, I think a lot of people take the backseat in communication.

And so a lot of communication happens to them, and it, it's difficult, either in real time or to muster the courage to figure out and say the right response, so a lot of people stay silent.

And I think I've done that for a great majority of my life.

Hmm

Download the Quince app for app-exclusive offers or go to quince.com slash NBID.

Hi, I'm Dr. Sasha Hamdani.

I'm a board-certified psychiatrist specializing in ADHD and someone who spent my career and much of my own life trying to understand why some people experience emotions so much more intensely than others.

For those of us that feel things too quickly, too deeply, and for too long, understanding the neuroscience behind emotional sensitivity can completely change the way we see ourselves.

Today, I'd like to share five key insights from the book.

Insight number one, you're not broken.

Your nervous system is speaking.

In

Okay.

And a lot, a lot of times you're going through life, and, like, when it first kind of peaks up, and it might be like you had this all along, but, you know, you were smart.

You got through school, and it wasn't a big deal.

Like, you're getting passed along elementary school, and then junior high happens, and everyone's like, "It's your hormones.

You're just a little bitchy around that time," or you're, you know- Or focus becomes harder and it's just like you need to apply yourself.

You're l- you don't have good work ethic.

You're too focused on being a social butterfly.

[laughs]

Mm-hmm

...

I was working on is because I was trying to figure out, like, what are skills that I can use for those moments where, and I see it in my son, where he's emotionally dysregulated and things feel very big and very scary.

And then of course you're not gonna be able to focus.

Of course you're not gonna be able to kind of get through what you're doing because it's hard.

You're right in the middle of this emotional flood that's happening in real time.

So I think if you can learn how to manage that, if you can learn how to, like, distance yourself from the moment, if you can learn how to- You know, walk through, like, thought process, like, challenging negative thoughts and, like, emotional kind of things.

Hmm.

Give me an example.

Okay.

I'll give you an example that happened two days ago.

I've been doing a lot of podcasts, and I got an email, 'cause I was supposed to travel and do this podcast, that they canceled, and it was two days before the podcast.

And I immediately took that upon myself as...

Like, I read the email, was so overwhelmed by this thought of I wasn't a big enough deal.

They didn't feel like they should keep me.

I know you said at the beginning that this is all wiring, but are there, like, identifiable differences in the brain between someone who you would consider too sensitive and someone who's not?

Why does social rejection hurt so much?

Hmm.

How much time do you have? [laughs] It's one of those things that, you know, it, you look at, um...

There are many different reasons that this is so painful.

Neurobiologically, there is inherently a dopamine imbalance.

So what's happening is that your brain already is- You know, struggling to emotionally regulate.

So something happens and instead of being like, "Okay, we can work with this," it's just that you're shot down and you're right now...

What are the strengths of highly sensitive people? What are the strengths of people with rejection sensitive dysphoria?

Porque si los síntomas se ven iguales, ¿cómo sabes el diagnóstico?

Okey, sí, comprendo tu pregunta.

Si se observan estos síntomas de atención fragmentada de manera generalizada, el médico realiza una evaluación exhaustiva.

Se examinan los antecedentes médicos y psiquiátricos, así como el entorno psicológico del paciente y el panorama general de su vida y lo que está sucediendo.

Llegan a un punto donde intentan averiguar si esto es TDAH o no, comenzando a analizar retrospectivamente los patrones.

¿Es este un patrón consistente? Desde el nacimiento esto estaba ocurriendo, con altibajos, y ha sido un patrón consistente.

¿Está realmente localizado alrededor de cosas traumáticas? ¿Esto es una respuesta al trauma? ¿Es esto algo que sucede cuando metabólicamente algo es diferente? Así que estás mirando el contexto y estás viendo cuándo estas cosas alcanzan su pico y su valle.

Sí.

Because if the symptoms look the same, how do you know the diagnosis?

Okay.

Yes.

So if, you know, you're seeing these symptoms of fragmented attention kind of throughout, and the doctor does a full assessment, they've looked at medical stuff, they've looked at psychiatric stuff, they've looked at...

the just psychological kind of environment that they're in and the state of affairs in terms of their life and what's happening.

And they get to a spot where they're trying to figure out, like, is this ADHD or is this not? Then you start looking back at patterns.

Is this a consistent pattern? From birth, this was going on with ups and downs, and this had been a consistent pattern.

Wow.

You do bring out that there are... upsides like this isn't just a negative thing it's not like sensitivity is so bad no like the creativity the intuition that comes with it the empathy let's talk about all the gifts that come with it

I think that being a highly emotionally sensitive person, I mean, from an evolutionary perspective, I mean, if you think about it right from the beginning, being emotionally sensitive, you would perceive things much sooner than the rest of the tribe where you could pick up where there was danger.

You could repair bonds within a tribe.

You could figure out even without... talking or seeing what was going on just from like energy shifts in the thing.

You're like, okay, there is a rift that's forming.

Let's try to figure out where we go from here.

So I think that there is, you know, we're just running on kind of ancient software.

But what are some small steps that people can start taking right away to learn to embrace this and learn how to harness this as a superpower and look at it as a strength?

And we don't talk about this enough, but what are some of the positive aspects of having ADHD?

Well, the one that I've been talking about and I feel so strongly about is the hyperfocus is one of them.

Because of that dysregulation of focus, where a lot of people have this kind of sequential, almost like battery for focus, people with ADHD, I think they have an interest-based nervous system.

So they're driven by interest and urgency and novelty.

If something is clicking in that.

You can just run with something and get done with a tremendous amount of work and do it really well, really well.

And so that's why like being in this weird world of social media, it's like I've been around people and All of them have ADHD because it's like, this is, you know, like slightly more on the impulsive side.

When someone's going through an emotional spiral, what's the quickest way from either stopping that spiral or to climb out of it quickly?

So I just wanna start with asking, like, why did you feel like this was the right time to write Too Sensitive?

Um, I think a couple of reasons.

One was more personal, and one was more, like, just, you know, looking at where we are in the world.

The personal side of things is, um, my dad passed a couple of years ago, so I was, like, right in the thick of really difficult emotional processing.

And, like, grief, I, I know objectively is really difficult for everybody, but for me, you know, w- who had been managing my ADHD to some degree, I felt like when I was...

Th- it was the first time I realized that when I was faced with something so emotionally heavy, and this has been a, a trend historically in the past, but this is the first time I actually realized my functional status goes down.

So it, you know, like, [lip smack] if I'm overwhelmed by stuff or if I have lots of stuff on my to-do list, most of the time I can delegate, I can figure out a way to hack around it.

Mm

Mm-hmm

... and this, it takes away a lot of the shame and the guilt, and it helps you kind of recognize and key into that moment, like, this is what's happening.

It's time-limited.

I just need to use the right tools.

'Cause we've been going through life, no one's given you the right tools of how to occupy that space and get out of that moment.

So for people who are highly emotionally sensitive, they're feeling things deeply, and quickly, and intensely, and for a very, very long time, and expected to just like, okay, shut it off, 'cause that's not convenient for everybody else.

But really, we have to use these specialized tools.

Mm-hmm.

Um, so I'm really v- very interested to learn, I- I understand it starts with a breathing exercise?

Yeah.

I mean, all of these tools in the toolkit, it's stuff you've heard about, because they are well-studied, well-documented.

These are the things that can actually help you in the moment and over time.

So one of the things that I love the most about breathing is, and you've heard it before, right? So you've, you're in the middle of a spiral, and someone's like, "Take a deep breath," and you're like, "I forgot how to breathe."

Mm

... which is where you take a deep inhale through your nose, right when you're at the top of that breath, you take another sharp little inhale through your nose, and then a long exhale through your mouth.

And what you're actually doing is you're getting that deep belly breathing, you're calm.

What are some other means of, of treatment?

I mean, uh, so the way that we treat ADHD is twofold.

You can do behavioral management or you could do medication management.

Behavioral management, you're working with, you know, trying to better handle executive function tasks and things like that.

So the, the set of skills to make your brain go from point A to point B, [laughs] that's executive function.

That's what you need.

So looking at your patterns, filling in the holes, doing things like that.

Yeah.

How can a partner or friend offer reassurance without becoming responsible for constantly regulating the sensitive person's emotions?

I love that question.

And it's something that took me a long time to figure out how to do within my relationships because like my pattern in my 20s was like, I don't know if I should be admitting to this because this makes me sound awful, but I would go about in a relationship and then I would hit like a snag in the road.

And then either I would cut and run because it was boring.

I wasn't getting that dopamine rush anymore.

Or I would cut and run because I was like, oh, they're going to break up with me.

So I'm going to leave before that happens.

The sneakiest.

Yeah.

Yeah.

I think a lot of times, like, if you go back and you actually think about the neuroanatomy of what's at play, there are two big, big things that we talk about.

Number one is the amygdala, and that is that emotional threat detector in the body, in the brain.

And the second part is your frontal lobe, that pr- prefrontal cortex directly under your forehead, smartest part of the brain.

Judgment, decision-making, processing, that's all that frontal lobe functioning.

When you're dealing with someone who's highly emotionally sensitive, that amygdala, hyper-responsive.

Do you think just modern society life is causing a lot of anxiety, depression, and ADHD versus, I don't know, living on a farm and working hard with your family unit back in the day or something like that? Like, is it just modern society is causing so much overwhelm of the brain and the emotions to be able to navigate all the, all that's happening?