E82 - Getting Diagnosed with Adult ADHD (with Kat Brown)

Kat Brown is an author & journalist whose work on mental health stigma and other social and entertainment commentary has appeared in The Telegraph, The Times and The Guardian. Her first book, No One Talks About This Stuff, is an anthology sharing people’s untold experiences of infertility and baby loss. Her second book, It's Not A Bloody Trend: Understanding Life as an ADHD Adult, was published a month before her first, which is a ridiculousness she really enjoys.

Interviewed by Dr Alex Curmi. If you would like to enquire about an online psychotherapy appointment with Dr. Alex, you can email - alexcurmitherapy@gmail.com.

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Transcript

 Welcome back to the Thinking Mind podcast. My name is Alex. I'm a consultant psychiatrist. Today I'm in conversation with Kat Brown. Kat Brown is a freelance journalist, commentator, and social media editor. She's the author of the book It's Not a Bloody Trend Understanding Life as an ADHD adult. In the book, she describes her own experiences with ADHD, the experiences of many others, and she also interviews many scientists and academics about ADHD. So today we have another discussion about ADHD, including the biggest misconceptions people have. Kat's path to getting diagnosed, the way Kat managed her condition with medication and also without medication and much more. This is the Thinking Mind Podcast, a podcast all about psychiatry, psychology, psychotherapy and related topics. If you like it, there are a few ways you can support it. You can share it to the friend. Give us a rating. Follow us on Apple, Spotify, or wherever you listen. And lastly, I also wanted to mention I'm now available for psychotherapy sessions both online and in person in the South London area, so if that's something you're interested in, you can email me at Alex Kurumi Therapy at gmail.com. And you can also find that email address in the description. Thanks for listening. 11s Katz Brown, thanks so much for joining me. Oh, thank you so much. What a lovely start to the week. What are some of the biggest misconceptions people have about ADHD? 2s To be honest, at the moment, I think the biggest misconception is that anything that we read in a newspaper about ADHD is correct. Um, obviously that's not to say that they aren't. I mean, for example, I have written several newspaper features about ADHD and uh, at the time of speaking was speaking just at the beginning of April. There was a cracking one in the Guardian the other day about ADHD, which is the overlap between autism and ADHD, which was only sort of really added to the DSM in about 2013. And by that, I mean, before then, people were just like, oh, you can only have one or the other, you can't have both. And it's now very much accepted that you can. 1s I think this is a misconception because we grow up in the UK, where I'm speaking to you now with particular social structures that are, for example, certain newspapers are very trustworthy. Uh, for example, the Times of London is known as the paper of record because it's for a lot, you know, for hundreds of years being the only newspaper that's admissible in a court of law as evidence. Um, unfortunately, over the last. Both decades. Really, we've seen that that isn't the case. And obviously, The Sun newspaper's relationship with the entire city of Liverpool suffered dramatically, to put it incredibly mildly, as a result of their coverage of the Hillsborough disaster. But we're now seeing particularly in in what we might term the right wing press, although it's important in this country to remember that what we consider right wing is positively leftie and compared to what we might experience in the USA. But we are seeing a lot of coverage of how we view waiting lists, for example, uh, in such a way as to suggest that all the people that have been referred by their GP for this waiting list and have therefore passed one, if not two. You know, unofficial tests to get on. There are basically just wasting people's time and don't really deserve to be on there. And it's all a lot of nonsense. And what is ADHD anyway? And all of these really awful, you know, fairly out of the dark ages thoughts about it, which don't really go into any of the actual facts and really, you know, really boring, just objective truths about ADHD. And to be honest, I'd say that that for the moment is arguably the most damaging misconception about ADHD, not just in terms of people of how society might think about this condition, but also in terms of how they might view friends, family, colleagues who are going through it and who therefore might themselves not feel comfortable in discussing it with them. And then, of course, for the people who are putting two and two together and going, oh, okay, this very much relates to me. It's damaging to them because then they may not feel comfortable in seeking the support that they need because yes, we might have got to, in my case, 37, in other cases, 5767 honestly, some people in their 80s, we've got through that without the support that we need. And so as a result, we've put other support structures in place, some of which are categorically neither helpful or healthy. 1s Absolutely. I think I think that misconception that. People. There isn't anything real going on. And, and that's people are just either making things up or making excuses for themselves and, and seeking some sort of medical legitimacy for problems. They should be able to get over themselves. It's obviously very damaging to people who have very real problems. Let's I mean, let's start with the basics. What is ADHD anyway? 2s ADHD is currently known as ADHD, which stands for Attention deficit Hyperactivity Disorder. Uh, in Germany, for example, it's known as Aids, which is syndrome rather than disorder. And that probably reflects it a bit more. ADHD is a colossal constellation of symptoms that interacts with each person's experience their upbringing, class, race, gender, different things that have happened through their life. And it can. Leads, if not supported in certain ways, to real issues, with concentration, with focus, with stimulation, with interest levels. Um, calling it a deficit of attention is, again, kind of ridiculous because it's more like a surfeit of attention and just not being able to necessarily direct it in the right way. Um, I'll give you a couple of examples from me and use myself as a guinea pig. Uh, so when I was a kid, I could laser focus on a book, and I read incredibly quickly. My parents joked that I basically taught myself to read when I was about four. Um, and so, you know, reading is deemed as a positive thing. It's a middle class thing. It's self-improving and all that sort of stuff. But because I was so easily bored, I wouldn't just read books, I would read literally anything I had to read at breakfast. I would read the backs of packets of cereal. I would read recipe books, because if I didn't, then my brain would just start pinging off everything around me. And I just got completely overwhelmed and it was barely even 730 in the morning. Um, another example from adulthood, and very recently, is that I, as a freelancer, really need to sort out my pension. Uh, I myself am self-employed. Nobody's giving me a pension. I need to sort that out. But in order to set up that pension, I first of all need to bring together all of my previous pensions from previous staff jobs that I've had. And believe me when I tell you that I've been putting that job off since last August because I got married, I changed my name not for work, but personally. And that blows pension companies minds. And so I need to send off my marriage certificate. But that is both too overwhelming because rather than thinking, okay, I need to send off my marriage certificate, I'm instead thinking 900 different things. I need to send off my marriage certificate to five different companies. What if they lose my marriage certificate? Do I have to send it? Uh. Special delivery. How how how how. And I'm thinking all of these things at the same time. And that is where problems can really set in with people. And where those negative coping strategies that I mentioned very briefly in our introduction can also come in. Yeah. And I I've, I'm in the middle of reading your book, which I'm really enjoying your book for a few reasons. It's a nice you've got a nice tripod set up in your book, but on the one hand, your personal experiences. On the other hand, you've interviewed a lot of academics and scientists, doctors who are working on this problem. But also you've gotten so many accounts from other people who have it. And what you've highlighted really nicely with that tripod is that. Obviously there's a there are commonalities between different people who have ADHD. There's often a common arc you can see across life. At the same time, people's presentation can be incredibly unique and variable and individual to them. Why do you think that is? Why? Why are different patient's presentations so unique? 2s It's like I had a hip replacement a couple of years ago and it got infected, and then I was on antibiotics for three months. You know, people have hip replacements all the time. This sort of thing doesn't happen. But it happened to me. And I am one person who's had a hip replacement. And similarly with ADHD, that is, you know, a syndrome of symptoms, but it will manifest in people depending on who they are and what their lives are. I think it's also really important to remember that we're we're talking about something that's taking place in the brain and brain. Science is it's the absolute baby of all sciences like psychology, psychiatry. These are these are things that however, what of a brilliant work, you know, the ancient Greeks and so on did. It's something that has only really been studied in a serious manner, if you like, for the best part of the last 200 years, which is absolutely crackers to think that we could know every single detail about how our brains work since then, and that that similarly goes for ADHD. I think the the thing that is really interesting to note, and this is again, why I, I really struggle when, you know, bad faith people or sometimes relatives will just go, oh, you know, this never really used to exist. It wasn't around in our day. People are making such a fuss. It's just like, stop being so lazy and use Google for one second and you can go back and see incredibly similar traits being detailed in not just medical literature, in common literature for for hundreds of years in in paintings, for example, in depictions of schoolrooms. And it's just so fascinating to see going back the same. Instances of, uh, don't forget, it's not real kids syndrome, disorder, neurological condition, as we should probably call it. But just because we we didn't have the tools to know what it was. Um, so we called it things like, you know, hyperactive condition of childhood and, and or just, you know, awful sort of malady type things. And it's just fascinating if you actually just sort of go back, you know, decades, 100 years, 200 years, then you can just see all the different ways that ADHD sort of spells it out, spells itself out in people's behaviors and in treatments, actually. I mean, we've been using stimulant medication to successfully treat what we now know as ADHD in kids since the since the 50s. Yes. And I think. One other factors that modernity brings out the problems associated with ADHD. Much more because as things move on, things like long term planning, delaying gratification, the ability to deal with your impulses, the ability to focus for long periods of time, all of those become more important as things move on, like tasks become moved from being more hands on to being much more abstract. And all of those things are things that people with ADHD tend to have difficulty with. So it might have been much less obvious 100 years ago. If someone had ADHD type difficulties, it might have been much less obvious because their environment was wasn't bringing out those difficulties quite as much. Well, and also people didn't care. If we think about a lot of people even 200 years ago. It's not as if they were working under the greatest of circumstances. People only really cared about people with power, people with privilege. And let's be real, people with money. Nobody cared if somebody in a workhouse had ADHD. I mean, let's be fair. Even if they knew about it, nobody cared about them at all. And I think it's also interesting to note that even the concept of childhood only really came into existence. Sort of. 300 years ago ish. Before then, it was just all children were treated like tiny adults, whether that was working alongside their families or in the ways that they were trussed up and treated and that sort of thing. Children as a concept didn't really exist even back then. So, yeah, fascinating to note. Yeah. So there's a sense of progress where we deal with. Bigger problems, and now we're dealing with, I wouldn't say smaller problems, but we're dealing with problems that now we're in a position to actually address because, you know, in the past 100 years or so, we've dealt with like huge socio economic problems, arguably bigger health problems, like problems with nutrition, problems with diseases of an infectious nature. And now we're in a position where we can start to deal with these slightly more abstract issues with our mental health, which is something we're seeing, which is, you know, really, really promising. And I'm actually I tend to be quite optimistic about, you know, the direction that that things are heading. But I work with ADHD patients right now and, and something I've noticed and something that you highlight in your book, which I think is really important to discuss, is it's hard to get a diagnosis. It's hard to access a diagnosis and treatment. What what was your path to getting a diagnosis like? I'd been a reasonably frequent flyer with the National Health Service throughout my life. Um, I had a bike accident when I was ten, and then shortly afterwards, I was diagnosed with what was then known as potential epilepsy and what we'd now know as absence seizures. Um, and when I was 18, uh, and I just, I was in my first year of university, I went to my doctor because I was suicidal and I wasn't diagnosed with anything, but I was referred to a counselor, and. You know, given antidepressants and that sort of thing. Um, I'd had insomnia throughout my tweens and teens and was briefly given some sleeping tablets when I was in my last year of university. I was treated again, not diagnosed, but just sort of treated for anxiety. I had therapy a few times over the years, sometimes through work insurance, sometimes privately. Um, and I was treated for binge eating disorder, which I didn't even know existed when I was diagnosed with it. I'd just gone to the GP going, oh, hello, I'm a bit depressed again. Uh, can we look into this and just all of these sort of different little visits that just sort of through my life made me feel greedy because I felt like I had this shopping list of things wrong with me, but they were all in my head. And, you know, society is not kind to people whose problems are all in their head. Because don't you just want a bit of attention? Aren't you just oversensitive? It's like, well, actually, no, it could be psychosis. Um, but again, anyway, that's another rant for another time. When I finally twigged that this could be ADHD, I'd gone through a reasonably dreadful few years. My husband denied experience, failed IVF. Um, we'd been to another clinician who had said that actually they didn't recommend we continue with IVF at all, and so therefore we wouldn't have children. And this is when the people who've never been through any of this pick up and go, why don't you just adopt? And it's like, well, why didn't you? So I was just feeling like my brain was not in the right space to to go through the adoption process, which I did look into quite seriously, let alone do that for children who really, really needed that. Um, and. Uh. 1s I saw somebody who I really like on Twitter and always retweets fun stuff. Retweet this question from an ADHD coach saying if you were diagnosed with ADHD in adulthood, how did you realize? And I'm always really curious, nosy as the way all journalists are about people and what makes them tick. So I clicked into this thread and I mean it was he's she's and theys of all ages of all backgrounds basically going cat brown, this is your life. And everything from the from that shopping list of mental health issues from, you know, children with epilepsy, which turns out to be, unbeknownst to me, a really massive comorbidity, uh, in ADHD, um, like really bad problems with finances. Like just basic trouble managing a budget. I mean, thank God for apps is all I can say. Um, the technology helps all of us on a daily basis, not just people with ADHD, but it's made managing tasks and everything more manageable. And so I saw this thread and I didn't as again, some naysayers would have it go, oh well, I've obviously got it. I'm going to go straight to my GP and demand it. I just read everything that I could flipping find about this, because it was fascinating and was reading up on how, you know, quite a lot of women particularly are being diagnosed in middle to later life, partly because they're often the carers taking their children to go and have ADHD assessments. And spoiler if you know you're listening to your children having a questionnaire, some of those might relate to you. Um, it's not necessarily the case that ADHD is genetic, in the same way that red hair is genetic, but there is an up to 80% heritability chance of that through various other sort of different factors around mental health. Um, so again, happening for lots of women and again, if we go back 50 years or so, uh, I mean, women just were not. In public life, in social life, in the way that we are now. Because, yes, quite a lot of women worked and a lot of women had to work, but similarly a lot of women were homemakers, partly because this was an economic climate that, for all of its problems then meant that a single salary could maintain a home and a family. And you didn't have to have, you know, both parents going out to work, although a lot of people did. But I mean, similarly, like social attitudes to to people who weren't white, frankly, were so appalling that. 1s Nobody again would. Would apply any sort of questions around health or mental health in the same way that they might do to a white person and some white people at that. And in America, it could be, even if you weren't the correct type of white. So if you were Italian, Irish or Polish, yes, exactly. This. I mean, we we say that. Well, not we say now, I think fingers crossed we are waking up to the fact, if we haven't already woken up to the fact that the UK still has an absolutely clanging problem with race along. Excuse me, along with so many other differences, but it's always been said that, you know, the USA has a race problem, the UK has a class problem, and these infinitesimal different layers of difference and the fact that, you know, unless you are white, upper middle class, earn a certain amount of money, do a certain type of career, speak a certain way, know the right way to behave, doing bunny is there. It's. 1s Absolutely. Yeah. Absolutely. Bananas. So again, there would be all these sort of certain ways that people might be paid attention to or might not. Yeah. So I basically read everything and then put all these different things together and look back at my life and was just like, well, this I would quite like to speak somebody about this, because it does sort of feel like this could be an answer, because I'd however many times that I'd been treated for something, I never felt like I had an answer. I never felt like I understood how I worked internally. Like this comparison that I often use is, is that a feeling like an avatar and a meat suit, like other people just seem to know how to navigate life? And that was just something that I didn't feel at all so impulsively because we were now in lockdown. Um, I went to, I went to, I'd been to my GP. Oh, sorry. So we'd just come out of lockdown one and I'd been for an in-person appointment with my GP, who had put me on a waiting list for an assessment and said it would be about a year. And I'd been through like a year's waiting list for eating disorder treatment for IVF. And to be frank, apart from the IVF having failed, neither of those experiences were particularly positive. However, grateful I was to have experienced the treatments such as it was. Um. 1s I just I just couldn't do that weight again because I was like, I know what the answer is now, and I want the rest of my life to start. And if I'd known then what I do now, particularly about treatment being a case of like a golden triangle, if you like. So not just medication, but behavioral coaching. Like getting those strategies in and therapy for accepting not just who you are now, but what your life has been so far. Plus all the lifestyle factors I might have, you know, cooled my heels a bit and just been quite happy to stay on that waiting list. But instead, I basically took the money from my banking app that I'd saved up to pay my tax return the next year, and I went private. And actually, if I hadn't gone private, I would have waited three years because I was accidentally left on that waiting list, and I received a call saying that the time had finally come for me to have my NHS assessment. As I was writing this book, which was three years after I'd been put on that waiting list initially, and that level of waiting, that level of uncertainty, which I'd already experienced, um, in 2022 when I was waiting to have my hip replacement and the constant shifting of times and all of that, which is, you know, fine, you appreciate it, you suck it up because you know, you're grateful for it to be happening already. But that would have been really, really flipping hard. How therapeutic was it for you just to get the diagnosis, do you think? 2s Massive. When people dismiss labels, I think what they're dismissing is labels like that, or labels, which are basically just words but delivered in a really negative way. Because nobody goes into the big Tesco and goes, oh, it's so awful. All of these items have got labels on them, why can't they just be free? Why can't they? Why can't they just be who they are and live their life? You try doing your flipping big shop without knowing what you're actually getting. For me, knowing that I had ADHD just instantly meant that I could be kinder on myself because I had spent my entire flipping life working my ass off just to try and get to the starting point of where I felt everybody else was like, why did I find certain things so hard? Why was why was I so crap with money? Why could I never save for anything? Why why why why why? And so just having this answer, particularly delivered in a really empathetic, kind way by the diagnosing psychiatrist, was just absolutely incredible. It wasn't like, you know what? Nothing that you've ever done was your fault. It's it's not that at all. I'm aware of plenty of stuff that I've done in my life that is very much my fault. And I fully fess up to all of those things and I, you know, take that responsibility. But it was an explanation, not an excuse. And it was I just I felt blissfully happy for approximately three days. Yeah. And the reason I asked you that question is because having read your account in your book, it's so similar to so many patients accounts that I meet every day, that many people have this sense that there's always been something wrong. They have a set of difficulties which makes them feel like they're uniquely flawed. And obviously, because these difficulties actually do interrupt their ability to achieve and progress through life, it really interrupts their self-image and makes them very, very self-critical and often just getting the diagnosis and learning a little bit more about ADHD by itself has a lot of therapeutic value, as you mentioned. I'd like to comment a little bit on diagnosis because you mentioned it. And, you know, I'm both a psychiatrist and I'm a psychotherapist. What that means is I deal a little bit with the tension of diagnosis, the pros and cons, and there's a lot of debate. A lot of mental health professionals tend to take one stance, either for diagnosis or against. And I think, like yourself, I tend to feel that diagnosis can be an incredibly useful to, but if used in the correct way. 2s The way diagnosis can be used well is as a as an explanation, a snapshot description of a person's difficulties as they stand now. That can be helpful because it helps people feel a lot less alone. Uh, as I said before. A skillfully given diagnosis can. Make people feel a lot less uniquely flawed. And I think that just removes a lot of pathos from from a person's life now, where it can be delivered badly is just like you said, if it's delivered in a way that's like stigmatizing. So one really stigmatizing diagnosis, which I still think can be a really useful diagnosis, is something like emotionally unstable personality disorder, or also known as borderline personality disorder, which describes a set of difficulties which is very common and which mental health professionals encounter every day. Now there's a way to deliver that diagnosis that is actually therapeutic, which is going through the different problems the diagnosis describes. Allowing the patient to see, you know, to confirm or deny whether they have those difficulties and to give some context to that. And, you know, I've certainly had the experience when I was in my training, in particular, of delivering that diagnosis in a way that was really helpful. But the opposite can also happen often. Patients with borderline personality disorder think that they might have bipolar through no fault of their own, because mental health difficulties are complicated. They might go and seek a diagnosis of bipolar. But the psychiatrist may say, you know, no, you don't have bipolar. But yes, you do have borderline personality disorder. In a way that's very dismissive. That leaves the patient still feeling like they're uniquely flawed and and also would not adequately underscoring that. Actually, even though borderline personality is a psychological condition, there's loads of things you can do. You know, there are specific therapies that have been designed to treat, you know, the set of problems. So yeah, that was a round of my own. But just I think this issue of diagnosis is very important. I mean, there's two different things in here, one of which is the importance of diagnosis in ADHD. Full stop, which I will come on to in a moment. The other is bedside manner. 1s I mean, after our IVF cycles failed, my husband and I went back into our clinic where we were met by a man neither of us had met and had met before, who hadn't treated us throughout anything. And he was the most awful stereotype of a medic who should never be allowed near patients, let alone near ones grieving. Now, my husband and I had taken in boxes of Cadbury's miniature heroes for the staff to say thank you for treating us, and that asshat did not get a single chocolate. He was absolutely appalling. So I mean, that's one thing. And I would say on on the can you can. Brilliant. Can you give some examples of because this is a lot of clinicians listening to this. So it'll be useful. Like what what what did he get colossally wrong do you think. 2s I mean, this is something that happens in in medicine throughout Jody Day, who wrote a brilliant book about which really helped me about facing up to not having children. Um, writes very, very well about these sort of similar things as well. It's it's the it's the dismissive nature of it all. It's, you know, it's forgetting that. Yeah. Well, this is absolutely happening on a, on a macro level. Yeah. In the wider field of things, this doesn't matter at all to the people sitting in front of you. This is really important. This is the most important thing. And how dare you not treat it with the civility, with the humility that this deserves? Because we are constantly hearing and reading and seeing evidence of malpractice, particularly in in maternal health care and in maternal medicine. And all of that is coming from people that thinking that they know best. And sometimes I'm sorry, but the patient knows best. Not in the literal sense, but in terms of the importance. Of what? This diagnosis or this, you know, this nonfunctioning thing, this, in my case, unexplained infertility and how important that is. And I'm sorry, but how dare somebody delivering that news? Not really. Take the time, take the effort to learn how to do that properly. That is utterly revolting. If you can't deal with people, go and work in a lab. So that's that. I would say that if we want evidence of a diagnosis treated well, that people can quite literally go and read from. There is a fantastic novel by Meg Mason called Sorrow and Bliss, which also randomly includes infertility, but is far more about somebody with the most chaotic life and chaotic family. It's very, very, very funny. But it towards the end she gets a diagnosis and we're not told what it is because it's theoretically not supposed to be important. But reading between the lines, it could be BPD, it could be schizophrenia, probably airing towards BPD, which instantly a lot of women with ADHD are misdiagnosed with. Which again, is why it's so important that anybody doing an ADHD assessment. Knows a hell of a lot about other conditions as well, and works with those because there are so many overlapping criteria trauma's another one, all of that sort of stuff. So yeah, big recommend to Sorrow and Bliss by Meg Mason. Read it, learn a little bit more about humanity. But in terms of why people are really pushing for a diagnosis, for an assessment, for ADHD, it's because treatment with medication remains the most important and successful way of navigating ADHD symptoms in a way that isn't, you know, just simply by growing up a bit. Like earlier, we spoke about how, you know, people might grow out of certain symptoms and that sort of thing. And certainly like 85% of adults diagnosed with ADHD will be diagnosed with combined type. Very, very few will be diagnosed with hyperactive impulsive type, the type that is very common in children simply because, you know, even if, you know, we live in a nunnery or something, we are still learning about how to deal with people. We are still learning social skills, even though, you know, they might be quite difficult for us to carry out and might require some level of masking or, you know, those negative coping strategies. But, um, like this, for example, from the World Federation of ADHD International Consensus statement from 2021, treatment with ADHD medications reduces accidental injuries, traumatic brain injury, substance abuse, cigarette smoking, educational underachievement, bone fractures, sexually transmitted infections, depression, suicide, criminal activity, and teenage pregnancy. I mean, these are fairly colossal reasons for at least trying medication. And Doctor Edward Halliwell, who's a brilliant ADHD writer who's written some some, to be honest, some of the most important, um, books on ADHD, both for clinicians and for the lay reader. He'd co-written them with John Ratty. Um, he made the wonderful point that, I mean, if you want to see whether ADHD medications are safe, you just have to look up lawsuits about them and see how many of any are successful because of anybody can smell malpractice. It is a lawyer, particularly in the US, and I just absolutely loved that because yes, some people will have concerns again, usually stemming from social stigma, usually stemming from a misunderstanding about what a stimulant medication is. Uh, spoiler it's not necessarily something that you're going to take in a nightclub, but it is going to stimulate areas of your brain that are under functioning. And yes, there are other medications that have no stimulant in them whatsoever. But again, it's just all about looking at why people want a diagnosis, whereas they may not pursue one for others. I mean, when I had my ADHD assessment, I was given like a very cursory, uh, autism screener again, and I got six out of ten for for ASD, if you like. And sometimes, as my psychiatrist said, treating ADHD can reduce those sort of autistic tendencies, if you like, because again, traits are shared. 1s Throughout humanity. What a shock. But also sometimes being treated with ADHD medication can, you know, sort out the ADHD symptoms and then really show what what else is there if you like. But I don't really feel the need to pursue an assessment for ASD, partly because I don't feel that anything else is having a negative impact on my life, but also because, you know, frankly, what's that going to do if I need support from work or from the government, I can apply to access to work, oh, God, as I have done before. And that's a ball ache and a half, I can tell you, but you don't need a diagnosis for that. So, you know, what's that going to do? That actually is one area where I'm more than happy to leave that place to somebody else, in the same way that when I came to the top of the list for my ADHD assessment, yes, I could have gone through and had an NHS diagnosis and and then, you know, I wouldn't have to continue paying for my, you know, regular checkups and that sort of thing. But at the same time, somebody else really needed that assessment and I didn't I didn't need to go through that again just so that I could. Feel, I don't know, accepted by the NHS in some kind of way or accepted morally by a wider branch of society. Yeah, that makes sense. Um, let's let's go back to medications a bit. It's worth pointing out to listeners that actually within psychiatry, ADHD medications are some of the most successful, the most effective with, as you say, some the least downsides. Um, according to the studies, I'm aware of something like 60 to 70% of patients with a diagnosis of ADHD who receive medication reports significant improvements with their particularly with the inattention of symptoms, which is huge for any medical treatment. A 60 to 70% success rate is is really significant compared to, for example, antidepressants for depression where some it's more like 30%. Uh, and it's still controversial. It's still controversial. And we're still doling them out for when we should be giving women HRT, for example. It's like people are so happy to dole out antidepressants like Smarties. And honestly, if anybody has tried to come off and depressants without the help of a pill cutter and quite a lot of internet assistance, that is absolutely no joke. Whereas, you know, ADHD meds, if we're talking about stimulants, they're in and out of your system in a day. Yeah, and I think depression is complicated because depression, I feel, is often the canary in the coal mine for other issues. And so many of the patients it's for ADHD who end up being diagnosed with ADHD report a history of anxiety and depression. I think it's a very common. I think anxiety often is a natural consequence of the constant sort of overstimulation, the difficulty people with ADHD have filtering out automatically unconscious sensory information. And so there's a sense of sensory overwhelm and obviously a hyperactive mind and body, which you can see how how that could make you anxious. And my intuition is that low mood is a natural consequence of facing lots of barriers in life and constantly striving and sort of difficulties, and depression is often the response to burnout as a part of fatigue. So, so many of the people ISIS have depression and and anxiety in the background. Often they that's usually diagnosed as the primary problem first and then eventually through further investigation, it's found that perhaps it's more likely to be ADHD. And then they see someone like myself. What's. What's your story? A very quick note on depression though, because I in that way that people who have read too much of the internet will suddenly think that they're an expert on absolutely flipping everything. I had experienced depression to a fairly serious degree since probably the age of 1112. Um, obviously it wasn't diagnosed for years or anything, but just obviously in my own experience. So when I was diagnosed with ADHD, I was like, right, well, don't need to take antidepressants anymore, then this will be absolutely fine because the ADHD meds will treat everything. And I mean, I didn't stop taking them overnight. I'm not a total idiot, and I had been taking ADHD antidepressants on and off for quite a long time by this point, but even so, I still did wind them down and come off them and then wonder why. A little while later I was hit by a horrendous depressive episode. And this, I think, is where a little learning, a little medium learning in patience really can be a dangerous thing, because there is this idea that, well, and actually it's fairly true a lot of the time that ADHD is like the overarching big boss, if you like, and you squash that with meds, with treatment, and you'll sort out quite a lot of the underlying problems. And for me, that's certainly been the case with insomnia, for example. But with depression, I then basically had to realize, no, no, no. For you, depression is a comorbidity. It will exist alongside ADHD. I have cyclical depression and every few years it'll pop up. I won't realize it's happening until a friend or a family member goes. I really think we just we just need to have a little, a little chat about why you were basically lying on the floor looking like a sad clown. And I was. Yeah, again, just sort of thinking that. Treating the ADHD would treat everything else wasn't necessarily the case there, but all of the other ways that we treat ADHD. Exercise being a colossal one. Lifestyle factors if you're on stimulant medication, change to decaf coffee, for heaven's sake. Just all of these things have just really, really helped me in just not take control of my life, but to be able to sort of add in other elements to how I live that have in turned really help to deal with, um, like my mood just more generally, uh, and obviously for, for women and, and people who were born as women, like any kind of time around their period around perimenopause and all of that is really going to have a massive add on effect to, to their ADHD symptoms as well as their general experience of life. But yeah, just being able to understand that a bit more and, and adding in like decent food as well as an extra type of medication is also incredibly important. Yeah. So it's like if there's one point we can triple underline today, it's. Even though. Many people think getting a mental health diagnosis, such as ADHD, can be a means of escaping responsibility. 1s And if delivered and used correctly, getting a diagnosis like ADHD can be a way of taking responsibility. Because yeah, I'm not sure how many people are going for an ADHD assessment to escape responsibility like those kinds of people are usually using. I mean, let's be real alcohol and drugs if they want to escape. Nobody thinks I'm going to join a three year long waiting list to escape responsibility for something. But certainly by by getting that diagnosis, it can help people who have felt enormously out of control to take control of their life. And I mean, adjacent to that, there is a reason why the City of London Police, which is a tiny, tiny police service operating in and around Liverpool Street in the wider City of London area. They've been operating a trial in which they screen every single person who comes through their doors in terms of custody, um, and screening them for ADHD and anybody that scores reasonably highly is basically fast tracked to go and have an ADHD assessment, because when I'm talking about ADHD meds, solving all of those things, it's not because, oh, they are they, you know, release a molecule that stops you getting pregnant or stops you ending up in prison and that sort of thing, like early understanding, early treatment, but crucially, the early understanding of your brain and how it might seek out adventure or, you know, come up against authority. Those are the sort of things that are really important for stopping those negative outcomes. Yeah. And from the patients I talked to, I really. 2s Mhm. And even, you know, sometimes with someone's psychotherapy hat on, particularly if you're more inclined towards psychoanalytic way of thinking, you can be a little bit skeptical of people's motivations and their intentions. But, but even with that lens, I basically never get the impression that my ADHD patients are trying to avoid responsibility, and I almost always get the impression that they're looking for a way forward. They're looking for an explanation, and they're really usually quite pleased to see how many different things they can do to improve their condition and to improve their quality of life. I think sometimes, uh, people might have the misconception that it's just about medication, but then when they find out there's so many other things you can do alongside it. It's actually, you know, you can see that they feel, uh, more empowered. Um, yeah. But it's also being told about those things. And I mean, again, even getting diagnosed through the NHS, one of the people that I interviewed for my book, um, who had a long history of substance abuse issues and had been sober for about nine years by the time she was diagnosed with ADHD. Um, she was really excited to try meds. She was at a really good place in recovery. She had lots of tools in her toolbox, but she had to she had to go on a two year waiting list for meds after her NHS assessment. Nobody tells you that. And similarly, when you're. When you're diagnosed, um, like privately, you're like that. That initial assessment is really wonderful. It's really holistic. But your checkups after that, which you're coughing up £200 for, are not holistic. There is, you know, how's your pulse? How's your how's your blood pressure, you know, how's your coffee? How are you? How are you able to sort of deal with these sorts of things? Like nobody is telling you, like, you know what? Exercise is really, really helpful. And don't worry if you don't like running or whatever. Just find something you love. Make it your whole identity. And when you stop loving it, just swap onto something else. And one of the people that I interviewed again, who's a researcher at um, I think KCL, uh, they do brilliant ADHD research lab. They do lots and lots of studies there. She was saying that her her father, who I think had, um, diabetes, was prescribed a gym membership through his GP. And she was like, why don't we do that for people who have depression or, or ADHD? Um, what? I mean, it's the cheapest thing in the world is just like, here you go. Gym membership. Wildly cheaper than medication. I mean, for example, after my hip replacement when I had the infection, a second operation and then ended up on mega antibiotics for three months, I did none of my rehab because every single time that I tried to do anything, I burst into tears and had a panic attack. And I'm only now really doing my rehab because of a completely chance targeted Instagram ad from Nuffield saying, oh, we run these free joint pain clinics. You get like personal training in a group twice a week in a free gym membership. Do you want to sign up? Yes, I flipping did and I tell you what, I am now going to the gym for multiple classes several times a week and oh my god, what a huge surprise! I feel so much better. Not just physically but mentally. But again, there is something about like gym memberships. A luxury isn't it? And I'm like, well, I mean not. Have you seen most gyms? Quite frankly, or, you know, group exercise? There is this sort of expectation that any kind of change or recovery is something that you have to do yourself. And of course, don't get me wrong, there are people in my joint pain group who don't bother coming up. Oh, don't bother turning up or don't go to the gym during the week. That's on them. I mean, you can lead a horse to water, etc. but at the same time, if you are feeling either totally overwhelmed or incredibly low. How the hell do you start? And, I mean, I couldn't do that for, like, a year and a half. And I am somebody with resources with, you know, a fairly good grasp of how all this stuff goes. But also, I am somebody who is, you know, lived with depression, treated or untreated for years. And I know how when you are just at a low ebb, whether that is circumstantial or through grief or, you know, just literally all of the neurons in your head going, oh, I don't think I'm going to fire today. It's really challenging to get going. But just by, you know, giving people this impetus and most importantly, giving them a clear program to follow rather than just going, here's a gym membership. What the hell do I do with that? Do I have to go and do I? What do these machines do? And they're like, oh, you don't have to do machines. We're actually going to do weight training because actually that's really good for your joints. We're going to learn about nutrition. We're going to do little sessions on sleep and managing pain. And what is real, if you like real pain versus muscle pain and that sort of thing. I mean, just the difference that could be made there is absolutely extraordinary. But because it's seen as soft. Mhm. And it's often that it's often communicated as soft. So I, I think about this a lot in doctor's consultations. You know you can give all the right information. But the way you deliver the information will implicitly unconsciously. Make the patient give some treatments more primacy than others. I wrote about this in an essay on psychiatric Medications, which I just released on the podcast last week. If you spend, for example, 20 minutes talking to a patient about medications, and then in the last five minutes you say, oh, and also exercise, eat healthy and go outside and make good friends and things like that. Unconsciously, because of that time difference, the patient's thinking, okay, medication is like 85%. The other stuff is like 15% with them. But then it's also vague. It's like, um, it's all very well seen. Eat healthy. But what about if you just say, okay, what I want you to do is get some brown bread and some reduced sugar and salt, Heinz baked beans. And I want you to have beans on toast for lunch every day. And the rest of it, you know, just carry on what you're doing and see how you go. Uh, or add in a yellow bell pepper into whatever you're cooking or eating. Even if you're having a bar of chocolate, just have a bell pepper, have half an avocado. And literally then because then you're like, instead of eat healthy, it's like, oh, I've got to have my beans on toast. I've got to have my half an avocado and a bell pepper. And then almost immediately, people are eating more healthily in inverted commas because their fiber content has just gone dramatically through the roof. And that's insoluble fiber. It's decent fats. It's all of these, you know, yellow, yellow bell peppers, if you like, have got more vitamin C than red ones, weirdly. And and again, the beans on toast, lots and lots of like good fiber, decent amount of protein and some nice carbs to help everything along that sort of specific thing. Or like if it's exercise. Okay, I just want you to, uh, walk up the escalator when he got off the tube. Just do that and you're like, oh, okay, I can walk up an escalator. That's fine. Uh, that's exercise. Or, you know, I want you to walk. You know, it's like when people talk about getting off the bus one stop earlier or something like that, those specific things. Because again, otherwise it's difficult enough for people with, you know, your average brain to be able to figure out what on earth exercise and eating healthily means. But literally anybody can, you know, have a pepper or something else like that. I mean, think of that phrase, an apple a day keeps the doctor away. That's, you know, so many people will still be like, I'm having an apple and being healthy just because they remember the rhyme. But particularly for people with ADHD who, let's not forget, have a I mean, think of the Ghostbusters and the proton guns going off. They've just got an absolutely enormous amount of attention and focus wandering around untethered. And they need something really concrete to be able to grab on. So if we're going to say something about exercise, sleep, whatever, there needs to be a concrete action that people can add into their routine rather than worrying about taking everything away, not least because, again, disordered eating is a massive overlap for people and it's just not worth it. So adding in rather than taking away for those sort of more general ideas is super helpful. Yeah. And if you know, if you're a clinician and maybe you feel you have you struggle to deal with this on the consultation. You know, you can always provide written guides. You can provide podcasts like this one, which allows the patient to at least go into the detail, uh, outside of the consultation and get that guidance. You know, it doesn't have to be something that, um, takes a huge amount of time. But I think the way the way it's delivered certainly is, is very, very important. Um, can we talk a little bit about your experience with ADHD medication? What was that like for you? 1s It took a really flipping long time for me to be able to get to a level where it was working without side effects. Um, before I was diagnosed, a friend of mine let me try one of her instant release tablets just so I could see if it did anything at all. And I don't think anything has been as good or as successful as that first tablet, even though I'm literally on that medication now. And I think that's because. That when I had that tablet, there was the combination of what it was actually doing, but also a massive placebo effect plus relief, plus everything else. It really was that trope of so many tabs being opened and then just being reduced down to one. Um, I mean, I experience quite a lot of side effects, even on very, very low levels of several meds. Um, suicidal ideation, really casually, like just thinking I was driving my car along the A3 and I was like, wow, I really could just drive it into the central reservation. I didn't want to, but it was just like, I also don't want those thoughts going through my head. So it probably took 8 or 9 months to be titrated to be got to a level where none of these things going on, and where I was happy with everything. Um, of course there is now a massive ADHD meds shortage across the UK. Um, lots of my friends. You are on L vans for example, and that just hasn't been available for absolutely ages. I mean, I'm also theoretically supposed to be on L vans, but because it isn't available, I'm now taking generic, um, decks amphetamine three times a day, and that's working reasonably well, I think. Um, I did have a medication break last year for about a month, just so I could sort of see the difference before and afterwards. And it's not sort of like I take the tablet and suddenly it's like, I am Mary Poppins. I can do absolutely everything, but it just means that I'm not forgetting things five times, because my brain is like a giant Great Dane puppy falling out of myself to get out the front door to go in because it's already thinking about the thing that I'm going to be doing in half an hour's time, instead of the things that are actually here. And just in terms of being able to to just get things done. And yeah, sometimes I have to add in extra things to make sure I get those things done. So if I want to listen to something, for example, and I love podcasts and I listen to a lot of podcasts and I find them incredibly useful, I absolutely have to listen to them whilst I'm driving the car somewhere, whilst I'm doing the gardening, whilst I'm walking, whilst I'm doing something physical. Because if I'm just. If I'm just sitting and trying to listen to something. Oh, I just I can't focus on that at all. But so medication. Absolutely. They're not perfect. They're not. I mean, I'm saying they're not perfect. As somebody who realistically would like after the last 20, 30 years, to be a completely different person altogether. But I'm not. And what I can say is that meds, coupled with everything that I've learned, coupled with the people that I've met and coupled with listening to other people's stories and listening to the the similarities and not the differences in their experiences. 1s It's just it's completely it's changed everything for the better. And what have been the most useful non medication strategies in terms of managing your symptoms. 2s Uh, so I have a lovely plate in the kitchen by the toaster where my keys live. If my keys are not in my bag with me about to leave the house, they go straight in there. Um, they don't stay in my handbag. They just live in the plate along with my car keys. Um, having routines for certain things is really important. Um, whether that is, like, how to leave the house, what I'm taking when I leave the house, when I make sure I've got with me. Um, for example, like, I always need pens. And so I have pens literally scattered around the house in the, in the way that so many people with long hair have, like, hair bands and stuff scattered around the house. I make sure that if I, for example, like wearing glasses, that I have glasses cleaner in the car and in a certain place where it never leaves in the in the house. Um, I have sunglasses in the car and in a certain drawer inside the house. People were really, really, like mean and stupid about Marie Kondo, for example, when her book came out. That is one of the most useful devices for people with ADHD, making sure that everything has a home and somewhere to live. Like, you can't lose something if it's only in 1 or 2 places. It's only if you're daydreaming and it ends up on top of the fridge that everything is going to end up being a nightmare. And I say that having absolutely no idea where my engagement ring has been for about the last six weeks, I just have to hope it'll turn up somewhere stupid. Um. Also just, I think being really careful about what and who you listen to about ADHD. So, um, your excellent podcast, of course. Um, one of the most useful ones for me is the ADHD experts podcast. I mean, it's got the most laborious intro known to man, you can absolutely skip the first 5 to 10 minutes of, like, throat clearing. But what is so brilliant about it is that it is always a talk by a researcher, by somebody really, like deep in the field of ADHD, they've got literally hundreds of episodes stretching back to God, something ridiculous like 2016. And actually one of those 2016 episodes aimed specifically at people who've been recently diagnosed as adults, remains one of the most useful things that I've ever listened to, and I continue to recommend it now. Um, I think being very careful about listening to somebody either who doesn't have ADHD or who does have ADHD, but this coaching thing is really challenging. There are so many coaching programs going around, particularly on Instagram, and it's like, okay, what sort of coaching program are we talking about? Uh, is it, you know, is it something with quite a long period of expertise, or is it something where at the end of it, you literally are just sent a PDF of a certificate that you can print off at home? Yes, in the UK. So anyone can call themselves a coach and more frighteningly, anyone can call themselves a psychotherapist. So it's very important to be aware of that. Again with with with psychotherapists. Fingers crossed. I hope that most of us are aware as, as lay users of this service about the back. And, you know, there being actual registers for counsellors and therapists. Sure. How many people are aware. So just for those who are unaware, there are registers back the Association of Counsellors and Psychotherapists. And it is to be fair, I mean, and there's the UCP as well. Yeah. They, um, they pay a certain amount to be listed on it, but it's a good register for people who are properly qualified. There isn't anything like that for coaching in the UK, but there are still good coaching services. Um, genius within is one connections in mind as another. Um, the only thing is, is they're also flipping expensive, which is again, why to be honest, like YouTube channels like How to ADHD by Jessica McCabe are really helpful and why podcasts and everything are really, really useful. Partly because they're people sharing their lived experiences. But also if somebody is if somebody is flogging like a dust or a powder or a certain type of tea or coffee or anything that is going to really help with your ADHD symptoms, please feel free to just treat it with all the skepticism that you would have somebody treating you like a detox tea or something. That's what our livers are literally for. Um, like, we've honestly just because we've got a diagnosis or we're on the pathway to diagnosis, it doesn't mean that our ability to use critical thinking has just dropped out of our heads. I think when we're feeling confused and a bit lost about things, that's when it can all feel. We can just tend to end up being a little bit helpless. And I think that's when we need to do we need to have some positive self-talk there or to be honest, even, you know, use negative self-talk in a good way and just be like, nope, snap out of it. Come on. We're still going to make sure that what we're using, what we're doing is, you know, valid and has science behind it. And I mean, I say that with the best will in the world because I will always occasionally fall prey to these things, often because I've heard, like, really shady people being interviewed on otherwise respectable platforms. And Alex, my God, I will be mortified if somebody ends up saying that about me down the line. Fingers crossed. But not. But yeah, just using just making sure that if in doubt, go to the science like and not necessarily web MD or Wikipedia. Although Wikipedia is not as bad as everybody says like. That's more sort of like pub. Sigh. And, you know, looking for actual like papers online and that sort of thing and making sure ideally that there's that they've been reviewed and tested and everything. And and if in doubt, just follow the researchers like Twitter, Instagram. Um, I mean, to be fair, if somebody is like flogging their multi-million pound company every two minutes, then don't worry about that. But, you know, go to the library, order books, find a book that's written in a way that you get on with library books. Also, audiobooks are also available from the library and go from there. But just make sure that whatever you're taking in that, you know, it's it's good. And if it's making you react in a way that isn't helping you in your journey, then feel free to put it down. Yeah, absolutely. And some skepticism about the different ways. People, the different treatments people might experiment with. Yeah. And just being using your common sense, you know, it would be one thing if it's a form of treatment that hasn't necessarily been scientifically validated because some just haven't. But at the same time, it's not patented. It's it's low risk. Something like ginseng comes to mind. So patients I've met anecdotally have, have uh, said that ginseng has been helpful. It hasn't been scientifically studied is my understanding. But also it's not owned by a company. It's not particularly expensive. So there are sort of different levels. Um, in terms of I mean, same for omega threes. I mean omega threes like fish oil capsules, um, from decent sources. Uh, I mean, that's those have been sort of very popular as an additional like supplement, uh, for people with ADHD. And I mean, to be fair, a lot of us don't get enough omega threes anyway. Uh, it's not as if we're all eating two portions of oily fish a week. I, I can't afford salmon twice a week with the best one in the world. And also quite a lot of oily fish has a horrendous texture that I really don't get on with. Um, I mean, similar there are some things around, uh, lion's mane, ashwagandha. And I always mispronounced that, and I do apologize. Um, but I mean, again, some, some things like, you know, whether it's magnesium at bedtime, if it's something that's making people feel better and they do it, I mean, I take fairly significant, like zinc supplements because I horribly have got like tiny, tiny little, uh, old warts around my fingers. And if I take a significant amount of zinc, they just die down and go. And if I go, I'm just going to stop this now for a bit. Then they all pop up again and it's just. They're not like noticeable, but they're noticeable to me because obviously it's that laser random focus. Again, I mean, similarly like taking a vitamin D supplement, um, arguably in the UK we can do with taking that the year round. And and again, vitamin D is a massive mood booster for, for everybody and particularly people who are prone to mood disorders, whether you have ADHD, depression, whatever. Vitamin D is absolutely scientifically validated as something everyone. It's very important for for everyone. I know you've got to go, but I'd like to close with one question, which is if someone's not sure if they're struggling with these kinds of difficulties, they're not sure. Maybe if they should seek an assessment or go forward. What are a couple of questions maybe they could ask themselves? 2s Uh, one is have do you live in England and have you googled right to choose which is a pathway that you can do through your GP? Your GP does have to refer you for this. Um, but basically for all the naysaying that there is around private healthcare, the NHS for a long time has been using private healthcare to fast track online assessments for ADHD. To be honest, I was assessed online. I mean, I'm doing this podcast online. Lots of stuff happens online provided that nobody needs to touch you, and that would not be the case in an ADHD assessment. One would really hope. Um, than doing them online is not a problem, but that can really speed things up from a matter of years being on a waiting list to a matter of months, if not weeks. Uh, so that would probably be the first thing. The second is like, nobody is stopping you from reading up about it. There are some really, really brilliant tools out there, whether they're websites or, you know, YouTube channels. Um, I'm a bit less on Instagram accounts just because they are so short. And also, you know, you get all the dopamine from beautifully laid out cards and everything. So by all means, use that as an introduction to somebody or something. But don't let that be the be all and end all. Um, also again, just. I think. Just ask the questions. If you see some truism going around, whether that is in a paper or online or anything else, such as, you know, oh, people are just all waiting and they don't have ADHD. Ask where the figures are on that, and if there aren't any figures on that, ask why and say, perhaps this shouldn't be in a news story in that case. Um, as a completely anecdotal idea, um, I was listening to The Hidden 20%, which is Ben Bransons podcast. He founded Seed Lip and reasonably recently was diagnosed with autism and ADHD, and he did a brilliant podcast with Doctor Renata Fiala, who was the psychiatrist who diagnosed him. Um, and she also, crucially, does work in the NHS, which again, should really be something that you look for if you are going for a private clinician. But she said that 5% of the people who have come to her for assessment don't have ADHD, and she didn't diagnose them with it, and they might have been, you know, a bit upset, a bit cross about it afterwards, but that's still an anecdotal 5%. And that is the only number that I have heard in any of these discussions around, oh, how many people aren't they don't have ADHD really, blah blah blah, unless they are literally a bad faith journalist on a Panorama documentary last May. Not that I still hold that in mind, but, um, you know, somebody being diagnosed who doesn't actually have ADHD. So just, you know, don't be scared about it. Go and do your research. Go and read up. Go and go and look. Talk to people. Also look around your own friendship group. Because the amazing thing is, is once you find out something about yourself, you know, like attracts like, and there will probably be other people in your circle circles who experience a very similar way of looking at the world as you do, but also just the thing that my psychiatrist told me, which is be very, very proud of everything that you have achieved so far, even if it doesn't feel like that much to you. It absolutely is like you've been playing life on hard mode. And as we as we all know, the older that we get, life is. Life is quite hard and there's a lot of stuff happening around us. So well flipping done you for getting this far. Yeah, absolutely. Like just like the general difficulty of life is a message that I find myself repeating on the podcast quite a lot because I feel like it's quite, um, cathartic to say out loud. There's so much I still would love to talk to you about, but you have to go to another podcast. So I'm going to let you go, but we will have to have you back on the programme at some point in the future. Kate Brown, where can people find you? 1s Oh, I would really love that, Alex and thank you for such a lovely chat. And thank you for letting me climb up on my high horse and then rapidly get down again when I've forgotten what I'm actually supposed to be saying. Um, having said don't go to Instagram. I am on Instagram, but I have two cats and a dog and I frequently go and see horses called Alan. So please come and find me at Cat, Brown writes. But most importantly is my lovely book, which is lots of people who actually know lots of stuff in it. I am merely the conduit for it. It's called it's not a bloody trend understanding life as an ADHD adult. And because you aren't an ADHD writer, unless you have two books out at the same time. Uh, my other book No One Talks about this stuff is basically a very similar idea, but it's 22 stories about people from all backgrounds, about how they've experienced infertility, baby loss and childlessness. And both of them I would describe as support groups in a book. So if these would be useful for you to read for your patients or for you more personally, uh, thank you very much, and I really hope you look out for them in libraries and all good bookshops. Wonderful. Kat Brown, thanks very much. Thank you so much for having me. 9s Thanks so much for listening this week. If you've got any feedback, as always, do get in touch. If you enjoyed the episode, why not give us a rating on Spotify or Apple Podcasts? Because it really helps other people to find us. If you want to get in touch, you can find us on Instagram or Twitter, or you can drop us an email. And if you value the show more generally, why not bias coffee? Thanks so much.