Hi Everyone, I'm Stephanie Sarkis PhD, a best-selling author and also a licensed, board-certified therapist for over 20 years. I specialize in gaslighting, anxiety, and ADHD. I also am interested in media's impact on the self. My latest book is Gaslighting: Recognize Manipulative and Emotionally Abusive People - and Break Free.

I am a blogger for Psychology Today and Huffington Post. My Psychology Today blog article, "11 Warning Signs of Gaslighting" went viral, and led to the Gaslighting book.

I am also the host of Talking Brains podcast, and the co-host of the Nerds in Love relationship advice podcast.

I was featured on Dan Harris' 10% Happier podcast regarding my practice of mindfulness meditation for helping with my ADHD and anxiety.

My op-ed in USA Today on Donald Trump being a gaslighter led to overwhelming support (and a few threatening emails and messages).

I'm also a Florida Supreme Court certified family and civil circuit mediator. I work with parents where either one or both have ADHD and/or gaslighting behaviors, in order to create a parenting plan that is in the best interests of their child(ren). I'm a collaborative divorce facilitator, a way to divorce that cooperative rather than adversarial. I have a private practice in Tampa, Florida, and I also consult with people online.

All my degrees and my training are from the University of Florida. I have three degrees in mental health counseling, and one in telecommunication production.


My proof

Ask me anything!



  1. Is gaslighting a form of abuse? Absolutely. It's particularly a form of emotional abuse - however, emotional, physical, financial, and sexual abuse are closely tied together.

  1. Do you have personal experience with gaslighting? Yes, however I don't go into details, due to privacy reasons. I am confident in stating that we are all being gaslighted by our current president. See my USA Today op-ed.

  1. What if you are in a relationship with a gaslighter? Get out. Relationships with gaslighters only get worse, never better - regardless of what a gaslighter promises you when you leave. Go "radio silence" - block phone numbers and emails. See the next question of what you should do if you have kids with the gaslighter. Also, always take your pet with you - do not leave it with the gaslighter.

  1. My children's other parent is a gaslighter. What can I do to coparent effectively? If you have children with a gaslighter, contact an attorney, and have a detailed parenting plan which even discusses acceptable forms of communication (email, text, family scheduling apps). Some survivors of gaslighting have it written into their parenting plans that they will only communicate with the gaslighter via email or text, so there is a written record. I'm not an attorney, so always seek their advice first before taking any legal steps, like completing a parenting plan. As a mediator and collaborative divorce facilitator, I help parents create a parenting plan that is in the best interests of their children. Coparenting with a Narcissist

  1. Is gaslighting a diagnosis? It's not currently in our diagnostic manual, but it is an apt description of the manipulative behaviors one (or a group) uses to confuse and gain control of others.

  1. What are behaviors of gaslighters? Some gaslighting behaviors include: Telling you something you saw or heard didn't happen; hiding your items and then blaming you for being "irresponsible"; telling others that you are crazy; projecting and accusing you of infidelity (when they are chronic cheaters); pitting you against other people; "recruiting" others to send you messages after you have ended the relationship; idealized ("lovebombing') at the beginning of a relationship, and then devaluing you later.


  1. Is ADHD real? Yes, there is large amount of well-designed research finding that ADHD is, in fact, very real, and highly heritable. In my family, ADHD-like behavior has been documented as far back as the 1600s. Here's some info on my family history: Understood video and article
  2. Is ADHD overdiagnosed? No, in fact it is underdiagnosed. According to research by Russell Barkley PhD et al., only 10% of people with ADHD seek help in the first year they realize they have symptoms.
  3. Doesn't everyone have ADHD? No. While everyone can be distracted and lose focus from time to time, you meet the diagnostic criteria for ADHD when you meet a certain number of symptoms and those symptoms cause impairment for you, more days than not.
  4. How do you feel about stimulant medication for ADHD? I am pro-stimulant medication, and have taken it for over 20 years. Your rate of addiction actually decreases when you take stimulant medication.


My replies are not a substitute for mental health treatment, nor should they be taken as such. Also, I am not able to make personal recommendations or diagnoses - I speak in generalities, based on the people I have worked with and my training (and in the case of ADHD and anxiety, my own life experiences). If you are considering hurting or killing yourself, please contact the Suicide Prevention Lifeline.

General Rule

Don't be a dick. Everyone is fighting a battle you know nothing about.

Social Media

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Comments: 322 • Responses: 98  • Date: 

Snakebite758 karma

What can you do if you are stuck interacting with someone gaslighting you for an extended period of time in a relationship you are unable to leave?

For example, if they're the President of your country and you cannot afford to relocate.

StephanieSarkisPhD17 karma

Ha, I can relate. Become as politically active as possible. Call out gaslighting when you see it. Back candidates that treat people equally and stand up against the abhorrent behaviors we've witnessed. As my friend Tony said, we all know someone who tends not to vote. Call them and help them register (it may be too late in some states for this election), take them to the polls (Uber is also offering free rides to polling locations), talk to them about how their vote counts. Here's how I spoke out: https://www.usatoday.com/story/opinion/2018/10/03/trump-classic-gaslighter-abusive-relationship-america-column/1445050002/

kingshmiley24 karma

In a world where Gaslighting has infected our society in such a pervasive way, what steps can we take to combat it when we see it happening in real time? How can we help those who are susceptible to the gaslighting?

StephanieSarkisPhD37 karma

Call it out when you see it. I just recorded a podcast with a therapist who spoke about Bystander Training - how to intervene when you witness a perpetrator harrassing someone. You stand by the victim, and call the behavior out for what it is. You will never change the gaslighter's mind, but you can speak out the truth. There is power in calling it what it is. I have a chapter on this in the Gaslighting book, and all the other chapters tailor this information for relationships, workplace, society, cults, friends, family. Edit: Just finished mixing the podcast I was referring to: https://anchor.fm/talkingbrains/episodes/Anxiety--Burnout--Tribalism---Taking-Action-e2f7dn

KnowsTheLaw8 karma

Is accumulating contradictory evidence of what a gaslighting person is telling you an effective strategy for confronting them?

StephanieSarkisPhD7 karma

See: "You will never change the gaslighter's mind." Gaslighters tend to have ego-syntonic personalities - they think everyone else has the problem and they are fine. Stating what you know is truth is different than spending time and energy accumulating "proof", which the gaslighter will just tell you is fake, or that you are crazy.

seanspotatobusiness-6 karma

What are you talking about? How has it infected society?

StephanieSarkisPhD16 karma

The US president is a gaslighter. My op-ed in USA Today I also have a whole chapter in my book on gaslighting in society. It is a common tactic of dictators, past and current. And also there is the societal issue of intimate partner violence (domestic violence).

kingshmiley12 karma

We are regularly told demonstrably false things by influential members of society as if they are obvious truth. Even when refuted, the lies are difficult to pull from the public consciousness.

This is my opinion feel free to disagree no hard feelings.

StephanieSarkisPhD13 karma

When Trump says "What you're seeing and what you're reading is not really happening," it is clear gaslighting behavior. Gaslighters also know that once you tell a lie over and over again to the public, it is interpreted as fact.

petitedanseuse-7 karma

Fake news!

StephanieSarkisPhD16 karma

A sign of dictators (and want-to-be dictators) is dismissing credible news sources as "fake". It's included in my chapter on gaslighting in society.

ADDthrowawayz22 karma

Dr Sarkis,

I was recently diagnosed with severe adult ADD, and the doctors are recommending stimulant medication. I have a ominous feeling about the treatment they are prescribing. I have had much success in my adult life without treatment, but as time goes on and I take on more responsibilities and more complex tasks (such as my dissertation), I am finding it harder and harder to get by (that's why I sought help in the first place). My hesitation is rooted in the suspicious that being untreated forced me to embrace my strengths and weaknesses as a person, and that a lot of the mechanisms I use to succeed are based on me being ADD. Do you think the medication will, for lack of better wording, erase my existing strengths or force me to relearn new successful habits? It sounds silly now that I've articulated it and typed it out, but I'm concerned I'm going to lose a piece of myself.

StephanieSarkisPhD36 karma

As a person with ADHD myself, stimulant medication makes it so I have access to those coping mechanisms. Without medication, it's like that tool box is harder to open. When stimulant medication is working effectively, you should still have the same personality, just more motivation to complete tasks and a greater ability to employ coping mechanisms. I would recommend a second opinion if you are unsure about treatment. Also ask questions, we really love questions - and if your doctor won't answer your questions, go to another one.

ajax667711 karma

I spent 10 years under-employed in fields I could easily cope in, before my diagnosis. (I had been fired from my job in my degree field. ) I've been medicated 2 years (now 38 yrs old) and have been back in my career field for about 6 months. I've been doing really well at work, but by the end of the day I have nothing left and my home and personal life are being severely neglected. The mail has piled up again and tasks are still very hard to accomplish, things like grocery shopping, or even self care. My Dr added lexapro for anxiety but I was falling asleep at my desk from it so I quit. I'm still on 40mg of vyvanse.

Am I doomed to living half a life because the meds can only do so much? Or do I need to switch to something different? Ive started self medicating with caffeine and sugar again and things feel like they are unraveling further. Work is good, but even there I'm walking away from my desk more and losing focus. How can I tell depression vs adhd for the things in failing at? Also, are genetic tests for medicine efficacy worth the price?

Thank you.

StephanieSarkisPhD6 karma

See your prescriber. Show them this post. Depression, ADHD, and anxiety can all look very similar. I'm not able to make personal suggestions. Genetic tests are not where they need to be to spend that amount of money, IMO. They only give you possibilities, not definite results.

showersareevil1 karma

I completely feel you. I have pretty bad adult ADD and my wife picks up most of the slack at home because I just don't have energy left after a full day of work on adderall.

Ive come to the conclusion that meditation is the only thing that will be a permanent fix to my mild depression and I need to learn to live in the moment. However, I'm too lazy to meditate and make it a habit so life is pretty mediocre

StephanieSarkisPhD6 karma

Even if you meditate for a few minutes at a time it can be helpful. Follow the STOP acronym:

Stop what you are doing

Take a deep breath


Proceed with relaxation and awareness

A book I recommend is The Mindfulness Prescription for Adult ADHD by Zylowska.

Here's a 10% Happier podcast I was on where I talk about my own use of mindfulness for ADHD and anxiety: https://www.stitcher.com/podcast/10-happier/e/54781934?autoplay=true

dragamex7 karma

Just got a diagnosis myself about 2 years ago. I'm 29 now, but I've suspected most of my life that I had it.

Adderrall has, without exaggeration, changed my life. It used to be I would have a trillion ideas, with plans on how to execute them, and even the right people to get involved - but once it came time to put that plan into action, I had no clue where to start. Even putting those thoughts on paper was extremely difficult. I performed terribly in school, not because I was dumb, but because when it came time to show what I had learned, I could not focus. This spilled over into my work life as I became an adult, and serial procrastination only compounded the problem.

Now I'm actually doing really well at work, and have energy, motivation, and focus to complete tasks. So much so I even have a small side business building. I lament the first 27 years of my life because I can't help but feel that they were wasted, but at least now things are looking up. Where once I was depressed and frustrated about my life, now I'm excited (and a little scared because I've never done this well. I'm just waiting for something to go wrong).

StephanieSarkisPhD7 karma

All your feelings are very normal for being diagnosed as an adult. (I was formally diagnosed at 23.) I'm so glad your quality of life has improved.

ADDthrowawayz6 karma

This is a very helpful response! I never considered the medication as opening up pathways to an existing tool box. The doctors have been great and very open about alternative options. I had already decided to pursue medication, and your answer helps me feel confident in my choice. Thank you for taking the time!

StephanieSarkisPhD3 karma

You are so very welcome!

BriarRose214 karma

Do you recommend anything other than stimulant medication? Not everyone can stay on stimulant medication for years at a time. It was causing me to have angry rage outbursts and I suffered worse symptoms on medication than I have in the year I've been off meds.

My stepfather has a heart condition and ADHD, and medication could kill him. What do you recommend for people who cannot take stimulants?

cowboysauce2 karma

Atomoxetine, guanfacine and clonidine are all non-stimulant medications that are used to treat ADHD. Atomoxetine is not recommended in those with heart conditions, but the other two should be fine.

StephanieSarkisPhD2 karma

Please provide a citation for your statement about atomoxetine not being recommended for people with heart conditions. One of the most recent studies says there is no known issue. https://www.mdpi.com/1660-4601/15/8/1789

StephanieSarkisPhD2 karma

I cannot give medication recommendations. In addition on stimulant medications, there are also non-stimulant medications available for ADHD. In head-to head-studies, all the FDA-approved non-stimulant medications are not as effective as stimulant medications for ADHD. See your prescriber for more information. The most effective nonmedication treatments for ADHD (and still, stimulant medications are the most effective) include exercise, mindfulness meditation, good sleep habits (including resolving any sleep disorders), cognitive-behavioral therapy, and Omega 3-6-9 (somewhat, and check with your doctor first).

lkyle5017 karma

Hi Dr. Sarkis, What is your opinion on caffeine and how it impacts ADHD?

StephanieSarkisPhD37 karma

Caffeine withdrawal, for the lack of a better word, sucks. Caffeine also only helps you focus for 30 minutes at a time. I do not recommend it as a treatment for ADHD. Also, people who take stimulant medication should watch their caffeine intake (talk to your doctor for more info).

FresYESpsych13 karma

Hi doc, fellow therapist here with a question about gaslighting. I have a patient right now who is very well read up on this particular issue as a function of his relationship with his wife. I tend not to ascribe labels, especially to those I'm not working directly with (like his wife), but I thought his scenario was an interesting one and I'm curious of your thoughts.

This man has been married to his wife for over 20 years, a relationship he describes as "90% beautiful and 10% troubling." The 10%, he said, is fairly unpredictable, his wife ranging between "minimally annoyed" to "outraged," usually about trivial things. It should be noted he's observed that these moments almost always precede his wife's monthly cycle - he keeps a journal with dates and his wife has discussed this with him. It's only during these times that his wife resorts to gaslighting behavior, primarily embellishing past "faults" of her husband, relying on gross misinterpretations of his actions as a means to tear him down. No amount of reasoning helps, though the anger is usually gone within hours and, according to the patient, the relationship is back to "normal" without resentment.

Side note - this patient is rather calm and really doesn't seem to be easily angered, which I believe has helped him to cope fairly well with this issue.

So I guess my question to you, particularly given your advice to "get out" of gaslighting relationships: what about those situations where the gaslighting isn't pervasive and limited to rather small (though quite predictable) blips in time that could potentially be related to hormonal changes?

For clarification's sake, this patient was referred to me after experiencing a traumatic event at work, the relationship stuff came up in passing during one session and I admittedly shifted some of the focus to it.

StephanieSarkisPhD11 karma

Case consult...awesome! I tell people that if your relationship is 99% good and 1% abusive, it is still an abusive relationship. Period. The tricky thing about abusers is that they are not bad all the time...it is part of that cycle of abuse. And it doesn't matter how the abuser arrived at their abusive behavior...they are still 100% responsible for their behavior.

FresYESpsych10 karma

Interesting perspective. I suppose I've accepted that, for one, abusive is, at least to some degree, relative to the experience of the presumably abused. Like I mentioned, the approach I take with patients is very non-labeling, we don't focus on diagnoses, but on experience and such. And I do my best to foster a very trusting relationship where the patient is afforded the opportunity make their own decisions.

This particular person is, without a doubt, in a very loving marriage with his wife. While he says 90/10, based on the conversations we've had and the stories he shares with me regularly, I'd guess that's a slight embellishment and that it's closer to 99/1. In fact, his wife seems like an incredibly committed partner and mother to their children whom he speaks very highly of with the exception of these infrequent "tiffs" (as he calls them).

To me, and I understand this is all just personal opinion, it seems a rather extreme response for him to just up and leave after over 20 years of 99% happy marriage because his wife slips into these unarguably unhealthy modes from time to time, with some indication of hormonal influence.

I truly appreciate you responding to this question, it's always good to get a fresh perspective! I certainly won't be encouraging this patient to "get out," as not only do I think that's a decision for him to make and that it'd obliterate the trust we've developed, but on a personal level given what I've come to know about the relationship, I think it's unwarranted.

In my 25 years as a practicing therapist, a good portion of which is focused squarely on relationships, I've come to accept that no marriage fits the mold of perfectly healthy. Everyone slips up from time to time, we all have our insecurities that are most apt to come out with those we trust the most, and that learning to love in spite of imperfections is what defines successful marriages. Hell, my wife and I have our moments, we both say things we don't mean and sometimes regret, but our mutual understanding that stupid things sometimes happen in tense moments allows us to move along and focus on what really does matter.

Again, thank you for responding!

StephanieSarkisPhD5 karma

You're welcome. Again, I'm not able to make specific recommendations, so my answer may have been different in consultation.

AutomaticLibrarian311 karma

I'm hoping you can help me with a tricky situation.

My girlfriend and I have been together for about a year and half now. She has a really bad relationship history including tons of gaslighting and abuse. In addition, she deals with ADHD and depression.

That said, I feel like a lot of her past is taken out on me. She gets defensive and shuts down whenever I bring up an issue. I know a lot of this is likely caused by her past trauma, but I don't know how to get through to her without being accused of gaslighting.

How can I be a more thoughtful boyfriend while also standing my ground? I want to understand her while also being understood myself.

StephanieSarkisPhD13 karma

It's important for us to set good boundaries and practice good self-care. I recommend going to couples' therapy. If one partner doesn't want to go, I encourage the other partner to go on their own.

_Liaison_9 karma

I have severe depression and zero focus. Adderall helps keep me at neutral rather than mildly suicidal, but doesn't improve my focus. I get overwhelmed and frustrated that my mind jumps around. What can I do?

StephanieSarkisPhD6 karma

I'm not able to give personal recommendations, but consider scheduling another appointment with your prescriber. Show them what you wrote here. Also, mindfulness meditation has been showing effectiveness in helping reduce the severity of anxiety, depression, and ADHD. I was interviewed on Dan Harris' 10% Happier podcast about my use of mindfulness meditation for ADHD and anxiety, and I talk about what I do and how it has helped: http://stephaniesarkis.com/interviews-podcasts/

kildoents7 karma

I have found that I am highly susceptible to gaslighting and manipulation. Is this in anyway attributable to my ADHD?

StephanieSarkisPhD16 karma

Yes. When we have ADHD (I say "we" because I have ADHD too), we tend to be more sensitive to others and more susceptible to having low self-esteem. When someone "lovebombs" us by telling us we're the best thing ever, it feels really, really good to a person with ADHD. Your dopamine level goes way up. However, with gaslighters, eventually they devalue their partner. and can see no good in them. This is confusing for people with ADHD, who wonder how someone could be so terrible, especially when they've tried so hard to be good.

captainvancouver6 karma

I wake up every night and can't get back to sleep because I have annoying songs/jingles playing in my head on a loop. Happens during the day as well, but it's been affecting my sleep now for a couple of weeks. How can I shut off these intrusive songs and get back to sleep?

StephanieSarkisPhD8 karma

Write them down or sing them into your phone's voice record app. Your brain will thank you. Also write out your dreams when you wake up. It's less "brain spam" for your head to carry around. :) Also, tell yourself before you go to bed that you'll have a restful sleep, and you will sleep through the night. (Don't use "I won't do jingles, because our subconscious doesn't process "not". And I just used not like 8 times.)

iamacarboncarbonbond2 karma

I have a similar problem. I have a hard time getting to sleep (and wake up multiple times at night) because my brain likes to repeat various embarrassing situations and mistakes over and over. To drown out my own memories, I put Netflix comedies on my laptop and turn the screen away to sleep. I know it's awful sleep hygiene, but I'm having a hard time breaking the cycle.

StephanieSarkisPhD6 karma

Brains can be scumbags like that sometimes. It's like, "Hey I'm ready for bed" Brain: "Let me remind you of all the times you fucked up in your life. And then Imma gonna replay that shit." Writing out your day's events before you go to bed can help.

Philoscifi5 karma

Hello. Can you suggest any tools to help with transitions from one activity or task to another?

Transitions seem to be a sticking point for my son and I, but once past that hump, I have some tools to help keep the ball rolling. I would appreciate your advice or direction for some pragmatic, in-the-moment tools or habit-forming processes to help start a task or to transition from one to another. I’m asking for myself and my son...and maybe my daughter when she gets older.

I appreciate your time and am looking forward to the answers in this thread!

StephanieSarkisPhD15 karma

I find using a timer helps transitions, and also I use Screen Time on my iPhone to limit my use of social media. Telling kids "30 minutes before bed", "15 minutes before bed", etc. helps them get into that mode. Also, shut off any electronic devices 60 minutes before bed (the ideal is 2 hours). Using backlit devices inhibits melatonin release (the hormone that gets you ready for sleep) and melatonin release is already inhibited in ADHD. I have an Understood video about that...I will find the link.

MyPizzaisLate5 karma

Hi Dr. Sarkis, do gaslighters know exactly what they are doing when they are being so manipulative? Or is it a trait that they are unaware of?

StephanieSarkisPhD8 karma

Depends on the gaslighter. For some, it is premeditated. For some, they don't know that they are doing it to fill a narcissistic void. For some, gaslighting behaviors were learned as a way to survive a narcissistic parent. Here's an article I wrote on that: https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201701/are-gaslighters-aware-what-they-do

the-local-dreamer5 karma

Hi Dr. Sarkis, thank you for doing this and being an advocate for mental health! I would describe myself as a "type A" personality with a lot of anxiety (diagnosed with GAD and a phobia). On the other hand, my SO of three years is super laid back with diagnosed ADHD. Normally we complement each other nicely, but sometimes we clash (getting to things on time, procrastination, lack of motivation... all issues rooted in ADHD that I've never personally experienced and have a hard time understanding). I love him so much, so do you have any tips for how to manage a relationship where there are two seemingly conflicting mental disorders?

StephanieSarkisPhD8 karma

Thanks so much! I reframe "Type A" as "high-achieving". :) Probably because I'm much more Type A. ha I'm Type A and my fiance is Type B. I think honesty and communication is key. Sometimes I need to say "I'm overwhelmed". Like if I'm given 5 options of things to do that day, my brain shuts down. But if I'm given option A or option B, that makes life much easier. Also, even if we have ADHD, we are 100% responsible for our behaviors, and we need to own up to it when we've hurt someone, and take steps to rectify it. I recommend Melissa Orlov's work with ADHD and couples - she has a book, a webinar series, and a group. Also, on the practical side - if you can afford it, hire a biweekly cleaning service.

the-local-dreamer2 karma

Wow I'm glad we're not the only pair out there like that! The feeling of being overwhelmed makes a lot of sense from what I've tried to read on ADHD. Thanks for the tips!!

StephanieSarkisPhD5 karma

You are so very welcome! Here's another example: the technology had a total meltdown right before the AMA started. I'm like "OMG what happened" and fiance goes, "Can I..." And I go something like, "ARRRRRRGHBLEERRRRGGG"

YourOldChemistrySet5 karma

I believe I was a gaslighter in the past. I almost felt like it was a veil over my eyes, I couldn't really see the error in my ways at the time. I just thought I was right all the time or too stubborn to admit I was wrong. When I finally stepped out of it and grew up, only then was I able to see how destructive I was and how I was treating people. I have since made amends the best way I could and have moved on with other relationships. I now tend to slow things down and have cooling off periods before important communication. What are some steps people can take to recognize this behavior pattern and change it in themselves?

StephanieSarkisPhD6 karma

First, I am SO proud of you for making those big changes in your life. I know it was a lot of hard work. I think one of the things you do - cooling off before important communication - is really great. For people wondering if they are a gaslighter, look to your family history. Did one or both of your parents (or other caretakers) have gaslighting/narcissistic behaviors? If so, you may have learned these behaviors as a survival strategy.

I have a whole chapter in Gaslighting about how to get help for one's own gaslighting behaviors. Therapy is very helpful, and I detail the types of therapy available, including Dialectical Behavior Therapy. Mindfulness meditation has also been found to be helpful to decrease the 0 to 60 in two seconds intense emotions that people can experience.

dickpiano4 karma

What do you think the root cause of anxiety is?

StephanieSarkisPhD7 karma

Mostly genetics. It's even been found that there are genetic mutations that make one more susceptible to developing PTSD after a trauma than others. Also, anxiety can develop from traumatic events. If you were bit by a dog when you were a kid, it is completely understandable that you would continue to have anxiety around dogs. There's also intergenerational trauma - for example, in Native populations. Native peoples' children were torn from them and placed in schools for supposed "acclimation", and the trauma experienced by families continues to the next generation.

Ristele4 karma

Is it a myth, or is it true that ADHD can be linked with clothing issues?

I've read a lot of comments on ADHD groups, from moms whose kids are suddenly unable to wear certain types of clothing. (like jeans, tight shirts...)

I also do experience it myself and I'm just wondering if there is indeed a link or if this is totally unrelated to ADHD.

StephanieSarkisPhD10 karma

Sensory overstimulation can be found in ADHD, autism spectrum disorder, and just by itself. The link is not known at this time. Sensory processing disorder was proposed for our diagnostic manual, DSM-5, but it was determined that more research needs to be done before this is officially a disorder. Sometimes I see kids where the sensory overstimulation improves, sometimes not. Depends on the person. What helps best is reducing exposure to or avoiding those sensory triggers.

rgundlach14 karma


StephanieSarkisPhD4 karma

I'm not able to suggest medications. Stimulant medication side effects include irritability, dry mouth, and insomnia. I usually recommend people make another appointment with their prescriber. Psychotropic medication research and technology is changing quickly, and there are more improved medications out every year.

Fausuto1 karma

I had mood problems with xr switched to concerta and works much better for me.

StephanieSarkisPhD3 karma

Here's a great example of how different things work for different people. Another person may have the exact opposite experience. A lot of it has to do with genetics. Like I mentioned in another post, if someone in your family has been diagnosed with ADHD and is doing well on a particular medication, find out the name of it, and give that information to your prescriber.

tokes19874 karma

My daughter is under investigation for ADHD, the school brought it to my attention. How do I know what's naughty behaviour and what's the possible ADHD? I'm a full time single parent. She's nearly 6, the light of my life but the reason I have lots of grey hair and bags under my eyes.... I could pour my heart out to you here. Is there any suggestions for books I can read? Pretty please....

StephanieSarkisPhD9 karma

Look at your family history. Family history is one of the biggest indicators of ADHD, as it is highly heritable. (See my FAQ about my family history.) Any books by Russell Barkley PhD are great - for parents of younger kids I recommend his Taking Charge of ADHD.

ValentineNole4 karma

Hi Dr. Sarkis,

What is the best way to deal with gaslighting in your employment with colleagues (but not with those in managerial positions) especially when the gaslighting is not yet to the point of bringing up through the chain of command?

StephanieSarkisPhD6 karma

Document, document, document. Make sure when you are documenting that you are using your personal electronic device and not the company's. Don't meet one-on-one - always have a witness present when meeting with a gaslighter. Know the chain of command and procedures for reporting harrassment (if your workplace has such a policy). Meet with your boss once a week (assuming he is not the gaslighter) to let him or her know what work you are doing so a gaslighter can't undermine and tell the boss otherwise. Also, consider whether it is time to report it.

AncientWyvernShield3 karma

How is an ocd behavior like excessive hand washing typically diagnosed and treated? I know for me personally i have an extremely hard time going in my bedroom and touching my bed, computer, controller ect. unless I’ve taken a shower or changed clothes and washed my hands a lot.

For me a lot of it stems from the fact that my family has 3 large dogs which I’m afraid to touch most of the time

StephanieSarkisPhD5 karma

We look at family history (since OCD is highly heritable) and we also look at how much the symptoms are impacting your functioning. For contrast we have 3 large dogs and while it gets to be a lot of fur at times, and I definitely wash my hands before cooking, etc. and have a Roomba - so I'm not sure how much of what you are going through is 3-dog-related, KWIM? That could be a trigger for the behavior, and the behavior manifests as OCD. Now I want to see a pic of your doggies. :)

AncientWyvernShield2 karma

Thanks for the answer.

I think what I meant as far as the dogs go is when I touch them their fur gives me a strange stench that literally wont go away in my head. We bath our dogs regulary so its not like they are disgusting and dirty. Also when they do their business outside I feel forced to check under their paws if they accidentally stepped in anything (feces). If they did and I have to clean them I literally throw away my entire day until I have an opportunity to clean myself multiple times. Same goes for touching things around my house. I dont know. It all relates to my bedroom. If i dont need to go into my bedroom until night time, I don’t worry about it. But it stops me from being productive because I cant work on my computer during the day. My family is also extremely angry at because im driving up the water bill (im down to 2 showers a day but the hand washing is too much) which is an added stressor.

It all sounds weird but honestly given your answer I think I may seriously have this problem.

StephanieSarkisPhD3 karma

It would be worth seeing a specialist either way.

temperance266843 karma

What are some of the long-term effects of chronic gaslighting and is there anything that can be done to help them? I suspect that my mother is quite narcissistic and part of that was her constant gaslighting. I've learned to recognize it and ignore it for the most part, but I definitely don't trust most of my early memories and I don't remember the bulk of my childhood aside from a few flashbulb memories.

My university offers free counseling sessions and I figure I might as well take advantage of them before I graduate, but I think it'd be much more beneficial if I could go in with a more concrete idea of how to verbalize the effect gaslighting has had on me and perhaps a few tools to help improve on those issues.

StephanieSarkisPhD6 karma

Being exposed to gaslighting can cause issues with self-esteem, difficulties with trust, difficulties with forming intimate relationships, and even exhibiting gaslighting symptoms themselves. I'll be clear here and say that if you have picked up what we call "fleas" from a gaslighter, it does not mean you have a personality disorder yourself. Sometimes those behaviors are learned as a survival mechanism for living with a gaslighter. I encourage people who have been exposed to narcissistic family members, especially parents, to seek counseling.

milesamsterdam3 karma

I would like to know if these rules I have been using in my life are effective in helping identify and correct manipulative behavior, stop creating victims, and what you would do to make them better?

Rule 1. In a relationship you don’t have to do anything you don’t want to do; you don’t owe anyone anything. Ever.

Rule 2. Prescribed Relationship: any relationship which begins in a professional or any other context in which an imbalance of power exists. e.g. your doctor, teacher, student, patient, coworker, boss, employee, bar tender, waitress, star of your movie, etc.

To use a position of power to coerce, force, or manipulate someone into a personal/sexual relationship is abuse.

Rule 3. negging, gaslighting, forced teaming, playing the victim, isolation, intimidation, and control are abuse. They lead to violence. They will kill you and after they do they will still say, “I’d never hurt them.”

StephanieSarkisPhD5 karma

You might like the book "Your Perfect Right" by Alberti. It speaks to the rights you mention, and more. I'd say there's truth in all of those, the exception being that in some relationships where a couple met and one was in a supervisory role, it was not manipulative (assuming both partners are adults). The caveat being that they were not forced or coerced into the relationship.

T_863 karma

Where did the term gaslighting come from?

StephanieSarkisPhD8 karma

From the intro in my book (paraphrased): there was a play in the 1930s called Gaslight, then a movie in 1944 called Gaslight, with Ingrid Bergman, directed by George Cukor. A husband tries to convince his wife that she's crazy. I'll stop there so I don't ruin the movie.

geyges5 karma

Surely psychological manipulation but more precisely "lies" existed before 1930s. Do we really need a new term for something that just means lying?

Isn't it more concerning that people are becoming more and more susceptible to propaganda and outright lies?

StephanieSarkisPhD4 karma

First, gaslighting is so much more than lying. I'll refer you to some of the other posts and the FAQ that detail what comprises gaslighting. Yes, these series of behaviors needs a name. Second, the human brain has always been susceptible to propaganda, and yes, it is concerning. We now have so much more information we are exposed to every day and have to filter out. That's where education about gaslighting and differentiating propaganda from accurate reporting needs to start early.

firkin_slang_whanger3 karma

As someone who was diagnosed with ADD in the 80s, what was the reason why it was decided to just encompass it all and name it ADHD? I never had the hyperactivity, just the attention deficit.

StephanieSarkisPhD3 karma

It's not really an "encompass it all" - just the name changed to ADHD to give a more accurate name to the symptoms. Consider the original term used in 1902 to describe ADHD behaviors - "defect in moral control".

Soliga2 karma

The hyperactivity doesn't necessarily mean the stereotypical 'bouncing off the walls' hyper, it can also mean that your hyper inside, the brain is hyper wanting to jump from task to task quickly and having a lot of random 'noise' making it difficult to focus on any one thing for too long.

StephanieSarkisPhD3 karma

In adults, it is commonly referred to as "inner restlessness".

McJumbos3 karma

What inspired you to go into therapy?

And why did you choose to specialize in gaslighting, anxiety, and ADHD?

I know this is unfair, but if you could only choose one to work exclusively in, which one would it be?

Btw, love your Talking brains podcast - great for the drive home :)

StephanieSarkisPhD8 karma

Even in middle school and high school I was the person that friends came to when they had relationship issues or parent issues. I was a peer counselor in high school. I also have a family history of ADHD and anxiety. My mom was a special ed teacher and my dad is an attorney, and they gave me enough freedom but also had realistic rules, and I still appreciate that every day. It's also probably why I'm interested in ethics and law of counseling, and taught it at UF and FAU.

And thank you about Talking Brains! Just recorded a new episode today on managing anxiety in today's political climate. It will be up by tomorrow.

McJumbos2 karma

OoooOoOooo - can't wait. Btw, keep up the great work especially keeping people aware of mental health!

StephanieSarkisPhD4 karma

Thank you! I apppreciate it!

ripplemon3 karma

My wife has anxiety and panic attacks, and I'm afraid her anxiety is trickling down to her children (I'm their step-dad).

What steps or actions can I use to my wife and kids when they are feeling anxious?

Can Anxiety be a learned behavior, like kids who grow up with alcoholics have a higher chance of becoming alcoholics themselves?

StephanieSarkisPhD7 karma

First, be supportive (by coming here, it sounds like you already are quite supportive!). Anxiety is largely genetic, but it can also be learned or acquired through trauma (as in the case of PTSD). I encourage people to go as a family or as a couple to a therapist. If the person with anxiety doesn't want to go, I encourage spouses to go on their own. I also recommend that a spouse or partner asks, "What can I do to help?" Sometimes we just need someone to listen.

cameronmyers3 karma

what do I do if I think I might have undiagnosed ADHD, and seeking professional help would be incredibly difficult? (Live in the UK)

StephanieSarkisPhD4 karma

Luckily, the UK is more open now about help for ADHD. I recommend contacting http://www.addiss.co.uk/ for help in your area.

cameronmyers3 karma

thank you very much for the reply!

Could I ask what the difference is between ADD and ADHD? I've never really been sure, and the terms get thrown around somewhat interchangably. I've thought that I have ADD, because I'm not hyperactive at all but I have the other symptoms of ADHD (most notably the inability to focus). Apparently ADD is no longer a diagnosis? I'm confused.

StephanieSarkisPhD4 karma

Same thing. They basically just retitled ADD to ADHD to give a more accurate description of the diagnosis.

cowboysauce2 karma

There was originally just ADD, then there was ADD with hyperactivity and without. All those are now subtypes of ADHD. ADD without hyperactivity is now ADHD predominantly inattentive (ADHD-PI). ADD with hyperactivity is now ADHD-H and there's AHDH combined (ADHD-C) to cover people who have both inattentive and hyperactive symptoms.

StephanieSarkisPhD3 karma

In 1902, George Still MD described ADHD behaviors as "an abnormal defect in moral control". Its first mention in the DSM was in 1968, 2nd edition. It was called "Hyperkinetic Reaction of Childhood". I give lectures about the history of the DSM and also the history of ADHD diagnostic criteria, theories, and research. Here's a good summary of the history of ADHD terminology: https://www.healthline.com/health/adhd/history#1902

Midnight_Agent2 karma

Thanks so much for doing this, first of all! I'm sorry if this is too long.

My brother, who lives in the house with my father and I, has diagnosed ADHD, OCD and Borderline Personality Disorder. He's been committed to the Mental Health ward of a hospital on a couple occasions. Our mother had all of these disorders and more, and is cut off from our entire family because of her manipulative behaviors (my sister and I are lucky to only have ADHD). He's been fired from or stormed out of every job he's ever had because of his temper and impulsiveness. Each time it was his supervisor's fault, and he was apparently a model employee. He gets incredibly upset anytime anything goes wrong or if he is ever criticized, stomping and slamming and screaming at you with any insult he can until he gets his way. He spent the last 5 years gaslighting my father and I before I stumbled across your article about it a few months back.

My father and I are at an impasse with him. He refuses to acknowledge there's a problem, and blames me for the situation. He refuses any help period, makes excuses not to take any medication and is consistently rude and condescending in conversation if you even try talking, all to the point where I have cut him out of my life entirely even though he lives 10 feet from me.

What can we do, or should we do, with someone like this? We're literally the only family he has, so we put up with it for that reason. Any sort of help you can provide would do wonders!

StephanieSarkisPhD3 karma

I would recommend that you see a counselor. Living with family members with mental health issues can be incredibly stressful - and so many emotions you can feel all at once. Practicing good self-care is essential when you are caretaking. I send you hugs.

Midnight_Agent2 karma

That's something I haven't considered. I may do just that, thanks so much!

StephanieSarkisPhD2 karma

You're welcome, glad to help.

ultikimatedive082 karma

I have ADHD and I believe my wife is a gaslighter. Needless to say the relationship is toxic. We have a child together and I'm step father to her 2 older kids... I have been trying to get out of the relationship for over a year, but can't seem to be able to get past the "honeymoon" phase after I've expressed my dissatisfaction with the relationship. In other words, she'll "get better" for a bit. Or use one example of different behavior, as a definition to her "change". Can you suggest a method in which I can avoid/overcome the emotional swings, so that I can just leave the relationship?

StephanieSarkisPhD3 karma

Unfortunately I'm not able to speak to your specific situation. Gaslighters and narcissist practice something called "hoovering"...if they get a whiff that you are leaving, they will promise they will get better, things will be different...but they never are. They just get worse. Pay attention to what a gaslighter does, not what they say. What they say is virtually meaningless. This is part 3 in a 3-part series I wrote about being in a relationship with a gaslighter: https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201512/so-youre-in-relationship-narcissist-now-what

ubspirit2 karma

I’m confused by your statements on gaslighting. As should be expected, you take a very critical view of the person doing the gaslighting, to the point of inferring there’s no help for them or chance of improvement. If it is a form of mental illness, isn’t that directly contradicting the work you are doing to help people suffering from gaslighters?

StephanieSarkisPhD6 karma

I have a whole chapter in Gaslighting on getting help for your own gaslighting behaviors. There's a difference between someone admitting that they are gaslighting, and a person with a personality disorder. People with NPD and ASD have "ego-syntonic" personalities - they think everyone else has a problem, and they are fine. Which makes treatment difficult - they don't think they need it. If someone realizes they have gaslighting behaviors and are willing to seek help for it, there you go. https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201701/are-gaslighters-aware-what-they-do

DeviantB2 karma

Is there a definitive test/scale for narcissistic personality traits?

Do narcissistic people gaslight their victims into believing they are narcissistic instead of them?

StephanieSarkisPhD7 karma

Yes, I can't think of the name of it right now. Also the MMPI picks up on these traits. Yes, projection is a big part of gaslighting. Here's my article on it: https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201702/why-gaslighters-accuse-you-gaslighting

numbbbb2 karma

Thank you for hosting this AMA. Super stoked reading this as I really need help with my current situation that involves your expertise.

I am a 29 yo dude that has recently discovered that I have ADHD and am currently in the process of seeking professional help as hard as it is.

My question is that over the last 6 years I have suffered emotional abuse from all of my immediate family while I was completely shut out from all outside interactions. I suspect I also suffer from Asperger's syndrome which kept me completely oblivious to the treatment I was receiving. At this point I have very little recollection of the last few years and I am finding it extremely difficult to move towards finding a solution. The ADHD makes it extremely difficult for me to focus on my problems and the Asperger's combined with the abuse has made my social behaviour such that the medical community refuses to help me and instead are worsening my current situation. How can I change my behaviour so that I can get the help that I need?

My loss of cognitive function makes it terribly difficult to communicate and it took me 10 minutes to write this out. I would really appreciate some help.

StephanieSarkisPhD6 karma

First, I would like to welcome you to our exclusive ADHD club - 11 million members in the US, and 4-8% of people worldwide. We have a secret handshake. I applaud your courage in seeking professional help. I too have been to therapy. I'm unable to give specific recommendations, but I'd recommend that you show the clinician your post, because you described your issues beautifully. For issues with communication - dictation really helps. Speak your emails, texts, and posts. Also, get any verbal instructions in writing. In addition, this sounds trite after all you have been through - but exercise is also key to improving your quality of life. If you are new to exercise, even taking a walk around the block can help boost neurotransmitter levels.

numbbbb2 karma

Awesome, thanks so much. Ill try to get some daily exercise.

StephanieSarkisPhD3 karma

Even parking further away from work or taking the stairs instead of the elevator counts!

princessblowhole2 karma

To what extent do you think nutrition and exercise impact the severity of ADHD symptoms? Do you feel that supplements (B-12, omega-3s, ect.) are helpful?

StephanieSarkisPhD12 karma

In my book Natural Relief for Adult ADHD, I discuss that stimulant medication is by far the most effective treatment for ADHD, but the following non-medication treatments have been found to be effective: 1. Exercise 2. Mindfulness meditation 3. Cognitive-behavioral therapy 4. Omega 3-6-9 (somewhat) 5. Good sleep habits and getting evaluated for sleep disorders. Practicing healthy eating habits helps everyone, ADHD or non-ADHD. People with ADHD do have a higher rate of food allergies and sensitivities than the general population, so rule that out, as these can also cause difficulties with focus. Also, as of 1994 the FDA no longer regulates supplements, so make sure you are using a good quality supplement. I recommend www.consumerlab.org for analysis. Also, there is no evidence in research of herbal supplements being effective for ADHD. Also, do not take mega-doses of vitamins without talking to your doctor first. Studies have found that people with ADHD have no discernible vitamin deficiency compared to people without.

MattsyKun2 karma

I know it's like super late, but I'd like to ask about the food sensitivities.

Do people with adhd have more sensitivities to textures and the like with foods? Both my bf and myself are adhd, and cooking for him is damn near impossible because 80% of the healthier foods I'd eat are stuff he says "the texture is meh". I'm curious if there's a link between the two!

StephanieSarkisPhD3 karma

Some do. See the question in this post about sensory sensitivities for my more detailed answer. People can have high sensory thresholds and low sensory thresholds. High = you need a lot of stimulation to keep your brain happy. Low = you need low sensory (low lighting, low sounds, no beeping noises in DIY stores).

FatalKoala2 karma

Co-hosting the Nerds In Love podcast and hosting the Talking Brains podcast, do you find any difference between a lot of the other work that you do and giving advice over a podcast?


StephanieSarkisPhD6 karma

First, I get to work with Kurt, and he is awesome. :) I find similarities and differences - first, my passion is helping people, so I get to achieve that with therapy, writing, and podcasts. A difference with podcasts is that I'm free to give advice, and in therapy, we are trained to give advice as little as possible - autonomy (you being in control of your own destiny and making your own choices) is highly encouraged.

McJames2 karma

I believe my wife gaslights me, mostly by aligning others against me (to the point where a few mutual friends have called me and asked me if they can tell her to stop) and by lying about the things she has said and done.

However, for MOST of the lying, I've come to believe that she actually believes her own lie - that she can't cope with the idea that she's argumentative, rude, selfish, and manipulative. To shield herself from the reality of it, she re-imagines our conversations or arguments so that she comes off as reasonable, non-charged, and loving, then suggests that I'm an angry person who doesn't love her and just wants to accuse her of bad things when I confront her with her own behavior. In other words I'M gaslighting HER. From what I've read of your work and others, this is not uncommon in narcissistic personalities.

I went into counseling over this a number of years ago, and it was very productive. I was dealing with lots of self-esteem issues that stemmed from identification with the aggressor. My wife came up, but not very often. After about 18 months of counseling, I came out a better person. Around the same time, she went into counseling on her own, and quit after about three months saying that neither she nor her counselor could make any progress because I wasn't coming with her - that all of her problems stem from me, and she can't deal with her problems without me there.

So, here's my question to you - would couples counseling be helpful in such a situation? If so, what should I expect of my counselor in figuring out and helping navigate this situation?

StephanieSarkisPhD4 karma

If a couple comes in and one person tells me that everything is the other person's fault, and that they need to be "fixed" (or similar wording) for the relationship to work, this is a red flag.

I was told by someone that he no longer needed to go to counseling after 3 sessions because "the counselor said I didn't have a problem". (Yeah, we don't usually say that.) He also said that another counselor "didn't know as much about counseling as I did". (Keep in mind this person was in an entirely different occupation.)

Consider restarting your own counseling.

McJames2 karma

I apologize for the follow-up, but I'm not sure I understand the first part of your reply.

Are you saying that it seems like I'm blaming everything on my wife (which is a red flag), and I should consider going back into counseling to deal with that?

StephanieSarkisPhD3 karma

I can’t speak to your personal situation, but no, that’s not what I meant.

AbigBLUEdinosaur2 karma

I brought up the possibility of ADHD with my primary care physician because I struggle daily with focus, motivation and memory issues. I often as people to repeat themselves and get frustrated very easily. Both my mom and my brother take medication for ADHD. My Dr. informed me that if I didn't have symptoms as a child then I don't have it as an adult. Is this true? How would they know whether or not I had symptoms as a child? They ended up prescribing me with a medication for anxiety which made a lot of my problems worse and caused more frustration because I never said anything about having problems with anxiety. How can I present my case in a way that will make them take me seriously?

StephanieSarkisPhD4 karma

One study found that 70% of adults with ADHD have difficulty remembering childhood symptoms. If you have a high IQ, you may have been able to come up with compensation techniques that made your ADHD not look as impairing. I have adults come in all the time that have difficulty remembering their symptoms, or had siblings with more severe symptoms, or don't think they had ADHD as a child...and then I look at their report cards. "Doesn't work to potential" "Doesn't stay in seat" "Bored" "Talks without raising hand" "Daydreams". Your family history of ADHD is a strong indication that you have it too - ADHD has a 75% heritability rate. See an ADHD specialist.

blablabla19842 karma

Do you think anxiety is more a mindset or a neurochemical imbalance?

Doesn't elevated glutemate and low gaba play a big role ?

Why have countries switched from a purely medication based way of dealing with it to a more therapy CBT and mindulness based way ? As the current way of dealing with it does little to address the chemicsl imbalance which I found was primarily the cause in me.

StephanieSarkisPhD8 karma

Genetics play a large role in anxiety. I always ask for a detailed family history whenever I meet with someone for an evaluation. Genetic makeup then leads to how the brain processes chemicals. However, there is also a component of anxiety-producing events. I've been through 6 hurricanes, and I always have heightened anxiety until hurricane season is over. That's probably environmental. However, I have genetic anxiety, so that adds to the mix. Antidepressant medications do address the brain's differing neurotransmitter levels in anxiety. I also address this with patients in therapy.

jerr1542 karma

I just found out recently (at 20) that I have ADHD. Is there any small changes I can make that would increase my productivity and retention rates at work slightly better?

StephanieSarkisPhD3 karma

Consider an evaluation for medication. I've been on stimulant medication for over 20 years, and it has greatly improved my quality of life. YMMV, however. Some "informal accommodations I recommend include: Break tasks down into smaller steps, and assign due dates for each of those steps. Schedule a weekly check-in with your boss to make sure you're on the right track. Get all instructions in writing - "Hey, could you send that in an email to me?" I have a chapter on workplace accommodations in Natural Relief for Adult ADHD.

RandomThrovv1 karma

The first year of our relationship was absolutely amazing. She was a thoughtful, caring, selfless person.

She had struggles with depression the following year, unrelated to our relationship. I helped her through it and things were still good. Then we had a child. She spiraled into post-partum depression, which she refused to acknowledge or get help for. It only got worse with the second child we had immediately after. Then both our children were diagnosed with ASD. Her depression kept getting worse for several more years before I managed to get her to seek help.

I suddenly found myself living with a vindictive narcissist that has been gaslighting me for the past ten years. It has gotten to a point where she alienated me from all my family and friends. I have literally no one to talk to except for her and my psychiatrist.

A question I spend a lot of time asking myself is: Did her personality actually change that drastically? Or did I just miss the warning signs early on and she was always like this? It feels like her personality had a polarity shift within several months. What, in your experience, triggers such behavior in people?

StephanieSarkisPhD3 karma

I'm not able to speak to your specific situation, but I am sorry you are going through this. Sometimes there are "red flags" (or even "pink flags", as I call things that aren't deal-breakers, but curious, keep-your-eye-on-it things). Sometimes the behaviors show up when a person is faced with abandonment (breakup), or when a partner or spouse asserts themselves. Others can have these behaviors as a manifestation of a brain injury or other brain insult. Chronic stress can also make these behaviors more apparent.

SlightShift1 karma

How do you feel about the line, “it’s not personal, it’s only business” ?

StephanieSarkisPhD26 karma

It's a way to dismiss one's non-ethical behavior.

[deleted]1 karma


StephanieSarkisPhD5 karma

Look for free or sliding scale clinics in your area. Some pharmaceutical companies have discounts based on income. Getting your prescription depends on the pharmacy - I went to one pharmacy where I had to contact corporate because of how I was treated - another pharmacy I now go to (in the same chain) is great.

KidPix6661 karma

Are you familiar with Anxiety Buffer Disruption Theory? I'm aware that there are traumatic experiences (such as PTSD from war, rape, and psychedelics) that can bring one's mortality and existence as a living-breathing animal to the forefront of their consciousness in an unbearably disturbing way.

Do you feel that humans can only function when we have a comfortable sense of denial as to our mortality and "creatureliness," or do you think our natural state of mind is at peace with these concepts?

StephanieSarkisPhD3 karma

Oh you'd probably like the Talking Brains podcast episode with Rick Moskovitz MD. He speaks on memory, trauma, and state-dependent learning. He speaks to all of this, and he's brilliant. http://stephaniesarkis.com/blog/rick-moskovitz-memory-trauma/

AquaSting1 karma

How would you explain to someone without ADHD what it’s like?

StephanieSarkisPhD6 karma

It's like your brain is a hamster wheel, always spinning. When I was doing my training, one of our young patients said "My brain pops like popcorn," and that is so accurate. It's also looking for the right word for something you want to say, but the file drawer with the words in it is rusted shut. When my stimulant medication is on board, it's like the file drawer just slides open and the right word pops out.

merinis5 karma

imagine reading a book, you're half way through it, and start a new paragraph. You read the first sentence of the paragraph, then the second. the second sentence doesn't make any sense to you because you can't remember the first sentence. You do this 4 or 5 times, saying. each. word. in. your. head. and. stare at the paper till the first sentence registers and becomes actual fucking words. Then you read the second one and it makes sense now, and you move on.

StephanieSarkisPhD10 karma

YES. Without stimulant medication, if I'm reading something I have to read (rather than reading for pleasure), I can read something a few times and not absorb it. With stimulant medication, I can read through something once and know what it says.

Vepr762X54R1 karma

Are you concerned about all these "troubled teen" camps popping up all over the place? and do you see the explosion of these camps as a sign of social decline?

StephanieSarkisPhD3 karma

Those have been around for a while. A long time. They are concerning.

FastG1 karma

Thanks for the AMA. As you know, there is a strong correlation of ADHD and/or anxiety with ASD. Do you think treatment for ADHD or anxiety should differ in people on the autism spectrum? If so, how?

StephanieSarkisPhD3 karma

Treatment is unique, and is on a case-by-case basis. (Btw, stats are if you have ASD your rates of ADHD are 60%; if you have ADHD, your rates of ASD are 10%. I know that may seem confusing...it is.) I think treatment should differ even when a person "just" has ADHD or "just" has ASD - even those disorders by themselves can vary greatly in symptoms and intensity of symptoms. How it should differ? It really depends on the person. Since ADHD and ASD are so highly genetic, when I am asking about family history, I ask what treatments have worked for others in the family with the same issues. So treatment needs to be individual, and also...treatment options can be similar. Medication, therapy...

dunyged1 karma

Why always take the dog?

StephanieSarkisPhD9 karma

So what dunyged is referring to is in my FAQ - when you leave a gaslighter/abuser, always take your pet. It's because your pet is now at an even higher risk of being abused or killed. https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201706/beware-narcissists-around-your-pet

merinis1 karma

I frequently hear people talk about hyperfocus or other aspects of their ADHD that they attribute to success, or at least as a positive trait in some way. Do you view any aspect of ADHD as beneficial, strictly inhibiting, or in some other way?

StephanieSarkisPhD3 karma

I'm trained in cognitive-behavioral therapy and solution-focused therapy, so my view of ADHD is that it is a serious disorder which can lead to increased rates of substance abuse and suicide, amongst others. However, I also ask patients what is going well, so we can work on increasing successes. People with ADHD have hit so many "speedbumps" in life...and we work together to create a smoother way of driving, so to speak.

merinis2 karma

Thanks for your answer. It's weird to me to see other people try and romanticize it when it's caused me and my family so many issues and nearly done a lot of damage to my life. I'm glad that the professional opinion of the people in the field is that it's dangerous and damaging.

StephanieSarkisPhD5 karma

Yes, I would say that's the majority opinion. For quite a few of us, we not only have seen the devastation ADHD can cause not only in the families we work with, but also in our own families, including deaths attributable to ADHD behavior and addiction.

xoxo521 karma

My bf and I both have adhd/anxiety. A good portion of our arguments follow a similar trajectory: he makes an immature comment => I call him out => he insists that’s not what he said/meant and I’m remembering wrong or that I’m misinterpreting what he meant (trying to downplay the offensive part of his comment) => I doubt my judgment and memory => I have to think back and repeat exactly what he said to “prove” I’m not misreading his original intent => I get even more frustrated that I have to go through this whole rigamarole to justify my initial reaction to his comment => I tell him to stop “gaslighting” => he denies doing that => he reflects for a while and owns up to whatever it was I was calling him out for => he gets hurt bc he says he would never intentionally gaslight me and it hurts him that I would think that (sometimes claiming he was stoned and not remembering things correctly).

Is this gaslighting? Or am I overreacting? Is there a better way for me to respond when this happens? I hate the argument changing from addressing the offensiveness of what he said to if he even said it in the first place.

StephanieSarkisPhD6 karma

I'd need to meet with you to give you specific recommendations - but what I can tell you is that the couples I see with both ADHD and anxiety have similar argument patterns. Is it gaslighting? Again, I'm not able to make that judgement from your post. I would recommend couples' therapy, as it seems there are some crucial issues for the two of you to work on. One way to stop arguing about whether someone said something is to state you know they said it and leave it at that. You can't argue when there's one person. Also, and not particular to your situation but to couples - arguing is normal in a relationship - it's fighting that is unhealthy.

xoxo522 karma

Thanks for responding!! We overall have a very loving relationship. Definitely the healthiest I’ve ever been in. We both see our own therapists and they both think we are good for each other so we joke that our relationship is “therapists approved”. I will try to not focus so much on whether he said a certain thing and just share my thoughts and leave it at that. I don’t think he does it with any malicious intent, it reminds me more of a child trying to get out of trouble. It’s just draining when it happens and when I saw your ama I thought it would be the perfect opportunity to ask. Thanks again!!

StephanieSarkisPhD3 karma

Well hey, who can beat a therapist-approved relationship? Mazel tov! Here's a video I did with Understood about ADHD and lying. It's more for parents, but explains the creative stories that people with ADHD can come up with. It's a survival mechanism. https://www.youtube.com/watch?v=wN2Ln51alRk

bravo_0081 karma

Dr. Sarkis,

What are your thoughts on ADHD and hypothyroidism interacting with each other?

I’ve been diagnosed with both and am treated for both. I find them to interact with each other in a type of feedback loop that can either be helpful or incredibly inhibitory.

Second question if you have time: I was told that ADHD is passed down through the mother. Is this true? And is there anyway to help children as they develop and grow to ensure ADHD impacts them less? (Oops, guess that was a multipart question!)

Thank you!

StephanieSarkisPhD3 karma

People with ADHD are more prone to having thyroid disorders and autoimmune issues than the general population. It is not known why at this point.

ADHD passes down through both parents at an equal rate.

Ha, multipart questions are great - it helps when they are written down! Help children as they develop and grow - if you suspect ADHD symptoms, take your child to a specialist for an evaluation. Studies have found the sooner your child gets proper treatment for ADHD, the higher their self-esteem, social competence, and grades will be. Also have consistent structure in the home.

najing_ftw1 karma

What are some of the more accurate fictional portrayals of gaslighting?

StephanieSarkisPhD6 karma

I had a radio interviewer ask me this, and I always feel like I know the exact answer...until I am asked. :) Of course, there is the classic 1944 movie "Gaslight"....there is an episode of Star Trek:TNG where Picard is being gaslighted.https://en.wikipedia.org/wiki/Chain_of_Command_(Star_Trek:_The_Next_Generation)) I feel like the movies Gone Girl and maybe Sleeping with the Enemy portray gaslighting/emotional abuse. (Although in Gone Girl I'd say that it is heightened for dramatic effect.)

zaccapoo2 karma

Girl on the train is another (albeit dramatic) portrayal of gaslighting. In my opinion it is even more so than gone girl.

Source: ex was a master gaslighter.

StephanieSarkisPhD3 karma

That’s the one I was thinking of! Thank you!! There are some Hitchcock ones too.

Riothegod11 karma

When you went on stimulants for ADHD, did you ever experience symptoms of anxiety, like your executive function is now over compensating? If so, how would recommend trying to calm down? I’m asking since I have ADHD-PI and i’m beginning to have this problem.

StephanieSarkisPhD4 karma

First - reaction to medication is highly individual. My experience may not have been your experience at all. I've been on stimulant medication for ADHD for over 20 years. I have anxiety anyway, and I found my anxiety actually decreased because I wasn't having to work 5 times as hard to only get half the amount of work done. However, it is not uncommon for people to have some increased anxiety on stimulant medication. Schedule an appointment with your prescriber. Diaphragmatic breathing and practicing mindfulness meditation can help in the meantime. Here's a 10% Happier podcast I was on re: my use of mindfulness meditation for ADHD and anxiety: http://stephaniesarkis.com/interviews-podcasts/

reefshadow1 karma

What is your opinion of the current president of the USA in regards to the behavior that you research?

StephanieSarkisPhD4 karma

I can sum that up in my USA Today op-ed, "Donald Trump is a classic gaslighter in an abusive relationship with America": https://www.usatoday.com/story/opinion/2018/10/03/trump-classic-gaslighter-abusive-relationship-america-column/1445050002/

GingerExpress881 karma

Thank you for your time here, Dr. Sarkis. I've recently decided that my sanity is more important to me, so I've had to part ways with a sibling due to their gaslighting and it's extreme effects on me. I still find myself having arguments with them in my head and struggle to get out of them sometimes. They've been a lot better lately, I just tell myself "NO" out loud and then think of puppies. Do you have any alternate suggestions for dealing with these mental arguments with the gaslighter?
Many thanks!

StephanieSarkisPhD3 karma

I think when someone has been in a highly conflictual relationship, the brain gets used to that level of heightened arousal, and continues that pattern. Cognitive-behavioral therapy can be helpful for that, including "thought-stopping". You're already doing that with substituting with puppies! Good job! I think realizing that this is your brain doing this because it's used to tension and sometimes needs time to adjust to a less-tension environment can help us detach from those thoughts. You might find Acceptance and Commitment Therapy interesting.

GingerExpress882 karma

Thank you so much for your response! I will research some cognitive-behavioral therapists in my area and see about learning some further techniques for thought-stopping. You're right, being subjected to such constant conflict for so many years, I just haven't gotten used to my sense of security now that I no longer have to deal with it.

StephanieSarkisPhD5 karma

You're welcome. Your brain's response reminds me of a friend that grew up with an abusive parent - when she cut off contact, she told me she would still create arguments with her parent in her mind. That was her normal - complete chaos - and being out of that chaos felt uncomfortable at times. Today she is happy and healthy.

cahaseler1 karma

Hi Dr Sarkis!

It looks like your proof link isn't working - I know it was fine when you first arranged this AMA, but it seems to have issues right now. Do you think you could tweet about this AMA publicly so people know it's you? Thanks!

StephanieSarkisPhD3 karma

Corrected it, as the gods would have it, tech meltdown right before the AMA. :)

ADD11221 karma

How can people with ADHD reconcile the desire for new and exciting vs staying on a committed relationship?

StephanieSarkisPhD1 karma

Change it up, and have equal distribution of chores. (I'm not kidding.) You'll like the Talking Brains podcast with Ari Tuckman PsyD MBA. He specializes in ADHD and sex and did a survey of couples about what helps keep them committed. http://stephaniesarkis.com/blog/talking-brains-episode-2/ His website is www.tuckmanpsych.com

GuyTallman1 karma

Hey! I have some serious ADHD and have most of my life. This never got medicated, because I always did well in class, I would have straight A grades but have abysmall citizenship marks (do they still do those?) Teachers would always comment things like, "GuyTallman is bright, but needs to talk less in class and not disturb other students. GuyTallman absorbs information well but needs to stay in his seat even if he has finished his work." Since I was never failing, it just wasn't a problem for any of the adults.

Now as an adult myself, this has led to some hard wired behaviors that are just part of who I am now. How much do you think medication helps for those who start later in life? Will this help with short term memory issues that I usually attribute to "being distracted?" Will this change my personality? Do people ever feel medication makes them "less creative?"

StephanieSarkisPhD4 karma

I love the visualization i had of your teacher calling you "GuyTallman". :) Our 16 year old dog refers to my 6'4" brother as "Tall One". :D I started stimulant medication when I was 23, and it has helped my quality of life tremendously. There's a post in this thread where I answer in some of the ways it has helped. When stimulant medication is working optimally, you still have your same personality (my medication is on board now, and I just shared that our dogs talk, so there you go). Most of the people I work with have found that stimulant medication actually helps their creativity because they are better able to follow through with their ideas. The oldest person who I've diagnosed with ADHD and subsequently went on to do well on stimulant medication was 83.

Bunbury911 karma

Hi, I was wondering: my boyfriend has relatively poor memory regarding everything except for numbers and dates. He’ll often remember things as having happened in a different order chronologically and will sometimes fill in memory gaps quite creatively. He’s a great story teller and his stories wouldn’t be nearly as interesting without the details his mind makes up to fill the gaps. He’ll almost always easily agree to my version of events the few times when I do correct him and there seems to be no agenda, so I am certain there is no intent to gaslight. But seeing as I’m planning to be with him for the rest of our lives, what can I do to protect myself from it having a confusing effect on me long term?

StephanieSarkisPhD3 karma

I can't give personal recommendations, but I think couples' counseling might be helpful.

DijonPepperberry1 karma

I have a colleague in psychiatry who was diagnosed with ADHD, AFTER graduating from her program and was in full practice. In hindsight it was so obvious (accidents, forgetful, distractable) to both of us, but we lamented the fact that two psychiatrists missed it.

Can you share a little bit more about what stimulant days vs nonstimulant days are like for you? And for people who've succeeded DESPITE their ADHD (it's hard to call it a disorder when you succeed so much), do you think it's fair to sometimes consider ADHD even in people without struggles in relationships/job/school?

StephanieSarkisPhD8 karma

I'm going to start with your last question first, because ADHD. My answer, in the words of one of our dogs, is "Oh hells yeah." (She's 16, and DGAF about niceties.) I do consider ADHD even if a person is "high functioning" because they may still not be working to their potential. And I especially consider it if there is a family history. It is very common for adults to come see me because they knew something was off - but because they were seen as high functioning (or couldn't remember childhood symptoms - that happens in 70% of ADHD adults, btw), the diagnosis was missed.

First question second: What are days like on and off meds. I am rarely off meds. If I am sick and need to rest, I won't take it. But usually I do, because it helps my quality of life. With medication, I am able to have a thought stick in my head instead of interrupting and saying, "I have to tell you this right now, or I'm gonna forget."; I'm able to clean the kitchen immediately after cooking; I'm better at math (I have a math LD, so this is a big deal); I'm able to follow multistep directions; I'm able to stop and evaluate if my course of action is effective; and I can sit still through a movie. I can also read through something once and know what it says instead of reading it over and over. Oh and I've been able to write 7 books.

DijonPepperberry2 karma

Thanks ! Great answer and perspective. I work exclusively with kids where symptoms are presented to me on a plate, and adult diagnosing is not a thing I do.

I think it's also important to hear a PhD therapist tout the usefulness of evidence based medication treatment because often it's a "meds are bad" world in therapy/public perception, when they are simply useful tools for people who need them.

Thanks again!

StephanieSarkisPhD3 karma

You are so very welcome! I'm all about "show me the numbers before I recommend this to people". And stimulant medication is by far the most effective treatment for ADHD, according to years of research. I also recommend evidence-based nonmedication treatments as an adjunct therapy: exercise, Omega 3-6-9 (somewhat effective), mindfulness meditation, and cognitive-behavioral therapy. There's another one that I can't remember. Adderall wearing off. :) I think I wrote it somewhere in here.

Thaddeus_Venture1 karma

Is there a good resource or test that you would recommend to someone that thinks they might be dealing with anxiety and/or depression? I feel like I've been having symptoms of anxiety for the last year and a half, which started after having my first panic attack (that occurred seamingly without reason). Since that event, I haven't really felt the same. Sweating, trouble breathing, trouble focusing, high highs and low lows.

StephanieSarkisPhD3 karma

The Anxiety and Depression Association of America has some great resources, including screeners for anxiety and depression. They also have information on treatment, and who specializes in anxiety and depression in your area.

blackwellsucks1 karma

It seems that there’s often a pretty fundamental disconnect between people who have ADHD and their family/friends who don’t. And as someone who was diagnosed as an adult, I’ve found it tough in many situations to explain to those without ADHD things like why I do the things I do, and why it’s tough for me to function in some ways that are considered pretty basic and normal.

I really don’t want to discredit the frustrations those around me feel when they’re dependent on me and maybe I—say—forget things or when I take a little longer to finish something.

So my question is: how can I better help those around me who don’t have ADHD understand my life experience better while still maintaining sympathy toward the way they’re feeling?

StephanieSarkisPhD3 karma

I think CHADD's clearinghouse has a lot of great resources on explaining ADHD to others: www.help4adhd.org

Maybe this video I made with Understood can help: https://www.youtube.com/watch?v=J1uWaQFQac0

The way I frame it is, everybody got somethin. If it's not ADHD, it's diabetes, heart disease, or any other medical issue. We would never tell someone with diabetes, "You can make that insulin on your own, just work harder" or "You're insulin shots are a crutch", why the hell do we say similar things to people with ADHD?

legogirl1 karma

I just wanted to start by saying thanks for bringing gaslighting to light (so to speak). I have ex who manipulates this ways, just one of the weapons in his arsenal, and just understanding it exists made me feel saner. Unfortunately it's also something I have to deal with at work, as I work in a high pressure very male dominated profession, and people use it as a way to make me less credible when they don't like what I have to say. Documenting everything has really helped there.

I have a question about ADHD. My 13 yo child is diagnosed more specifically with ADD. He's got very poor impulse control and attention issues in particular, like everything is a new science experiment. It's kind of unfortunate because he's very intelligent but isn't always successful because of his other challenges. He's medicated and other than social skills is doing fairly well. My actual question... his doctor suggested we look into neurofeedback type training. It's so expensive. Is it really worth it? I see him improving every year with his ADD as he learns coping skills, and he is healthy but underweight. I wish I didn't need to win the lottery just to know if it was going to help.

StephanieSarkisPhD3 karma

You're welcome, anything I can do to help. I'm glad documenting has helped in your workplace. There are many other women who have told me about gaslighting behaviors in their male-dominated workplace. (Yes, I know not all men gaslight.)

ADHD question: neurofeedback is not effective in treating ADHD. Russell Barkley PhD, THE researcher in ADHD, had an article about it's ineffectiveness. I speak about this in my Natural Relief book. Your return on investment (ROI) is poor with neurofeedback. I quickly found this, it cites Barkley: http://www.neuroregulation.org/article/view/13677

marchaeus1 karma

Hi, Dr. Sarkis. About a year ago I noticed that I had an unusually bad attention span compared to others and the more I tried/failed I would get super anxious about it. I became worried I might have ADHD, though I wasn't hyper child. I was tired of struggling to pay attention when my wife or friends needed my full attention for an extended period of time. Without realizing it, I was miles away in my head. It was a daily battle. Went to a psychiatrist and found out that I indeed had ADHD int he psychiatrist's eyes. They said the "hyperactivity" can manifest as anxiety for some adults (I'm 30). I do have a ton of anxiety about work, family, and friends when I'm not on Adderall.

I keep hearing that long term use of Adderall can affect brain function later in life but I can't any hard evidence to back that up. Should I be worried? I like having an anxiety level of 3/10 instead of 7/10 all the time.

StephanieSarkisPhD3 karma

You can have primary anxiety with ADHD (you inherited the genes for both), and you can have secondary anxiety with ADHD (you developed anxiety because you had to work harder than everyone else and still didn't meet expectations, and/or you got in trouble in class for not raising your hand, speaking out, etc.) As we get older, our frontal lobe develops, and symptoms can "morph". Anxiety can also be a side effect of stimulants. I'm not able to give an answer to your specific experiences.

Haven't seen any research showing Adderall can affect brain function later in life. Stimulants have been available since 1936 in the US, so there are a lot of longitudinal studies available. Not much longitudinal research available with the non-stimulants for ADHD. I've been on Adderall for over 20 years and I'm a fan of my brain's functionality, so I've read a lot of studies on it.

Nephermancer0 karma

Hi there, 27 year old male here, USA. I'm a year out of a 7 year relationship in which I was gas lit, emotionally and sometimes physically abused and manipulated by my ex-boyfirend. I grew up poor and he is extensively wealthy and this made for an extremely unhealthy dynamic in which he used his influence and wealth to coerce, incite fear, or "pay me off." We are both diagnosed with manic depression and adhd. His with a bit more violent tendencies than my own. Im still struggling with separating what was my old life in this dynamic to my new life without and away from him. In this time I have developed severe anxiety towards social and general interaction with the world. I work a low paying job and have no health insurance when just a few years ago I was on a cocktail of medication that at times helped but others proved too much. What steps can I take to regain emotional independence (without meds) and rebuilding/separating my tendencies that once mixed with his?

StephanieSarkisPhD4 karma

I am very sorry you experienced this. And I applaud your courage for getting out of a toxic relationship. It is very common after leaving an abusive relationship to feel anxiety about your role in the world and your interactions. A high level of distrust can develop (understandable, because the person who you were most vulnerable with mistreated you). Look up clinics that offer free or sliding scale therapy and medication. Some pharmaceutical companies offer discounts based on income. Some of the healing just takes time. Here's an article I wrote on breaking free: https://www.mindbodygreen.com/articles/what-to-do-when-youve-been-gaslighted and another on Psych Today: https://www.psychologytoday.com/us/blog/here-there-and-everywhere/201606/how-leave-narcissist-good

Baller_McFly-5 karma

I don't believe anxiety, depression, or ADHD exist. Can you say anything to change my view?

StephanieSarkisPhD1 karma


happiness7734-6 karma

Do you get upset about the misuse of the term gaslighting in public discourse? I do. If someone is aware they are being gaslit, they are not being gaslit. Gaslighting can only work as a technique of psychological manipulation if the target is in the dark about it. Instead, we have people on TV shows screaming about how they are being gaslit. It is so annoying.

StephanieSarkisPhD10 karma

I'm actually happy that people are at least talking about manipulation and using the term "gaslighting". Before, we either didn't have a name for these sociopathic behaviors, or it was not the social norm to call them out. Every term is misused in different ways by some...and gaslighters will call someone a gaslighter because they are projecting.