Hello! I’m Dr. Menon, a psychologist specializing in therapy related to ADHD and Autism in adults.

Given, say, a medium sized gym assembly of randomly selected adults- How many people in the bleachers do you think deal with the effects of ADHD while being completely unaware that is the cause of their struggles?

Great question! While the rates are much higher for children, adults with an "official" diagnosis of ADHD are 3-5% and those experiencing symptoms/characteristics of ADHD are slightly higher at 5-7%, according to multiple recent research publications.

What's your best tips for ADHD in an adult working shiftwork and overtime at a hospital and hence have no sleeping-pattern and everything is chaos?

I think the most critical thing here is to create some structure within the chaos. Even if the hours and length of the work day change, you can create routines that reset you before, during and after the shift. I would start with making list of the main things you want to do each day and each week, based on your personal priorities (examples: exercise, cook at home vs ordering food, laundry, time alone or with friends,family etc.). Then, plug that (wish)list into the times around your work schedule. If your schedule changes from week to week, you can revise the plan each week to make sure what's important to you fits into the time you have.

I love learning new things but after Ive done it once and I feel I know how to do it, it loses its appeal.

I also have a hard time to finish things bc I look for more stimulation after cleaning 3 spoons.

Could this be ADHD? Im not hyperactive or anything...

Edit: A wandering mind would describe it best.

What you are describing is a drop in motivation after the initial rush or thrill of learning. Developing and strengthening motivation and persistence is definitely something that can be learned and practiced. There are 3 parts to the motivation equation: activation, persistence, and intensity.
Activation happens when we are getting started. For example, we might gather supplies, some music, and some friends before we start cleaning the garage.
Persistence occurs when we keep going, even though obstacles may come up. We stick with the task of cleaning the garage even when the day is getting hotter and our friends don’t show up.
Intensity shows up in concentration and effort. Only a few people came to help clean? We each work harder to get the job done.

Given the overlap between ADHD, ASD, and OCD symptoms, do you foresee the DSM-6 moving towards a more "all encompassing" diagnosis as to not let people who exhibit a little of all 3 fail to meet the criteria for diagnosis?

Also, with more studies focusing on autism in girls and how many are misdiagnosed as having ADHD because they don't display the stereotypical restrictive/repetitive behaviors, do you think there will also be a change in diagnosis criteria in the DSM-6?

Both questions are extremely pertinent to my life right now, so I greatly appreciate your time!

Oohh awesome question, I read that even for the DSM 5 it was close to approving a larger category of Executive Dysfunction but at least we have a broader category of ASD and not divided between Autism and Asperger's for now. I think viewing these diagnoses across genders and with a gender equity lens is crucial. I write about this on my website. www.mythrivecollective.com. There's a lot of great research coming out that has us moving beyond the stereotypical male model of the diagnosis. I hope that you can benefit from these changes.

Hey thank you for doing this!

So recently i went to a Behavioral Specialist about seeing if my breathing problem was related to anxiety and also about Adhd since i was there anyways, and i was told as a 25 yo, my doctor couldnt diagnose me with Adhd until she talked to a parent or someone that knew me as a child. I found it weird. Is this normal for diagnosing adults with adhd?

If possible I do like to get a history and ask questions about childhood from a parent or close contact. Sometimes there are old report cards to look at too. It's not always an option to speak to someone who knew the client as a child, but it's best practice. I was trained to make sure I complete a "multisource, multimethod" evaluation.

What are the benefits of someone who would be diagnosed with autism as an adult? What would they gain by seeking an official diagnosis?

Great question! Many clients I have met have told me that they have felt like something is different about them for a long time. As a neurodiversity-affirming psychologist, that's not necessarily viewed as a problem. But, they also say that they have a hard time being themselves around others and it affects making and keeping relationships. That's when a diagnosis may be helpful - to reframe the "why" behind something (i.e., it's not because you are cold, rude, uncaring etc.) and use some science-based interventions and techniques that are supportive of the neurodiverse brain.

How do I deal with a persistent case of "action paralysis"? I know exactly what to do to get my life together but I can spend hours just lying down berating myself for not getting up and Doing The Thing and still find myself unable to move. I fear that all the introspection I do to get better is never going to help me because of my inability to put that knowledge to use.

Thank you for asking. You've got some good advice about starting with the smallest most manageable step. And as you can see berating yourself has not worked for you. Maybe you can come up with some incentives and using some simple tricks like “if I do this then I get that” approach just to get you started. Introspection is important but sometimes we need a different tool to move to action.

If you could give one thought or "hack" to every teacher across the nation for how to improve their teaching to help students with ADHD or ASD, what would you give?

I'm a school psychologist also and have a deep respect for educators! Thanks for asking your question! It's hard to pick one thought but the foundation is developing a strong relationship with your student. Get to know them as people. We've all read the research and seen the news stories about what angry, isolated, and deeply unhappy students can do, right? So, helping them feel connected to you and their classroom community, helping them feel like they add value and meaning are critical.

When it comes to women, it is said that ADHD is underreported due to misdiagnosis and because girls tend to hide their ADHD related issue better, only to often crash and burn sometime later in life.

What are some of the more noticeable signs in adult women with ADHD? And what are some of the suggested supportive mechanisms that one can explore when they’ve been diagnosed with ADHD?

Unfortunately we don't have a clear cut answer as to why ADHD presents differently in men and women but we certainly know that it does. It is likely to be a combination of genetics, hormones and environmental factors. Here's a recent blog post on the topic:https://mythrivecollective.com/adhd-in-girls-and-women/

When dating, I tend to get really excited when I meet new people but quickly look for others even if everything is working out. Is there any correlation between ADHD and relationship satisfaction?

There sure is! That first connection is thrilling, exciting and rewarding. After that early phase in a relationship, the dopamine release that we get when we experience a "reward" gets spread out. So, we seek it again by meeting new people. The pattern keeps repeating.

Hi. Question about adult diagnosis of ASD. I have a sibling with a genetic disorder highly correlated with ASD occurrence. He has a lot of issues, they are complex and intermingle.

He also is very opposed to seeing someone to help me improve his mental health circumstances. His issues are significant enough that I often whether SSI disability might be an option for him.

Any advice on how to approach a conversation about diagnosis or trying mental health services? There is obviously a lot of shame and stigma for some people around these topics.

What a caring sibling you are! This is hard for people to accept and move into action, especially because of the shame and stigma. There may have been many uncomfortable experiences along the way. What I've seen work in session is to have your brother and you attend but say to your brother that the session is for you to learn more about options. Alternatively, you can meet with an attorney about SSDI and ask questions like : "What kind of benefits would he get/ what does he need to get them? An evaluation?" That might open the door to next steps.

My original comment was deleted because I suppose I didn't phrase it in the exact right way, but could you go into more detail about how you approach therapy with ND individuals and how it differs from therapy more broadly?

Asking as an adult recently diagnosed with ADHD (and not diagnosed but presumed ASD), and I'm considering looking for a specialist like yourself.

I have a specific sequence that I go through, that I've developed after research and my years of practice. My approach is ND-affirming, first and foremost. There's nothing "wrong with you". The main concepts that we cover are understanding your identity and core values, building self-concept and self-esteem, reframing habits and behaviors (camouflaging, masking etc.) in the context of ND, working on navigating relationships and understanding the perspectives of others, your sensory needs and putting all of this together.

ADHD and porn addiction. I'd like to know your thoughts on this. Seems a high correlation.

Are there specific types of advice you would offer someone with ADHD and breaking porn addiction?

Is there evidence suggesting that stimulant based ADHD meds increases sex or porn drive?

The tendency towards addiction and addictive behaviors is definitely stronger in the ADHD brain. Why? Because of a possible calming effect, because they may feel the effects more intensely or they are more sensitive to the effects of any substance or behavior that becomes addictive. The process of breaking the addiction is long and challenging and really needs a professional partner. Th search for dopamine and finding alternatives is the key. I can't respond to the medication questions since I'm not an MD.

As an adult female, I’ve found it difficult to find a specialist I can talk to. I have a therapist I see regularly, but she works mainly with family systems and has said she doesn’t know any adult autism specific psychologists/therapists to refer me to if I want to explore diagnosis. She’s said she thinks I may instead have a combo of other behaviors/diagnoses.

What’s the best/most effective way or resource for finding someone/psychologist/therapist who specializes in adult autism, specifically in differentiation between ASD and other things (selective mutism, hypersensitivity, etc)?

I work in this niche exactly and many clients have found me through therapy directories such as Mental Health Match. I really like collaborating with other therapists as part of a client's team. I have several who alternate appointments between their regular therapist and me. Sometimes, I do the evaluation part only to differentiate between ASD and other things, as you said. I welcome that too.

When I was 16, I was diagnosed with High Functioning Autism, ASD. I have never fully believed this was the correct diagnosis.

Recently I picked up a book on ADHD and it was like reading a guide to my life, my experiences and difficulties. I am wondering, is it possible for ASD & ADHD to coexist? Also, is it common for ADHD adolescents & adults to be mis-diagnosed with High functioning autism? Thank you.

Absolutely. First, I want to say I'm so glad that you found a resource that resonated with you. ASD and ADHD can definitely co-exist. In psyc terms it's called comorbidity. There are usually a lot of misdiagnoses along the way, unfortunately. I've met clients with a range of diagnoses such as Bipolar Depression, Borderline Personality Disorder etc. that are really ADHD and ASD.

What's your tips on creating a healthier lifestyle when you have ADHD? Better eating, cutting alcohol and the gym specifically.

The most common downfall of ADHD is being inconsistent. You may have great ideas and be inspired to take action but then the action doesn't turn into a regular habit. Why? Because being consistent is not as much fun to our brains as it is to try new things. So, making things routine and setting some rules around your behavior ( I will eat x for breakfast, y for lunch, and z for dinner; I will have 1-2 drinks (if appropriate) when I go out with friends but I won't drink at home, and so on). The other key is to change the environment and patterns, like driving straight to the gym before or after work or stocking your house with things that make it easier to make the healthier choices that match your values.

Adult diagnosed ADHD here. I've had success with ADHD meds (Vyvanse and Adderall) to help me focus on daily tasks.

I've also recently experimented with microdosing psilocybin as an effective treatment, but with very different results. While stimulants help me "blend in" a bit more, the psilocybin helps me effectively utilize my "ADHD thinking" (if that makes sense).

Do you have any opinions on psychedelics as treatment for ADHD?

Sorry - it's a great question but outside my scope of practice. I would definitely ask in a group that focuses on psychedelics.

I’m currently in the process of becoming a psychotherapist and I’m wondering which resources you recommend for learning how to specialize in treating ADHD? What types of therapies/modalities do you recommend focussing on? It’s something I’m very interested in but can’t seem to find much information on. Thanks!

Best wishes to you on your journey! Feel free to reach out through my website as well. I have taught grad school for many years and continue to love mentoring. I would look into the work of Guare and Dawson on executive functioning skills and of course, Russell Barkley for ADHD to get you started.

If I recognize slight symptoms in myself (things like stimming; vocal stims, physical stims like fidgeting with my fingers, flicking my hands around, etc) but nothing that genuinely disrupts my day-to-day, do you think it would be worth pursuing a diagnosis? Would it really change anything at this point? Shouldn't I save those resources and accommodations for folks who need it more than I do?

28 year old male, for whatever that's worth.

Thank you!

Thank you for asking! I think the key question is whether or not it is affecting your daily activities and meeting the goals that you've set out. If it is disruptive to you, whether or not you have a diagnosis you can certainly benefit from some support. In general, stimming is basically meeting a natural need for sensory stimulation. And actually, if you try to resist it becomes more difficult and more disruptive to you. Stimming is a way to self-regulate and get into a frame of mind where self-control becomes easier.

I am an adult male who received a late (39) diagnosis of ADHD. I am struggling with just how little self awareness I have had throughout my whole life when it comes to my ADHD. I also struggle with imposter syndrome, and frequently catch myself doubting my diagnosis, even though there is a mountain of evidence supporting it. Is this common? Is there anything I can do to try to help this? Thanks in advance ( and thank you for what you do )

Thank you for this question. Yes, it is common. Often the lack of self-awareness is a coping mechanism and may serve a purpose for you. It protects you from feeling shame and vulnerability to the impact of others' feelings towards you. That said, I would recommend exploring and increasing your self-awareness while still protecting yourself. Maybe you can ask a trusted friend or colleague for constructive feedback. I do this a lot in session. Self-doubt and imposter syndrome are real! It comes from noticing your own inconsistencies which can lead to not trusting yourself. I want to say that your strengths and weaknesses do co-exist. Both can be true. Accepting that is the way out.

My question is, how probable it is for 3 generations to be autistic?

I've always been more similar to my dad in terms of personality, especially the "autistic" traits. After several sessions with my therapist talking about my family/parents, she also said that it's very likely he's autistic too, however she obviously wasn't able to diagnose him without a proper evaluation. I've spent quiet a while thinking about it (thanks for overthinking every single thing, brain) and remembered how I've heard several people use our surname as an adjective when talking about some of our traits. In particular, being stubborn, being bad/harsh with people (i.e always talking as it is), liking monotonous work, fixating on things, fixating on being on time/having a routine or a plan, feeling anxious about a sudden change in plans, etc. And while I am the only diagnosed one, I'm also the one with the worst symptoms. So I'm curious to know about the genetics of autism and if it's just a coincidence?

There's a lot of good research about the genetic links of autism and we definitely need more. There's been huge growth in the field in the last 10 years especially. My opinion is that it's one reason why we are seeing higher rates of diagnoses in adults, who may have been missed when they were younger. Rates are as higher as an 80% "genetic risk" of inheriting genes related to autism.

Are you currently accepting clients? I find that it can be hard to find a mental health professional trained in ADHD and Autism.

Also, if someone was hesitant to reach out for therapy, what advice would you tell them?

Thanks so much for asking! Yes, I am currently accepting clients for both therapy and evaluations. I am licensed in Illinois and have telehealth authorization to practice in 30-plus states. The most current list is here: https://mythrivecollective.com/online-therapy/

You also asked a great question about being hesitant to reach out for therapy. It’s a common feeling. That's why I offer a free consultation so people can get to know me and start to feel comfortable with the process. I have a great deal of respect for clients who reach out for the first time because it's such a brave thing to do. I like to emphasize that we progress in therapy at the clients pace and it's therapy is not something that is done to them.

Do you have any tips or tricks for parents with adhd raising kids with adhd? Our house always feels chaotic with three neurodiverse brains!

I love this question. The good news is that you have awareness of each other's needs and "get" each other. A visual schedule will probably be the most helpful thing for your household schedule. Having set days and times for when routine things happen (making lunches, laundry days, cleaning days, etc.) helps to calm the chaos and increase consistency.Then there will also be space for new and extra things in the week (a special event, etc.)If you forget something check the schedule! And there's always the next moment to get back on track.

What are your thoughts on ABA?

It's become a controversial topic in and out of the autistic community, mainly because people have experienced poor quality of services. The principles of ABA can be very helpful in providing tools and strategies for supporting calming and productive behavior. However, it needs to be used carefully and without the intention to "change" someone and with respect for neurodiversity.

Hi doctor! I was diagnosed with adhd and low support autism. It explains a lot but there’s one specific issue that I can’t get an answer for - I completely lack the ability to execute anything that doesn’t have a specific step by step blueprint to follow.

Here’s a very simplified bake sale example. - The bake part - I can do this cause it’s black and white, with followable list of specific ingredients and preparation steps. - The sale part - I find this overwhelmingly confusing and frustrating. My brain literally feels like the South Park “collect underpants - ? - profit” meme. How do I sell this? Where do I sell this and how do I find a spot? It’s really hard to explain cause it’s quite nuanced but basically, it’s what other people just seem to get by default or find obvious. If I ask for help it’s always very vague advice that doesn’t help me at all or something like “What do you mean?? Just do it.”

Is this a neurodiverse trait or is it just me? Could it just be part of a learning disability? I’ve had a history of dyscalculia and dyspraxia among other things.

Planning and organization are critical executive functioning skills that we need to execute any activity. What you write about the sale part is very interesting. I wonder if we can take what feels vague to you and make it more specific. For example, once you decide what you're going to bake and you make it, you can think about where and give yourself a couple of choices: “I will sell it at school or I will sell it at the park.” By giving yourself some fixed choices like a multiple-choice answer it might be easier to move into action. In terms of asking for help, the more specific question you asked the more precise answer and advice you might get. For example, if you ask “how do I start or what do I do” You might get a vague answer in response. Instead, if you ask should I wear should I sell this or should I sell cookies or brownies? You might get a more specific answer which could also help you move forward.

Hey! My wife is ADHD and (recently diagnosed) ASD.

Is there anything I can do that might help shutdowns or meltdowns?

Thanks!

Edit: I'm ADHD too so I understand her neurodiverse struggles, it's just hard sometimes haha

Yes it is hard and I appreciate your intentions. I think asking her direct plain questions will be key to avoiding the meltdowns in the first place. Checking in with each other before having a conversation and agreeing to wait until each of you are in the zone will lead to better communication. There's a concept called "Window of Tolerance" that helps us know if we are in the optimal range for social engagement and other things. That would be something to check in about with each other before you 2 engage in conversation.

I hear lots of other ADHDers talking about sex addiction and pornography addiction...people who love to date new people etc. Evidently, that falls into the novelty/stimulation section... But Is the other end of the spectrum equally represented? (Are there ADHD folks out there with little interest in it? ) Or would that be falling more on the Autism spectrum? (I know it's all one neurodivergent spectrum)

Both ends of the spectrum are evident and can part of ADHD diagnosis.

Wait, are you still making Speed Stick?

hahah - nope, not me

Why does ADHD present differently in men and women? Is there a sex chromosome association (if so please provide a reference) or something more neurostructural?

Unfortunately we don't have a clear cut answer as to why ADHD presents differently in men and women but we certainly know that it does. It is likely to be a combination of genetics, hormones and environmental factors. Here's a recent blog post on the topic:https://mythrivecollective.com/adhd-in-girls-and-women/

How can I find out more about your services? What state do you practice in?

Thanks for asking! Please check out my website at www.mythrivecollective.com. I am part of a great team of clinicians based in IL. I can provide telehealth video sessions in 30+ states.

I want to be a psychologist when I grow up! So my question is... how did you get to where you are now?

I have degrees in clinical psychology and school psychology. I was always curious about how the brain and mind work and loved helping people solve problems. That suits my interest in both testing and evaluation as well as therapy. There are many different specialties within psychology. I worked in a lot of different places before I knew what I Liked best (hospital, school, outpatient clinics).

best wishes to you

I'm 47 y/o m and trying to navigate having possibly having ADHD. It's been a struggle because I can't actually book time with a therapist. My insurance connected me with a Psychiatrist who just talks to me over the phone for 2-4 minutes and writes me a script. (sometimes he's at the grocery store during the call)

How do I tell if the meds are having a meaningful impact? Do I need to also see a councilor? (Currently taking Adderall XR 10mg. just feels like I drank espresso to me)

The most effective treatment is a combination of meds (if appropriate) and therapy a well as having a good professional partner. Could you try another psychiatrist in your insurance network? Sometimes there's a wait for a specialist and you can also try primary care first. It takes time to do a good assessment but good effective treatment can only be based on that. It also takes time for your body to adjust to the meds, even if they are appropriate and to see a meaningful impact.

Is there any even semi-reliable way of self diagnosing either of these conditions?

I know a lot of people, myself included, who cannot afford to see a professional, but I think it would be beneficial to know what one is dealing with even if they can't get help.

I get it. I wish there were more accessible resources to go around. Here's a website that may help. https://embrace-autism.com/

I was diagnosed with ADHD as a child in my home country and had behavioural therapy as a child which helped keep my symptoms in check. I am an adult now and have moved and settled in a new country, but am worried about ADHD manifesting in my adult life.

I talked to a few friends who suggest that it is best if I find someone who has a dual culture/multicultural background like me as it can be a big part of my history and some nuances may not be picked up by a monocultured therapist.

Do you know if there has been any studies relating to this?

It's appropriate to seek people from a similar background for therapy, especially if you identify with your culture of origin. There is research backing this but most importantly, it will help you establish rapport with your therapist, which is the foundation for good care.

I've very recently learned I'm autistic and have ADHD (38F). I also have some childhood and early adult trauma. I have tried talk therapy and CBT in the past, and didn't find it helped at all in changing my thought and behaviour patterns (it did help me set boundaries, which I like but some I've had to set them with really do not). I did like my therapists a lot, and did feel I connected with them, but didn't reach therapeutic goals. Is there a type of therapy you recommend / practice that might be better for ND folks? Thanks!

That's a great question. I'm glad that you found therapists that you liked and that you felt a good connection. I wonder if the trauma has not been fully resolved and that might be something to address before going back to traditional therapy. You could consider treatment such as brainspotting or EMDR to see if that is appropriate for you.

How can we tell if a lack of focus is due to ADHD vs depression vs some other issue?

There's a lot of overlap on the impact of ADHD and depression on your executive functioning skills. The end result (lack of focus) is the observed behavior. A thorough evaluation can help answer your question and also offer recommendations for how to address the lack of focus regardless of its source.

Not sure if this is still going on but still let me post it. I am a UX research student trying to digitise therapy options like cognitive behavioural therapy to make it more accessible to children and students. What are your thoughts on this?

Thank you for your work! I think there are many types of learners and if we had tools like the one you are developing, it can help reach more people.

Now that "chemical imbalance in the brain" is debunked, how do you prove the existence of ADHD?

The use of medications in the treatment of ADHD and another psychiatric diagnosis to "normalize function" that's where the problem lies and that's where the flaw was in the chemical imbalance theory. It doesn't necessarily mean that ADHD, ASD or more broadly, deficits and dysfunction in excessive functioning skills doesn't exist and that people are not experiencing significant impact on their lives because of them. A good diagnostic process includes a detailed history, conversations with close contacts (with consent) and the use of norm-referenced measures to assess skills.

What advice do you have for someone in a relationship with an ADHD partner?

This is a great question because diagnoses of any kind can add a lot of stress to the relationship. First I would learn as much as I can about the diagnosis and I would also plan on having some clear communication with your partner to learn more about their specific characteristics and needs. It's also important to take care of your own needs and to be able to clearly explain what they are to someone. Setting up a good household system or a pattern of communication that is clear and has guidelines will also help you. Ambiguity and vague expectations are not your friend in this situation.

I had adhd like symptoms and got diagnosed with autism this year after various tests and stuff(I am 29 M).

I am in therapy but I dont really see any improvement, I wanna focus on study but I always end up sidetracking either studying useless stuff or just not studying at all, sometimes I have an actual useful day but it doesnt persist for more than one. Any ideas?

I would like to know where and what you are studying and how long are you trying to persist with it? We all work best at different times of the day and in different settings (super quiet, some noise etc.). Think about when you had a successful, useful day and see if you can recreate that. For example, I do my best writing in the morning but I can see clients all day long. There are some tasks I can do together like talk on the phone and fold laundry but other task (like AMAs!) need my full attention. Finally, there are many types of therapy. If you are not seeing the results you want, it might be time to explore other options. Best wishes to you!

What are your thoughts on the show the good doctor?

I haven't seen it.

After a recent work trip with my new manager, I believe she has undiagnosed ASD. Any tips on working for someone who is probably ASD (but doesn’t know it) ?

Bonus question: how does ASD present differently in adult women vs men, and is that why women have a lower chance of being diagnosed?

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It will be important to communicate in a very clear and direct way. I wouldn't wait for things to be understood Or hint at things. You might even feel like you're being blunt but that's OK. I would also watch for feedback. You may not be diagnosing correctly and if you get a reaction like “wow that's pretty blunt or direct” then that shows a certain level of perception too.

Here's a post I wrote:https://mythrivecollective.com/autism-and-female-gender-identity/

Hi there dr menon. Can I ask is it possible to have both because I just recently got diagnosed with adhd long time coming at 27 but my mental health nurse said that I can't have autism because I have adhd? But yet my national health service web page says you can have both and I am conflicted and scared to try and find out if I have autism now due to what my nurse said

It's definitely possible to have both. In psyc terms it's called co-morbidity. There's a lot of overlap between the core characteristics of both ADHD and ASD but also some important differences that a trained professional can help you sort out.