Sasha Hamdani (on ADHD)

8:58Sasha Hamdani:I'm delighted that we have the same observation because I got there and I started meeting. I remember I met this girl at a coffee shop and she was shooting math and she was also very interesting and pretty. And I went to her house and it was this very nice house in Montecito. and there were other children of rich kids that were just completely neglected. There's like this whole cadre of rich, neglected kids there that I thought was so freaky and weird.

9:26Dax Shepard:It's weird.

9:27Sasha Hamdani:I'm so curious. How old are you?

9:28Dax Shepard:I'm 39.

9:29Sasha Hamdani:I can cut it out. Okay, 39. We're very close in age. Yeah, very, very close. We're the same. Basically the same, but I am 38. I just, I'm sorry. I just don't. I have to be honest. You have to be honest. I have to be honest. You're committed to being honest. I am, I am. You've had a very similar trajectory in that you two were trying to very much hide from your culture. I happen to know this from a post of yours.

9:47Dax Shepard:I had purple contacts for a while. I wanted them.

9:52Sasha Hamdani:I wanted them. The violet ones, the color blends.

9:54Dax Shepard:Yes, I wanted them.

9:55Sasha Hamdani:The irony, you guys are both such babes. It's incredible that you would be trying to become.

10:00Dax Shepard:You're going through that in your formative years and you're already feeling othered. Yes. And so you really do whatever. And when I'm saying othered, I mean from a physical, like in ninth grade, I show up to public school coming from private school, so I didn't really know anybody. I have my violin contacts. I have headgear during the day. Oh, boy, yeah.

10:19Sasha Hamdani:Not even nocturnal. We could have taken a fucking break for six hours.

10:22Dax Shepard:Oh, I did. Two periods into that school, I was like, this goes.

10:26Sasha Hamdani:You're a survivor if you went to high school with headgear. No, you can't.

10:30Dax Shepard:You don't make it out. You don't make it out. And I was like, wrong. Let me deal with the palate issues and the overbite. I'll deal with it. Yeah, yeah. At a different time. Yeah, that's right.

10:40Sasha Hamdani:Okay, but you're kind of a wunderkind. And you get diagnosed with ADHD at nine years old, which that's the beginning of these diagnoses. Yeah, maybe the uptick in these. That's early.

10:48Dax Shepard:Well, it depends.

10:50Sasha Hamdani:Where you're at, probably.

10:51Dax Shepard:Also, gender. For boys, typical age of diagnosis is between five and seven. For women, do you know what it is? 40. 35 years old. 35. Yeah, yeah, yeah. Gendered age. Usually, they've had their own kids. They're like, this is weird. They go to the doctor. The kid gets diagnosed. And then the mom gets diagnosed. Yep. Interesting.

11:09Sasha Hamdani:Okay, so you do get a diagnosis. and then that's immediately helpful, yeah? In that you get medication that starts working?

11:15Dax Shepard:Yes. I'm hesitating because it's a weird story. Okay, great. Tell us. Okay, so fourth grade, I was pretty boisterous as a kid. Substitute teacher comes along. I create an insurrection in the classroom. I got everyone to stand up on their desk, start chanting it. And like, that's horrifying. I have kids. I can't imagine treating a teacher or a substitute teacher like that ever. But I was just the person who did that. Within an hour of that happening, the substitute teacher calls my teacher. My teacher calls from a doctor's appointment. She calls my parents and she's like, do something. And so then my parents got me.

11:49Dax Shepard:My mom was a pediatrician. So I got in with a physician. I got diagnosed and I got treated. But it was so stigmatized at that time. They didn't tell me my diagnosis.

12:00Sasha Hamdani:Oh, interesting.

12:01Dax Shepard:That's why I feel like I was diagnosed twice because I was on medication, hugely helpful. My parents were like, okay, take this vitamin. And I was like, whoa, this vitamin is working so much.

12:12Sasha Hamdani:Beats the shit out of Flintstones. Well, I took those too. Oh, I love those.

12:17Dax Shepard:They were so chalky and disgusting. Yeah, but I know, but they're so nostalgic. So I could sit through class. I could pay attention. I wasn't getting in trouble. And school wasn't painful for me. It was never hard for me before, but I was so bored. I was like, I can't sit here and do this. And so it became very manageable. And that kind of propelled me through this stupid vitamin. And then I did well enough throughout my schooling through high school that I got into a combined undergrad graduate program. So I started medical school at 18.

12:49Sasha Hamdani:It's like I condensed to a six-year program, right? At University of Missouri, Kansas City? Yes. Oh, so my dad went there. He did? You shut up right now. Yes, he did. Did he really? He did before he went to tech. Ashok's in the mix here. Really? Yeah, his Sim is in the mix right now. Oh, the Sim. Yeah, yeah, yeah. Okay.

13:08Dax Shepard:He's very proud of us. Yeah, he is. So I went there, and that was the first time I'd been away from my parents. That was the first time I'd been by myself. I'm like, there's so much stuff and freedom and also laundry and all of this other stuff that I've never had to worry about because my mom would do it. I don't know how to feed myself.

13:30Sasha Hamdani:No. Oh, sorry. How dare you. Your mom waited on you hand and foot. I did my laundry starting from age like eight. Okay, okay. My mom tried. Could you scream make me a milkshake from the bottom of the stairs and she would make you one? No, that's nowadays. Now you're thinking of the wrong story. I was making a milkshake in basically the middle of the night. Okay. And she was like calling from her room like, stop. There was a blender going and everyone was asleep. And she was like, what are you doing? I'm like, I'm making a milkshake. so I was making it. Okay, okay. So you have some things a little place.

14:06Sasha Hamdani:Sorry, sorry, sorry.

14:07Dax Shepard:Sorry, I probably could yell. My mom would be like, yeah! Amazing! She did try to instill skills and I just was uninterested. In high school, I was playing sports and I was doing all this other stuff and if you had told me your laundry's not going to get done, I'd be like, okay, I'll just wear my parka to school. It's fine. I don't care about that stuff. And I still kind of don't care about that stuff. There was a lot going on And I went from being one of the smart kids in my school to all of a sudden being quite literally the bottom of my class. When I realized something was wrong and I brought it up to my parents is I did this neuro test.

14:45Dax Shepard:So neuroanatomy. And I stayed up, really tried to focus. And I was like, I know this brain inside out. It was really interesting to me. And it was visual. And I was like, I got this. This is so easy. Go into the test. I'm like, this is amazing. I'm getting all of them. This is perfect. I'm the first one out of that test. And then they had this thing where they would like post your grades with your ID number. So like the next day I'm like showing up. I'm still looking for my ID number. And you're looking at all of these grades and you're like 90, 80, whatever. And I was like, there is some loser who got a 32.

15:16Dax Shepard:And I was like, well, that's me. What?

15:19Sasha Hamdani:Yeah. What a disconnect.

15:21Dax Shepard:I didn't flip over. Oh, oh.

15:23Sasha Hamdani:Oh, you just did half of the test.

15:26Dax Shepard:I got 100%. I didn't flip it over. Okay. Hey, you'd think the perfect— Oh, you would think. I went and I was like, please, this is going to break my self-esteem. And I was like, I'll be on the other side of the room. You can give it to me orally. Just read me the questions. I will tell you the answers. And the guy was like, you're either going to learn from this or you're not. And I was like, okay, well, I guess I'm not. So I remember telling my parents, they're like, well, are you taking your vitamin? I was like, respectfully, I don't even know where that is. I don't know what you're talking about.

15:55Sasha Hamdani:And you still thought it was a vitamin and you're in college. Straight up thought it was a vitamin. Okay, so I have a little beef with your parents. This is an ongoing beef. You also could have been told at nine years old that this notion that there's all these things we can't tell kids is so silly. I don't understand why. It was a different time, though. It's not terribly different. I mean, you guys are pretty young. No, no, no. Even like when my brother was little, which is eight years below me, ADD was if you have that, you're problematic. Sure, but there's no reason that the child couldn't understand that they have ADHD and explain what limitations and what other things are going to be coming their way so they have an expectation and some tolerance.

16:32Sasha Hamdani:They can understand that.

16:33Dax Shepard:I think that could have happened. But I also think, I have thought about this a ton since I'm a parent now. How would I have handled that differently? In that time, it was so stigmatized. There was a kid who had ADHD a couple grades above me in that private school. And that kid got expelled for putting fireworks in a toilet. And they were like, this kid is nothing. He's broke. He's bad. We don't know what to do with him. He can't be at school anymore. And all the room parents were talking about it. I was just very highly aware of this. And then I was also the only brown kid in this sea of white children.

17:09Dax Shepard:I already felt weird. So I think my parents probably were doing at that point what they thought was the best. They were trying to intervene.

17:16Sasha Hamdani:They think they're protecting you.

17:17Dax Shepard:Yes.

17:18Sasha Hamdani:But I don't think lack of information is ever protection, personally.

17:21Dax Shepard:You're not wrong. They redeem themselves big because I'll tell you what they did that was correct. So after that, so I'm like, yeah, I don't know where my vitamin is.

17:30Sasha Hamdani:Next topic.

17:32Dax Shepard:And they're like, okay, heads up. This vitamin is actually ADHD medication. You have ADHD. I was like, no, I don't. I've been medicated against my will. I feel really angry about... Deceived. Yes. And so I was like, let's just start over. So then I really tried to apply myself in school. I would wake up at 5.30 in the morning. I would start studying. I would study for like 12 hours a day. I'd be so into it that I would get into periods where I was like, I should probably go eat. And I was like, no, no, no, I got to finish this chapter. I was just trashing my body to get those results. And I took another exam.

18:05Dax Shepard:And after my best efforts, I still got a 60%. Why? Because I was so tired the day before the test and so run down that I was foggy and I couldn't think at that time. And I was like, previously, when I was on this vitamin, I never had those problems. I don't understand what's happening. And so then my dad was like, listen, you might not make it through medical school. Just come home. Who cares? Let's learn about your brain. He brings me back to California and we go to a library, straight up old school library, pulling out textbooks. Both of us were just sitting on the floor. He is reading textbooks about ADHD.

18:42Dax Shepard:And he's like, this sounds like you. And I'm like, that does sound like me. And so we learned so much. And I thought it was handled in such a curious and open way. Him and my mom both were like, we wish that we had that verbiage to tell you. We didn't know. And you were under our care for so long. We didn't know what a fracturing there would be when you left and you were out of that environment. So then truly I had to like scrape and claw to get out of that hole. But eventually I tried a bunch of different medications and some of them wouldn't let me eat. and some of them would let me sleep. There were some that were a disaster.

19:18Dax Shepard:But then it was a combination of finding a good medication and finding the right therapeutic things. And I don't think I truly figured it out until I got into residency. So after med school, I was just surrounded by psychiatrists and therapists. And I was like, this is my happy place. This is great. Because med school, it was so hard. The entirety of med school, it was like all of my attendings. I don't know whether I was already pegged as a problem, But I had an episode where there was an attending who came to my office. I didn't do very well on a test. And he had been kind of rough on me the whole time.

19:51Dax Shepard:But he's like, don't worry about it. You know what we're going to do? And we have these little cubicle offices. And he just brings like a box with them. And he starts packing up my office. And he's like, you could just go home. You came here for a reason. Maybe you'll meet your husband here. And I was like, oh, wow. Oh, my God. So especially now as a mom of a girl, I was like, if anyone spoke to my girl like that, I would be feral. In that moment, you're so embarrassed and you're so confused. Like, why is someone who's supposed to be helping me through my educational steps doing this? You just don't do anything.

20:20Dax Shepard:And so I just carried that. Yeah. But then I feel like residency just reversed all of that because I felt traumatized in med school. And then in residency, all those pieces got rebuilt. And they were like, this is what you're good at. Lead with that. And then we'll work on the back end.

20:37Sasha Hamdani:Okay. So you've become specialized in ADHD.

20:41Dax Shepard:I'm taking off my shoes. Oh, please. Yeah, do it.

20:43Sasha Hamdani:You can dump the socks too, whatever you want.

20:45Dax Shepard:No one's ready for that.

20:46Sasha Hamdani:Okay. I would love to know the historical understanding of ADHD as a condition. I'd love to start with when maybe first enters the DSM or when does it appear and what did we think it was then and how would we now define it today?

21:03Dax Shepard:So the problem with that is it has had such an evolving course and it has had so many different names. When it was first noticed, it was in the 1700s, we had a patient who was extremely restless. And that's what we're describing now as fidgeting or a sign of like that physical impulsivity. And then as it moved on, it got the name a hyperkinetic condition. That was an interesting kind of segue because it really dialed down on the hyperactive component. Then as we progressed, we didn't get into formal ADD territory, which it's not called anymore, until the 80s, I believe.

21:37Sasha Hamdani:That's when I was introduced to this concept. It was ADD.

21:40Dax Shepard:ADD, yeah. And that's what I was diagnosed with initially. That came later. And then just recently in the DSM-5, I got beef with the DSM-5. There's a lot of beef to be had with the DSM in general. So now what our standard diagnosis is, is ADHD is attention deficit hyperactivity disorder. It's broken into three subtypes. So if you have ADHD, it's always called ADHD, but you can have the inattentive presentation, you can have the hyperactive presentation, or you can have the combined type, which is kind of like a combination of both. A huge problem is people sometimes are like, I can't have ADHD because I'm not hyperactive.

22:14Dax Shepard:Because it's in the name. Right. Yeah, I don't like that.

22:18Sasha Hamdani:It's too wide of an umbrella, we would say, maybe.

22:20Dax Shepard:It's too wide, but it's also too narrow. It focuses so, so, so stringently on just the focus components. And it doesn't touch at all on other areas of regulation. Because I think ADHD at its base, it's a dopamine dysregulation error. So you have dopamine dysregulation when it comes to attention. You have dopamine dysregulation when it comes to impulsivity. You have dopamine dysregulation with sleep, with appetite, with emotions. All of that is so huge, but we never really touch on it. With the emotional side of things in particular, if we don't change that with ADHD, this is why people are going to get misdiagnosed with anxiety and depression for a million billion years.

23:00Sasha Hamdani:Yeah. I guess currently, though, it is diagnosed through symptoms. Yeah. You're reporting symptoms. Yeah. If it fulfills enough criteria, we would say you have it. My curiosity is, are we approaching or do you believe we'll get to a point where there will be different diagnostic tools, DNA markers, where we'll go, oh, we see this clumping of this here. Would it be fMRI brain scan where we would see something that would let us know? Is there going to be a day where we can read the actual percentages of neurotransmitters and say, oh, you have this exact cocktail that ends up to this? Like, are we approaching any kind of diagnostic tool that's not just symptom related?

23:41Dax Shepard:No.

23:42Sasha Hamdani:Okay.

23:43Dax Shepard:Let me tell you why on all of those fronts. I think about that all the time. If there was something tangible we could grab onto and check a level of something, that would be amazing. So with the levels of dopamine, dopamine, serotonin, you can usually check those. There are a lot of things floating around with like a urine test where you pee and then they check your levels. The reason why those are incredibly unreliable is because sometimes it's not truly that you don't have enough dopamine. It's just not present in the spot where you need it to be at the right time. It's a dysregulation.

24:15Sasha Hamdani:So what happens if I come to you and I'm like, okay, I think I have it. What do you ask?

24:20Dax Shepard:So there's a couple of things. The thing that makes a good ADHD diagnostic interview is that not only are you checking for symptoms, but you are simultaneously ruling out other things. And I think that's what makes it such a complicated thing to do. Because I have patients who have come in and they're like, I went online for an assessment and it says I definitely have it. And I'm like, what? Yeah. And I understand the thing about ADHD that I know because I have it. When you are right in the middle of trying to navigate a brain that feels so overly chaotic for you, you are willing to point yourself in any direction to fix it.

24:56Dax Shepard:Yes, that's right. You're desperate. That population is a vulnerable population because they are the people desperate to want help. So I understand why people are taking tests online. It's just not a super valid test because it's capturing you in a very subjective manner. It's not giving good timelines. It's not ruling out any other things. So it's giving this very skewed kind of thing. With ADHD, when you're looking at the criteria, you're screening for both the inattentive symptoms, the hyperactive symptoms, and then obviously you'll get if it's combined from both of those. You want to check timelines, see if these symptoms presented before 12.

25:31Dax Shepard:When you're assessing for an adult, that can get tricky because if you're asking them to recall retroactive data, that's hard. A lot of people don't remember. And a lot of people have spent so much time during their childhood where their parents have masked, covered up, fixed kind of symptomology that it's hard to assess. So that's difficult. You have to really dig back to get good criteria. And then when you're asking questions, like, for example, with the inattentiveness. You're asking, is it hard to stay engaged with a task? Do you feel like it's difficult to organize things? Do you feel like you get distracted halfway through the conversation?

26:07Dax Shepard:You're asking things about focus and focus adjacent topics. But you also have to ask, is this present during a depressive episode? Is this present when there's substances involved? Did you notice this before or after you got on thyroid medication? You're asking all of these things while you're doing a simultaneous screening for other things. So it becomes pretty complicated.

26:32Sasha Hamdani:It's so dynamic.

26:33Dax Shepard:You're doing a comprehensive medical rule out. It's confusing from a psychiatric perspective. Like, is this bipolar? Is this ADHD? Is this depression? Is this anxiety? Is this trauma? They're all things that overlap really beautifully and can mimic it. So you need to be able to kind of pull from the diagnosis, what the patient is saying, ask the right questions to get to where you're going. And I'll tell you, a lot of people come to me 100 % dead set. I have ADHD. And by the time we're done with the interview, it's like, no, you didn't. I mean, this was trauma. This is what was causing it. And so it takes someone who's been trained to be able to discern that.

27:12Sasha Hamdani:Over a protracted period of time as well, I would imagine. This isn't something you're doing in five minutes. You really need to learn quite a bit before you're there. You do need to learn a lot. And then we probably get into the other issue, which is I'm sure it is a spectrum condition. So what do we say that 79 % of these symptoms equals it or 71 % or whatever? You know, when is it a disorder? When are you one deviation below a disorder? You could still be suffering a lot of the symptoms before you're chronically in this. Yeah, formally or pathologically in this condition. And it doesn't mean that's irrelevant that you're just a step before it.

27:45Sasha Hamdani:So my great curiosity is, so what are the inattentive symptoms? And I also want to talk about how it manifests differently in men and women and boys and girls. To your point, my hunch is the DSM was originally just assembled with the boy symptoms. Correct. And so I imagine they really present differently in males and females. So how do they and what are those symptoms?

28:06Dax Shepard:So with inattentive, you're looking at difficulty with starting a task, staying engaged in a task, completing tasks, having difficulty with disorganization. You're looking at issues with executive function, the skills that are required for processing and getting a goal done, goal-oriented behaviors done. Those are kind of more the inattentive symptomology. Hyperactive, you're thinking more like physical and verbal impulsivity. These are the kids and adults who have difficulty staying in their chair. They're constantly fidgeting. They're blurting out things. They're interrupting.

28:45Sasha Hamdani:Interrupting. Ding, ding, ding, ding. Also, we should say Dax is looking for a diagnosis by the end of this. Can I just tell you one second how I got interested? You must know Gabar Mate. Yeah. I'm walking him to his car and he says to me, have you ever been diagnosed with ADHD? And I just went, that's a weird thing for him to say and he's an expert on it. So I just went like, oh, that's really interesting he said that. And then I, too, my algorithm became like everyone else's, and I start seeing these different things. I interview a friend who's been diagnosed since he was a kid, and he tells me that ADHD folks have an outsized sense of justice.

29:16Sasha Hamdani:And I'm like, if that, in fact, is one, I definitely suffer. So, you know, I'm just not oblivious to a lot of these things do sound a lot like me.

29:25Dax Shepard:Here's the deal. I am not going to diagnose you. Yeah, I don't want you to. And I'm not. I'm actually not looking for that.

29:31Sasha Hamdani:I don't care if I do or I don't have it.

29:33Dax Shepard:Well, you should. I think that there is nothing more liberating than understanding your brain. You deserve to have a good diagnosis and to know how your brain works. When I went from not knowing what was going on and then I sat with my dad and then we actually went back to a physician and he explained, like, these are the things that are going on in your brain and this is why you might have difficulty with this. I gave myself so much, number one, grace about things that I beat myself up about for years and years.

29:59Sasha Hamdani:Right, right. The self-flagellation, which again is, I understand, one of the conditions.

30:04Dax Shepard:Emotional regulation needs to be as part of that. For example, so my dad passed last year in April.

30:13Sasha Hamdani:I'm sorry.

30:14Dax Shepard:We found out he had lung cancer. We found out he had this spot and they were like, it's annoying, but we'll get it treated, whatever. So we go, we get it treated. He goes through the chemo, he goes through radiation. He calls me one day and he's like, I just don't feel great. So I aboard a flight. I go over. I'm like, you look awful. I take him to the hospital. Everyone's like, no, we can't do a PET scan. It's too soon. I was like, do it. We don't care if insurance doesn't cover it. Something's wrong. It was everywhere. And he died 13 days later. What?

30:40Sasha Hamdani:13 days. Oh, my God.

30:43Dax Shepard:13 days. But what I noticed, I think this is probably why I feel so passionately about the emotional regulation part, is that the colliding of grief and ADHD was so destabilizing for me. It was like my brain exploded. The brain fog was so bad. And grief, horrific for everybody. But I think for someone with ADHD who's experiencing that emotional dysregulation already, I had no idea how I was ever going to get through coping with those big emotions. I was like, this is too much for my brain. I can't parent. I can't get through a workday and see these patients without just losing it. So when I was going through all of that and I had a really tough time with that because I knew I had ADHD.

31:27Dax Shepard:I mean, it was hard because I was like, this is tremendous. I felt like I was completely broken down and starting from scratch. I was like, because I know how my brain works, I need to create systems that are very low lift for me right now and find a way to rebuild that way. If I didn't have a diagnosis or an understanding of my brain like this actually makes sense to me or this is what I believe is going on, I think I would have just kept trying to do what everyone else told me to do, which didn't work. Yeah.

31:56Sasha Hamdani:Stay tuned for more Armchair Expert, if you dare. Thank you to our presenting sponsor, Apple TV, the new U.S. home of Formula One. You can now watch complete all-access live coverage of every Grand Prix, including practice, qualifying, and sprints all in one place. I will be consuming all of those things, Monica. I know you will. I kill for Friday to start watching Practice One, following in on a sprint weekend. Oh my gosh, two races. And this season brings a ton of new energy to the sport. New teams like Cadillac and Audi just joining the grid. New drivers stepping into major seats. Lando Norris defending his first World Drivers Championship.

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33:20Sasha Hamdani:That's smart. Not checking your phone's battery before heading out. That'll get you every time. Of course, your phone dies on the way to meet someone, leaving you wandering around quietly panicking about being in the wrong spot. Yeah, checking first is smart. So check Allstate first for a quote that could save you hundreds. You're in good hands with Allstate. Potential savings vary subject to terms, conditions, and availability. Allstate North American Insurance Co. and affiliates Northbrook, Illinois. We are supported by Intuit TurboTax. April 15th is coming up fast. And if you're like most people, you're probably dreading the whole tax thing.

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36:09Dax Shepard:I'll tell you, after he passed, I don't drink. I don't really do anything super interesting. I was just like, my brain is so loud. I want it to be quiet right now.

36:22Sasha Hamdani:Yeah, it's insufferable. I want it to be quiet. Yes.

36:24Dax Shepard:And I was just like, what can I do? I knew at that point it was my emotional regulation. And I was looking for a way to medicate this. Yes.

36:34Sasha Hamdani:You needed relief.

36:35Dax Shepard:Yeah. And I was like, that isn't something that I can medicate. My brain is having a really hard time with things that are really big. And so I need to find safety to get through these kind of moments. And my husband, his mom passed because of brain cancer years before. So he was really well-versed and supported all of us through it. He kind of saw what I needed and helped me through that moment. But I think if I didn't know about ADHD, I would have ended up in a really weird spot. Yeah.

37:02Sasha Hamdani:Yeah, I believe that. That makes a lot of sense. Okay, now back to the male-female differences. And my hunch was that the original criteria was probably just addressing the boy issues.

37:12Dax Shepard:Yeah.

37:13Sasha Hamdani:And you thought you agreed. So how did they express differently?

37:16Dax Shepard:Going back to like boys getting diagnosed way earlier than females. Typically, boys present with more of the hyperactive symptomology. So they're the ones who are causing problems in the classroom. They are disruptive. They're getting up in the class. They're bothering others.

37:29Sasha Hamdani:Which is probably why you got diagnosed early because you were behaving like that. Because of the coo.

37:33Dax Shepard:Like a boy. Yeah. Absolutely. And I think about that a lot. And I'm like, I'm actually pretty grateful for that presentation because it got picked up. But girls, on the other hand, are mostly inattentive. They're like the daydreamers that are spacing out in class and they're doodling. So those girls are pleasures to have in class. They're not bothering anybody. They're getting passed along. And then what happens is as the external pressures rise and as they're doing harder things, as they're doing more adult things like getting into relationships or starting families, your needs exponentially increase.

38:08Dax Shepard:And what is demanded of you increases and you just aren't able to cope anymore. And then it feels very much like a breaking point. Two other reasons that people assigned female at birth don't get diagnosed. Number one is the hormonal part of all of this. When women are going through hormonal shifts, when your estrogen is dropping, your dopamine drops also, your symptoms get worse. Now, these women or girls who are going through their first periods or things like that, their ADHD symptoms are 10 out of 10. Horrible. And they're going through all of these attentional issues. They're also going through emotional dysregulation because they're like, what do I do?

38:49Dax Shepard:My dopamine's all off. And that's when they're like, she's bitchy because of her period. Right. Oh, you want your period?

38:54Sasha Hamdani:Well, yeah, I saw a post of yours that was like 30 % PMS symptoms for ADHD girls versus 10 % for the general pop.

39:04Dax Shepard:It's significant. Wait, really? You feel it 30 % more? Is that what you're saying? It's more common. PMDD is significantly more common in the ADHD population. It sucks because you're in a situation where you're like, okay, well, my mood is already garbage around that time before my period. But now I can't focus and I can't do the things I want to do. And it's even harder for me to emotionally deal with it. Like that doesn't seem fair. So that's another huge one. And then the last one is quite literally just, I'm not trying to get political here or it's not even political, but there is a societal difference in expectations for females.

39:41Dax Shepard:So females are expected to kind of toe the line and mask. So what is acceptable for a boy to be doing in class is very unacceptable for a girl. So the girl now learns to hide that behavior. So then what happens is that this high achieving, very capable student or child goes through life. They are now getting applauded for masking their stuff. And so when at times it becomes overwhelming and they can't, people are like, what's wrong with you? Why are you so emotional? What's happening? Why are things falling apart? Why are you breaking down at work? It feels like such a huge shift in their baseline functioning.

40:21Dax Shepard:But really, they're just busting their ass trying to feel and look normal.

40:26Sasha Hamdani:Yeah. Okay, I want to ask if these things I've heard anecdotally or around the digital campfire are, in fact, people ADHD over indexing. So there's a rejection. Sensitive dysphoria? Yeah, tell me about that. I would love to tell you about that. Yeah.

40:44Dax Shepard:So I've become obsessed with that. Since my dad was sick, I mean, I was just like, what's happening? Why am I so sensitive to certain things? So rejection-sensitive dysphoria is the very, very real emotional, sometimes physical, pain that comes from real or perceived rejection or criticism. So someone criticizes you or rejects you or you think that that's happening, and all of a sudden you can't stop thinking about it. You're beating yourself up about it. No one likes getting rejected. That's not it. I have told my husband, it is like someone sucked the air out of my lungs. It feels that significant to me.

41:20Dax Shepard:Rejection-sensitive disorder, I think it's so important to recognize and to know about because it's so hard for the person who's experiencing. It's also so hard for the people around that person.

41:31Sasha Hamdani:Oh, yeah.

41:32Dax Shepard:The relationships. When it's a tiptoe around them. Oh, my God. So when my husband and I get into fights, I'm so sensitive that if I know we're kind of beefing with each other, he'll look at me and I will just start crying and then I will chase him around the house. And I'm like, and another thing. And another thing. He's like, chill out. because I feel like this urgency that I have to resolve this so that this feeling goes away.

41:54Sasha Hamdani:This is the email, right?

41:55Dax Shepard:Yes. So what we do, I'm not an effective communicator when I'm in that state. I'm emotional and I'm angry and I'm scared and I'm sad and all of the things all at once. And it's too much right in that moment. So what I do is I literally write an email and I draft it and I draft it. And usually it takes three or four passes because I'm like, that's not what I want to say. So already by the end of it, I've come down pretty significantly.

42:18Sasha Hamdani:You've regulated a bit.

42:19Dax Shepard:Yeah, because I've had this like safe place, the safety of my laptop. I'm like, this is my happy place. I can write this down and I can take as many tries as I want to make it sound the way I want. Then I send it off to him. And we have a whole folder of this. Usually I'll send him a text message. I'm like, I sent you something. He'll read it. And then he will think about it and process it. And usually by that time, I'm like, I'm going to just go somewhere else. Like I'll go sit in my closet or I'll go sit in the car or I'll go and hang out with the kids. I don't want to be around him because I'm looking for as he's reading it, what his face is doing.

42:50Dax Shepard:And so then what he'll do is he'll respond to it and he'll make pizza rolls. And then he'll put it out and then we'll have like a fun snack and we'll talk about it and then we'll be done. And it's the best system we've ever had.

43:05Sasha Hamdani:I loved reading that because I guess my knee jerk, this exists in my relationship. And my knee jerk is we are good enough communicators and we are smart enough and we've all done enough work that we can sit down and talk about this. That's where I come from. It feels like a failure that we would have to be texting each other or emailing. But then hearing you say that, I was like, I also must admit it does go smoother if those couple steps happen before we confront something verbally. I'm happy to be relieved of the shame of us failing and being great at talking immediately, I guess.

43:37Dax Shepard:I don't know how people do talk immediately. Whether it's ADHD or not, I think time is kind of important. Time and giving yourself that space to regulate before you come into and like try to resolve a situation. Because otherwise, this is so messed up. But I think I'm realizing now that if I come off of an argument and I want to address it right away, I want to show him how hurt I feel and how badly that hurt. And it's not about resolving it. It's about wallowing in it. And then I get angrier and madder.

44:07Sasha Hamdani:I mean, it's pause when agitated. It's the whole thing.

44:10Dax Shepard:Yeah.

44:11Sasha Hamdani:How about this inflated sense of justice or this inflated discomfort with injustice?

44:17Dax Shepard:So it's not a clinical term. You see it a lot in autism as well, but it has to do with like rigidity, being very rigid and having a set expectation in your brain and then having it not come to fruition in the way that you planned. I think that's kind of where it stems from. And so you're looking at like a huge gamut of presentations of ADHD. So there's some people who, in order to maintain their ADHD, they have become very rigid about things. They have built these structures for themselves where it's like, this is how it has to be because this is how I can function. Right.

44:50Sasha Hamdani:That's where I can have compassion for it is you're very easily dysregulated. You somehow learn this about yourself, whether you're conscious of it or not. And yes, the more things that you can map out and plan out and control, the less chance you'll have at dysregulation. So I'm sympathetic to it. My thing is like the airport. All my character defects come out at the airport because I'm being asked to cooperate with the TSA to do things that I think are illogical or make no sense. I'm powerless. People are taking photos of us. I don't like that. They might be taking pictures of my kids, this big storm of things.

45:26Sasha Hamdani:And I do a pretty effective job of controlling my day, you know, normally. And so, yes, I have learned that before we leave to the airport for the best outcome, I have to have that expectation. That helps me enormously to just go like, okay, we're going to get there and some guy's going to tell you to hold your pants up and also hold your hands over your head at the same time, which you know is impossible. People are going to take pictures. They're curious. Get over that. But if I walk in ill-prepared or unprepared for what's going to happen, that's when some massive dysregulation happens pretty quickly.

45:57Dax Shepard:Yeah. We're all trying to get by. There are some brains that are just more sensitive to these things than others.

46:04Sasha Hamdani:Do you ever spend any of your time or focus thinking about the evolutionary aspect of it? I do wonder if this would even be a quote condition without the incredible amount of stimulation. What do you think about that?

46:18Dax Shepard:There's been some thought about if we're looking at ADHD just from evolutionary perspective and we're looking at hunters versus gatherers. ADHD people are the people who are going off and they're hunting and they're doing these things that involve risk and adaptation and impulsivity to some degree.

46:35Sasha Hamdani:Novelty seeking.

46:36Dax Shepard:Yeah. And they're great at that. And now we're putting that same group of people that would thrive in that environment in a new environment. And I don't necessarily think it is, well, maybe it is due to all the stimulation, but I think it is just society adapts and evolves based on what its needs are. and the needs are, there is just a much larger neurotypical population. And so the world is built for a neurotypical. Now you're expecting this population of people whose brains are wired differently to occupy space in a world that just wasn't built for them. And a really easy example of that is for ADHD, a lot of people have delayed melatonin onset.

47:14Dax Shepard:So their brains don't feel a normal, I feel sleepy at 10 and then I'm going to wake up at seven. Theirs are like, I want to go to sleep at one and I would love to wake up at 10 a.m. But that's not where society runs. You've missed three hours of meetings already.

47:29Sasha Hamdani:Yeah, you're right. There was a lot of different outlets for a lot of different types of brains before. But we have really homogenized the work experience, which is you go to a box, you sit in a chair, you do this thing. There's not like, oh, yeah, why don't you go explore over that other peak? We'll weave the baskets. We're more apt to sit here and weave these baskets, you know, everyone has a bit of an outlet. Now it's like, no, no, everyone's supposed to wake up at six and everyone's supposed to do this and that. So you had funneling us all into the same thing. There's going to be a lot of tension there.

48:01I think it's tough because you are expecting people as you're growing up to function and

48:08Dax Shepard:learn skills in an environment that's not built for them. So you're already kind of starting off at a deficit. And then, you know, you hit adulthood and they're like, okay, fend for yourself. You haven't really had time to build good skills unless you've actually really dialed down, understood ADHD, learn how to make accommodations for yourself. It's kind of like you're going through this environment that you never really figured out with schooling. You never really grabbed hold of it. And then now you're an adult and you have to figure out what to do with it, but you don't have any of those foundational skill sets.

48:36Sasha Hamdani:What do you think about the fact that so many people, especially from social media and stuff, are self-diagnosing? I have a problem with that. And this comes up a lot on the show. That's partly why we were so excited to have you. But I think it's a problem that so many people are walking around saying I have ADHD when they don't know if they have it or they think they have it based on what they've seen. Because for me, I'm like, well, what about the people who really have it? To me, that takes away from it is something happening in your brain.

49:06Dax Shepard:A neurodevelopmental condition.

49:08Sasha Hamdani:Right. What are your thoughts on that?

49:10Dax Shepard:So I kind of have a hot take on that. And my hot take is that I think self-diagnosis is actually good to a point. And the reason for that, and I'll tell you what the point is too, I think that it is incredibly valid to have someone learn about what is happening in their brain, find things out on social media or in books or in literature or research that looks like them and grab hold of that and start learning verbiage of how to describe their own internal environment. I think that's a wonderful thing. And I think that that can be a wonderful stepping stone to accessing care. And I know that's not an accessible step for a lot of people, but that next step, I have problems with it when it moves from self-diagnosis to the medication standpoint.

49:57Dax Shepard:That's really where I start to draw the line, because when you start trying to treat yourself, You haven't done the exclusionary kind of thing to figure out what else is going on. And medications of any type, they're not without risk. You're doing things that could potentially impact other things in big ways. So if you think you have ADHD and you want to learn behavioral strategies that help an ADHD brain, go for it, man. My hunch, Monica, is that your issue is much more the person who says, I have ADHD, so

50:29Sasha Hamdani:deal with this. Using it as an excuse. I don't think you would ever have a problem with someone going, I think I have ADHD. So, wow, I should explore these tools that have been shown to work really well with ADHD. Let me try them. Great. These are helping. I think your fear is probably more like I proclaimed I'm this and you have to lower your expectations of me now. Yeah, exactly. Obviously, if someone's like, oh, I think I have it, I'm going to do research and learn about it and figure out how to help myself. That's amazing. That's what I would want for everyone. But that to me is not what's happening.

50:59Sasha Hamdani:I think people are saying, I have it. And so I'm late. And I think the reason I don't have an issue with it is I come from a background where alcoholics self-diagnose. That is the full premise. No one can tell you're an alcoholic. You have to tell yourself you're an alcoholic. And then you have these steps at your disposal if you want to try this. And no one's declaring, I'm an alcoholic. So deal with the fact I didn't come to work. So for me, the association with the self-diagnosis is very positive.

51:25Dax Shepard:I think you're right. If you're using ADHD as an excuse, and if you're saying, I can't do this, and you don't have a formal diagnosis for someone who does have ADHD, that can be extremely irritating. And I've been guilty of that, where people have said that, and I'm like, you don't know what it's like. You can't possibly know like I do. At the end of the day, I have no way of knowing that. I have no way of knowing what's going on in their brain. What they're feeling. Yeah, you don't know. What their dysfunction is. I don't know. So I've tried to peel that back and figure out and look at why is this bothering me so much.

51:58Dax Shepard:But using self-diagnosis as a tool to get steps to get a formal diagnosis or get more access to knowledge about things and research about things so you can learn about your internal environment. I think that there is a huge space for lived experience and talking about that.

52:16Sasha Hamdani:Yeah, you're fierce. I'm going to be like, I am ADHD. I have time blindness. Don't ever expect me to be on time. Yeah. Yeah, and that happens. And it's like, guys, I don't want to be on time either. But I think it should be more like, I have ADHD. Yeah, I think I relate to this time blindness thing. What are the three best tools? Yes. Because I know I do have to be on time places. We all have stuff, and we have to figure out how to live in this world. You know, we're not islands. That's why I'm going to just quickly say neurotypical is bullshit as well. It's the same reason the DSM is fucked up.

52:45Sasha Hamdani:Because it has some premise of normal, which simply doesn't exist. There might be eight people who don't have something going on.

52:54Dax Shepard:There's zero people.

52:54Sasha Hamdani:We're all variable.

52:55Dax Shepard:And I think the neurodivergent terminology, it was like a psychological term that came out in the 90s. And it was really this umbrella term to talk about autism and ADHD and all of these other things. And the neurotypical was just kind of like a byproduct. What's the opposite of this? Yeah, DSM has problems.

53:13Sasha Hamdani:Yeah, yeah, yeah. How do stimulants work? Why is that an effective medication?

53:18Dax Shepard:This is a weird area of medicine because it's not this cut and dried mechanism. So basically where a majority of that deficit happens is that frontal lobe. So directly underneath your forehead, that's where all that executive function judgment processing happens. So what a stimulant does from just like a very rudimentary perspective, if your brain has a million different things going on a million different times, because of that underlying dopamine and norepinephrine dysregulation. So everything is just floating by an incredible space. You can take a stimulant, a Ritalin derivative, something in that family, and it actually works a little bit counterintuitively because it slows things down.

54:02Dax Shepard:And really, it's not that it's slowing things down. It just speeds everything up to match what's going on with your brain. It like synchronizes it almost.

54:10Sasha Hamdani:Yeah, it is very counterintuitive. I very much feel like I would benefit, but I also know I can't be on that.

54:17Dax Shepard:Oh, my God. There's so many better things.

54:21Sasha Hamdani:Than being on a stimulant. Yeah.

54:23Dax Shepard:Oh, tell me. Okay, so here's the deal. If you're treating ADHD, you could do it behaviorally or you could do it medicinally, right? And with medicine, for ADHD, there are stimulants and there are non-stimulants. And so the stimulants are what everyone thinks of. And they're our gold standard right now because they work well. They work reliably. And you could tell pretty quickly, is this going to work or is this not going to work? Those are things like Adderall derivatives, Ritalin derivatives. Those are all part of that class. But for a lot of people with ADHD, stimulants, even the long-acting ones, they'll give you like a six to eight-hour coverage.

54:56Dax Shepard:But ADHD exists outside of that six to eight hours. So then it's like, what are we doing for the rest of that? So non-stimulants, a lot of them give you a 24-hour coverage. For the great majority, they either fall under the category of an antidepressant or a blood pressure medication or some other class. Interesting. And you are getting additional benefits. So for those people who have ADHD, who are also anxious, here's a medication that's going to help with ADHD. Well, it is a blood pressure medication. So there's long acting formulations of blood pressure medications that can help with anxiety and ADHD.

55:32Dax Shepard:Or you're doing an antidepressant, which is going to help with depression and anxiety and ADHD. Or you can do something long acting that people take for shift work disorder. So it really depends on what you need and what you're looking for and what else is happening at the same time. But for a lot of people, when they're coming to the doctor, they're assuming if I have ADHD, I need to be on a stimulant. I need to be on Vyvanse. I need to be on Adderall. I need to be on Ritalin. And 90 % of the time, that's not the direction we're starting at. Because I always tell people we need to build skills.

56:04Dax Shepard:So we need to work on that. If that's not possible because your ADHD is dysregulating everything. We need to give a medication that's going to give 24-hour coverage as much as possible so that you have a chance to kind of see and build. There's some people who just that diagnosis immediately lifts them. It gives them the permission to study and make changes and do those things that they don't need to be on medication. So it's not like an absolute you have to be on medication to treat your ADHD. But there are a lot of people that in order to build and cement those habits, they need to be on medication.

56:39Dax Shepard:And that's also incredibly valid. It just depends on how your brain is wired.

56:43Sasha Hamdani:So your first book, Self-Care for People with ADHD, you have over 100 tips. It's fast moving. It's for an ADHD brain to read this book.

56:52Dax Shepard:Just little page long blips. I can tell you my favorite one in that book, and it's do a headstand. That's not the one that's going to work the best or anything. It's just the weirdest one. But there is something about that change. One, you're doing something weird. How I figured this out is when I was in medical school, I was studying for organic chemistry. It was just so boring to me. I was like, I can't do this anymore. My mom would be like, just do something to change your position or just do something to distract yourself a little bit. And it was that inversion of a headstand. That's hilarious, not necessarily the most impactful, but that's one if you're bored and in the middle of stuff.

57:25Dax Shepard:Another one I think that is important. So the book is broken up into separate areas. And it breaks it down in terms of emotional self-care, physical self-care, professional self-care, all of those other things. I think if I were to pick from those, because some of that book is also things like giving yourself permission to grieve if you haven't gotten a diagnosis. Because a lot of these people are coming to a diagnosis late in life. I'm done with the career portion of my life. I'm done with the child-rearing portion. I missed on so much, and now I'm having to grieve this diagnosis.

57:58Sasha Hamdani:I bet there's a feeling of, oh, man, I could have blank, which is heartbreaking.

58:02Dax Shepard:It's hard. But, you know, what I tell patients who are in that position is that this whole time you have been building skills. You have been building structures. You have had this brain this whole time. And so now it's what you do with it. And it's what you make of it with this new opportunity. And so you wouldn't have built those skills that you needed if things were different, potentially. Another very, very important one is just making time for physical activity. I feel like such a hypocrite because I hate exercise. I think it sucks. It's so boring and it's so hard for me to motivate myself.

58:38Dax Shepard:But it truly does make my brain work better.

58:40Sasha Hamdani:Let's talk about the forthcoming book. Yeah. That will be out. That's called Too Sensitive. Too Sensitive. Rejection, Resilience, and the Science of Feeling Deeply. I like this. Thank you so much. So is this exclusively ADHD? Because this feels like this could encompass more than just ADHD.

58:56Dax Shepard:No, it's not exclusively. But, you know, the thing about, like, we were talking about rejection-sensitive dysphoria. Almost 100 % of people with ADHD have rejection-sensitive dysphoria.

59:05Sasha Hamdani:I feel like I have ADHD now. I also have hypochondria. The irony of all this would be, yeah. I know that I have it. Don't self-diagnose. No, I'm not. I'm not.

59:16Dax Shepard:I'm not. But I do have that. So the concept of rejection sensitivity is for you. I started writing this book when I was all dysregulated with my dad. It came about during that time. And I was like, this is the worst part of my ADHD, my emotional dysregulation. This is the thing that will bring me to my knees every time. If I can't focus or if I can't do things, I'll make a hack around it or I'll delegate. I can't delegate someone to take care of my emotions. Yeah. And so I'm like, there has to be a better way to think about this and learn about it and talk about it. And I think that's why I have so much beef with the DSM.

59:46Dax Shepard:And by the way, Europe changed their criteria in 2019 to include emotional dysregulation as part of a core component. We haven't. And so I look at it like, say your diabetes. So bad that you started to lose your vision. Now, instead of someone being like, oh, okay, well, let's fix your diabetes. They're like, no, no. Okay, let's just give you glasses. Let's treat anxiety and depression instead of treating the underlying diabetes. The underlying diabetes is ADHD. And the anxiety and the depression and the rejection sensitivity and the emotional dysregulation, that's what's causing the vision loss.

1:00:22Dax Shepard:Right. It's a symptom, not the cause. It's a core part of it. It's not a separate diagnosis. And so if we don't get on top of this, what happens, and I've seen it so many times, is that for women in particular, I'm seeing women who are on antidepressant number six or seven. They're coming to me and they're like, I don't know what to do anymore. I think I have ADHD. Did you talk to someone about this? Yes, I've talked to my doctor for years. What did they say? First thing that they're going to hear is they're going to say, well, you're doing too well. There's no way you could have ADHD. The second thing they're going to hear is, no, it's anxiety and depression.

1:01:00Dax Shepard:Let's treat that first. The third thing they're going to hear is after there's six or seven antidepressants in, then they're going to say, listen, these antidepressants aren't working. Can I please look into ADHD? They're going to be like, we can't treat ADHD until your anxiety and depression are clear. These people aren't getting help, and it's because emotional dysregulation isn't in the criteria.

1:01:18Sasha Hamdani:I have a loved one who has come to this late in life, and it's so fucking impressive because they've done it without any help on their own. But they said to me. I finally realized that I'm processing everything different than everyone else around me. And I'm realizing that these really crazed states I am going through are that thing.

1:01:42Dax Shepard:Yeah.

1:01:42Sasha Hamdani:And it has not fixed it, but it has helped me go, oh, that thing's happening. And no one else around you is really experiencing it. So if I pop off now at work or try to let everyone know, A, they don't care because they're not experiencing it. And this is without any help from anybody. Just his ability to go, oh, that thing's happening is incredibly powerful. It really, I feel like, takes a lot of the heft of it away.

1:02:07Dax Shepard:And it probably gives you a little bit more agency. The way that this book is set up, the first part of it is truly just the science behind. And a lot of the evolutionary perspective and just like the history of it, how it came about, the neurobiology, what is actually happening, What areas of the brain are being triggered that amygdala is being hyperactive because it's assessing threats all the time, even though it's not appropriate. And then the second part of the book is how deeply do you feel? So it's actually an assessment where you can actually walk through and be like, is this me? Where do I fall?

1:02:40Dax Shepard:It's broken down into like you're probably in a spot where emotional sensitivity isn't a huge issue. You should read this if it applies to other people you love so you have better understanding. Or this probably does apply to you. Maybe it's not all the time. or this is probably you. This is probably something that's pretty significant, but you haven't had really all that much verbiage for it because we don't talk about it. And then it goes into the tools you use. There's just 12 tools that you use. And then the last part of the book, which is my favorite, are real world examples of how you get triggered.

1:03:11Dax Shepard:So it's a quote, and then it is what's happening in your brain and then how you get out of that moment. So when I was researching, I was pulling from all these different psychological principles. I'm like, what actually does work? So this is just an amalgamation of all of those principles together to actually help with this select thing.

1:03:31Sasha Hamdani:Yeah. I mean, I can immediately think of several people I can't wait to buy it for, which will be triggering. But then. Well, good.

1:03:40Dax Shepard:I can't decide on the covers. You guys can help me with that.

1:03:42Sasha Hamdani:Oh. When you see it on your nightstand, don't be triggered. Well, Sasha, this has been a blast. You have a very popular Instagram account. That would be very fun for people to go through because I think a lot of stuff would feel quite familiar as you describe it. Oh, there was one last thing selfishly I wanted you to talk about, and that is parenting with ADHD. What can you tell me about that?

1:04:07Dax Shepard:It's hard. It's hard. Parenting with ADHD is a huge expansion of what your needs are. Because not only are you having to manage your own brain, you're having to manage and guide little people's brains as well.

1:04:22Sasha Hamdani:Help them regulate. That's really your job. Yes.

1:04:24Dax Shepard:And model good behavior. And from the logistical standpoint, it feels like it's just a lot to do. My kids are in two separate classes, which is two different class party schedules. and two different field trip schedules and two different teachers and end of school things and parent-teacher conferences. And that probably doesn't sound super overwhelming, but that's so hard for me to keep track of. And which one is this? Which one is this? And like, you have to really create good systems around that. And I think the most, most vital thing that I could tell anybody who is parenting with an ADHD brain, give yourself grace.

1:05:05Dax Shepard:Let yourself mess up. and have a hard time. Because when I got pregnant, I had numerous Pinterest boards of the kind of parent I wanted to be, like what I wanted their nursery to look like. Immediately you have this kid, you're sleep deprived, you have breast milk everywhere. This is just not what you thought it was. And that goes out the window and you're just like, this is probably going to be harder than what I thought. And one of the best things that we've done as a family is work through moments that are hard and difficult kind of together. as a team and problem solving. So there are times, this literally happened two days ago where I was just like, this is hard for mom because there is so much.

1:05:45Dax Shepard:So when you give me a show and tell bag and you're like, I have to do this by tomorrow and it's 8.30 at night right before you're going to bed, you run downstairs and you're like, I forgot to do this and I have to bring it in the morning. That's hard for me. And I'll do that. But this is why I snapped at that or this is why I had a hard time. And then what I tell my kids when we have conversations like that, like, any idea is a good idea. Come up with solutions and let's talk about it. And so they're like, well, he could have turned in his bag to you earlier today. Well, he could have figured out what he wanted to put in there.

1:06:21Sasha Hamdani:Yeah, siblings are great at coming up with ideas for the other sibling. So many good ideas. I know what he could have done.

1:06:26Dax Shepard:So many good ideas.

1:06:28Sasha Hamdani:They're not great at figuring out what they should have done, but boy, they can see right through the problem in their sister.

1:06:33Dax Shepard:Yeah, I think it's just giving yourself grace when you mess up. Use it as a learning opportunity for everybody. I think I was so focused on hiding parts of myself from them where I'm like, what am I doing? I don't know what their brain is going to look like.

1:06:46Sasha Hamdani:Well, again, your asymmetric rejection reaction. You can feel rejected from your family. You can feel rejected. Yeah, yeah, yeah.

1:06:52Dax Shepard:Getting burned by my five-year-old. I feel like here we are.

1:06:58Sasha Hamdani:Okay, well, this was lovely. Cannot wait for the new book. Currently, though, you could start with self-care for people with ADHD and then look forward to sensitive rejection, resilience and the science of feeling deeply. I hope you come back. This was a blast. Stay tuned for more Armchair Expert, if you dare.

1:07:22Sasha Hamdani:We hope you enjoyed this episode. Unfortunately, they made some mistakes. I have to say I'm only three days into no dairy. How's it going? And I'm already noticing. Oh, that's good. I hate it. Well, that's good. I was saying last night I almost would rather have a runny nose all the time. You have to, yeah, decide, I guess. Duh. It's the worst one you know. It's better to live in ignorance. That's true. Just go, oh, I'm just someone with a runny nose. I know. Ugh. Well, then you can pick, like, if there's something you really want with cheese, and you just know what you're getting yourself into.

1:07:59Sasha Hamdani:You just go, okay, I'm going to cough. I'm going to cough for a day. Yeah, exactly. I'm going to blow my nose a lot. Exactly. And that's going to be that. Yeah. Well, but also good if you know you don't want to be coughing, if you have a big thing to do, if you have something to do on stage. If I'm going to be like talking. For a living. For a living. Yeah. Yeah, yeah, yeah. Someone's got to edit around your coughing and to a clearing. Sure. Sure, that. that that's good to know. I would never, I mean, never say never. If I had to, I guess I would. But I could never give up cheese. It's my favorite food.

1:08:40Sasha Hamdani:It's so good. And it makes, it can make something that's virtually tasteless. Like a macaroni noodle on its own in a box of Kraft macaroni and cheese. You're not going to eat that. You add that cheese to it. Now you've got one of nature's greatest offerings. Best, best, best. Okay, I wanted to tell you that in a very fun way, Lincoln has now kind of joined a little bit into our Sim Talk insofar as we were laying in bed a couple nights ago and she was telling a story about a girl in class had a caterpillar on her shoulder. Okay. And apparently there's like a season for this. Oh. And there's caterpillars all over the trees at school and they're dripping down on people.

1:09:20Oh, okay.

1:09:21Sasha Hamdani:That just made me feel gross. And then we were just talking about caterpillars And all of a sudden, I just had this thought and I said, you know, Lincoln, when we die and we wake up in like a medical room and they go, you were in a simulation. I think one of the things they're going to say is, and by the way, you thought that there was a tiny little sleeve of mayonnaise and that that little sleeve of mayonnaise went into a dark cloth and came out as a butterfly. And you bought into that. You don't call it, oh God. That's what it is. A caterpillar is just a little tube of mayonnaise. And we have bought into the idea that that thing somehow goes into a dark cloth and comes out as a butterfly is preposterous.

1:10:08Sasha Hamdani:When we're talking about like the bus maybe is proof of the sim. I now think the caterpillar butterfly metamorphosis story we've been told is insane. How would it go from mayonnaise to a butterfly? Well, how would a seed this small turn into you? Oh, like the embryo? Yeah. It starts as a sesame seed size. I know. That's crazy. That is crazy. But I don't think as nuts as like a little tube of goo goes into a cloth and is now a flying, most beautiful, colorful structure. Where's it all coming from? That mayonnaise? Don't call it that. It is. It's like so nasty. Oh, my God. So then we were having a lot of fun with what else they were going to say to us.

1:10:57Sasha Hamdani:Like, you guys, you thought an octopus could swim over an environment and immediately become that environment without even looking. Their eyes are looking up at the surface of the water. And then they just hover over some coral. And then their whole body immediately is the color of the coral. Oh, camouflage. Get real. Look. Get real. Yes, beings are very impressive. Is there anyone you want to add to this one? So right now it's like leading the charge is like butterflies. We're going to feel so stupid that we bought into that. And then for us, the octopi, camouflaging. Okay, that's a big one. Have you watched it recently?

1:11:35Sasha Hamdani:It's impossible. Monica, it could swim over your face and it would just be your face. What are we talking about? Wait, really? Yes. You mean the camouflage? Is that what you mean? The bioluminescence or whatever the thing it's called, it's identical to whatever it's swimming over. No way. It's not an LCD TV. It is. It is. They're telling us it is. Also a TV. I mean, all of it. It's all. It's. TV I'm fine with. No. A TV. This is a prehistoric glob of goo. Glob of goo. Well. Okay. You're fine with it. I'm still. I mean, I just think humans is. That's a bigger. To me, that's a bigger leap from going from a sesame seed to you is bigger to me than the mayonnaise.

1:12:19Sasha Hamdani:God. But at least the thing is cell dividing and it's taking on building blocks through nutrition to create the new cells. And you can just see the course of action. It's like it's doubling every time it divides. It's very trackable. That's a sesame seed with no eye, nothing. Becomes a human. Yeah. It's wild. It's wild. But again, this gooey slug enters a cloth and then it flies away. Okay. Okay. Yeah. You're not as perplexed by it, but I just think it's one of the. It's a miracle. It's one of the hardest to believe things that happens in nature. Yeah. I mean, there's some things like ladybugs that I don't like, but have grown to like a little more.

1:13:03Sasha Hamdani:Okay. What are they doing? That's so startling. Really just the way they look. It's like, wow. No, or like same with fruits or like the pineapple. It's like nature made this. Nature made this pineapple, this thing with spikes and this hat on it and the sweetness. I know, but I'm struggling with the gap between these two organisms. If you were to like, you just look at all of nature and we didn't know that those were the same things. They'd be two of the last things you ever even put in a category, a caterpillar and a butterfly. Sure. it's like a elephant going under a cloth and coming out as a rattlesnake yeah okay you don't like my examples or not my examples they're just things that I find like wild about the world yeah you're um you're really blown away with growth yeah and like um the ladybug doesn't grow it just is very it's just how is it red with polka it like nature made polka dots like perfect Polka dots.

1:14:11Sasha Hamdani:That is astounding. On top, like, on an insect. Like, what? That doesn't even make sense. It is crazy. And then if it turned into a screwdriver at some point. Sure. You'd be like, hold on. What are you trying to say? I don't have that. I'm not that bewildered by metamorphosis and change. One animal turning into another animal. Yeah, because of the seed turning into you. Like, I'm primed with that and that. Yeah, my distinction is like it was one thing and now it's another. At least the seed was always a human, you know? Well, the butterfly was always a caterpillar. It just. That's what they're trying to tell us.

1:14:51Sasha Hamdani:That's what they want us to believe. Yeah. I mean, yeah. Sim. The Sim is crazy. It is. I mean, what about magic? We're going to feel foolish. What about magic? We're going to feel foolish. You're going to feel foolish because you're going to be like, they're going to be like, no, that was magic. Like those tricks that David Blaine did aren't tricks. That's magic. And like you spent so much time trying to figure out what were the tricks since there are no tricks. Yeah. I mean, as you know, I spent no time trying to figure it out because I know I can't figure it out. Right. And I know it's not magic.

1:15:24Sasha Hamdani:Yeah, but you're going to find out it's magic. Oh, we were playing 32 Questions last night at dinner. Oh. And Delta really stumbled upon one. Now, I would argue that she was wrong on both fronts, but one of the questions was, is it man-made? Oh, okay. Or is it from nature? Okay. I like that. Yeah. And so it wasn't man-made. We figured that out early. And then later on the line, it was not from nature. And then so I kind of bailed out of the game. So I'm like, well, if it's not man-made and it's not from nature, then it can't be anything. Okay. Right? There's nothing that's neither of those things.

1:15:58Sasha Hamdani:Let me think. Let me think. Not man-made. And not from nature. Did she mean like cotton or something? Again, that's from nature. But like I could see her think like. Well, what it was was weirdly it was both nature and man-made, which is maybe why she didn't think it was either. An eyelash.

1:16:21Dax Shepard:Oh.

1:16:23Sasha Hamdani:So that's both nature and man-made. That feels like she stumbled upon a riddle. Oh, that is a good riddle. Yeah. What's man-made? What is man-made and from nature? Made from nature. And eyelash. Although she said it was neither. Yeah, she meant both. But I can understand why she said neither. It's like, is it man-made? No. At that moment, she was like, no, no, the body made it. Nature made it. Right. And then, is it from nature? And it's like, no, it's human-made. Sure. Sure. Well, yeah, yeah. Interesting. That's a fun game. Yeah, it was. It's fun for a while. I bail out pretty early. My attrition for 30 questions is brief.

1:17:05Sasha Hamdani:Once we, like, I guess I just, I lose hope. Again, when I heard it's not man-made and it's not from nature, I'm like, well, then I can't continue to get, I'm running a fool's errand now. Oh, wow. Because there's nothing that is not either one of those things. Okay. Okay. Yeah. Comment if you can think of something that's neither. That's a riddle. Well, it's not really a riddle. It's just a hard question. Would we say like thoughts? Or man-made. Well, I guess it depends on how we're saying man-made. If we're saying— They can't exist without a human. Hmm. Okay. Like a wrench doesn't exist in nature.

1:17:44Sasha Hamdani:Yeah, exactly. But a man didn't, well, I guess construct thoughts, but it's more abstract than that. They didn't invent thoughts. I think it's an example of it's both in that case because it is the human thought. Like, is human thought man-made or nature-made? Yeah. And it's both. Or neither. I'll play with Delta. Stay tuned for more Armchair Expert, if you dare.

1:18:22Sasha Hamdani:Let's play. Play. 32 questions. Why don't you want to play? Okay. You have something? No, you have to do it. No. Oh, okay. Think of something. Okay. I have it. Is it man-made? Yes. Would it be sold at Walmart? Yes. Is it smaller than a microwave? Yes. Is it for personal hygiene? No. Do you plug it in? No. Okay. It's smaller than a microwave. You don't plug it in. They sell it at Walmart.

1:18:56Sasha Hamdani:Is this where you give up? We're getting close to where I would give up. Okay. Rob, do you have any questions? Is it food related? No. No. Okay. So we're not eating it. It's smaller than a microwave. Is it bigger than an iPhone? No. Wow. Okay, great. We just really got. So it's kind of microscopic. But they sell it. They sell it. It's smaller than an iPhone. It's not personal hygiene and it's not electric. Is it a pen? No. Is it home improvement related? No. No. Would it be in your living room? I would say no. Like, it could be. Would it be in your kitchen?

1:19:39Sasha Hamdani:Not traditionally. Would it be in your bathroom? No. Would it be in your closet? It could be in your closet. Could be in your closet. Your nightstand? Yeah. I'd probably put it in my nightstand. Wow. Not electric. Well, not plugged in. Is it battery powered? I think.

1:20:07Sasha Hamdani:It's not plugged in. But it's electronic. It's electronic? Is it electronic? Yeah. Is it a vibrator? No. We were led there. Yeah. Nightstand. Yeah. It has a battery smaller than an iPhone. These days you do plug in your vibrators. For a period. They're not tethered. Right, correct. If you've got one that's tethered, I tip my hat to you. You need that kind of voltage. Yeah. Yeah, yeah. A remote? No, it's not a remote, but you're kind of in the right zone-ish. In the nightstand, not a remote, not a vibrator. It's electric. I mean, I don't know if it's electric. God. I don't know if it's electric Okay Can be It can be

1:21:08Sasha Hamdani:Oh wow I'm picturing a nightstand drawer I mean don't get so stuck in the nightstand It just it could be there Okay And you said it is or isn't electric It can be Batteries Let's say it has battery. Does it tell time? Is it a watch? Close. Very, very close. Some would say it's a kind of. An Apple watch? No. Like one of those fucking rings you wear, like a health monitoring? Think a little more archaic. A stopwatch? Yes. A stopwatch. Good job. A stopwatch. Yeah. Do you have a stopwatch? I have one in my nightstand. You see? Okay. You have a stopwatch? No, I don't. Oh. No, a stopwatch. What made you think of a stopwatch?

1:22:01Sasha Hamdani:Because there's a stopwatch we're using at the SAG Awards. Top of mind, as you would say. Top of mind. Okay. Okay. I mean, I feel like I'd keep it in the nightstand or I'd keep it, you know, yeah, in the garage toolbox. I'm going to meditate on why the game for me gets frustrating. Okay. Probably just because I don't know and I don't like not knowing. Sure, probably.

1:22:29Dax Shepard:Calvin likes it and it's frustrating for me too.

1:22:31Sasha Hamdani:Yeah, it's hard, right?

1:22:33Dax Shepard:Especially when you, I'm not sure he's always answering correctly.

1:22:36Sasha Hamdani:I have the same, and is this a male thing? I'm like suspicious that either they forgot or. Yeah, like Vinny we can't play with because he's. He'll just change it, right? Yeah, yeah, yeah. That's the other thing. You catch these kids changing it. Like if you guess it too quick, they don't like that. Yep. Sure. And what should happen is it should be written down on a piece of paper to keep everything above board. Well, I mean, playing with kids is different than playing with adults. Like I think if you play with kids, sure, it could be a little like, are they switching it? Are they, what are they up to?

1:23:05Sasha Hamdani:I mean, a lot of the time, like this is a long game. Yeah. And I'm not even sure if they remember. Sure. But if you're playing with an adult and you don't trust it, that's on you. Uh-huh. Okay. Adults know what they're doing. Yeah. Whether or not they would change it is another thing. There is some legion of people that would change it. Sure. But if they don't know the answers, like that's like a little like, you know. It was very easy when they were tiny children. Yeah. Because you knew it was something they could see in the room. Of course. It's the glow. Yeah, yeah, yeah. You could narrow it down pretty quick and go, is it a light switch?

1:23:44Sasha Hamdani:That's because they look at it immediately, too, and then say they have it. Wow. Every time you ask. Is it brown? No. Yeah, I know. So cute. See little caterpillars turning into butterflies all over the place. All right, should we do some facts? Yeah, let's do some facts. Okay. I didn't bring it up in the interview, although I was tempted to. What? You know, Sasha holds a very dear, it's a very important name to me. It is. That's who you had sex with. Oh, yeah, that's your first girlfriend. Let's definitely not say that to Sasha. That was your first girlfriend or the first person you had a crush on.

1:24:24Sasha Hamdani:We're getting close. It's so relevant that my therapist remembered her name. Is this because she had the sauna? No, that was Randy. That was later. Okay, so elementary school could not, no girls like me. And I like so many girls. I was just telling Delta this the other day. Yeah. I was like, I like so many girls. None of them like me. I got to sixth grade with my new look that my brother gave me. Right, right, right, right, right. And the most popular girl in the whole junior high. Yeah. Sasha Crossett. Okay, yeah. Who was an eighth grader. Yeah, I knew she was an eighth grader. Came up and gave me a note in the hallway.

1:24:52Sasha Hamdani:In the sixth grade hall. Okay. And I took it into my science class and I opened it up and it said, will you go with me? So you dated. Yeah, yeah, yeah, yeah. But she wasn't your first girlfriend? I had to, I gotta be careful. This is, I'm gonna call her Frank. Frank? I had like a Valentine once. It was. Oh. Let's just leave it at that. Wait, what happened? I had a, I don't know if you'd call her a girlfriend. I had a girl who I think. Did you talk to her? Yeah, a little bit. And I think on Valentine's Day, maybe I gave her something. I want to say she gave me some fudge or something. But yeah, I do remember her name.

1:25:29Sasha Hamdani:The reason it's so important is that it is a transition from no girls like me to the most popular girl in the world. I know. This was a humongous, the biggest 180 of my life. That's huge. I also think I was kind of right in saying your first girlfriend. Because I'm not counting this fudge girl. Yeah, that's fine. That's fine. Yeah, we made out. We made out a ton. We would make out in front of the buses. Dean, you didn't make out with fudge. No, no, no, no. Yeah, she was your first girlfriend. So I'm right. Yes. And I guess I'm impressed you didn't bring it up because it's really important. We haven't interviewed a Sasha.

1:26:06Sasha Hamdani:No, we haven't. No. I have only met one Sasha since then. Sasha Baron Cohen. I guess two. Thank you for pointing that out. Yeah. The other was a Russian dude I knew. Oh, sure. I know. All right. Well, Godmother's Bookstore, you know, I was like, it's in Montecito. And then you guys were like, it's not in Montecito. We're from there. Yeah, yeah, yeah. And then. It's in Santa Barbara, right? Okay. Which I think Rob said Summerland. Summerland. Oh, okay. And everyone was like, yeah, that's not Montecito. Okay, which is fine. But then when I Googled, I said, where is Godmother's Bookstore? It said Godmother's Bookstore is located 2280 Lily Ave.

1:26:49Sasha Hamdani:I think Rob had said that because you said Lily. That's her middle name. Summerland, California, founded by Jennifer Rudolph Walsh and Victoria Jackson in 2024. Oh, it's pretty new. I'll say. It is situated in a restored 1920s. 1920s barn. Also, Victoria Jackson, the performer from Saturday Night Live. Victoria Jackson. Who's that? A beautiful blonde castmate in the late 80s. Oh, I don't know. I see her SNL. I don't know. It's a different Victoria Jackson. It's a cosmetics mogul. Oh. Cosmetics mogul. Okay, Greg. With a renowned literary agent. Oh. Well, it's situated in a restored 1920s barn, often described as a cozy curated space near Montecito.

1:27:31Sasha Hamdani:It says that. Near Montecito, it does. Open daily. You're having a hard time with this one. You're having a real hard time. You're taking another swing at it. It said it, though. I didn't even say. I said, where is it? And it even included Montecito. Yeah, yeah, yeah. So it's such a cute bookstore. Oh, my God. I could live there. Oh, brand new, too. It feels old. Yeah. Timeless. I love it. Okay. Now, you know how I was on D? Pseudoepideferin. Thank you. Which is meth. Precursor. Does meth eat alcohol? Jess said he used to make it like a Pac-Man. And it was like the meth would eat the alcohol. Yeah.

1:28:20Sasha Hamdani:Does it? It doesn't eat alcohol. But it gets you high, which offsets the inebriated effects of alcohol. Okay. Because alcohol is such a depressant. So if you imagine you took a Xanax and then you took an Adderall, the Adderall would lift you out of the Xanax feeling. Oh, interesting. And this is why people do speedballs. Coke and heroin, they're opposites. So you're kind of leveling off both sides, both downsides of the drug. Interesting. A heavy heroin does your nodding off. It's not ideal. Coke, you're too edgy, gnawing on your face, you know. So I think that's what he means. Is it right-sized as an ebriation?

1:28:59Sasha Hamdani:I don't think it metabolizes the alcohol any faster. Okay. So cocaine does the same thing. Got it. All right. What was the most popular Flintstones vitamin flavor? Based on nostalgic discussions, the orange Flintstones vitamin was widely considered. That's what I think of. Really? I was a red. I'm a red. She liked great. I think they made orange really front and center in the ads. It says purple and in some cases the iron fortified versions were less popular due to tase. With some users describing purple as yuck. Wow. Purple was my favorite. Really? You and Sasha could have shared vitamins. Oh, Valentines.

1:29:43Sasha Hamdani:That's cute. God, I loved them. Says nothing about red. I'm going to give you credit for something. Oh my gosh. So you've been saying for a while that Gabor Mate is a expert in ADHD. And every time you say it, I have to stop myself from saying, is that true? I don't remember that. I know he was like a trauma expert, but I don't remember ADHD. So I thought this was my in. Yeah, to correct me. Yes. Gabor Mate is a Canadian physician and author. He has worked in family practices and specializes in childhood development and trauma, including long-term effects on physical and mental health, such as autoimmune diseases, cancer, ADHD, and addiction.

1:30:28Sasha Hamdani:So it's in there. Yeah. It's in there. He had his circuitous path, if you remember when we interviewed him. He started working with the addicts in Skid Row there. Yes. That wasn't his thing, but that became his thing. Yeah, exactly. Kind of like Sapolsky being a fucking primatologist as a hobby, you know? Oh, yeah. I think his addiction trauma stuff more was his hobby. Right. But now he's really known for that. Yeah, yeah. Yeah, he's written five books exploring topics such as ADHD, stress, developmental psychology, and addiction. Now, if you guys missed that episode, you really should go back.

1:31:01Sasha Hamdani:That is such a great episode we did with him. Oh, I guess I'd like to say one thing, too. Eric died, my friend. Oh, yeah. I'm so sorry. And he was such a beautiful dude. And I think it would— Eric Dane. Eric Dane, yeah. I think it would be a lovely episode to listen to if you're curious about what kind of spirit Eric had. Yeah. Yeah. Yeah. I'm sorry. How are you doing? Well, I was talking to Lincoln about it. And I said, I, well, first I go straight to like gratitude. Right? Like I had a lot of, I was, when you hear someone has ALS, my worst nightmare of that would be I have lock-in syndrome. Right.

1:31:40Sasha Hamdani:And although he was very, very diminished physically at the end, he couldn't move much of his body, if at all. He could talk. Yeah. So he avoided that phase. So I just immediately, in the same way when my dad died, I felt grateful. Like it didn't get gruesome. Yeah. So I was grateful for that. I know how many people were around. That made me grateful. And then the sadness, I think, for me takes a minute. And I was talking last night to Lincoln. I said, I don't know. Imagine you came home from school today and mom said, dad died today. Don't. Could you comprehend that? And she's like, no. I'm like, yeah, wouldn't it take you a long time?

1:32:21Sasha Hamdani:You'd be like, no, that's not true. That's not right. And then months later, you'd be like, oh, wow, that really is true. That's, so I think I'm in that phase where it's like, is it? No. Yeah. I mean, intellectually, I know, but also, no. I think that's totally normal. I think that's, yeah, how most people are processing. It takes a minute. I feel guilty about that. Like, I see people, well, in real life and in movies, they hear bad news, and then they are immediately devastated. And I'm so protective, I think. I have so much like well-worn neural pathways that I'm like, I have so much shit that just engages right away to prevent me from feeling terrible.

1:33:00Sasha Hamdani:Yeah. And I think it takes a while for me to be willing to let that in. Yeah. You shouldn't feel guilty about that. I think it's totally normal. And what's the problem? There's nothing wrong with it. No, other than I think, well, my fear would be like, let's say I had been standing at the hospital and they pronounced my dad dead. And then all of his friends were there and they start crying and I don't. And now I appear to be sociopath. That's like the fear probably. That's on them. Or I watch these fucking datelines and the cops show up and I've witnessed something terrible and I'm kind of stable and they interpret that as guilt.

1:33:40Sasha Hamdani:Right. Like these are the crazy thoughts I have about like, oh, you're supposed to act a certain, people expect you to act a certain way. And if you don't, they start filling in explanations as to why you're not reacting the way they do. I know. But that's on other people. That's on those people who are deciding that everyone should be reacting the way they react. Yeah. I think it takes a long time to process all of these things. Yeah. And, yeah. And I'm sorry. It's really sad. loss is hard yeah when i some uh two weeks ago uh there's lots of laughing yeah that's good that's good yeah okay sorry i interrupted that fact check for that but i had forgotten that i wanted to say yeah yeah well let's just end on that well do you have another one well it's just about pmdd which is really bad pms oh right people people with adhd get pms sometimes worse Yeah, and I have, I'm pretty sure I have PMDD.

1:34:38Sasha Hamdani:Okay. And so then I was thinking. PMDD?

1:34:45Sasha Hamdani:Are you complaining things?

1:34:50Sasha Hamdani:God. I do think I have it. And then I was like, I also have that rejection thing. Maybe I have ADHD. Yay. Boy, you talk about a 180.

1:35:08Sasha Hamdani:No, I don't think I do. But it's all a spectrum, you know? It is. It is. So that's it. All right. Love you. Love you. Love you.