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Welcome to the Domavvey podcast. Great conversations with fascinating people. This episode's guest is Dr. Kieran
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Kennedy, also known as the hot dog. He's a New Zealand born and trained psychiatrist and ADHD specialist.
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Shifting away from thinking about autism and ADHD and neurode divergence as being
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this blanket negative or a defect or a failing, that's where we need to shift
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away from. A lot of people with ADHD are incredibly creative. They're incredibly
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successful. >> The goal of this episode is to cut through the noise and misinformation
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surrounding ADHD and get good advice from one of Australasia's most qualified
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experts. I hope you like it. >> Dr. Kieran Kennedy, welcome to my podcast.
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>> Thank you so much for having me. Yeah. >> Well, look at this. The hot dog. Is Is
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it helpful or a hindrance being an attractive dog? >> Well, I'm going to sound like a prick
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however I answer that. Um, look, I mean, it meant for some some fun um, you know, patient experiences
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during medical school things in some ways, but yeah, maybe I'm gym obsess bodybuilding doctor isn't what a lot of
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people expect possibly, but >> yeah, cover boy as well. You've been on
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the cover of Men's Health magazine. Um, and if you go to your Instagram page,
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there's some modeling shots there and you're like, I want this guy to be my
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doctor. >> I was going to say either people are going to say that or they're going to
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say, get me out of his clinic right now. Um, but no, so yeah, I've dabbled in a
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few different things alongside medicine, so keeps it interesting. >> Well, I put on Instagram that you're
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coming in so I could outsource some questions. And I was thinking the questions would be um in particular in
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relation to your specialty, which is ADHD, and most of them were um but there was there was one um annoying one from a
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friend of mine, Annie, >> just saying um who's middle-aged by the way, a married mom of two. She says, "Oh
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my god, I think I just developed ADHD." Hello, Dr. Kennedy. Oh my god, I think
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I've also just become a cougar. >> Do you get do you get a bit of that in
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your line of work? >> A little bit. I mean, I think thankfully being a psychiatrist means the patient
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doctor boundaries are pretty firm with psychiatrists, but um yeah, a little bit. like you know a lot of joking which
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is good but probably as we'll go into as well I think maybe looking not your
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stereotypical psychiatrist and doing fitness modeling and bodybuilding and things I think it's it's now meant that
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I in a weird way get to do things like this because I think that's kind of what
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kicked off a lot of this initial media work and speaking work and I think people were interested to talk to
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someone about touchyfeies and mental health but who also was kind of doing bodybuilding shows and things So yeah,
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it's been a bit of a wild career rides, but um yeah, no, I mean, thank you Annie
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for that. That's >> I appreciate it. >> Far too. >> So you're um yeah, you're based in
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Sydney and you're like the um the the the go-to guy on the the Australia and
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Sydney media scene when it comes to anything professional related to ADHD. What brings you back to New Zealand at
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the moment? >> Uh visiting family. Yeah. So Faro brings me back here pretty regularly. So, it's
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um yeah, it's always so nice to be back in Oakuckland. Like, I grew up in Wuku,
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so not too far from Oakland, but then >> moved into the Big Smoke for uni and
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went to Oakland University for for way too many years, to be honest. Um so, yeah, spent a lot of life here in
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Oakland before, you know, um please don't come for me, but moving over to the ditch in terms of being in Sydney
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now. So, yeah, it's just lovely to come back and visit mom and dad and my brothers and
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>> and things. So, it's so nice to be home. So, who who was Kieran Kennedy before he
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was a doctor? Yeah. Rural upbringing. >> Good question. Yeah. Um, yes. Rural
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upbringing. Yep. So, I grew up in Wuku. Uh, my both sides of my family had dairy
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farms. So, my dad's side and mom's side both had big dairy farms out there out
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in sort of um Ottowaka and then the Afu Peninsula. So, grew up Yeah. basically just pretty typical, I guess, jumping in
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creeks and running around cow sheds and and things. Um, so that was kind of early life, which again is is wild to
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think that I'm kind of doing what I'm doing now. But yeah, I just absolutely
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loved kind of being outside and and farm life and things when I was a kid. So it
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was a great place to grow up. >> Was that ever an option to become like a farmer?
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>> Yeah, I mean it was I remember there was one point cuz I have three brothers, so
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kind of a big family of boys. There was a point where I remember I think it was my mom's side of the the farm. There was
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a bit of a is it kind of going to be sold up once once granddad passed away and things or do any of you boys kind of
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want to move into farming? Um none of us did. We sort of wanted to to go our own
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path which is a bit sad to think now but yeah no for me I I think not. I was um always a bit more into the books. Was a
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bit of a bookworm probably by that stage rather than being on the farm. So probably lucky cows that I didn't go
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into that. I think much more books now. What? Yeah. What drew you towards medicine? Where where did where did that
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sort of um interest or intrigue begin? >> Yeah. Well, I think I always I mean,
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initially I wanted to be a vet for a long time. I I just loved being out on the farm and I loved animals. You know,
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dad was also a bit animal obsessed. So, there was just chickens and birds and dogs, cats, everything else when we were
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growing up. So, always sort of knew that I sort of loved biology and nature and wanted to help people or animals
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initially in some way. And then I think as I kind of moved through college and got older, I realized I loved just
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rambling with people and talking and hearing their stories. And so I think that's when I pivoted and said, "We'll
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give med school a crack." So >> yeah, for better or worse. Um, but here
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we are now. So it's Yeah. >> So how how do you end up in psychiatry and and what does it sort of mean
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specifically? >> Yeah, it's a good question because I often, you know, I think there's quite a
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bit of confusion around psychiatrist, psychologist, kind of the different terms and things. So a psychiatrist I
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guess in a nutshell is a doctor who has specialized and done training in mental health. Um so we train in depression,
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anxiety, schizophrenia. There's also quite a lot of neurology and brain sort
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of training too. So um that's sort of a doctor who specialized there and then
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psychology um is equally if not more important. But a psychologist is someone who might help people through talking
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therapy and different things. Um but yeah for me I started doing a psychology degree at Oakland University and then
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after I finished that degree I decided you know um I would dive into doing another five years of study and went to
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Oakland medical school and the rest is history. So yeah got a wee bit swayed by the bright lights of plastic surgery and
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surgery for a while. I actually really enjoyed that as a student but I think I always knew that I was going to go into
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psychiatry because I loved psychology and just talking to people really. So, it's um yeah, it was a bit of a clearcut
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path for me really. >> Oh, did you look at the plastic surgery thing, did you?
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>> I did. Yeah, really. I mean, not talking boob jobs and things like that, but um
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yeah, I love I mean, I did a a stint in plastic surgery at Middlemore Hospital when I did my internship and it's just
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fascinating stuff. you know, that reconstructive plastic surgery. If people are in burns or they're in car
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accidents and they need sort of reconstructive work to their face, there's sort of breast cancer removal
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and breast augmentation and things. It's it's just amazing surgery. So, got a
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little bit swayed there for a while, but I think >> Oh, that sort of plastic. I was thinking
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more like Hollywood or Housewives of Melbourne. >> Yeah. Not quite. I mean, who knows where
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I'd be now and what I'd be doing if I went down that path, but um yeah, no,
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the the public plastic surgery is a lot different to that sort of cosmetic plastics. Um but yeah, I think
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eventually always knew I was going to move into psychiatry and just have always had a real passion for mental
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health really. So, it's um yeah, I sort of stepped away from any inklings of
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surgery and and then started my psychiatry training in Oakland initially. >> Yeah. When we when we set this podcast
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up, I I thought, how are we going to structure it because there's so many there I mean there's so many um angles
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and directions we could go in. You've even written a book about mental health
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and that's one of your sort of I suppose passions I guess men's mental health. Um
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that could be a podcast for another day all on its own. Um ultimately I decide the direction to go in is ADHD because
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there's so much um >> I don't know, so much stigma about it, so many questions about it, so many um
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>> so much online. Yeah. >> Yeah. So much BS. So how did Yeah. How did you get into that as sort of an area
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of expertise? >> Yeah, interesting. in terms of sort of I did my general psychiatric training and
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initially that was in Oakland and then I moved over to Melbourne um initially when I went to Australia to finish my
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training there at the Alfred Hospital in Melbourne and I sort of did my training
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in what they call consult liaison psychiatry which is working in the hospital and it's when I guess physical
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health conditions that are impacting the brain end up affecting our mental health
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our mood or causing psychotic symptoms. So, a real interest in brain development
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and that kind of intersection. And I guess that fell into then becoming really interested in
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neurodedevelopmental conditions, uh, autism, ADHD, >> and kind of as, as luck would have it, I
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guess it was around that same time that I finished my training that Australia, but also just the world was exploding in
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terms of of awareness for ADHD and information slash, as you say, BS on social media about ADHD. And so there
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was just a real need for psychiatrists to be working in that area and sort of came across an opportunity for for
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further training in ADHD specifically and then work within a clinic. So yeah, it's been quite a few years now that
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I've just specialized in seeing mainly adults for ADHD diagnosis and treatment
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and support and >> it's just a fascinating area but sort of also lends itself to sort of speaking
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and TV work and media work because there is a lot of misinformation around it as
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well. >> Do do you have ADHD yourself? >> I don't. No. Which I think is why I find
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it so fascinating to be honest. Um I get asked that question quite a lot. Um but
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yeah, I think in a lot of ways my brain is quite neurotypical and sometimes I I think um you know I would like a little
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bit of spice. I would like a bit of neurode divergence sometimes. >> Well, could could someone with ADHD um
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like do the work required to get through medical school? >> Absolutely. Yeah, definitely. I mean,
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you know, I think as we'll go into ADHD and neurode divergence, autism as well,
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you know, I often talk to patients about it being a bit of a double-edged sword sometimes. There are a lot of things
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about ADHD that can make the world we have to live in now very difficult. But there are a lot of things about ADHD as
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well that can absolutely be a bit of a superpower to use that kind of bit of a corny overuse phrase. But, you know, it
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can absolutely drive a lot of, you know, real passion and interest, creativity, hyperfocus, you know, and and I know um
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doctors and and people I went to med school with even who have ADHD diagnoses. So, it's it's definitely not
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a block to anything. Um, >> so yeah. >> Well, I've got a couple of establishment
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questions and then I've got um the questions that I outsourced from Instagram. Um, I do this often with
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guests and I don't I don't recall ever having as many questions on one subject
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as what there's been for this. >> Yeah. Well, that's great. >> So, first of all, um, for people that
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are new to it, what is ADHD? I remember growing up, um, it was called ADD and it
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was generally naughty kids at school or kids with behavioral issues. >> Yeah, absolutely.
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>> Is it the same thing? >> It is the same thing. It's kind of we
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used to talk about it more separately as being hyperactivity or attentional issues. And so ADD was kind of the the
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old terminology, but I guess attention deficit hyperactivity disorder. ADHD as we know it now, it's a combination of
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what we call inattentive symptoms. So that can look like struggling to focus, being really distractable to things
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around us. It can be issues with memory, time management, organization. And then
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there's that more stereotypical classical hyperactivity side to ADHD. And that's what we used to sort of think
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about with ADHD was sort of, to be honest, that stereotypical naughty little boy that was running around the
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classroom and not able to sit still or kicking desks over, whatever it was. Um, but hyperactivity can look like really
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struggling to sit still, being overactive, over talkative, struggling with impulse control.
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>> So, what we know ADHD is now is often a really complex mixture of those
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different symptoms for people. And it's absolutely not that stereotypical old
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school view of ADHD, which is why I think there's been a bit of an explosion
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now for adults especially realizing they have this because it's it's not
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necessarily the loud overactive kind of naughty kid or teenager or adult. It can
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look really really different for different people. >> Why do you think there has been like a
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sudden explosion in it? It feels like since I don't know maybe 2020, the last
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half decade. I don't know, maybe it's the rise of Tik Tok as well. I don't know. What do you
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think? Why is it suddenly everywhere? >> Yeah. I mean, I definitely think,
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you know, I have a bit of a lovehate relationship with with social media when it comes to medical and health stuff.
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You know, I think there's been a lot more information shared from people themselves around having ADHD and what
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that looks like. Uh and then there's just been a lot more awareness I think for kids but also adults around what
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ADHD can look like and particularly for women you know for girls and women. We now know that so many girls were missed
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when it comes to diagnosis of ADHD during childhood and and adolescence because they didn't look like that
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stereotypical loud naughty overactive hyperactive boy. And so now I think a lot of people that were younger during
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that time have now hit adulthood and we've become aware that ADHD can look very different. So more people are
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presenting for assessment and diagnosis. So there's a lot out there around rising
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rates of ADHD and autism and neurode divergence and you know we can go down the the Trump rabbit hole if we want to
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but a lot of misinformation around what's the Tylenol thing. >> Oh my god, don't even get me started.
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But you know, so there's misinformation about why ADHD rates are rising, but a
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lot of it comes down to the fact that there's a different way of diagnosing ADHD now. And we also know that
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especially for adults, ADHD can look very different and can actually be quite subtle in a lot of ways. So that sort of
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led to a bit of an explosion of info online and on social media, on Tik Tok, but also a bit of an explosion of of
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people now seeking out diagnosis. >> What are some of the some of the most
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common traits? And then maybe just a couple of the less common traits as well. >> Yeah, I mean the most common would be
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sort of the inattentive side actually especially for adults. And so that would look like really struggling to focus is
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a very very common kind of core symptom. People might find it difficult to focus
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in lectures or with reading or study if they're studying. They might find it
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difficult to focus on tasks for work or even chores at home. They find that they
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just lose their focus. they get very distracted and jump into other things without finishing the first thing. Um,
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so that's common. Um, hyperactivity is still also common in adults, but rather
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than being, you know, a little kid rushing around and and sort of smashing windows or anything like that, for
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adults that might just look like being very uncomfortable and restless if we have to sit still. Or it might look like
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never really resting or slowing down. You know, I think we all know someone who is kind of constantly rushing around
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and busy, never stopping, always on the go. So, that's really quite common as
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well. Probably less common symptoms that people maybe wouldn't really realize can
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be difficulty actually retaining information. So, a lot of patients I see actually struggle to take in information
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that they've read or if they've talked to someone, they're sort of nodding
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along and smiling politely, but then when that person walks away, they they realize they they didn't take any of
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that in and they have no idea what they just asked them to do. So, retention and
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memory is is part of ADHD. And then impulsivity as well. And again, for adults, that's not always looking like
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struggling with alcohol or drugs or, you know, buying Porsches on a whim. It can
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often look like struggling to manage your finances or being impulsive in your dating life or impulsive with decisions.
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Um, so it can kind of look quite different and subtle and people often don't think that those things can be
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part of ADHD. with with your vast experience and knowledge, can you see someone and sort
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of go, you've probably got ADHD? >> Uh, >> or is it just way more complex than
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that? >> Look, sometimes I can, you know, amongst friends and people I meet, I think
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they're often like, please don't analyze me, like cover your eyes, kind of thing.
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Um, look, I mean, sometimes it can be quite clear that someone might be struggling to focus or they might be
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quite hyperactive, but a lot of the time, again, I think for adults, it's it's actually quite complex and and
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quite sort of internal. So, you know, the ADHD assessment process really is quite in-depth in terms of teasing out
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and talking about a lot of these things. Um, I think I've got a pretty good barometer now for meeting patients and
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kind of getting a gut feel pretty early for, you know, whether we're looking at
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ADHD or neurode divergence or maybe we're looking at an anxiety disorder that is also impacting someone's
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attention and focus. So, yeah, I think I've got a reasonable barometer, but um
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I promise I switch it off when I'm not in the >> You're not judging judging people every
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second. >> No, I'm not analyzing people in the supermarket. Thank god. I think that
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would drive me nuts. But um yeah, pretty good read otherwise. >> Okay. Um as I said, I outsourced to
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Instagram. Um so there's a ton of questions here. So they may not go they might be sort of scatter gun. They might
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sort of go backwards and forwards. Um but we'll run through these. >> If ADHD presents itself differently in
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people, how can you tell if someone has it? >> A really really great question. I think
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it's sticking to the core symptoms in terms of what I guess the DSM which is
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our diagnostic manual that psychiatrists use to kind of diagnose conditions in a
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structured way around the world. There are still a very kind of set you know uh number of criteria I guess for meeting a
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diagnosis. So, I guess the key for me if I'm assessing someone, for example, is
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to move through those symptoms, but really try and tease out with that person how it affects them because
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struggling to focus for me might not look like struggling to focus for you depending on the type of work you do or
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if you're studying. So it can be tricky, but I guess it's kind of the underpinning is that we go off those
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core inattentive and hyperactive symptoms and then from there we tease out how those things impact someone. So
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it is complex and and everyone can be different, but there are sort of core symptoms and things that we know really
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look and feel and sound like ADHD. And I guess those things kind of are the core
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structure to an ADHD diagnosis that everyone needs to meet. How long has ADHD been around? I'm 70
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and all of a sudden it's everywhere. Yeah, >> really good question. I think Yeah, my
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grandma asked me the same thing not that long ago really. >> Um yeah, she was like it just was never
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around when when we were at school and I sort of >> but but it was around but it just wasn't
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diagnosed or it was left untreated. >> Definitely. it was probably just wasn't
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recognized for most people. And if it was recognized, it was again, as we've
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said, it was those, you know, kids that were just absolutely not able to sit still or they were running around or
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being really disruptive. And >> unfortunately, for a lot of those kids, it wasn't noted as being ADHD. It was
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labeled as just really naughty or really bad. You don't want to work at school.
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So, >> it's always been there. Um but absolutely, you know, it's it's
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something that's just really come more to the four recently. But it is a diagnosis in some form that's been
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really kind of talked about in present sort of even from the the 1960s, the '7s. And so it's been around for a long
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time. I think it's now more that we're just really really recognizing how it
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can impact kids and adults in a more subtle way. So >> what's going on the on what's going on
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in the brain of someone with ADHD? >> Yep. Love that one. Um, basically, you
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know, we could definitely talk for an hour about that, but I might put you to sleep. I promise I won't. Um, I guess in
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a nutshell, we know with ADHD from that point of birth really, someone's brain is developing just
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slightly different when they have ADHD compared to someone who doesn't. And that's the crux of a
00:21:06
neurodedevelopmental disorder. And so in ADHD, we know that there are pathways and circuits in the brain that just
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function a little bit differently in terms of dopamine, neurochemical levels, stimulation levels compared to someone
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who doesn't have ADHD. And a lot of that is to do with the preffrontal cortex and
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the frontal lobe, which people might have heard about. That's really involved
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in a lot of our attentional, motivation, memory, personality based aspects. And so it's those connections and circuits
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in particular that we know just work slightly differently for people with ADHD. It's definitely not that they are
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underworking, overworking, that they're damaged or defective or flawed. It's
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just that we know there's a spectrum of the way the brain can develop and operate. And for people with ADHD,
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their development of certain areas is just on a slightly different part of that spectrum to someone who doesn't
00:22:01
have ADHD. And as we've said, that can affect how much you focus, how destructible you might be, how restless
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you are when you're sitting still. Um, so it's sort of a bit of a complex mix
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of different chemical balances and and circuitry in the brain that's just slightly different.
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>> Yeah. So you're born with it. >> Yeah. So the >> And is it is it exasperated with screen
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time or >> you're depleting your dopamine or anything like that or >> Yeah, we definitely know those things
00:22:28
can impact. So I guess like autism, the current understanding of ADHD is that it's it's something that we are sort of
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born with in terms of how the brain develops across childhood and across our life. So that's a key part of the
00:22:42
diagnosis for adults is actually looking back to early symptoms that were there during your childhood or primary school
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years. And so we know there's that kind of genetic or biological underpinning, but
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then absolutely different things that come our way across childhood, potentially even screen time and other
00:23:01
things that can impact our focus time and things that can potentially buffer symptoms here and impact how prominent
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they are or how much they get displayed or not displayed. >> Um, so yeah, it's a bit of a complex
00:23:13
mixture of your genetics and your biology, but then also what your brain's exposed to as you grow up as well. for
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people who suspect they might have it. What's what's the next step? What does
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the assessment process look like? >> Yeah, I love this one. I mean, I was hoping this was going to come up because
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I think this is one of the hardest parts, especially for adults. It's well, how the heck do I go about getting this
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sorted then? For New Zealand and Australia, it's very similar really. So, I think the first port would be to see
00:23:39
your GP really or if you have a psychologist, also talking to your psychologist. And at the moment anyway,
00:23:45
it's then getting an appointment to see a psychiatrist who has experience with
00:23:50
ADHD and is able to provide that diagnostic assessment. Psychologists can also diagnose ADHD, clinical
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psychologists and developmental psychologists. Um, but I guess in terms of moving into treatment, especially
00:24:03
medication, it would be getting a referral from your GP to meet with a psychiatrist. That kind of needs to lend
00:24:10
itself to that pathway. Um there are some changes potentially coming in in New Zealand and Australia in coming
00:24:16
years actually where GPS are potentially going to have further training to be able to potentially diagnose and then
00:24:23
also treat ADHD too. And I guess that comes from the fact that there's a real
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bottleneck I think especially for people in New Zealand when it comes to actually
00:24:32
accessing a psychiatrist. You know there can be really long wait times and it can
00:24:36
also be really expensive to to get a private ADHD assessment. it sort of can be in the the thousands of dollars type
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range. >> So, sort of giving GPS more scope and experience to potentially also help
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diagnose ADHD is something to hopefully kind of open up that access for people. But yeah, I think if anyone is sitting
00:24:57
here thinking, [ __ ] I might have ADHD, it would be starting with your GP and booking an appointment there to just
00:25:04
discuss that and and then getting a referral from there. Mhm. >> I think you answered the next question
00:25:10
uh in that answer. Someone wanted to know why is it such a long and costly process. I think you answered that
00:25:14
there's just there's so many people that want to get checked and so few gatekeepers.
00:25:18
>> Absolutely. And even within psychiatry, it's still quite a subsp specialized
00:25:23
field to work in. So you know if there's x number of psychiatrists in the country
00:25:28
there will only be a very small proportion of those psychiatrists who feel comfortable or are trained or are
00:25:34
able to diagnose and then treat and manage ADHD. So it's kind of a bit of a bottleneck type situation at the moment.
00:25:42
But also you know ADHD really being a private psychiatric um sort of diagnosis at the moment too means that the cost
00:25:51
involved in that can be quite high. So, you know, without getting on my soap box
00:25:55
too much today and and ranting about politics, you know, I think for Australia, but also New Zealand, future
00:26:02
work around ADHD needs to come with opening up potential public, you know, services and and um access for people
00:26:10
because that financial barrier is a significant one for a lot of people. You know, rightly so. people can't
00:26:16
necessarily afford to be paying >> $1,500 or $2,000 to see a psychiatrist for a diagnosis. So,
00:26:24
>> we do really need some shift to happen there in the system as well. >> Is that the sort of amount you can
00:26:28
expect to pay to be tested >> potentially? Yeah, there's a there's a
00:26:31
huge range. So, there will absolutely be hopefully, you know, some access that's
00:26:36
cheaper than that, but absolutely. I mean, especially in Australia, people paying significant kind of costs to see
00:26:43
a psychiatrist for ADHD. And again, that's I think come around that demand supply side and and the bottleneck kind
00:26:51
of model in terms of there are just a lot of people waiting for ADHD assessments. Um, you know, and I will
00:26:58
also say it's because there's a lot of work that goes into the diagnostic
00:27:02
process as well. There's a lot of kind of moving through scales, looking at school reports. there's significant time
00:27:08
and often multiple sessions included in the diagnosis. So I guess in terms of seeing a specialist for that multiple
00:27:14
times overall the cost can be significant. Yeah. >> With that with that in mind is that is
00:27:21
it sort of like a privilege condition and what what I mean is that um like if I'm if if I'm work at the Bluebird
00:27:28
factory and I'm on minimum wage and I've got three kids at home, the last thing
00:27:30
I'm going to do is put 1,500 bucks into a diagnosis. >> Yeah. 100%. And and I definitely think
00:27:35
that's part of it, you know, and that's why some of the the systems around
00:27:40
mental health in general for New Zealand and Australia, but especially conditions
00:27:43
like ADHD, that really needs to change and there needs to be more support, I think, from public health services and
00:27:50
the government to open up access here. And that might look like making sure more public clinicians are sort of able
00:27:57
to diagnose but also supporting people maybe in terms of public funding for for psychiatric assessments for ADHD as well
00:28:05
because absolutely you know I think it's it is in some ways a bit of a privileged
00:28:10
position to a be able to think about well your focus and destructibility and some of these symptoms um but also then
00:28:19
afford to take a hit out of a family's savings or income to to get this assessment and and the diagnosis as
00:28:27
well. It's it's significant. So that really needs to change. >> Yeah. Cuz that could be the difference
00:28:31
between taking your family away for Christmas holiday or even having a Christmas and not does it matter if it's
00:28:36
undiagnosed? >> Really depends. You know, I think this is an interesting thing around neurode
00:28:41
divergence as well because I really really want to make it clear for people that having ADHD, autism, neurode
00:28:48
divergence, this is not a blanket negative, you know, it's not a defect or a flaw or a mutation. It's not because
00:28:55
of Tylenol or paracetamol obviously, you know, and so for a lot of people living
00:29:00
with ADHD especially, it can have a lot of strengths and great things to it. And
00:29:05
if that's the case, people might not necessarily feel they need to get a formal kind of medical diagnostic stamp
00:29:11
or get treatment. You know, even personally, I know people who, you know, we think, well, probably there's a a
00:29:18
little bit of a whiff of ADHD there, but they're really happy. It's serving them
00:29:22
in their lives. They're not feeling it's sort of enabling sort of disabling them
00:29:26
in any way. And so, someone in that sort of boat might not want to seek out a formal diagnosis or get treatment. And I
00:29:33
think that's really important to call out. But where it does tip into causing
00:29:38
significant negative impacts or impacting someone's potential with study or work or relationships, that's when it
00:29:45
obviously borders into that disorder territory and where someone really might feel they need that medical kind of
00:29:51
diagnosis and treatment and support. >> Yeah. Is it um is it incorrect or even
00:29:58
offensive if someone that doesn't have a diagnosis like talks about oh you know
00:30:01
my ADHD brain potentially. I mean, and again, I think that's where some of that
00:30:07
stigma comes in around, you know, even now, you know, we hear it and and it's
00:30:12
out there in terms of like, oh, yeah, he's got ADHD, or like, well, my ADHD is
00:30:18
playing up again, you know, and I think it can be used in a bit of a stigmatizing way in terms of sometimes
00:30:24
it's to do with things that just aren't ADHD at all, you know. So, it definitely
00:30:29
can tip into that. And that's where again I think that stereotypical view of
00:30:33
a little boy struggling to sit still in class and being really naughty and misbehaving. That's where that kind of
00:30:39
stigma and stereotype can carry over a bit still. >> Yeah. I suppose that leads onto this
00:30:44
question. Uh what can I say to shut down people who say h everyone's got ADHD
00:30:49
these days? It really grinds my gears. >> Yeah. And I absolutely hear you. You
00:30:53
know, I think for people who have a diagnosis of ADHD or think they might, this can be one of the hardest parts
00:31:01
about living right now with neurode divergence. You know, I think there's so
00:31:05
much online and in social media and there's all this misinformation. I think
00:31:09
people who are concerned they might have ADHD can often kind of gaslight themselves a little bit to be honest and
00:31:16
and say well you know everyone saying they have it now or people are talking about having ADHD if they you know can't
00:31:24
focus on their phone for 5 seconds you know and and so that is really difficult I think in terms of how we might respond
00:31:31
to someone saying that in terms of oh no you don't have it everyone's got ADHD
00:31:36
that's definitely not the case everyone might struggle with focus. At points,
00:31:40
all of us might forget something or mix someone's name up or if we're sitting in
00:31:45
a car for two hours, we might feel a bit antsy and restless. So, everyone potentially struggles with features that
00:31:52
can look and feel like ADHD, but not everyone has the certain clustering of those symptoms at a severe enough level
00:32:01
to warrant an ADHD diagnosis. So, yeah, I don't know. without saying jog on. I
00:32:06
mean, I think I think if people are kind of hearing that, it would be, you know,
00:32:10
just politely letting them know that um absolutely not everyone has ADHD. About 2.6%
00:32:18
of New Zealand adults have a diagnosis of ADHD. Um so it's definitely not everyone, but it is a significant
00:32:25
number. And probably the number of adults that >> have it, but don't have a diagnosis yet
00:32:29
is quite a lot more than that. So again, I think there's this a bit of a misconception in terms of just we're
00:32:36
hearing so much about it. It feels like everyone's bloody got it or thinking
00:32:40
they've got it, but it it actually still is quite a a subsp specialized kind of
00:32:44
not overly common condition in a lot of ways, too. >> Yeah. 2%'s tiny.
00:32:49
>> Yeah, >> that really surprises me. Does it does it um change or evolve with age? like
00:32:53
does it does it do the symptoms get uh you know worse or better or >> yeah I mean it really depends on the
00:32:59
person but for a lot of people it can change and get better. So for a lot of adults with ADHD if they were really
00:33:06
quite hyperactive or more physically restless and things as a child that often gets better as we get older for
00:33:13
adults it sort of tempers itself a bit but also understandably as we get older we get a little bit better hopefully at
00:33:19
containing some of that energy or impulsivity. So adults are more likely to have the more focus, attention, time
00:33:26
management, memory side of symptoms because the hyperactive side often changes. So it can definitely change
00:33:33
over time. Um, something else I want to let people know is that it can sort of change as well across your life
00:33:38
depending on what's on your plate, you know. So I often meet people for the first time who have always struggled a
00:33:46
little bit, but maybe then they've had their first child. And so for women, often ADHD can really start to ramp up
00:33:52
and impact things more when they're just juggling more. They're juggling a
00:33:56
toddler now as well as trying to go back to work. Or I might meet someone who's
00:34:01
had a promotion at work and suddenly the increased demands of their new job makes
00:34:07
focus and memory and attention really really start to ramp up and impact their ability to work. So symptoms can
00:34:14
definitely change in flux depending on what's going on in our life, how much
00:34:17
pressure is on our brain, also even other mental health struggles. It can worsen if we're depressed or anxious
00:34:23
too. >> Does it present differently in men and women? >> Can do. Yeah. So women, especially as
00:34:29
adults, are more likely to have more internal or inattentive symptoms. So women are more likely to struggle with
00:34:37
focus, memory, time management, that side of things. They're also more likely
00:34:41
to feel hyperactivity in terms of restlessness and fidgeting or wanting to talk or interrupt others. But women are
00:34:49
far more likely to contain those symptoms. And so a lot here is also to do with that socialization of girls and
00:34:57
women in terms of well if you're a good girl then you are quiet and you behave
00:35:02
and you sit still in class. Whereas for boys and men in terms of the boys will be boys and no he's just a you know a
00:35:09
young lad boys are more able to express hyperactivity and energy and loudness. So I actually meet a lot of women who
00:35:18
have always kind of sat holding in this kind of sense of restlessness and fidgeting and impulsivity because for
00:35:26
various reasons, you know, girls and women are kind of taught from a young age that they really just need to be
00:35:32
quiet and polite and behave and they need to contain those symptoms. So it definitely can look a lot different for
00:35:39
for men and women because of kind of biology, but also because of kind of stereotypes around masculinity and
00:35:45
femininity and what's okay to express or show as a man versus a woman. >> Yeah. With that in mind, what's the
00:35:52
reaction do you see when adults get diagnosed? Is it um like is it um is it is it is it crushing? Is it a sense of
00:35:59
relief? Is there shame or what is it? >> Yeah. I mean, any one of those words
00:36:05
you've just said, Dom, is like pretty common. Um, I often talk to people about
00:36:09
it feeling like a weird mixture of emotions. Lots of patients tell me there's a sense of
00:36:14
>> real relief, you know, validation. They've kind of maybe thought something's there or something's wrong
00:36:20
or difficult for quite a long time, maybe years or decades. So, often, you know, when I tell people at the end of
00:36:27
the assessment, you know, yes, I do think you have ADHD. For a lot of people, it's quite emotional in terms of
00:36:33
being this overwhelming relief and a sense of validation. You know, I think a lot of adults might have grown up being
00:36:40
told they were lazy or they were dumb. That's something I hear a lot is people
00:36:44
sort of saying, "Well, I just always felt like maybe I was dumb because I couldn't keep up in class." So,
00:36:50
>> it's often really positive and validating, but then there can be a mixture of sort of a little bit of grief
00:36:56
and even anger and sadness, too. I think for a lot of adults getting diagnosed, there's often a bit of sadness and
00:37:03
frustration and anger around the fact that well, I very clearly had these symptoms as a kid or I was really
00:37:09
struggling in school, but people just told me I was naughty or lazy or, you know, I wasn't smart. So, there can
00:37:16
often be a bit of a weird kind of melting pot of different emotions with it. >> Yes. It's almost like a sense of
00:37:22
validation in a way for Yeah. Oh, that's sad. Someone said, um, what would be the
00:37:26
benefits of me getting tested and diagnosed? I'm a 50-y old male. >> Really good question. Um, I think it
00:37:32
depends for me as a psychiatrist, it depends on how much you think those symptoms are impacting your life,
00:37:39
>> you know, at whatever age you're at, whether you're in your 50s or you're in
00:37:43
your 70s. You know, I've met people in their 60s and 70s for ADHD assessments
00:37:47
and diagnosis. And again, whether it's work, whether it's family life, whether
00:37:52
it's things with sports or hobbies, I think if there are things with potential
00:37:57
focus or hyperactivity where you feel actually this is impacting my life, it's
00:38:02
affecting my mood, it's affecting my family life, it's affecting my ability
00:38:06
to progress my hobby or career in this way. no matter what age you are, you know, I think someone can then benefit
00:38:14
from knowing the diagnosis is there and even potentially seeking out treatment to improve those things too. I think
00:38:21
again it can be a little bit of a stigma or a stereotype that ADHD and autism and
00:38:25
things are just things that kids get diagnosed with and that you know if you're beyond that then there's really
00:38:30
no point. But um it again depends on how much someone thinks this is impacting their life in a negative way.
00:38:37
Um there's a term that gets thrown around a bit these days. Um active relaxer.
00:38:41
>> You've heard active relaxer. Is is that an ADHD thing or not? It can be but not
00:38:46
always. >> It might be. Yeah. You know, I think a lot of people with ADHD that have more
00:38:50
maybe hyperactive traits, they really would not feel that it's relaxing or comfortable in any way to just blob on
00:38:58
the couch or watch a movie or Love Island for six episodes. >> Yeah. Exactly. you know, I mean, I might
00:39:03
love that, but I think for for someone with hyperactivity or ADHD, for them that would often actually feel really
00:39:10
quite uncomfortable to to relax and rest with doing nothing. So, for them, they might find themselves actually much
00:39:18
happier and more relaxed in a way if they are active and on the go. They're into sport or exercise or doing
00:39:24
different jobs or diving into the backyard. But again, I think it's important to call out, as with a lot of
00:39:30
these things, just because someone's an active relaxer doesn't necessarily mean
00:39:34
they have ADHD. I think personalitywise and and for other reasons, a lot of people actually just prefer to be active
00:39:41
and on the go. And exercise or running or sport for them is is a real mindful relaxing thing. So, yeah, bit of an
00:39:48
annoying psychiatristy answer to say it can be, but also it might not be. >> No, no, no, that's a great answer. Thank
00:39:53
you. Um on Instagram someone asked uh there's a common saying just try the medication and if it works you've got
00:40:00
ADHD. Is there any truth to that or is that just a myth? >> Bit of a myth. Yeah, I often hear that
00:40:05
one too. People are like well if you take rolin and it just you know makes you want to party or it does nothing
00:40:12
then that shows you don't have ADHD. Um that's not wholly true you know unfortunately. I mean, it might put me
00:40:20
out of a job if that was the way we worked out how people, you know, how we sort of work out the diagnosis. Um, but
00:40:27
no, you know, I think even people with ADHD, not all of the medication is helpful for
00:40:33
all people with ADHD. So someone with ADHD might be prescribed rtoolin for example as a common treatment a common
00:40:40
medication and even though they have really significant ADHD that medication just might not actually do much for them
00:40:46
or help them with focus or calming. Um so yeah I think doing the old trying one from a friend or something and then
00:40:55
working out whether you have it based on that. Um, yeah, bit of a myth. >> That must um Does that grind you a
00:41:01
gears? Like you you've done 10 years of study or whatever it is and someone that
00:41:05
reads something online thinks they can bypass that. >> Oh, sometimes, you know, I'm not going
00:41:11
to lie, in terms of some of the stuff we see on social media, you know, Instagram, Tik Tok, some of it is really
00:41:18
not very helpful. Um, and you know, again, with all respect to everyone else, there there's a lot of people
00:41:24
online giving people really quite significant health advice actually. Um, and again, it's with respect that, you
00:41:32
know, sometimes I might think, well, you haven't actually done a psychology degree. You're not a doctor. Um, but
00:41:40
again, it depends. I think when people are sharing their personal experience and things they've heard and seen what
00:41:45
works for them, >> that's amazing. I love that. And I love that about social media now in terms of
00:41:51
getting people's experience and knowledge out there. But yeah, when it tips into people kind of giving health
00:41:59
advice or feeling that they maybe might know better than a health professional, that can get a little bit dangerous and
00:42:05
a little bit gear grinding at times. >> Yeah. Yeah. Calm down. You've got
00:42:08
200,000 followers, but you really know [ __ ] >> But I mean, that's currency these days.
00:42:13
That beats my medical degree. >> Yeah. 200,000 followers. you can probably earn more than what you're
00:42:18
earning with your degrees. >> Absolutely. >> Um, what can someone expect when they
00:42:22
start taking ADHD medicine? >> Uh, really good question. I mean, in terms of, let's say, the classic what to
00:42:29
expect if the medication's working and working well, someone might notice or
00:42:34
expect their focus and attention to improve. They might just be able to stick with a task for longer without
00:42:41
getting distracted or their mind wandering. They might have less procrastination, be able to start things
00:42:47
better. If someone's actually quite hyperactive, they might feel like their brain and body are actually just a lot
00:42:52
calmer and more able to sit in a meeting or sit for study or or different parts of work.
00:42:59
>> But again, you know, it's why I love what I do. But it's very very
00:43:03
individual. You know, there's no kind of blanket statement of you take the medication and then you will feel this
00:43:09
way. Because just like ADHD can look at different for everyone, the effects of the medication can also look different
00:43:15
for everyone as well. So it's a very individual kind of unique thing in terms
00:43:19
of what it actually does and how it works. >> Those first things that you said um that
00:43:25
would feel like a gamecher I think for a lot of people. >> Yeah. >> It would be like an epiphany.
00:43:30
>> Absolutely. You know, and part of the reason I love this work as well is when
00:43:34
we get the diagnosis right and we prescribe the right treatment and it works and maybe someone's also getting
00:43:41
psychology support and things when it all sings like that, it can be absolutely lifechanging for people, you
00:43:48
know, and there's heaps of different things I hear from people in terms of how it helps them. But, you know, it's
00:43:53
it's always so rewarding to come back and meet someone for a follow-up session
00:43:58
after we've started medication and to have them say, "Oh my god, like I never
00:44:02
realized that other people's brains aren't just constantly full of noise and
00:44:08
random songs and thoughts and looking at that bird outside the window." You know,
00:44:13
people actually feeling like their brain quiet, you know, quiets down even that can just be lifechanging for people. So
00:44:22
it can be really really helpful and effective. >> Can can it be successfully managed
00:44:27
without medication? >> Absolutely. >> Yeah. And I think this is really really
00:44:32
important because I think a lot of the stuff and especially what we see online about ADHD is very medication focused
00:44:39
and I think especially that's a bit of a worry sometimes for parents in terms of
00:44:43
kids. Um, but definitely there are uh massively kind of um effective treatments for ADHD that don't involve
00:44:50
medication. There's ADHD specific psychology and coaching and obviously that takes a little bit more work and
00:44:58
time than taking a tablet, but that is just as effective for a lot of people as a medication. So, there are definitely
00:45:05
things on that front. And then we also know, which I really froth over as well, we know that there's a lot of things
00:45:11
just lifestyle and physical health-wise that can help improve ADHD as well. We actually know that exercise and sport
00:45:18
can kind of cause a a dopamine change in the brain in the same way certain doses
00:45:23
of medication can. So regular exercise and activity for people with ADHD is in a way also actually treating and
00:45:32
improving ADHD symptoms. diet, sleep, looking after your mood and anxiety levels. All of these things can be
00:45:40
massively helpful to improving ADHD. And so sometimes what we do is work with people around those things and we might
00:45:47
never actually touch medication at all. >> All those things you said um they're
00:45:52
they're just generally good for a person's overall well-being, aren't
00:45:55
they? >> 100%. you know, and I think that's when I first especially started getting into
00:45:59
the media and speaking kind of work in medicine was because people were sort of like this is kind of weird for a dude
00:46:07
working in mental health to also be bodybuilding. But for me it was almost a bit weird
00:46:12
that we weren't thinking that those things should go hand in hand because exercise, sport, our diet, our sleep,
00:46:20
getting out in nature, we now know that all of these things have a massive kind of part to play when it comes to how our
00:46:28
general mental health is doing as well. So >> that's definitely true for ADHD as well.
00:46:32
>> Oh yeah, just a sidebar, there's um nothing worse than an unfit doctor, eh?
00:46:37
>> Wow. Like does it annoy you when you see someone that's giving out medical advice
00:46:41
and they can't take, you know, great care of themselves? >> Well, yeah. I mean, I think it's tricky,
00:46:46
isn't it? Because I think doctors are also just people, you know, and I think,
00:46:51
well, God, we won't even go there, but I think doctors can have their own vices
00:46:55
in so many ways and struggle with, you know, similar things. And you know I I think it's really really important the
00:47:02
main part is that that doctors are kind of not bringing their personal side of things into recommendations for
00:47:08
patients. But >> yeah I mean god all of us are just human too and so I think doctors can struggle
00:47:14
with weight and health and exercise and things just as much as others as well. >> What misconception about ADHD frustrates
00:47:22
you the most as a psychiatrist? >> That's a really good one. I mean, I
00:47:27
think for me it would be something we've already touched on, which is that sense
00:47:30
of h everyone has ADHD now or I've actually even unfortunately heard it from medical colleagues as well in terms
00:47:38
of h this isn't even a real condition. This is something that's just made up so
00:47:42
private psychiatrists and can make money and you know go away to Europe on their
00:47:47
holidays and so that's >> Did you go to Europe on your holiday? I may have actually, but you've really
00:47:55
dropped me in at. Yeah. [ __ ] I kind of walked into that one, didn't I? >> But a European summer is wonderful.
00:48:03
>> That had nothing to do with my work. >> No, but you know, I think it's that it's
00:48:08
it's the stigma side of it. And it's not just with ADHD, but it's it's medicine
00:48:13
in general. I think there can be still a massive amount of stigma around mental health and psychiatry. And so that is
00:48:24
kind of one of the main things that frustrates me in terms of, you know, even unfortunately hearing from GPS
00:48:30
sometimes in terms of GPS having told their patients, oh, you don't have ADHD.
00:48:35
That's just something that everyone thinks they've got now. And if you see
00:48:38
the psychiatrist, they'll definitely say you have it because they, you know, are
00:48:42
telling everyone they've got it. And that is just absolutely not true. And also it's just very damaging and
00:48:49
discriminatory not only to my profession but to people living with with mental illness or living with ADHD or autism.
00:48:56
So yeah, that's definitely my soap boxy kind of gear grind. That's for sure.
00:49:02
>> How do you distinguish between someone genuinely struggling with ADHD and
00:49:06
someone simply caught in modernday distraction? >> Yeah. And I mean, that's a big part of
00:49:11
of my work. And when I meet someone for an ADHD assessment, that's probably the
00:49:15
hardest part, actually, is trying to work out, well, are you experiencing struggles with focus and attention and
00:49:23
memory because we're looking at ADHD, or are you struggling because you are juggling three jobs and you don't sleep
00:49:33
more than three hours a night? or maybe you have depression, maybe you have an anxiety disorder. And so all of these
00:49:40
other things, including modern-day pressures, can sometimes kind of really make it tricky to work out what's
00:49:46
causing what. Um, often, again, I mean, someone who's trained as a psychologist
00:49:52
or a psychiatrist to diagnose ADHD, that's a big part of it is teasing out what's going on here. But definitely a
00:49:59
part of the ADHD assessment process is making sure that there isn't another condition or something else going on
00:50:06
here that actually might be kind of >> masking and looking like ADHD. So a big
00:50:11
part of my work is also sometimes telling people I don't think you have ADHD. I think you have an anxiety
00:50:18
disorder or you might actually have bipolar disorder. You might have depression. And so kind of helping
00:50:25
support people with treatments and avenues for those things even as an initial step and then coming back to see
00:50:31
if ADHD is there underneath. That's a big part of the process as well. >> Oh, that's interesting. It it can sort
00:50:37
of present as those other things as well. >> Definitely. Wow. >> So I think we don't think enough about
00:50:42
that side of depression and anxiety disorders or other mental health conditions. But
00:50:47
>> that's so interesting. >> Absolutely. If someone has a really
00:50:51
nasty sort of dug in anxiety disorder, let's say generalized anxiety disorder
00:50:56
or panic disorder, that can absolutely shortcircuit our ability to focus or not get distracted or remember things. If
00:51:06
someone is really depressed, what it can actually do is affect the cognition of the brain and even look like dementia
00:51:13
for some people if they're significantly depressed. So part of ADHD assessment is
00:51:19
also making sure there isn't something else going on that is kind of causing
00:51:24
the same symptoms that might look like ADHD. So >> it's definitely a a pretty complex kind
00:51:30
of process as well to tease all that out. >> Yeah. What are some of the most common
00:51:35
misdiagnosis you see before ADHD is properly identified? >> This is a common one especially for
00:51:41
girls and women. You know, I meet a lot of women now who have been told for many, many years, you have anxiety or
00:51:49
you're just stressed or, you know, you need to kind of um sleep more and you
00:51:54
know, so they've been told things that >> eat more iron. >> Well, exactly. Yeah. You know, and so a
00:52:00
lot of of sort of struggling with ADHD type symptoms can be put down to other things.
00:52:05
>> And again, that's because it's complex. As we've just said, an anxiety disorder
00:52:09
or depression can look like ADHD sometimes, >> but also I think there's been a big
00:52:14
misunderstanding about what ADHD looks like too, especially for girls and women. And so, yeah, I think kind of
00:52:21
anxiety, depression, being told you're just generally struggling with your mental health. That's a very common one
00:52:27
to see people come to me with, you know, and then when we go through everything,
00:52:31
we actually realize, well, you you've had pretty significant ADHD your whole
00:52:35
life. It's not anxiety. >> How's how's that for people to digest?
00:52:41
Is that like a relief? Is that is that good news? Is it >> I mean, I think often it's it's really
00:52:46
relieving and validating and can be quite emotional in a positive way because I think, you know, it doesn't
00:52:53
matter whether it's your physical health or your mental health. I think a lot of
00:52:55
people can relate to feeling that something's not right or maybe we're not
00:53:00
kind of quite down the right track of the diagnosis or the treatment. And it can be very isolating and difficult to
00:53:07
feel like you're in the medical system or seeing a doctor or a psychologist and
00:53:11
you're not feeling heard in terms of what you're experiencing or what you
00:53:15
feel in your gut is going on. So I think it is really really validating and and positive for some people to kind of hear
00:53:22
that in the end. >> How do you help patients move from something's wrong with me to this is
00:53:28
part of how my brain works? >> Oh, I love that question. Um, look, it doesn't happen overnight, you know, and
00:53:34
and I always talk to patients about, you know, you might feel actually really angry and upset that this has been
00:53:41
missed till now, or you might feel a little bit of a mixture of shame. You know, I think a lot of people actually
00:53:47
come to see me and they say, >> I haven't told anyone that I'm having
00:53:51
this appointment. You know, I haven't told my parents or my partner or my friends because there still can be kind
00:53:56
of shame and guilt when it comes to this stuff. So, I really just tell people to
00:54:02
to let those emotions just come out and and feel them however they sort of come and kind of just giving your brain time
00:54:09
to process that is the main thing. But again, I think it's pushing back on that
00:54:14
stigma and like we've said, you know, autism, ADHD, neurodedevelopmental conditions, these are not kind of flaws
00:54:22
or defects. These are not our brain should be operating on this level but people with ADHD are at this lower
00:54:28
level. That is not what neurodedevelopmental conditions are. They are just a different way of the
00:54:34
brain developing and and sort of filtering in the world and and things. So I think talking to people about that
00:54:42
in in terms of that misconception of what ADHD is is often one of the best ways to kind of shift from that I have a
00:54:50
disease or a disorder or I'm defective to I just have a neurodedevelopmental
00:54:55
condition and that just means my brain operates on a slightly different part of the spectrum compared to maybe the
00:55:00
person sitting next to me. >> How can friends, family or employers better support someone with ADHD? H uh I
00:55:08
think really the understanding part is the big one here. So you know I think whether we're friends especially friends
00:55:14
and family it's hearing that person out and believing them when they tell you
00:55:19
they are struggling. Yeah. Absolutely. You know but also not kind of just pushing you know oh everyone's got it
00:55:26
now or that's fashionable. >> Yeah. That's because you're on your
00:55:29
phone 5 hours a day. I'm guilty. >> That might not help. It doesn't help me
00:55:33
that's for sure. But, you know, that's also not what ADHD is. So, I think this
00:55:38
is for mental health in general as well. Obviously, when someone comes to us and
00:55:42
says, "I'm struggling or something is there or something's not right." It's
00:55:46
just hearing them in that moment. Just listening to them, not trying to fix it or solve it or push it away with, "Oh,
00:55:53
well, that's just rubbish. That's a tick tock diagnosis." It's just hearing them
00:55:57
and believing them, you know. And then I think when it comes to workplaces or family life, it's also being open to the
00:56:05
fact that there are just different ways that people's brains operate best. And
00:56:09
so in a workplace that might look like being understanding of someone wearing noise cancelling headphones in the
00:56:15
office to kind of get distractions out. It might be understanding of them needing written instructions so that
00:56:21
they can remember kind of instructions better, you know. So, I think it's just
00:56:25
taking into account some of the things that people feel can help them operate best and kind of not shutting those
00:56:33
things down because they're maybe different to the majority. I think it's
00:56:36
again just being open. >> You just said there about written instructions. Is that is that a thing
00:56:43
>> that can help? Yeah. >> Oh my [ __ ] god. Like, >> are you a list man or
00:56:47
>> My god, I um I feel so embarrassed about so much stuff I I do, but like
00:56:52
everyone's on Outlook these days or your calendar online, but I still like having
00:56:56
an old traditional diary and I I like to write things down and >> it's something that I sort of keep
00:57:01
hidden because it's embarrassing because it makes me look like a boomer, but I
00:57:05
need to write things down. >> You like having it physically kind of Yeah, definitely. And again, that's
00:57:10
that's probably just you and that's how you feel things flow best and you can
00:57:15
keep track of things. >> But yeah, for people with ADHD, having things in multiple different formats in
00:57:21
terms of audio, written, you know, that can help information soak in and stick. And it also can make us feel we're kind
00:57:29
of just more in control of the logistics and organization, what's going on. So
00:57:34
yeah, I won't diagnose you over the table, D, but >> Oh, no, no, no, no, no. Um, what gives
00:57:40
you the most hope about uh the growing conversation around ADHD? >> I think the most hope is around the fact
00:57:47
that it's becoming more okay to talk about ADHD and to talk about mental health in general. You know, I think for
00:57:55
me that's one of the biggest things that came from the the pandemic, you know, is
00:58:00
just even when it comes to depression and anxiety and we've had >> athletes and you know, all manner of
00:58:07
people coming out being honest now and open about struggling with their mental health or having a diagnosis having
00:58:13
ADHD. For me, that's the most hopeful kind of positive part to it because for
00:58:18
a long long time, anything on the mental health front or the neurode divergent front has just kind of been this shadowy
00:58:26
sort of it's shameful. It's your fault. It's a bit of a personal failing. It's
00:58:31
something to hide. Um, but I think now the discussion and awareness that's out
00:58:37
there around ADHD is a positive thing because it's it's hopefully showing
00:58:42
people that this isn't something to be ashamed of. It's not something to hide.
00:58:46
It's not something that's a negative or you know a flaw. Um, so that's the most
00:58:51
positive thing for me and I think in Australia and New Zealand that's something I've seen just working in
00:58:57
psychiatry in recent years. this shift in terms of how we're thinking about mental health and mental illness.
00:59:04
>> It's kind of becoming on par with physical health now finally for the
00:59:08
first time. And we've still got a long way to go. >> But, you know, I think when we can be
00:59:11
thinking about what's going on in here in an equal way to how we think about
00:59:17
what's going on out here or with our heart or our gut, you know, it's just as
00:59:21
important and valid. So, that's that's the big hopeful part. >> Yeah. You've done so much uh fantastic
00:59:26
work in that mental health space. How old are you? Can I ask? I'm >> 37.
00:59:30
>> 37. Okay. So, you're like 15 years younger than me, but you're um you you
00:59:34
were raised on a on a farm in sort of rural New Zealand. >> You What was your What was your dad
00:59:38
like? Was he much of a communicator or >> uh Yeah. >> Stoic? >> I mean, on the outside quite like a
00:59:44
stoic classic Kiwi guy. I guess my dad's a policeman. Like, so he was like the
00:59:49
local town policeman when I was growing up, which was um a good thing and a bad thing in some ways.
00:59:57
maybe kept me in line, which is probably a good thing. >> Just knows all your [ __ ] Knows
01:00:01
everything that's going on. >> Get away with anything. Um, but my dad actually and most of the men in my
01:00:08
family, like my grandfathers and everyone, probably kind of stoic on the outside, but actually, you know, he's
01:00:14
probably going to kill me for saying this, but softy on the inside. Do you know what I mean? Like good at
01:00:18
communicating with his kids, >> talking about emotions and and that type of thing in a lot of ways. So again, I
01:00:24
think I grew up with that sense of >> of that being okay. Um, you know, I think growing up in Wau, I mean, it was
01:00:32
a great place to grow up, but for a for a young guy that was probably a bit more
01:00:37
emotionally sensitive and was into school work and, you know, that was a little bit of a different different
01:00:43
mold, you know, kind of the old nerd and and all of that kind of thing thrown around a wee bit. Um, but yeah, I think
01:00:51
I had a really good kind of model in my dad and and things for that. >> Oh, that's cool. Yeah, because I think a
01:00:58
lot of rural kids probably have like a different sort of environment. You know, like farmers are notoriously bad at
01:01:03
communicating. >> 100%. >> It's a stereotype that >> Yeah. And I mean I think even now it's
01:01:08
you know wherever you live in in New Zealand but also even Australia that sense of especially that slightly older
01:01:15
generation you know my parents' generation talking about like touchy feelies and emotions and depression and
01:01:21
anxiety and oh I can't focus or it's hard to remember stuff at school you
01:01:26
know that that would have been taken in a very different way um you know even 10
01:01:31
20 years ago. So yeah, it's um you know, I've really loved this part of my career
01:01:38
as well as time's gone on in terms of just being able to be a bit of a voice
01:01:43
>> for that. You know, you can grow up on a farm or you can enjoy going to the gym
01:01:48
or you can, you know, do bodybuilding if you want to, but that doesn't mean that
01:01:53
you then can't also kind of be emotive or talk about mental health or how you're feeling or prioritize other areas
01:02:00
as well. So yeah, I think that's shifting. But yeah. >> Oh no, no, it is. It is. And it can't
01:02:05
happen fast enough. God, we'll have to get you back um another day for another
01:02:09
conversation all about that because as I alluded to before, you've done so much
01:02:12
work in that mental health space. >> Yeah. No, I'd love that. But yeah,
01:02:15
definitely we will. >> How often do you get back? As infrequently as possible?
01:02:20
>> No, probably far too much. My parents are like stay over that. >> No, probably at least, you know, three
01:02:27
three times a year. Three or four times a year. Cool. >> I mean, it's such a quick flight from
01:02:31
Sydney now, which is which is great, but it's sort of it's longer to drive down
01:02:35
to Rooua than it is to fly from like Oakland to Sydney. >> Yeah. You took your partner to Rooua.
01:02:41
>> Yeah, we went to Rooua. We saw the old mudpools and so that was a blast from
01:02:47
the past cuz Yeah. I mean, that was Ro Vegas was the the Kennedy family holiday destination when I was a kid. So, yeah.
01:02:55
I mean, I will say I think for for my partner and I, the luge the luge was quite slightly less high and steep and
01:03:03
fast than I remember it as a kid. >> Do they still make you do the slow lane
01:03:07
for the first trip down? They do. >> They do. Oh, come on. >> And test the brakes, you know, make sure
01:03:12
you're not slamming it into the concrete. >> Um, but no, it was great. I love I love
01:03:17
coming back and New Zealand will obviously always be my home and and it's such a special place, so coming back to
01:03:23
see my family, but Also just to be around, you know, some Kiwis and hear some New Zealand accents. It's nice as
01:03:31
well. >> Oh, if you want to hear some New Zealand accents, just go to Bondi every once in
01:03:34
a while. You can find them >> or the Gold Coast possibly. There's there's a lot of Kiwi accents around
01:03:39
there. >> Um, a couple more on ADHD. Uh, how can ADHD affect relationships, careers, and
01:03:46
self-esteem? >> It can affect all of those things in really complex multiple ways. really
01:03:54
>> mostly negative or >> often positive, you know. I mean, I think in terms of relationships and
01:03:59
work, people with ADHD, oh god, I mean, there's there's any number of positives, but they can be
01:04:05
incredibly creative and active, motivated, you know, multi-talented, jumping into different things. Um, you
01:04:13
know, but that can be a bit of a double-edged sword sometimes as well. People can struggle to
01:04:18
>> maybe, for example, remember something their partner has told them. Often
01:04:21
people tell me that whole we talked about this on Monday or I told you this was coming up on Saturday and that can
01:04:28
actually cause a lot of friction in relationships. Um you know so something like that might impact a relationship
01:04:34
negatively. Something else that people might have heard about as well is what we call RSD or rejection sensitive
01:04:41
dysphoria. It's a bit of a mouthful but that is very common with ADHD. And what
01:04:46
that is is actually being incredibly sensitive and hypervigilant to any rejection from others. And so people
01:04:53
with ADHD often feel like they might monitor or scan their partner or their friends or their family for any tiny
01:05:01
little hint of rejection or abandonment or you're not happy with me. I'm not
01:05:06
pleasing you. >> And that can cause an incredibly kind of strong emotional reaction in people with
01:05:13
ADHD. So that can also come into play with relationships as well if we're kind
01:05:18
of really reading and feeling potential signs and signals a lot. You know, it might just be that our partner's had a
01:05:24
bad day at work and they're actually exhausted. But for us, them slumping down on the couch,
01:05:29
>> it might feel like they've done something wrong or they're not happy in
01:05:33
the relationship anymore, they're going to leave me, >> you know. So there are so many various
01:05:38
ways ADHD can impact our work and relationships. >> And self-esteem is a big one, too. You
01:05:43
know, I think especially if people grow up as kids feeling like they just couldn't keep up in class or something
01:05:48
was different compared to their friends and the other kids in class, >> usually what we do as kids,
01:05:54
unfortunately, is we just flip that back in on ourselves and we think, well, that
01:05:58
must be because I'm not smart enough or I'm different or I'm weird. So, I hear
01:06:03
that a lot from people with autism and ADHD diagnoses is a sense of kind of really directing that blame and shame
01:06:11
inward and that can really kind of hit self-esteem even later on as adults. >> Do you think there are hidden strengths
01:06:18
in ADHD that we don't talk about often enough? >> Yeah, I I really really do.
01:06:23
>> You probably addressed some of them just before actually. >> Definitely. You know, I think again
01:06:27
shifting away from thinking about autism and ADHD and neurode divergence as being
01:06:32
this blanket negative or a defect or a failing. That's where we need to shift
01:06:37
away from. You know, a lot of people with ADHD are incredibly creative. They're incredibly successful. You know,
01:06:45
someone who has a touch of hyperactivity might be extremely kind of active and motivated within their career or their
01:06:53
personal pursuits or sport. Someone who has inattentive features of ADHD might struggle with distractability
01:07:00
and focus at times, but they also might be really good at switching between different tasks or have periods where
01:07:06
they hyperfocus and they can actually just zone into doing something with incredible intensity.
01:07:12
>> So, there are some definite ways that ADHD can be, you know, quote unquote, to
01:07:17
use the cheesy term, a bit of a superpower, and it's it's not a negative. Um,
01:07:22
>> yeah, that's what people say. I've got ADHD. It's my superpower, is it?
01:07:26
>> Yeah, I absolutely think it can be, you know, and I think it's so important,
01:07:30
especially for our kids, that we we make sure to push the fact that ADHD isn't
01:07:36
just a negative thing. It It can have a lot of kind of superpowery, really fantastic things about it sometimes as
01:07:42
well. >> What would you change tomorrow about the way our health system approaches ADHD if
01:07:47
you were in charge? >> Yeah, that's a big one. Um, I mean, I think for me it would be increasing
01:07:54
access to ADHD assessment and treatment with sort of more assistance for people on the funding side. You know, I think
01:08:03
it's one thing to say, "Oh, well, we should have ADHD assessments in the
01:08:07
public system," but obviously the public system is also, especially with psychiatry right now, it's really also
01:08:13
supporting a lot of people struggling with psychosis and with substance and addiction issues, with depression. Um,
01:08:21
so it's a really complex issue, but I think for me it would be coming round to
01:08:26
helping people access ADHD assessments and treatment. And what that might look like is more funding to give people
01:08:33
rebates or money back in terms of if they need to see a private psychiatrist, there would be some more financial
01:08:40
support around that for people because what we don't want, as we said before,
01:08:44
is for this to become a a privileged pathway in psychiatry and medicine where only the people who can afford to pay
01:08:52
significant amounts for support get that support. So >> I think for for me it would be that
01:08:57
funding side but possibly if any politicians heard that they would um you know roll their eyes and become a naive
01:09:04
ranting doctor just asking for more money. Um but no that access side would be for me the big one. Yeah.
01:09:10
>> Do you get a lot of people thanking you? Like what what sort of reaction do you
01:09:13
get when you diagnose someone? Like it must be life-changing for a lot of people.
01:09:17
>> Yeah, it really is. you know, it's um and and that's the most rewarding part
01:09:22
of my job and why I love what I do. It's meeting people at one point in their
01:09:27
life where they're really really struggling and and really, you know, feeling like they're not managing and
01:09:32
then I'm definitely not going to take all the credit for it because it's a lot
01:09:35
of things usually, but then meeting them 6 months or a year down the track and hearing that they have finished the
01:09:42
degree that they were really struggling to stay afloat with or they've finally
01:09:46
started that business that they wanted to for so long or their relationships are better, their general health is
01:09:51
better. You know, that's really amazing. Um, I went to sort of like a a charity
01:09:56
event over in Sydney recently and um, I just happened to sort of meet a patient there. Someone that I'd seen and
01:10:04
assessed and started on a treatment plan for ADHD was there and he came up to me
01:10:09
and sort of said, "Oh, I hope this isn't awkward in terms of it's a bit weird.
01:10:12
You're not supposed to hug your psychiatrist or know them in person." Um, but no, he just sort of said, "I
01:10:18
just want to thank you so much in terms of like it's it's changed my life and
01:10:23
>> work and my relationship and even, you know, my health, my physical health is
01:10:28
so much better. So, yeah, it's just absolutely lovely to to kind of help support people and whether my part's
01:10:36
just 1% of that or it's a bigger chunk of that, it's it's, you know, just
01:10:40
lovely to be a part of that." If someone's listening to this or watching this now and they're they're
01:10:45
feeling a certain way, like um yeah, maybe they're they're feeling emotional
01:10:48
because it feels like what you're talking about is describing them or maybe it feels like a a weight off their
01:10:55
shoulders because they finally got some sort of clarity. Like what would your message be to those people who are ADHD
01:11:01
curious? >> Yeah, I mean I think letting yourself just feel that emotion is the main one.
01:11:06
You know, that'll make me sound like a bit of a, you know, a a woohoo kind of
01:11:12
very >> You go to Byron Bay. >> I was just gonna say some crystals. Go
01:11:16
to Byron Bay. >> I promise I'm not shaking crystals um to anyone listening to this, but I just
01:11:21
letting yourself feel that and know that it's okay to feel like this resonates
01:11:26
with you and and to feel that, holy [ __ ] this might be me or this is me, but this feels really validating to hear
01:11:34
this. It's just leaning into that, I think, you know, and and I guess what I would
01:11:39
want to say to people just in general when we're thinking about mental health
01:11:42
and mental health conditions or diagnosis, >> it's it's to just know that that's just
01:11:47
as valid as anything else in medicine or health, you know, like if if we wouldn't
01:11:52
shy away from booking an appointment to see our GP hopefully to talk about blood
01:11:57
on the toilet bowl or a missed heartbeat or a sore gut, you know, that's been
01:12:03
there for a we should not be thinking or feeling any differently about seeing a doctor or
01:12:09
seeking out some professional support if we're worried about our mental health or
01:12:14
if we're hearing something about a symptom and thinking, "Oh [ __ ] this
01:12:17
might be me." So, I just want those people listening or anyone listening to
01:12:22
know that if it's to do with mental health and what's going on inside your
01:12:26
skull, that is just as valid to be feeling and checking out and getting support for as anything else. So,
01:12:32
>> just lean into that. you um you said earlier on um that the first step is to
01:12:36
go and see your GP for a chat about it. Um is there anything people can do before then? Like are there any like
01:12:41
books that you swear by or like online resources or anything? >> Yeah, I mean there's some really really
01:12:46
good ones. There's um you know the ADHD Foundation in Australia has really good
01:12:53
information and obviously it's Australianbased but Australia and New Zealand very very closely linked and
01:12:59
very similar. So that's got a lot of great resources for people. Um, you know, there are some really great
01:13:05
books as well. You know, I think there's the, you know, it all makes sense now is
01:13:10
is a book that is really helpful and validating for a lot of people as well. Um, you know, so I think just not being
01:13:17
afraid to kind of go online and have a bit of a look and a research as well. >> Um, I will say keep an open mind and and
01:13:23
stay skeptical perhaps if you're on Instagram and Tik Tok. There's a lot of
01:13:29
really great information on there about health and mental health and ADHD, but there's also a lot of um kind of
01:13:36
misinformation and and you know, rubbish for want of a better word out there as well. So, I think, you know, if you're
01:13:43
online and you're watching Tik Toks or you're following someone who, you know,
01:13:48
is talking about their experience with ADHD, it's with absolute all respect that I say to people sharing content,
01:13:55
you know, but it it's just keep an open mind in terms of well, ask your doctor
01:14:00
um about those things you hear as well. >> Well, Dr. Karen Kennedy, this has been
01:14:05
really insightful. It's not my usual sort of episode. It's been um like a
01:14:09
like an FAQ, I guess, >> quick for ADHD. >> ADHD. But um I've got I I've learned a
01:14:15
lot. I've got no doubt a lot of people listening to this or watching this will
01:14:18
get a lot out of it as well. >> No, I hope so. And and no, thank you so much for having me, Dom. Like I say,
01:14:22
it's it's just very very humbling for me to be here actually. You know, listen to
01:14:27
you on the radio for a long time and then, you know, other people you've had,
01:14:31
you know, Nigel Latter and and things, you know, rested soul. you know, it's
01:14:37
just really really humbling to be here and >> to get this info out there. So, thank
01:14:40
you for having me. >> When you when you're back for your next um family holiday in uh Pokawi, come
01:14:46
back and we'll um we'll chat about um mental health. >> No, we will. Yeah, I'll get off the
01:14:50
potato farm for a bit and we'll um I'll stop pulling potatoes. We'll come have a
01:14:55
chat about general mental health. >> Do they make you work? >> I was going to say, show me your nails.
01:15:01
>> Those nails haven't seen soil in years. >> I was going to say they're very Sydney
01:15:04
nails. I'm sorry to say so my family will rubbish me for that but no I would
01:15:08
absolutely love to come back and like you say there's um even just general mental health there's so much we could
01:15:13
talk about but thank you so much for having me >> yeah no way you're going on the farm
01:15:16
after this you're going to the gym and it's curls today isn't it again
01:15:19
>> some more scrambled eggs and then some curls >> Dr. Kieran Kennedy, the hot dog. Thank
01:15:25
you for coming on the podcast, mate. Really appreciate it. It's been great. >> Thank you, mate. Thanks so much.