May 13, 2025 • 32 mins
Why are so many women being diagnosed with ADHD later in life? What does your partner’s penis have to do with your bacterial vaginosis diagnosis? And when to worry about a lumpy boob.
In this episode, psychiatrist and ADHD specialist Dr Kieran Kennedy discusses how women often experience more inattentive features of ADHD and why they may try to mask the symptoms. We also talk about time blindness, memory issues and emotional dysregulation.
And is ADHD making you feel more sensitive to rejection? We discuss a condition called rejection sensitive dysphoria.
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CREDITS
Hosts: Claire Murphy and Dr Mariam
Guest: Dr Kieran Kennedy
Senior Producers: Claire Murphy and Sasha Tannock Audio Producers: Scott Stronach Video Producer: Julian Rosario
Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.
Information discussed in Well is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:11):
You're listening to a Muma Mia podcast.
Speaker 2 (00:14):
Mamma Mia acknowledges the traditional owners of the land and
waters that this podcast is recorded on.
Speaker 3 (00:20):
Oh well, Hi there, but are you happy?
Speaker 4 (00:22):
Fam?
Speaker 2 (00:22):
I am Claire Murphy. I'm from Mumma MEA's new health
podcast called Well. It's hosted by me and doctor Merriam
who is this absolutely brilliant gp and advocate for women's health. Well,
if you haven't come across it yet, is a podcast
about the taboo, the annoying, the embarrassing, and the scary.
We cover concerns that you might be considering seeing a
doctor about, from I don't know insomnia, to weird periods
(00:45):
to how to prevent dementia. And this month we're focusing
in on the mind. So in this episode we're talking
about ADHD in particular, including how women often experience more
inattentive features and why they may try to mask those symptoms.
We're also going to talk about things like time blindness
and memory issues and emotional dysregulation and if you have
been diagnosed with ADHD or feel that you might have it,
(01:07):
or someone you know and they're always told they're just
too sensitive, maybe they're dealing with a condition called rejection
sensitive dysphoria. This is well Australian women. Welcome to your
full body health check. I'm Claire Murphy, the journalist who
wants to know everything about your health, and let's be
(01:28):
honest my own while we're at it.
Speaker 5 (01:30):
And I'm doctor Mariam, the GP girlfriend that you wish
you had so you could ask all those annoying health
questions over a glass of wine midweek.
Speaker 2 (01:42):
Today, we're trying to focus so we can talk about ADHD.
I'm so sorry if that is a terrible, terrible joke,
I forgot what you said.
Speaker 4 (01:50):
Stop it.
Speaker 2 (01:52):
We are legitimately going to find out if those ADHD
tests on TikTok are real or bullshit. We're going to
look at the pros and cons of medicating and how
we manage some of the tougher parts of an ADHD diagnosis,
like you know, your partner feeling like you just don't
care when really you're struggling to remember things. Will also
beating into a quick consults where you can ask our
(02:12):
very own doctor Marriam anything about your weird and wonderful
body doing weird and wonderful things.
Speaker 3 (02:18):
Today.
Speaker 2 (02:18):
Amali says she's got no idea how to tell the
difference between a good lump and a bad lump. But
first up, it's time to head to med school for
today's lesson on why your vagina's problem might also be
your partner's fault.
Speaker 3 (02:30):
Welcome to med school.
Speaker 2 (02:32):
Look, we found something out recently which is very interesting
because we as women have been dealing with it pretty
much solo. But we've heard it actually can get better
if we treat the men in our lives too. So
an Australian clinical trial found that bacterial vaginosis can actually
be transmitted sexually and that treating a suffer's male partner
(02:53):
for it could reduce reinfection and reoccurrence. So technically it
is also an STI. According to Professor Katrina Bradshaw, who
co authored the study, it appears the penis and its microbiome.
I don't know why I get weirdly laughy when I
say the word penis.
Speaker 3 (03:09):
I'm very immature.
Speaker 2 (03:10):
I've seen peters and it's microbiome plays a role in
some instances, not all off BV bacterial vaginosis cases and
their partners, with uncircumcised men having a more how should
we put this diverse microbiome than circumcised men, including the
types of bacteria that can take over the vagina.
Speaker 5 (03:29):
Yes, this is such a great study and I'm hoping
this is going to lead to guideline changes and maybe
a new name, bacterial pinios. That sounds like Harry Potter
doing some kind of spell bucketerial pineosice. But yeah, recurrent
BV massive issues something I see all the time in clinic.
(03:50):
We know bb effects one in three females reproductive age.
We treat it fifty percent of the time. It will
come back within three months. It's very frustrating, very difficult
to treat. So yeah, now with this study we're seeing
this potentially maybe some going back and forth from partners
getting treated and she's having sexual contact again with her partner,
they're getting reinfected.
Speaker 2 (04:11):
Well, you know, like men, you're not responsible for all
the things, but in this instance.
Speaker 3 (04:15):
Most of the things you are, let's be honest responsible.
Speaker 2 (04:17):
Maybe in this instance that's terial pineos be gone. Okay,
grab your fidget spinners, folks, it's check up time today.
Speaker 3 (04:26):
We are talking about ADHD. Yes, let's do it. It's
time for the checkup.
Speaker 2 (04:32):
ADHD is really having a moment on social media right now.
I particularly love this song by Guy with the Hair
on TikTok, so funny.
Speaker 1 (04:41):
I have ADHD, and just maybe it's a thing that
sometimes I get distracted with, Oh look a shiny ring.
I start a project than my god, like nine hours
go by and all I've done is started twenty other
things in crime. When I'm super hyper focused, yeah I
notice everything, But when I'm not, my frazzle dots go
bivity bobbity thing. I don't think it's a secret that
(05:04):
some people think I'm different just because I have the
attention span of a goldfish or a pigeon. So if
you are like me and talk it ninety miles per hour,
then help me normalize us born with eighty HD powers.
Speaker 2 (05:16):
And I also saw this really great video of lots
of hidden symptoms of ADHD, so people who actually have
been diagnosed with it talk about the ways in which
they knew maybe they were. Things like being able to
predict the movie plot from the get go, so your
worst cinema going friend you could potentially have hating appointments
if they're in the afternoon because it is way too
long to be in waiting mode. And being able to
(05:37):
smash out an essay at the last minute, even though
you've had like actual weeks to get it done, but
then also constantly losing your things, not being able to
remember someone's name, and fighting with your significant other because
you forgot that thing again. And it's actually believed to
be the most common mental health condition around the globe.
There's about a million Aussies who have been diagnosed. Mariam,
(05:58):
If someone does come into your rooms and you have
a suspicion that they might have ADHD, what are you
actually looking out for and are you seeing more people
come forward looking for.
Speaker 3 (06:07):
A diagnosis now?
Speaker 5 (06:08):
Yeah, So if someone comes into my claim and I
suspect or they suspect they might have ADHD, I'm looking
out for a few key signs and symptoms and I
usually kind of direct the consult by using like an
ADHD Adult questionnaire, which kind of helps we through and
kind of direct those questions so I can get those
answers that I need. So we know that there's three
(06:28):
types of ADHD. So there's the hyperactive and impulsive type,
and generally the signs we see with that are you're restless,
you're agitated, your fidgety, you know, you're interrupting conversations, you
can't wait in the line, you're talking over people, you're
acting impulsively, and you're not thinking of consequences.
Speaker 2 (06:49):
Then this is what we see commonly in like young
boys and where they're like a thinking habit.
Speaker 5 (06:53):
Yeah, and so I think that's kind of the picture
of people always assume ADHD looks like but it doesn't
always look like that, you know. It can also be
the inattentive type, and this is where most females generally
tend to fit as well. Here we're looking for difficulties
with attention, so difficulty starting tasks, initiating tasks, finishing tasks,
poor time management for getting appointments, easily distractable, you're going
(07:18):
off with the fairies, you're daydreaming, you're losing things, you're procrastinating.
And the third type is a combination of the two
as well. I also consider the context of these symptoms,
whether they were being present in childhood and their effect
on your quality of life in different settings, whether that's
work at home and in relationships, and then family history
is also a big part of the consult as well
(07:39):
as for whether I'm seeing more people come in definitely,
and I think that's just because ADHD is finally getting
the platform it deserves, is a lot more awareness. Interestingly,
being a female GP, I see a lot of patients
going through the perimenopause or space, and I'm picking up
ADHD so much in these patients a lot from my
own conversations with the patients, but a lot of the
(08:00):
time they're like, hey, I think I have ADHD. We
know those hormonal changes can exacerbate a lot of the
symptoms of ADHD.
Speaker 2 (08:07):
What do people need to do to prepare for a
diet diagnosis? I've heard it does involve a lot of
appointments and a fair bit of paperwork, and it can
also be pretty costly too.
Speaker 5 (08:18):
Unfortunately that is the case. You know, gps are really
pushing for a massive reform with ADHD, and we're hoping
that will come in the near future, but for the
time being, it is a bit of a process. You
start by seeing your GP. Your GP will assess your
symptoms and your history. They will use those screening tools
and questionnaires in the consultation or send you home with them,
(08:38):
and if they do suspect you have ADHD, you'll be
given a referral to a psychiatrist. Or a psychologist who
has that specialty in diagnosing ADHD. It's your preference where
you want to go. But a lot of people prefer
just going straight to the psychiatrist because they can prescribe
the medication if you do have ADHD and the medication
is needed, so you just kind.
Speaker 3 (08:57):
Of save that extra step.
Speaker 5 (08:59):
Unfortunately, diagnosis does come with a hefty price tag, and
that could range from one thousand to three thousand dollars
with limited rebates. But to make your appointments more effectively,
I will offer some advice which people might find helpful,
and so I always say document your symptoms. So anything
you suspect might be ADHD related, put it all down
(09:20):
in a journal and write its impact on your quality
of life and how long you've had these symptoms, what
school life was like for you, what your partner thinks,
what your family thinks, those sorts of things.
Speaker 3 (09:31):
Gather your history.
Speaker 5 (09:32):
So if you've seen mental health professionals in the past,
try to get your notes from them as well. That
will be really helpful for the psychiatrist or psychologists to
collaborate and help with with the diagnosis. So complete the
questionnaires and take those to the appointment and prepare questions.
So if you are diagnosed with ADHD, you're going to
leave with a million questions. Try to think, Okay, if
I do have ADHD, what are things that I want
(09:53):
to know? Write them down and make sure that you
get those answers before you leave that appointment and ask
for support. So bring a friend or a trusted family
member for emotional support or to help remember important details
and get that organizational help. So a big part of
why people find the diagnosis process difficult is because of
that organizational part.
Speaker 2 (10:14):
I need to ask you about another person who can
potentially be in your ADHD diagnosis journey, and that is
the ADHD coach in this instance. Who is an ADHD
coach And do you ever refer people to them?
Speaker 5 (10:25):
Yeah, definitely. So the Australasian ADHD guidelines actually recommend ADHD
coaching as a valuable non pharmacological tool for managing ADHD,
and the approach focuses on educating people about ADHD, leveraging
their strengths, and developing practical strategies to modified behavior, so
like you know, emotional regulation, time management skills, those sorts
(10:48):
of things. The coaches might be allied health professionals or
they might be specialized ADHD coaches. It's just important to
ensure that they're affiliated and credited by the International Coaching Federation.
So if you are booked in, make sure that they
have that tick of approval. That's really important. The only
issue with accessing ADHD co coaches is that might require
(11:11):
a private payment, so there might not be any Medicare rebate.
Some psychologists do offer that service and if they do
that you might get some rebate through the Better Access Plan.
Speaker 2 (11:22):
Okay, So because we are talking about ADHD, we absolutely
wanted to speak to somebody who specializes in this space.
So the other day I caught up with doctor Kieran Kennedy.
He's a psychiatrist and ADHD specialist and health and mental
health advocate.
Speaker 3 (11:36):
He's also the author of the book.
Speaker 2 (11:38):
The Manual, A Practical Guide to Life, Health and Happiness. Kieran,
thank you so much for joining us today to dispel
some ADHD myths and beliefs.
Speaker 3 (11:52):
But we wanted to.
Speaker 2 (11:53):
Start with something that has become more apparent in recent years,
and that is that ADHD presents differently in girls and women.
Speaker 3 (12:02):
As opposed to what it does in boys and men.
Speaker 4 (12:05):
As you say, there's so much out there at the
moment around ADHD, and I think in a lot of ways,
girls and women are being hit with the brunt of
a lot of that information. And I obviously see a
lot of women questioning ADHD as a diagnosis at whatever
age and stage they might be at. And I think
it is this really growing awareness, thankfully around ADHD presenting
(12:28):
differently not just for girls and boys, but also for
men and women as well. We know that that's different
for a number of reasons. I mean, as with all
medicine and mental health, you know, there's an element of
biology potentially there in terms of how ADHD presents differently
in the brain for girls and boys versus men and
women as well. But a really interesting part to it
(12:50):
is that women often present more with inattentive features of ADHD,
which is where the struggles are actually less overt or
externally observable, and so that might be focus and distraction
related issues, It might be really struggling with rejection, sensitivity, organization, procrastination,
(13:11):
all of these elements that I think for a long
time we didn't traditionally see on the surface as being ADHD.
Compared to say, the more hyperactive or behavioral features, which
are a lot more common in boys and men comparatively
I think for women and for a lot of adults.
In terms of adult ADHD for women, we're also seeing
(13:33):
that culture, gender pressures, socialization. This has a huge part
to play for ADHD for women and girls as well,
because even if there are hyperactive elements or other features,
I think from an early age, girls are pressured to
be behaving in a certain way, presenting in a certain way.
And so I speak to a lot of women who
(13:54):
have their entire lives really known and felt something's there
on the inside, but they've sort of been pressured in
a way to containing that and to actually never really
allowing themselves in a lot of ways to align with
or really recognize those fearstures of ADHD that might be
there all along.
Speaker 2 (14:12):
Well. Some of the things that we're seeing these women
experience include things like time blindness, which is I've only
just come to realize is something that our boss Mia
Friedman has to deal with because she believes in her
brain that everything is just twenty minutes either twenty minutes
to do twenty minutes away, and so she doesn't have
a comprehension of just how long things might take to
do or to travel to and so that then will
(14:34):
often lead to.
Speaker 3 (14:34):
Things like chronic lateness.
Speaker 2 (14:37):
How do we find strategies to deal with those kinds
of things?
Speaker 4 (14:41):
Yeah, really tricky, and I mean time blindness is a
really really interesting one that so many women and just
people of all gender struggle with when it comes to ADHD.
But it's not on we typically sort of really put
up the front of our mind. But it is one,
as you say, that can really impact our work, It
can impact our relationships, our personal goals, and so I
(15:01):
think when it comes to time blindness, it's that level
of insight that's the first step, and that's key. I
think often with time blindness, we're often just that we're
blind to the fact that we can actually really struggle
to sort of conceptualize time in our mind and how
long things might take, or that we need some scaffold.
So I think being aware that time blindness might be
(15:23):
part of ADHD for you is a really really kind
of key one to just acknowledge it, and then strategies
for that do come around just giving ourselves more structure
and planning when it comes to timing. It's also practice
we know that for ADHD, a lot of these things
do gradually kind of change and can improve with time
(15:44):
and practice. So it's almost like a little bit of
a muscle.
Speaker 3 (15:47):
Does ADHD affect your memory?
Speaker 4 (15:49):
Memory and retention are really prominent features of ADHD for
a lot of people. And it's amazing how many people
I see who actually get a little bit emotional or
obviously anxious when we come to this point of the assessment,
because they've often said to themselves, God, I wonder whether
I'm sort of getting early onset dementia here, or I
just always felt like some was actually wrong with my
(16:11):
brain when it comes to memory. But if we really
nail it down, it's not so much an issue with
the actual memory or recalling things or laying down memories.
It's more an issue with that intentional dynamic, meaning our
brain didn't quite get the chance to sort of take
and focus on and retain that information from the get go,
(16:32):
And so that's where things like names being given instructions
by a colleague or our partner conversations. Even it's often
the sense that it's it's not the hardware of our
brain that's struggling to actually lay down memories and recall them.
It's the fact that that intentional dynamic of ADHD impacts
being able to take in that information and then recall
(16:55):
it later.
Speaker 2 (16:56):
A lot of people who have ad actually say they
struggle with personal relationships.
Speaker 3 (17:00):
And it can be for various reasons.
Speaker 2 (17:02):
I mean, the time blindness and the chronic lateness and
you know, the memory issues like all of that can
add up if you are in a relationship with someone
who has eighty eight and they can get frustrating. But
other strategies to help improve communication for someone who is
struggling to maintain a relationship.
Speaker 4 (17:19):
Yeah, definitely. And I think you know, for so long
as well, we focused on for kids obviously with school
and learning, but also for adults when it comes to study,
but also work. We focused on that very work learning
study related side to ADHD and how these symptoms impact
kids and adults, and especially for adults. We know that
(17:41):
the impacts on relationships and our personal lives are just
as wide reaching and significant, and relationships as an area
where those with ADHD can really struggle, And as you say,
it's often to do with a number of different things,
but I think it's often the level of again calling
that out an insight around what's happening and why that
(18:03):
I see making the biggest difference. And I think part
of my work and working with people with ADHD that
I love so much is just these beautiful little ripple
effects to a diagnosis that we see. And I have
so many patients say, God, things have been so much
better with my partner and with my nearest and dearest
since the diagnosis, because not only now do I understand
(18:25):
where some of these things were coming from, but they
have a much gentler, more open understanding of that as well.
And with ADHD, we know obviously that things like forgetting
a conversation with our partner, or struggling with time management
or getting to the restaurant to meet them on time,
these things are not anything to do with an active
(18:45):
sense of trying to do those things, or not finding
that relationship important, or not valuing that information or that time.
It's just that these things on a more neurochemical level
are very, very difficult.
Speaker 2 (18:58):
Can we talk about diagnosis, because if you're to believe
social media, you can ask one question, like I was
just watching a video of someone who said pretending to
be the therapist, saying, do you interrupt people a lot,
and the person who's the patient says, no, I don't no,
because I'm constantly stopping myself in my head saying don't interrupt,
don't interrupt, don't interrupt, don't interrupt it, and thinking about
(19:18):
what it is that I'm going to say to contribute to,
and then forgetting what I was going to say, and
then the therapist goes, oh, you definitely have ADHD, Like,
is it that simple?
Speaker 4 (19:28):
Unfortunately not. I mean, my job will be a lot
easier if it was. But no, I'm so glad that
you wanted to chat on this point because I see
so much of it too, and it does drive me
slightly insane, even as a psychiatrist to see some of this.
I mean, I think even earlier today, I saw something
on my Instagram scroll of if you see green in
(19:50):
this image, it means you have ADHD. There's so much
floating around on social media now that obviously is really
grounded and misinformation, but also for me as an ADHD psychiatrist,
really concerns me because I think it oversimplifies and actually
disregards a lot of what ADHD is. And I've had
(20:11):
a lot of patience and even friends and people I
know with ADHD say when they see that type of
thing on social media, it's actually really quite invalidating to
feel that their experience and their diagnosis and condition can
be boiled down to a oh yeah, you look at
this color chart and if you can see green rather
than blue, then it means you must.
Speaker 2 (20:30):
Have as can We talk about another aspect of ADHD,
and that is dysregulation and rejection sensitive dysphoria.
Speaker 3 (20:39):
Now a lot of women I know have.
Speaker 2 (20:41):
Experienced this, not because they have ADHD, but because they
get PMT. You go through this week every twenty eight
days where you think everybody hates you, and there's no
reason for it, but you just have convinced yourself that
everyone hates you, no one likes you, You're the worst
person in the world. And that is apparently something there's
quite common for people who have ADHD, but not just
(21:01):
for one week every twenty eight days.
Speaker 4 (21:03):
Yeah, exactly. I mean it might be slightly worse for
that one week every twenty eight days.
Speaker 3 (21:08):
Okay, that's rip that week.
Speaker 4 (21:11):
Here exactly, very very are But no, you're exactly right.
For those with ADHD and for neurodivigence in general. We
know that regulating emotions can be really quite difficult. I
often talk to patients about pinball emotions, where there's a
sense that our emotions can really shift and pinball and
change quite quickly but also quite intensely. And I think
(21:32):
hand in hand with that can come RSD, where As
you say, we're sort of really really hyper vigilant to
any perceived sense of rejection abandonment, that the other person
or people might be displeased or unhappy. And the interesting
thing is that we're starting to see there might be
a neurological correlate to that in terms of that vigilance
(21:55):
to rejection and emotional responses in ADHD. But the fascinating
thing is that for those who struggle with rejection sensitivity
and ADHD, it's often because there's been a collection of
messages and signs across their life from early in childhood
that they're not quite behaving as they should, or they're
(22:17):
not quite achieving as much as they could. She would
have amazing potential if she just learned to not talk
so much in class, And so when it comes to
rejection sensitivity, it's often this background history of being made
to feel and soak in explicit and implicit messages across
a lifetime. That lead us to be really really sensitive
(22:40):
to gauging how we're doing with other people. And if
we sense that there's a sense from them that we
are not doing as we should, performing as we should,
or that they might be considering rejecting or leaving, that
can strike this hugely powerful emotional and even physical type
reaction where we feel that intensely. And so we now
(23:03):
know that that is really really common for a lot
of people with neurodivergence and ADHD.
Speaker 2 (23:07):
Do we know what causes ADHD? I've been reading quite
a bit that it's got a genetic hereditory aspect to it.
Is that what we sort of understand is its root cause.
Speaker 4 (23:18):
Yeah, absolutely, we know that compared to especially a lot
of our psychiatric or neurodevelopmental conditions, ADHD has a significant
genetic component. So we are much more likely to have
a diagnosis of ADHD or maybe struggle with subdiagnostic traits
or elements of ADHD if we have a direct family
(23:39):
member who also struggles with ADHD or has the diagnosis.
We're not exactly sure how and why that gets expressed
in some people rather than others. There's no clear environmental
cause for ADHD or one clear trigger or switch, and
so it's probably, as with much of medicine, this really
(24:00):
complicated melting pot mix of genetic, biological, environmental, and other
factors that leads to ADHD being there.
Speaker 3 (24:10):
Well, finally, let's talk about medication.
Speaker 2 (24:11):
I did see this great video of a doctor who
said the side effects of taking ADHD medication might be
that you graduate high school or graduate university, or reduce
your likelihood of getting arrested, or becoming an addict or
getting divorced. Like, could we talk about the impacts of
ADHD medication?
Speaker 4 (24:31):
Absolutely, you know, And I love that spin on it
as well. You know. I think there's a lot out
there about ADHD medication. But as you say, if the
diagnosis is there, if the medication is right for someone
and it works, the positive side effects and spin offs
can be some massive improvements and supports. It's really really
important to not feel like medication is the only option,
(24:54):
because it's absolutely not. We know that psychology and coaching
for ADHD can make a huge difference. Things like a
balanced diet, regular meals, exercise, sleep, managing other elements of
our mental health like mood and anxiety. These things can
all help support and prop up our brain to make
(25:15):
sure ADHD symptoms are significantly improved.
Speaker 2 (25:17):
What's the side effects that we need to be concerned about.
Speaker 4 (25:21):
When it comes to stimulant medications for ADHD, There are
some potential significant risks, even though those are very very low.
I don't want to worry people or parents at all.
With adults, we can notice some initial things because it
is a stimulant around our heart rate picking up slightly,
maybe some headaches, shapes, even feeling slightly anxious as the
medication settles in. But significant symptoms to watch out for
(25:44):
can be reduced appetites, reduce food and taken loss of weight.
That's one that mean kids need to be regularly monitored
by their pediatrician or psychiatrist and GP sleep can be
something that's impacted sometimes. And the very very rare but
potentially serious side effects would be around the heart and
brain and so depending on the psychiatrist and doctor. Getting
(26:08):
checks for heart fire, option with an ECG, getting routine
blood tests, getting a medical exam. All of these are
paths to the medication side of things that mean we
try and make sure there are no significant risk factors
or contraindications for people. Generally they're very safe medications, but
as we mentioned, it's always a weighing of risks verst
(26:29):
benefits and can be a complicated question. So definitely one
of people, whether they're on medication or not. For a DHD,
if you have concerns, if you have questions, going straight
to the horse's mouth and talking to your GP or
your psychiatrist about that is really really key.
Speaker 2 (26:44):
A really big thank you to doctor Kennedy for taking
the time to explain a bit more about ADHD to us.
Speaker 3 (26:50):
Mariam, how did you feel about what he said?
Speaker 5 (26:52):
What he was speaking about with females obviously getting diagnosed
later in life, and that's generally what we see in
general practice is you know, females in that forty five
age range group coming in and getting that diagnosis. And
a big part of it is those cultural and gentle
pressures to behave a certain way. So it's really sad
to I think they've been masking and acting for all
(27:13):
this way because of all these pressures on how they
should behave.
Speaker 2 (27:16):
It sounds thoroughly exhausting that they've had to essentially put
on a show every day just to get through. Yeah,
from waking to sleep that's incredible. Next, we are heading
into the consultation room to find out exactly what is
totally fine and normal when you touch your boobs and
might find something a little lumpy and what is it
totally not fine and needs a biopsy kind of lump.
(27:38):
As we remind you all to do your monthly boob checks.
Speaker 4 (27:47):
The doctor will see you now. Just through here to
consort Room one.
Speaker 5 (27:52):
Thank you for waiting.
Speaker 3 (27:53):
How can I help you?
Speaker 1 (27:54):
So?
Speaker 2 (27:54):
This is where you can have your health concerns heard.
If you have something you want to ask doctor Marriam
or any expert in the health space, make sure you
reach out our email as well at mmamea dot com
dot are you all leave a voice note. You can
find a link to that in the show notes. Amali
said in this question and it is one for all
the lumpy boobed gals.
Speaker 3 (28:13):
Okay, here we go.
Speaker 6 (28:14):
She wrote this, I just don't know if I'm doing
my breast check exams right. I've been doing them for
a while now, and I feel things in there. They're
not lumps as such, but they're not not lumps, if
you know what I mean.
Speaker 2 (28:26):
Now, I hear you, Amali, as a fellow lumpy boobed gal,
and I've been trying to tell my colleagues that I
wish it wasn't an HR violation and I could allow
them to touch my boobs so they could feel what
I can feel. Because everyone's boobs feel different, right, they
have decided not to break that HR violation.
Speaker 3 (28:42):
You're lost, ah, exactly, So how.
Speaker 2 (28:45):
Do we tell the difference? And what are we actually
feeling when we're feeling our boobs?
Speaker 5 (28:48):
Yeah, Amali, First of all, great work that you are
breast aware, so we know breast self awareness is about
becoming familiar, having your relationship with your breasts, getting on
top of how they look and feel. So generally advise
all my patients to be breast self aware, and that's
doing a breast examination every month, and I generally recommend
that two to three days after your period if you
(29:10):
don't have a period anymore, setting a start date every
month and sticking to that date. Everyone's breast look and
feel different. They may be lumpy, you might have inverted nipples,
whatever it might be. Everyone's breasts are normal, so you
need to get used to your normal by doing these
self examination tests. So, Amali, the things that you might
(29:31):
be feeling when you're examining your breast. They might be
the fatty tissue which you've described. They could be the
glandular tissue, and that includes the lobes and the lobules,
and that's what produces milk. You've got the milk ducks,
which are thin tubes that go from the lobules to
the nipples. You've got the nipples and.
Speaker 3 (29:46):
That because lobules is the most glorious word. I have. Lobules.
Is that what I'm feeling under my nipple.
Speaker 5 (29:54):
You've got some lobules.
Speaker 1 (29:55):
I love that.
Speaker 5 (29:56):
And then yeah, so you've got these milk ducts, which
are thin tubes that carry the milk from the lobules
to the nipple, the nipple and the surrounding areola. And
then you've got the supportive connective tissue. You've also got
lymph vessels and lymph nodes. And when you're doing an examination,
you want to make sure that you're going under the arm,
around the breast, all the way below the collar bone,
all those lumpy breasts. You need to know what your
(30:17):
normal is. So if you're feeling something and you're not
quite sure, just go in and see your GP. They'll
do a breast examination, and there's aside whether or not
you need some imaging. If the imaging is all fine,
then we know that's your normal, and then you just
continue examinations and then if anything changes, you see your doctor.
So it's just knowing what is right for you and
what is your normal. It's very important to note that
(30:39):
self awareness does not replace the two yearly mammograms, so
you still need to do those mammograms from the age
of fifty, or if you want to do them earlier,
you can do them from the age of forty as well.
Speaker 2 (30:48):
There's also been a lot of chat around about DNSE
breasts because imaging it's harder to pick up breast cancer.
If you have dance breast. Can you feel if your
breast tissue is dense, like, would it feel different to
someone who's isn't.
Speaker 5 (31:00):
It may or may not feel that way during examination.
We only generally pick that up in imaging. But yeah,
if you've got any concerns during an examination and you're
feeling like, oh, I don't know if this is normal,
just see your doctor get some clarity, don't leave it.
Speaker 2 (31:15):
Thank you Omali, and remember if you do want to
send through a question to doctor Mariam go in our
show notes, leave us a voice note, or if you
want to remain anonymous, there's a way to do that too.
Thank you so much for joining us on our well
adventure today. If you have any questions about what we
discussed or any health concerns you want us to look into,
shoot us an email well at mamamea dot com.
Speaker 3 (31:34):
Dot au or leave us a voice note.
Speaker 2 (31:37):
Next week, we're talking about two things that can either
be a constant companion or an infrequent visitor, but always
messes with our heads. It is something that both Mariam
and I have experienced at some stage. We're talking about
anxiety and depression. They also sometimes hang out together along
with Adhd, as we.
Speaker 3 (31:55):
Found out today.
Speaker 2 (31:56):
And if you are interested in anything that you have
heard or learnt here today, make sure you sign up
to the Well newsletter. You can find a link to
that in our show notes. Of course, the advice you've
heard here today.
Speaker 3 (32:06):
It's general.
Speaker 2 (32:07):
It may not suit your exact needs, so make sure
you reach out to your own doctor or a health
specialist to get the info that is one hundred percent
right for you and Mariam.
Speaker 3 (32:15):
We will see you for your appointment next week. Back
to your opinions.
Speaker 2 (32:23):
Well is produced by me Claire Murphy, Our Group Executive
producer Georgie Page and SEENI producer Sasha Tanic, with audio
production by Scott Stronik. We hope you enjoyed this episode
of Well. If you're after more women's health news, just
like this, Well is your full body health Check. We
drop episodes every week on a Thursday. Coming up in
(32:45):
our next topic, we're going to be focusing in on
the body, so we're delving into weight, weight loss, drugs,
and body longevity. There's a link to follow us right
there in the show notes.
You're listening to a Muma Mia podcast.
Speaker 2 (00:14):
Mamma Mia acknowledges the traditional owners of the land and
waters that this podcast is recorded on.
Speaker 3 (00:20):
Oh well, Hi there, but are you happy?
Speaker 4 (00:22):
Fam?
Speaker 2 (00:22):
I am Claire Murphy. I'm from Mumma MEA's new health
podcast called Well. It's hosted by me and doctor Merriam
who is this absolutely brilliant gp and advocate for women's health. Well,
if you haven't come across it yet, is a podcast
about the taboo, the annoying, the embarrassing, and the scary.
We cover concerns that you might be considering seeing a
doctor about, from I don't know insomnia, to weird periods
(00:45):
to how to prevent dementia. And this month we're focusing
in on the mind. So in this episode we're talking
about ADHD in particular, including how women often experience more
inattentive features and why they may try to mask those symptoms.
We're also going to talk about things like time blindness
and memory issues and emotional dysregulation and if you have
been diagnosed with ADHD or feel that you might have it,
(01:07):
or someone you know and they're always told they're just
too sensitive, maybe they're dealing with a condition called rejection
sensitive dysphoria. This is well Australian women. Welcome to your
full body health check. I'm Claire Murphy, the journalist who
wants to know everything about your health, and let's be
(01:28):
honest my own while we're at it.
Speaker 5 (01:30):
And I'm doctor Mariam, the GP girlfriend that you wish
you had so you could ask all those annoying health
questions over a glass of wine midweek.
Speaker 2 (01:42):
Today, we're trying to focus so we can talk about ADHD.
I'm so sorry if that is a terrible, terrible joke,
I forgot what you said.
Speaker 4 (01:50):
Stop it.
Speaker 2 (01:52):
We are legitimately going to find out if those ADHD
tests on TikTok are real or bullshit. We're going to
look at the pros and cons of medicating and how
we manage some of the tougher parts of an ADHD diagnosis,
like you know, your partner feeling like you just don't
care when really you're struggling to remember things. Will also
beating into a quick consults where you can ask our
(02:12):
very own doctor Marriam anything about your weird and wonderful
body doing weird and wonderful things.
Speaker 3 (02:18):
Today.
Speaker 2 (02:18):
Amali says she's got no idea how to tell the
difference between a good lump and a bad lump. But
first up, it's time to head to med school for
today's lesson on why your vagina's problem might also be
your partner's fault.
Speaker 3 (02:30):
Welcome to med school.
Speaker 2 (02:32):
Look, we found something out recently which is very interesting
because we as women have been dealing with it pretty
much solo. But we've heard it actually can get better
if we treat the men in our lives too. So
an Australian clinical trial found that bacterial vaginosis can actually
be transmitted sexually and that treating a suffer's male partner
(02:53):
for it could reduce reinfection and reoccurrence. So technically it
is also an STI. According to Professor Katrina Bradshaw, who
co authored the study, it appears the penis and its microbiome.
I don't know why I get weirdly laughy when I
say the word penis.
Speaker 3 (03:09):
I'm very immature.
Speaker 2 (03:10):
I've seen peters and it's microbiome plays a role in
some instances, not all off BV bacterial vaginosis cases and
their partners, with uncircumcised men having a more how should
we put this diverse microbiome than circumcised men, including the
types of bacteria that can take over the vagina.
Speaker 5 (03:29):
Yes, this is such a great study and I'm hoping
this is going to lead to guideline changes and maybe
a new name, bacterial pinios. That sounds like Harry Potter
doing some kind of spell bucketerial pineosice. But yeah, recurrent
BV massive issues something I see all the time in clinic.
(03:50):
We know bb effects one in three females reproductive age.
We treat it fifty percent of the time. It will
come back within three months. It's very frustrating, very difficult
to treat. So yeah, now with this study we're seeing
this potentially maybe some going back and forth from partners
getting treated and she's having sexual contact again with her partner,
they're getting reinfected.
Speaker 2 (04:11):
Well, you know, like men, you're not responsible for all
the things, but in this instance.
Speaker 3 (04:15):
Most of the things you are, let's be honest responsible.
Speaker 2 (04:17):
Maybe in this instance that's terial pineos be gone. Okay,
grab your fidget spinners, folks, it's check up time today.
Speaker 3 (04:26):
We are talking about ADHD. Yes, let's do it. It's
time for the checkup.
Speaker 2 (04:32):
ADHD is really having a moment on social media right now.
I particularly love this song by Guy with the Hair
on TikTok, so funny.
Speaker 1 (04:41):
I have ADHD, and just maybe it's a thing that
sometimes I get distracted with, Oh look a shiny ring.
I start a project than my god, like nine hours
go by and all I've done is started twenty other
things in crime. When I'm super hyper focused, yeah I
notice everything, But when I'm not, my frazzle dots go
bivity bobbity thing. I don't think it's a secret that
(05:04):
some people think I'm different just because I have the
attention span of a goldfish or a pigeon. So if
you are like me and talk it ninety miles per hour,
then help me normalize us born with eighty HD powers.
Speaker 2 (05:16):
And I also saw this really great video of lots
of hidden symptoms of ADHD, so people who actually have
been diagnosed with it talk about the ways in which
they knew maybe they were. Things like being able to
predict the movie plot from the get go, so your
worst cinema going friend you could potentially have hating appointments
if they're in the afternoon because it is way too
long to be in waiting mode. And being able to
(05:37):
smash out an essay at the last minute, even though
you've had like actual weeks to get it done, but
then also constantly losing your things, not being able to
remember someone's name, and fighting with your significant other because
you forgot that thing again. And it's actually believed to
be the most common mental health condition around the globe.
There's about a million Aussies who have been diagnosed. Mariam,
(05:58):
If someone does come into your rooms and you have
a suspicion that they might have ADHD, what are you
actually looking out for and are you seeing more people
come forward looking for.
Speaker 3 (06:07):
A diagnosis now?
Speaker 5 (06:08):
Yeah, So if someone comes into my claim and I
suspect or they suspect they might have ADHD, I'm looking
out for a few key signs and symptoms and I
usually kind of direct the consult by using like an
ADHD Adult questionnaire, which kind of helps we through and
kind of direct those questions so I can get those
answers that I need. So we know that there's three
(06:28):
types of ADHD. So there's the hyperactive and impulsive type,
and generally the signs we see with that are you're restless,
you're agitated, your fidgety, you know, you're interrupting conversations, you
can't wait in the line, you're talking over people, you're
acting impulsively, and you're not thinking of consequences.
Speaker 2 (06:49):
Then this is what we see commonly in like young
boys and where they're like a thinking habit.
Speaker 5 (06:53):
Yeah, and so I think that's kind of the picture
of people always assume ADHD looks like but it doesn't
always look like that, you know. It can also be
the inattentive type, and this is where most females generally
tend to fit as well. Here we're looking for difficulties
with attention, so difficulty starting tasks, initiating tasks, finishing tasks,
poor time management for getting appointments, easily distractable, you're going
(07:18):
off with the fairies, you're daydreaming, you're losing things, you're procrastinating.
And the third type is a combination of the two
as well. I also consider the context of these symptoms,
whether they were being present in childhood and their effect
on your quality of life in different settings, whether that's
work at home and in relationships, and then family history
is also a big part of the consult as well
(07:39):
as for whether I'm seeing more people come in definitely,
and I think that's just because ADHD is finally getting
the platform it deserves, is a lot more awareness. Interestingly,
being a female GP, I see a lot of patients
going through the perimenopause or space, and I'm picking up
ADHD so much in these patients a lot from my
own conversations with the patients, but a lot of the
(08:00):
time they're like, hey, I think I have ADHD. We
know those hormonal changes can exacerbate a lot of the
symptoms of ADHD.
Speaker 2 (08:07):
What do people need to do to prepare for a
diet diagnosis? I've heard it does involve a lot of
appointments and a fair bit of paperwork, and it can
also be pretty costly too.
Speaker 5 (08:18):
Unfortunately that is the case. You know, gps are really
pushing for a massive reform with ADHD, and we're hoping
that will come in the near future, but for the
time being, it is a bit of a process. You
start by seeing your GP. Your GP will assess your
symptoms and your history. They will use those screening tools
and questionnaires in the consultation or send you home with them,
(08:38):
and if they do suspect you have ADHD, you'll be
given a referral to a psychiatrist. Or a psychologist who
has that specialty in diagnosing ADHD. It's your preference where
you want to go. But a lot of people prefer
just going straight to the psychiatrist because they can prescribe
the medication if you do have ADHD and the medication
is needed, so you just kind.
Speaker 3 (08:57):
Of save that extra step.
Speaker 5 (08:59):
Unfortunately, diagnosis does come with a hefty price tag, and
that could range from one thousand to three thousand dollars
with limited rebates. But to make your appointments more effectively,
I will offer some advice which people might find helpful,
and so I always say document your symptoms. So anything
you suspect might be ADHD related, put it all down
(09:20):
in a journal and write its impact on your quality
of life and how long you've had these symptoms, what
school life was like for you, what your partner thinks,
what your family thinks, those sorts of things.
Speaker 3 (09:31):
Gather your history.
Speaker 5 (09:32):
So if you've seen mental health professionals in the past,
try to get your notes from them as well. That
will be really helpful for the psychiatrist or psychologists to
collaborate and help with with the diagnosis. So complete the
questionnaires and take those to the appointment and prepare questions.
So if you are diagnosed with ADHD, you're going to
leave with a million questions. Try to think, Okay, if
I do have ADHD, what are things that I want
(09:53):
to know? Write them down and make sure that you
get those answers before you leave that appointment and ask
for support. So bring a friend or a trusted family
member for emotional support or to help remember important details
and get that organizational help. So a big part of
why people find the diagnosis process difficult is because of
that organizational part.
Speaker 2 (10:14):
I need to ask you about another person who can
potentially be in your ADHD diagnosis journey, and that is
the ADHD coach in this instance. Who is an ADHD
coach And do you ever refer people to them?
Speaker 5 (10:25):
Yeah, definitely. So the Australasian ADHD guidelines actually recommend ADHD
coaching as a valuable non pharmacological tool for managing ADHD,
and the approach focuses on educating people about ADHD, leveraging
their strengths, and developing practical strategies to modified behavior, so
like you know, emotional regulation, time management skills, those sorts
(10:48):
of things. The coaches might be allied health professionals or
they might be specialized ADHD coaches. It's just important to
ensure that they're affiliated and credited by the International Coaching Federation.
So if you are booked in, make sure that they
have that tick of approval. That's really important. The only
issue with accessing ADHD co coaches is that might require
(11:11):
a private payment, so there might not be any Medicare rebate.
Some psychologists do offer that service and if they do
that you might get some rebate through the Better Access Plan.
Speaker 2 (11:22):
Okay, So because we are talking about ADHD, we absolutely
wanted to speak to somebody who specializes in this space.
So the other day I caught up with doctor Kieran Kennedy.
He's a psychiatrist and ADHD specialist and health and mental
health advocate.
Speaker 3 (11:36):
He's also the author of the book.
Speaker 2 (11:38):
The Manual, A Practical Guide to Life, Health and Happiness. Kieran,
thank you so much for joining us today to dispel
some ADHD myths and beliefs.
Speaker 3 (11:52):
But we wanted to.
Speaker 2 (11:53):
Start with something that has become more apparent in recent years,
and that is that ADHD presents differently in girls and women.
Speaker 3 (12:02):
As opposed to what it does in boys and men.
Speaker 4 (12:05):
As you say, there's so much out there at the
moment around ADHD, and I think in a lot of ways,
girls and women are being hit with the brunt of
a lot of that information. And I obviously see a
lot of women questioning ADHD as a diagnosis at whatever
age and stage they might be at. And I think
it is this really growing awareness, thankfully around ADHD presenting
(12:28):
differently not just for girls and boys, but also for
men and women as well. We know that that's different
for a number of reasons. I mean, as with all
medicine and mental health, you know, there's an element of
biology potentially there in terms of how ADHD presents differently
in the brain for girls and boys versus men and
women as well. But a really interesting part to it
(12:50):
is that women often present more with inattentive features of ADHD,
which is where the struggles are actually less overt or
externally observable, and so that might be focus and distraction
related issues, It might be really struggling with rejection, sensitivity, organization, procrastination,
(13:11):
all of these elements that I think for a long
time we didn't traditionally see on the surface as being ADHD.
Compared to say, the more hyperactive or behavioral features, which
are a lot more common in boys and men comparatively
I think for women and for a lot of adults.
In terms of adult ADHD for women, we're also seeing
(13:33):
that culture, gender pressures, socialization. This has a huge part
to play for ADHD for women and girls as well,
because even if there are hyperactive elements or other features,
I think from an early age, girls are pressured to
be behaving in a certain way, presenting in a certain way.
And so I speak to a lot of women who
(13:54):
have their entire lives really known and felt something's there
on the inside, but they've sort of been pressured in
a way to containing that and to actually never really
allowing themselves in a lot of ways to align with
or really recognize those fearstures of ADHD that might be
there all along.
Speaker 2 (14:12):
Well. Some of the things that we're seeing these women
experience include things like time blindness, which is I've only
just come to realize is something that our boss Mia
Friedman has to deal with because she believes in her
brain that everything is just twenty minutes either twenty minutes
to do twenty minutes away, and so she doesn't have
a comprehension of just how long things might take to
do or to travel to and so that then will
(14:34):
often lead to.
Speaker 3 (14:34):
Things like chronic lateness.
Speaker 2 (14:37):
How do we find strategies to deal with those kinds
of things?
Speaker 4 (14:41):
Yeah, really tricky, and I mean time blindness is a
really really interesting one that so many women and just
people of all gender struggle with when it comes to ADHD.
But it's not on we typically sort of really put
up the front of our mind. But it is one,
as you say, that can really impact our work, It
can impact our relationships, our personal goals, and so I
(15:01):
think when it comes to time blindness, it's that level
of insight that's the first step, and that's key. I
think often with time blindness, we're often just that we're
blind to the fact that we can actually really struggle
to sort of conceptualize time in our mind and how
long things might take, or that we need some scaffold.
So I think being aware that time blindness might be
(15:23):
part of ADHD for you is a really really kind
of key one to just acknowledge it, and then strategies
for that do come around just giving ourselves more structure
and planning when it comes to timing. It's also practice
we know that for ADHD, a lot of these things
do gradually kind of change and can improve with time
(15:44):
and practice. So it's almost like a little bit of
a muscle.
Speaker 3 (15:47):
Does ADHD affect your memory?
Speaker 4 (15:49):
Memory and retention are really prominent features of ADHD for
a lot of people. And it's amazing how many people
I see who actually get a little bit emotional or
obviously anxious when we come to this point of the assessment,
because they've often said to themselves, God, I wonder whether
I'm sort of getting early onset dementia here, or I
just always felt like some was actually wrong with my
(16:11):
brain when it comes to memory. But if we really
nail it down, it's not so much an issue with
the actual memory or recalling things or laying down memories.
It's more an issue with that intentional dynamic, meaning our
brain didn't quite get the chance to sort of take
and focus on and retain that information from the get go,
(16:32):
And so that's where things like names being given instructions
by a colleague or our partner conversations. Even it's often
the sense that it's it's not the hardware of our
brain that's struggling to actually lay down memories and recall them.
It's the fact that that intentional dynamic of ADHD impacts
being able to take in that information and then recall
(16:55):
it later.
Speaker 2 (16:56):
A lot of people who have ad actually say they
struggle with personal relationships.
Speaker 3 (17:00):
And it can be for various reasons.
Speaker 2 (17:02):
I mean, the time blindness and the chronic lateness and
you know, the memory issues like all of that can
add up if you are in a relationship with someone
who has eighty eight and they can get frustrating. But
other strategies to help improve communication for someone who is
struggling to maintain a relationship.
Speaker 4 (17:19):
Yeah, definitely. And I think you know, for so long
as well, we focused on for kids obviously with school
and learning, but also for adults when it comes to study,
but also work. We focused on that very work learning
study related side to ADHD and how these symptoms impact
kids and adults, and especially for adults. We know that
(17:41):
the impacts on relationships and our personal lives are just
as wide reaching and significant, and relationships as an area
where those with ADHD can really struggle, And as you say,
it's often to do with a number of different things,
but I think it's often the level of again calling
that out an insight around what's happening and why that
(18:03):
I see making the biggest difference. And I think part
of my work and working with people with ADHD that
I love so much is just these beautiful little ripple
effects to a diagnosis that we see. And I have
so many patients say, God, things have been so much
better with my partner and with my nearest and dearest
since the diagnosis, because not only now do I understand
(18:25):
where some of these things were coming from, but they
have a much gentler, more open understanding of that as well.
And with ADHD, we know obviously that things like forgetting
a conversation with our partner, or struggling with time management
or getting to the restaurant to meet them on time,
these things are not anything to do with an active
(18:45):
sense of trying to do those things, or not finding
that relationship important, or not valuing that information or that time.
It's just that these things on a more neurochemical level
are very, very difficult.
Speaker 2 (18:58):
Can we talk about diagnosis, because if you're to believe
social media, you can ask one question, like I was
just watching a video of someone who said pretending to
be the therapist, saying, do you interrupt people a lot,
and the person who's the patient says, no, I don't no,
because I'm constantly stopping myself in my head saying don't interrupt,
don't interrupt, don't interrupt, don't interrupt it, and thinking about
(19:18):
what it is that I'm going to say to contribute to,
and then forgetting what I was going to say, and
then the therapist goes, oh, you definitely have ADHD, Like,
is it that simple?
Speaker 4 (19:28):
Unfortunately not. I mean, my job will be a lot
easier if it was. But no, I'm so glad that
you wanted to chat on this point because I see
so much of it too, and it does drive me
slightly insane, even as a psychiatrist to see some of this.
I mean, I think even earlier today, I saw something
on my Instagram scroll of if you see green in
(19:50):
this image, it means you have ADHD. There's so much
floating around on social media now that obviously is really
grounded and misinformation, but also for me as an ADHD psychiatrist,
really concerns me because I think it oversimplifies and actually
disregards a lot of what ADHD is. And I've had
(20:11):
a lot of patience and even friends and people I
know with ADHD say when they see that type of
thing on social media, it's actually really quite invalidating to
feel that their experience and their diagnosis and condition can
be boiled down to a oh yeah, you look at
this color chart and if you can see green rather
than blue, then it means you must.
Speaker 2 (20:30):
Have as can We talk about another aspect of ADHD,
and that is dysregulation and rejection sensitive dysphoria.
Speaker 3 (20:39):
Now a lot of women I know have.
Speaker 2 (20:41):
Experienced this, not because they have ADHD, but because they
get PMT. You go through this week every twenty eight
days where you think everybody hates you, and there's no
reason for it, but you just have convinced yourself that
everyone hates you, no one likes you, You're the worst
person in the world. And that is apparently something there's
quite common for people who have ADHD, but not just
(21:01):
for one week every twenty eight days.
Speaker 4 (21:03):
Yeah, exactly. I mean it might be slightly worse for
that one week every twenty eight days.
Speaker 3 (21:08):
Okay, that's rip that week.
Speaker 4 (21:11):
Here exactly, very very are But no, you're exactly right.
For those with ADHD and for neurodivigence in general. We
know that regulating emotions can be really quite difficult. I
often talk to patients about pinball emotions, where there's a
sense that our emotions can really shift and pinball and
change quite quickly but also quite intensely. And I think
(21:32):
hand in hand with that can come RSD, where As
you say, we're sort of really really hyper vigilant to
any perceived sense of rejection abandonment, that the other person
or people might be displeased or unhappy. And the interesting
thing is that we're starting to see there might be
a neurological correlate to that in terms of that vigilance
(21:55):
to rejection and emotional responses in ADHD. But the fascinating
thing is that for those who struggle with rejection sensitivity
and ADHD, it's often because there's been a collection of
messages and signs across their life from early in childhood
that they're not quite behaving as they should, or they're
(22:17):
not quite achieving as much as they could. She would
have amazing potential if she just learned to not talk
so much in class, And so when it comes to
rejection sensitivity, it's often this background history of being made
to feel and soak in explicit and implicit messages across
a lifetime. That lead us to be really really sensitive
(22:40):
to gauging how we're doing with other people. And if
we sense that there's a sense from them that we
are not doing as we should, performing as we should,
or that they might be considering rejecting or leaving, that
can strike this hugely powerful emotional and even physical type
reaction where we feel that intensely. And so we now
(23:03):
know that that is really really common for a lot
of people with neurodivergence and ADHD.
Speaker 2 (23:07):
Do we know what causes ADHD? I've been reading quite
a bit that it's got a genetic hereditory aspect to it.
Is that what we sort of understand is its root cause.
Speaker 4 (23:18):
Yeah, absolutely, we know that compared to especially a lot
of our psychiatric or neurodevelopmental conditions, ADHD has a significant
genetic component. So we are much more likely to have
a diagnosis of ADHD or maybe struggle with subdiagnostic traits
or elements of ADHD if we have a direct family
(23:39):
member who also struggles with ADHD or has the diagnosis.
We're not exactly sure how and why that gets expressed
in some people rather than others. There's no clear environmental
cause for ADHD or one clear trigger or switch, and
so it's probably, as with much of medicine, this really
(24:00):
complicated melting pot mix of genetic, biological, environmental, and other
factors that leads to ADHD being there.
Speaker 3 (24:10):
Well, finally, let's talk about medication.
Speaker 2 (24:11):
I did see this great video of a doctor who
said the side effects of taking ADHD medication might be
that you graduate high school or graduate university, or reduce
your likelihood of getting arrested, or becoming an addict or
getting divorced. Like, could we talk about the impacts of
ADHD medication?
Speaker 4 (24:31):
Absolutely, you know, And I love that spin on it
as well. You know. I think there's a lot out
there about ADHD medication. But as you say, if the
diagnosis is there, if the medication is right for someone
and it works, the positive side effects and spin offs
can be some massive improvements and supports. It's really really
important to not feel like medication is the only option,
(24:54):
because it's absolutely not. We know that psychology and coaching
for ADHD can make a huge difference. Things like a
balanced diet, regular meals, exercise, sleep, managing other elements of
our mental health like mood and anxiety. These things can
all help support and prop up our brain to make
(25:15):
sure ADHD symptoms are significantly improved.
Speaker 2 (25:17):
What's the side effects that we need to be concerned about.
Speaker 4 (25:21):
When it comes to stimulant medications for ADHD, There are
some potential significant risks, even though those are very very low.
I don't want to worry people or parents at all.
With adults, we can notice some initial things because it
is a stimulant around our heart rate picking up slightly,
maybe some headaches, shapes, even feeling slightly anxious as the
medication settles in. But significant symptoms to watch out for
(25:44):
can be reduced appetites, reduce food and taken loss of weight.
That's one that mean kids need to be regularly monitored
by their pediatrician or psychiatrist and GP sleep can be
something that's impacted sometimes. And the very very rare but
potentially serious side effects would be around the heart and
brain and so depending on the psychiatrist and doctor. Getting
(26:08):
checks for heart fire, option with an ECG, getting routine
blood tests, getting a medical exam. All of these are
paths to the medication side of things that mean we
try and make sure there are no significant risk factors
or contraindications for people. Generally they're very safe medications, but
as we mentioned, it's always a weighing of risks verst
(26:29):
benefits and can be a complicated question. So definitely one
of people, whether they're on medication or not. For a DHD,
if you have concerns, if you have questions, going straight
to the horse's mouth and talking to your GP or
your psychiatrist about that is really really key.
Speaker 2 (26:44):
A really big thank you to doctor Kennedy for taking
the time to explain a bit more about ADHD to us.
Speaker 3 (26:50):
Mariam, how did you feel about what he said?
Speaker 5 (26:52):
What he was speaking about with females obviously getting diagnosed
later in life, and that's generally what we see in
general practice is you know, females in that forty five
age range group coming in and getting that diagnosis. And
a big part of it is those cultural and gentle
pressures to behave a certain way. So it's really sad
to I think they've been masking and acting for all
(27:13):
this way because of all these pressures on how they
should behave.
Speaker 2 (27:16):
It sounds thoroughly exhausting that they've had to essentially put
on a show every day just to get through. Yeah,
from waking to sleep that's incredible. Next, we are heading
into the consultation room to find out exactly what is
totally fine and normal when you touch your boobs and
might find something a little lumpy and what is it
totally not fine and needs a biopsy kind of lump.
(27:38):
As we remind you all to do your monthly boob checks.
Speaker 4 (27:47):
The doctor will see you now. Just through here to
consort Room one.
Speaker 5 (27:52):
Thank you for waiting.
Speaker 3 (27:53):
How can I help you?
Speaker 1 (27:54):
So?
Speaker 2 (27:54):
This is where you can have your health concerns heard.
If you have something you want to ask doctor Marriam
or any expert in the health space, make sure you
reach out our email as well at mmamea dot com
dot are you all leave a voice note. You can
find a link to that in the show notes. Amali
said in this question and it is one for all
the lumpy boobed gals.
Speaker 3 (28:13):
Okay, here we go.
Speaker 6 (28:14):
She wrote this, I just don't know if I'm doing
my breast check exams right. I've been doing them for
a while now, and I feel things in there. They're
not lumps as such, but they're not not lumps, if
you know what I mean.
Speaker 2 (28:26):
Now, I hear you, Amali, as a fellow lumpy boobed gal,
and I've been trying to tell my colleagues that I
wish it wasn't an HR violation and I could allow
them to touch my boobs so they could feel what
I can feel. Because everyone's boobs feel different, right, they
have decided not to break that HR violation.
Speaker 3 (28:42):
You're lost, ah, exactly, So how.
Speaker 2 (28:45):
Do we tell the difference? And what are we actually
feeling when we're feeling our boobs?
Speaker 5 (28:48):
Yeah, Amali, First of all, great work that you are
breast aware, so we know breast self awareness is about
becoming familiar, having your relationship with your breasts, getting on
top of how they look and feel. So generally advise
all my patients to be breast self aware, and that's
doing a breast examination every month, and I generally recommend
that two to three days after your period if you
(29:10):
don't have a period anymore, setting a start date every
month and sticking to that date. Everyone's breast look and
feel different. They may be lumpy, you might have inverted nipples,
whatever it might be. Everyone's breasts are normal, so you
need to get used to your normal by doing these
self examination tests. So, Amali, the things that you might
(29:31):
be feeling when you're examining your breast. They might be
the fatty tissue which you've described. They could be the
glandular tissue, and that includes the lobes and the lobules,
and that's what produces milk. You've got the milk ducks,
which are thin tubes that go from the lobules to
the nipples. You've got the nipples and.
Speaker 3 (29:46):
That because lobules is the most glorious word. I have. Lobules.
Is that what I'm feeling under my nipple.
Speaker 5 (29:54):
You've got some lobules.
Speaker 1 (29:55):
I love that.
Speaker 5 (29:56):
And then yeah, so you've got these milk ducts, which
are thin tubes that carry the milk from the lobules
to the nipple, the nipple and the surrounding areola. And
then you've got the supportive connective tissue. You've also got
lymph vessels and lymph nodes. And when you're doing an examination,
you want to make sure that you're going under the arm,
around the breast, all the way below the collar bone,
all those lumpy breasts. You need to know what your
(30:17):
normal is. So if you're feeling something and you're not
quite sure, just go in and see your GP. They'll
do a breast examination, and there's aside whether or not
you need some imaging. If the imaging is all fine,
then we know that's your normal, and then you just
continue examinations and then if anything changes, you see your doctor.
So it's just knowing what is right for you and
what is your normal. It's very important to note that
(30:39):
self awareness does not replace the two yearly mammograms, so
you still need to do those mammograms from the age
of fifty, or if you want to do them earlier,
you can do them from the age of forty as well.
Speaker 2 (30:48):
There's also been a lot of chat around about DNSE
breasts because imaging it's harder to pick up breast cancer.
If you have dance breast. Can you feel if your
breast tissue is dense, like, would it feel different to
someone who's isn't.
Speaker 5 (31:00):
It may or may not feel that way during examination.
We only generally pick that up in imaging. But yeah,
if you've got any concerns during an examination and you're
feeling like, oh, I don't know if this is normal,
just see your doctor get some clarity, don't leave it.
Speaker 2 (31:15):
Thank you Omali, and remember if you do want to
send through a question to doctor Mariam go in our
show notes, leave us a voice note, or if you
want to remain anonymous, there's a way to do that too.
Thank you so much for joining us on our well
adventure today. If you have any questions about what we
discussed or any health concerns you want us to look into,
shoot us an email well at mamamea dot com.
Speaker 3 (31:34):
Dot au or leave us a voice note.
Speaker 2 (31:37):
Next week, we're talking about two things that can either
be a constant companion or an infrequent visitor, but always
messes with our heads. It is something that both Mariam
and I have experienced at some stage. We're talking about
anxiety and depression. They also sometimes hang out together along
with Adhd, as we.
Speaker 3 (31:55):
Found out today.
Speaker 2 (31:56):
And if you are interested in anything that you have
heard or learnt here today, make sure you sign up
to the Well newsletter. You can find a link to
that in our show notes. Of course, the advice you've
heard here today.
Speaker 3 (32:06):
It's general.
Speaker 2 (32:07):
It may not suit your exact needs, so make sure
you reach out to your own doctor or a health
specialist to get the info that is one hundred percent
right for you and Mariam.
Speaker 3 (32:15):
We will see you for your appointment next week. Back
to your opinions.
Speaker 2 (32:23):
Well is produced by me Claire Murphy, Our Group Executive
producer Georgie Page and SEENI producer Sasha Tanic, with audio
production by Scott Stronik. We hope you enjoyed this episode
of Well. If you're after more women's health news, just
like this, Well is your full body health Check. We
drop episodes every week on a Thursday. Coming up in
(32:45):
our next topic, we're going to be focusing in on
the body, so we're delving into weight, weight loss, drugs,
and body longevity. There's a link to follow us right
there in the show notes.
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