Understanding Adult ADHD with Jules Galloway

Episode Transcript
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Speaker 1 (00:19):
Music.
This is Wellness by Designs,and I'm your host, andrew
Whitfield-Cook.
Joining us today is JulesGalloway.
She's a straight-talkingnaturopath, a speaker, a mentor
and a podcaster with over 20years of experience, and Jules
has made it her mission to helppeople recover from fatigue,
anxiety and mental health issues.

(00:40):
Today, we're going to betalking about mainly adult ADHD.
Welcome to Wellness by Designs,jules.
How are you?

Speaker 2 (00:48):
I'm really good.
Thank you, and thanks so muchfor having me.

Speaker 1 (00:52):
Thank you for coming on board today.
Thank you for taking time outof your busy day.
So, jules, tell us why thereseems to be a sudden rise or
there definitely is a suddenrise in diagnosis.
Is there a rise in prevalence,or are we just catching people
who have previously fallenthrough the net?

Speaker 2 (01:13):
I love this question because at the moment, it
doesn't matter where you turn,you hear people saying it just
feels like everyone is gettingan ADHD diagnosis at the moment,
or everyone's identifying as anADHD right now.
And it does kind of feel thatway because, like when you're on
social media, the algorithm'sgoing to show you more of the

(01:35):
thing that you've alreadyclicked on or that you've
hovered on or that you'reinterested in.
So if you're already interestedin a topic, it's going to show
you more of that topic, and soif you're already looking down
that rabbit hole of ADHD, it'sgoing to show you more ADHD.
The other thing is that ADHD isroaming packs, right, family
packs and friend packs.
So once one person becomesdiagnosed with ADHD, there's a

(01:59):
really high chance that there'sgoing to be a ripple effect
through that pack where otherpeople start to go oh, actually,
that kind of makes sense for metoo.
And so there's this huge riseright now in awareness of ADHD,
and it's partly being driven by,you know, the internet, like a

(02:20):
lot of social media and justpeople talking about it.
There's a lot of celebritiesare coming out in the news
saying that they're ADHDers aswell.
Like there's just that hugerise in awareness and then also
there's this huge decline inshame around it, which is
amazing.
So, rather than keep it underwraps and be like, oh yes, I'm

(02:43):
an ADHDer, but I'm not going totell anyone because it's really
embarrassing and I don't wantanyone to judge me and I don't
want it to harm my job prospectsor whatever Like people are
actually finding that they cantalk about it more openly now
because the shame has declined,because the awareness has grown
right.
So then of course, we do feellike it's everywhere, because

(03:04):
suddenly more people are talkingabout it without the shame
attached, which is amazing.
And then more people arelearning about it and then
starting to go oh geez, I thinkthat might be me, maybe I should
get an assessment, and so we'reseeing this huge increase in
diagnoses at the moment.
But what has actually happenedis that it's a course correction

(03:28):
, because there was actually anunder diagnosis going on for so
long.
There were so many people thatwere being missed.
For so long they were eitherbeing missed completely or they
were being misdiagnosed.
So and this is particularly uh,this is particularly prevalent
for uh women and those assignedfemale at birth, because a lot

(03:49):
of us were being misdiagnosedwith just general anxiety
disorder or perimenopause, oreven, like some people were
being misdiagnosed with likebipolar, etc.
Or because women and thoseassigned female at birth
actually present differently tomen.
We just weren't picked up in thefirst place because we don't

(04:10):
look like the typical ADHDerthat we were taught so like it
was only three years ago that myhusband went to a GP to get the
ball rolling for his own ADHDdiagnosis because you need to
get a referral from the GP toget to the next stage, and the
doctor looked him up and downand actually said, oh ADHD, yeah

(04:33):
, that's just young hyperactiveboys on red cordial.
I don't think that's you and Iwas like what.
We were both like what, and soimagine how that would be for
women.
Like we're not hyperactive,like there's a type of ADHD
called inattentive ADHD, wheretraditionally and this is very,
like you know, sweepinggeneralisation but it was the

(04:55):
girl at school who was juststaring, dreaming out the window
, right, or just talking toeveryone around her, but maybe
she still got her work done, soshe wasn't the squeaky wheel in
the classroom, the kid who washyperactive, who was like
throwing something across theroom or being violent or yelling
or acting out.
They were the squeaky wheelsthat got diagnosed.

(05:15):
So what we're seeing is we'replaying this giant game of
catch-up now, where all thepeople got missed who all the
people who got missed aresuddenly actually being
diagnosed, and so, of course,you're going to see the pendulum
swing from underdiagnosis to abit of what we feel like is this
overdiagnosis at the moment,but actually it's just a course

(05:38):
correction.

Speaker 1 (05:40):
I think you've made so many interesting points there
, one I want to get back to.
But firstly, you made a reallysalient point there and it's a
warning for any practitioner.
You were talking about medicalpractitioners, but for any
practitioner to project youropinions onto the patient

(06:01):
presentation and I understandyou know we're saying sort of in
my medical or health opinion Iget that, but you've got to look
at facts rather than prejudice.
So, for instance, your husbandwas like a you know kids on red
cordial sort of thing, more thanthat.

(06:21):
So I have a couple of otherquestions and that is how would
you easily what would be ahallmark of teasing, apart from
adhd versus bipolar?

Speaker 2 (06:38):
oh look, bipolar is yeah, it's it's a whole other
rabbit hole.
Um, there is a lot of crossoverof symptoms and this is the
problem and again, especially inwomen, uh, there seems to be
like a real like misdiagnosisgoing on there.
Um, bipolar go.

(06:59):
You know, people with bipolarwill generally go through manic
periods, so they will actuallyhave periods in time where they
might not sleep or they mightexhibit manic behaviours, and
then there will be times whenthey are completely the opposite

(07:20):
of that.
People with bipolar do feelemotions very, very strongly.
I was listening to a podcastthe other day and they were
interviewing an author who wasbipolar, who's written a book,
who described it as, like theaverage person feels emotions on
like a scale of one to 10 andhe feels the emotions on a scale
of like minus five to 15.
So it's just that, and a lot ofADHDs will feel the same way,

(07:44):
but with bipolar it does tend tocycle.
So it's just that, and a lot ofADHDs will feel the same way,
but with bipolar it does tend tocycle.
So you will actually have thesecycles and these flips where
you go from one end of that 10to minus 5 to 15 to the other.
You know, and sometimes maybejust from 2 to 8, right, but
like you know, it can be quitewide.

(08:04):
So I don't know personallyenough about bipolar to really
speak on all the symptoms andthe science, although ask me
again in a couple of years andI'll probably have more
knowledge of it because it seemsto be something that we do have
to look into more Because,again, it's one of those things
that is popping up a lot more inour clinics, whereas before we
never really used to see so muchof it and I used to consider it

(08:27):
to be outside scope of practicea lot.
But now there's so much we cando to support the other
therapies bipolar people aredoing.
But with ADHD there's, there,are there's, you know you can.
Actually what you need to dofirst is look at the three
different types of ADHD and Ithink where it starts to get
confused with bipolar is thatsome of the hyperactive and

(08:50):
risk-taking and impulsive traitsof ADHD were being mistaken for
like manic behaviour of bipolar.

Speaker 1 (09:00):
Do you tend to, though, if I can ask it this way
, with people with ADHD, do youtend to get pressure of speech,
flight of ideas?
I get the hyperactivity and Iget the mind hyperactivity and
the squirrel sort of sensation,that sort of thing.
But do you get that flight ofideas in a very quick, sweeping

(09:22):
response and the the pressure ofspeech where people it's almost
like a volume has to come outin one breath, sort of thing?

Speaker 2 (09:31):
some adhd is, yes, not all.
Uh, we all present differentlythere.
There's so like, like I said,there's three different types.
So there's inattentive adhd,there's hyperactive adhd and
then there's combined, where youget to have both right
sometimes.
So it really and it alsodepends on so many other things

(09:51):
about that person, like how fasttheir processing speed is like,
how fast they think, how fastthey respond it might have to do
with, like you know, differenttypes of intelligence or
different types of thinking inthe world, whether there's any
autistic traits happening forthat person as well.
But yes, with ADHD there issomething called hyperfocus.

(10:13):
That happens when we reallyhone in on something that we're
very interested in.
And I have heard it describedbefore.
I think it was Michelle Livick,a psychologist, who said we
have an interest-based attentionsystem or an interest-based
nervous system.
So once we get hooked intosomething and really
hyper-focused on something, wecan focus and concentrate on

(10:37):
that thing to the exclusion of alot of other things.
So when we get into ahyper-focused mode, we might
forget to eat, we might forgetto go to the toilet, we might
forget to move, we might belocked in, and you can see this
not just with me, it mighthappen with work, because
obviously my special interest isnatural medicine, so if I end

(10:59):
up down some PubMed rabbit hole,I might forget to come up for
air With other people.
It might be gaming, it might besomething else, it might be
exercise.
So there's lots of differentkinds of hyperfocus.
But yes, when you do get reallyfocused and honed in on
something like that, there isthat, you know, that kind of

(11:19):
dialogue and thinking that goesalong with it, because we do get
really excited and reallyrevved up, especially if
something is of special interest.

Speaker 1 (11:30):
Can we go a little bit into the physiology,
pathophysiology, whatever youwant to call it.
What's going on in the brainwith ADHD?

Speaker 2 (11:41):
Yeah, so we don't know everything there is to know
yet, but I'll give you whatscience, where the science is
currently at.
So what we know is that it'swell, first of all, it's classed
as a neurodevelopmentaldisorder.
Now, the word disorder, right,like, don't shoot me for that,
I'm just quoting, like what theDSM is up to.

(12:02):
But I personally wouldn't callit a disorder.
I think I would prefer to callit a disorder.
I think it's.
I would prefer to call it abrain type.
But yeah, it's aneurodevelopmental disorder, in
inverted commas, which means youwere born that way.
This is not something thatdevelops later in life or
develops after a virus or anaccident or this or that.
It was there since birth.
You came out of the womb withthis brain type already, okay.

(12:25):
And so with this brain typecomes an issue in the prefrontal
cortex where there's problemswith information processing.
So the brain can't tell thedifference between signals and
noise.
Okay, it has trouble workingout what to focus on and where
to place its attention.
Okay, we know that we've gotproblems up there with

(12:49):
norepinephrine and dopamine, andyou'll notice that if you dig
into the pharmacology of ADHDstimulant medications like
that's what they're doing, likethe mechanism of action is that
they're increasingnorepinephrine and dopamine at
certain points in the brain andso say we're off.

(13:10):
Meds say you know, we've gotthis beautiful, amazing brain
type that is considered adisorder by some and we've got
problems with norepinephrine anddopamine.
Okay, now, if it was allworking, hunky-dory.
Norepinephrine enhances thesignals in the brain, dopamine
reduces the noise.
I've also heard heard it can umdescribed as like a conductor of

(13:32):
an orchestra and I went to.
I went to the ballet recentlybecause I've recently moved to
Melbourne and I'm binging onculture as you do, and I went to
the ballet recently and theyhad a live orchestra in the pit
and prior to the show starting,the orchestra is warming up.
You know, guy with the oboeslike playing a few notes, guy

(13:54):
over there with the tubasplaying a few notes, guy over
there on the whatever is doing afew bit.
The guy with the drums hasturned up.
No one's doing anything thatreally resembles music yet yet
there's a little bit of noise.
And it was really interestingbecause, as an ADHD, I was like
listening to them walking,warming up and I didn't know who
to pay attention to, right, Iwas like, oh, that guy's making

(14:16):
noise.
Oh, that guy's making noise.
My attention was being pulled inall these different directions
and I have heard it describedthat the prefrontal cortex, when
it's working, you know, whenyou've got your beautiful
norepinephrine and dopaminehumming along nicely, it's like
having a conductor in front ofthat orchestra.
That then shows you who to payattention to.

(14:37):
But it also cuts the noise ofthe other instruments so that
you focus on this one.
And, sure enough, at the balletthis conductor came out and,
you know, taps the baton andeveryone shuts up and then he
points and he's like you play,you stop, you louder, you
quieter, and suddenly you've gotsomeone in charge that shows
you who to focus on and thensuddenly it functions.

(15:00):
And so if you can think of thebrain like that, if you can
think of the brain like that, ifyou can think of the prefrontal
cortex like that, it helps youto understand.
Then when it's not working foran ADHDer, like what is going on
in that brain, we can'tdifferentiate the signals from
the noise and that then startsto show up in our daily lives as

(15:23):
problems with like focus,problems with attention,
problems with staying on task,problems with problem solving,
issues with executive function,emotional regulation, impulse
control, and the list goes on.
So that's how it's showing upfor ADHDers, especially when

(15:45):
they are dysregulated and theirconductor isn't working
correctly.

Speaker 1 (15:50):
Just before we move on to our next question, here's
another question.
It took my interest earlier.
You said ADHDers tend to groupin family packs.
I get that genetics, verticaltransmission, but friend packs
as well.
That's really interesting.
Why is that?

(16:10):
Is that because ADHs understandwhat other ADHs are going
through?

Speaker 2 (16:19):
There's a couple of different ways of looking at
this.
My psychologist who did myinitial assessment, she called
it neuro kin.
She's like you meet someone,you vibe with them.
Oh, your brain's like my brain,you get me.
Oh my god.
Sometimes when you're an adhdyou feel like you're from

(16:41):
another planet.
And I know autistic people havethis going on as well,
sometimes even more so for them.
But ADHDers, we, you know, we'revery, we're keen to connect,
we're often quite.
I mean, there's introvertsamong us, but we're often quite
social people.
We vibe off other people.
That's great.
But then when we go somewherewe sometimes feel like we're a

(17:04):
bit awkward or we don't fit inor we blurt out the wrong thing
at the wrong moment, because youknow, impulse control right and
we will often go away after asocial engagement going oh my
God, did I say the wrong thing?
Oh my God.
There's this thing with ADHD inthe ADHD community called
rejection, sensitivity dysphoria, where we take it really badly

(17:33):
when we think that someone isrejecting us or doesn't like us
or doesn't approve of us orwho's you know who's thought
that we said the wrong thing.
And, of course, when you've gotkind of the blirty outy
personality where you go out andyou say stuff before you think
it through because, remember, itdoesn't get to go past the
conductor first, it just comesout the mouth.
Then often what will happen is,after some sort of social

(17:54):
engagement or social interaction, we'll be overthinking it and
getting really anxious about it.
Now that's cool, like that'spart of life and we learn
strategies to deal with it, andthat's awesome.
But let me tell you, when youmeet up with a fellow ADHDer and

(18:15):
you realize they're like you, alot of that anxiety and
awkwardness goes out the windowbecause it's like oh my god, I'm
.
I say, you know like I, I wemade a new friend recently, um,
and it was someone in our youknow, in our local neighborhood
that we've, you know that we'vemet and we had dinner and he and
you know he actually said atone stage he's like oh my god,
I'm so sorry.
Um, I tend to say thingswithout thinking it through
first.
I kind of like I blurt thingsout a bit, um, and we're like oh

(18:38):
my god, it's fine, me too,right?
So when you meet your neurokin,you feel like they get you, but
you also feel like you can dropthe mask.
You don't have to mask aroundthem.
You don't have to act like aneurotypical person around them
in order to be accepted.
And so, of course, what happens?
We congregate in packs.
We all find each other rightBecause we feel comfortable

(19:01):
around each other, and perhapssometimes we gravitate towards
each other in other ways as well.
So ADHD is they.
Like.
You know, when they're youngerespecially, but sometimes even
when we're older, they like toengage in risk-taking behaviors.
They're impulsive, they're edgy, they're a bit out there,
they're a bit naughty, they, youknow, sometimes we, we do
things that are considered risky, like.

(19:24):
Sometimes, when you do thosethings, you'll end up being
friends with other people who dothose things.
So you know, for example, when Iwas young, I used to go out to
a lot of rave parties, right, Iwas very naughty, but, yeah, I
was like a party kid, right, andof course, like I don't do that
now, I've done a complete 180on that one.

(19:45):
But of course, I met otherpeople who also went out and
partied a lot, rather than, youknow, being very responsible in
their 20s.
And so, of course, now, lookingback, a lot of the people from
that era of my life wereprobably other ADHDers.
There's probably a moregenerous sprinkling of them

(20:08):
through that community than outthere in the real world.
And also I've seen it inextreme sports.
You know, I've literally gotADHD clients who are like stunt
people, who are martial artists,et cetera, who are, you know,

(20:28):
athletes and sports people.
So when you think about what ittakes to be, you know, in that
community as well, like, ofcourse we're going to form packs
of, you know, dysregulated ADHDpeople, it's just natural.
Like, if you look at theentrepreneurial community, right

(20:50):
, we already know like there'sactually been research done on
this that ADHDers are morelikely to try and start their
own business than you know, thanneurotypical people.
So there's a greater percentageof us in the entrepreneurial
community than there is outthere in the regular world.

(21:11):
So of course we find each otherand of course we vibe with each
other.
That was a really, really longstory, wasn't it?

Speaker 1 (21:22):
Yeah, but it's poignant in that I love that
neuro kin.
That's really funny.
Jules, can I ask, with regardsto gender differences of
presentation with adhd symptoms,anything specific there with
regards to, let's say,presentation in women?

Speaker 2 (21:43):
presentation in women .
Okay.
So, uh, women and thoseassigned female at birth, have a
bunch of hormones runningaround in their bodies, and I'm
sure we're all pretty across, uhand we have these beautiful
cycles, er.
So, um, unless we'reperimenopausal which I'll get to
in a minute, because, oh god,that's like adhd danger, danger

(22:03):
time okay, so we already know,uh, there's been research done
that, uh, adhd symptoms increaseand the symptoms of ADHD
comorbidities.
So you know, like things likeanxiety, sleep disorders, etc.
But we already know that ADHDsymptoms increase during the
luteal phase of the cycle.
Okay, and we already know thatADHD and PMDD are co-occurring

(22:30):
conditions, and so we alreadyknow that there's something
going on in that luteal phasethat is really not good for
ADHDs and can really spark a lotof mental health issues.
We already know some of us haveissues with serotonin.
So I definitely think there'slike a serotonin connection
there as well.
It's not just about dopamineand norepinephrine.

(22:51):
I know like every time you openup research on ADHD and
neurotransmitters and all ofwhat's going on in the brain,
like you know, the focus isplaced so much on dopamine and
norepinephrine, but we have toconsider some of the other stuff
that's going on as well, andserotonin is a big one.

(23:12):
So we already know, like ADHD,luteal phase, like, yeah, not a
great time for us.
Adhd and PMDD if you happen tobe someone who's you know you've
got both of those in the sameperson yeah, not going to be
great for that person in theirweek before their period as well
.
We know that stimulant medsbecome less effective going up

(23:32):
to the period.
So again, in that luteal phase,and especially in that second
half of that luteal phase, thecloser you get to your period,
the less you know, the lesseffective the medications are.
And there's some amazingpsychiatrists out there now who
are actually open to changingthe dosage of medication

(23:54):
depending on where the person isin their cycle.
So that's really great to seeLike we're coming along in leaps
and bounds the last few years.
Let me tell you it's reallywonderful.
So then we get to peri-perterritory and and god help us
all because estrogen is neededfor the transmission of dopamine

(24:14):
, okay.
So if adhd is have problemswith dopamine and you drop the
estrogen, what happens?
Right?
Yeah, shit hits fan, okay.
So that's where you see a realdanger time for women.
And also you see a massivespike in diagnoses at
perimenopausal time, not justbecause the estrogen's dropping

(24:36):
away and all of a sudden theseADHD symptoms are coming to the
surface, but like, of coursethat's happening.
But it's also the exact pointin time where a lot of people's
children are getting diagnosed.
So mum is like 45 years old,she's got a 10 year old who's
going through a diagnostic, youknow, through an assessment

(25:00):
themselves, and the child is,you know, being asked all these
assessment questions.
Mum's being asked all theseassessment questions and's being
asked all these assessmentquestions.
And mum is sitting there goingwell, holy crap, this sounds
like me too.
I just thought that everyonewas like this.
Most people in my family arelike this is really normal for
me.
I thought everyone had thatproblem.

(25:22):
No, because ADHD runs infamilies, right?
So of course everyone you'reclose to has that problem.
Of course it feels normal toyou.
So suddenly mum's like goingwhat?
And then she goes off and getsher assessment.
And so it's like this perfectintersection of the awareness
coming in because of you know,she's learning about what ADHD

(25:44):
looks like, because she'ssitting in on her child's
assessments and she's down thatrabbit hole every night googling
on behalf of her, of her child.
But then it's a perfectintersection of that and her own
hormones deciding to have a bitof a party on their way out.
And then boom, right now we'vegot a mum who's in crisis, who's
got you know, who's reallystruggling, who was like I don't

(26:05):
understand, like I've alwaysbeen a bit scatty, or I've
always had trouble focusing, orI've always had a bit of anxiety
, but now it's ramping up.
Okay, because perimenopausejust decided to set that on fire
for her.

Speaker 1 (26:20):
What about addressing ?
You're speaking earlier aboutthe importance of serotonin.
We know about the gut brainsuperhighway and we're talking
here about neurodiversity,definitely, which will be
affected by diet and lifestyle.
So you've potentially gotneuroinflammation on top of the

(26:40):
genetic imprint, if you like.
What are the important pointsto think of as practitioners
when trying to treat this, tomanage this gut and the
inflammation and the signalsthat are being sent to the brain
?

Speaker 2 (26:57):
Yeah, so much inflammation begins in the gut
and we know this Like we'renaturopaths and nutritionists,
we're practitioners, like weknow this inside out right, like
if you've got a gut problem,you've probably got an
inflammation problem somewhere,and we've already known this
from dealing with our autoimmunepatients or our chronic fatigue
patients or our osteoarthritispatients or whatever it is that

(27:21):
you see in clinic that isinflammatory.
Chances are you were alwayslooking at that gut, okay, you
always brought it back to thegut and you've got to get that
gut right in order to get theinflammation down.
Neuro-inflammation is nodifferent.
So when we've gotneuro-inflammation going on,
even if it's super, super mildwe're not talking that it's at a
level where any scan would pickit up, but we're talking about

(27:43):
super mild it can still changemoods, thoughts, it changes
brain function, okay, and soeven a mild amount of
neuroinflammation is going to behuge for an ADHDer ADHDers we
already know like there isresearch to show that we produce
more inflammatory cytokinesthan neurotypical people, and so

(28:08):
it becomes even more imperativethat we look to that gut and we
sort that gut out.
Now, unfortunately for ADHDersalong, you know, with some of
that impulse control and youknow some of those other ADHD
symptoms.
A lot of ADHDers have a poordiet.

(28:28):
They might, you know, theymight not be able to have the
executive function to shop forhealthy food and cook healthy
food every day.
They might have binge eatingissues.
They might have sugar issues.
They might have caffeine issuesbecause they're using caffeine
as a stimulant to actually calmthemselves down, like a lot of

(28:51):
ADHDers have caffeine, andactually feel more calm rather
than revved up.
That's a fun fact.
So, you know, a lot of ADHDerswill come to us already with,
you know, diet and lifestyledrivers that are causing the gut
issues.
Okay, so they're already morepredisposed to having gut issues
.
They're already morepredisposed to the diet and
lifestyle factors that cause thegut issues.
Okay, so they're already morepredisposed to having gut issues
.
They're already morepredisposed to the diet and
lifestyle factors that cause thegut issues.

(29:13):
They're already morepredisposed to creating
inflammation when they have agut issue.
Well, great, we're screwed now,aren't we?
But what we need to do is wepeel it apart very slowly, very
gently, but we definitely,definitely have to get that gut
right.
And so I'm always looking forbacterial overgrowth in the gut,
fungal overgrowth in the gut,increased intestinal
permeability you know, all thethings, all the things that we

(29:35):
look at.
I look at, you know, I do a lotof functional testing, I do a
lot of microbiome testing.
I often do some SIBO testing topinpoint what's going on.
But then we have to sometimesthrow the textbook out the
window of what we would normallydo with a client and work out
what is achievable for theperson sitting in front of us,

(29:57):
for this beautiful, you know,neurodivergent, struggling
person who's sitting in front ofus.
So you might be like, oh my God, like I really think this
person needs a SIBO diet or alow FODMAP diet or this diet or
that diet, and they, they'restruggling to just go and buy
food from the supermarket afterwork, right.

(30:17):
They're struggling to do workand shopping in the same day,
right, because their executivefunction is being tested,
they're stressed, they're tired,they're inflamed, right.
So we have to go very gentlywith with our adhd's, we have to
be very interactive with them.
Sometimes we have to put littleappointments in between the big
appointments to check up onthem or check in on them or get

(30:38):
someone else to come in and likea health coach or someone to
come in and and help to coachthem to keep them on track.
We make small changes ratherthan big ones.
If needed, we ask questions ofthat client around sort of
bandwidth and capacity and whatthey can do and sometimes like
it's a massive struggle just toget them off gluten or just to

(31:01):
get the sugar down.
But sometimes we have to alsothrow not just the textbook but
the timeline out, the window ofhow quickly we want these
changes to happen for the person.
And then also, like you know,there's plenty of beautiful like
gut healing supplements andherbs and things that we can do
in the meantime andanti-inflammatory herbs and
supplements and things that wecan do in the meantime to help

(31:23):
bring some of those symptoms,some of that neuroinflammation
down, while the other changesare being made.
So, yeah, there's a lot going on, but just treat it like in
terms of what you're looking forthat's driving the inflammation
.
Treat it like any inflammationpatient that you've ever had in
front of you.
Right, it all comes back towhat gut stress.

(31:46):
Yeah, it's no different.
Different it's just this timeyou might have to change.
You know your treatment plan alittle bit um, can I ask with
regards to stimulants?

Speaker 1 (32:00):
you know it's commonly said that, for instance
, that you know people with addadhd often do well on caffeine
or caffeinated drinks, and Ishould.
I'm going to change that,forgive me.
They do well on coffee, and thereason I'm saying coffee, not
caffeinated sugary drinks, isbecause I'm asking the question

(32:24):
is it the caffeine that's goodfor these people as a mind
stimulant to help settle thingsdown, or could it be that the
chlorogenic acid and theantioxidants and the other
components of a good coffee areactually helping the gut
inflammation because, as we know, coffee is the prime therapy

(32:46):
for, for instance, fatty liverdisease?

Speaker 2 (32:55):
I hate to burst your bubble mate, but I think it's.
I really think it's thestimulant activity.
The stimulant yeah, yeah, Ireally do um, so a double shot
I've and I only say this becauseI've, yes, I've had, I've had

(33:17):
clients come to me and have quadshots, quad shots.
I'm like how are you alive?
But anyway, uh, I only be.
You know.
Look, I, I get what you'resaying and I love that we have
spun coffee in a way that it isnow healthy and is going to heal
our gut.
I'm so stoked for that becauseI personally drink coffee and my
husband works in the coffeeindustry, so I'm on board with

(33:39):
that cherry picking of data.
The reality is that, then, whyhave I got so many clients?
When they come to me, they havea coffee habit and a gut issue
all in the one person Like, whyis the coffee not fixing their
bacterial overgrowth in the gut?

(34:00):
Why has coffee not fixed theirleaky gut?
Maybe it's the milk and thesugar in the coffee, who knows?
Maybe it's the milk and thesugar in the coffee, who knows?
Maybe if you were just to havelike a, you know, a cold brew
black coffee, that was you knowwho knows.
Although, actually did you sayit was the acid, because cold
brew is lower in acid, I think.
So scrap that.

(34:21):
But just thinking out loud, butlook, if you're in a perfect
world, I would swap out all thecoffee for green tea, because
the green tea's got theL-theanine and we know
L-theanine is, like, superuseful for ADHDers.
However, in reality, it's morelikely they're going to have a

(34:42):
coffee in the morning and downan L-theanine capsule.

Speaker 1 (34:44):
All right, let's keep it real.
Can I ask from there, though?
We talk about stimulants havinga calming effect?
This is something I'vestruggled with, even though I do
it, and that is we talk aboutstimulants having a calming
effect because of thenorepinephrine and the dopamine
activity, but then we go andprescribe calming herbs like

(35:10):
kava, like lavender, like hopseven for some people, but
ashwagandha more of a tonic sortof herb, I get that one, but
I've struggled with this.
Why am I prescribing, and whydoes it appear to work for these
people, these calming herbs?

Speaker 2 (35:33):
Do they work on ADHDs ?

Speaker 1 (35:36):
Okay.

Speaker 2 (35:37):
It depends on the person.
It depends on the person.
It depends on the presentation.
It depends on which, whichflavor of adhd they are like,
are they inattentive, are theyhyperactive, etc.
I've I've had a lot of hit andmiss with giving calming herbs
to my adhd, like I know you'remeant to do it if someone's

(36:01):
stressed, if someone is stressedand they're anxious and I don't
know, like here have somepassionflower, here have some
kava, here have some magnolia,here have some L-theanine, like
you know, because, don't forget,you're calming nutrients as
well, like your GABA.
Honestly, I have had moresuccess with nutrients to calm
people down than herbs in myadhd clients.

(36:24):
It's not to say that the herbsdon't work and I have given, you
know, beautiful, like lemonbalm and passion flower type
formulas to people and it works.
But it really depends, I think,on why is the anxiety happening
in the first place.
Like you know, there's adifference between the calming

(36:45):
effect of a stimulant comparedto the calming effect of, like a
beautiful anxiolytic or, youknow, sedative or something
right.
So what is the reason that thatperson is anxious, like?
Why are they anxious?
Okay, are they anxious becausethey're stressed, because their

(37:05):
executive function has beentested and they're overwhelmed
because ADHD is.
We love a bit of pushing thered button into overwhelm, right
, we do too much and then we hitthat overwhelm button and then
you know that's when mentalhealth, can you know, escalate
in terms of, like anxiety,depression, moods, et cetera.

(37:27):
So, if and also ADHD is quiteprone to having a history of
trauma, okay, so, and they'relike it really does, and that's
a whole other conversation about.
You know whether the trauma hasincreased the ADHD symptoms or
whether the ADHD symptoms havepredisposed the person to having

(37:48):
a life that just happens tohave more trauma.
And ADHD families often havemore trauma in them.
That's a whole otherconversation.
But we do know that ADHD andtrauma do go hand in hand, right
.
So we're also talking aboutvagus nerve dysregulation then.
Right, so we've got, you know,we've got things for that, we've
got lifestyle things, we've gotvagus nerve toning things we

(38:11):
can do.
We've got herbs for that aswell.
But we, yeah, I think we need tolook really deeply into why the
person is anxious and then workour way back from there,
because I think in the past, asherbalists years ago, we were
taught person is anxious, givethem anxiolytic herb, watch
person get better and it's likegreat, I'm happy for you if that

(38:34):
works, I'm so happy for you.
But it's just not like it's notwhat I always see in clinic.
But I also find that with myADHD is you might need to give
them anxiolytics in theafternoon and the evening, but
in the morning, like let themhave their stimulants, et cetera
.
So you might need to pace itaccording to what that person

(38:57):
needs throughout the day.
And I'm not saying don't tryanxiolytic herbs, I'm not saying
don't do that.
And, by the way, saffron isamazing because that brings down
the neuroinflammation right aswell as dealing with the anxiety
.
So we're like we're doing morethan one thing with saffron,
like give them the saffron, Ilove it, it's honestly, it's
it's honestly it's probably mynumber one herb for anxiety in

(39:20):
adhd.
But saffron is different toyour.
You know if, if someone hadacute anxiety, you will often
reach for, like the passionflower or the carver, like you
said, but you wouldn't bethinking saffron as your first
line.
And so I think with our adhd'swe just need to approach it from
just a slightly different angle.

Speaker 1 (39:43):
I think this is one of the reasons I respect you so
much, jules is that you don'tjust look at the symptom.
You look at why that person ishaving that symptom.
Don't treat the symptom, treatthe person.

Speaker 2 (39:55):
I love you, thank you .

Speaker 1 (39:58):
Now what about medications?
And in here I think we need tosort of address an elephant in
the room and that is thesparsity of medications on the
market at the moment, becauseADHs are going through all sorts
of issues trying to get theirmethylphenidate and things like
that, even the correct dosage.

(40:18):
Some doses are in and out ofstock at time to time.
It's an abhorrent time in theAustralian market with medicines
at the moment.
But take us through how we canbest serve our patients with
regards to them being onmedications and probably wanting

(40:39):
to stay on them if they're, youknow, severe, at least how we
can support them so that we canactually A not interact and B
benefit their symptom picture.

Speaker 2 (40:53):
Yeah, the first thing we need to do is learn what
each medication does, becausewhen a person comes to you
saying they're on ADHD meds, weneed to understand the nuances
between the different types ofmeds, and you know even the
different types of stimulantmeds.
So I think we need to getreally clear on what each one is
and what it does.
This is what I teach in, like,my ADHD for Practitioners course

(41:13):
.
There's actually like a wholebit on medication, because it is
so important when someone sitsin front of you and tells you
what they're on, like you, youneed to immediately be able to
go oh, I know how that works, soI know what that's doing in
your brain, so now I know how towork with it or around it.
So, yeah, and obviously thefirst thing I would say is we
need to be very respectful ofthe fact that if someone is

(41:36):
choosing to be on medication,that we need to be supportive of
that.
If someone is choosing to be onmedication, that we need to be
supportive of that.
If someone is choosing to notbe on medication, we can be
supportive of that too, but Iwork in with whatever the
patient wants because, don'tforget, a lot of people have
lived their whole lives up till40, 50, even 60 years old,
struggling throughout life,raw-dogging it as they call it

(41:59):
in the ADHD community.
Raw dogging is where you'regoing through life without any
meds and then they're finallygiven an opportunity to try what
they think is this magic pillthat is going to fix them in
inverted commas and that isgoing to help them to get
through life like a neurotypicalperson, like, hey, I just wake

(42:20):
up and I do my dishes, and it'snot a struggle to do my dishes
right, like that sort of stuff.
So the we need to understandthat, like, when people are
being late diagnosed as adults,they're often very medication
curious because they're like, ohwhat if this fixes things for
me?
Okay, we often know it doesn't,but that's, that's the culture.

(42:43):
Is that that people?
They want this to be a magicpill.
Okay, and we, you know it's notour job to tell them that it's
not going to, because for somepeople it is, but for some
people it's not okay.
So, yeah, there's three.
There's three different kinds ofcommon stimulant meds on the
market.
So there's dexamphetamine, okay.
There's methylphenidate, whichis also known as Ritalin, which

(43:08):
comes in like a short acting,which is a more common one, but
sometimes a long acting one,which is like a slow release.
And then there'slisdexamphetamine, which is also
known as Vyvanse, which is theone that has been out of stock
the most in the last 12 months.
Two years, however long, isstill going to have out of stock
issues for a little while, Ithink.
And they're the ones that arethe first line.

(43:32):
So often the doctors will oftenjust prescribe the one that's
their favourite or the one thatthey seem to get the best
results with.
It's a bit like if you had tochoose between passionflower and
lemon balm, like sometimes youmake a different decision for
different people based on yourown logic or your own experience
and research, right.
So doctors are no different.

(43:54):
There isn't a guide for whichone of those three.
To start with, when I went totry stimulant meds after I was
diagnosed I'm not on themanymore, but I wanted to give
them a run.
I wanted to experience what itfelt like.
So I was like right, I'm goingto give this a go, right.
So off I went to thepsychiatrist and he actually

(44:14):
said which one do you want totry?
And I was like hold up, mate,that's your job.
And he's like you know, there'sa long acting one and a medium
acting one and a short actingone, and I was like, huh, all
right.
So I think he meant the longacting one was liz
dexamphetamine by vance.
The medium acting one wasmethylphenidate ritalin.
Then the short acting one wasdexamphetamine, because I think

(44:35):
he was talking about how long ittakes for that drug to really
leave your system.
But yeah, he had like thiscollaborative approach where it
was like if I'd said, yep, I'vedone a lot of reading and I
think I'm a Ritalin girl, hewould have been like, yeah, sure
, we'll start with that one.
So there's no exact science towhat people are prescribing out

(44:56):
there out of those three.
So then there's going to beside effects and you know issues
that go along with thatpotentially for a lot of clients
.
The biggest one that I see iscrashes, where people like bomb
out at like 3, 4, 5 in theafternoon and struggle to
function for the rest of the day.

(45:17):
So it's like a big crash, andthat can sometimes change
depending on which medication.
So if a medication is notworking they might try a
different one.
Often people forget to eat.
Their appetite gets suppressedon medication.
That's another big one that wesee.
So getting healthy food intothem becomes even more of a

(45:37):
struggle.
Ps, best tip is to give them asmoothie before they have their
stimulant meds, at the start ofthe day, and make things easy to
get down, like soups for lunch,anything that's easy, just get
it down.
But you know we do haveagitation, jitteriness, anxiety,
sleep problems, like there arelots of things that can happen.

(45:59):
I've had people come to me whohad an increase in tinnitus in
ringing in their ears, which I'mlike okay, is this causing some
neuroinflammation for them?
What's going on?
So you know, we've had likeincreases in restless leg
syndrome, which is, by the way,really common in ADHD as well.
It's a co-occurring condition.
So, as you can see, like Icould go on and on.

(46:24):
But there are bunches of sideeffects.
But there are also things we cando as a practitioner to help
alleviate those side effects.
Did I mention saffron, our goodfriend?
So then, if the side effectsreally are too great, or if the
person is not a good candidatefor stimulant medication in the
first place perhaps they've gotgot a history of addiction or
high blood pressure, which islike a red flag to a doctor.
They won't prescribe them.
Then you go to non-stimulantmedications.

(46:45):
The most common one is an SNRIcalled atomoxidine, also known
as Stratera, and then if thatdoesn't work or if they are
looking for other options, andalso if the person has high
blood pressure pressure, theywill often go to a different
type of non-stimulant familycalled the alpha-2 agonists, and
that is like.
Clonidine and guanfacine arethe two there that you'll come

(47:08):
across most often.
So, as you can see that it'snot just about dexamphetamine or
Ritalin or Vyvanse.
There are other options thatpeople are going to be given if
the first line of medicationisn't the right option for them.
So we need to get across all thedifferent types of medications
and what they do and what theside effects could potentially

(47:31):
be, how we might be able to helpwith that.
A big one, by the way, withstimulant meds is it can
irritate the stomach.
So have a think about what youmight do.
If someone came to you with anirritated digestive system, I
would be immediately thinkinglike your beautiful sort of gut
healing, gut sealing, gutsoothing kind of powders,

(47:52):
because that way it might helpthem to tolerate that medication
better.
So you've also got off-labelprescribing, which we're not
supposed to speak about but doeshappen where medications that
we think might be helpful forADHD, that in the future might
be listed as being officiallyhelpful for ADHD, are currently

(48:14):
being prescribed in an off-labelway and, lo and behold, it does
help.
So there are a few things there.
And then also there'sprescribing that's probably
going to happen in a lot of yourclients for co-occurring
conditions, and the biggest onesthat come to mind there's
plenty, but the biggest oneswould be like SSRIs and
antidepressants, and then youknow like anxiety meds, sleep

(48:38):
medications as well and then youknow like anxiety meds, sleep
medications as well.
So you know we can, you know wemight not.
I know that traditionally,naturopaths were always kind of
thinking that part of our rolewas to sort of get the client to
a point where they can come offtheir medication.
You know, if you normally, ifyou get a client who comes to
you who's got anxiety andthey've, you know, got this

(49:02):
anxiety disorder and the doctorsput them on an SSRI, then, like
, they come to you and they'relike look, I'm on esotelopram,
I'm on 20 milligrams, I'd loveto get off it.
I feel like I've done the workwith my psychologist and trauma
therapy.
Da, da, da, da, da.
I'm ready to give this a go.
Can you support me as I wean offthe meds Sick?

(49:24):
Like this is our time to shine,like this is what we do, and
we've always had that mindset.
That that's what we do is likeif someone comes to us, we help
them get off the meds, butsometimes with ADHD and
stimulant meds, our job is tohelp them to tolerate the meds
better.
They might want to stay on themeds because maybe it is
life-changing for them.
Like I said, it's not foreveryone I'm not on them anymore

(49:46):
but it does work for a lot ofpeople.
So I think we also have to havea little bit of a mindset shift
about what it means to be anaturopath or a nutritionist or
a natural health practitionerand what the goal is here for
the client and how we can bestget that person to their goal.

Speaker 1 (50:05):
Jules, this again ties into why I respect you so
much, and that's that you'readdressing the human, the
patient in front of you, notjust addressing the symptoms but
the cause.
Can I lead in to that one andthat is my opinion is I wish the
Australian government, themedical fraternity, would

(50:28):
realise that part of anaturopath's job is not to just
simply take people offmedications but indeed to help,
using evidence-led medicine,maybe manage that patient's
medication's safety or efficacy.
For instance, zinc has beenshown to help in many people,

(50:49):
the efficacy of an SSRI.
So we're not talking aboutdecreasing the medicine, unless
the doctor chooses that.
But what we're talking about ishelping the patient to get more
benefit from that medicineBecause, as we know, it's a 50%.
It's a flip of a coin on thefirst choice of SSRI, whether
it's going to work or not.
So wouldn't it be great if wecould improve the chances of

(51:12):
your medicine, doctor, working?
That's what I love aboutnutritional medicine.
Leading on from there, whatother tools have we got?
You mentioned the gutsuperhighway.
You've mentioned saffron.
So let's throw in a probioticin there, because there's a
bifidobacterium longum that'sbeen used successfully to help

(51:33):
people with their mood stability.

Speaker 2 (51:36):
What else do you use?
Flexibility, what else and notonly, not only that, but with
neuroinflammation, a lot of theprobiotic stuff that's coming
out is is to do with, like, theresearch that's coming out
around these beautiful bacteria.
It has to do with getting thatneuroinflammation down.
So again, like, if you know,while you're doing your gut work

(51:56):
and while you're like gettingthem off the gluten and while
you're doing all of that stuff,like there are things you can be
doing that areanti-inflammatory.
Yeah, yeah, sorry, got offtrack.

Speaker 1 (52:07):
What was?

Speaker 2 (52:07):
the question.

Speaker 1 (52:09):
Well, the question was what are the nutrients?
What else do you use?
You mentioned L-theanine, yeah.

Speaker 2 (52:14):
Yep, l-theanine.
I do use a bit of GABA as wellif they're not sleeping well.
I use a lot of tyrosine becauseit's a precursor for dopamine,
but don't forget good old iron.
Iron is also needed fordopamine production.
Everyone goes towards thetyrosine because like that's the
fancy one, like that's the onethat you often see on social

(52:38):
media, because you know you needthat to make dopamine.
Well, you need iron as well.
It's just not as exciting totalk about that on instagram,
right?
So get their, get their ironchecked, even if they're not
bleeding monthly.
Like get their iron checkedeven if they're not vegan.
Get their iron checked.
So.
So magnesium huge, like needed,very much needed to keep that

(53:04):
nervous system calm, to keep theblood sugar stable.
You know all the things thatmagnesium does helps them sleep,
helps with muscle soreness andstiffness, because you know that
can be a side effect ofstimulant meds as well.
Helps with restless legsyndrome.
So does iron, by the way.
So does fixing up the SIBO, butthat's another story.
Vitamin D like good old vitaminD often very low in ADHD is

(53:29):
especially the ones who like tosit inside and hyper-focus on
things like gaming or who worklong hours, who aren't really
great at having like an outdoorfitness regime or anything Like.
So many of my ADHD clients arelow in vitamin D and, just you
know, not getting enough sun.
We need to put them all outsidelike a pot plant on the regular

(53:50):
.
Omega-3s fish oils huge, likeso needed, almost cliched, it's
so needed, right?
If you've got an adhd, you needto be considering omega-3s.
Uh, there's so many otherthings, you know.
There's b vitamins, activatedb's, iodine, like we could go
all day.
Um, but I I would say if, like Ihad to pick like a handful, I

(54:14):
would be looking at iron,vitamin d, omega-3s, zinc, yeah,
and then sprinkle in thatL-C-N-E, right, sprinkle it in,
get it in there, If you know, ifyou think it's appropriate, of
course.
And then don't forget also, youmight want to also not just

(54:34):
focus on that dopamine, but lookat things like serotonin as
well.
So don't forget, like you know,all your beautiful precursors
for serotonin as well.
So don't forget, like you know,all your beautiful precursors
for serotonin as well.

Speaker 1 (54:44):
Jules, I love your mind.
You talk about ADHD and goingdown the rabbit hole, but your
rabbit holes are dedicated tothe care of your patients and
you've helped so many women's,and indeed couples to not just
with fatigue, which you're verywell known for, but also with
these neurodiverse or diverseconditions, and I just, I really

(55:07):
thank you from my heart forwhat you've put in for the
community, for the Australiancommunity.
That's what it is so just thankyou for your diligence and your
dedication to your patients.
I really appreciate you.

Speaker 2 (55:19):
Thank you so much and look like my attention is now
starting to really turn to, youknow, getting the next
generation of practitioners likeup to speed on this, and to not
only give other practitionersthe knowledge they need on this,
because this is this is why Irun my adhd course for

(55:42):
practitioners.
But this, you know it's.
I love those kookaburras in thebackground.
I hope they make it onto the,onto the podcast.

Speaker 1 (55:49):
That's beautiful, um that's through the window I know
right.

Speaker 2 (55:55):
Um, I don't just want them to have the actual science
and the knowledge, I also wantthem to adopt a neuroaffirming
you know,neurodiversity-affirming
framework for their practice, sothat we can then help these
beautiful neurodivergent clientsfrom a place of non-judgment,

(56:17):
from a place that'strauma-informed, from a place
that's neuroaffinformed, from aplace that's neuro-affirming, so
that our customers have ourcustomers sorry, our clients our
patients have the bestexperience with us as well, so
that they feel heard, so thatthey feel seen, so that they
feel held, and that's wherewe're going to get the best
clinical outcomes for them.

Speaker 1 (56:37):
I love your work, jules, gallow Galloway and
everyone.
If you want to delve furtherinto this, remember that Jules
has got a course up on thedesignsforhealthcomau website.
You just click in, go in inyour practitioner login and then
go to education and they're allunder there and I think it's
under the nervous system.
Everyone, thank you so much forjoining us today and Jules,

(56:59):
thank you for joining us today.
And Jules, thank you forjoining us.
Remember everyone.
You can catch up on this andall the other podcasts on your
favourite channel or the Designsfor Health website.
I'm Andrew Whitfield-Cook.
This is Wellness by Designs.

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